9 CFR 590.560 - Health and hygiene of personnel.

Code of Federal Regulations, 2013 CFR

2013-01-01

..., including toilets, lavatories, lockers, and dressing rooms shall be adequate and meet State and local requirements for food processing plants. (b) Toilets and dressing rooms shall be kept clean and adequately ventilated to eliminate odors and kept adequately supplied with soap, towels, and tissues. Toilet rooms shall...

9 CFR 590.560 - Health and hygiene of personnel.

Code of Federal Regulations, 2014 CFR

2014-01-01

..., including toilets, lavatories, lockers, and dressing rooms shall be adequate and meet State and local requirements for food processing plants. (b) Toilets and dressing rooms shall be kept clean and adequately ventilated to eliminate odors and kept adequately supplied with soap, towels, and tissues. Toilet rooms shall...

9 CFR 590.560 - Health and hygiene of personnel.

Code of Federal Regulations, 2012 CFR

2012-01-01

..., including toilets, lavatories, lockers, and dressing rooms shall be adequate and meet State and local requirements for food processing plants. (b) Toilets and dressing rooms shall be kept clean and adequately ventilated to eliminate odors and kept adequately supplied with soap, towels, and tissues. Toilet rooms shall...

Genre-Specific Cultivation Effects: Lagged Associations between Overall TV Viewing, Local TV News Viewing, and Fatalistic Beliefs about Cancer Prevention

PubMed Central

Niederdeppe, Jeff

2014-01-01

Cultivation theory and research has been criticized for its failure to consider variation in effects by genre, employ appropriate third-variable controls, and determine causal direction. Recent studies, controlling for a variety of demographic characteristics and media use variables, have found that exposure to local television (TV) newscasts is associated with a variety of problematic “real-world” beliefs. However, many of these studies have not adequately assessed causal direction. Redressing this limitation, we analyzed data from a two-wave national representative survey which permitted tests of lagged association between overall TV viewing, local TV news viewing, and fatalistic beliefs about cancer prevention. We first replicated the original cultivation effect and found a positive association between overall TV viewing at time 1 and increased fatalistic beliefs about cancer prevention at time 2. Analyses also provided evidence that local TV news viewing at time 1 predicts increased fatalistic beliefs about cancer prevention at time 2. There was little evidence for reverse causation in predicting changes in overall TV viewing or local TV news viewing. The paper concludes with a discussion of theoretical and practical implications of these findings. PMID:25605981

Lithologic controls on AIRSAR signatures of bedrock and alluvium, at Lunar Crater, Nevada

NASA Technical Reports Server (NTRS)

Rivard, Benoit; Diorio, Marc; Budkewitsch, Paul

1995-01-01

Radar backscatter intensity as measured by calibrated synthetic aperture radar (SAR) systems is primarily controlled by three factors: local incidence angle, wavelength-scale roughness, and dielectric permittivity of surface materials. In order to make adequate use of radar observations for geological investigations of surface type, the relationships between lithology and the above characteristics must be adequately understood. In arid terrains weathering signatures (e.g. fracturing, debris grain size and shape, slope characteristics) are controlled to some extent by lithologic characteristics of the parent bedrock. These textural features of outcrops and their associated debris control radar backscatter to varying degrees. The quad-polarization JPL AIRSAR system allows sampling of textures at three distinct wavelength scales: C-band (5.66 cm), L-band (23.98 cm), and P-band (68.13 cm). This paper presents a discussion of AIRSAR data using recent field observations of weathered felsic and basaltic volcanic rock units exposed in the southern part of the Lunar Crater Volcanic Field, in the Pancake Range of central Nevada. The focus is on the relationship of radar backscatter at multiple wavelengths to weathering style and parent bedrock lithology.

Hospital Based Customization of a Medical Information System

PubMed Central

Rath, Marilyn A.; Ferguson, Julie C.

1983-01-01

A Medical Information System must be current if it is to be a viable adjunct to patient care within a hospital setting. Hospital-based customization provides a means of achieving this timeliness with maximum user satisfaction. It, however, requires a major commitment in personnel time as well as additional software and training expenses. The enhanced control of system modifications and overall flexibility in planning the change process result in enthusiastic support of this approach by many hospitals. The key factors for success include careful selection of local personnel with adequate vendor support, extensive QA control, thorough auditing/validation and direct user involvement.

Transoral bisected resection for T1-2 oral tongue squamous cell carcinoma to secure adequate deep margin.

PubMed

Choi, Nayeon; Cho, Jae-Keun; Lee, Eun Kyu; Won, Sung Jun; Kim, Bo Young; Baek, Chung-Hwan

2017-10-01

To investigate the clinical usefulness of transoral bisected resection (TBR) asa new method to secure adequate deep resection margin in T1-2 oral tongue squamous cell carcinomas (SCC). Among 75 patients with cT1-2N0 oral tongue SCCs, 45 (60%) received transoral en-bloc resection (TER) while 30 (40%) received patients underwent TBR. Primary tumor resection was performed with 1.5-cm surgical resection margin for both groups. Mucosal and deep resection margins, adjuvant treatments including re-resection of the tongue and cheomoradiotherapy, local and regional recurrence free survival, and overall survival were compared between the two groups. Mean deep resection margin in the TBR group was 9.9mm (95% CI: 8.4-11.4mm), which was significantly (P<0.001) wider than that of the TER group (mean: 5.4mm, 95% CI: 4.5-6.3mm). However, mucosal resection margins were not significantly (P=0.153) different between the two groups. Re-resection of tongue was performed for 6 (13.3%) of 17 (37.8%) patients with inadequate deep resection margin in the TER group and none (0%) in 4 (13.3%) patients with inadequate deep resection margin in the TBR group. Adjuvant radiation due to inadequate deep resection margin was performed for 6.7% of patients in both groups. The TBR group had better local recurrence free survival than the TER group. However, regional recurrence free survival and overall survival were not significantly different between the two groups. TBR could provide adequate deep resection margin for early stage tongue cancers with better local tumor control than TER. It can decrease the necessity of adjuvant treatment for re-resection of the tongue. Copyright © 2017 Elsevier Ltd. All rights reserved.

Hazard Analysis and Critical Control Points among Chinese Food Business Operators.

PubMed

Saccares, Stefano; Amadei, Paolo; Masotti, Gianfranco; Condoleo, Roberto; Guidi, Alessandra

2014-08-28

The purpose of the present paper is to highlight some critical situations emerged during the implementation of long-term projects locally managed by Prevention Services, to control some manufacturing companies in Rome and Prato, Central Italy. In particular, some critical issues on the application of self-control in marketing and catering held by Chinese operators are underlined. The study showed serious flaws in preparing and controlling of manuals for good hygiene practice, participating of the consultants among food business operators (FBOs) to the control of the procedures. Only after regular actions by the Prevention Services, there have been satisfying results. This confirms the need to have qualified and expert partners able to promptly act among FBOs and to give adequate support to authorities in charge in order to guarantee food safety.

Supplementary routes to local anaesthesia.

PubMed

Meechan, J G

2002-11-01

The satisfactory provision of many dental treatments, particularly endodontics, relies on achieving excellent pain control. Unfortunately, the administration of a local anaesthetic solution does not always produce satisfactory anaesthesia of the dental pulp. This may be distressing for both patient and operator. Fortunately, failure of local anaesthetic injections can be overcome. This is often achieved by using alternative routes of approach for subsequent injections. Nerves such as the inferior alveolar nerve can be anaesthetized by a variety of block methods. However, techniques of anaesthesia other than the standard infiltration and regional block injections may be employed successfully when these former methods have failed to produce adequate pain control. This paper describes some supplementary local anaesthetic techniques that may be used to achieve pulpal anaesthesia for endodontic procedures when conventional approaches have failed. Although some of these techniques can be used as the primary form of anaesthesia, these are normally employed as 'back-up'. The methods described are intraligamentary (periodontal ligament) injections, intraosseous anaesthesia and the intrapulpal approach. The factors that influence the success of these methods and the advantages and disadvantages of each technique are discussed. The advent of new instrumentation, which permits the slow delivery of local anaesthetic solution has led to the development of novel methods of anaesthesia in dentistry. These new approaches are discussed.

State Implementation Plans (SIP): Submissions that EPA has Found Adequate or Inadequate

EPA Pesticide Factsheets

EPA/OTAQ’s State and Local Transportation Resources are for air quality and transportation government and community leaders. Information on state implementation plans (SIPs) that EPA has found either adequate or inadequate is provided here.

Periosteal infusion of bupivacaine/morphine post sternal fracture: a new analgesic technique.

PubMed

Duncan, Michael A; McNicholas, Walter; O'Keeffe, Declan; O'Reilly, Maeve

2002-01-01

Sternal fracture pain is severe and is difficult to alleviate due to the forces acting on the chest wall during respiration. We describe a continuous infusion regional analgesic technique for pain due to sternal fracture. A 47-year-old woman presented with a spontaneous sternal fracture, precluding effective coughing. Diclofenac and increasing doses of opioids did not give adequate pain relief and led to opioid toxicity. Two brief periods of analgesia were achieved with deep subcutaneous infiltration of bupivacaine. An epidural catheter was positioned periosteally, and an infusion of bupivacaine was commenced at 5 mL/h, achieving long-lasting analgesia. The bupivacaine concentration was reduced in a stepwise fashion from 0.5% to 0.25% and was changed to levobupivacaine after 3 days. Adding morphine (5 mg/60 mL levobupivicaine) permitted a reduction in infusion rate. The catheter was removed after 14 days because a local infection developed that resolved uneventfully with antibiotic therapy. Continuous infusion of local anesthetic and opioid to a sternal fracture site using a periosteally positioned catheter led to successful analgesia and hence improved respiratory function. Clinicians should consider placing a periosteal catheter when pain associated with sternal fracture cannot be adequately controlled with conventional methods.

Epidemiologic study of deaths and injuries due to tornadoes.

PubMed

Carter, A O; Millson, M E; Allen, D E

1989-12-01

A case-control study, using both matched and unmatched controls, was carried out on individuals who were injured or killed by a series of tornadoes that passed through Ontario, Canada, on May 31, 1985. Many serious injuries (25%) and almost all (83%) deaths were the result of becoming airborne, while most minor injuries (94%) were due to being struck by objects. Head injury was the most common injury type. Few (21%) of those in buildings chose the recommended location, and most (61%) were not in the least damaged part. Most (91%) had less than one minute's warning, and only 47% had a functioning radio at the time the tornado hit. The following risk factors for injury and death were identified: poor building anchorage; location other than in a basement, especially outdoors; age over 70 years; and high wind strength. These findings support previous findings and point to measures which have potential for preventing death or serious injury in future tornadoes: adequate warning systems and public education to ensure that individuals understand the warning and respond by seeking appropriate shelter. Those in adequately anchored buildings should shelter in an interior room or basement. Those who are outdoors, in poorly anchored buildings, mobile homes, or portable classrooms require access to an adequately anchored building, preferably with a basement, during severe storm warnings. This should be arranged by local authorities.

Experience in estimating neutron poison worths

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

Chiang, R.T.; Congdon, S.P.

1989-01-01

Gadolinia, {sup 135}Xe, {sup 149}Sm, control rod, and soluble boron are five neutron poisons that may appear in light water reactor assemblies. Reliable neutron poison worth estimation is useful for evaluating core operating strategies, fuel cycle economics, and reactor safety design. Based on physical presence, neutron poisons can be divided into two categories: local poisons and global poisons. Gadolinia and control rod are local poisons, and {sup 135}Xe, {sup 149}Sm, and soluble boron are global poisons. The first-order perturbation method is commonly used to estimate nuclide worths in fuel assemblies. It is well known, however, that the first-order perturbation methodmore » was developed for small perturbations, such as the perturbation due to weak absorbers, and that neutron poisons are not weak absorbers. The authors have developed an improved method to replace the first-order perturbation method, which yields very poor results, for estimating local poison worths. It has also been shown that the first-order perturbation method seems adequate to estimate worths for global poisons caused by flux compensation.« less

Analysis of TMT primary mirror control-structure interaction

NASA Astrophysics Data System (ADS)

MacMynowski, Douglas G.; Thompson, Peter M.; Sirota, Mark J.

2008-07-01

The primary mirror control system (M1CS) keeps the 492 segments of the Thirty Meter Telescope primary mirror aligned in the presence of disturbances. A global position control loop uses feedback from inter-segment edge sensors to three actuators behind each segment that control segment piston, tip and tilt. If soft force actuators are used (e.g. voice-coil), then in addition to the global position loop there will be a local servo loop to provide stiffness. While the M1 control system at Keck compensates only for slow disturbances such as gravity and thermal variations, the M1CS for TMT will need to provide some compensation for higher frequency wind disturbances in order to meet stringent error budget targets. An analysis of expected high-wavenumber wind forces on M1 suggests that a 1Hz control bandwidth is required for the global feedback of segment edge-sensorbased position information in order to minimize high spatial frequency segment response for both seeing-limited and adaptive optics performance. A much higher bandwidth is required from the local servo loop to provide adequate stiffness to wind or acoustic disturbances. A related paper presents the control designs for the local actuator servo loops. The disturbance rejection requirements would not be difficult to achieve for a single segment, but the structural coupling between segments mounted on a flexible mirror cell results in controlstructure interaction (CSI) that limits the achievable bandwidth. Using a combination of simplified modeling to build intuition and the full telescope finite element model for verification, we present designs and analysis for both the local servo loop and global loop demonstrating sufficient bandwidth and resulting wind-disturbance rejection despite the presence of CSI.

Knowledge, attitudes and practices (KAP) among agricultural extension workers concerning the reduction of the adverse impact of pesticides in agricultural areas in Tanzania.

PubMed

Ngowi, A V F; Maeda, D N; Partanen, T J

2002-01-01

Extension workers are educated locally to enable them to train farmers in using improved local farming methods and imported technology, such as pesticides, to increase crop production. However, the extension workers are not adequately trained in health aspects of pesticides and hence are unable to provide adequate services to farmers with regard to safe use of pesticides. The present study assessed the knowledge, attitudes and practices of agricultural extension workers with respect to health effects of pesticides in order to develop strategies for the control of pesticide exposure and prevention of pesticide poisoning in Tanzania. A survey of Tanzanian agricultural extensionists was undertaken in 1991-1994 using a standardized questionnaire in face-to-face interviews. Extensionists who were district agricultural officers, assistant agricultural officers, agricultural assistants, and field assistants, working in the coffee and cotton growing areas (N = 61) within a radius of 15 km of farm, estate or village under farm worker study (reported elsewhere) were included in the survey. The majority of extensionists knew that pesticides could enter the human body but only a quarter perceived pesticides as a major problem in the community they served. The majority showed awareness of potential health hazards of the different pesticides used in their service areas, but they did not recognize what pesticides were responsible for poisoning. A high proportion was familiar with first aid procedures in case of pesticide poisoning; however, many procedures described were not appropriate for pesticide poisoning. The survey indicated that training of agricultural workers in health aspects of pesticide exposure is an important task for adequate provision of service to farmers with regard to safe use of pesticides in Tanzania. Nevertheless, the appropriate role of extensionists in reducing the health impact of pesticides would be to advocate pesticides of low toxicity or non-chemical pest control.

47 CFR 17.4 - Antenna structure registration.

Code of Federal Regulations, 2014 CFR

2014-10-01

... provisions of the relevant local zoning process. The local notice shall contain all of the descriptive... not adequately evaluate the potentially significant environmental effects of the proposal. The Request...

Resection followed by vascularized bone autograft in patients with possible recurrence of malignant bone tumors after conservative treatment

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

Metaizeau, J.P.; Olive, D.; Bey, P.

1984-04-01

In conservative treatment of malignant bone tumors, assessment of the local condition is difficult. The radiological changes seen in the irradiated tumor and the frequent occurrence of pathological fractures at this site may give rise to the fear that the tumor has relapsed. Resection of the whole of the involved bone is the best way to assure adequate local control but the extent of the bone defect and the bad local conditions secondary to irradiation make reconstruction hazardous. In two patients (one with Ewing's sarcoma of the femur and one with osteogenic sarcoma of the humerus) the authors used amore » free, vascularized fibular graft for the reconstruction having obtained consolidation of the limb after resection of the irradiated tumor, with preservation of its function. The encouraging results obtained have suggested a conservative attitude as primary treatment of specific malignant bone tumors.« less

32 CFR 842.65 - Claims not payable.

Code of Federal Regulations, 2011 CFR

2011-07-01

... contract or agreement providing employee benefits through insurance, local law, or custom, where the United... USAF/JACC, may authorize an award where local benefits are not adequate. Local benefits are deducted... independent contractor. (o) Arises out of personal activities of dependents, guests, servants, or pets of...

32 CFR 842.65 - Claims not payable.

Code of Federal Regulations, 2014 CFR

2014-07-01

... contract or agreement providing employee benefits through insurance, local law, or custom, where the United... USAF/JACC, may authorize an award where local benefits are not adequate. Local benefits are deducted... independent contractor. (o) Arises out of personal activities of dependents, guests, servants, or pets of...

32 CFR 842.65 - Claims not payable.

Code of Federal Regulations, 2010 CFR

2010-07-01

... contract or agreement providing employee benefits through insurance, local law, or custom, where the United... USAF/JACC, may authorize an award where local benefits are not adequate. Local benefits are deducted... independent contractor. (o) Arises out of personal activities of dependents, guests, servants, or pets of...

32 CFR 842.65 - Claims not payable.

Code of Federal Regulations, 2012 CFR

2012-07-01

... contract or agreement providing employee benefits through insurance, local law, or custom, where the United... USAF/JACC, may authorize an award where local benefits are not adequate. Local benefits are deducted... independent contractor. (o) Arises out of personal activities of dependents, guests, servants, or pets of...

32 CFR 842.65 - Claims not payable.

Code of Federal Regulations, 2013 CFR

2013-07-01

... contract or agreement providing employee benefits through insurance, local law, or custom, where the United... USAF/JACC, may authorize an award where local benefits are not adequate. Local benefits are deducted... independent contractor. (o) Arises out of personal activities of dependents, guests, servants, or pets of...

ELECTROFISHING DISTANCE NEEDED TO ESTIMATE FISH SPECIES RICHNESS IN RAFTABLE WESTERN USA RIVERS

EPA Science Inventory

A critical issue in river monitoring is the minimum amount of sampling distance required to adequately represent the fish assemblage of a reach. Determining adequate sampling distance is important because it affects estimates of fish assemblage integrity and diversity at local a...

Noise assessment of unsuppressed TF-34-GE-100A engine at Warfield ANG, Baltimore, Maryland

NASA Astrophysics Data System (ADS)

Shaffer, Winston J., II; Ellis, John C., II

1987-12-01

This report presents the results of noise data measurements of an unsuppressed TF34-GE-100A engine and a community noise survey of the local area around the engine. Three recommendations were made. A two barrier design should be installed as an interim noise control measure. Justification and installation of a noise suppressor, as a long term solution, should be pursued. Day-night sound levels should continue to be monitored until adequate characterization of the airport noise environment is obtained.

Evaluation of strontium 90 irradiation in treatment of cutaneous mast cell tumors in cats: 35 cases (1992-2002).

PubMed

Turrel, Jane M; Farrelly, John; Page, Rodney L; McEntee, Margaret C

2006-03-15

To determine the efficacy of strontium 90 beta irradiation in the management of cutaneous mast cell tumors (CMCTs) in cats. Retrospective case series. 35 client-owned cats with CMCTs. Medical records of cats with CMCTs in which tumors were radiated by use of a strontium 90 ophthalmic applicator from 1992 to 2002 were reviewed. Cats were included if CMCT was diagnosed, there were no other sites of MCT involvement at the time of treatment, and records contained adequate follow-up information to permit retrospective assessment of local tumor control. 54 tumors in 35 cats were treated with a median dose of 135 Gy of strontium 90 beta irradiation, resulting in local tumor control in 53 of 54 (98%) tumors with a median follow-up time of 783 days after treatment. Median survival time was 1,075 days. Adverse effects of treatment appeared to be infrequent and of mild severity. Results indicated that strontium 90 beta irradiation resulted in long-term tumor control and should be considered an effective alternative to surgical resection in management of CMCTs in cats.

Temperature Control. Honeywell Planning Guide.

ERIC Educational Resources Information Center

Honeywell, Inc., Minneapolis, Minn.

Presents planning considerations in selecting proper temperature control systems. Various aspects are discussed including--(1) adequate environmental control, (2) adequate control area, (3) control system design, (4) operators rate their systems, (5) type of control components, (6) basic control system, (7) automatic control systems, and (8)…

[Constipation in patients with diabetes mellitus].

PubMed

Rossol, Siegbert

2007-11-01

Up to 60% of the patients with diabetes mellitus suffer from gastrointestinal tract symptoms that arise pathogenetically from a disturbance of the autonomous nervous system. Patient age, disease duration and poor control of diabetes mellitus correlate positively with the presence of gastrointestinal symptoms. Chronic constipation, in addition to diarrhoea, gall bladder dysfunction and incontinence, is increasingly regarded as a serious problem and for the first time, is now considered in the current guidelines of the professional societies. Modern diagnosis and treatment facilitate systematic control of the symptoms. Treatment necessitates long-term intake of laxatives, proper diabetes control and other accompanying general measures such as adequate amounts of liquids, dietary fibre and exercise. Motility and secretion-stimulating, osmotically active or locally applied laxatives are used. Slow transit constipation, which is typically observed in diabetics, can be best controlled with polyethylene glycol, bisacodyl or sodium picosulphate.

Selenium and the control of thyroid hormone metabolism.

PubMed

Köhrle, Josef

2005-08-01

Thyroid hormone synthesis, metabolism and action require adequate availability of the essential trace elements iodine and selenium, which affect homeostasis of thyroid hormone-dependent metabolic pathways. The three selenocysteine-containing iodothyronine deiodinases constitute a novel gene family. Selenium is retained and deiodinase expression is maintained at almost normal levels in the thyroid gland, the brain and several other endocrine tissues during selenium deficiency, thus guaranteeing adequate local and systemic levels of the active thyroid hormone T(3). Due to their low tissue concentrations and their mRNA SECIS elements deiodinases rank high in the cellular and tissue-specific hierarchy of selenium distribution among various selenoproteins. While systemic selenium status and expression of abundant selenoproteins (glutathione peroxidase or selenoprotein P) is already impaired in patients with cancer, disturbed gastrointestinal resorption, unbalanced nutrition or patients requiring intensive care treatment, selenium-dependent deiodinase function might still be adequate. However, disease-associated alterations in proinflammatory cytokines, growth factors, hormones and pharmaceuticals modulate deiodinase isoenzyme expression independent from altered selenium status and might thus pretend causal relationships between systemic selenium status and altered thyroid hormone metabolism. Limited or inadequate supply of both trace elements, iodine and selenium, leads to complex rearrangements of thyroid hormone metabolism enabling adaptation to unfavorable conditions.

Understanding Your Adequate Yearly Progress (AYP), 2011-2012

ERIC Educational Resources Information Center

Missouri Department of Elementary and Secondary Education, 2011

2011-01-01

The "No Child Left Behind Act (NCLB) of 2001" requires all schools, districts/local education agencies (LEAs) and states to show that students are making Adequate Yearly Progress (AYP). NCLB requires states to establish targets in the following ways: (1) Annual Proficiency Target; (2) Attendance/Graduation Rates; and (3) Participation…

29 CFR 417.4 - Pre-hearing conference.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Constitution and Bylaws for Removal of Officers of Local Labor Organizations § 417.4 Pre-hearing conference. (a... constitution and bylaws of the labor organization do not provide an adequate procedure for the removal of an...) on the question of whether its constitution and bylaws provide an adequate procedure for the removal...

29 CFR 417.4 - Pre-hearing conference.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Constitution and Bylaws for Removal of Officers of Local Labor Organizations § 417.4 Pre-hearing conference. (a... constitution and bylaws of the labor organization do not provide an adequate procedure for the removal of an...) on the question of whether its constitution and bylaws provide an adequate procedure for the removal...

29 CFR 417.4 - Pre-hearing conference.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Constitution and Bylaws for Removal of Officers of Local Labor Organizations § 417.4 Pre-hearing conference. (a... constitution and bylaws of the labor organization do not provide an adequate procedure for the removal of an...) on the question of whether its constitution and bylaws provide an adequate procedure for the removal...

Tuberculosis infection control measures in health care facilities offering tb services in Ikeja local government area, Lagos, South West, Nigeria.

PubMed

Kuyinu, Y A; Mohammed, A S; Adeyeye, O O; Odugbemi, B A; Goodman, O O; Odusanya, O O

2016-03-15

Tuberculosis infection among health care workers is capable of worsening the existing health human resource problems of low--and middle-income countries. Tuberculosis infection control is often weakly implemented in these parts of the world therefore, understanding the reasons for poor implementation of tuberculosis infection control guidelines are important. This study was aimed at assessing tuberculosis infection control practices and barriers to its implementation in Ikeja, Nigeria. A cross-sectional study in 20 tuberculosis care facilities (16 public and 4 private) in Ikeja, Lagos was conducted. The study included a facility survey to assess the availability of tuberculosis infection control guidelines, the adequacy of facilities to prevent transmission of tuberculosis and observations of practices to assess the implementation of tuberculosis infection control guidelines. Four focus group discussions were carried out to highlight HCWs' perceptions on tuberculosis infection control guidelines and barriers to its implementation. The observational study showed that none of the clinics had a tuberculosis infection control plan. No clinic was consistently screening patients for cough. Twelve facilities (60%) consistently provided masks to patients who were coughing. Ventilation in the waiting areas was assessed to be adequate in 60% of the clinics while four clinics (20%) possessed N-95 respirators. Findings from the focus group discussions showed weak managerial support, poor funding, under-staffing, lack of space and not wanting to be seen as stigmatizing against tuberculosis patients as barriers that hindered the implementation of TB infection control measures. Tuberculosis infection control measures were not adequately implemented in health facilities in Ikeja, Nigeria. A multi-pronged approach is required to address the identified barriers to the implementation of tuberculosis infection control guidelines.

The iodized salt programme in Bangalore, India provides adequate iodine intakes in pregnant women and more-than-adequate iodine intakes in their children.

PubMed

Jaiswal, Nidhi; Melse-Boonstra, Alida; Sharma, Surjeet Kaur; Srinivasan, Krishnamachari; Zimmermann, Michael B

2015-02-01

To compare the iodine status of pregnant women and their children who were sharing all meals in Bangalore, India. A cross-sectional study evaluating demographic characteristics, household salt iodine concentration and salt usage patterns, urinary iodine concentrations (UIC) in women and children, and maternal thyroid volume (ultrasound). Antenatal clinic of an urban tertiary-care hospital, which serves a low-income population. Healthy pregnant women in all trimesters, aged 18-35 years, who had healthy children aged 3-15 years. Median (range) iodine concentrations of household powdered and crystal salt were 55·9 (17·2-65·9) ppm and 18·9 (2·2-68·2) ppm, respectively. The contribution of iodine-containing supplements and multi-micronutrient powders to iodine intake in the families was negligible. Adequately iodized salt, together with small amounts of iodine in local foods, were providing adequate iodine during pregnancy: (i) the overall median (range) UIC in women was 172 (5-1024) µg/l; (ii) the median UIC was >150 µg/l in all trimesters; and (iii) thyroid size was not significantly different across trimesters. At the same time, the median (range) UIC in children was 220 (10-782) µg/l, indicating more-than-adequate iodine intake at this age. Median UIC was significantly higher in children than in their mothers (P=0·008). In this selected urban population of southern India, the iodized salt programme provides adequate iodine to women throughout pregnancy, at the expense of higher iodine intake in their children. Thus we suggest that the current cut-off for median UIC in children indicating more-than-adequate intake, recommended by the WHO/UNICEF/International Council for the Control of Iodine Deficiency Disorders may, need to be reconsidered.

Rectal cancer delivery of radiotherapy in adequate time and with adequate dose is influenced by treatment center, treatment schedule, and gender and is prognostic parameter for local control: Results of study CAO/ARO/AIO-94

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

Fietkau, Rainer; Roedel, Claus; Hohenberger, Werner

2007-03-15

Purpose: The impact of the delivery of radiotherapy (RT) on treatment results in rectal cancer patients is unknown. Methods and Materials: The data from 788 patients with rectal cancer treated within the German CAO/AIO/ARO-94 phase III trial were analyzed concerning the impact of the delivery of RT (adequate RT: minimal radiation RT dose delivered, 4300 cGy for neoadjuvant RT or 4700 cGy for adjuvant RT; completion of RT in <44 days for neoadjuvant RT or <49 days for adjuvant RT) in different centers on the locoregional recurrence rate (LRR) and disease-free survival (DFS) at 5 years. The LRR, DFS, andmore » delivery of RT were analyzed as endpoints in multivariate analysis. Results: A significant difference was found between the centers and the delivery of RT. The overall delivery of RT was a prognostic factor for the LRR (no RT, 29.6% {+-} 7.8%; inadequate RT, 21.2% {+-} 5.6%; adequate RT, 6.8% {+-} 1.4%; p = 0.0001) and DFS (no RT, 55.1% {+-} 9.1%; inadequate RT, 57.4% {+-} 6.3%; adequate RT, 69.1% {+-} 2.3%; p = 0.02). Postoperatively, delivery of RT was a prognostic factor for LRR on multivariate analysis (together with pathologic stage) but not for DFS (independent parameters, pathologic stage and age). Preoperatively, on multivariate analysis, pathologic stage, but not delivery of RT, was an independent prognostic parameter for LRR and DFS (together with adequate chemotherapy). On multivariate analysis, the treatment center, treatment schedule (neoadjuvant vs. adjuvant RT), and gender were prognostic parameters for adequate RT. Conclusion: Delivery of RT should be regarded as a prognostic factor for LRR in rectal cancer and is influenced by the treatment center, treatment schedule, and patient gender.« less

Psoas abscess secondary to retroperitoneal distant metastases from squamous cell carcinoma of the cervix with thrombosis of the inferior vena cava and duodenal infiltration treated by Whipple procedure: A case report and review of the literature.

PubMed

Mehdorn, Matthias; Petersen, Tim-Ole; Bartels, Michael; Jansen-Winkeln, Boris; Kassahun, Woubet Tefera

2016-08-11

Psoas abscess is a rare clinical disease of various origins. Most common causes include hematogenous spread of bacteria from a different primary source, spondylodiscitis or perforated intestinal organs. But rarely some abscesses are related to malignant metastatic disease. In this case report we present the case of a patient with known squamous cell carcinoma of the cervix treated with radio-chemotherapy three years prior. She now presented with a psoas abscess and subsequent complete inferior vena cava thrombosis, as well as duodenal and vertebral infiltration. The abscess was drained over a prolonged period of time and later was found to be a complication caused by metastases of the cervical carcinoma. Due to the massive extent of the metastases a Whipple procedure was performed to successfully control the local progress of the metastasis. As psoas abscess is an unspecific disease which presents with non-specific symptoms adequate therapy may be delayed due to lack of early diagnostic results. This case report highlights the difficulties of managing a malignant abscess and demonstrates some diagnostic pitfalls that might be encountered. It stresses the necessity of adequate diagnostics to initiate successful therapy. Reports on psoas abscesses that are related to cervix carcinoma are scarce, probably due to the rarity of this event, and are limited to very few case reports. We are the first to report a case in which an extensive and complex abdominal procedure was needed for local control to improve quality of life.

Funding the Formula Adequately in Oklahoma

ERIC Educational Resources Information Center

Hancock, Kenneth

2015-01-01

This report is a longevity, simulational study that looks at how the ratio of state support to local support effects the number of school districts that breaks the common school's funding formula which in turns effects the equity of distribution to the common schools. After nearly two decades of adequately supporting the funding formula, Oklahoma…

29 CFR 417.4 - Pre-hearing conference.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Constitution and Bylaws for Removal of Officers of Local Labor Organizations § 417.4 Pre-hearing conference. (a... constitution and bylaws of the labor organization do not provide an adequate procedure for the removal of an... question of whether its constitution and bylaws provide an adequate procedure for the removal of an elected...

29 CFR 417.4 - Pre-hearing conference.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Constitution and Bylaws for Removal of Officers of Local Labor Organizations § 417.4 Pre-hearing conference. (a... constitution and bylaws of the labor organization do not provide an adequate procedure for the removal of an... question of whether its constitution and bylaws provide an adequate procedure for the removal of an elected...

Efficacy of tumescent local anesthesia with variable lidocaine concentration in 3430 consecutive cases of liposuction.

PubMed

Habbema, Louis

2010-06-01

Lidocaine toxicity is a potential complication related to using tumescent local anesthesia (TLA) as the exclusive form of pain management in surgical procedures. We sought to determine the minimum concentration of lidocaine in the tumescent solution required to provide adequate anesthesia in patients undergoing liposuction using TLA exclusively. Liposuction using TLA exclusively was performed in 3430 procedures by the same surgeon. The initial concentration of 1000 mg/L lidocaine in the tumescent solution was gradually reduced to find the minimum required for adequate anesthesia. Adequate anesthesia was achieved using a lidocaine concentration of 500 mg/L saline in all areas treated and 400 mg/L saline for most of the areas treated. Data are based on the specific TLA technique used by the same surgeon. Lidocaine serum levels were not analyzed. For patients undergoing liposuction using TLA exclusively, the concentration of lidocaine in the normal saline solution required for adequate anesthesia is 400 mg/L for most body areas and 500 mg/L for some sensitive areas. Copyright 2009 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

Developing cancer control capacity in state and local public health agencies.

PubMed

Meissner, H I; Bergner, L; Marconi, K M

1992-01-01

In 1986, the National Cancer Institute began a major grant program to enhance the technical capabilities of public health departments in cancer prevention and control. This effort, commonly referred to as "capacity building" for cancer control, provided funding to support eight State and one local health department. The program focused on developing the knowledge and skills of health department personnel to implement intervention programs in such areas as smoking cessation, diet modification, and breast and cervical cancer screening. The grants ranged from 2 to 5 years in length, with funding of $125,000 to $1.6 million per grant. The total for the program was $7.4 million. While the priorities set for these grants were nominally similar, their capacity building activities in cancer prevention and control evolved into unique interventions reflecting the individual needs and priorities of each State or locality. Their experiences illustrate that technical development for planning, implementing, and evaluating cancer prevention and control programs is a complex process that must occur at multiple levels, regardless of overall approach. Factors found to contribute to successful implementation of technical development programs include* commitment of the organization's leadership to provide adequate support for staff and activities and to keep cancer prevention and control on the organizational agenda,* the existence of appropriate data to monitor and evaluate programs,* appropriately trained staff,* building linkages with State and community agencies and coalitions to guide community action,* an established plan or process for achieving cancer control objectives,* access to the advice of and participation of individual cancer and health experts,* an informed State legislature,* diffusion of cancer prevention and control efforts,and* the ability to obtain funds needed for future activities.

Inferential Processing among Adequate and Struggling Adolescent Comprehenders and Relations to Reading Comprehension

PubMed Central

Barth, Amy E.; Barnes, Marcia; Francis, David J.; Vaughn, Sharon; York, Mary

2015-01-01

Separate mixed model analyses of variance (ANOVA) were conducted to examine the effect of textual distance on the accuracy and speed of text consistency judgments among adequate and struggling comprehenders across grades 6–12 (n = 1203). Multiple regressions examined whether accuracy in text consistency judgments uniquely accounted for variance in comprehension. Results suggest that there is considerable growth across the middle and high school years, particularly for adequate comprehenders in those text integration processes that maintain local coherence. Accuracy in text consistency judgments accounted for significant unique variance for passage-level, but not sentence-level comprehension, particularly for adequate comprehenders. PMID:26166946

Schistosomiasis mansoni in Bananal (State of São Paulo, Brazil): IV. Study on the public awareness of its risks in the Palha District.

PubMed

da Silva, Rubens Antonio; de Carvalho, Maria Esther; Zacharias, Fabiana; de Lima, Valquíria R; Teles, Horacio M S

2002-01-01

A rather high prevalence of mansoni schistosomiasis has been observed in some localities of Bananal, State of São Paulo, during the past decade. The highest prevalence of schistosomiasis was found in the Palha District; it was thus considered adequate for an evaluation of public awareness of the risks involved in acquiring schistosomiasis, a likely outcome of certain behavior patterns. We interviewed 542 district-dwellers. The 5-to-39 age-group constituted 65.5% of the whole sample. Concerning the infection, 69.2% had hearsay information; 46.1% know the infection; 69.6% know how it is acquired; 31.5% know about the symptoms and 57.1% know what can be done to avoid infection; 17.7% declared to have acquired the infection at least once in their lifetime; 62.3% reported total or partial immersion in collections of water of Bananal, once or twice a week, 53.9% of these for bathing or fishing. Although most (91.7%) households have treated running water, are connected to the sewage network or have septic tanks, 9% of the people interviewed use to defecate on the field. It became clear that the educational messages aimed at this population had not been adequate, having failed to fulfil any expectations. The local people received only piecemeal and subjective information about their problem. The control of schistosomiasis requires an integrated practice, which includes the analysis of macro-determinant factors, such as basic sanitation, habitation, education and health care. In short, we require a multidisciplinary vision of the mechanisms of transmission of the infection, which depends upon adequate planning and well trained personnel, intent on their educational work, to attain satisfactory results.

Implementing large-scale food fortification in Ghana: lessons learned.

PubMed

Nyumuah, Richard Odum; Hoang, Thuy-Co Caroline; Amoaful, Esi Foriwa; Agble, Rosanna; Meyer, Marc; Wirth, James P; Locatelli-Rossi, Lorenzo; Panagides, Dora

2012-12-01

Food fortification began in Ghana in 1996 when legislation was passed to enforce the iodization of salt. This paper describes the development of the Ghanaian fortification program and identifies lessons learned in implementing fortification initiatives (universal salt iodization, fortification of vegetable oil and wheat flour) from 1996 to date. This paper identifies achievements, challenges, and lessons learned in implementing large scale food fortification in Ghana. Primary data was collected through interviews with key members of the National Food Fortification Alliance (NFFA), implementation staff of the Food Fortification Project, and staff of GAIN. Secondary data was collected through desk review of documentation from the project offices of the National Food Fortification Project and the National Secretariat for the Implementation of the National Salt Iodization in Ghana. Reduction of the prevalence of goiter has been observed, and coverage of households with adequately iodized salt increased between 1996 and 2006. Two models were designed to increase production of adequately iodized salt: one to procure and distribute potassium iodate (KIO3) locally, and the second, the salt bank cooperative (SBC) model, specifically designed for small-scale artisanal salt farmers. This resulted in the establishment of a centralized potassium iodate procurement and distribution system, tailored to local needs and ensuring competitive and stable prices. The SBC model allowed for nearly 157 MT of adequately iodized salt to be produced in 2011 in a region where adequately iodized salt was initially not available. For vegetable oil fortification, implementing quantitative analysis methods for accurate control of added fortificant proved challenging but was overcome with the use of a rapid test device, confirming that 95% of vegetable oil is adequately fortified in Ghana. However, appropriate compliance with national standards on wheat flour continues to pose challenges due to adverse sensory effects, which have led producers to reduce the dosage of premix in wheat flour. Challenges to access to premix experienced by small producers can be overcome with a central procurement model in which the distributor leverages the overall volume by tendering for a consolidated order. The SBC model has the potential to be expanded and to considerably increase the coverage of the population consuming iodized salt in Ghana. Successful implementation of the cost-effective iCheck CHROMA rapid test device should be replicated in other countries where quality control of fortified vegetable oil is a challenge, and extended to additional food vehicles, such as wheat flour and salt. Only a reduced impact on iron deficiency in Ghana can be expected, given the low level of fortificant added to the wheat flour. An integrated approach, with complementary programs including additional iron-fortified food vehicles, should be explored to maximize health impact.

Chapter 5. Essential equipment, pharmaceuticals and supplies. Recommendations and standard operating procedures for intensive care unit and hospital preparations for an influenza epidemic or mass disaster.

PubMed

Sprung, Charles L; Kesecioglu, Jozef

2010-04-01

To provide recommendations and standard operating procedures for intensive care unit and hospital preparations for an influenza pandemic or mass disaster with a specific focus on essential equipment, pharmaceuticals and supplies. Based on a literature review and expert opinion, a Delphi process was used to define the essential topics including essential equipment, pharmaceuticals and supplies. Key recommendations include: (1) ensure that adequate essential medical equipment, pharmaceuticals and important supplies are available during a disaster; (2) develop a communication and coordination system between health care facilities and local/regional/state/country governmental authorities for the provision of additional support; (3) determine the required resources, order and stockpile adequate resources, and judiciously distribute them; (4) acquire additional mechanical ventilators that are portable, provide adequate gas exchange for a range of clinical conditions, function with low-flow oxygen and without high pressure, and are safe for patients and staff; (5) provide advanced ventilatory support and rescue therapies including high levels of inspired oxygen and positive end-expiratory pressure, volume and pressure control ventilation, inhaled nitric oxide, high-frequency ventilation, prone positioning ventilation and extracorporeal membrane oxygenation; (6) triage scarce resources including equipment, pharmaceuticals and supplies based on those who are likely to benefit most or on a 'first come, first served' basis. Judicious planning and adoption of protocols for providing adequate equipment, pharmaceuticals and supplies are necessary to optimize outcomes during a pandemic.

Regulatory T cells in the control of host-microorganism interactions (*).

PubMed

Belkaid, Yasmine; Tarbell, Kristin

2009-01-01

Each microenvironment requires a specific set of regulatory elements that are finely and constantly tuned to maintain local homeostasis. Various populations of regulatory T cells contribute to the maintenance of this equilibrium and establishment of controlled immune responses. In particular, regulatory T cells limit the magnitude of effector responses, which may result in failure to adequately control infection. However, regulatory T cells also help limit collateral tissue damage caused by vigorous antimicrobial immune responses against pathogenic microbes as well as commensals. In this review, we describe various situations in which the balance between regulatory T cells and effector immune functions influence the outcome of host-microorganism coexistence and discuss current hypotheses and points of polemic associated with the origin, target, and antigen specificity of both endogenous and induced regulatory T cells during these interactions.

A parasitological survey in three selected communities in Luapula Province, Northern Rhodesia

PubMed Central

McCullough, Fergus; Friis-Hansen, Bent

1961-01-01

The authors present the results of a parasitological survey conducted among children living in three rural and geographically separate communities selected for the work of the Health and Nutrition Scheme, Fort Rosebery, Northern Rhodesia. The survey included observations on Plasmodium spp. and other parasites of the blood, Endamoeba spp., and helminth and arthropod parasites. In addition, data on the distribution and taxonomy of local anophelines and fresh-water molluscs are given. As was expected, malaria, urinary bilharziasis and hookworm were the most important parasitic infections recorded, though the prevalence of each varied considerably in each community. Such local variation in prevalence of a particular parasitic infection should prove to be encouraging, rather than discouraging, to the initiation of control measures. The results of the present survey support the view, too frequently forgotten, that for an adequate understanding of the prevalence of different parasitic infections precise, local investigations are imperative; without such investigations, broad conclusions are seldom valid. PMID:13773853

Focal cryotherapy of localized prostate cancer: a systematic review of the literature.

PubMed

Shah, Taimur Tariq; Ahmed, Hashim; Kanthabalan, Abi; Lau, Benjamin; Ghei, Maneesh; Maraj, Barry; Arya, Manit

2014-11-01

Radical/whole gland treatment for prostate cancer has significant side-effects. Therefore focal treatments such as cryotherapy have been used to treat localized lesions whilst aiming to provide adequate cancer control with minimal side-effects. We performed a systematic review of Pubmed/Medline and Cochrane databases' to yield 9 papers for primary focal prostate cryotherapy and 2 papers for focal salvage treatment (radio-recurrent). The results of 1582 primary patients showed biochemical disease-free survival between 71-93% at 9-70 months follow-up. Incontinence rates were 0-3.6% and ED 0-42%. Recto-urethral fistula occurred in only 2 patients. Salvage focal cryotherapy had biochemical disease-free survival of 50-68% at 3 years. ED occurred in 60-71%. Focal cryotherapy appears to be an effective treatment for primary localized prostate cancer and compares favorably to radical/whole gland treatments in medium-term oncological outcomes and side-effects. Although more studies are needed it is also effective for radio-recurrent cancer with a low complications rates.

A parasitological survey in three selected communities in Luapula Province, Northern Rhodesia.

PubMed

MCCULLOUGH, F; FRIIS-HANSEN, B

1961-01-01

The authors present the results of a parasitological survey conducted among children living in three rural and geographically separate communities selected for the work of the Health and Nutrition Scheme, Fort Rosebery, Northern Rhodesia. The survey included observations on Plasmodium spp. and other parasites of the blood, Endamoeba spp., and helminth and arthropod parasites. In addition, data on the distribution and taxonomy of local anophelines and fresh-water molluscs are given.As was expected, malaria, urinary bilharziasis and hookworm were the most important parasitic infections recorded, though the prevalence of each varied considerably in each community. Such local variation in prevalence of a particular parasitic infection should prove to be encouraging, rather than discouraging, to the initiation of control measures.The results of the present survey support the view, too frequently forgotten, that for an adequate understanding of the prevalence of different parasitic infections precise, local investigations are imperative; without such investigations, broad conclusions are seldom valid.

Hydrologic implications of solid-water disposal

USGS Publications Warehouse

Schneider, William Joseph

1970-01-01

Site selection for disposal of solid wastes must be based on adequate water-resources information if pollutional potential is to be minimized. This will require regional as well as localized data on the water resources of the area. Only through such an approach can adequate protection be afforded to the environment in general and the water resources in particular.

The role of size polydispersity in magnetic fluid hyperthermia: average vs. local infra/over-heating effects.

PubMed

Munoz-Menendez, Cristina; Conde-Leboran, Ivan; Baldomir, Daniel; Chubykalo-Fesenko, Oksana; Serantes, David

2015-11-07

An efficient and safe hyperthermia cancer treatment requires the accurate control of the heating performance of magnetic nanoparticles, which is directly related to their size. However, in any particle system the existence of some size polydispersity is experimentally unavoidable, which results in a different local heating output and consequently a different hyperthermia performance depending on the size of each particle. With the aim to shed some light on this significant issue, we have used a Monte Carlo technique to study the role of size polydispersity in heat dissipation at both the local (single particle) and global (macroscopic average) levels. We have systematically varied size polydispersity, temperature and interparticle dipolar interaction conditions, and evaluated local heating as a function of these parameters. Our results provide a simple guide on how to choose, for a given polydispersity degree, the more adequate average particle size so that the local variation in the released heat is kept within some limits that correspond to safety boundaries for the average-system hyperthermia performance. All together we believe that our results may help in the design of more effective magnetic hyperthermia applications.

Use of planetary soils within CELSS: The plant viewpoint

NASA Astrophysics Data System (ADS)

Art Spomer, L.

1994-11-01

The major functions of soil relative to plant growth include retention and supply of water and minerals, provision of anchorage and support for the root, and provision of an otherwise adequate physical and chemical environment to ensure an extensive, functioning root system. The physical and chemical nature of the solid matrix constituting a soil interacts with the soil confinement configuration, the growing environment, and plant requirements to determine the soil's suitability for plant growth. A wide range of natural and manufactured terrestrial materials have proven adequate soils provided they are not chemically harmful to plants (or animals eating the plants), are suitably prepared for the specific use, and are used in a compatible confinement system. It is presumed this same rationale can be applied to planetary soils for growing plants within any controlled environment life support system (CELSS). The basic concepts of soil and soil-plant interactions are reviewed relative to using soils constituted from local planetary materials for growing plants.

Emphysematous cystitis: a rare cause of gross hematuria.

PubMed

Chang, Chirn-Bin; Chang, Chia-Chu

2011-05-01

Emphysematous cystitis is a relatively rare infectious condition of the urinary bladder. The mortality rate is high if the diagnosis is delayed or if the treatment is inadequate. We present an uncommon case of emphysematous cystitis and highlight the risk factors for this disease. An 81-year-old man with a past medical history of type 2 diabetes and a central pontine infarction presented to the Emergency Department due to gross hematuria. Computed tomography (CT) and plain radiography revealed localized gas within the bladder that was compatible with the diagnosis of emphysematous cystitis. A Foley catheter was inserted. Urine culture grew Klebsiella pneumoniae; 2 g cefotaxime daily was initiated. Subsequent plain radiography and CT scan showed regression of intraluminal gas. We recommend CT for the definitive diagnosis of emphysematous cystitis. Adequate antibiotic therapy, strict blood glucose control, adequate drainage of urine, and early goal-directed therapy for suspected sepsis are suggested to prevent the complications of emphysematous cystitis. Copyright © 2011 Elsevier Inc. All rights reserved.

Sense or nonsense? Traditional methods of animal parasitic disease control.

PubMed

Schillhorn van Veen, T W

1997-07-31

In recent years, there has been a resurgence of interest in traditional health-care practices in the western as well as in the developing world. In animal health, this has led to further interest in ethnoveterinary research and development, a relatively new field of study that covers traditional practices, ethnobotany and application of animal care practices embedded in local tradition. This development has practical applications for animal parasite control, whether related to epidemiology, diagnostics and therapy, or to comprehensive disease control methods leading to integrated pest/disease management. Examples are provided of traditional practices in diagnostics, herd-, grazing- and pasture-management as well as of manipulation and treatment. Many of these applications indicate a basic understanding of disease, especially epidemiology, by farmers and herders, although not always explained, or explainable, in rational western ways. Although abuse and quackery exist, the application of traditional practices seems to make sense in areas without adequate veterinary services. Moreover, acknowledgement of the value of traditional knowledge empowers local herders/farmers to try to solve their herds' disease problems in a cost-effective way. Traditional practices often make sense, albeit with some regulation to ascertain safety and to prevent abuse.

Fiber-optic control and thermometry of single-cell thermosensation logic.

PubMed

Fedotov, I V; Safronov, N A; Ermakova, Yu G; Matlashov, M E; Sidorov-Biryukov, D A; Fedotov, A B; Belousov, V V; Zheltikov, A M

2015-11-13

Thermal activation of transient receptor potential (TRP) cation channels is one of the most striking examples of temperature-controlled processes in cell biology. As the evidence indicating the fundamental role of such processes in thermosensation builds at a fast pace, adequately accurate tools that would allow heat receptor logic behind thermosensation to be examined on a single-cell level are in great demand. Here, we demonstrate a specifically designed fiber-optic probe that enables thermal activation with simultaneous online thermometry of individual cells expressing genetically encoded TRP channels. This probe integrates a fiber-optic tract for the delivery of laser light with a two-wire microwave transmission line. A diamond microcrystal fixed on the fiber tip is heated by laser radiation transmitted through the fiber, providing a local heating of a cell culture, enabling a well-controlled TRP-assisted thermal activation of cells. Online local temperature measurements are performed by using the temperature-dependent frequency shift of optically detected magnetic resonance, induced by coupling the microwave field, delivered by the microwave transmission line, to nitrogen--vacancy centers in the diamond microcrystal. Activation of TRP channels is verified by using genetically encoded fluorescence indicators, visualizing an increase in the calcium flow through activated TRP channels.

Health literacy of an urban business community.

PubMed

Johnson, Barbara H; Hayes, Sandra C; Ekundayo, Olugbemiga T; Wheeler, Primus; Ford, D'Arcy M

2012-02-01

The impact of community-based organizations on the delivery of health care knowledge is well documented. Little research has focused on the importance of health literacy in the dissemination of health care information by minority small business owners. This study sampled 38 business owners within a local business district to assess their level of health literacy. Although adequate health literacy is not required to serve as a community resource, it may be necessary to understand the health literacy level of local business owners as gatekeepers in order to develop appropriate training/educational programs. The results of this descriptive cross-sectional study indicate that for sample of business owners, health literacy levels are adequate. The findings suggest the feasibility of using local business owners as disseminators of health-related materials to the communities in which they operate their businesses.

Alabama's Foundation Program: An Adequate and Equitable School Funding Mechanism?

ERIC Educational Resources Information Center

Coe, Dennis Randal

2016-01-01

The purpose of this study was to determine the extent to which the foundation program was an adequate and equitable funding mechanism for public schools in the state of Alabama. This study analyzed funding and academic data and evaluated adequacy and equity through the lenses of poverty, geographic location, local tax effort, and type of school…

The role of radiation therapy in the management of plasma cell tumors.

PubMed

Mill, W B; Griffith, R

1980-02-15

A retrospective review is reported of 128 patients presenting with multiple myeloma and 16 patients presenting with solitary plasmacytoma. Ninety-one percent of 116 evaluable patients treated for palliation of painful bone disease received some degree of subjective pain relief. The radiation dose most frequently prescribed was between 1500 and 2000 rad. Of the 278 ports treated, only 17 (6.1%) were re-treated to the same area at a later date. There was no increase in incidence of re-treatment with lower radiation doses. Ten of the 13 patients treated for a solitary plasmacytoma with a minumum follow-up period of three years have local tumor control. The median survival in the solitary plasmacytomas is five and one-half years. Data from the literature on 27 additional solitary plasmacytomas combined with our data suggest an improved local control and a decrease in dissemination with doses greater than 5000 rad. It is concluded that low doses of radiation are usually adequate to treat painful bone lesions of multiple myeloma and doses of 5000-6500 rad in six to seven weeks are recommended for solitary plasmacytomas.

Stereotactic Body Radiotherapy in the Management of Oligometastatic Disease.

PubMed

Ahmed, Kamran A; Torres-Roca, Javier F

2016-01-01

The treatment of oligometastatic disease has become common as imaging techniques have advanced and the management of systemic disease has improved. Use of highly targeted, hypofractionated regimens of stereotactic body radiotherapy (SBRT) is now a primary management option for patients with oligometastatic disease. The properties of SBRT are summarized and the results of retrospective and prospective studies of SBRT use in the management of oligometastases are reviewed. Future directions of SBRT, including optimizing dose and fractionation schedules, are also discussed. SBRT can deliver highly conformal, dosed radiation treatments for ablative tumors in a few treatment sessions. Phase 1/2 trials and retrospective institutional results support use of SBRT as a treatment option for oligometastatic disease metastasized to the lung, liver, and spine, and SBRT offers adequate toxicity profiles with good rates of local control. Future directions will involve optimizing dose and fractionation schedules for select histologies to improve rates of local control while limiting toxicity to normal structures. SBRT offers an excellent management option for patients with oligometastases. However, additional research is still needed to optimize dose and fractionation schedules.

Phase II trial evaluating the feasibility of interdigitating folfox with chemoradiotherapy in locally advanced and metastatic rectal cancer.

PubMed

Michael, M; Chander, S; McKendrick, J; MacKay, J R; Steel, M; Hicks, R; Heriot, A; Leong, T; Cooray, P; Jefford, M; Zalcberg, J; Bressel, M; McClure, B; Ngan, S Y

2014-11-11

Patients (pts) with metastatic rectal cancer and symptomatic primary, require local and systemic control. Chemotherapy used during chemoradiotherapy (CRT) is adequate for radiosensitisation, but suboptimal for systemic control. The aim of this phase II study was to assess tolerability, local/systemic benefits, of a novel regimen delivering interdigitating intensive chemotherapy with radical CRT. Eligible pts had untreated synchronous symptomatic primary/metastatic rectal cancer. A total of 12 weeks of treatment with split-course pelvic CRT (total 50.4 Gy with concurrent oxaliplatin and 5-FU infusion) alternating with FOLFOX chemotherapy. All pts staged with CT, MRI and FDG-PET pre and post treatment. Twenty-six pts were treated. Rectal primary MRI stage: T3 81% and T4 15%. Liver metastases in 81%. Twenty-four pts (92%) completed the 12-week regimen. All patients received planned RT dose, and for both agents over 88% of patients achieved a relative dose intensity of >75%. Grade 3 toxicities: neutropenia 23%, diarrhoea 15%, and radiation skin reaction 12%. Grade 4 toxicity: neutropenia 15%. FDG-PET metabolic response rate for rectal primary 96%, and for metastatic disease 60%. Delivery of interdigitating chemotherapy with radical CRT was feasible to treat both primary and metastatic rectal cancer. High completion and response rates were encouraging.

Nurse-Led Programs to Facilitate Enrollment to Children's Oncology Group Cancer Control Trials.

PubMed

Haugen, Maureen; Kelly, Katherine Patterson; Leonard, Marcia; Mills, Denise; Sung, Lillian; Mowbray, Catriona; Landier, Wendy

2016-09-01

The progress made over the past 50 years in disease-directed clinical trials has significantly increased cure rates for children and adolescents with cancer. The Children's Oncology Group (COG) is now conducting more studies that emphasize improving quality of life for young people with cancer. These types of clinical trials are classified as cancer control (CCL) studies by the National Cancer Institute and require different resources and approaches to facilitate adequate accrual and implementation at COG institutions. Several COG institutions that had previously experienced problems with low accruals to CCL trials have successfully implemented local nursing leadership for these types of studies. Successful models of nurses as institutional leaders and "champions" of CCL trials are described. © 2015 by Association of Pediatric Hematology/Oncology Nurses.

Drinking Water Quality in Hospitals and Other Buildings ...

EPA Pesticide Factsheets

Drinking water quality entering large buildings is generally adequately controlled by the water utility, but localized problems may occur within building or “premise” plumbing. Particular concerns are loss of disinfectant residual and temperature variability, which may enhance pathogen activity and metallic corrosion. Disinfection systems are available to building managers and are being installed in a variety of commercial buildings (hospitals, hotels, office buildings.) Yet our understanding of such additional treatment and of how to monitor end water quality at these buildings is limited. This class lecture will discuss challenges in maintaining acceptable water quality in hospitals, schools and other buildings. To give a lecture to a class of graduate students (ENVE 6054: Physical/Chemical Processes for Water Quality Control) at the University of Cincinnati, by presenting past research projects.

Ensuring successful introduction of Wolbachia in natural populations of Aedes aegypti by means of feedback control.

PubMed

Bliman, Pierre-Alexandre; Aronna, M Soledad; Coelho, Flávio C; da Silva, Moacyr A H B

2018-04-01

The control of the spread of dengue fever by introduction of the intracellular parasitic bacterium Wolbachia in populations of the vector Aedes aegypti, is presently one of the most promising tools for eliminating dengue, in the absence of an efficient vaccine. The success of this operation requires locally careful planning to determine the adequate number of individuals carrying the Wolbachia parasite that need to be introduced into the natural population. The introduced mosquitoes are expected to eventually replace the Wolbachia-free population and guarantee permanent protection against the transmission of dengue to human. In this study, we propose and analyze a model describing the fundamental aspects of the competition between mosquitoes carrying Wolbachia and mosquitoes free of the parasite. We then use feedback control techniques to devise an introduction protocol that is proved to guarantee that the population converges to a stable equilibrium where the totality of mosquitoes carry Wolbachia.

POOL WATER TREATMENT AND COOLING SYSTEM DESCRIPTION DOCUMENT

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

V. King

2000-06-19

The Pool Water Treatment and Cooling System is located in the Waste Handling Building (WHB), and is comprised of various process subsystems designed to support waste handling operations. This system maintains the pool water temperature within an acceptable range, maintains water quality standards that support remote underwater operations and prevent corrosion, detects leakage from the pool liner, provides the capability to remove debris from the pool, controls the pool water level, and helps limit radiological exposure to personnel. The pool structure and liner, pool lighting, and the fuel staging racks in the pool are not within the scope of themore » Pool Water Treatment and Cooling System. Pool water temperature control is accomplished by circulating the pool water through heat exchangers. Adequate circulation and mixing of the pool water is provided to prevent localized thermal hotspots in the pool. Treatment of the pool water is accomplished by a water treatment system that circulates the pool water through filters, and ion exchange units. These water treatment units remove radioactive and non-radioactive particulate and dissolved solids from the water, thereby providing the water clarity needed to conduct waste handling operations. The system also controls pool water chemistry to prevent advanced corrosion of the pool liner, pool components, and fuel assemblies. Removal of radioactivity from the pool water contributes to the project ALARA (as low as is reasonably achievable) goals. A leak detection system is provided to detect and alarm leaks through the pool liner. The pool level control system monitors the water level to ensure that the minimum water level required for adequate radiological shielding is maintained. Through interface with a demineralized water system, adequate makeup is provided to compensate for loss of water inventory through evaporation and waste handling operations. Interface with the Site Radiological Monitoring System provides continuous radiological monitoring of the pool water. The Pool Water Treatment and Cooling System interfaces with the Waste Handling Building System, Site-Generated Radiological Waste Handling System, Site Radiological Monitoring System, Waste Handling Building Electrical System, Site Water System, and the Monitored Geologic Repository Operations Monitoring and Control System.« less

25 CFR 32.4 - Policies.

Code of Federal Regulations, 2011 CFR

2011-04-01

... schools shall not be used as substitutes for providing adequate local family social services. Each school... aspects of the education process. (4) Ensure that each agency or local school board shall be authorized and empowered to function as the policy making body for the school, consistent with the authority...

36 CFR 242.12 - Local advisory committees.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 36 Parks, Forests, and Public Property 2 2013-07-01 2013-07-01 false Local advisory committees. 242.12 Section 242.12 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE... the existing State fish and game advisory committees do not adequately provide advice to, and assist...

36 CFR 242.12 - Local advisory committees.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 36 Parks, Forests, and Public Property 2 2012-07-01 2012-07-01 false Local advisory committees. 242.12 Section 242.12 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE... the existing State fish and game advisory committees do not adequately provide advice to, and assist...

36 CFR 242.12 - Local advisory committees.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 36 Parks, Forests, and Public Property 2 2014-07-01 2014-07-01 false Local advisory committees. 242.12 Section 242.12 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE... the existing State fish and game advisory committees do not adequately provide advice to, and assist...

75 FR 42786 - Accounting Guide for LSC Recipients (2010 Edition)

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-22

... adequate accounting and financial reporting system, including the use of specific internal controls and... the Accounting Procedures and Internal Control Checklist in Appendix VII. Sections G2, G3, and M of... the responsibilities of a recipient to maintain adequate accounting records and internal control...

Review of: Methods to complete watershed analysis on Pacific Lumber lands in Northern California

Treesearch

L. M. Reid

1999-01-01

The three questions of primary concern for this review are: 1) are the WDNR modules adequately and validly modified to suit local conditions, as required by the HCP/SYP? 2) is there an adequate "distinct cumulative effects assessment" method, as required by the HCP/SYP? 3) will the cumulative effects assessment method and the modified WDNR modules be...

Patient perception of understanding health education and instructions has moderating effect on glycemic control

PubMed Central

2014-01-01

Background Whether health literacy is independently associated with processes or outcomes of diabetes-related care is controversial. We tried to demonstrate the interaction of health literacy and understanding of health education and instructions in achieving glycemic control. Methods Five hundred and one consecutive patients with type 2 diabetes mellitus (DM) in the outpatient clinic of the metabolism department were recruited into this pilot study. The demographic data were collected from patients’ self-reports. The clinical background information was collected through electronic medical records. A questionnaire derived from part of the Mandarin Health Literacy Scale was used to measure numeracy and functional health literacy of people with diabetes. Health literacy levels were categorized into inadequate, marginal and adequate. Patient self-ratings of their perceived understanding of the health education information and instructions provided by their case manager in the past were categorized into two subgroups: better and poor. Patients with an HbA1c level equal to or below 7% were considered to have good glycemic control. Multivariate logistic regression was used to find associated factors of health literacy and understanding of health education and instructions. GENMOD procedures were used to analyze repeated outcome measurements of glycemic control. Results Higher educational attainment and higher household income (odds ratios were 2.23 and 2.22, respectively) were significantly associated with patients who had adequate health literacy. Higher educational attainment and patients with a family history of DM (odds ratios were 4.99 and 1.85, respectively) were significantly associated with better understanding of health education and instructions. Adequate health literacy is not the only factor associated with good glycemic control. The effect of adequate health literacy in achieving good glycemic control might be masked by patients with better understanding of health education and instructions. Conclusions Our results revealed that not only were patients with adequate health literacy associated with good glycemic control but patients with marginal health literacy were also able to achieve good glycemic control. Adequate health literacy and better understanding of health education is highly correlated. The role of adequate health literacy on glycemic control could be suppressed if variables are over-controlled during analysis. PMID:24996669

The internal architecture of dendritic spines revealed by super-resolution imaging: What did we learn so far?

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

MacGillavry, Harold D., E-mail: h.d.macgillavry@uu.nl; Hoogenraad, Casper C., E-mail: c.hoogenraad@uu.nl

2015-07-15

The molecular architecture of dendritic spines defines the efficiency of signal transmission across excitatory synapses. It is therefore critical to understand the mechanisms that control the dynamic localization of the molecular constituents within spines. However, because of the small scale at which most processes within spines take place, conventional light microscopy techniques are not adequate to provide the necessary level of resolution. Recently, super-resolution imaging techniques have overcome the classical barrier imposed by the diffraction of light, and can now resolve the localization and dynamic behavior of proteins within small compartments with nanometer precision, revolutionizing the study of dendritic spinemore » architecture. Here, we highlight exciting new findings from recent super-resolution studies on neuronal spines, and discuss how these studies revealed important new insights into how protein complexes are assembled and how their dynamic behavior shapes the efficiency of synaptic transmission.« less

Urban ecosystem services for resilience planning and management in New York City.

PubMed

McPhearson, Timon; Hamstead, Zoé A; Kremer, Peleg

2014-05-01

We review the current state of knowledge about urban ecosystem services in New York City (NYC) and how these services are regulated, planned for, and managed. Focusing on ecosystem services that have presented challenges in NYC-including stormwater quality enhancement and flood control, drinking water quality, food provisioning and recreation-we find that mismatches between the scale of production and scale of management occur where service provision is insufficient. Adequate production of locally produced services and services which are more accessible when produced locally is challenging in the context of dense urban development that is characteristic of NYC. Management approaches are needed to address scale mismatches in the production and consumption of ecosystem services. By coordinating along multiple scales of management and promoting best management practices, urban leaders have an opportunity to ensure that nature and ecosystem processes are protected in cities to support the delivery of fundamental urban ecosystem services.

Treatment of giant cell tumor of bone: Current concepts.

PubMed

Puri, Ajay; Agarwal, Manish

2007-04-01

Giant cell tumor (GCT) of bone though one of the commonest bone tumors encountered by an orthopedic surgeon continues to intrigue treating surgeons. Usually benign, they are locally aggressive and may occasionally undergo malignant transformation. The surgeon needs to strike a balance during treatment between reducing the incidence of local recurrence while preserving maximal function.Differing opinions pertaining to the use of adjuvants for extension of curettage, the relative role of bone graft or cement to pack the defect and the management of recurrent lesions are some of the issues that offer topics for eternal debate.Current literature suggests that intralesional curettage strikes the best balance between controlling disease and preserving optimum function in the majority of the cases though there may be occasions where the extent of the disease mandates resection to ensure adequate disease clearance.An accompanying treatment algorithm helps outline the management strategy in GCT.

Local anesthetic infusion pump for pain management following open inguinal hernia repair: a meta-analysis.

PubMed

Wu, Chien-Chih; Bai, Chyi-Huey; Huang, Ming-Te; Wu, Chih-Hsiung; Tam, Ka-Wai

2014-01-01

Open inguinal hernia repair is one of the most painful procedures in day surgery. A continuous ambulatory analgesic is thought to reduce postoperative pain when it is applied to the surgical site. The aim of this study is to evaluate the efficacy of local anesthetic infusion pump following open inguinal hernia repair for the reduction of postoperative pain. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) that have investigated the outcomes of using an infusion pump for delivering a local anesthetic contrasted to a control group for open inguinal hernia repair. Pain was assessed from Day 1 to Day 5 following the surgery. The secondary outcomes included analgesia use and postoperative complications. We reviewed 5 trials that totaled 288 patients. The analgesic effects of bupivacaine (4 trials) and ropivacaine (one trial) were compared with a placebo group. The pooled mean difference in the score measuring the degree of pain diminished significantly at Day 1 to Day 4 in the experimental group. Two studies have reported that the number of analgesics required also decreased in the experimental group. No bupivacaine-related complication was reported. Our results revealed that applying a local anesthetic infusion pump following inguinal hernia repairs was more efficacious for reducing postoperative pain than a placebo. However, the findings were based on a small body of evidence in which methodological quality was not high. The potential benefits of applying a local anesthetic infusion pump to hernia repair must still be adequately investigated using further RCTs. Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

10 CFR 503.36 - State or local requirements.

Code of Federal Regulations, 2011 CFR

2011-01-01

... zoning law; (2) The petitioner has made a good faith effort to obtain a variance from the State or local... petitioner is not entitled to an exemption for lack of alternate fuel supply, site limitation, environmental... supply, site limitation, environmental requirements, or inability to obtain adequate capital, the...

Improving the efficiency of dissolved oxygen control using an on-line control system based on a genetic algorithm evolving FWNN software sensor.

PubMed

Ruan, Jujun; Zhang, Chao; Li, Ya; Li, Peiyi; Yang, Zaizhi; Chen, Xiaohong; Huang, Mingzhi; Zhang, Tao

2017-02-01

This work proposes an on-line hybrid intelligent control system based on a genetic algorithm (GA) evolving fuzzy wavelet neural network software sensor to control dissolved oxygen (DO) in an anaerobic/anoxic/oxic process for treating papermaking wastewater. With the self-learning and memory abilities of neural network, handling the uncertainty capacity of fuzzy logic, analyzing local detail superiority of wavelet transform and global search of GA, this proposed control system can extract the dynamic behavior and complex interrelationships between various operation variables. The results indicate that the reasonable forecasting and control performances were achieved with optimal DO, and the effluent quality was stable at and below the desired values in real time. Our proposed hybrid approach proved to be a robust and effective DO control tool, attaining not only adequate effluent quality but also minimizing the demand for energy, and is easily integrated into a global monitoring system for purposes of cost management. Copyright © 2016 Elsevier Ltd. All rights reserved.

The Effects of Cryotherapy on Proprioception System

PubMed Central

Furmanek, Mariusz Paweł; Słomka, Kajetan; Juras, Grzegorz

2014-01-01

Proprioception plays an important role in the complex mechanism of joint control. Contemporary sport activities impose extremely high physical demands on athletes. Winter sports are played in areas with excessively low temperatures. Moreover, many athletes are subjected to treatments that involve local lowering of the body temperature before, during, and after physical activity. This work reviews the current knowledge regarding the influence of local cryotherapy on the proprioception system. The reviewed literature identified several tests that evaluate different aspects of proprioception. There is no universally agreed protocol, or clear set of criteria for test conditions. The outcomes of different tests and assessments of cryotherapy procedures using different cold modalities are poorly correlated. In general, the published results on the mechanism of cryotherapy effects on proprioception are not uniquely conclusive and are frequently contradictory. Additional high-quality research is required to explicitly answer the following questions: (1) whether local cryotherapy influences all aspects of proprioception; (2) whether the current methods of evaluation are adequate for the exploration of the relationship between cryotherapy and proprioception; and (3) whether the application of local cryotherapy is safe for athletes regarding proprioception. The review clearly showed that there is no comprehensive model relating cryotherapy and proprioception. PMID:25478573

The effects of cryotherapy on proprioception system.

PubMed

Furmanek, Mariusz Paweł; Słomka, Kajetan; Juras, Grzegorz

2014-01-01

Proprioception plays an important role in the complex mechanism of joint control. Contemporary sport activities impose extremely high physical demands on athletes. Winter sports are played in areas with excessively low temperatures. Moreover, many athletes are subjected to treatments that involve local lowering of the body temperature before, during, and after physical activity. This work reviews the current knowledge regarding the influence of local cryotherapy on the proprioception system. The reviewed literature identified several tests that evaluate different aspects of proprioception. There is no universally agreed protocol, or clear set of criteria for test conditions. The outcomes of different tests and assessments of cryotherapy procedures using different cold modalities are poorly correlated. In general, the published results on the mechanism of cryotherapy effects on proprioception are not uniquely conclusive and are frequently contradictory. Additional high-quality research is required to explicitly answer the following questions: (1) whether local cryotherapy influences all aspects of proprioception; (2) whether the current methods of evaluation are adequate for the exploration of the relationship between cryotherapy and proprioception; and (3) whether the application of local cryotherapy is safe for athletes regarding proprioception. The review clearly showed that there is no comprehensive model relating cryotherapy and proprioception.

Dispersal of radioisotope labelled solution following deep dermal injection in Ehlers-Danlos syndrome.

PubMed

Oliver, D W; Balan, K K; Burrows, N P; Hall, P N

2000-06-01

Ehlers-Danlos syndrome (EDS) is the commonest inherited disorder of connective tissue, affecting around 10 000 patients in the UK. Patients with EDS have reported that local anaesthetic is often ineffective. Patients with less severe skin laxity often have the most problems. We have postulated that this resistance to local anaesthetics is not due to the lax connective tissues as is often assumed. This study used radioactively labelled solution ((99m)Tc-pertechnetate) administered as a deep dermal injection in the forearm. The rate of dispersal of isotope was measured over 60 min and found to be identical between six patients with EDS and three controls. The effects of local anaesthetics are complex and depend on the individual chemical properties of the agent and a number of tissue factors. This study would suggest that the lack of effectiveness of local anaesthetic solutions is not due to rapid dispersal of solution. It is unlikely therefore that its lack of effect can be compensated for by simply increasing the amount used. The diagnosis of EDS should be considered in any patient who complains unexpectedly of pain during their procedure, particularly when the surgeon knows that an adequate volume of local anaesthetic has been used. Copyright 2000 The British Association of Plastic Surgeons.

After-action review of the 2009-10 H1N1 Influenza Outbreak Response: Ohio's Public Health System's performance.

PubMed

Mase, William A; Bickford, Beth; Thomas, Casey L; Jones, Shamika D; Bisesi, Michael

In early 2009, H1N1 influenza was identified within the human population. Centers for Disease Control and Prevention (CDC) officials responded with focused assessment, policy development, and assurances. The response was mobilized through efforts including procurement of adequate vaccine supply, local area span of control, materials acquisition, and facilities and resource identification. Qualitative evaluation of the assurance functions specific to the system's ability to assure safe and healthy conditions are reported. The methodology mirrors the Homeland Security Exercise and Evaluation Program used to assess system capability. Findings demonstrate the effectiveness of community responsive disease prevention efforts in partnership with the public health systems mission to unify traditional public sector systems, for-profit systems, and local area systems was accomplished. As a result of this response pharmaceutical industries, healthcare providers, healthcare agencies, police/safety, colleges, and health and human service agencies were united. Findings demonstrate the effectiveness of community response strategies utilizing feedback from system stakeholders. After-action review processes are critical in all-hazards preparedness. This analysis of local health district response to the H1N1 influenza outbreak informs future public health service delivery. Results provide a synthesis of local health department's emergency response strategies, challenges encountered, and future-focused emergency response strategy implementation. A synthesis is provided as to policy and practice developments which have emerged over the past seven years with regard to lessons learned from the 2009-10 H1N1 influenza outbreak and response.

[Peroperative risks in cerebral aneurysm surgery].

PubMed

Mustaki, J P; Bissonnette, B; Archer, D; Boulard, G; Ravussin, P

1996-01-01

The perioperative complications associated with cerebral aneurysm surgery require a specific anaesthetic management. Four major perioperative accidents are discussed in this review. The anaesthetic and surgical management in case of rebleeding subsequent to the re-rupture of the aneurysm is mainly prophylactic. It includes haemodynamic stability assurance, maintenance of mean arterial pressure (MAP) between 80-90 mmHg during stimulation of the patient such as endotracheal intubation, application of the skull-pin head-holder, incision, and craniotomy. The aneurysmal transmural pressure should be adequately maintained by avoiding an aggressive decrease of intracranial pressure. Once the skull is open, the brain must be kept slack in order to decrease pressure under the retractors and avoid the risks of stretching and tearing of the adjacent vessels. If, despite these precautions, the aneurysm ruptures again. MAP should be decreased to 60 mmHg and the brain rendered more slack, in order to allow direct clipping of the aneurysm, or temporary clipping of the adjacent vessels. The optimal agents in this situation are isoflurane (which decreases CMRO2), intravenous anaesthetic agents (inspite their negative inotropic effect, they may potentially protect the brain) and sodium nitroprusside. Vasospasm occurs usually between the 3rd and the 7th day after subarachnoid haemorrhage. It may be seen peroperatively. The optimal treatment, as well as prophylaxis, is moderate controlled hypertension (MAP > 100 mmHg), associated with hypervolaemia and haemodilution, the so-called triple H therapy, with strict control of the filling pressures. Other beneficial therapies are calcium antagonists (nimodipine and nicardipine), the removal of the blood accumulated around the brain and in the cisternae, and possibly local administration of papaverine. Abrupt MAP increases are controlled in order to maintain adequate aneurysmal transmural pressure. Beta-blockers, local anaesthetics administered locally or intravenously, a carefully titrated level of anaesthesia, a maintained volaemia play a protective role. Cerebral oedema is sometimes already present at the opening of the skull or may arise later, due to a high pressure under the retractors, to the surgical manipulations of the brain or to brain ischaemia subsequent to temporary clipping. Its treatment is aggressive, with intravenous agents, mannitol, deep hypocapnia and/or lumbar drainage. Prophylaxis, according to the "brain homeostasis concept", is the preferred method to avoid these four peroperative accidents. It includes normal blood volume, normoglycaemia, moderate hypocapnia, normotension, soft manipulation of the brain and optimal brain relaxation.

Control landscapes are almost always trap free: a geometric assessment

NASA Astrophysics Data System (ADS)

Russell, Benjamin; Rabitz, Herschel; Wu, Re-Bing

2017-05-01

A proof is presented that almost all closed, finite dimensional quantum systems have trap free (i.e. free from local optima) landscapes for a large and physically general class of circumstances, which includes qubit evolutions in quantum computing. This result offers an explanation for why gradient-based methods succeed so frequently in quantum control. The role of singular controls is analyzed using geometric tools in the case of the control of the propagator, and thus in the case of observables as well. Singular controls have been implicated as a source of landscape traps. The conditions under which singular controls can introduce traps, and thus interrupt the progress of a control optimization, are discussed and a geometrical characterization of the issue is presented. It is shown that a control being singular is not sufficient to cause control optimization progress to halt, and sufficient conditions for a trap free landscape are presented. It is further shown that the local surjectivity (full rank) assumption of landscape analysis can be refined to the condition that the end-point map is transverse to each of the level sets of the fidelity function. This mild condition is shown to be sufficient for a quantum system’s landscape to be trap free. The control landscape is shown to be trap free for all but a null set of Hamiltonians using a geometric technique based on the parametric transversality theorem. Numerical evidence confirming this analysis is also presented. This new result is the analogue of the work of Altifini, wherein it was shown that controllability holds for all but a null set of quantum systems in the dipole approximation. These collective results indicate that the availability of adequate control resources remains the most physically relevant issue for achieving high fidelity control performance while also avoiding landscape traps.

The cold chain and the expanded program on immunization in Chile: an evaluation exercise.

PubMed

Carrasco, R; Dinstrans, R; Montaldo, I; Medina, E; Reyes, M; Vergara, I; Piwonka, A; Thomas, E R

1982-01-01

It was decided that a study of the cold chain should be conducted in Chile in an effort to identify situations that could be corrected and to improve the technical and administrative development of the program. Specifically, study objectives were as follows: to determine the degree to which the EPI standards for procurement, receipt, transfer, control, maintenance, and distribution of vaccines were being met; to assess the turnover, knowledge, and training of auxiliary vaccination personnel against the relevant standards established for vaccine and cold chain management; to determine the antigenic potency of measles vaccine samples available at the time visits were made to local clinics, regional health storage sites, and the central supply facility; and to test a written instrument designed for the express purpose of assessing achievement of the first 2 objectives cited. The study sought to provide a descriptive assessment of work being performed at the central, regional, and local levels in the Metropolitan Region. The operating units involved included the airport and main supply center at the central level; the 7 storage facilities of the Metropolitan Region's 78 local clinics providing maternal and child health care. 40 clinics, selected by lot, represented 51% of the region's 78 clinics and provided coverage for 49% of the population assigned to the region's health services. The units studied failed to satisfy half the investigated Expanded Program for Immunization (EPI) standards, i.e., the average achievement rating of the 3 levels combined (49.3%) fell short of half the desired 100%. The airport unit met very few of the EPI implementation standards, scoring only 20% in this area. Deficiencies were found in systems for shipping vaccine in cold boxes, for making cold rooms permanently available, and for providing adequate vaccine transportation. The central supply facility, responsible for the purchase, storage, distribution, and maintenance of an adequate vaccine stock, had an achievement score of only 41%. The regional level, represented by the 7 storage facilities studied, obtained a lower overall achievement score than the other 2 levels and appears to be a high-risk link in the cold chain. The local level, represented by the 40 clinics studied, attained the highest average achievement score of any level (57%). Yet, serious deficiencies also emerged at this level, particularly regarding implementation and control activities. These deficiencies were aggravated by the fact that vaccines undoubtedly encounter a larger number of potentially damaging contingencies at the local level than they do elsewhere. Suggestions are made for overcoming these difficulties.

Extraction of maxillary teeth by dental students without palatal infiltration of local anaesthesia: a randomised controlled trial.

PubMed

Khan, S R; Qazi, S R

2017-11-01

Palatal infiltration of local anaesthesia (LA) for maxillary tooth extractions is painful. One of the techniques for reducing the discomfort of this injection is to avoid it altogether. Given enough time, LA administered only as buccal infiltration diffuses to reach and anaesthetise the palatal tissues. The aim of this double-blind randomised controlled trial was to test the hypothesis that buccal infiltration alone of LA by dental students should be adequate for maxillary tooth extractions. Fifty adult patients presenting for single-tooth maxillary extractions were randomly allocated between two groups. The control group received palatal injections of 0.1 ml 2% lidocaine with 1:100,000 adrenaline, whilst the experimental group received a similar amount of saline (placebo). Extractions performed without further administration of LA were categorised as successful. Palatal infiltration of lidocaine with adrenaline was significantly more effective than saline (P = 0.002). Overall buccal infiltration alone was successful in 28% patients, with a 40% success rate in the posterior maxilla. Results suggest that dental students should, as a matter of routine, extract maxillary teeth with both buccal and palatal infiltration of LA, whilst buccal infiltration alone may be considered in the posterior maxilla. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Catch me if you can--the use of image guidance in the radiotherapy of an unusual case of esophageal cancer.

PubMed

Jensen, Alexandra D; Grehn, Christian; Nikoghosyan, Anna; Thieke, Christian; Krempien, Robert; Huber, Peter E; Debus, Jürgen; Münter, Marc W

2009-07-01

Despite maximum therapy the prognosis of esophageal carcinoma still remains extremely poor. New treatment strategies including improved radiation therapy techniques promise better outcome by improving local control through precise dose delivery due to higher conformality. A 62-year-old patient with locally advanced carcinoma of the gastroesophageal junction underwent definitive radiochemotherapy with intensity-modulated radiation therapy (IMRT). On positioning control with the in-room CT, the distal esophagus, and hence the tumor, was found to be highly mobile exhibiting changes in position of up to 4 cm from fraction to fraction. IMRT plans were created for various positions establishing a plan library to choose from as appropriate. CT scans were performed prior to each treatment fraction to clarify esophagus position in order to choose the adequate treatment plan. Image guidance was crucial in this unusual case of esophageal carcinoma. Without the information from position control CTs, the tumor would have received only about half the prescribed dose due to variations in position. For this specific case, in-room CT scans are probably superior to kilo- or megavoltage CTs due to the higher soft-tissue contrast enabling detection of positioning variation of the organ and offering the possibility to use the CT for treatment planning.

Results with OECD recommended positive control sensitizers in the maximization, Buehler and local lymph node assays.

PubMed

Basketter, D A; Selbie, E; Scholes, E W; Lees, D; Kimber, I; Botham, P A

1993-01-01

The guinea pig maximization test and the Buehler occluded patch test are used widely to identify the sensitization potential of new chemicals. This information enables toxicologists and/or regulatory authorities to determine whether a chemical should be classified formally as a skin sensitizer. Both to improve and to harmonize these assessments internationally, the OECD has recommended recently that moderate rather than strong contact sensitizers are used as positive control substances. The purpose is to ensure an adequate level of sensitivity in sensitization assays performed at specific testing establishments. Results from two laboratories reported here show that the minimum acceptable standard laid down by the OECD can be achieved and indeed commonly exceeded by a substantial margin. Furthermore, results with these positive controls in a new method, the local lymph node assay, also appear to satisfy similar criteria, suggesting results from this assay, including negative data, should be acceptable for classification purposes. However, a review of the way in which results with new chemicals will be interpreted for regulatory purposes, in the context of positive control data, reveals that considerable inadequacies still exist. It is recommended that ultimately, sensitization data can only be interpreted meaningfully (i.e. to protect humans from sensitization hazards) by considering the potency of the contact allergen in the context of the sensitivity of the assay performed at the particular testing institution.

Locally Sourced Capital for Small Businesses in Rural Communities

ERIC Educational Resources Information Center

Tampien, Jordan

2016-01-01

Lack of adequate access to capital is a major barrier for rural entrepreneurs. Washington State University Extension and the Association of Washington Cities partnered to explore and test an innovative local investment approach that provides access to capital and engages the community in the success of individual businesses. The approach offers…

20 CFR 654.402 - Variances.

Code of Federal Regulations, 2010 CFR

2010-04-01

... subpart by filing a written application for such a variance with the local Job Service office serving the... which the employer has taken to protect the health and safety of workers and adequately show that such... local Job Service office shall send the request to the State office which, in turn, shall forward it to...

Local anesthesia strategies for the patient with a "hot" tooth.

PubMed

Nusstein, John M; Reader, Al; Drum, Melissa

2010-04-01

Attaining local anesthesia for the treatment of teeth diagnosed with irreversible pulpitis ("hot" tooth) can be a challenge. This article looks at the strategies a dentist can use to help achieve adequate pulpal anesthesia for the patient, thereby eliminating or reducing treatment pain. Copyright 2010 Elsevier Inc. All rights reserved.

Injury control in practice. Home radiator burns in inner-city children.

PubMed

Quinlan, K P

1996-09-01

To describe thermal burns from radiators in the homes of children in the inner city and an intervention to decrease the risk for this pediatric injury. Academic medical center in Chicago. Case series of 10 radiator-related burns. The burns described were found to be clustered in an area of a public housing project served by steam radiators. No burns were associated with hot water radiators. Just 14% of housing units with young children had adequate radiator covers and radiator pipe insulation. Radiator covers and insulation have now been replaced or repaired in all units of the 11 housing project buildings served by steam radiators. Steam radiators in the home represent a particular childhood burn hazard. Community-based clinicians are in a unique position to recognize local patterns of injury and work with other agencies in injury control efforts.

Local people's attitudes towards conservation and wildlife tourism around Sariska Tiger Reserve, India.

PubMed

Udaya Sekhar, Nagothu

2003-12-01

Conservationists in the recent years view local peoples' support for protected areas management as an important element of biodiversity conservation. This is often linked to the direct benefits, which local communities get from the protected areas. These benefits could be in the form of biomass resources, park funds diverted to local villages by state agencies and revenue from wildlife tourism. There are a very few studies which have attempted to study the direct relationship between benefits from wildlife tourism and local support for conservation. In India, wildlife tourism is restricted, and mostly controlled by state and private agencies. Wildlife conservation policy does not view tourism in protected areas as a source of revenue for the local communities. The present study examines the local people's attitudes towards wildlife tourism and the impact of benefits from tourism on the local support for Sariska Tiger Reserve (STR), India. STR is a flagship for tourism where protected areas are increasingly being visited and where local support for wildlife tourism has not been studied adequately. Results indicate that two-thirds of the respondents were positive towards tourism and support for conservation. The respondents were aware that more tourism benefits are possible from a well-conserved protected area. There appears to be correlation between benefits obtained by local people from wildlife tourism and other sources, and support for protected area existence, suggesting that benefits impact people's attitudes towards conservation. Some of the main problems are the unequal distribution of tourism benefits, lack of locals' involvement in tourism and development. There is a need to clearly address these issues, so that protected areas may get the support of local people, which may lead to sustainable development.

Massive oral bleeding after full-mouth extraction in a patient with B-cell lymphocytic leukemia/small lymphocytic lymphoma reversed with recombinant activated factor VII.

PubMed

Sprenker, Collin; Omar, Hesham R; Powless, R Andrew; Mangar, Devanand; Camporesi, Enrico

2016-02-01

Full-mouth extraction can be associated with intraoral bleeding, which usually is controlled with local hemostatic measures. Recombinant activated factor VII (rFVIIa) occasionally is used to stop bleeding in a variety of off-label indications, with the main argument curtailing its use being thrombotic events. The authors describe the use of rFVIIa for bleeding after full-mouth extraction in a patient with undiagnosed B-cell lymphocytic leukemia/small lymphocytic lymphoma. A 72-year-old man underwent full-mouth extraction (18 teeth). The next day, the patient experienced massive oral bleeding. The authors administered tranexamic acid, aminocaproic acid, and a total of 12 units of packed red blood cells in addition to local hemostatic measures without control of bleeding. On postoperative day 10, the authors administered 5,000 micrograms of rFVIIa, and within 2 hours oral the bleeding ceased. The authors performed flow cytometry and diagnosed B-cell lymphocytic leukemia/small lymphocytic lymphoma. Unexplained massive oral bleeding despite adequate local hemostatic measures should prompt further investigations for underlying bleeding or coagulation disorders. The authors describe the successful use of rFVIIa in massive oral bleeding. Further studies are mandatory to study the effectiveness of this drug for this off-label indication. Copyright © 2016 American Dental Association. Published by Elsevier Inc. All rights reserved.

Local antimicrobial administration for prophylaxis of surgical site infections.

PubMed

Huiras, Paul; Logan, Jill K; Papadopoulos, Stella; Whitney, Dana

2012-11-01

Despite a lack of consensus guidelines, local antibiotic administration for prophylaxis of surgical site infections is used during many surgical procedures. The rationale behind this practice is to provide high antibiotic concentrations at the site of surgery while minimizing systemic exposure and adverse effects. Local antibiotic administration for surgical site prophylaxis has inherent limitations in that antibiotics are applied after the incision is made, rather than the current standard for surgical site prophylaxis that recommends providing adequate antibiotic concentrations at the site before the incision. The efficacy and safety of local application of antibiotics for surgical site prophylaxis have been assessed in different types of surgery with a variety of antibiotic agents and methods of application. We identified 22 prospective, randomized, controlled trials that evaluated local application of antibiotics for surgical site prophylaxis. These trials were subsequently divided and analyzed based on the type of surgical procedure: dermatologic, orthopedic, abdominal, colorectal, and cardiothoracic. Methods of local application analyzed included irrigations, powders, ointments, pastes, beads, sponges, and fleeces. Overall, there is a significant lack of level I evidence supporting this practice for any of the surgical genres evaluated. In addition, the literature spans several decades, and changes in surgical procedures, systemic antibiotic prophylaxis, and microbial flora make conclusions difficult to determine. Based on available data, the efficacy of local antibiotic administration for the prophylaxis of surgical site infections remains uncertain, and recommendations supporting this practice for surgical site prophylaxis cannot be made. © 2012 Pharmacotherapy Publications, Inc.

47 CFR 17.4 - Antenna structure registration.

Code of Federal Regulations, 2012 CFR

2012-10-01

... local notice shall contain all of the descriptive information as to geographic location, configuration... submitted by the prospective ASR applicant does not adequately evaluate the potentially significant...

47 CFR 17.4 - Antenna structure registration.

Code of Federal Regulations, 2013 CFR

2013-10-01

... local notice shall contain all of the descriptive information as to geographic location, configuration... submitted by the prospective ASR applicant does not adequately evaluate the potentially significant...

Intraseptal anesthesia: a review of a relevant injection technique.

PubMed

Woodmansey, Karl

2005-01-01

Although overshadowed by intraosseous anesthesia and the periodontal ligament injection, intraseptal anesthesia remains a useful local anesthesia technique for general dentists. Intraseptal anesthesia can be employed with safety and efficacy as an alternative to conventional local infiltration or regional nerve block injections. It also can serve as an adjunctive technique when conventional techniques fail to achieve adequate local anesthesia. This article reviews the intraseptal anesthesia technique, including its indications and limitations.

Integrated urban drainage, status and perspectives.

PubMed

Harremoës, P

2002-01-01

This paper summarises the status of urban storm drainage as an integrated professional discipline, including the management-policy interface, by which the goals of society are implemented. The paper assesses the development of the discipline since the INTERURBA conference in 1992 and includes aspects of the papers presented at the INTERURBA-II conference in 2001 and the discussions during the conference. Tools for integrated analysis have been developed, but there is less implementation than could be expected. That is due to lack of adequate knowledge about important mechanisms, coupled with a significant conservatism in the business. However, significant integrated analyses have been reported. Most of them deal with the sewer system and the treatment plant, while few incorporate the receiving water as anything but the object of the loads to be minimised by engineering measures up-stream. Important measures are local infiltration, source control, storage basins, local treatment and real time control. New paradigms have been introduced: risk of pollution due to system failure, technology for water reuse, sustainability, new architecture and greener up-stream solutions as opposed to down-stream concrete solutions. The challenge is to combine the inherited approaches with the new approaches by flexibility and adaptability.

Modelling the morphology of migrating bacterial colonies

NASA Astrophysics Data System (ADS)

Nishiyama, A.; Tokihiro, T.; Badoual, M.; Grammaticos, B.

2010-08-01

We present a model which aims at describing the morphology of colonies of Proteus mirabilis and Bacillus subtilis. Our model is based on a cellular automaton which is obtained by the adequate discretisation of a diffusion-like equation, describing the migration of the bacteria, to which we have added rules simulating the consolidation process. Our basic assumption, following the findings of the group of Chuo University, is that the migration and consolidation processes are controlled by the local density of the bacteria. We show that it is possible within our model to reproduce the morphological diagrams of both bacteria species. Moreover, we model some detailed experiments done by the Chuo University group, obtaining a fine agreement.

Financing State and Local Government: Future Challenges and Opportunities.

ERIC Educational Resources Information Center

Wildasin, David E.; Childress, Michael T.; Hackbart, Merl; Lynch, Lawrence K.; Martie, Charles W.

This report focuses on state and local taxation in the state of Kentucky. It looks into what "the ideal" tax system looks like and how Kentucky's system compares, whether the current system will provide adequate revenue for the long-term, whether the tax system is efficient, how fair and equitable the tax system is, and whether the state…

Further Education outside the Jurisdiction of Local Education Authorities in Post-War England

ERIC Educational Resources Information Center

Simmons, Robin

2014-01-01

This article revisits the three decades following the end of World War Two--a time when, following the 1944 Education Act, local education authorities (LEAs) were the key agencies responsible for running the education system across England. For the first time, there was a statutory requirement for LEAs to secure adequate facilities for further…

Report: EPA Has Adequate Controls to Manage Advice From Science and Research Federal Advisory Committees, but Transparency Could Be Improved

EPA Pesticide Factsheets

Report #17-P-0124, March 13, 2017. Science plays an integral role in the EPA's mission. The EPA has an adequate system of controls to manage recommendations from its science and research federal advisory committees.

40 CFR 716.25 - Adequate file search.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 32 2013-07-01 2013-07-01 false Adequate file search. 716.25 Section 716.25 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT HEALTH AND SAFETY DATA REPORTING General Provisions § 716.25 Adequate file search. The scope of a...

40 CFR 716.25 - Adequate file search.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 30 2010-07-01 2010-07-01 false Adequate file search. 716.25 Section 716.25 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT HEALTH AND SAFETY DATA REPORTING General Provisions § 716.25 Adequate file search. The scope of a...

40 CFR 716.25 - Adequate file search.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 31 2014-07-01 2014-07-01 false Adequate file search. 716.25 Section 716.25 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT HEALTH AND SAFETY DATA REPORTING General Provisions § 716.25 Adequate file search. The scope of a...

40 CFR 716.25 - Adequate file search.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 32 2012-07-01 2012-07-01 false Adequate file search. 716.25 Section 716.25 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT HEALTH AND SAFETY DATA REPORTING General Provisions § 716.25 Adequate file search. The scope of a...

40 CFR 716.25 - Adequate file search.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 31 2011-07-01 2011-07-01 false Adequate file search. 716.25 Section 716.25 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT HEALTH AND SAFETY DATA REPORTING General Provisions § 716.25 Adequate file search. The scope of a...

Modeling Elevation and Aspect Controls on Emerging Ecohydrologic Processes and Ecosystem Patterns Using the Component-based Landlab Framework

NASA Astrophysics Data System (ADS)

Nudurupati, S. S.; Istanbulluoglu, E.; Adams, J. M.; Hobley, D. E. J.; Gasparini, N. M.; Tucker, G. E.; Hutton, E. W. H.

2014-12-01

Topography plays a commanding role on the organization of ecohydrologic processes and resulting vegetation patterns. In southwestern United States, climate conditions lead to terrain aspect- and elevation-controlled ecosystems, with mesic north-facing and xeric south-facing vegetation types; and changes in biodiversity as a function of elevation from shrublands in low desert elevations, to mixed grass/shrublands in mid elevations, and forests at high elevations and ridge tops. These observed patterns have been attributed to differences in topography-mediated local soil moisture availability, micro-climatology, and life history processes of plants that control chances of plant establishment and survival. While ecohydrologic models represent local vegetation dynamics in sufficient detail up to sub-hourly time scales, plant life history and competition for space and resources has not been adequately represented in models. In this study we develop an ecohydrologic cellular automata model within the Landlab component-based modeling framework. This model couples local vegetation dynamics (biomass production, death) and plant establishment and competition processes for resources and space. This model is used to study the vegetation organization in a semiarid New Mexico catchment where elevation and hillslope aspect play a defining role on plant types. Processes that lead to observed plant types across the landscape are examined by initializing the domain with randomly assigned plant types and systematically changing model parameters that couple plant response with soil moisture dynamics. Climate perturbation experiments are conducted to examine the plant response in space and time. Understanding the inherently transient ecohydrologic systems is critical to improve predictions of climate change impacts on ecosystems.

78 FR 21000 - Self-Regulatory Organizations; Chicago Mercantile Exchange Inc.; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-08

... adequate accounting system, internal accounting controls, and procedures for safeguarding customer and firm... an adequate accounting system, internal accounting controls, and procedures for safeguarding customer... ability to provide to the Exchange in an acceptable form a complete set of equity system reports...

Does Radiotherapy after Surgery Affect Outcomes in Ewing's Sarcoma of the Pelvis?

PubMed

Puri, Ajay; Gulia, Ashish; Crasto, Saniya; Vora, Tushar; Khanna, Nehal; Laskar, Siddharth

2018-01-01

The impact of postoperative radiotherapy (PORT) on outcomes has been a matter of debate after adequate resection in Ewing's sarcoma of the pelvis. We evaluated our cases after surgical excision in pelvic Ewing's sarcoma and assessed local control and overall survival (OS) with respect to PORT and chemotherapy-induced percentage necrosis. Forty four surgically operated patients (June 2002-November 2014) of localized Ewing's sarcoma were retrospectively reviewed. There were 31 males and 13 females. Age ranged from 2 to 53 years. All patients received institutional chemotherapy protocol. No patient received preoperative radiotherapy. Specimen was analyzed for margins and chemotherapy-induced percentage necrosis. PORT was offered to patients on case-by-case basis. Presence of a large preoperative soft-tissue component, margin evaluation, and percentage necrosis were factors considered. At time of the last followup, 29 patients were alive, 11 died, and 4 were lost to followup. Survivors had a minimum followup of 2 years (range: 31-118 months, mean = 69 months). One of twenty (5%) patients with PORT had a local recurrence as against 2 of 24 (8%) without PORT. OS of all patients was 76% at 5 years. Twelve patients with <90% necrosis had OS of 56% and 32 with >90% necrosis had OS of 83% ( P = 0.040). OS of patients with PORT was 74%, without PORT was 78% ( P = 0.629). The decision to offer PORT after surgical excision in pelvic Ewing's sarcoma is multifactorial; the absence of PORT in selected cases is not detrimental to local control. Poor responders to chemotherapy had poorer survival while PORT did not impact on outcomes.

Local exhaust ventilation for the control of welding fumes in the construction industry--a literature review.

PubMed

Flynn, Michael R; Susi, Pam

2012-08-01

Arc welding is a common unit operation in the construction industry, where frequent changes in location and welding position make it more difficult to control fume exposures than in industries where fixed locations are the norm. Welders may be exposed to a variety of toxic airborne contaminants including manganese (Mn) and hexavalent chromium (CrVI). Local exhaust ventilation (LEV) is a well-known engineering control for welding fumes but has not been adopted widely in the construction industry. This literature review presents data on the performance of a variety of LEV systems for welding fume control from the construction (five references), shipyard (five references), and other industries. The studies indicate that LEV can reduce fume exposures to total particulate, Mn, and CrVI to levels below currently relevant standards. Field studies suggest that 40-50% or more reduction in exposure is possible with portable or fixed LEV systems relative to natural ventilation but that correct positioning of the hood and adequate exhaust flow rates are essential. Successful implementation of extraction guns for gas metal arc welding (GMAW) and flux core arc welding has been demonstrated, indicating that a successful balance between extraction airflow and shielding gas requirements is possible. Work practices are an important part of achieving successful control of fume exposures; in particular, positioning the hood close to the arc, checking exhaust flow rates, and avoiding the plume. Further research is needed on hood size effects for controlling welding fume with portable LEV systems and identifying and overcoming barriers to LEV use in construction.

Diffusion and utilization of scientific and technological knowledge within state and local governments

NASA Technical Reports Server (NTRS)

Feller, I.; Flanary, P. E.

1979-01-01

The state-of-the-art is reviewed concerning current knowledge of processes by which technological innovation and scientific information are disseminated among state and local governments. The effectiveness of various mechanisms, strategies, and approaches by which federal agencies have sought to transfer technology to state, regional, and city governments are assessed. It is concluded that the existing relationships between the state and local governments, and the scientific communities are not adequate.

77 FR 34337 - Lake Tahoe Federal Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-11

... associations, (8) education, (9) property rights advocates, (10) science and research, (11) California local... adequately represented on the LTFAC. We encourage and welcome applications for qualified female, minority, or...

Development of the Optimum Operation Scheduling Model of Domestic Electric Appliances for the Supply-Demand Adjustment in a Power System

NASA Astrophysics Data System (ADS)

Ikegami, Takashi; Iwafune, Yumiko; Ogimoto, Kazuhiko

The high penetration of variable renewable generation such as Photovoltaic (PV) systems will cause the issue of supply-demand imbalance in a whole power system. The activation of the residential power usage, storage and generation by sophisticated scheduling and control using the Home Energy Management System (HEMS) will be needed to balance power supply and demand in the near future. In order to evaluate the applicability of the HEMS as a distributed controller for local and system-wide supply-demand balances, we developed an optimum operation scheduling model of domestic electric appliances using the mixed integer linear programming. Applying this model to several houses with dynamic electricity prices reflecting the power balance of the total power system, it was found that the adequate changes in electricity prices bring about the shift of residential power usages to control the amount of the reverse power flow due to excess PV generation.

Localized delivery of growth factors for periodontal tissue regeneration: role, strategies, and perspectives.

PubMed

Chen, Fa-Ming; Shelton, Richard M; Jin, Yan; Chapple, Iain L C

2009-05-01

Difficulties associated with achieving predictable periodontal regeneration, means that novel techniques need to be developed in order to regenerate the extensive soft and hard tissue destruction that results from periodontitis. Localized delivery of growth factors to the periodontium is an emerging and versatile therapeutic approach, with the potential to become a powerful tool in future regenerative periodontal therapy. Optimized delivery regimes and well-defined release kinetics appear to be logical prerequisites for safe and efficacious clinical application of growth factors and to avoid unwanted side effects and toxicity. While adequate concentrations of growth factor(s) need to be appropriately localized, delivery vehicles are also expected to possess properties such as protein protection, precision in controlled release, biocompatibility and biodegradability, self-regulated therapeutic activity, potential for multiple delivery, and good cell/tissue penetration. Here, current knowledge, recent advances, and future possibilities of growth factor delivery strategies are outlined for periodontal regeneration. First, the role of those growth factors that have been implicated in the periodontal healing/regeneration process, general requirements for their delivery, and the different material types available are described. A detailed discussion follows of current strategies for the selection of devices for localized growth factor delivery, with particular emphasis placed upon their advantages and disadvantages and future prospects for ongoing studies in reconstructing the tooth supporting apparatus.

Care provider order entry (CPOE): a perspective on factors leading to success or to failure.

PubMed

Ozdas, A; Miller, R A

2007-01-01

Authors provide a perspective on factors leading to successful care provider order entry (CPOE) implementations. Viewpoint of authors supported by background literature review. Authors review both benefits and challenges related to CPOE implementation using three guiding principles: (1) a clinical approach to clinical systems, which claims that CPOE implementation is analogous to a "good" clinician delivering care to a patient; (2) a commitment to quality, which advocates that no compromises should be made in implementing system functionality and clinical system content - the highest objective for CPOE implementation is to provide better quality of care and increased safety for patients; (3) a commitment to fairness, as evidenced by respect for individuals and support of local autonomy, which advocates for minimizing disruptions to clinician-users' workflows, and adequate local control over CPOE system design and evolution, including clinical content management. Past experiences with CPOE implementation can inform future installation attempts. Sociocultural factors dominate in determining the success of implementation, and should govern technical factors.

Are There Enough Doctors in My Rural Community? Perceptions of the Local Physician Supply

ERIC Educational Resources Information Center

Biola, Holly; Pathman, Donald E.

2009-01-01

Purpose: To assess whether people in the rural Southeast perceive that there is an adequate number of physicians in their communities, assess how these perceptions relate to county physician-to-population (PtP) ratios, and identify other factors associated with the perception that there are enough local physicians. Methods: Adults (n = 4,879) from…

Effects of Distant Green Space on Physical Activity in Sydney, Australia.

PubMed

Chong, Shanley; Byun, Roy; Mazumdar, Soumya; Bauman, Adrian; Jalaludin, Bin

2017-01-01

The aim was to investigate the association between distant green space and physical activity modified by local green space. Information about physical activity, demographic and socioeconomic background at the individual level was extracted from the New South Wales Population Health Survey. The proportion of a postcode that was parkland was used as a proxy measure for access to parklands and was calculated for each individual. There was a significant relationship between distant green space and engaging in moderate-to-vigorous physical activity (MVPA) at least once a week. No significant relationship was found between adequate physical activity and distant green space. No significant relationships were found between adequate physical activity, engaging in MVPA, and local green space. However, if respondents lived in greater local green space (≥25%), there was a significant relationship between engaging in MVPA at least once a week and distance green space of ≥20%. This study highlights the important effect of distant green space on physical activity. Our findings also suggest that moderate size of local green space together with moderate size of distant green space are important levers for participation of physical activity.

Colorado Springs dedicates zero-discharge coal plant. [Ray D. Nixon plant

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

Hennessy, M.; Zeien, C.T.

1980-12-01

The zero-discharge Ray D. Nixon coal-fired power plant was designed to treat and recycle effluents in a region with limited water supplies. The site purchase included groundwater rights and some diversion rights, but a properly-managed local aquifer was determined to be adequate. The closed-loop design recovers 95 percent of the water for reuse. The overall water-management system produces adequate water and treats effluents at less cost and with higher water-quality protection than alternate systems. (DCK)

21 CFR 113.40 - Equipment and procedures.

Code of Federal Regulations, 2014 CFR

2014-04-01

... have adequate filter systems to ensure a supply of clean, dry air. A steam controller activated by the... ensure a supply of clean, dry air. (5) Steam introduction. Steam shall be distributed in the bottom of... temperature controllers should have adequate filter systems to ensure a supply of clean, dry air. (5) Bleeders...

21 CFR 113.40 - Equipment and procedures.

Code of Federal Regulations, 2013 CFR

2013-04-01

... have adequate filter systems to ensure a supply of clean, dry air. A steam controller activated by the... ensure a supply of clean, dry air. (5) Steam introduction. Steam shall be distributed in the bottom of... temperature controllers should have adequate filter systems to ensure a supply of clean, dry air. (5) Bleeders...

21 CFR 113.40 - Equipment and procedures.

Code of Federal Regulations, 2012 CFR

2012-04-01

... have adequate filter systems to ensure a supply of clean, dry air. A steam controller activated by the... ensure a supply of clean, dry air. (5) Steam introduction. Steam shall be distributed in the bottom of... temperature controllers should have adequate filter systems to ensure a supply of clean, dry air. (5) Bleeders...

Skin temperature response to cryotherapy.

PubMed

Chesterton, Linda S; Foster, Nadine E; Ross, Lesley

2002-04-01

To compare the localized skin-cooling effects of 2 cryotherapy modalities and to review the clinical relevance of the results. Randomized controlled trial with repeated measures. Laboratory experiment. Convenience sample of 20 volunteers (13 women, 7 men), ages 21.3 to 44 years (mean, 31.3 +/- 6.8 y). A flexible frozen gel pack, a 454 g packet of frozen peas, or a control applied to the anterior thigh. No blinding was undertaken. Surface skin temperature under the modality at baseline and 10 and 20 minutes after application. Significant effects were recorded for modality (F(2) = 290.56, P <.0001), time (F(1.27) = 1868.07, P <.0001), and their interaction (F(2.09) = 305.47, P <.0001). After 20 minutes, frozen peas produced the lowest mean skin temperature +/- standard deviation of 10.8 degrees C +/- 2.28 degrees C compared with 14.4 degrees C +/- 2.53 degrees C from the gel pack and 26.1 degrees C +/- 1.75 degrees C from the control. Skin temperature fell between both time periods with the application of frozen peas but stabilized after 10 minutes of gel pack and control application. Application of frozen peas produced mean skin temperatures adequate to induce localized skin analgesia, to reduce nerve conduction velocity, and to reduce metabolic enzyme activity to clinically relevant levels. Flexible frozen gel packs did not cool skin sufficiently to achieve these levels. Copyright 2002 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

21 CFR 110.80 - Processes and controls.

Code of Federal Regulations, 2011 CFR

2011-04-01

... safe and of adequate sanitary quality. (12) Batters, breading, sauces, gravies, dressings, and other...) Cooling to an adequate temperature during manufacturing. (vi) Disposing of batters at appropriate...

Exposure control practices for administering nitrous oxide: A survey of dentists, dental hygienists, and dental assistants.

PubMed

Boiano, James M; Steege, Andrea L; Sweeney, Marie H

2017-06-01

Engineering, administrative, and work practice controls have been recommended for many years to minimize exposure to nitrous oxide during dental procedures. To better understand the extent to which these exposure controls are used, the NIOSH Health and Safety Practices Survey of Healthcare Workers was conducted among members of professional practice organizations representing dentists, dental hygienists and dental assistants. The anonymous, modular, web-based survey was completed by 284 dental professionals in private practice who administered nitrous oxide to adult and/or pediatric patients in the seven days prior to the survey. Use of primary engineering controls (i.e., nasal scavenging mask and/or local exhaust ventilation (LEV) near the patient's mouth) was nearly universal, reported by 93% and 96% of respondents who administered to adult (A) and pediatric (P) patients, respectively. However, adherence to other recommended precautionary practices were lacking to varying degrees, and were essentially no different among those administering nitrous oxide to adult or pediatric patients. Examples of work practices which increase exposure risk, expressed as percent of respondents, included: not checking nitrous oxide equipment for leaks (41% A; 48% P); starting nitrous oxide gas flow before delivery mask or airway mask was applied to patient (13% A; 12% P); and not turning off nitrous oxide gas flow before turning off oxygen flow to the patient (8% A; 7% P). Absence of standard procedures to minimize worker exposure to nitrous oxide (13% of all respondents) and not being trained on safe handling and administration of nitrous oxide (3%) were examples of breaches of administrative controls which may also increase exposure risk. Successful management of nitrous oxide emissions should include properly fitted nasal scavenging masks, supplemental LEV (when nitrous oxide levels cannot be adequately controlled using nasal masks alone), adequate general ventilation, regular inspection of nitrous oxide delivery and scavenging equipment for leaks, availability of standard procedures to minimize exposure, periodic training, ambient air and exposure monitoring, and medical surveillance.

Recording epileptic activity with MEG in a light-weight magnetic shield.

PubMed

De Tiège, Xavier; Op de Beeck, Marc; Funke, Michael; Legros, Benjamin; Parkkonen, Lauri; Goldman, Serge; Van Bogaert, Patrick

2008-12-01

Ten patients with focal epilepsy were studied with magnetoencephalography (MEG) to determine if a new light-weight magnetically shielded room (lMSR) provides sufficient attenuation of magnetic interference to detect and localize the magnetic correlates of epileptic activity. Interictal MEG epileptic events co-localizing with the presumed location of the epileptogenic zone were found in all patients. MEG measurements performed in the lMSR provide an adequate signal-to-noise ratio for non-invasive localization of epileptic foci.

Case study of odor and indoor air quality assessment in the dewatering building at the Stickney Water Reclamation Plant.

PubMed

Sharma, Manju; O'Connell, Susan; Garelli, Brett; Sattayatewa, Chakkrid; Moschandreas, Demetrios; Pagilla, Krishna

2012-01-01

Indoor air quality (IAQ) and odors were determined using sampling/monitoring, measurement, and modeling methods in a large dewatering building at a very large water reclamation plant. The ultimate goal was to determine control strategies to reduce the sensory impacts on the workforce and achieve odor reduction within the building. Study approaches included: (1) investigation of air mixing by using CO(2) as an indicator, (2) measurement of airflow capacity of ventilation fans, (3) measurement of odors and odorants, (4) development of statistical and IAQ models, and (5) recommendation of control strategies. The results showed that air quality in the building complies with occupational safety and health guidelines; however, nuisance odors that can increase stress and productivity loss still persist. Excess roof fan capacity induced odor dispersion to the upper levels. Lack of a local air exhaust system of sufficient capacity and optimum design was found to be the contributor to occasional less than adequate indoor air quality and odors. Overall, air ventilation rate in the building has less effect on persistence of odors in the building. Odor/odorant emission rates from centrifuge drops were approximately 100 times higher than those from the open conveyors. Based on measurements and modeling, the key control strategies recommended include increasing local air exhaust system capacity and relocation of exhaust hoods closer to the centrifuge drops.

Hypertension in Developing Countries: A Major Challenge for the Future.

PubMed

Mohsen Ibrahim, M

2018-05-01

Outline recent epidemiologic data regarding hypertension in developing countries, distinguish differences from developed countries, and identify challenges in management and future perspectives. Increased sugar intake, air and noise pollution, and low birth weight are emerging hypertension risk factors. The major challenges in management are difficulties in accurate diagnosis of hypertension and adequate blood pressure control. In contrast to developed countries, hypertension prevalence rates are on the rise in developing countries with no improvement in awareness or control rates. The increasing burden of hypertension is largely attributable to behavioral factors, urbanization, unhealthy diet, obesity, social stress, and inactivity. Health authorities, medical societies, and drug industry can collaborate to improve hypertension control through education programs, public awareness campaigns, legislation to limit salt intake, encourage generic drugs, development and dissemination of national guidelines, and involving nurses and pharmacists in hypertension management. More epidemiologic data are needed in the future to identify reasons behind increased prevalence and poor blood pressure control and examine trends in prevalence, awareness, treatment, and control. National programs for better hypertension control based on local culture, economic characteristics, and available resources in the population are needed. The role of new tools for hypertension management should be tested in developing world.

40 CFR 310.16 - What kind of cost documentation is necessary?

Code of Federal Regulations, 2010 CFR

2010-07-01

...) SUPERFUND, EMERGENCY PLANNING, AND COMMUNITY RIGHT-TO-KNOW PROGRAMS REIMBURSEMENT TO LOCAL GOVERNMENTS FOR... cost documentation is necessary? Cost documentation must be adequate for an audit. At a minimum, you...

Brain shaving: adaptive detection for brain PET data

NASA Astrophysics Data System (ADS)

Grecchi, Elisabetta; Doyle, Orla M.; Bertoldo, Alessandra; Pavese, Nicola; Turkheimer, Federico E.

2014-05-01

The intricacy of brain biology is such that the variation of imaging end-points in health and disease exhibits an unpredictable range of spatial distributions from the extremely localized to the very diffuse. This represents a challenge for the two standard approaches to analysis, the mass univariate and the multivariate that exhibit either strong specificity but not as good sensitivity (the former) or poor specificity and comparatively better sensitivity (the latter). In this work, we develop an analytical methodology for positron emission tomography that operates an extraction (‘shaving’) of coherent patterns of signal variation while maintaining control of the type I error. The methodology operates two rotations on the image data, one local using the wavelet transform and one global using the singular value decomposition. The control of specificity is obtained by using the gap statistic that selects, within each eigenvector, a subset of significantly coherent elements. Face-validity of the algorithm is demonstrated using a paradigmatic data-set with two radiotracers, [11C]-raclopride and [11C]-(R)-PK11195, measured on the same Huntington's disease patients, a disorder with a genetic based diagnosis. The algorithm is able to detect the two well-known separate but connected processes of dopamine neuronal loss (localized in the basal ganglia) and neuroinflammation (diffusive around the whole brain). These processes are at the two extremes of the distributional envelope, one being very sparse and the latter being perfectly Gaussian and they are not adequately detected by the univariate and the multivariate approaches.

Nasopharyngeal carcinoma.

PubMed

Kamran, Sophia C; Riaz, Nadeem; Lee, Nancy

2015-07-01

Nasopharyngeal carcinoma is uncommon in the United States, with only 0.2 to 0.5 cases per 100,00 people; this is in contrast to southern China and Hong Kong, where the incidence is 25 to 50 per 100,000 people. There is a potential link between Epstein-Barr virus and the development of nasopharyngeal carcinoma. Radiotherapy alone as a single modality leads to similar 10-year survival rates in United States, Denmark, and Hong Kong (34%, 37%, and 43%, respectively). Multiple studies have shown an advantage to concurrent chemoradiation in the treatment of advanced disease. Radiation therapy remains the mainstay of salvage therapy, and modern techniques have allowed clinicians to achieve adequate local control without excessive toxicity. Copyright © 2015 Elsevier Inc. All rights reserved.

Pre-slip and Localized Strain Band - A Study Based on Large Sample Experiment and DIC

NASA Astrophysics Data System (ADS)

Ji, Y.; Zhuo, Y. Q.; Liu, L.; Ma, J.

2017-12-01

Meta-instability stage (MIS) is the stage occurs between a fault reaching the peak differential stress and the onset of the final stress drop. It is the crucial stage during which a fault transits from "stick" to "slip". Therefore, if one can quantitatively analyze the spatial and temporal characteristics of the deformation field of a fault at MIS, it will be of great significance both to fault mechanics and earthquake prediction study. In order to do so, a series of stick-slip experiments were conducted using a biaxial servo-controlled pressure machine. Digital images of the sample surfaces were captured by a high speed camera and processed using a digital image correlation method (DIC). If images of a rock sample are acquired before and after deformation, then DIC can be used to infer the displacement and strain fields. In our study, sample images were captured at the rate of 1000 frame per second and the resolution is 2048 by 2048 in pixel. The displacement filed, strain filed and fault displacement were calculated from the captured images. Our data shows that (1) pre-sliding can be a three-stage process, including a relative long and slow first stage at slipping rate of 7.9nm/s, a relatively short and fast second one at rate of 3µm/s and the last stage only last for 0.2s but the slipping rate reached as high as 220µm/s. (2) Localized strain bands were observed nearly perpendicular to the fault. A possible mechanism is that the pre-sliding is distributed heterogeneously along the fault, which means there are relatively adequately sliding segments and the less sliding ones, they become the constrain condition of deformation of the adjacent subregion. The localized deformation band tends to radiate from the discontinuity point of sliding. While the adequately sliding segments are competing with the less sliding ones, the strain bands are evolving accordingly.

Estimating the financial resources needed for local public health departments in Minnesota: a multimethod approach.

PubMed

Riley, William; Briggs, Jill; McCullough, Mac

2011-01-01

This study presents a model for determining total funding needed for individual local health departments. The aim is to determine the financial resources needed to provide services for statewide local public health departments in Minnesota based on a gaps analysis done to estimate the funding needs. We used a multimethod analysis consisting of 3 approaches to estimate gaps in local public health funding consisting of (1) interviews of selected local public health leaders, (2) a Delphi panel, and (3) a Nominal Group Technique. On the basis of these 3 approaches, a consensus estimate of funding gaps was generated for statewide projections. The study includes an analysis of cost, performance, and outcomes from 2005 to 2007 for all 87 local governmental health departments in Minnesota. For each of the methods, we selected a panel to represent a profile of Minnesota health departments. The 2 main outcome measures were local-level gaps in financial resources and total resources needed to provide public health services at the local level. The total public health expenditure in Minnesota for local governmental public health departments was $302 million in 2007 ($58.92 per person). The consensus estimate of the financial gaps in local public health departments indicates that an additional $32.5 million (a 10.7% increase or $6.32 per person) is needed to adequately serve public health needs in the local communities. It is possible to make informed estimates of funding gaps for public health activities on the basis of a combination of quantitative methods. There is a wide variation in public health expenditure at the local levels, and methods are needed to establish minimum baseline expenditure levels to adequately treat a population. The gaps analysis can be used by stakeholders to inform policy makers of the need for improved funding of the public health system.

The Role of Transanal Surgery in the Management of T1 Rectal Cancers.

PubMed

Hassan, Imran; Wise, Paul E; Margolin, David A; Fleshman, James W

2015-09-01

The management of T1 rectal cancers is based on finding the balance between optimal oncologic outcomes and acceptable functional results for the patient. While radical resection involving a proctectomy is considered the most oncologically adequate option, its adverse effects on patient reported outcomes makes this a less than ideal choice in certain circumstances. While local excision can circumvent some of the adverse functional outcomes, its inadequacy in assessing metastatic lymph node disease and the subsequent negative impact of untreated positive lymph nodes on patient prognosis is a cause for concern. As a result, the therapeutic strategy has to be based on patient and disease-related factors in order to identify the best treatment choice that maximizes survival benefit and preserves health-related quality of life. After adequate preoperative staging work up, in selected patients with favorable pathological features, local excision can be considered. These cancers can be removed by transanal local excision or transanal endoscopic microsurgery, depending on the location of the cancer and expertise available. While perioperative morbidity is minimal, close postoperative follow-up is essential.

Clinical characteristics and patient-reported outcomes in patients with inadequately controlled rheumatoid arthritis despite ongoing treatment.

PubMed

Taylor, Peter C; Alten, Rieke; Gomez-Reino, Juan J; Caporali, Roberto; Bertin, Philippe; Sullivan, Emma; Wood, Robert; Piercy, James; Vasilescu, Radu; Spurden, Dean; Alvir, Jose; Tarallo, Miriam

2018-01-01

Despite the wide array of treatments available for rheumatoid arthritis (RA), some patients continue to report unmet clinical needs. We investigated the extent of inadequate disease control in patients with RA. Data were drawn from the Adelphi 2014 RA Disease-Specific Program in France, Germany, Italy, Spain and the UK. Rheumatologists provided patient demographics, comorbidities, satisfaction with RA control and other clinical details. Patients reported their level of satisfaction and completed the EuroQoL 5-Dimensions Health Questionnaire and Work Productivity and Activity Impairment Questionnaire. Patients had been on their current therapy ≥3 months and had 28-joint disease activity scores (DAS28) reported. Adequately controlled (DAS28 ≤3.2) and inadequately controlled (DAS28 >3.2) patient cohorts were compared using univariate tests. Of 1147 patients, 74% were women, the mean age was 52 years and the mean time since RA diagnosis was 7 years. Twenty-seven percent of patients had inadequately controlled RA, whereas 73% had adequately controlled RA. Inadequately controlled patients were more affected clinically versus adequately controlled patients; 69% vs 13% had moderate/severe RA, the current level of pain was 4.6 vs 2.3, and 67% vs 41% experienced flares, respectively (all p<0.0001). Inadequately controlled patients had higher rates of depression (16% vs 5%; p<0.0001), worse health state, greater work and activity impairment, and lower satisfaction rates among the patients and their physicians than the adequately controlled cohort. RA was insufficiently controlled in over a quarter of patients despite their current therapy and this had a negative impact on the patients.

Pathological response of locally advanced rectal cancer to preoperative chemotherapy without pelvic irradiation.

PubMed

Bensignor, T; Brouquet, A; Dariane, C; Thirot-Bidault, A; Lazure, T; Julié, C; Nordlinger, B; Penna, C; Benoist, S

2015-06-01

Pathological response to chemotherapy without pelvic irradiation is not well defined in rectal cancer. This study aimed to evaluate the objective pathological response to preoperative chemotherapy without pelvic irradiation in middle or low locally advanced rectal cancer (LARC). Between 2008 and 2013, 22 patients with middle or low LARC (T3/4 and/or N+ and circumferential resection margin < 2 mm) and synchronous metastatic disease or a contraindication to pelvic irradiation underwent rectal resection after preoperative chemotherapy. The pathological response of rectal tumour was analysed according to the Rödel tumour regression grading (TRG) system. Predictive factors of objective pathological response (TRG 2-4) were analysed. All patients underwent rectal surgery after a median of six cycles of preoperative chemotherapy. Of these, 20 (91%) had sphincter saving surgery and an R0 resection. Twelve (55%) patients had an objective pathological response (TRG 2-4), including one complete response. Poor response (TRG 0-1) to chemotherapy was noted in 10 (45%) patients. In univariate analyses, none of the factors examined was found to be predictive of an objective pathological response to chemotherapy. At a median follow-up of 37.2 months, none of the 22 patients experienced local recurrence. Of the 19 patients with Stage IV rectal cancer, 15 (79%) had liver surgery with curative intent. Preoperative chemotherapy without pelvic irradiation is associated with objective pathological response and adequate local control in selected patients with LARC. Further prospective controlled studies will address the question of whether it can be used as a valuable alternative to radiochemotherapy in LARC. Colorectal Disease © 2014 The Association of Coloproctology of Great Britain and Ireland.

From home, to market, to headquarters, to home. Relocating health services planning and purchasing in New Zealand.

PubMed

Gauld, Robin

2002-01-01

Health sector restructuring has been in vogue, but no country has engaged in as much health sector restructuring as New Zealand where, in a decade, there have been four different public health sector structures. This article discusses New Zealand's four structures with an emphasis on relocating the critical functions of health care planning and purchasing, and on the development of the present district health board system. The four structures include: an area health board system (1989-1991) with planning and purchasing located at "home" in local areas and closely aligned with service provision; a competitive internal market system (1993-1996) which separated planning and purchasing from service provision; a centralised system with a "headquarters" controlling planning and purchasing (1997-1999) while maintaining the distance from provision; and the district health board system currently under development (1999-) which sees purchasing and planning sent home again to regions and linked closely with service provision. The present system entails the devolution of considerable responsibility to the local level, within a framework of strong central government control. Based on New Zealand's experience, the article notes that all but the market structure appear to have provided an adequate environment for effective health care planning and purchasing.

Using Tradtional Ecological Knowledge to Protect Wetlands: the Swinomish Tribe's Wetland Cultural Assessment Project

NASA Astrophysics Data System (ADS)

Mitchell, T.

2017-12-01

"Traditional" wetland physical assessment modules do not adequately identify Tribal cultural values of wetlands and thus wetlands may not be adequately protected for cultural uses. This Swinomish Wetlands Cultural Assessment Project has developed a cultural resource scoring module that can be incorporated into wetland assessments to better inform wetland protections. Local native knowledge was gathered about the traditional uses of 99 native wetland plant species. A cultural scoring matrix was developed based on the presence of traditionally used plants in several use categories including: construction, ceremonial, subsistence, medicinal, common use, plant rarity, and place of value for each wetland. The combined score of the cultural and physcial modules provides an overall wetland score that relates to proscribed buffer protection widths. With this local native knowledge incorporated into wetland assessments, we are protecting and preserving Swinomish Reservation wetlands for both cultural uses and ecological functionality through the Tribe's wetland protection law.

A prospective, randomized evaluation of the effects of epidural needle rotation on the distribution of epidural block.

PubMed

Borghi, Battista; Agnoletti, Vanni; Ricci, Alessandro; van Oven, Hanna; Montone, Nicoletta; Casati, Andrea

2004-05-01

We evaluated the effects of turning the tip of the Tuohy needle 45 degrees toward the operative side before threading the epidural catheter (45 degrees -rotation group, n = 24) as compared to a conventional insertion technique with the tip of the Tuohy needle oriented at 90 degrees cephalad (control group, n = 24) on the distribution of 10 mL of 0.75% ropivacaine with 10 microg sufentanil in 48 patients undergoing total hip replacement. The catheter was introduced 3 to 4 cm beyond the tip of the Tuohy needle. A blinded observer recorded sensory and motor blocks on both sides, quality of analgesia, and volumes of local anesthetic used during the first 48 h of patient-controlled epidural analgesia. Readiness to surgery required 21 +/- 6 min in the control group and 17 +/- 7 min in the 45 degree-rotation group (P > 0.50). The maximum sensory level reached on the operative side was T10 (T10-7) in the control group and T9 (T10-6) in the 45 degree-rotation group (P > 0.50); whereas the maximum sensory level reached on the nonoperative side was T10 (T12-9) in the control group and L3 (L5-T12) in the 45 degree-rotation group (P = 0.0005). Complete motor blockade of the operative limb was achieved earlier in the 45 degree-rotation than in the control group, and motor block of the nonoperative side was more intense in patients in the control group. Two-segment regression of sensory level on the surgical side was similar in the two groups, but occurred earlier on the nonoperative side in the 45 degree-rotation group (94 +/- 70 min) than in the control group (178 +/- 40 min) (P = 0.0005). Postoperative analgesia was similar in the 2 groups, but the 45 degree-rotation group consumed less local anesthetic (242 +/- 35 mL) than the control group (297 +/- 60 mL) (P = 0.0005). We conclude that the rotation of the Tuohy introducer needle 45 degrees toward the operative side before threading the epidural catheter provides a preferential distribution of sensory and motor block toward the operative side, reducing the volume of local anesthetic solution required to maintain postoperative analgesia. Turning the Tuohy introducer needle 45 degrees toward the operative side before threading the epidural catheter is a simple maneuver that produces a preferential distribution of epidural anesthesia and analgesia toward the operative side, minimizing the volume of local anesthetic required to provide adequate pain relief after total hip arthroplasty.

New Insights into Eosinophilic Otitis Media.

PubMed

Kanazawa, Hiromi; Yoshida, Naohiro; Iino, Yukiko

2015-12-01

Eosinophilic otitis media (EOM) is a type of intractable otitis media that occurs mainly in patients with bronchial asthma (BA). In 2011, the diagnostic criteria for EOM were established. EOM is characterized by the presence of a highly viscous yellowish effusion containing eosinophils and immunoglobulin E (IgE), eosinophil chemoattractants, such as eosinophil cationic protein, interleukin-5, and eotaxin. Local sensitization against foreign agents such as fungi or bacteria (e.g., Staphylococcus aureus) may result in local IgE production in the middle ear and may be responsible for the severity of EOM. The clinical features of EOM closely resemble localized eosinophilic granulomatosis polyangiitis, therefore it is necessary to be vigilant to the symptoms of mononeuritis, polyneuritis, and skin purpura during diagnosis. Standard treatment for EOM is the instillation of triamcinolone acetonide into the mesotympanum. However, severe cases exhibiting strong inflammation and otorrhea are not easily controlled with antibiotics and/or corticosteroids. We proposed the introduction of a severity score to evaluate the severity of EOM. This score correlated with local IgE levels in middle ear effusion. Clinically, the risk factors associated with this severity score were body mass index, and the duration of bronchial asthma (from the onset of BA to the age of the first consultation of otitis media to our hospital). We emphasize that early diagnosis and adequate treatment are vital in preventing progressive and sudden hearing loss resulting from EOM.

Efficacy of a new sealant to prevent white spot lesions during fixed orthodontic treatment : A 12-month, single-center, randomized controlled clinical trial.

PubMed

Hammad, Shaza M; Knösel, Michael

2016-11-01

White spot lesions (WSLs) are an undesirable side effect of fixed orthodontic appliance therapy and are reported to occur in 2-96 % of orthodontic patients. In this study, the efficacy of a new sealant to prevent WSLs during fixed orthodontic treatment was compared to a control group that did not receive sealant. For this 2-arm parallel-group randomized trial, 50 subjects aged 12-18 years (mean age 14.57 ± 2.04 years) were recruited from the orthodontics department at Mansoura University, Egypt. Eligibility criteria were no restorations, no active WSLs or caries, and adequate oral hygiene. Subjects were randomized in a 1:1 ratio to one of the two arms prior to undergoing fixed orthodontic treatment, namely a single application of SeLECT Defense™ sealant during the bracketing appointment or no sealant (control arm). Instructions and dentifrices for local home fluoridation regimen were identical in both groups. Oral hygiene was assessed using the Approximal Plaque Index (API) at specified time intervals. Dental photographs were taken for blinded WSLs assessment; inter- and intra-operator error were also calculated. Categorical data were tested using the χ 2 test, and a logistic regression model was adopted to detect associations between decalcification (WSLs), sealant application, and oral hygiene status. Only excellent or good oral hygiene were independent prognostic factors for preventing severe WSLs (p = 0.035). No significant effect on caries incidence was observed for the sealant. In combination with adequate oral hygiene SeLECT Defense™ helps to reduced the frequency of WSLs. However, the sealat showed no significant effect as sole preventive strategy.

Command and Control in a Complex World

DTIC Science & Technology

2012-05-22

definition of command and control does not adequately address changes introduced through technology trends, our understanding of the global operating...processes. The current joint definition of command and control does not adequately address changes introduced through technology trends, our...the problem is actually solved.  There are no  definitive ,  objective solutions to wicked problems.  For a complete  definition  of wicked problems, see

Evaluation of preventive and control measures for lead exposure in a South African lead-acid battery recycling smelter.

PubMed

Dyosi, Sindiswa

2007-10-01

In South Africa, new lead regulations released in February 2002 served as motivation for a cross-sectional study investigating the effectiveness of preventive and control measures implemented in a lead smelter that recycles lead-acid batteries. Twenty-two workers were observed and interviewed. Structured questionnaires were used to gather workers' personal information, perception about their work environment, health risks, and work practices. Retrospective data from air monitoring and medical surveillance programs were obtained from the plant's records. The smelter implemented a number of control measures for lead exposure, including engineering controls, administrative controls, and, as a last resort, personal protective equipment. Engineering controls were rated the best control measure and included local exhaust ventilation systems and wet methods. Positive pressure systems were used in the offices and laboratory. The local exhaust ventilation system was rated the best engineering control measure. Although control measures were used, areas such as smelting and refinery had average lead in air levels above 0.15 mg/m(3), the occupational exposure limit for lead. This was a concern especially with regard to the smelting area because those workers had the second highest mean blood lead levels; workers in the battery breaking area had the highest. Regular use of personal protective equipment by some workers in the "lead exposure zones" was not observed. Although the mean blood lead levels had been below 40 micro g/dL for more than 90% of the workers since 2001, more than 70% of workers reported concerns about their health while working in the smelter. Even though control measures were implemented, they were not adequate because in some areas lead in air exceeded the occupational exposure limit. Therefore, improvement of existing measures and regular monitoring of personal protective equipment use were included in the recommendations given to the smelter.

Chapter 3. Coordination and collaboration with interface units. Recommendations and standard operating procedures for intensive care unit and hospital preparations for an influenza epidemic or mass disaster.

PubMed

Joynt, Gavin M; Loo, Shi; Taylor, Bruce L; Margalit, Gila; Christian, Michael D; Sandrock, Christian; Danis, Marion; Leoniv, Yuval; Sprung, Charles L

2010-04-01

To provide recommendations and standard operating procedures (SOPs) for intensive care unit (ICU) and hospital preparations for an influenza pandemic or mass disaster with a specific focus on enhancing coordination and collaboration between the ICU and other key stakeholders. Based on a literature review and expert opinion, a Delphi process was used to define the essential topics including coordination and collaboration. Key recommendations include: (1) establish an Incident Management System with Emergency Executive Control Groups at facility, local, regional/state or national levels to exercise authority and direction over resource use and communications; (2) develop a system of communication, coordination and collaboration between the ICU and key interface departments within the hospital; (3) identify key functions or processes requiring coordination and collaboration, the most important of these being manpower and resources utilization (surge capacity) and re-allocation of personnel, equipment and physical space; (4) develop processes to allow smooth inter-departmental patient transfers; (5) creating systems and guidelines is not sufficient, it is important to: (a) identify the roles and responsibilities of key individuals necessary for the implementation of the guidelines; (b) ensure that these individuals are adequately trained and prepared to perform their roles; (c) ensure adequate equipment to allow key coordination and collaboration activities; (d) ensure an adequate physical environment to allow staff to properly implement guidelines; (6) trigger events for determining a crisis should be defined. Judicious planning and adoption of protocols for coordination and collaboration with interface units are necessary to optimize outcomes during a pandemic.

Chapter 3. Coordination and collaboration with interface units

PubMed Central

Joynt, Gavin M.; Loo, Shi; Taylor, Bruce L.; Margalit, Gila; Christian, Michael D.; Sandrock, Christian; Danis, Marion; Leoniv, Yuval

2016-01-01

Purpose To provide recommendations and standard operating procedures (SOPs) for intensive care unit (ICU) and hospital preparations for an influenza pandemic or mass disaster with a specific focus on enhancing coordination and collaboration between the ICU and other key stakeholders. Methods Based on a literature review and expert opinion, a Delphi process was used to define the essential topics including coordination and collaboration. Results Key recommendations include: (1) establish an Incident Management System with Emergency Executive Control Groups at facility, local, regional/state or national levels to exercise authority and direction over resource use and communications; (2) develop a system of communication, coordination and collaboration between the ICU and key interface departments within the hospital; (3) identify key functions or processes requiring coordination and collaboration, the most important of these being manpower and resources utilization (surge capacity) and re-allocation of personnel, equipment and physical space; (4) develop processes to allow smooth inter-departmental patient transfers; (5) creating systems and guidelines is not sufficient, it is important to: (a) identify the roles and responsibilities of key individuals necessary for the implementation of the guidelines; (b) ensure that these individuals are adequately trained and prepared to perform their roles; (c) ensure adequate equipment to allow key coordination and collaboration activities; (d) ensure an adequate physical environment to allow staff to properly implement guidelines; (6) trigger events for determining a crisis should be defined. Conclusions Judicious planning and adoption of protocols for coordination and collaboration with interface units are necessary to optimize outcomes during a pandemic. PMID:20213418

Selenium Status Alters the Immune Response and Expulsion of Adult Heligmosomoides bakeri Worms in Mice

PubMed Central

Cheung, Lumei; Beshah, Ethiopia; Shea-Donohue, Terez; Urban, Joseph F.

2013-01-01

Heligmosomoides bakeri is a nematode with parasitic development exclusively in the small intestine of infected mice that induces a potent STAT6-dependent Th2 immune response. We previously demonstrated that host protective expulsion of adult H. bakeri worms from a challenge infection was delayed in selenium (Se)-deficient mice. In order to explore mechanisms associated with the delayed expulsion, 3-week-old female BALB/c mice were placed on a torula yeast-based diet with or without 0.2 ppm Se, and after 5 weeks, they were inoculated with H. bakeri infective third-stage larvae (L3s). Two weeks after inoculation, the mice were treated with an anthelmintic and then rested, reinoculated with L3s, and evaluated at various times after reinoculation. Analysis of gene expression in parasite-induced cysts and surrounding tissue isolated from the intestine of infected mice showed that the local-tissue Th2 response was decreased in Se-deficient mice compared to that in Se-adequate mice. In addition, adult worms recovered from Se-deficient mice had higher ATP levels than worms from Se-adequate mice, indicating greater metabolic activity in the face of a suboptimal Se-dependent local immune response. Notably, the process of worm expulsion was restored within 2 to 4 days after feeding a Se-adequate diet to Se-deficient mice. Expulsion was associated with an increased local expression of Th2-associated genes in the small intestine, intestinal glutathione peroxidase activity, secreted Relm-β protein, anti-H. bakeri IgG1 production, and reduced worm fecundity and ATP-dependent metabolic activity. PMID:23649095

Endocervical ultrasound applicator for integrated hyperthermia and HDR brachytherapy in the treatment of locally advanced cervical carcinoma.

PubMed

Wootton, Jeffery H; Hsu, I-Chow Joe; Diederich, Chris J

2011-02-01

The clinical success of hyperthermia adjunct to radiotherapy depends on adequate temperature elevation in the tumor with minimal temperature rise in organs at risk. Existing technologies for thermal treatment of the cervix have limited spatial control or rapid energy falloff. The objective of this work is to develop an endocervical applicator using a linear array of multisectored tubular ultrasound transducers to provide 3-D conformal, locally targeted hyperthermia concomitant to radiotherapy in the uterine cervix. The catheter-based device is integrated within a HDR brachytherapy applicator to facilitate sequential and potentially simultaneous heat and radiation delivery. Treatment planning images from 35 patients who underwent HDR brachytherapy for locally advanced cervical cancer were inspected to assess the dimensions of radiation clinical target volumes (CTVs) and gross tumor volumes (GTVs) surrounding the cervix and the proximity of organs at risk. Biothermal simulation was used to identify applicator and catheter material parameters to adequately heat the cervix with minimal thermal dose accumulation in nontargeted structures. A family of ultrasound applicators was fabricated with two to three tubular transducers operating at 6.6-7.4 MHz that are unsectored (360 degrees), bisectored (2 x 180 degrees), or trisectored (3 x 120 degrees) for control of energy deposition in angle and along the device length in order to satisfy anatomical constraints. The device is housed in a 6 mm diameter PET catheter with cooling water flow for endocervical implantation. Devices were characterized by measuring acoustic efficiencies, rotational acoustic intensity distributions, and rotational temperature distributions in phantom. The CTV in HDR brachytherapy plans extends 20.5 +/- 5.0 mm from the endocervical tandem with the rectum and bladder typically <8 mm from the target boundary. The GTV extends 19.4 +/- 7.3 mm from the tandem. Simulations indicate that for 60 min treatments the applicator can heat to 41 degrees C and deliver > 5EM(43 degrees C) over 4-5 cm diameter with Tmax < 45 degrees C and 1 kg m(-3) s(-1) blood perfusion. The 41 degrees C contour diameter is reduced to 3-4 cm at 3 kg m(-3) s(-1) perfusion. Differential power control to transducer elements and sectors demonstrates tailoring of heating along the device length and in angle. Sector cuts are associated with a 14-47 degrees acoustic dead zone, depending on cut width, resulting in a approximately 2-4 degrees C temperature reduction within the dead zone below Tmax. Dead zones can be oriented for thermal protection of the rectum and bladder. Fabricated devices have acoustic efficiencies of 33.4%-51.8% with acoustic output that is well collimated in length, reflects the sectoring strategy, and is strongly correlated with temperature distributions. A catheter-based ultrasound applicator was developed for endocervical implantation with locally targeted, 3-D conformal thermal delivery to the uterine cervix. Feasibility of heating clinically relevant target volumes was demonstrated with power control along the device length and in angle to treat the cervix with minimal thermal dose delivery to the rectum and bladder.

Perceptions on the right to adequate food after a major landslide disaster: a cross-sectional survey of two districts in Uganda.

PubMed

Rukundo, Peter M; Iversen, Per O; Andreassen, Bård A; Oshaug, Arne; Kikafunda, Joyce; Rukooko, Byaruhanga

2015-04-25

Despite the instruments on the right to adequate food adopted by the United Nations, there exists limited information on how this right is perceived. Following a major 2010 landslide disaster in the Bududa district of Eastern Uganda and the resettlement of some affected households into the Kiryandongo district in Western Uganda, we surveyed both districts to explore perceptions about the right to adequate food among households with different experiences; disaster-affected and controls. We deployed qualitative and quantitative techniques to a cross-sectional survey. The index respondent was the head of each randomly selected household from the landslide affected communities and controls from a bordering sub-county. Data was collected by interviews and focus group discussions (FGDs). Structured entries were tested statistically to report associations using Pearson's Chi-square at the 95% CI. Information from FGDs was transcribed, coded, sequenced and patterned. Findings from both techniques were triangulated to facilitate interpretations. Analysis included 1,078 interview entries and 12 FGDs. Significant differences between the affected and control households (P < 0.05) were observed with: age; education level; religious affiliation; existence of assets that complement food source; and having received relief food. Analysis between groups showed differences in responses on: whether everyone has a right to adequate food; who was supposed to supply relief food; whether relief food was adequate; and preferred choice on the means to ensure the right to adequate food. FGDs emphasized that access to land was the most important means to food and income. Affected households desired remedial interventions especially alternative land for livelihood. Despite the provision of adequate relief food being a state's obligation, there was no opportunity to exercise choice and preference. Comprehension and awareness of accountability and transparency issues was also low. Though a significant proportion of participants affirmed they have a right to adequate food, relief food was largely perceived as insufficient. Given the high regard for land as a preferred remedy, a resettlement policy is of the essence to streamline post-landslide displacement and resettlement. Information materials need to be assembled and disseminated to stimulate awareness and debate on the right to adequate food.

Methodology to Estimate Passenger Flow : Riverside Line, Massachusetts Bay Transit Authority, Boston, MA

DOT National Transportation Integrated Search

1981-08-01

management techniques to operate local transit systems more efficiently and economically. In particular, the ability to accurately ascertain route specific passenger flows or passenger demands has become essential for adequate resource allocation and...

Study of improved modeling and solution procedures for nonlinear analysis. [aircraft-like structures

NASA Technical Reports Server (NTRS)

Kamat, M. P.

1979-01-01

An evaluation of the ACTION computer code on an aircraft like structure is presented. This computer program proved adequate in predicting gross response parameters in structures which undergo severe localized cross sectional deformations.

Los Angeles and Its Mistress Machine

ERIC Educational Resources Information Center

Marx, Wesley

1973-01-01

Los Angeles city has acute air pollution problems because of lack of an adequate mass transit system and the type of local industries. Air pollution in Los Angeles has affected agricultural production, vegetation, and public health in nearby areas. (PS)

34 CFR 426.23 - What selection criteria does the Secretary use for the Community-Based Organization Projects?

Code of Federal Regulations, 2013 CFR

2013-07-01

... technical and professional health careers; (2) Provides for adequate and appropriate involvement of local... identification of partnership members; (ii) Involvement of partnership members in the planning of the project...

34 CFR 426.23 - What selection criteria does the Secretary use for the Community-Based Organization Projects?

Code of Federal Regulations, 2012 CFR

2012-07-01

... technical and professional health careers; (2) Provides for adequate and appropriate involvement of local... identification of partnership members; (ii) Involvement of partnership members in the planning of the project...

34 CFR 426.23 - What selection criteria does the Secretary use for the Community-Based Organization Projects?

Code of Federal Regulations, 2011 CFR

2011-07-01

... technical and professional health careers; (2) Provides for adequate and appropriate involvement of local... identification of partnership members; (ii) Involvement of partnership members in the planning of the project...

34 CFR 426.23 - What selection criteria does the Secretary use for the Community-Based Organization Projects?

Code of Federal Regulations, 2014 CFR

2014-07-01

... technical and professional health careers; (2) Provides for adequate and appropriate involvement of local... identification of partnership members; (ii) Involvement of partnership members in the planning of the project...

Coverage of Adequately Iodized Salt Is Suboptimal and Rice Fortification Using Public Distribution Channels Could Reach Low-Income Households: Findings from a Cross-Sectional Survey of Anganwadi Center Catchment Areas in Telangana, India.

PubMed

Wirth, James P; Leyvraz, Magali; Sodani, Prahlad R; Aaron, Grant J; Sharma, Narottam D; Woodruff, Bradley A

2016-01-01

Food fortification is a cost-effective approach to prevent and control of micronutrient deficiencies in India. A cross-sectional survey of children 0-35 months of age residing in the catchment areas of anganwadi centers in the state of Telangana was conducted to assess the coverage of adequately iodized salt and the potential for rice fortification. Salt samples were collected and tested for iodine concentration using iodometric titration. Information on demographics, household rice consumption, and Telangana's rice sector was collected and interpreted. In households of selected children, 79% of salt samples were found to be adequately iodized. Salt brand and district were significant predictors of inadequately iodized salt. Daily rice consumption among children and women averaged 122 grams and 321 grams per day, respectively. Approximately 28% of households reported consuming rice produced themselves or purchased from a local farmer, 65% purchased rice from a market or shop, 6% got rice from a public distribution system site, and 2% obtained it from a rice mill. In the catchment areas of Telangana's anganwadi centers, there is significant variation in the coverage of adequately iodized salt by district. Future surveys in Telangana should measure the coverage of salt iodization in the general population using quantitative methods. Nonetheless, increasing the adequacy of iodization of smaller salt manufacturers would help achieve universal salt iodization in Telangana. Despite high consumption of rice, our findings suggest that large-scale market-based rice fortification is not feasible in Telangana due to a large proportion of households producing their own rice and highly fragmented rice distribution. Distributing fortified rice via Telangana's public distribution system may be a viable approach to target low-income households, but would only reach a small proportion of the population in Telangana.

Coverage of Adequately Iodized Salt Is Suboptimal and Rice Fortification Using Public Distribution Channels Could Reach Low-Income Households: Findings from a Cross-Sectional Survey of Anganwadi Center Catchment Areas in Telangana, India

PubMed Central

Wirth, James P.; Leyvraz, Magali; Sodani, Prahlad R.; Aaron, Grant J.; Sharma, Narottam D.; Woodruff, Bradley A.

2016-01-01

Food fortification is a cost-effective approach to prevent and control of micronutrient deficiencies in India. A cross-sectional survey of children 0–35 months of age residing in the catchment areas of anganwadi centers in the state of Telangana was conducted to assess the coverage of adequately iodized salt and the potential for rice fortification. Salt samples were collected and tested for iodine concentration using iodometric titration. Information on demographics, household rice consumption, and Telangana’s rice sector was collected and interpreted. In households of selected children, 79% of salt samples were found to be adequately iodized. Salt brand and district were significant predictors of inadequately iodized salt. Daily rice consumption among children and women averaged 122 grams and 321 grams per day, respectively. Approximately 28% of households reported consuming rice produced themselves or purchased from a local farmer, 65% purchased rice from a market or shop, 6% got rice from a public distribution system site, and 2% obtained it from a rice mill. In the catchment areas of Telangana’s anganwadi centers, there is significant variation in the coverage of adequately iodized salt by district. Future surveys in Telangana should measure the coverage of salt iodization in the general population using quantitative methods. Nonetheless, increasing the adequacy of iodization of smaller salt manufacturers would help achieve universal salt iodization in Telangana. Despite high consumption of rice, our findings suggest that large-scale market-based rice fortification is not feasible in Telangana due to a large proportion of households producing their own rice and highly fragmented rice distribution. Distributing fortified rice via Telangana’s public distribution system may be a viable approach to target low-income households, but would only reach a small proportion of the population in Telangana. PMID:27447925

Region 9: California Adequate Letter (7/14/2017)

EPA Pesticide Factsheets

EPA approves California Air Resources Board Motor Vehicle Emissions Budgets in San Joaquin Valley Unified Air Pollution Control Districts 2016 Plan for 2008 8-Hour Ozone Standard adequate for transportation conformity purposes announced in Federal Register

Methodological reporting quality of randomized controlled trials: A survey of seven core journals of orthopaedics from Mainland China over 5 years following the CONSORT statement.

PubMed

Zhang, J; Chen, X; Zhu, Q; Cui, J; Cao, L; Su, J

2016-11-01

In recent years, the number of randomized controlled trials (RCTs) in the field of orthopaedics is increasing in Mainland China. However, randomized controlled trials (RCTs) are inclined to bias if they lack methodological quality. Therefore, we performed a survey of RCT to assess: (1) What about the quality of RCTs in the field of orthopedics in Mainland China? (2) Whether there is difference between the core journals of the Chinese department of orthopedics and Orthopaedics Traumatology Surgery & Research (OTSR). This research aimed to evaluate the methodological reporting quality according to the CONSORT statement of randomized controlled trials (RCTs) in seven key orthopaedic journals published in Mainland China over 5 years from 2010 to 2014. All of the articles were hand researched on Chongqing VIP database between 2010 and 2014. Studies were considered eligible if the words "random", "randomly", "randomization", "randomized" were employed to describe the allocation way. Trials including animals, cadavers, trials published as abstracts and case report, trials dealing with subgroups analysis, or trials without the outcomes were excluded. In addition, eight articles selected from Orthopaedics Traumatology Surgery & Research (OTSR) between 2010 and 2014 were included in this study for comparison. The identified RCTs are analyzed using a modified version of the Consolidated Standards of Reporting Trials (CONSORT), including the sample size calculation, allocation sequence generation, allocation concealment, blinding and handling of dropouts. A total of 222 RCTs were identified in seven core orthopaedic journals. No trials reported adequate sample size calculation, 74 (33.4%) reported adequate allocation generation, 8 (3.7%) trials reported adequate allocation concealment, 18 (8.1%) trials reported adequate blinding and 16 (7.2%) trials reported handling of dropouts. In OTSR, 1 (12.5%) trial reported adequate sample size calculation, 4 (50.0%) reported adequate allocation generation, 1 (12.5%) trials reported adequate allocation concealment, 2 (25.0%) trials reported adequate blinding and 5 (62.5%) trials reported handling of dropouts. There were statistical differences as for sample size calculation and handling of dropouts between papers from Mainland China and OTSR (P<0.05). The findings of this study show that the methodological reporting quality of RCTs in seven core orthopaedic journals from the Mainland China is far from satisfaction and it needs to further improve to keep up with the standards of the CONSORT statement. Level III case control. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Present epidemiology of tuberculosis. Prevention and control programs.

PubMed

Orcau, Àngels; Caylà, Joan A; Martínez, José A

2011-03-01

Tuberculosis (TB) has affected humanity since the beginning of the recorded time and is associated with poverty, malnutrition, overcrowding, and immunosuppression. Since Koch discovered the infectious nature of the disease in 1882, knowledge about its history and physiopathology has advanced, but it continues to be a global public health problem. More than 9 million new cases occurred in 2008 worldwide (with an incidence of 139/100,000 inhabitants), of whom more than one million died. Over half million of the cases presented with multidrug resistant-TB. Africa represents the continent with the highest incidence and the most HIV co-infection. The situation in Eastern Europe is also worrisome because of the high incidence and frequency drug resistance. In developed countries, TB has been localized in more vulnerable populations, such as immigrants and persons with social contention. There is an increase of extra-pulmonary presentation in this context, related to non-European ethnicity, HIV infection, and younger age. In Spain, the increasing immigrant population has presented a need to improve coordination between territories and strengthen surveillance The global control plan is based on the DOTS strategy, although the objectives and activities were redefined in 2006 to incorporate the measurement of global development, and community and healthcare strengthening. Adequate control measures in a more local context and continual activity evaluation are necessary to decrease the burden of suffering and economic loss that causes this ancient disease. Copyright © 2011 Elsevier España S.L. All rights reserved.

Spinal atypical protein kinase C activity is necessary to stabilize inactivity-induced phrenic motor facilitation

PubMed Central

Strey, K.A.; Nichols, N.L.; Baertsch, N.A.; Broytman, O.; Baker-Herman, T.L.

2012-01-01

The neural network controlling breathing must establish rhythmic motor output at a level adequate to sustain life. Reduced respiratory neural activity elicits a novel form of plasticity in circuits driving the diaphragm known as inactivity-induced phrenic motor facilitation (iPMF), a rebound increase in phrenic inspiratory output observed once respiratory neural drive is restored. The mechanisms underlying iPMF are unknown. Here, we demonstrate in anesthetized rats that spinal mechanisms give rise to iPMF, and that iPMF consists of at least two mechanistically distinct phases: 1) an early, labile phase that requires atypical PKC (PKCζ and/or PKCΙ/λ) activity to transition to a 2) late, stable phase. Early (but not late) iPMF is associated with increased interactions between PKCζ/Ι and the scaffolding protein ZIP/p62 in spinal regions associated with the phrenic motor pool. Although PKCζ/Ι activity is necessary for iPMF, spinal aPKC activity is not necessary for phrenic long-term facilitation (pLTF) following acute intermittent hypoxia, an activity-independent form of spinal respiratory plasticity. Thus, while iPMF and pLTF both manifest as prolonged increases in phrenic burst amplitude, they arise from distinct spinal cellular pathways. Our data are consistent with the hypotheses that: 1) local mechanisms sense and respond to reduced respiratory-related activity in the phrenic motor pool, and 2) inactivity-induced increases in phrenic inspiratory output require local PKCζ/Ι activity to stabilize into a long-lasting iPMF. Although the physiological role of iPMF is unknown, we suspect that iPMF represents a compensatory mechanism, assuring adequate motor output in a physiological system where prolonged inactivity ends life. PMID:23152633

Error Correction, Control Systems and Fuzzy Logic

NASA Technical Reports Server (NTRS)

Smith, Earl B.

2004-01-01

This paper will be a discussion on dealing with errors. While error correction and communication is important when dealing with spacecraft vehicles, the issue of control system design is also important. There will be certain commands that one wants a motion device to execute. An adequate control system will be necessary to make sure that the instruments and devices will receive the necessary commands. As it will be discussed later, the actual value will not always be equal to the intended or desired value. Hence, an adequate controller will be necessary so that the gap between the two values will be closed.

Local infiltration analgesia for total knee arthroplasty: should ketorolac be added?

PubMed

Andersen, K V; Nikolajsen, L; Haraldsted, V; Odgaard, A; Søballe, K

2013-08-01

Adequate postoperative analgesia with minimal side-effects is essential for early mobilization and recovery in patients undergoing total knee arthroplasty (TKA). High-volume local infiltration analgesia (LIA) with ropivacaine has been introduced, but effects of adjuvants are still debated. We tested the hypothesis that the addition of ketorolac to LIA significantly improves analgesia after TKA. Sixty patients undergoing TKA were randomized to receive intraoperative LIA (ropivacaine 300 mg and epinephrine 0.5 mg) combined with either ketorolac 30 mg (ketorolac group) or saline (control group). After surgery, eight bolus doses of ropivacaine 100 mg combined with either ketorolac 15 mg (ketorolac group) or saline (control group) were administered every 6 h via an intra-articular catheter. The primary outcome was postoperative consumption of i.v. morphine patient-controlled analgesia (PCA). Secondary outcomes were time to first request of i.v. morphine PCA, pain intensity, side-effects, and readiness for hospital discharge. Consumption of i.v. morphine PCA was lower in the ketorolac group vs control group {0-6 h: 0 (0-0) vs 5 (0-10) mg, P<0.0001; 0-48 h: 10 (0-22.5) vs 48.75 (30-82.5) mg, P<0.0001 [median (inter-quartile range, IQR)]}. Time to first request of i.v. morphine PCA was longer in the ketorolac group vs the control group [490 (248-617) vs 223 (115-319) min, P=0.02, median (IQR)]. Early postoperative pain (<48 h) and readiness for hospital discharge were also significantly reduced in the ketorolac group. LIA with ketorolac results in reduced morphine consumption, reduced pain intensity, and earlier readiness for hospital discharge.

Radiosurgery and radiotherapy for sacral tumors.

PubMed

Gibbs, Iris C; Chang, Steven D

2003-08-15

Sacral tumors represent a small subset of spinal lesions and typically include chordomas, metastases, other primary bone tumors, and benign schwannomas. Resection is the standard treatment for many sacral tumors, but many types of sacral lesions have the potential for recurrence after excision. In these cases, adjuvant radiotherapy is often beneficial. Although conventional radiotherapy plays an important role in the management of spinal lesions, the radiation doses required for adequate local control of many sacral lesions generally exceed the tolerance doses of normal tissues, thus limiting its definitive role in the management of sacral tumors. Recent advances in the field of stereotactic radiosurgery have allowed precise targeting of the sacrum. In this report the authors review the use of these two forms of radiation treatment and their role in managing sacral tumors.

Malachite green and chloramphenicol in aquatic products from regions around Dongting Lake in Hunan, China.

PubMed

He, Jiang; Cui, Jingzhen

2016-01-01

Aquatic products are important sources of animal proteins in human diet, especially in developing countries. As such, the safety of aquatic products is of primary concern. In this study, a standard method is used to detect malachite green (MG) and chloramphenicol (CAP) and to analyse the contents of these banned chemicals in turtle, mandarin fish and grass carp sampled from the region surrounding Dongting Lake area in Hunan, China. Results showed that 10.6% of the samples were MG-positive, most of them turtles. CAP was found in 8.3% of the samples, mostly in mandarin fish. These data indicated that these banned substances are still used in the surveyed area. Hence, adequate strategies must be implemented by the local government to control these banned substances.

Diabetes Insipidus—Difficulties in Diagnosis and Treatment; Use of Synthetic Lysine-8 Vasopressin in Patients Intolerant of Other Therapy

PubMed Central

Eisenberg, Eugene

1965-01-01

Frequent errors in the diagnosis of diabetes insipidus arise from (1) failure to produce an adequate stimulus for release of antidiuretic hormone, and (2) failure to appreciate acute or chronic changes in renal function that may obscure test results. Properly timed determination of body weight, urine volume and serum and urine osmolarity during the course of water deprivation, and comparison of these values with those obtained after administration of exogenous vasopressin, eliminates most diagnostic errors. In four patients who had experienced local and systemic reactions to other exogenous forms of vasopressin, diabetes insipidus was satisfactorily controlled by administration of synthetic lysine-8 vasopressin in nasal spray. A fifth patient was also treated satisfactorily with this preparation. PMID:14290932

Redox-shuttling between chloroplast and cytosol: integration of intra-chloroplast and extra-chloroplast metabolism.

PubMed

Taniguchi, Mitsutaka; Miyake, Hiroshi

2012-06-01

Reducing equivalents produced in the chloroplast are essential for many key cellular metabolic enzyme reactions. Two redox shuttle systems transfer reductant out of the chloroplast; these systems consist of metabolite transporters, coupled with stromal and cytosolic dehydrogenase isozymes. The transporters function in the redox shuttle and also operate as key enzymes in carbon/nitrogen metabolism. To maintain adequate levels of reductant and proper metabolic balance, the shuttle systems are finely controlled. Also, in the leaves of C(4) plants, cell-specific division of carbon and nitrogen assimilation includes cell-specific localization of the redox shuttle systems. The redox shuttle systems are tightly linked to cellular metabolic pathways and are essential for maintaining metabolic balance between energy and reducing equivalents. Copyright © 2012 Elsevier Ltd. All rights reserved.

Time domain localization technique with sparsity constraint for imaging acoustic sources

NASA Astrophysics Data System (ADS)

Padois, Thomas; Doutres, Olivier; Sgard, Franck; Berry, Alain

2017-09-01

This paper addresses source localization technique in time domain for broadband acoustic sources. The objective is to accurately and quickly detect the position and amplitude of noise sources in workplaces in order to propose adequate noise control options and prevent workers hearing loss or safety risk. First, the generalized cross correlation associated with a spherical microphone array is used to generate an initial noise source map. Then a linear inverse problem is defined to improve this initial map. Commonly, the linear inverse problem is solved with an l2 -regularization. In this study, two sparsity constraints are used to solve the inverse problem, the orthogonal matching pursuit and the truncated Newton interior-point method. Synthetic data are used to highlight the performances of the technique. High resolution imaging is achieved for various acoustic sources configurations. Moreover, the amplitudes of the acoustic sources are correctly estimated. A comparison of computation times shows that the technique is compatible with quasi real-time generation of noise source maps. Finally, the technique is tested with real data.

MILSBILLS: Military Standard Billing System

DTIC Science & Technology

1985-01-01

disbursing offices and w’ose adjustments will be included in their Statement of Interfund 1,ansactions. c. Ensuring that there are adequate controls over...adjustments will be included in their Statement of Interfund Transactions. c. Ensuring that there are adequate controls over interfund related...by the DSAA. 3 iAutomatic adjustments may be withheld from specific customers if there is a pattern of abuse of this authority. When such a pattern

Health in global context; beyond the social determinants of health?

PubMed Central

Krumeich, Anja; Meershoek, Agnes

2014-01-01

The rise of the social determinants of health (SDH) discourse on the basis of statistical evidence that correlates ill health to SDH and pictures causal pathways in comprehensive theoretical frameworks led to widespread awareness that health and health disparities are the outcome of complex pathways of interconnecting SDH. In this paper we explore whether and how SDH frameworks can be translated to effectively inform particular national health policies. To this end we identified major challenges for this translation followed by reflections on ways to overcome them. Most important challenges affecting adequate translation of these frameworks into concrete policy and intervention are 1) overcoming the inclination to conceptualize SDH as mere barriers to health behavior to be modified by lifestyle interventions by addressing them as structural factors instead; 2) obtaining sufficient in-depth insight in and evidence for the exact nature of the relationship between SDs and health; 3) to adequately translate the general determinants and pathways into explanations for ill health and limited access to health care in local settings; 4) to develop and implement policies and other interventions that are adjusted to those local circumstances. We conclude that to transform generic SDH models into useful policy tools and to prevent them to transform in SDH themselves, in depth understanding of the unique interplay between local, national and global SDH in a local setting, gathered by ethnographic research, is needed to be able to address structural SD in the local setting and decrease health inequity.

Local hyperspectral data multisharpening based on linear/linear-quadratic nonnegative matrix factorization by integrating lidar data

NASA Astrophysics Data System (ADS)

Benhalouche, Fatima Zohra; Karoui, Moussa Sofiane; Deville, Yannick; Ouamri, Abdelaziz

2015-10-01

In this paper, a new Spectral-Unmixing-based approach, using Nonnegative Matrix Factorization (NMF), is proposed to locally multi-sharpen hyperspectral data by integrating a Digital Surface Model (DSM) obtained from LIDAR data. In this new approach, the nature of the local mixing model is detected by using the local variance of the object elevations. The hyper/multispectral images are explored using small zones. In each zone, the variance of the object elevations is calculated from the DSM data in this zone. This variance is compared to a threshold value and the adequate linear/linearquadratic spectral unmixing technique is used in the considered zone to independently unmix hyperspectral and multispectral data, using an adequate linear/linear-quadratic NMF-based approach. The obtained spectral and spatial information thus respectively extracted from the hyper/multispectral images are then recombined in the considered zone, according to the selected mixing model. Experiments based on synthetic hyper/multispectral data are carried out to evaluate the performance of the proposed multi-sharpening approach and literature linear/linear-quadratic approaches used on the whole hyper/multispectral data. In these experiments, real DSM data are used to generate synthetic data containing linear and linear-quadratic mixed pixel zones. The DSM data are also used for locally detecting the nature of the mixing model in the proposed approach. Globally, the proposed approach yields good spatial and spectral fidelities for the multi-sharpened data and significantly outperforms the used literature methods.

R & D: An Alchemist's Dream.

ERIC Educational Resources Information Center

Mathias, Charles McC., Jr.

1980-01-01

The value of scientific research can only be measured by the resulting benefits to society. Federal policymakers must ensure that funding for research and development is adequate and that research results are applied to the serious problems facing state and local governments. (SK)

Examination of Regional Transit Service Under Contracting : A Case Study in the Greater New Orleans Region

DOT National Transportation Integrated Search

2011-04-01

Many local governments and transit agencies in the United States face financial difficulties in providing adequate public transit service in individual systems, and in providing sufficient regional coordination to accommodate transit trips involving ...

Experimental power spectral density analysis for mid- to high-spatial frequency surface error control.

PubMed

Hoyo, Javier Del; Choi, Heejoo; Burge, James H; Kim, Geon-Hee; Kim, Dae Wook

2017-06-20

The control of surface errors as a function of spatial frequency is critical during the fabrication of modern optical systems. A large-scale surface figure error is controlled by a guided removal process, such as computer-controlled optical surfacing. Smaller-scale surface errors are controlled by polishing process parameters. Surface errors of only a few millimeters may degrade the performance of an optical system, causing background noise from scattered light and reducing imaging contrast for large optical systems. Conventionally, the microsurface roughness is often given by the root mean square at a high spatial frequency range, with errors within a 0.5×0.5  mm local surface map with 500×500 pixels. This surface specification is not adequate to fully describe the characteristics for advanced optical systems. The process for controlling and minimizing mid- to high-spatial frequency surface errors with periods of up to ∼2-3  mm was investigated for many optical fabrication conditions using the measured surface power spectral density (PSD) of a finished Zerodur optical surface. Then, the surface PSD was systematically related to various fabrication process parameters, such as the grinding methods, polishing interface materials, and polishing compounds. The retraceable experimental polishing conditions and processes used to produce an optimal optical surface PSD are presented.

Light pollution from the ground, the air and the space

NASA Astrophysics Data System (ADS)

Sánchez de Miguel, A.; Zamorano, J.; Gómez Castaño, J.; Aubé, M.; Bará, S.; Gallego, J.; Kyba, C. C. M.; Lombraña, D.; Nievas, M.; Pascual, S.; Tapia, C.

2015-05-01

The sky brightness is one of the things that most harms astronomical observation, near cities and on mountain observatories. Currently there are several initiatives to control light pollution, but the sky brightness measurements are usually local. To exercise adequate control of light pollution is necessary measurements of light pollution sources and their relation to the spatiotemporal variation of the sky brightness. We use various approaches: data taken ashore with photometers SQM and relate emissions and detected with VIIRS and DMSP satellites. We also use multispectral data taken from the International Space Station to distinguish different types of lamps that contribute to light pollution. Finally we used a spectrograph SAND for temporal analysis of the evolution of the contribution of the lights in the sky brightness of a big city like Madrid. Also we have performed a citizen science program to classify the night time images taken from the ISS (Sánchez de Miguel et al. 2014, A&G, 55, 4, 36).

Piloted evaluation of an integrated propulsion and flight control simulator

NASA Technical Reports Server (NTRS)

Bright, Michelle M.; Simon, Donald L.

1992-01-01

A piloted evaluation of the integrated flight and propulsion control simulator for advanced integrated propulsion and airframe control design is described. The evaluation will cover control effector gains and deadbands, control effectiveness and control authority, and heads up display functionality. For this evaluation the flight simulator is configured for transition flight using an advanced Short Take-Off and Vertical Landing fighter aircraft model, a simplified high-bypass turbofan engine model, fighter cockpit displays, and pilot effectors. The piloted tasks used for rating displays and control effector gains are described. Pilot comments and simulation results confirm that the display symbology and control gains are very adequate for the transition flight task. Additionally, it is demonstrated that this small-scale, fixed base flight simulator facility can adequately perform a real time, piloted control evaluation.

Aerial estimation of the size of gull breeding colonies

USGS Publications Warehouse

Kadlec, J.A.; Drury, W.H.

1968-01-01

Counts on photographs and visual estimates of the numbers of territorial gulls are usually reliable indicators of the number of gull nests, but single visual estimates are not adequate to measure the number of nests in individual colonies. To properly interpret gull counts requires that several islands with known numbers of nests be photographed to establish the ratio of gulls to nests applicable for a given local census. Visual estimates are adequate to determine total breeding gull numbers by regions. Neither visual estimates nor photography will reliably detect annual changes of less than about 2.5 percent.

Dog and cat management through sterilization: Implications for population dynamics and veterinary public policies.

PubMed

Dias, Ricardo Augusto; Baquero, Oswaldo Santos; Guilloux, Aline Gil Alves; Moretti, Caio Figueiredo; de Lucca, Tosca; Rodrigues, Ricardo Conde Alves; Castagna, Cláudio Luiz; Presotto, Douglas; Kronitzky, Yury Cezar; Grisi-Filho, José Henrique Hildebrand; Ferreira, Fernando; Amaku, Marcos

2015-11-01

The present study aimed to compare different sterilization scenarios allowing the adoption of the most adequate strategy to control owned dog and cat population sizes as the official veterinary public policy for animal control in an urban area of Campinas municipality, Brazil. To achieve this goal, the vital parameters of the owned pet population were measured in a neighborhood of Campinas called Jardim Vila Olimpia through questionnaires used in two census studies performed in February 2012 and June 2013. Different hypothetical sterilization scenarios were compared with the scenario of a single sterilization campaign performed in the study area between the census studies. Using a deterministic mathematical model, population dynamics were simulated for these different scenarios. We have observed that for both owned dogs and cats, the impact on the population size achieved by a single sterilization campaign would be diluted over the years, equating to the impact achieved by the usual sterilization rate practiced before the sterilization campaign yearly. Moreover, using local and global sensitivity analyses, we assessed the relative influence on animal population evolution of each vital parameter used in the mathematical models. The more influential parameters for both species were the carrying capacity of the environment and sterilization rates of males and females (for both species). We observed that even with sterilizing 100% of the intact animals annually, it would not be possible to obtain proportions greater than 86% and 88% of sterilized dogs and cats, respectively, after 20 years due to the high introduction of new intact animals. There is no public dog and cat sterilization service in place in the city, and sporadic and local sterilization campaigns are performed with a prior communication to the owners to bring their animals to be sterilized in a selected veterinary facility. If a sterilization campaign was performed annually in the study area, it would have the most favorable cost effectiveness ratio after 20 years compared to the scenarios of 50% and 100% sterilization of intact animals annually. These results allowed the veterinary public policy stakeholders to make decisions based on scientific evidence to implement adequate control of dog and cat populations in urban areas, aiming to reduce zoonosis transmission to humans and other problems associated with uncontrolled animal populations. Copyright © 2015 Elsevier B.V. All rights reserved.

Systematic Review of Plant-Based Homeopathic Basic Research: An Update.

PubMed

Ücker, Annekathrin; Baumgartner, Stephan; Sokol, Anezka; Huber, Roman; Doesburg, Paul; Jäger, Tim

2018-05-01

 Plant-based test systems have been described as a useful tool for investigating possible effects of homeopathic preparations. The last reviews of this research field were published in 2009/2011. Due to recent developments in the field, an update is warranted. Publications on plant-based test systems were analysed with regard to publication quality, reproducibility and potential for further research.  A literature search was conducted in online databases and specific journals, including publications from 2008 to 2017 dealing with plant-based test systems in homeopathic basic research. To be included, they had to contain statistical analysis and fulfil quality criteria according to a pre-defined manuscript information score (MIS). Publications scoring at least 5 points (maximum 10 points) were assumed to be adequate. They were analysed for the use of adequate controls, outcome and reproducibility.  Seventy-four publications on plant-based test systems were found. Thirty-nine publications were either abstracts or proceedings of conferences and were excluded. From the remaining 35 publications, 26 reached a score of 5 or higher in the MIS. Adequate controls were used in 13 of these publications. All of them described specific effects of homeopathic preparations. The publication quality still varied: a substantial number of publications (23%) did not adequately document the methods used. Four reported on replication trials. One replication trial found effects of homeopathic preparations comparable to the original study. Three replication trials failed to confirm the original study but identified possible external influencing factors. Five publications described novel plant-based test systems. Eight trials used systematic negative control experiments to document test system stability.  Regarding research design, future trials should implement adequate controls to identify specific effects of homeopathic preparations and include systematic negative control experiments. Further external and internal replication trials, and control of influencing factors, are needed to verify results. Standardised test systems should be developed. The Faculty of Homeopathy.

On the ability of human listeners to distinguish between front and back.

PubMed

Zhang, Peter Xinya; Hartmann, William M

2010-02-01

In order to determine whether a sound source is in front or in back, listeners can use location-dependent spectral cues caused by diffraction from their anatomy. This capability was studied using a precise virtual reality technique (VRX) based on a transaural technology. Presented with a virtual baseline simulation accurate up to 16 kHz, listeners could not distinguish between the simulation and a real source. Experiments requiring listeners to discriminate between front and back locations were performed using controlled modifications of the baseline simulation to test hypotheses about the important spectral cues. The experiments concluded: (1) Front/back cues were not confined to any particular 1/3rd or 2/3rd octave frequency region. Often adequate cues were available in any of several disjoint frequency regions. (2) Spectral dips were more important than spectral peaks. (3) Neither monaural cues nor interaural spectral level difference cues were adequate. (4) Replacing baseline spectra by sharpened spectra had minimal effect on discrimination performance. (5) When presented with an interaural time difference less than 200 micros, which pulled the image to the side, listeners still successfully discriminated between front and back, suggesting that front/back discrimination is independent of azimuthal localization within certain limits. Copyright 2009 Elsevier B.V. All rights reserved.

On the ability of human listeners to distinguish between front and back

PubMed Central

Zhang, Peter Xinya; Hartmann, William M.

2009-01-01

In order to determine whether a sound source is in front or in back, listeners can use location-dependent spectral cues caused by diffraction from their anatomy. This capability was studied using a precise virtual-reality technique (VRX) based on a transaural technology. Presented with a virtual baseline simulation accurate up to 16 kHz, listeners could not distinguish between the simulation and a real source. Experiments requiring listeners to discriminate between front and back locations were performed using controlled modifications of the baseline simulation to test hypotheses about the important spectral cues. The experiments concluded: (1) Front/back cues were not confined to any particular 1/3rd or 2/3rd octave frequency region. Often adequate cues were available in any of several disjoint frequency regions. (2) Spectral dips were more important than spectral peaks. (3) Neither monaural cues nor interaural spectral level difference cues were adequate. (4) Replacing baseline spectra by sharpened spectra had minimal effect on discrimination performance. (5) When presented with an interaural time difference less than 200 μs, which pulled the image to the side, listeners still successfully discriminated between front and back, suggesting that front/back discrimination is independent of azimuthal localization within certain limits. PMID:19900525

[Modification of pertussis vaccination schedule in Chile, immunization of special groups and control strategies: Commentary from the Consultive Committee of Immunizations of The Chilean Society of Infectious Diseases].

PubMed

Potin, Marcela; Cerda, Jaime; Contreras, Lily; Muñoz, Alma; Ripoll, Erna; Vergara, Rodrigo

2012-06-01

In Chile, an increased number of notifications of cases of whooping cough was detected at the beginning of October 2010, and maintained through 2012. Accumulated cases during 2011 were 2,581 (15.0 per 100,000), which is greater than the number of cases registered during the period 2008-2010 (2,460 cases). On the other hand, the local sanitary authority introduced a modification of pertussis vaccination schedule (starting 2012), which consists in the replacement of the second booster of pertussis vaccine (DTwP, administered to 4-year-old children) as well as diphtheria-tetanus toxoid (dT, administered to second grade scholars) for an acellular pertussis vaccine with reduced antigenic content (dTpa), which will be administrated to first grade scholars. The Consultive Committee of Immunizations considers that the modification is adequate, since it extends the age of protection, reducing at least in theory the infection in older scholars and adolescents -who are significant sources of transmission of Bordetella pertussis to infants- using an adequate vaccine formulation (acellular pertussis vaccine). The available evidence regarding vaccination in special groups (adolescents and adults, health-care workers and pregnant women) and cocooning strategy are commented.

14 CFR 25.1143 - Engine controls.

Code of Federal Regulations, 2014 CFR

2014-01-01

... means of controlling its engine. (d) For each fluid injection (other than fuel) system and its controls... injection fluid is adequately controlled. (e) If a power or thrust control incorporates a fuel shutoff...

14 CFR 25.1143 - Engine controls.

Code of Federal Regulations, 2013 CFR

2013-01-01

... means of controlling its engine. (d) For each fluid injection (other than fuel) system and its controls... injection fluid is adequately controlled. (e) If a power or thrust control incorporates a fuel shutoff...

33 CFR 203.62 - Drought assistance.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Supplies: Contaminated Water Sources and Drought Assistance § 203.62 Drought assistance. (a) Authority. The... non-Federal responsibility for providing an adequate supply of water to local inhabitants. Corps assistance to provide emergency water supplies will only be considered when non-Federal interests have...

49 CFR 374.309 - Terminal facilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

...) Passenger security. All terminals and stations must provide adequate security for passengers and their attendants and be regularly patrolled. (b) Outside facilities. At terminals and stations that are closed when... accommodations, and telephone numbers for local taxi service and police. (c) Maintenance. Terminals shall be...

Controls Over Ministry of Interior Fuel Contracts Could be Improved

DTIC Science & Technology

2016-01-20

Fiscal Year 1395 Commitment Letter improved reporting requirements designed to specify adequate documentation of the Afghan Ministry of Interior fuel...1395 Commitment Letter improved reporting requirements designed to specify adequate documentation of the Afghan Ministry of Interior fuel consumption...of Defense F r a u d , W a s t e & A b u s e FOR OFFICIAL USE ONLY FOR OFFICIAL USE ONLY Results in Brief Controls Over Ministry of Interior Fuel

[The comprehensive prevention of suppurative wound infection in the postoperative period in diabetic patients].

PubMed

Veligotskiĭ, N N; Florikian, A K; Bashura, G S; Dubenko, V V

1998-01-01

The strict acceptance of the radicalism principles while the purulent inflammation origin eliminate, an accurate sanation and early placement of suture on the operation wound, its adequate and active drainage in combination with expedient local with the help of foamy aerosol "Dioxizol" and stable compensation of hyperglycemia, correction of the homeostasis disorders are necessary in the treatment of diabetes mellitus patients with local purulent-necrotic disease of the soft tissues.

Analyzing transmission dynamics of cholera with public health interventions.

PubMed

Posny, Drew; Wang, Jin; Mukandavire, Zindoga; Modnak, Chairat

2015-06-01

Cholera continues to be a serious public health concern in developing countries and the global increase in the number of reported outbreaks suggests that activities to control the diseases and surveillance programs to identify or predict the occurrence of the next outbreaks are not adequate. These outbreaks have increased in frequency, severity, duration and endemicity in recent years. Mathematical models for infectious diseases play a critical role in predicting and understanding disease mechanisms, and have long provided basic insights in the possible ways to control infectious diseases. In this paper, we present a new deterministic cholera epidemiological model with three types of control measures incorporated into a cholera epidemic setting: treatment, vaccination and sanitation. Essential dynamical properties of the model with constant intervention controls which include local and global stabilities for the equilibria are carefully analyzed. Further, using optimal control techniques, we perform a study to investigate cost-effective solutions for time-dependent public health interventions in order to curb disease transmission in epidemic settings. Our results show that the basic reproductive number (R0) remains the model's epidemic threshold despite the inclusion of a package of cholera interventions. For time-dependent controls, the results suggest that these interventions closely interplay with each other, and the costs of controls directly affect the length and strength of each control in an optimal strategy. Copyright © 2015 Elsevier Inc. All rights reserved.

Patients with Gout Treated with Conventional Urate-lowering Therapy: Association with Disease Control, Health-related Quality of Life, and Work Productivity.

PubMed

Wood, Robert; Fermer, Steve; Ramachandran, Sulabha; Baumgartner, Scott; Morlock, Robert

2016-10-01

Implications of inadequate gout control were assessed through health-related quality of life (HRQOL) and work productivity of patients with gout adequately controlled while taking conventional urate-lowering therapy (ULT) for ≥ 3 months vs those whose gout was inadequately controlled. Retrospective data were drawn from the Adelphi Disease Specific Programme (DSP), a cross-sectional survey of patients with gout in France, Germany, the United Kingdom, and the United States. Patients completed these questionnaires: EQ-5D (3L), Patient Reported Outcomes Measurement Information System (PROMIS) Health Assessment Questionnaire (HAQ), and Work Productivity and Activity Impairment. Inadequate control was defined as the most recent serum uric acid (SUA) level > 6 mg/dl (> 360 µmol/l) or ≥ 2 flares in the last 12 months; adequate control as SUA level ≤ 6 mg/dl (≤ 360 µmol/l) and 0 flares. Appropriate statistical tests were used to assess differences between groups. There were 836 (69%) inadequately and 368 (31%) adequately controlled gout cases. Mean age was 61 and 63 years and duration of current ULT was 32 and 57 months, respectively. Patients experiencing inadequate control reported significantly worse functioning and HRQOL, as measured by the EQ-5D (0.790 vs 0.877; difference: -0.087; p < 0.001) and PROMIS HAQ (13.21 vs 6.91; difference: 6.30; p < 0.001) scales. Productivity was also more impaired (work time missed: 4.5% vs 1.3%; impairment while working: 19.1% vs 5.2%; overall work impairment: 20.4% vs 5.6%; activity impairment: 20.3% vs 5.3%; all p < 0.001). Less than one-third of patients had gout that was adequately controlled. Those experiencing inadequately controlled gout reported significantly worse functioning, quality of life, and work productivity. Gout treatment strategies to improve disease control may lead to improvements in HRQOL and productivity.

Recommendations for intensive care unit and hospital preparations for an influenza epidemic or mass disaster: summary report of the European Society of Intensive Care Medicine's Task Force for intensive care unit triage during an influenza epidemic or mass disaster.

PubMed

Sprung, Charles L; Zimmerman, Janice L; Christian, Michael D; Joynt, Gavin M; Hick, John L; Taylor, Bruce; Richards, Guy A; Sandrock, Christian; Cohen, Robert; Adini, Bruria

2010-03-01

To provide recommendations and standard operating procedures for intensive care units and hospital preparedness for an influenza pandemic. Based on a literature review and expert opinion, a Delphi process was used to define the essential topics. Key recommendations include: Hospitals should increase their ICU beds to the maximal extent by expanding ICU capacity and expanding ICUs into other areas. Hospitals should have appropriate beds and monitors for these expansion areas. Establish a management system with control groups at facility, local, regional and/or national levels to exercise authority over resources. Establish a system of communication, coordination and collaboration between the ICU and key interface departments. A plan to access, coordinate and increase labor resources is required with a central inventory of all clinical and non-clinical staff. Delegate duties not within the usual scope of workers' practice. Ensure that adequate essential medical equipment, pharmaceuticals and supplies are available. Protect patients and staff with infection control practices and supporting occupational health policies. Maintain staff confidence with reassurance plans for legal protection and assistance. Have objective, ethical, transparent triage criteria that are applied equitably and publically disclosed. ICU triage of patients should be based on the likelihood for patients to benefit most or a 'first come, first served' basis. Develop protocols for safe performance of high-risk procedures. Train and educate staff. Mortality, although inevitable during a severe influenza outbreak or disaster, can be reduced by adequate preparation.

21 CFR 1404.900 - Adequate evidence.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 9 2011-04-01 2011-04-01 false Adequate evidence. 1404.900 Section 1404.900 Food and Drugs OFFICE OF NATIONAL DRUG CONTROL POLICY GOVERNMENTWIDE DEBARMENT AND SUSPENSION... support the reasonable belief that a particular act or omission has occurred. ...

21 CFR 1404.900 - Adequate evidence.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 9 2014-04-01 2014-04-01 false Adequate evidence. 1404.900 Section 1404.900 Food and Drugs OFFICE OF NATIONAL DRUG CONTROL POLICY GOVERNMENTWIDE DEBARMENT AND SUSPENSION... support the reasonable belief that a particular act or omission has occurred. ...

21 CFR 1404.900 - Adequate evidence.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 9 2013-04-01 2013-04-01 false Adequate evidence. 1404.900 Section 1404.900 Food and Drugs OFFICE OF NATIONAL DRUG CONTROL POLICY GOVERNMENTWIDE DEBARMENT AND SUSPENSION... support the reasonable belief that a particular act or omission has occurred. ...

21 CFR 1404.900 - Adequate evidence.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 9 2012-04-01 2012-04-01 false Adequate evidence. 1404.900 Section 1404.900 Food and Drugs OFFICE OF NATIONAL DRUG CONTROL POLICY GOVERNMENTWIDE DEBARMENT AND SUSPENSION... support the reasonable belief that a particular act or omission has occurred. ...

21 CFR 1404.900 - Adequate evidence.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Adequate evidence. 1404.900 Section 1404.900 Food and Drugs OFFICE OF NATIONAL DRUG CONTROL POLICY GOVERNMENTWIDE DEBARMENT AND SUSPENSION... support the reasonable belief that a particular act or omission has occurred. ...

Relative associations of cattle movements, local spread, and biosecurity with bovine viral diarrhoea virus (BVDV) seropositivity in beef and dairy herds.

PubMed

Gates, M C; Woolhouse, M E J; Gunn, G J; Humphry, R W

2013-11-01

The success of bovine viral diarrhoea virus (BVDV) eradication campaigns can be undermined by spread through local transmission pathways and poor farmer compliance with biosecurity recommendations. This work combines recent survey data with cattle movement data to explore the issues likely to impact on the success of BVDV control in Scotland. In this analysis, data from 249 beef suckler herds and 185 dairy herds in Scotland were studied retrospectively to determine the relative influence of cattle movements, local spread, and biosecurity on BVDV seropositivity. Multivariable logistic regression models revealed that cattle movement risk factors had approximately 3 times greater explanatory power than risk factors for local spread amongst beef suckler herds, but approximately the same explanatory power as risk factors for local spread amongst dairy herds. These findings are most likely related to differences in cattle husbandry practices and suggest that where financial prioritization is required, focusing on reducing movement-based risk is likely to be of greatest benefit when applied to beef suckler herds. The reported use of biosecurity measures such as purchasing cattle from BVDV accredited herds only, performing diagnostic screening at the time of sale, implementing isolation periods for purchased cattle, and installing double fencing on shared field boundaries had minimal impact on the risk of beef or dairy herds being seropositive for BVDV. Only 28% of beef farmers and 24% of dairy farmers with seropositive herds recognized that their cattle were affected by BVDV and those that did perceive a problem were no less likely to sell animals as replacement breeding stock and no more likely to implement biosecurity measures against local spread than farmers with no perceived problems. In relation to the current legislative framework for BVDV control in Scotland, these findings emphasize the importance of requiring infected herds take appropriate biosecurity measures to prevent further disease transmission and conducting adequate follow-up to ensure that biosecurity measures are being implemented correctly in the field. Copyright © 2013 Elsevier B.V. All rights reserved.

Creating Opportunities for Training California's Public Health Workforce

ERIC Educational Resources Information Center

Demers, Anne L.; Mamary, Edward; Ebin, Vicki J.

2011-01-01

Introduction: Today there are significant challenges to public health, and effective responses to them will require complex approaches and strategies implemented by a qualified workforce. An adequately prepared workforce requires long-term development; however, local health departments have limited financial and staff resources. Schools and…

Personnel Needs of Two-Year College Libraries.

ERIC Educational Resources Information Center

Blocker, Clyde E.

Community college librarians should have an understanding of student and faculty characteristics at the local institution, occupationally oriented programs, and the role of professional and semiprofessional library staff members in order to serve their clientele more adequately. Realizing that community college students have average or below…

Education Issues. Transition Series.

ERIC Educational Resources Information Center

Comptroller General of the U.S., Washington, DC.

The United States educational system is not meeting the increasing demand for highly skilled workers required in the international marketplace. While local, state, and federal governments spend $221 billion on public elementary and secondary education, only a small percentage of the nation's students have adequate reasoning and problem-solving…

Housing for Migrant Agricultural Workers.

ERIC Educational Resources Information Center

Simons, J. W.; And Others

Intended to assist the producer in meeting the housing regulations of Federal, state, and local governments for migratory workers and thereby to attract better labor through adequate housing, this agricultural handbook contains discussions of the migrant-labor situation; regulations and standards; general housing considerations (i.e., length of…

Nationwide examples of state and local funds for mass transit : final report, December 2008.

DOT National Transportation Integrated Search

2008-12-04

One of the transportation challenges facing Texas is the identification of adequate funding for : mobility projects. During the 80th Texas Legislature, several proposals were made to address : mass transit funding for the metropolitan areas of the st...

40 CFR 35.2116 - Collection system.

Code of Federal Regulations, 2010 CFR

2010-07-01

... STATE AND LOCAL ASSISTANCE Grants for Construction of Treatment Works § 35.2116 Collection system... adequately treat such collected wastewater and where the bulk (generally two-thirds) of the expected flow (flow from existing plus future residential users) will be from the resident population on October 18...

34 CFR 361.37 - Information and referral programs.

Code of Federal Regulations, 2010 CFR

2010-07-01

... State agency will implement an information and referral system adequate to ensure that individuals with... receiving vocational rehabilitation services if the agency is operating on an order of selection, are... statewide workforce investment system. (b) The State unit must refer to local extended employment providers...

Effects of antioxidants on CD4 and viral load in HIV-infected women in sub-Saharan Africa - dietary supplements vs. local diet.

PubMed

Nkengfack, Germaine N; Torimiro, Judith N; Englert, Heike

2012-02-01

In sub-Sahara Africa, micronutrient deficiency, especially of antioxidant micronutrients including vitamins A, C, and E, beta-carotene, selenium, zinc, and polyphenols is very common in HIV-positive patients. Amongst adults, women are the most vulnerable. Antioxidants are known to play a vital role in the immune system, reducing oxidative stress. Oxidative stress is induced by excess production of reactive oxygen species (ROS), due to the HIV infection. Such damage may be prevented or moderated through adequate oral intake of antioxidants, scavenging ROS, as well as protecting cells and tissues against oxidative stress. Antioxidants can be provided to the body through locally available antioxidant rich-diets such as fruit-and-vegetable-based diets and/or dietary supplements. Provision of antioxidants through local diets or dietary supplements exercise beneficial effects on biological markers of the immune system (CD4 and viral load). However, while dietary supplements represent a costly and short-term strategy to limiting antioxidant deficiency, local diets, combined with adequate nutritional education, can provide a low-cost and long-term strategy to reduce oxidative stress, prevent micronutrient deficiency, and slow down HIV disease progression. The former can be applicable in countries around the West, Central, and South coast of Africa, which are rich in natural food resources. In contrast with significant evidence that dietary supplements confer benefits in HIV patients, fewer data are available relating to the benefits of local diets. Thus the need to do more research in this area arises. This review compares available data on effects of antioxidants on CD4 and viral load in HIV-positive women noneligible for antiretroviral therapy. Intake of antioxidants though dietary supplements and local diet, associated with nutritional education, is compared. Studies conducted in sub-Sahara Africa are considered.

Can we scientifically and reliably measure the level of consciousness in vegetative and minimally conscious States? Rasch analysis of the coma recovery scale-revised.

PubMed

La Porta, Fabio; Caselli, Serena; Ianes, Aladar Bruno; Cameli, Olivia; Lino, Mario; Piperno, Roberto; Sighinolfi, Antonella; Lombardi, Francesco; Tennant, Alan

2013-03-01

(1) To appraise, by the means of Rasch analysis, the internal validity and reliability of the Coma Recovery Scale-Revised (CRS-R) in a sample of patients with disorder of consciousness (DOC); and (2) to provide information about the comparability of CRS-R scores across persons with DOC across different settings and groups, including different etiologies. Multicenter observational prospective study. Two rehabilitation wards, 1 intermediate care facility, and 2 nursing homes in Italy. Consecutively admitted patients (N=129) for which assessments at 2 different time points were available, giving a total sample of 258 observations. Not applicable. CRS-R. After controlling for any possible dependency between persons' measures collected at different time points, and for uniform differential item functioning by etiology showed by the visual subscale, Rasch analysis demonstrated adequate satisfaction of all the model's requirements, including adequate ordering of scoring categories, unidimensionality, local independence, invariance (χ(2)21=27.798, P=.146), and absence of differential item functioning across patients' sex, age, time, and setting. The reliability (person separation index=.896) was adequate for individual person measurement. We devised a practical raw score to measure conversion tables based on the CRS-R calibrations. The CRS-R is a psychometrically sound and robust measurement tool. The linear measures of ability derived from the CRS-R total scores do satisfy all the principles of scientific measurement and are sufficiently reliable for high stakes assessments, such as the diagnosis of the level of consciousness in individual patients. Future studies are needed to directly explore the capabilities of the CRS-R measures to reduce the risk of vegetative state misdiagnosis. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Promoting Food Security for All Children.

PubMed

2015-11-01

Sixteen million US children (21%) live in households without consistent access to adequate food. After multiple risk factors are considered, children who live in households that are food insecure, even at the lowest levels, are likely to be sick more often, recover from illness more slowly, and be hospitalized more frequently. Lack of adequate healthy food can impair a child's ability to concentrate and perform well in school and is linked to higher levels of behavioral and emotional problems from preschool through adolescence. Food insecurity can affect children in any community, not only traditionally underserved ones. Pediatricians can play a central role in screening and identifying children at risk for food insecurity and in connecting families with needed community resources. Pediatricians should also advocate for federal and local policies that support access to adequate healthy food for an active and healthy life for all children and their families. Copyright © 2015 by the American Academy of Pediatrics.

Spacecraft Formation Flying Maneuvers Using Linear Quadratic Regulation With No Radial Axis Inputs

NASA Technical Reports Server (NTRS)

Starin, Scott R.; Yedavalli, R. K.; Sparks, Andrew G.; Bauer, Frank H. (Technical Monitor)

2001-01-01

Regarding multiple spacecraft formation flying, the observation has been made that control thrust need only be applied coplanar to the local horizon to achieve complete controllability of a two-satellite (leader-follower) formation. A formulation of orbital dynamics using the state of one satellite relative to another is used. Without the need for thrust along the radial (zenith-nadir) axis of the relative reference frame, propulsion system simplifications and weight reduction may be accomplished. This work focuses on the validation of this control system on its own merits, and in comparison to a related system which does provide thrust along the radial axis of the relative frame. Maneuver simulations are performed using commercial ODE solvers to propagate the Keplerian dynamics of a controlled satellite relative to an uncontrolled leader. These short maneuver simulations demonstrate the capacity of the controller to perform changes from one formation geometry to another. Control algorithm performance is evaluated based on measures such as the fuel required to complete a maneuver and the maximum acceleration required by the controller. Based on this evaluation, the exclusion of the radial axis of control still allows enough control authority to use Linear Quadratic Regulator (LQR) techniques to design a gain matrix of adequate performance over finite maneuvers. Additional simulations are conducted including perturbations and using no radial control inputs. A major conclusion presented is that control inputs along the three axes have significantly different relationships to the governing orbital dynamics that may be exploited using LQR.

Evolution of the VLT instrument control system toward industry standards

NASA Astrophysics Data System (ADS)

Kiekebusch, Mario J.; Chiozzi, Gianluca; Knudstrup, Jens; Popovic, Dan; Zins, Gerard

2010-07-01

The VLT control system is a large distributed system consisting of Linux Workstations providing the high level coordination and interfaces to the users, and VME-based Local Control Units (LCU's) running the VxWorks real-time operating system with commercial and proprietary boards acting as the interface to the instrument functions. After more than 10 years of VLT operations, some of the applied technologies used by the astronomical instruments are being discontinued making it difficult to find adequate hardware for future projects. In order to deal with this obsolescence, the VLT Instrumentation Framework is being extended to adopt well established Commercial Off The Shelf (COTS) components connected through industry standard fieldbuses. This ensures a flexible state of the art hardware configuration for the next generation VLT instruments allowing the access to instrument devices via more compact and simpler control units like PC-based Programmable Logical Controllers (PLC's). It also makes it possible to control devices directly from the Instrument Workstation through a normal Ethernet connection. This paper outlines the requirements that motivated this work, as well as the architecture and the design of the framework extension. In addition, it describes the preliminary results on a use case which is a VLTI visitor instrument used as a pilot project to validate the concepts and the suitability of some COTS products like a PC-based PLCs, EtherCAT8 and OPC UA6 as solutions for instrument control.

Macrocognition in Teams and Analysis of Information Flow During the Haiti Disaster Relief

DTIC Science & Technology

2011-06-01

supplies, clean water and electricity. TIE TIE TIE Local soccer field is now a safe landing ground for helicopters. TIE TIE TIE Five flights have...TIE TIE OR’s adequate medical supplies, clean water and electricity (generator) TIE TIE TIE Local soccer field is landing pad. TIE TIE TIE 5... soccer /helo pad, TIE TIE TIE Have own ambulances for transport. TIE TIE TIE 62 Contact: "NAME" (Ground Coordinator) Haiti cell "PHONE", "E

Water resources of the Redwood River watershed, southwestern Minnesota

USGS Publications Warehouse

Van Voast, Wayne A.; Jerabek, L.A.; Novitzki, R.P.

1970-01-01

The land surface slopes gently northeastward and eastward from altitudes greater than 1900 feet at the southwestern edge to less than 850 feet at the mouth of the Redwood River in the east. The area has slight local relief shaped by continental glaciation. The Redwood River and its tributaries, many of which are ephemeral, and ponds and lakes in the area provide water for local use and habitat for wildlife. The glacial drift and sedimentary rocks yield generally adequate water supplies for municipalities, households, and farms.

The Cool Hand Luke Effect: Failure to Communicate Effectively (Invited)

NASA Astrophysics Data System (ADS)

Davidson, M. A.

2010-12-01

There is a growing concern with the accelerating rate of local sea level change and its implications for local and regional planning and development. While there are a growing number of local governments that are beginning to seriously consider their adaptation options, the vast majority of local leaders have not yet developed confidence in the various scenarios that are currently available. To adequately address the range of possible impacts and options for addressing local sea level change, one must have more than high resolution data, model output and decision support tools. We need to have a better understandin of the range of likely impacts upon and the value of local ecosystem services as well as as understanding of the foundations of the local economies. A sound scientific foundation must exist to support 'decision making under uncertainty' but we also need to understand the very local specific cultural frameworks within which decision makers must work. This is why working with local civic organizations, NGOs and other boundary organizations is increasingly important.

The personal and general hygiene practices of food handlers in the delicatessen sections of retail outlets in South Africa.

PubMed

van Tonder, Izanne; Lues, Jan F R; Theron, Maria M

2007-11-01

This paper presents data on personal- and general-hygiene knowledge and practices among food handlers in the delicatessens of a major retail group in the Western Cape in South Africa. Food handlers were interviewed by means of a structured questionnaire. Although the majority of food handlers adhered to basic hygiene principles, there is definitely a need for proper and continuous training in personal and general hygiene, not only for food handlers, but also for management. The study reported here is of importance particularly in view of new local regulations governing the application of the hazard analysis and critical control point (HACCP) system. Management is responsible for the implementation of this system, and where supervision is not adequate, the manager of the outlet should intervene to ensure that staff conform to the requirements.

Synovial sarcoma of the temporomandibular joint and infratemporal fossa.

PubMed

Nomura, Fuminori; Kishimoto, Seiji

2014-12-01

Synovial sarcoma in the head and neck region is rare, and is difficult to resect with adequate safety margins because of its anatomical complexity. We herein report our experiences with synovial sarcoma in this region, and review the literature regarding the management of such cases. We retrospectively examined four cases of synovial sarcoma arising from the temporomandibular joint (TMJ) area and infratemporal fossa. Only one patient remains alive without disease, while the other three patients have died. The local control of these tumors has improved because of the progress in the surgical operation methods, while it is expected that there is still a high rate of deaths due to distant metastasis increase. The development of strong chemotherapy is needed for the use after the initial treatment and surgery. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Media and Innovation Spark a Revolution in Higher Education in Iran

ERIC Educational Resources Information Center

Cummings, John; Rashidpour, Ebrahim

1976-01-01

A massive growth of the economy has fueled a continuing crisis in providing adequately trained professionals for Iran. One answer has been the creation of the Free University of Iran. Local Centers will form a network modeled after the British Open University. (Author/BD)

Use of DNA barcodes to identify invasive armyworm Spodoptera species in Florida

USDA-ARS?s Scientific Manuscript database

A critical component for sustaining adequate food production is the protection of local agriculture from invasive pest insects. Essential to this goal is the ability to accurately distinguish foreign from closely related domestic species, a process that has traditionally required identification of d...

Protecting Our Own. Community Child Passenger Safety Programs.

ERIC Educational Resources Information Center

National Highway Traffic Safety Administration (DOT), Washington, DC.

This manual provides information on implementing a local child passenger safety program. It covers understanding the problems and solutions; deciding what can be done; planning and carrying out a project; providing adequate, accurate, and current technical information; and reaching additional sources of information. Chapter 1 provides community…

Sexual Harassment and Government Accountants: Anecdotal Evidence from the Profession.

ERIC Educational Resources Information Center

Stanko, Brian; Miller, Gerald J.

1996-01-01

Female accountants (330 of 650) in local, state, or federal agencies responded to general attitude statements and added narrative comments indicating that sexual harassment is a serious problem in the government accounting workplace. Many feel that their agencies have not addressed the issue adequately. (SK)

34 CFR 361.37 - Information and referral programs.

Code of Federal Regulations, 2012 CFR

2012-07-01

... State agency will implement an information and referral system adequate to ensure that individuals with... statewide workforce investment system. (b) The State unit must refer to local extended employment providers....e., employment in an integrated setting); (2) Consistent with § 361.52 of this part, provide the...

34 CFR 361.37 - Information and referral programs.

Code of Federal Regulations, 2013 CFR

2013-07-01

... State agency will implement an information and referral system adequate to ensure that individuals with... statewide workforce investment system. (b) The State unit must refer to local extended employment providers....e., employment in an integrated setting); (2) Consistent with § 361.52 of this part, provide the...

34 CFR 361.37 - Information and referral programs.

Code of Federal Regulations, 2014 CFR

2014-07-01

... State agency will implement an information and referral system adequate to ensure that individuals with... statewide workforce investment system. (b) The State unit must refer to local extended employment providers....e., employment in an integrated setting); (2) Consistent with § 361.52 of this part, provide the...

34 CFR 361.37 - Information and referral programs.

Code of Federal Regulations, 2011 CFR

2011-07-01

... State agency will implement an information and referral system adequate to ensure that individuals with... statewide workforce investment system. (b) The State unit must refer to local extended employment providers....e., employment in an integrated setting); (2) Consistent with § 361.52 of this part, provide the...

40 CFR 35.935-8 - Supervision.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Supervision. 35.935-8 Section 35.935-8 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GRANTS AND OTHER FEDERAL ASSISTANCE STATE AND LOCAL... any project involving Step 3, the grantee will provide and maintain competent and adequate engineering...

Aid and Education in the South Pacific.

ERIC Educational Resources Information Center

Luteru, P. H.; Teasdale, G. R.

1993-01-01

Pacific Island nations perceive their main educational needs and priorities to be expansion of primary education, locally relevant curriculum development, provision of adequate facilities and resources, and teacher education. Yet, driven by self-interest, international aid donors such as Australia and New Zealand concentrate their funding on…

78 FR 46274 - Pyroxasulfone; Pesticide Tolerances

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-31

... following a 4-week dermal exposure producing local inflammation and systemic effects of minimal to mild...- linear approach (i.e., Reference dose (RfD)) will adequately account for all chronic toxicity, including... and other relevant data. Cancer risk is quantified using a linear or nonlinear approach. If sufficient...

Understanding the value of local ecological knowledge and practices for habitat restoration in human-altered floodplain systems: a case from Bangladesh.

PubMed

Mamun, Abdullah-Al

2010-05-01

Worldwide there is a declining trend in natural fish catch (FAO, The state of world fisheries and aquaculture. http://www.fao.org/documents/show_cdr.asp?url_file=/docrep/007/y5600e/y5600e00.htm , 2002) and Bangladesh is no exception. The vast inland fisheries of Bangladesh have been declining over the years, largely a result of human alteration of the aquatic habitats arising from human interventions in the floodplain systems such as the establishment of water control structures which favor agricultural production but reduce fish habitats. It can be assumed that conventional management measures are not adequate to conserve natural fisheries and exploring alternative knowledge systems to complement existing management is warranted. This paper focuses on local ecological knowledge and several other local practices held by fishers engaging directly with floodplain ecosystems. These knowledge systems and practices may be valuable tools for understanding ecosystems processes and related changes and developing local level responses to avert negative consequences of such changes. This may help in devising alternatives to ecosystem management and the conservation of floodplain fish habitats of Bangladesh and elsewhere in the world. This study was conducted in a natural depression (locally called beel) and its surrounding floodplain system located in north central Bangladesh which has become highly degraded. The results of the study indicate that the fishers and local users of the floodplain ecosystems are rich in local ecological knowledge concerning the hydrology of the floodplains and small lakes, the habitat preferences of fish, the role of agricultural crops on fish habitats, and the impact of habitat human interventions in aquatic ecosystems. Given the apparent inadequacy of the present management regime, this article argues for an inclusion of local knowledge and practices into habitat management as a more holistic approach to floodplain habitat restoration and conservation that encourages multi-level cooperation and which builds on diversified knowledge systems.

Medicare and Medicaid Programs; Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers. Final rule.

PubMed

2016-09-16

This final rule establishes national emergency preparedness requirements for Medicare- and Medicaid-participating providers and suppliers to plan adequately for both natural and man-made disasters, and coordinate with federal, state, tribal, regional, and local emergency preparedness systems. It will also assist providers and suppliers to adequately prepare to meet the needs of patients, residents, clients, and participants during disasters and emergency situations. Despite some variations, our regulations will provide consistent emergency preparedness requirements, enhance patient safety during emergencies for persons served by Medicare- and Medicaid-participating facilities, and establish a more coordinated and defined response to natural and man-made disasters.

A cluster randomized trial of routine HIV-1 viral load monitoring in Zambia: study design, implementation, and baseline cohort characteristics.

PubMed

Koethe, John R; Westfall, Andrew O; Luhanga, Dora K; Clark, Gina M; Goldman, Jason D; Mulenga, Priscilla L; Cantrell, Ronald A; Chi, Benjamin H; Zulu, Isaac; Saag, Michael S; Stringer, Jeffrey S A

2010-03-12

The benefit of routine HIV-1 viral load (VL) monitoring of patients on antiretroviral therapy (ART) in resource-constrained settings is uncertain because of the high costs associated with the test and the limited treatment options. We designed a cluster randomized controlled trial to compare the use of routine VL testing at ART-initiation and at 3, 6, 12, and 18 months, versus our local standard of care (which uses immunological and clinical criteria to diagnose treatment failure, with discretionary VL testing when the two do not agree). Dedicated study personnel were integrated into public-sector ART clinics. We collected participant information in a dedicated research database. Twelve ART clinics in Lusaka, Zambia constituted the units of randomization. Study clinics were stratified into pairs according to matching criteria (historical mortality rate, size, and duration of operation) to limit the effect of clustering, and independently randomized to the intervention and control arms. The study was powered to detect a 36% reduction in mortality at 18 months. From December 2006 to May 2008, we completed enrollment of 1973 participants. Measured baseline characteristics did not differ significantly between the study arms. Enrollment was staggered by clinic pair and truncated at two matched sites. A large clinical trial of routing VL monitoring was successfully implemented in a dynamic and rapidly growing national ART program. Close collaboration with local health authorities and adequate reserve staff were critical to success. Randomized controlled trials such as this will likely prove valuable in determining long-term outcomes in resource-constrained settings. Clinicaltrials.gov NCT00929604.

Piloted evaluation of an integrated propulsion and flight control simulator

NASA Technical Reports Server (NTRS)

Bright, Michelle M.; Simon, Donald L.

1992-01-01

This paper describes a piloted evaluation of the integrated flight and propulsion control simulator at NASA Lewis Research Center. The purpose of this evaluation is to demonstrate the suitability and effectiveness of this fixed based simulator for advanced integrated propulsion and airframe control design. The evaluation will cover control effector gains and deadbands, control effectiveness and control authority, and heads up display functionality. For this evaluation the flight simulator is configured for transition flight using an advanced Short Take-Off and vertical Landing fighter aircraft model, a simplified high-bypass turbofan engine model, fighter cockpit, displays, and pilot effectors. The paper describes the piloted tasks used for rating displays and control effector gains. Pilot comments and simulation results confirm that the display symbology and control gains are very adequate for the transition flight task. Additionally, it is demonstrated that this small-scale, fixed base flight simulator facility can adequately perform a real time, piloted control evaluation.

Naming Speed in Dyslexia and Dyscalculia

ERIC Educational Resources Information Center

Willburger, Edith; Fussenegger, Barbara; Moll, Kristina; Wood, Guilherme; Landerl, Karin

2008-01-01

In four carefully selected samples of 8- to 10-year old children with dyslexia (but age adequate arithmetic skills), dyscalculia (but age adequate reading skills), dyslexia/dyscalculia and controls a domain-general deficit in rapid automatized naming (RAN) was found for both dyslexia groups. Dyscalculic children exhibited a domain-specific deficit…

21 CFR 211.46 - Ventilation, air filtration, air heating and cooling.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 4 2014-04-01 2014-04-01 false Ventilation, air filtration, air heating and... Buildings and Facilities § 211.46 Ventilation, air filtration, air heating and cooling. (a) Adequate ventilation shall be provided. (b) Equipment for adequate control over air pressure, micro-organisms, dust...

21 CFR 211.46 - Ventilation, air filtration, air heating and cooling.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 4 2013-04-01 2013-04-01 false Ventilation, air filtration, air heating and... Buildings and Facilities § 211.46 Ventilation, air filtration, air heating and cooling. (a) Adequate ventilation shall be provided. (b) Equipment for adequate control over air pressure, micro-organisms, dust...

21 CFR 211.46 - Ventilation, air filtration, air heating and cooling.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 4 2012-04-01 2012-04-01 false Ventilation, air filtration, air heating and... Buildings and Facilities § 211.46 Ventilation, air filtration, air heating and cooling. (a) Adequate ventilation shall be provided. (b) Equipment for adequate control over air pressure, micro-organisms, dust...

21 CFR 211.46 - Ventilation, air filtration, air heating and cooling.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 4 2011-04-01 2011-04-01 false Ventilation, air filtration, air heating and... Buildings and Facilities § 211.46 Ventilation, air filtration, air heating and cooling. (a) Adequate ventilation shall be provided. (b) Equipment for adequate control over air pressure, micro-organisms, dust...

Resection Arthroplasty Compared With Total Hip Arthroplasty in Treating Chronic Hip Pain of Patients With a History of Substance Abuse.

PubMed

Curtis, William; Marmor, Meir

2018-03-16

Retrospective comparison of surgical management of severe hip pain in patients with a history of substance abuse treated by modified Girdlestone resection arthroplasty (RA) vs delayed total hip arthroplasty (THA) following yearlong sobriety pathway. Patients were identified using charts, current procedural terminology (CPT) code query, and THA sobriety pathway registry. The primary outcome was adequate pain control following surgery, defined as visual analog scale ≤ 5 or verbal description of "moderate" or lower pain. RA patients with infectious arthritis were analyzed separately. The secondary outcome was the level of mobility after surgery. In the THA pathway, 15 of 28 (53.6%) proved sobriety, 11 (39.3%) underwent THA, and 9 (32.1%) achieved adequate pain control (median 77 days). After RA, 19 (76%) achieved adequate pain control (median 119.5 days). Preoperative infection did not significantly affect time to pain control after RA (P = .94). Time to adequate pain control was not significantly different between RA and THA patients (P = .19). Three patients (30%) experienced improved level of mobility after THA and 7 (70%) experienced no change. After RA, 7 patients (29.1%) experienced improved level of mobility, 3 (13.6%) lost mobility, and 14 (63.6%) experienced no change. Three RA patients were later converted to THA without complication. Yearlong sobriety pathway leading to THA leads to successful pain control in less than one-third of enrolled patients. Compared to delayed THA, RA enables more patients with substance abuse to be treated sooner and results in successful reduction of pain in a similar proportion of patients. RA may be an effective pain-reducing procedure for these patients. Copyright © 2018 Elsevier Inc. All rights reserved.

Optical microscopy of targeted drug delivery and local distribution in skin of a topical minocycline: implications in translational research and guidance for therapeutic dose selection (Conference Presentation)

NASA Astrophysics Data System (ADS)

Hermsmeier, Maiko; Sawant, Tanvee; Lac, Diana; Yamamoto, Akira; Chen, Xin; Huang, Susan Y.; Nagavarapu, Usha; Evans, Conor L.; Chan, Kin Foong; Daniels, AnnaMarie

2017-02-01

Acne vulgaris is a chronic inflammatory skin condition commonly resulting in negative aesthetic and social impacts on those affected. Minocycline, currently available as an oral antibiotic for moderate to severe acne, has a known minimum inhibitory concentration (MIC) for the acne-causing bacterium Propionibacterium acnes (P. acnes) in vitro, with its anti-inflammatory properties also eliciting inhibitory effects on pro-inflammatory molecules. A novel topical gel composition containing solubilized minocycline (BPX-01) has been developed to directly deliver the drug to the skin. Because minocycline is a known fluorophore, fluorescence microscopy and concurrent quantitative measurements were performed on excised human facial skin dosed with different concentrations, in order to determine the spatial distribution of the drug and quantification of its local concentration in the epidermis and the pilosebaceous unit where P. acnes generally reside. Local minocycline delivery confirmed achievement of an adequate therapeutic dose to support clinical studies. Subsequently, a 4-week double-blind, randomized, vehicle controlled clinical study was performed to assess the safety and efficacy of 1% minocycline BPX-01 applied daily. No instances of cutaneous toxicity were reported, and a greater than 1 log reduction of P. acnes count was observed at week 4 with statistical significance from baseline and vehicle control. In addition, no detectable amounts of minocycline in the plasma were reported, suggesting the potential of this new formulation to diminish the known systemic adverse effects associated with oral minocycline. Follow-on clinical plans are underway to further establish the safety of BPX-01 and to evaluate its efficacy against inflammatory acne lesions in a 225 patient multi-center dose-finding study.

Importance of adequate local spatiotemporal transmission measures in malaria cohort studies: application to the relation between placental malaria and first malaria infection in infants.

PubMed

Le Port, Agnès; Cottrell, Gilles; Chandre, Fabrice; Cot, Michel; Massougbodji, Achille; Garcia, André

2013-07-01

According to several studies, infants whose mothers had a malaria-infected placenta (MIP) at delivery are at increased risk of a first malaria infection. Immune tolerance caused by intrauterine contact with the parasite could explain this phenomenon, but it is also known that infants who are highly exposed to Anopheles mosquitoes infected with Plasmodium are at greater risk of contracting malaria. Consequently, local malaria transmission must be taken into account to demonstrate the immune tolerance hypothesis. From data collected between 2007 and 2010 on 545 infants followed from birth to age 18 months in southern Benin, we compared estimates of the effect of MIP on time to first malaria infection obtained through different Cox models. In these models, MIP was adjusted for either 1) "village-like" time-independent exposure variables or 2) spatiotemporal exposure prediction derived from local climatic, environmental, and behavioral factors. Only the use of exposure prediction improved the model's goodness of fit (Bayesian Information Criterion) and led to clear conclusions regarding the effect of placental infection, whereas the models using the village-like variables were less successful than the univariate model. This demonstrated clearly the benefit of adequately taking transmission into account in cohort studies of malaria.

The almost-invisible perineurioma.

PubMed

Restrepo, Carlos E; Amrami, Kimberly K; Howe, Benjamin M; Dyck, P James B; Mauermann, Michelle L; Spinner, Robert J

2015-09-01

Intraneural perineurioma is a rare, benign slow-growing lesion arising from the perineurial cells that surrounds the peripheral nerve fibers. Typically it presents during childhood and young adulthood as a motor mononeuropathy. MRI plays an essential role in the diagnosis and localization of the lesion, which appears as a fusiform enlargement of the nerve fascicles that enhances intensely with gadolinium. Despite the typical clinical and radiological features, intraneural perineurioma remains largely underdiagnosed because of the lack of familiarity with this entity, but also as a result of technical limitations with conventional MRI that is typically performed as a screening test over a large field of view and without contrast sequences. The purpose of this article is to present the pitfalls and pearls learned from years of experience in the diagnosis and management of this relatively rare condition. Clinical suspicion and detailed neurological examination followed by high-quality electrophysiological studies (EPS) must lead to an adequate preimaging localization of the lesion and narrowing of the imaging area. The use of high-resolution (3-T) MRI combined with gadolinium administration will allow adequate visualization of the internal anatomy of the nerve and help in differentiating other causes of neuropathy. In cases where the lesion is not recognized but clinical suspicion is high, possible errors must be assessed, including the EPS localization, area of imaging, MRI resolution, and slice thickness.

14 CFR 171.113 - Installation requirements.

Code of Federal Regulations, 2013 CFR

2013-01-01

... facilities. (c) The facility must have a reliable source of suitable primary power, either from a power distribution system or locally generated. Also, adequate power capacity must be provided for operation of test... a facility will be required to have standby power for the SDF and monitor accessories to supplement...

14 CFR 171.113 - Installation requirements.

Code of Federal Regulations, 2014 CFR

2014-01-01

... facilities. (c) The facility must have a reliable source of suitable primary power, either from a power distribution system or locally generated. Also, adequate power capacity must be provided for operation of test... a facility will be required to have standby power for the SDF and monitor accessories to supplement...

14 CFR 171.113 - Installation requirements.

Code of Federal Regulations, 2012 CFR

2012-01-01

... facilities. (c) The facility must have a reliable source of suitable primary power, either from a power distribution system or locally generated. Also, adequate power capacity must be provided for operation of test... a facility will be required to have standby power for the SDF and monitor accessories to supplement...

24 CFR 115.205 - Certification procedures.

Code of Federal Regulations, 2010 CFR

2010-04-01

... to the agency and for communication procedures between the agency and HUD that are adequate to permit... certify to the Assistant Secretary that the state or local fair housing law, “on its face,” continues to... Section 115.205 Housing and Urban Development Regulations Relating to Housing and Urban Development OFFICE...

Complementary Roles of Spark Range and Onboard Free-Flight Measurements for Projectile Development

DTIC Science & Technology

2009-08-01

MET data adequate for aerodynamic analysis requires coordinating with local MET personnel for the release of balloons at strategic times and...TACOM ARDEC AMSRD AAR AEM C M CORZO A READDY R LEE J COSME BLDG 94 PICATINNY ARSENAL NJ 07806-5000 1 COMMANDER US

Preparing New Teachers for Contemporary Middle Grades Schools

ERIC Educational Resources Information Center

Edwards, Susan

2013-01-01

This article describes the middle grades teacher preparation program at Augusta State University in Georgia. It describes the negotiation between the middle school concept and the standardized testing culture of the local schools as the faculty redesigned the undergraduate middle grades program to adequately address both. Ways in which new…

High School Reform: Integration of Special Education. inForum

ERIC Educational Resources Information Center

Muller, Eve; Burdette, Paula

2007-01-01

Evidence suggests that students throughout the nation are not being adequately prepared for post-secondary life and that students with disabilities face even greater post-school challenges (Wagner, Newman, Cameto, Garza, & Levine, 2005). In response to such evidence, many states and localities are initiating high school reform activities and,…

The Anthropology of Poverty in Black Communities: A Critique and Systems Alternative.

ERIC Educational Resources Information Center

Maxwell, Andrew H.

1988-01-01

Ethnographers have not adequately studied societal determinants of poverty. This article demonstrates the utility of using systems theory to assess interactions between local organizations, national bureaucracies, and corporations. Numerous futile attempts of some the poor and working class Bostonians to halt gentrification show how…

[Design of a multicenter study for assessing the effectiveness of extracorporeal shockwave therapy in epicondylitis humeri radialis].

PubMed

Haake, M; Jensen, K; Prinz, H; Willenberg, T

2000-01-01

Previously published studies concerning, extracorporeal shock-wave therapy (ESWT) in the treatment of lateral epicondylitis do not fulfil the biometric standards of modern clinical research. The objective of the trial is to show that ESWT is effective in the treatment of chronic LE. A prospective, randomized, placebo-controlled, single-blinded, multicenter trial with an independent blinded observer was designed. The effectiveness of ESWT is evaluated by comparison with a control group in which sham-ESWT is performed, both under local anaesthesia. Outcome is determined on the basis of the Roles/Maudsley-Score. Inclusion criteria are a history of at least 6 months of LE and failure of conventional treatment. The therapy includes 3 sessions of low energy ESWT with 2000 impulses (energy flux density 0.07-0.09 mJ/mm2). Sample size is 272 patients. Randomisation started in October 1998 and is planned over a period of two and a half years. Only a randomised clinical trial with adequate control of placebo effects and observer bias can provide the required evidence for the efficiency of ESWT in the treatment of lateral epicondylitis of the elbow.

A Reinforcement Sensor Embedded Vertical Handoff Controller for Vehicular Heterogeneous Wireless Networks

PubMed Central

Li, Limin; Xu, Yubin; Soong, Boon-Hee; Ma, Lin

2013-01-01

Vehicular communication platforms that provide real-time access to wireless networks have drawn more and more attention in recent years. IEEE 802.11p is the main radio access technology that supports communication for high mobility terminals, however, due to its limited coverage, IEEE 802.11p is usually deployed by coupling with cellular networks to achieve seamless mobility. In a heterogeneous cellular/802.11p network, vehicular communication is characterized by its short time span in association with a wireless local area network (WLAN). Moreover, for the media access control (MAC) scheme used for WLAN, the network throughput dramatically decreases with increasing user quantity. In response to these compelling problems, we propose a reinforcement sensor (RFS) embedded vertical handoff control strategy to support mobility management. The RFS has online learning capability and can provide optimal handoff decisions in an adaptive fashion without prior knowledge. The algorithm integrates considerations including vehicular mobility, traffic load, handoff latency, and network status. Simulation results verify that the proposed algorithm can adaptively adjust the handoff strategy, allowing users to stay connected to the best network. Furthermore, the algorithm can ensure that RSUs are adequate, thereby guaranteeing a high quality user experience. PMID:24193101

Getting back on tap: the policy context and cost of ensuring access to low-cost drinking water in Massachusetts schools.

PubMed

Cradock, Angie L; Wilking, Cara L; Olliges, Sarah A; Gortmaker, Steven L

2012-09-01

Adequate water intake may have important health benefits for schoolchildren. Layers of federal, state, and local policy are relevant to provision of water within schools. Recently passed state and federal laws require free drinking-water access for students during mealtimes. To review Massachusetts local district wellness policies related to water access, provide estimates of costs for three water-provision strategies, and discuss implications for policy relevant to adequate drinking-water access. Legal research was conducted using the LexisNexis legal database and government websites. Local wellness policies were double-coded using existing research tools. Costs of three water-delivery options were estimated using a 10-year school-district perspective. Prior to 2010, most Massachusetts public school district wellness policies (92%-94%) did not address access to free drinking water. Ten-year costs per school for providing water during mealtimes to students, including dispenser unit, installation, water testing, water, cups, and labor, range between $12,544 and $27,922 (depending on water-delivery option) assuming the average Massachusetts school enrollment. Water-provision strategies relying on tap water are more economical than bottled water in the long term. Policy recommendations and cost considerations deserve attention at the local, state, and federal levels. Recommendations are discussed to ensure access to safe, free drinking water for all students. Copyright © 2012 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Equipment modifications for perennial nutsedge control in fallow organic transition

USDA-ARS?s Scientific Manuscript database

Perennial nutsedges are extremely difficult to control in organic crop transition and production systems. Herbicides suitable for use in certified organic production do not adequately control perennial nutsedges. Cultural and mechanical control are partially effective in controlling perennial nuts...

Interpreting beta-diversity components over time to conserve metacommunities in highly dynamic ecosystems.

PubMed

Ruhí, Albert; Datry, Thibault; Sabo, John L

2017-12-01

The concept of metacommunity (i.e., a set of local communities linked by dispersal) has gained great popularity among community ecologists. However, metacommunity research mostly addresses questions on spatial patterns of biodiversity at the regional scale, whereas conservation planning requires quantifying temporal variation in those metacommunities and the contributions that individual (local) sites make to regional dynamics. We propose that recent advances in diversity-partitioning methods may allow for a better understanding of metacommunity dynamics and the identification of keystone sites. We used time series of the 2 components of beta diversity (richness and replacement) and the contributions of local sites to these components to examine which sites controlled source-sink dynamics in a highly dynamic model system (an intermittent river). The relative importance of the richness and replacement components of beta diversity fluctuated over time, and sample aggregation led to underestimation of beta diversity by up to 35%. Our literature review revealed that research on intermittent rivers would benefit greatly from examination of beta-diversity components over time. Adequately appraising spatiotemporal variability in community composition and identifying sites that are pivotal for maintaining biodiversity at the landscape scale are key needs for conservation prioritization and planning. Thus, our framework may be used to guide conservation actions in highly dynamic ecosystems when time-series data describing biodiversity across sites connected by dispersal are available. © 2017 Society for Conservation Biology.

Radiation therapy in adenoid-cystic carcinoma

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

Vikram, B.; Strong, E.W.; Shah, J.P.

1984-02-01

Between 1949-1977, 74 patients with adenoid-cystic carcinoma of various head and neck sites were treated by radiation therapy at Memorial Sloan-Kettering Cancer Center. Radiation therapy alone was employed in 49 patients for recurrent, unresectable disease, and in 25 patients it was given as an adjunct to surgical resection. Among the 49 patients treated with radiation therapy alone, tumor regression was seen in 47 (96%). However, 44 of the 47 (93.5%) subsequently relapsed locally. Relapse occurred within 18 months in one-half of the patients and within 5 years in all of them. Of the 25 patients who received adjunctive radiation therapymore » about one-half relapsed locally within five years. There were 9 patients in this group, however, whose field size exceeded 8x8 cm and the dose of radiation also exceeded 4500 rad: 88% of these patients remained relapse-free at 5 years, compared with only 22% of the other 16 whose dose, or field size, or both, were inadequate by comparison. These data suggest that when irradiation is employed for advanced, inoperable adenoid-cystic carcinoma, it offers useful palliation but is rarely, if ever, curative. Postoperative irradiation, on the other hand, might improve the local control and the survival in patients with operable adenoid-cystic carcinoma who are at high risk for relapse, but only if the field size and the dose are adequate.« less

Advances in organ preserving strategies in rectal cancer patients.

PubMed

Stijns, Rutger C H; Tromp, Mike-Stephen R; Hugen, Niek; de Wilt, Johannes H W

2018-02-01

Treatment of rectal cancer patients has been subjected to change over the past thirty years. Total mesorectal excision is considered the cornerstone of rectal cancer treatment, but is also associated with significant morbidity resulting in an impaired quality of life. The addition of neoadjuvant chemoradiotherapy to surgery has shown to improve survival and local control and may lead to a partial or even complete response (CR). This raises questions regarding the necessity for subsequent radical surgery. After careful patient selection local excision and wait-and-see approaches are explored, aiming to improve quality of life without compromising oncological outcome. A multimodality diagnostic approach for optimal staging is crucial in determining the appropriate neoadjuvant treatment regimen. Adequate endoscopic restaging of rectal tumours after multimodality treatment will aid in selecting patients who are eligible for an organ preserving approach. The role and accuracy of imaging in the detection of the primary tumour, residual rectal cancer or local recurrence seems vital. Alternative neoadjuvant regimens are currently explored to increase the rate of clinical CRs, which may support organ preserving approaches. This review aims to generate insight into the advances in diagnostics and treatment modalities in all stages of rectal cancer and will highlight future studies that may support further implementation of organ preservation treatment in rectal cancer. Copyright © 2017 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

NASA guidelines for assuring the adequacy and appropriateness of security safeguards in sensitive applications

NASA Technical Reports Server (NTRS)

Tompkins, F. G.

1984-01-01

The Office of Management and Budget (OMB) Circular A-71, transmittal Memorandum No. 1, requires that each agency establish a management control process to assure that appropriate administrative, physical and technical safeguards are incorporated into all new computer applications. In addition to security specifications, the management control process should assure that the safeguards are adequate for the application. The security activities that should be integral to the system development process are examined. The software quality assurance process to assure that adequate and appropriate controls are incorporated into sensitive applications is also examined. Security for software packages is also discussed.

Wind Farm LES Simulations Using an Overset Methodology

NASA Astrophysics Data System (ADS)

Ananthan, Shreyas; Yellapantula, Shashank

2017-11-01

Accurate simulation of wind farm wakes under realistic atmospheric inflow conditions and complex terrain requires modeling a wide range of length and time scales. The computational domain can span several kilometers while requiring mesh resolutions in O(10-6) to adequately resolve the boundary layer on the blade surface. Overset mesh methodology offers an attractive option to address the disparate range of length scales; it allows embedding body-confirming meshes around turbine geomtries within nested wake capturing meshes of varying resolutions necessary to accurately model the inflow turbulence and the resulting wake structures. Dynamic overset hole-cutting algorithms permit relative mesh motion that allow this nested mesh structure to track unsteady inflow direction changes, turbine control changes (yaw and pitch), and wake propagation. An LES model with overset mesh for localized mesh refinement is used to analyze wind farm wakes and performance and compared with local mesh refinements using non-conformal (hanging node) unstructured meshes. Turbine structures will be modeled using both actuator line approaches and fully-resolved structures to test the efficacy of overset methods for wind farm applications. Exascale Computing Project (ECP), Project Number: 17-SC-20-SC, a collaborative effort of two DOE organizations - the Office of Science and the National Nuclear Security Administration.

Jellyfish Stings and Their Management: A Review

PubMed Central

Cegolon, Luca; Heymann, William C.; Lange, John H.; Mastrangelo, Giuseppe

2013-01-01

Jellyfish (cnidarians) have a worldwide distribution. Despite most being harmless, some species may cause local and also systemic reactions. Treatment of jellyfish envenomation is directed at: alleviating the local effects of venom, preventing further nematocyst discharges and controlling systemic reactions, including shock. In severe cases, the most important step is stabilizing and maintaining vital functions. With some differences between species, there seems to be evidence and consensus on oral/topical analgesics, hot water and ice packs as effective painkillers and on 30 s application of domestic vinegar (4%–6% acetic acid) to prevent further discharge of unfired nematocysts remaining on the skin. Conversely, alcohol, methylated spirits and fresh water should be carefully avoided, since they could massively discharge nematocysts; pressure immobilization bandaging should also be avoided, as laboratory studies show that it stimulates additional venom discharge from nematocysts. Most treatment approaches are presently founded on relatively weak evidence; therefore, further research (especially randomized clinical trials) is strongly recommended. Dissemination of appropriate treatment modalities should be deployed to better inform and educate those at risk. Adequate signage should be placed at beaches to notify tourists of the jellyfish risk. Swimmers in risky areas should wear protective equipment. PMID:23434796

21 CFR 113.40 - Equipment and procedures.

Code of Federal Regulations, 2011 CFR

2011-04-01

... ensure a supply of clean, dry air. (3) Pressure gages. Each retort should be equipped with a pressure... should have adequate filter systems to ensure a supply of clean, dry air. (3) Pressure gages. (i) Each... controllers should have adequate filter systems to ensure a supply of clean, dry air. (3) Pressure gages. Each...

State University of New York Maritime College: Selected Financial Management Practices.

ERIC Educational Resources Information Center

New York State Office of the Comptroller, Albany. Div. of Management Audit.

This report presents audit findings of the financial management practices at the State University of New York (SUNY) Maritime College, which trains students to become licensed officers in the U.S. Merchant Marines. Specifically, the audit examined whether SUNY Maritime maintains an adequate internal control environment and adequate internal…

Children's Needs -- for Universal Food Service and Nutrition.

ERIC Educational Resources Information Center

Briggs, George M.

Good nutrition and adequate nutritious food are not only essential to good health but also represent the difference between life and death. Nutrition is the world's number one problem today, along with war and population control. Good nutrition means providing, with care and love, all 45 essential nutrients in adequate amounts to each child -- one…

Wiener-Hopf optimal control of a hydraulic canal prototype with fractional order dynamics.

PubMed

Feliu-Batlle, Vicente; Feliu-Talegón, Daniel; San-Millan, Andres; Rivas-Pérez, Raúl

2017-06-26

This article addresses the control of a laboratory hydraulic canal prototype that has fractional order dynamics and a time delay. Controlling this prototype is relevant since its dynamics closely resembles the dynamics of real main irrigation canals. Moreover, the dynamics of hydraulic canals vary largely when the operation regime changes since they are strongly nonlinear systems. All this makes difficult to design adequate controllers. The controller proposed in this article looks for a good time response to step commands. The design criterium for this controller is minimizing the integral performance index ISE. Then a new methodology to control fractional order processes with a time delay, based on the Wiener-Hopf control and the Padé approximation of the time delay, is developed. Moreover, in order to improve the robustness of the control system, a gain scheduling fractional order controller is proposed. Experiments show the adequate performance of the proposed controller. Copyright © 2017 ISA. Published by Elsevier Ltd. All rights reserved.

[Blood-nerve barrier: structure and function].

PubMed

Kanda, Takashi

2011-06-01

The blood-nerve barrier (BNB) is a dynamic interface between the endoneurial microenvironment and surrounding extracellular space or blood contents, and is localized the innermost layer of multilayered ensheathing perineurium and endoneurial microvessels. Since the BNB is a key structure controlling the internal milieu of the peripheral nerve parenchyma, adequate understanding of the BNB is crucial for developing treatment strategies for human peripheral nervous system disorders, including Guillain-Barré syndrome, chronic inflammatory demyelinating polyneuropathy, and diabetic and various metabolic/toxic neuropathies. However, fewer studies have been conducted on the BNB, if we compare against the number of studies on the blood-brain barrier. This is because of the lack of adequate human cell lines originating from the BNB. In our laboratory, human immortal cell lines from the BNB, namely, the endothelial cell line and pericyte cell line, have recently been established and vigorous investigations of their biological and physiological properties are now underway. Pericytes constituting the BNB were found to possess robust ability of controlling BNB integrity via secretion of various cytokines and growth factors including bFGF, VEGF, GDNF, BDNF, and angiopoietin-1. Unknown soluble factors secreted by pericytes also contribute to the upregulation of claudin-5 in endothelial cells in the BNB and thus, strengthen the barrier function of the BNB. In diabetic neuropathy, pericytes were shown to regulate the vascular basement membrane, while AGEs were shown to induce basement membrane hypertrophy and disrupt the BNB by increasing the autocrine secretion of VEGF and TGF-beta from pericytes. In this review article, we discuss the macroscopic and microscopic anatomy of the human BNB as well as the molecular mechanisms of mononuclear cell infiltration across the BNB.

Dental management of patients receiving anticoagulant and/or antiplatelet treatment

PubMed Central

Chaveli-López, Begonya; Gavaldá-Esteve, Carmen

2014-01-01

Introduction: Adequate hemostasis is crucial for the success of invasive dental treatment, since bleeding problems can give rise to complications associated with important morbidity-mortality. The dental treatment of patients who tend to an increased risk of bleeding due to the use of anticoagulant and/or antiplatelet drugs raises a challenge in the daily practice of dental professionals. Adequate knowledge of the mechanisms underlying hemostasis, and the optimized management of such patients, are therefore very important issues. Objectives: A study is made of the anticoagulant / antiplatelet drugs currently available on the market, with evaluation of the risks and benefits of suspending such drugs prior to invasive dental treatment. In addition, a review is made of the current management protocols used in these patients. Material and Methods: A literature search was made in the PubMed, Cochrane Library and Scopus databases, covering all studies published in the last 5 years in English and Spanish. Studies conducted in humans and with scientific evidence levels 1 and 2 (metaanalyses, systematic reviews, randomized phase 1 and 2 trials, cohort studies and case-control studies) were considered. The keywords used for the search were: tooth extraction, oral surgery, hemostasis, platelet aggregation inhibitors, antiplatelet drugs, anticoagulants, warfarin, acenocoumarol. Results and Conclusions: Many management protocols have been developed, though in all cases a full clinical history is required, together with complementary hemostatic tests to minimize any risks derived from dental treatment. Many authors consider that patient medication indicated for the treatment of background disease should not be altered or suspended unless so indicated by the prescribing physician. Local hemostatic measures have been shown to suffice for controlling possible bleeding problems resulting from dental treatment. Key words:Tooth extraction, oral surgery, hemostasis, platelet aggregation inhibitors, antiplatelet drugs, anticoagulants, warfarin, acenocoumarol. PMID:24790716

Intraoperative 3D Navigation for Single or Multiple 125I-Seed Localization in Breast-Preserving Cancer Surgery.

PubMed

Pouw, Bas; de Wit-van der Veen, Linda J; van Duijnhoven, Frederieke; Rutgers, Emiel J Th; Stokkel, Marcel P M; Valdés Olmos, Renato A; Vrancken Peeters, Marie-Jeanne T F D

2016-05-01

Mammographic screening has led to the identification of more women with nonpalpable breast cancer, many of them to be treated with breast-preserving surgery. To accomplish radical tumor excision, adequate localization techniques such as radioactive seed localization (RSL) are required. For RSL, a radioactive I-seed is implanted central in the tumor to enable intraoperative localization using a γ-probe. In case of extensive tumor or multifocal carcinoma, multiple I-seeds can be used to delineate the involved area. Preoperative imaging is performed different from surgical positioning; therefore, exact I-seed depth remains unknown during surgery. Twenty patients (mean age, 56.8 years) with 25 implanted I-seeds scheduled for RSL were included. Sixteen patients had 1 I-seed implanted in the primary lesion, 3 patients had 2 I-seeds, and 1 patient had 3 I-seeds. Freehand SPECT localized I-seeds by measuring γ-counts from different directions, all registered by an optical tracking system. A reconstruction and visualization algorithm enabled 3-dimensional (3D) navigation toward the I-seeds. Freehand SPECT visualized all I-seeds in primary tumors and provided preincision depth information. The deviation, mean (SD), between the freehand SPECT depth and the surgical depth estimation was 1.9 (2.1) mm (range, 0-7 mm). Three-dimensional freehand SPECT was especially useful identifying multiple implanted I-seeds because the conventional γ-probe has more difficulty discriminating I-seeds transcutaneous. Freehand SPECT with 3D navigation is a valuable tool in RSL for both single and multiple implanted I-seeds in breast-preserving cancer surgery. Freehand SPECT provides continuous updating 3D imaging with information about depth and location of the I-seeds contributing to adequate excision of nonpalpable breast cancer.

Sinonasal mucosal melanoma: retrospective survival study of 25 patients.

PubMed

Vandenhende, C; Leroy, X; Chevalier, D; Mortuaire, G

2012-02-01

To determine potential prognostic factors for survival in patients with mucosal malignant melanoma of the sinonasal tract. Patients managed between 1991 and 2008 were assessed retrospectively. The seventh edition Union for International Cancer Control (7th UICC) tumour-node-metastasis classification was used for tumour staging. Kaplan-Meier and log rank tests were used for survival analysis. Twenty-five patients were studied (six were tumour stage three, eight tumour stage four(a) and 11 tumour stage four(b)). Surgery was performed on 23 patients (92 per cent). Fifteen received post-operative radiotherapy. Mean follow up was 31.3 months (range, two to 99 months). Three-year disease-free survival was improved in patients with stage four tumour arising from the nasal fossa, versus other sites, and in those with stage four tumour treated with surgery plus adjuvant radiotherapy, versus other treatments. Patients with melanoma of the nasal cavity have very poor survival rates. Treatment is still based on adequate surgical resection with safe margins. In this study, post-operative radiotherapy improved local control only for stage four tumours.

[Prognosis and treatment of dry mouth. Systematic review].

PubMed

López-López, José; Jané Salas, Enric; Chimenos Küstner, Eduardo

2014-02-04

There are no clearly established protocols for the treatment of dry mouth. The aim of this paper is a systematic review of the literature of the past 10 years using the words « dry mouth », « prognosis », « treatment » and « dentistry ». The initial search found 1,450 entries and within the restriction « clinical trials OR randomized controlled trial OR systemic reviews » it has been reduced to 522, which 145 were meta-analysis and systematic reviews. Papers not relevant to the issue were removed reducing the entries to 53. Twenty-four were dismissed (8 irrelevant, 7 reviews without adequate information and 9 personal opinions). Of the 29 items tested, 15 were controlled trials, 2 uncontrolled trials, 4 observational studies, 2 systematic reviews and 5 non systematic reviews. The most studied patients were Sjögren's syndrome and the irradiated patients. Treatments are focused on the etiology, prevention, symptomatic, local salivary stimulation and systemic treatments. It can be concluded that treatment must be individualized, salivary substitutes and mechanical stimulation techniques can be applied. Copyright © 2013 Elsevier España, S.L. All rights reserved.

Red cell substitutes.

PubMed

Winslow, Robert M

2007-01-01

Oxygen-carrying plasma expanders (blood substitutes) have been sought for over a century. Development of current products is a result of evolution in the understanding of proteins in general, of hemoglobin in particular, and of how cell-free hemoglobin interacts with the control of local blood flow to ensure adequate tissue oxygenation. Hemoglobin-based products are considered in four "generations" corresponding to major improvements. First-generation products consisted of hemoglobin, freed of red cell membranes (stroma-free hemoglobin [SFH]), which was renal toxic and vasoactive. Second-generation products were polymerized with aldehyde reagents to reduce or eliminate the renal toxicity, but the products were heterogeneous and still vasoactive. Third-generation products employed more specific intramolecular crosslinking to eliminate polymerization and promote homogeneity, but they also remained vasoactive. Fourth-generation products are based on a new understanding of the way in which microvascular blood flow is controlled and the influence of O(2) delivery to vascular walls. After more than a century of research, one of these new solutions should find use as an alternative to red cells for transfusion in certain clinical settings.

Electronic-Reconstruction-Enhanced Tunneling Conductance at Terrace Edges of Ultrathin Oxide Films.

PubMed

Wang, Lingfei; Kim, Rokyeon; Kim, Yoonkoo; Kim, Choong H; Hwang, Sangwoon; Cho, Myung Rae; Shin, Yeong Jae; Das, Saikat; Kim, Jeong Rae; Kalinin, Sergei V; Kim, Miyoung; Yang, Sang Mo; Noh, Tae Won

2017-11-01

Quantum mechanical tunneling of electrons across ultrathin insulating oxide barriers has been studied extensively for decades due to its great potential in electronic-device applications. In the few-nanometers-thick epitaxial oxide films, atomic-scale structural imperfections, such as the ubiquitously existed one-unit-cell-high terrace edges, can dramatically affect the tunneling probability and device performance. However, the underlying physics has not been investigated adequately. Here, taking ultrathin BaTiO 3 films as a model system, an intrinsic tunneling-conductance enhancement is reported near the terrace edges. Scanning-probe-microscopy results demonstrate the existence of highly conductive regions (tens of nanometers wide) near the terrace edges. First-principles calculations suggest that the terrace-edge geometry can trigger an electronic reconstruction, which reduces the effective tunneling barrier width locally. Furthermore, such tunneling-conductance enhancement can be discovered in other transition metal oxides and controlled by surface-termination engineering. The controllable electronic reconstruction can facilitate the implementation of oxide electronic devices and discovery of exotic low-dimensional quantum phases. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Engineering controls for furniture strippers to meet the OSHA methylene chloride PEL.

PubMed

Estill, Cheryl Fairfield; Watkins, Daniel S; Shulman, Stanley A; Kurimo, Robert W; Kovein, Ronald J

2002-01-01

This case study demonstrates how methylene chloride exposures during furniture stripping can be reduced to below the Occupational Safety and Health Administration (OSHA) permissible exposure limit (PEL) of 25 ppm (as an 8-hour time-weighted average). Five surveys were conducted at one facility; the first four resulted in employee exposure geometric means from 39 to 332 ppm. For the fifth survey local exhaust ventilation was used at the stripping tank and the rinsing area, which together exhausted 138 m3/min (4860 ft3/min). Additional controls included providing adequate make-up air, adding paraffin wax to the stripping solution, raising the level of the stripping solution in the tank, and discussing good work practices with the employee. The employees' methylene chloride exposures during the fifth survey resulted in a geometric mean of 5.6 ppm with a 95% upper confidence limit of 8.3 ppm, which was found to be significantly lower than the OSHA PEL and the OSHA action level of 12.5 ppm. The cost of the ventilation system was $8900.

Modeling the dynamics of multipartite quantum systems created departing from two-level systems using general local and non-local interactions

NASA Astrophysics Data System (ADS)

Delgado, Francisco

2017-12-01

Quantum information is an emergent area merging physics, mathematics, computer science and engineering. To reach its technological goals, it is requiring adequate approaches to understand how to combine physical restrictions, computational approaches and technological requirements to get functional universal quantum information processing. This work presents the modeling and the analysis of certain general type of Hamiltonian representing several physical systems used in quantum information and establishing a dynamics reduction in a natural grammar for bipartite processing based on entangled states.

Efficacy, tolerability, and safety of hypnosis in adult irritable bowel syndrome: systematic review and meta-analysis.

PubMed

Schaefert, Rainer; Klose, Petra; Moser, Gabriele; Häuser, Winfried

2014-06-01

To assess the efficacy, tolerability, and safety of hypnosis in adult irritable bowel syndrome by a meta-analysis of randomized controlled trials. Studies were identified by a literature search of the databases Allied and Complementary Medicine Database, Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, PubMed, PsycINFO, and Scopus (from inception to June 30, 2013). Primary outcomes were adequate symptom relief, global gastrointestinal score, and safety. Summary relative risks (RRs) with number needed to treat (NNT) and standardized mean differences (SMDs) with 95% confidence intervals (95% CIs) were calculated using random-effects models. Eight randomized controlled trials with a total of 464 patients and a median of 8.5 (7-12) hypnosis sessions over a median of 12 (5-12) weeks were included into the analysis. At the end of therapy, hypnosis was superior to control conditions in producing adequate symptom relief (RR, 1.69 [95% CI = 1.14-2.51]; NNT, 5 [3-10]) and in reducing global gastrointestinal score (SMD, 0.32 [95% CI = -0.56 to -0.08]). At long-term follow-up, hypnosis was superior to controls in adequate symptom relief (RR, 2.17 [95% CI = 1.22-3.87]; NNT, 3 [2-10]), but not in reducing global gastrointestinal score (SMD, -0.57 [-1.40 to 0.26]). One (0.4%) of 238 patients in the hypnosis group dropped out due to an adverse event (panic attack). This meta-analysis demonstrated that hypnosis was safe and provided long-term adequate symptom relief in 54% of patients with irritable bowel syndrome refractory to conventional therapy.

76 FR 31456 - Special Conditions: Gulfstream Model GVI Airplane; Electronic Flight Control System: Control...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-01

... Control System: Control Surface Position Awareness AGENCY: Federal Aviation Administration (FAA), DOT... electronic flight control system. The applicable airworthiness regulations do not contain adequate or... regulatory adequacy pursuant to section 611 of Public Law 92-574, the ``Noise Control Act of 1972.'' The FAA...

Status and Distribution of Wintering Waterfowl in Narragansett Bay, Rhode Island, 2005-2014

EPA Science Inventory

Estuaries on the east coast of the U.S. provide habitats used by a number of waterfowl species in winter. Aerial surveys of many of these wintering areas have been conducted over the past 50 plus years, but data from larger-scale surveys may not adequately capture local fluctuat...

24 CFR 248.233 - Approval of a plan of action that includes incentives.

Code of Federal Regulations, 2010 CFR

2010-04-01

...) After taking into account local market conditions, the incentives are necessary to achieve the purposes... term of the mortgage, adequate expenditures will be made for the proper maintenance and operation of... the adjusted income of the tenant or the fair market rent, whichever is lower; (5) Any resulting...

Civic Disobedience: Anti-SB 1070 Graffiti, Marginalized Voices, and Citizenship in a Politically Privatized Public Sphere

ERIC Educational Resources Information Center

Oliver, Veronica

2014-01-01

With neither national nor local-level discussions of Senate Bill 1070 adequately addressing bottom line issues such as marginalization, access, and civic engagement, an exploration of marginalized rhetorical acts can provide an informative lens for understanding challenges among marginalized people, their rhetorical tools, and their relations to…

Foreign Higher Education Institutes in Gulf Cooperation Council (GCC) Countries

ERIC Educational Resources Information Center

Naithani, Pranav

2011-01-01

Gulf cooperation council (GCC) countries are witnessing an exponential growth in new foreign higher education institutions on account of government policies which promote setting up of local campuses of renowned foreign universities. But GCC countries have not been able to adequately address key quality related issues in higher education domain…

Training of Fishermen for the Tuna Industry.

ERIC Educational Resources Information Center

Juhl, Rolf

The report concerns a failure to train fishermen for the Puerto Rico tuna industry. The objectives were to train fishermen for the purpose of replacing foreign crews aboard tuna vessels and create a cadre of local fishermen with experience in high seas commercial fisheries. The failure appears to be associated with the lack of adequate berthing…

76 FR 69758 - Draft Environmental Assessment, Incidental Take Plan, and Application for an Incidental Take...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-09

... local governments. DATES: Comment Period: To ensure consideration, we must receive your written comments... describes the proposed action and possible alternatives, and analyzes the effects of the alternatives on the... avoidance, minimization, and mitigation measures) and other alternatives in the draft EA are adequate to...

Preserving biodiversity under current and future climates: a case study

Treesearch

John W. Coulston; Kurt H. Riitters

2005-01-01

Aim The conservation of biological and genetic diversity is a major goal of reserve systems at local, regional, and national levels. The International Union for the Conservation of Nature and Natural Resources suggests a 12% threshold (area basis) for adequate protection of biological and genetic diversity of a plant community. However,...

Assessing satellite-based start-of-season trends in the US High Plains

USDA-ARS?s Scientific Manuscript database

To adequately assess the effects of global warming it is necessary to address trends and impacts at the local level. This study examines phenological changes in the start-of-season (SOS) derived from satellite observations from 1982–2008 in the US High Plains region. The surface climate-based SOS wa...

48 CFR 3052.236-70 - Special precautions for work at operating airports.

Code of Federal Regulations, 2010 CFR

2010-10-01

... effort to reduce the disruption of the Contractor's operation. (b) Unless otherwise specified by local... daylight hours and by red lights at other times. The red lights along the edge of the construction areas... shall provide adequate watch to maintain the lights in working condition at all times other than...

Transforming Foreign Language Grammar Classes through Teacher Training: An Experience from Nepal

ERIC Educational Resources Information Center

Poudel, Kamal Kumar

2018-01-01

In Nepal, unlike elsewhere, local studies have almost continually suggested that there has not been adequate reflection of the teacher training output in the real classroom situation. English teachers commonly blame on the unfavourable environment as the main obstacle to the successful classroom application of their knowledge and skills needed for…

Satellite News Feeds: Protecting a Transient Interest.

ERIC Educational Resources Information Center

Atwater, Tony; And Others

Satellite news gathering (SNG) has been widely adopted in broadcast journalism in recent years, and appears likely to grow in importance as local television news operations increase their reliance on it. However, because the technology for SNG is so new, information transmitted through SNG systems is not adequately protected under current laws.…

Hemostatic Agents in Periapical Surgery: A Randomized Study of Gauze Impregnated in Epinephrine versus Aluminum Chloride.

PubMed

Menéndez-Nieto, Isabel; Cervera-Ballester, Juan; Maestre-Ferrín, Laura; Blaya-Tárraga, Juan Antonio; Peñarrocha-Oltra, David; Peñarrocha-Diago, Miguel

2016-11-01

Adequate bleeding control is essential for the success of periapical surgery. The aim of this study was to evaluate the effects of 2 hemostatic agents on the outcome of periapical surgery and their relationship with patient and teeth parameters. A prospective study was designed with 2 randomized parallel groups, depending on the hemostatic agent used: gauze impregnated in epinephrine (epinephrine group) and aluminum chloride (aluminum chloride group). The analysis of the hemorrhage control was judged before and after the application of the hemostatic agents by the surgeon, and 2 examiners independently recorded it as adequate (complete hemorrhage control) or inadequate (incomplete hemorrhage control). Ninety-nine patients with a periradicular lesion were enrolled in this study and divided into 2 groups: gauze impregnated in epinephrine in 48 patients (epinephrine group) or aluminum chloride in 51 (aluminum chloride group). In epinephrine group adequate hemostasis was achieved in 25 cases, and in aluminum chloride group it was achieved in 37 cases (P < .05). The outcome was better in the aluminum chloride group than in the gauze impregnated in epinephrine group. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

[Reasons to recommend vaccination against dengue in Easter Island: Immunization Advisory Committee of Sociedad Chilena de Infectología].

PubMed

Fica, Alberto; Potin, Marcela; Moreno, Gabriela; Véliz, Liliana; Cerda, Jaime; Escobar, Carola; Wilhelm, Jan

2016-08-01

Dengue was first diagnosed on Easter Island on year 2002 and thereafter recurrent outbreaks have occurred involving different serotypes of dengue virus. Its vector, Aedes aegypti has not been eliminated despite the small size of the island. Conditions at the local hospital preclude adequate management of severe and hemorrhagic cases due to the absence of a Critical Care Unit as well as no availability of platelets, or plasma units for transfusion. Besides, transfer, of severely affected patients to continental Chile is cumbersome, slow and expensive. In this scenario, it is advisable to implement selective vaccination of Easter Island habitants with an available quadrivalent attenuated dengue vaccine with the aim to reduce hemorrhagic and severe dengue cases. This strategy should not replace permanent efforts to control waste disposal sites, water sources, maintain vector surveillance and increase education of the population.

Advanced Strain-Isolation-Pad Material with Bonded Fibrous Construction

NASA Technical Reports Server (NTRS)

Seibold, R. W.; Saito, C. A.; Buller, B. W.

1982-01-01

The feasibility of utilizing air lay and liquid lay felt deposition techniques to fabricate strain isolation pad (SIP) materials for the Space Shuttle Orbiter was demonstrated. These materials were developed as candidate replacements for the present needled felt SIP used between the ceramic tiles and the aluminum skin on the undersurface of the Orbiter. The SIP materials that were developed consisted of high temperature aramid fibers deposited by controlled fluid (air or liquid) carriers to form low density unbonded felts. The deposited felts were then bonded at the fiber intersections with a small amount of high temperature polyimide resin. This type of bonded felt construction can potentially eliminate two of the problems associated with the present SIP, viz., transmittal of localized stresses into the tiles and load history dependent mechanical response. However, further work is needed to achieve adequate through thickness tensile strength in the bonded felts.

Spatial Working Memory Performance and fMRI Activation Interactions in Abstinent Adolescent Marijuana Users

PubMed Central

Padula, Claudia B.; Schweinsburg, Alecia D.; Tapert, Susan F.

2008-01-01

Previous studies have suggested neural disruption and reorganization in adult marijuana users. However, it remains unclear whether these effects persist in adolescents after 28 days of abstinence and, if they do, what Performance × Brain Response interactions occur. Adolescent marijuana users (n = 17) and controls (n = 17) aged 16–18 years were recruited from local schools. Functional magnetic resonance imaging data were collected after 28 days’ monitored abstinence as participants performed a spatial working memory task. Marijuana users show Performance × Brain Response interactions in the bilateral temporal lobes, left anterior cingulate, left parahippocampal gyrus, and right thalamus (clusters ≥ 1358 μl; p <.05), although groups do not differ on behavioral measures of task performance. Marijuana users show differences in brain response to a spatial working memory task despite adequate performance, suggesting a different approach to the task via altered neural pathways. PMID:18072830

Current options in the treatment of mast cell mediator-related symptoms in mastocytosis.

PubMed

Escribano, Luis; Akin, Cem; Castells, Mariana; Schwartz, Lawrence B

2006-01-01

Patients with mastocytosis have symptoms related to the tissue response to the release of mediators from mast cells (MC), local mast cell burden or associated non-mast cell hematological disorders. MC contain an array of biologically active mediators in their granules, which are preformed and stored. MC are also able to produce newly generated membrane-derived lipid mediators and are a source of multifunctional cytokines. Mediator-related symptoms can include pruritus, flushing, syncope, gastric distress, nausea and vomiting, diarrhea, bone pain and neuropsychiatric disturbances; these symptoms are variably controlled by adequate medications. Management of patients within all categories of mastocytosis includes: a) a careful counseling of patients (parents in pediatric cases) and care providers, b) avoidance of factors triggering acute mediator release, c) treatment of acute and chronic MC-mediator symptoms and, if indicated, d) an attempt for cytoreduction and treatment of organ infiltration by mast cells.

Basis for selecting optimum antibiotic regimens for secondary peritonitis.

PubMed

Maseda, Emilio; Gimenez, Maria-Jose; Gilsanz, Fernando; Aguilar, Lorenzo

2016-01-01

Adequate management of severely ill patients with secondary peritonitis requires supportive therapy of organ dysfunction, source control of infection and antimicrobial therapy. Since secondary peritonitis is polymicrobial, appropriate empiric therapy requires combination therapy in order to achieve the needed coverage for both common and more unusual organisms. This article reviews etiological agents, resistance mechanisms and their prevalence, how and when to cover them and guidelines for treatment in the literature. Local surveillances are the basis for the selection of compounds in antibiotic regimens, which should be further adapted to the increasing number of patients with risk factors for resistance (clinical setting, comorbidities, previous antibiotic treatments, previous colonization, severity…). Inadequate antimicrobial regimens are strongly associated with unfavorable outcomes. Awareness of resistance epidemiology and of clinical consequences of inadequate therapy against resistant bacteria is crucial for clinicians treating secondary peritonitis, with delicate balance between optimization of empirical therapy (improving outcomes) and antimicrobial overuse (increasing resistance emergence).

LIBRA: An inexpensive geodetic network densification system

NASA Technical Reports Server (NTRS)

Fliegel, H. F.; Gantsweg, M.; Callahan, P. S.

1975-01-01

A description is given of the Libra (Locations Interposed by Ranging Aircraft) system, by which geodesy and earth strain measurements can be performed rapidly and inexpensively to several hundred auxiliary points with respect to a few fundamental control points established by any other technique, such as radio interferometry or satellite ranging. This low-cost means of extending the accuracy of space age geodesy to local surveys provides speed and spatial resolution useful, for example, for earthquake hazards estimation. Libra may be combined with an existing system, Aries (Astronomical Radio Interferometric Earth Surveying) to provide a balanced system adequate to meet the geophysical needs, and applicable to conventional surveying. The basic hardware design was outlined and specifications were defined. Then need for network densification was described. The following activities required to implement the proposed Libra system are also described: hardware development, data reduction, tropospheric calibrations, schedule of development and estimated costs.

Controlled local drug delivery strategies from chitosan hydrogels for wound healing.

PubMed

Elviri, Lisa; Bianchera, Annalisa; Bergonzi, Carlo; Bettini, Ruggero

2017-07-01

The main target of tissue engineering is the preparation and application of adequate materials for the design and production of scaffolds, that possess properties promoting cell adhesion, proliferation and differentiation. The use of natural polysaccharides, such as chitosan, to prepare hydrogels for wound healing and controlled drug delivery is a research topic of wide and increasing interest. Areas covered: This review presents the latest results and challenges in the preparation of chitosan and chitosan-based scaffold/hydrogel for wound healing applications. A detailed overview of their behavior in terms of controlled drug delivery, divided by drug categories, and efficacy was provided and critically discussed. Expert opinion: The need to establish and exploit the advantages of natural biomaterials in combination with active compounds is playing a pivotal role in the regenerative medicine fields. The challenges posed by the many variables affecting tissue repair and regeneration need to be standardized and adhere to recognized guidelines to improve the quality of evidence in the wound healing process. Currently, different methodologies are followed to prepare innovative scaffold formulations and structures. Innovative technologies such as 3D printing or bio-electrospray are promising to create chitosan-based scaffolds with finely controlled structures with customizable shape porosity and thickness. Chitosan scaffolds could be designed in combination with a variety of polysaccharides or active compounds with selected and reproducible spacial distribution, providing active wound dressing with highly tunable controlled drug delivery.

Lithological and textural controls on radar and diurnal thermal signatures of weathered volcanic deposits, Lunar Crater region, Nevada

NASA Technical Reports Server (NTRS)

Plaut, Jeffrey J.; Rivard, Benoit

1992-01-01

Radar backscatter intensity as measured by calibrated synthetic aperture radar (SAR) systems is primarily controlled by three factors: local incidence angle, wavelength-scale roughness, and dielectric permittivity of surface materials. Radar observations may be of limited use for geological investigations of surface composition, unless the relationships between lithology and the above characteristics can be adequately understood. In arid terrains, such as the Southwest U.S., weathering signatures (e.g. soil development, fracturing, debris grain size and shape, and hill slope characteristics) are controlled to some extent by lithologic characteristics of the parent bedrock. These textural features of outcrops and their associated debris will affect radar backscatter to varying degrees, and the multiple-wavelength capability of the JPL Airborne SAR (AIRSAR) system allows sampling of textures at three distinct scales. Diurnal temperature excursions of geologic surfaces are controlled primarily by the thermal inertia of surface materials, which is a measure of the resistance of a material to a change in temperature. Other influences include albedo, surface slopes affecting insolation, local meteorological conditions and surface emissivity at the relevant thermal wavelengths. To first order, thermal inertia variations on arid terrain surfaces result from grain size distribution and porosity differences, at scales ranging from micrometers to tens of meters. Diurnal thermal emission observations, such as those made by the JPL Thermal Infrared Multispectral Scanner (TIMS) airborne instrument, are thus influenced by geometric surface characteristics at scales comparable to those controlling radar backscatter. A preliminary report on a project involving a combination of field, laboratory and remote sensing observations of weathered felsic-to basaltic volcanic rock units exposed in the southern part of the Lunar Crater Volcanic Field, in the Pancake Range of central Nevada is presented. Focus is on the relationship of radar backscatter cross sections at multiple wavelengths, apparent diurnal temperature excursions identified in multi-temporal TIMS images, surface geometries related to weathering style, and parent bedrock lithology.

Controlled release of metronidazole from composite poly-ε-caprolactone/alginate (PCL/alginate) rings for dental implants.

PubMed

Lan, Shih-Feng; Kehinde, Timilehin; Zhang, Xiangming; Khajotia, Sharukh; Schmidtke, David W; Starly, Binil

2013-06-01

Dental implants provide support for dental crowns and bridges by serving as abutments for the replacement of missing teeth. To prevent bacterial accumulation and growth at the site of implantation, solutions such as systemic antibiotics and localized delivery of bactericidal agents are often employed. The objective of this study was to demonstrate a novel method of controlled localized delivery of antibacterial agents to an implant site using a biodegradable custom fabricated ring. The study involved incorporating a model antibacterial agent (metronidazole) into custom designed poly-ε-caprolactone/alginate (PCL/alginate) composite rings to produce the intended controlled release profile. The rings can be designed to fit around the body of any root form dental implants of various diameters, shapes and sizes. In vitro release studies indicate that pure (100%) alginate rings exhibited an expected burst release of metronidazole in the first few hours, whereas Alginate/PCL composite rings produced a medium burst release followed by a sustained release for a period greater than 4 weeks. By varying the PCL/alginate weight ratios, we have shown that we can control the amount of antibacterial agents released to provide the minimal inhibitory concentration (MIC) needed for adequate protection. The fabricated composite rings have achieved a 50% antibacterial agent release profile over the first 48 h and the remaining amount slowly released over the remainder of the study period. The PCL/alginate agent release characteristic fits the Ritger-Peppas model indicating a diffusion-based mechanism during the 30-day study period. The developed system demonstrates a controllable drug release profile and the potential for the ring to inhibit bacterial biofilm growth for the prevention of diseases such as peri-implantitis resulting from bacterial infection at the implant site. Copyright © 2013 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Localized excitations in hydrogen-bonded molecular crystals

NASA Astrophysics Data System (ADS)

Alexander, D. M.; Krumhansl, J. A.

1986-05-01

Localized excitations analogous to the small Holstein polaron, to localized modes in alkali halides, and to localized excitonic states, are postulated for a set of internal vibrational modes in crystalline acetanilide. The theoretical framework in which one can describe the characteristics of the ir and Raman spectroscopy peaks associated with these localized states is adequately provided by the Davydov model (formally equivalent to the Holstein polaron model). The possible low-lying excitations arising from this model are determined using a variational approach. Hence, the contribution to the spectral function due to each type of excitation can be calculated. The internal modes of chief concern here are the amide-I (CO stretch) and the N-H stretch modes for which we demonstrate consistency of the theoretical model with the available ir data. Past theoretical approaches will be discussed and reasons why one should prefer one description over another will be examined.

21 CFR 226.58 - Laboratory controls.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 4 2012-04-01 2012-04-01 false Laboratory controls. 226.58 Section 226.58 Food...: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR TYPE A MEDICATED ARTICLES Product Quality Control § 226.58 Laboratory controls. Laboratory controls shall include the establishment of adequate specifications and test...

21 CFR 226.58 - Laboratory controls.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 4 2011-04-01 2011-04-01 false Laboratory controls. 226.58 Section 226.58 Food...: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR TYPE A MEDICATED ARTICLES Product Quality Control § 226.58 Laboratory controls. Laboratory controls shall include the establishment of adequate specifications and test...

21 CFR 226.58 - Laboratory controls.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 4 2013-04-01 2013-04-01 false Laboratory controls. 226.58 Section 226.58 Food...: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR TYPE A MEDICATED ARTICLES Product Quality Control § 226.58 Laboratory controls. Laboratory controls shall include the establishment of adequate specifications and test...

What controls the stable isotope composition of precipitation in the Mekong Delta? A model-based statistical approach

NASA Astrophysics Data System (ADS)

Le Duy, Nguyen; Heidbüchel, Ingo; Meyer, Hanno; Merz, Bruno; Apel, Heiko

2018-02-01

This study analyzes the influence of local and regional climatic factors on the stable isotopic composition of rainfall in the Vietnamese Mekong Delta (VMD) as part of the Asian monsoon region. It is based on 1.5 years of weekly rainfall samples. In the first step, the isotopic composition of the samples is analyzed by local meteoric water lines (LMWLs) and single-factor linear correlations. Additionally, the contribution of several regional and local factors is quantified by multiple linear regression (MLR) of all possible factor combinations and by relative importance analysis. This approach is novel for the interpretation of isotopic records and enables an objective quantification of the explained variance in isotopic records for individual factors. In this study, the local factors are extracted from local climate records, while the regional factors are derived from atmospheric backward trajectories of water particles. The regional factors, i.e., precipitation, temperature, relative humidity and the length of backward trajectories, are combined with equivalent local climatic parameters to explain the response variables δ18O, δ2H, and d-excess of precipitation at the station of measurement. The results indicate that (i) MLR can better explain the isotopic variation in precipitation (R2 = 0.8) compared to single-factor linear regression (R2 = 0.3); (ii) the isotopic variation in precipitation is controlled dominantly by regional moisture regimes (˜ 70 %) compared to local climatic conditions (˜ 30 %); (iii) the most important climatic parameter during the rainy season is the precipitation amount along the trajectories of air mass movement; (iv) the influence of local precipitation amount and temperature is not significant during the rainy season, unlike the regional precipitation amount effect; (v) secondary fractionation processes (e.g., sub-cloud evaporation) can be identified through the d-excess and take place mainly in the dry season, either locally for δ18O and δ2H, or along the air mass trajectories for d-excess. The analysis shows that regional and local factors vary in importance over the seasons and that the source regions and transport pathways, and particularly the climatic conditions along the pathways, have a large influence on the isotopic composition of rainfall. Although the general results have been reported qualitatively in previous studies (proving the validity of the approach), the proposed method provides quantitative estimates of the controlling factors, both for the whole data set and for distinct seasons. Therefore, it is argued that the approach constitutes an advancement in the statistical analysis of isotopic records in rainfall that can supplement or precede more complex studies utilizing atmospheric models. Due to its relative simplicity, the method can be easily transferred to other regions, or extended with other factors. The results illustrate that the interpretation of the isotopic composition of precipitation as a recorder of local climatic conditions, as for example performed for paleorecords of water isotopes, may not be adequate in the southern part of the Indochinese Peninsula, and likely neither in other regions affected by monsoon processes. However, the presented approach could open a pathway towards better and seasonally differentiated reconstruction of paleoclimates based on isotopic records.

Clinical outcome of dedifferentiated liposarcoma in the extremities: A retrospective case series of 7 patients.

PubMed

Kito, Munehisa; Yoshimura, Yasuo; Isobe, Ken'ichi; Aoki, Kaoru; Suzuki, Shuichiro; Tanaka, Atsushi; Okamoto, Masanori; Sano, Kenji; Kato, Hiroyuki

2016-09-01

Wide resection is the generally recommended surgical treatment for dedifferentiated liposarcoma (DDLPS) in the extremities. However, it may be appropriate to distinguish the surgical margin of low-grade atypical lipomatous tumor (ALT)/well-differentiated liposarcoma (WDLPS) area from the high-grade dedifferentiated area, because the low- and high-grade areas can be clearly separated, both radiologically and histologically. This study re-evaluated the details of surgical margin of DDLPS in the extremities, and aimed to investigate the optimal surgical margin and the usefulness of adjuvant therapy for DDLPS in the extremities. Seven patients diagnosed with DDLPS in the extremities and treated between 1995 and 2013 were analyzed. The use of adjuvant therapy before and after surgery was assessed, and the surgical margins for the ALT/WDLPS and dedifferentiated areas were re-evaluated by using the specimens resected at surgery. Subsequently, the recurrence rates, metastatic rates, and oncological outcomes were examined. Four and three patients had wide (adequate wide margin, n = 3; inadequate wide margin, n = 1) and marginal margins for the dedifferentiated area, respectively, while three and four patients had wide (adequate wide margin, n = 2; inadequate wide margin, n = 1) and marginal margins for the ALT/WDLPS area, respectively. Postoperative radiotherapy was performed in three patients with an inadequate wide margin or a marginal margin for the dedifferentiated area. No patient had local recurrence. Distant metastases occurred in two patients. These patients died of their disease. The other five patients were disease-free. The ALT/WDLPS and dedifferentiated areas in the tumor margin may be better to be considered separately in determining the appropriate resection extent for DDLPS in the extremities. Postoperative radiotherapy may provide good local control for cases with a narrow surgical margin. Copyright © 2016 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

The American Society for Therapeutic Radiology and Oncology (ASTRO) evidence-based review of the role of radiosurgery for brain metastases

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

Mehta, Minesh P.; Tsao, May N.; Whelan, Timothy J.

2005-09-01

Purpose: To systematically review the evidence for the use of stereotactic radiosurgery in adult patients with brain metastases. Methods: Key clinical questions to be addressed in this evidence-based review were identified. Outcomes considered were overall survival, quality of life or symptom control, brain tumor control or response and toxicity. MEDLINE (1990-2004 June Week 2), CANCERLIT (1990-2003), CINAHL (1990-2004 June Week 2), EMBASE (1990-2004 Week 25), and the Cochrane library (2004 issue 2) databases were searched using OVID. In addition, the Physician Data Query clinical trials database, the proceedings of the American Society of Clinical Oncology (ASCO) (1997-2004), ASTRO (1997-2004), andmore » the European Society of Therapeutic Radiology and Oncology (ESTRO) (1997-2003) were searched. Data from the literature search were reviewed and tabulated. This process included an assessment of the level of evidence. Results: For patients with newly diagnosed brain metastases, managed with whole-brain radiotherapy alone vs. whole-brain radiotherapy and radiosurgery boost, there were three randomized controlled trials, zero prospective studies, and seven retrospective series (which satisfied inclusion criteria). For patients with up to three (<4 cm) newly diagnosed brain metastases (and in one study up to four brain metastases), radiosurgery boost with whole-brain radiotherapy significantly improves local brain control rates as compared with whole-brain radiotherapy alone (Level I-III evidence). In one large randomized trial, survival benefit with whole-brain radiotherapy was observed in patients with single brain metastasis. In this trial, an overall increased ability to taper down on steroid dose and an improvement in Karnofsky performance status was seen in patients who were treated with radiosurgery boost as compared with patients treated with whole-brain radiotherapy alone. However, Level I evidence regarding overall quality of life outcomes using a validated instrument has not been reported. All randomized trials showed improved local control with the addition of radiosurgery to whole-brain radiotherapy. For patients with multiple brain metastases, there is no overall survival benefit with the use of radiosurgery boost to whole-brain radiotherapy (Level I-III evidence). Radiosurgery boost is associated with a small risk of early or late toxicity. In patients treated with radiosurgery alone (withholding whole-brain radiotherapy) as initial treatment, there were 2 randomized trials, 2 prospective cohort studies, and 16 retrospective series. There is Level I to Level III evidence that the use of radiosurgery alone does not alter survival as compared to the use of whole-brain radiotherapy. However, there is Level I to Level III evidence that omission of whole-brain radiotherapy results in poorer intracranial disease control, both local and distant (defined as remaining brain, outside the radiosurgery field). Quality of life outcomes have not been adequately reported. Radiosurgery is associated with a small risk of early or late toxicity. Radiosurgery as salvage for patients with brain metastases was reported in zero randomized trials, one prospective study, and seven retrospective series. Conclusions: Based on Level I-III evidence, for selected patients with small (up to 4 cm) brain metastases (up to three in number and four in one randomized trial), the addition of radiosurgery boost to whole-brain radiotherapy improves brain control as compared with whole-brain radiotherapy alone. In patients with a single brain metastasis, radiosurgery boost with whole-brain radiotherapy improves survival. There is a small risk of toxicity associated with radiosurgery boost as compared with whole-brain radiotherapy alone. In selected patients treated with radiosurgery alone for newly diagnosed brain metastases, overall survival is not altered. However, local and distant brain control is significantly poorer with omission of upfront whole-brain radiotherapy (Level I-III evidence). Whether neurocognition or quality of life outcomes are different between initial radiosurgery alone vs. whole-brain radiotherapy (with or without radiosurgery boost) is unknown, because this has not been adequately tested. There was no statistically significant difference in overall toxicity between those treated with radiosurgery alone vs. whole-brain radiotherapy and radiosurgery boost based on an interim report from one randomized study. There is insufficient evidence as to the clinical benefit/risks radiosurgery used in the setting of recurrent or progressive brain metastases, although radiographic responses are well-documented.« less

14 CFR 23.1143 - Engine controls.

Code of Federal Regulations, 2014 CFR

2014-01-01

... independent of those for every other engine or supercharger. (e) For each fluid injection (other than fuel... flow of the injection fluid is adequately controlled. (f) If a power, thrust, or a fuel control (other than a mixture control) incorporates a fuel shutoff feature, the control must have a means to prevent...

14 CFR 23.1143 - Engine controls.

Code of Federal Regulations, 2013 CFR

2013-01-01

... independent of those for every other engine or supercharger. (e) For each fluid injection (other than fuel... flow of the injection fluid is adequately controlled. (f) If a power, thrust, or a fuel control (other than a mixture control) incorporates a fuel shutoff feature, the control must have a means to prevent...

Developing hand therapy skills in Bangladesh: experiences of Australian volunteers.

PubMed

O'Brien, Lisa; Hardman, Alison

2014-01-01

Bangladesh is a developing country whose health system is highly dependent on project funding from foreign countries. Interplast Australia & New Zealand have supported volunteer hand therapists to provide training to local staff in the management of hand injuries and burns since 2006. We aimed to explore and describe the volunteers' own experience and provide recommendations for future therapy capacity building projects in developing countries. This qualitative study involved nine volunteer therapists, who attended a focus group to discuss their experiences, including the key milestones, challenges, and progress achieved. The two authors analyzed transcripts independently and emergent themes were discussed and identified by consensus. Overall the experience was extremely positive and rewarding for volunteers. Key learnings and challenges encountered in this project were cultural differences in learning styles, the need to adapt our approach to 2 facilitate sustainable local solutions, attrition of skilled local staff, and concerns regarding volunteer health and safety. Recommendations for similar projects include allowing adequate time for in-country scoping and planning, coordination and pooling of resources, and the use of strategies that encourage the shift to confident local ownership of ongoing learning and skill development. Volunteering in a health capacity building program in developing countries can be a challenging but immensely rewarding experience. Programs designed to meet the health demands in developing countries should emphasize adequate training of professionals in the use of transferable, sustainable and cost effective techniques. Time spent in the scoping and planning phase is crucial, as is coordination of efforts and pooling of resources. 2C. Crown Copyright © 2014. Published by Elsevier Inc. All rights reserved.

30 CFR 72.630 - Drill dust control at underground areas of underground mines.

Code of Federal Regulations, 2010 CFR

2010-07-01

... condition. Dust collectors approved under Part 33—Dust Collectors for Use in Connection with Rock Drilling...) Ventilation control. To adequately control dust from drilling rock, the air current shall be so directed that...

30 CFR 72.630 - Drill dust control at underground areas of underground mines.

Code of Federal Regulations, 2011 CFR

2011-07-01

... condition. Dust collectors approved under Part 33—Dust Collectors for Use in Connection with Rock Drilling...) Ventilation control. To adequately control dust from drilling rock, the air current shall be so directed that...

Molecular Genetics Information System (MOLGENIS): alternatives in developing local experimental genomics databases.

PubMed

Swertz, Morris A; De Brock, E O; Van Hijum, Sacha A F T; De Jong, Anne; Buist, Girbe; Baerends, Richard J S; Kok, Jan; Kuipers, Oscar P; Jansen, Ritsert C

2004-09-01

Genomic research laboratories need adequate infrastructure to support management of their data production and research workflow. But what makes infrastructure adequate? A lack of appropriate criteria makes any decision on buying or developing a system difficult. Here, we report on the decision process for the case of a molecular genetics group establishing a microarray laboratory. Five typical requirements for experimental genomics database systems were identified: (i) evolution ability to keep up with the fast developing genomics field; (ii) a suitable data model to deal with local diversity; (iii) suitable storage of data files in the system; (iv) easy exchange with other software; and (v) low maintenance costs. The computer scientists and the researchers of the local microarray laboratory considered alternative solutions for these five requirements and chose the following options: (i) use of automatic code generation; (ii) a customized data model based on standards; (iii) storage of datasets as black boxes instead of decomposing them in database tables; (iv) loosely linking to other programs for improved flexibility; and (v) a low-maintenance web-based user interface. Our team evaluated existing microarray databases and then decided to build a new system, Molecular Genetics Information System (MOLGENIS), implemented using code generation in a period of three months. This case can provide valuable insights and lessons to both software developers and a user community embarking on large-scale genomic projects. http://www.molgenis.nl

Joint Control for Dummies: An Elaboration of Lowenkron's Model of Joint (Stimulus) Control

ERIC Educational Resources Information Center

Sidener, David W.

2006-01-01

The following paper describes Lowenkron's model of joint (stimulus) control. Joint control is described as a means of accounting for performances, especially generalized performances, for which a history of contingency control does not provide an adequate account. Examples are provided to illustrate instances in which joint control may facilitate…

Tier 3 batch system data locality via managed caches

NASA Astrophysics Data System (ADS)

Fischer, Max; Giffels, Manuel; Jung, Christopher; Kühn, Eileen; Quast, Günter

2015-05-01

Modern data processing increasingly relies on data locality for performance and scalability, whereas the common HEP approaches aim for uniform resource pools with minimal locality, recently even across site boundaries. To combine advantages of both, the High- Performance Data Analysis (HPDA) Tier 3 concept opportunistically establishes data locality via coordinated caches. In accordance with HEP Tier 3 activities, the design incorporates two major assumptions: First, only a fraction of data is accessed regularly and thus the deciding factor for overall throughput. Second, data access may fallback to non-local, making permanent local data availability an inefficient resource usage strategy. Based on this, the HPDA design generically extends available storage hierarchies into the batch system. Using the batch system itself for scheduling file locality, an array of independent caches on the worker nodes is dynamically populated with high-profile data. Cache state information is exposed to the batch system both for managing caches and scheduling jobs. As a result, users directly work with a regular, adequately sized storage system. However, their automated batch processes are presented with local replications of data whenever possible.

Fibrin glue for local haemostasis in haemophilia surgery.

PubMed

Rodriguez-Merchan, E Carlos

2017-12-01

Local fibrin glue (FG) appears to be a useful local haemostatic agent for severe haemorrhage in people with haemophilia (PWH) undergoing surgical procedures. To evaluate the role of local FG in PWH. A review of the literature on the topic has been performed. Local FG is not always necessary to achieve haemostasis in all surgical procedures performed in PWH. However, it could be a good adjunct therapy, primarily when a surgical field will bleed more than expected (e.g. patients with inhibitors), and also for circumcisions, dental extractions, and surgical treatment of pseudotumours. Although correct surgical haemostasis can typically be achieved by the infusion of factor concentrate at the adequate dose, my recommendation for surgeons is always to have local FG by their side. Local FG appears to be an effective adjunctive therapy for cases in which bleeding is likely (e.g. patients with inhibitors), and for circumcisions, oral surgery, and treatment of pseudotumours. Through the use of local FG, the doses of factor concentrate necessary to prevent bleeding could be reduced, providing considerable cost savings.

14 CFR 133.33 - Operating rules.

Code of Federal Regulations, 2011 CFR

2011-01-01

... that directional control is adequate. (4) Accelerate into forward flight to verify that no attitude... traffic control, if necessary, and a detailed chart depicting the flight routes and altitudes. (2) Each...

14 CFR 133.33 - Operating rules.

Code of Federal Regulations, 2012 CFR

2012-01-01

... that directional control is adequate. (4) Accelerate into forward flight to verify that no attitude... traffic control, if necessary, and a detailed chart depicting the flight routes and altitudes. (2) Each...

14 CFR 133.33 - Operating rules.

Code of Federal Regulations, 2014 CFR

2014-01-01

... that directional control is adequate. (4) Accelerate into forward flight to verify that no attitude... traffic control, if necessary, and a detailed chart depicting the flight routes and altitudes. (2) Each...

14 CFR 133.33 - Operating rules.

Code of Federal Regulations, 2013 CFR

2013-01-01

... that directional control is adequate. (4) Accelerate into forward flight to verify that no attitude... traffic control, if necessary, and a detailed chart depicting the flight routes and altitudes. (2) Each...

40 CFR 64.3 - Monitoring design criteria.

Code of Federal Regulations, 2010 CFR

2010-07-01

... that are adequate to ensure the continuing validity of the data. The owner or operator shall consider... and control device operational variability, the reliability and latitude built into the control...

Which Food Security Determinants Predict Adequate Vegetable Consumption among Rural Western Australian Children?

PubMed Central

Godrich, Stephanie L.; Lo, Johnny; Davies, Christina R.; Darby, Jill; Devine, Amanda

2017-01-01

Improving the suboptimal vegetable consumption among the majority of Australian children is imperative in reducing chronic disease risk. The objective of this research was to determine whether there was a relationship between food security determinants (FSD) (i.e., food availability, access, and utilisation dimensions) and adequate vegetable consumption among children living in regional and remote Western Australia (WA). Caregiver-child dyads (n = 256) living in non-metropolitan/rural WA completed cross-sectional surveys that included questions on FSD, demographics and usual vegetable intake. A total of 187 dyads were included in analyses, which included descriptive and logistic regression analyses via IBM SPSS (version 23). A total of 13.4% of children in this sample had adequate vegetable intake. FSD that met inclusion criteria (p ≤ 0.20) for multivariable regression analyses included price; promotion; quality; location of food outlets; variety of vegetable types; financial resources; and transport to outlets. After adjustment for potential demographic confounders, the FSD that predicted adequate vegetable consumption were, variety of vegetable types consumed (p = 0.007), promotion (p = 0.017), location of food outlets (p = 0.027), and price (p = 0.043). Food retail outlets should ensure that adequate varieties of vegetable types (i.e., fresh, frozen, tinned) are available, vegetable messages should be promoted through food retail outlets and in community settings, towns should include a range of vegetable purchasing options, increase their reliance on a local food supply and increase transport options to enable affordable vegetable purchasing. PMID:28054955

Which Food Security Determinants Predict Adequate Vegetable Consumption among Rural Western Australian Children?

PubMed

Godrich, Stephanie L; Lo, Johnny; Davies, Christina R; Darby, Jill; Devine, Amanda

2017-01-03

Improving the suboptimal vegetable consumption among the majority of Australian children is imperative in reducing chronic disease risk. The objective of this research was to determine whether there was a relationship between food security determinants (FSD) (i.e., food availability, access, and utilisation dimensions) and adequate vegetable consumption among children living in regional and remote Western Australia (WA). Caregiver-child dyads ( n = 256) living in non-metropolitan/rural WA completed cross-sectional surveys that included questions on FSD, demographics and usual vegetable intake. A total of 187 dyads were included in analyses, which included descriptive and logistic regression analyses via IBM SPSS (version 23). A total of 13.4% of children in this sample had adequate vegetable intake. FSD that met inclusion criteria ( p ≤ 0.20) for multivariable regression analyses included price; promotion; quality; location of food outlets; variety of vegetable types; financial resources; and transport to outlets. After adjustment for potential demographic confounders, the FSD that predicted adequate vegetable consumption were, variety of vegetable types consumed ( p = 0.007), promotion ( p = 0.017), location of food outlets ( p = 0.027), and price ( p = 0.043). Food retail outlets should ensure that adequate varieties of vegetable types (i.e., fresh, frozen, tinned) are available, vegetable messages should be promoted through food retail outlets and in community settings, towns should include a range of vegetable purchasing options, increase their reliance on a local food supply and increase transport options to enable affordable vegetable purchasing.

Field evaluation of an engineering control for respirable crystalline silica exposures during mortar removal.

PubMed

Collingwood, Scott; Heitbrink, William A

2007-11-01

During mortar removal with a right angle grinder, a building renovation process known as "tuck pointing," worker exposures to respirable crystalline silica can be as high as 5 mg/m(3), 100 times the recommended exposure limit developed by the National Institute for Occupational Safety and Health. To reduce the risk of silicosis among these workers, a vacuum cleaner can be used to exhaust 80 ft(3)/min (2.26 m(3)/min) from a hood mounted on the grinder. Field trials examined the ability of vacuum cleaners to maintain adequate exhaust ventilation rates and measure exposure outcomes when using this engineering control. These field trials involved task-based exposure measurement of respirable dust and crystalline silica exposures during mortar removal. These measurements were compared with published exposure data. Vacuum cleaner airflows were obtained by measuring and digitally logging vacuum cleaner static pressure at the inlet to the vacuum cleaner motor. Static pressures were converted to airflows based on experimentally determined fan curves. In two cases, video exposure monitoring was conducted to study the relationship between worker activities and dust exposure. Worker activities were video taped concurrent with aerosol photometer measurement of dust exposure and vacuum cleaner static pressure as a measure of airflow. During these field trials, respirable crystalline silica exposures for 22 samples had a geometric mean of 0.06 mg/m(3) and a range of less than 0.01 to 0.86 mg/m(3). For three other studies, respirable crystalline silica exposures during mortar removal have a geometric means of 1.1 to 0.35. Although this field study documented noticeably less exposure to crystalline silica, video exposure monitoring found that the local exhaust ventilation provided incomplete dust control due to low exhaust flow rates, certain work practices, and missing mortar. Vacuum cleaner airflow decrease had a range of 3 to 0.4 ft(3)/min (0.08 to 0.01 m(3)/sec(2)) over a range of vacuum cleaners, hose diameters, and hose lengths. To control worker exposure to respirable crystalline silica, local exhaust ventilation needs to be incorporated into a comprehensive silica control program that includes respiratory protection, worker training, and local exhaust ventilation.

Power law-based local search in spider monkey optimisation for lower order system modelling

NASA Astrophysics Data System (ADS)

Sharma, Ajay; Sharma, Harish; Bhargava, Annapurna; Sharma, Nirmala

2017-01-01

The nature-inspired algorithms (NIAs) have shown efficiency to solve many complex real-world optimisation problems. The efficiency of NIAs is measured by their ability to find adequate results within a reasonable amount of time, rather than an ability to guarantee the optimal solution. This paper presents a solution for lower order system modelling using spider monkey optimisation (SMO) algorithm to obtain a better approximation for lower order systems and reflects almost original higher order system's characteristics. Further, a local search strategy, namely, power law-based local search is incorporated with SMO. The proposed strategy is named as power law-based local search in SMO (PLSMO). The efficiency, accuracy and reliability of the proposed algorithm is tested over 20 well-known benchmark functions. Then, the PLSMO algorithm is applied to solve the lower order system modelling problem.

14 CFR 25.253 - High-speed characteristics.

Code of Federal Regulations, 2014 CFR

2014-01-01

... sudden or excessive reduction of elevator control force as VDF/MDF is reached. (4) Adequate roll..., inadvertent control movements, low stick force gradient in relation to control friction, passenger movement... VMO/MMO, the slope of the elevator control force versus speed curve need not be stable at speeds...

14 CFR 25.253 - High-speed characteristics.

Code of Federal Regulations, 2013 CFR

2013-01-01

... sudden or excessive reduction of elevator control force as VDF/MDF is reached. (4) Adequate roll..., inadvertent control movements, low stick force gradient in relation to control friction, passenger movement... VMO/MMO, the slope of the elevator control force versus speed curve need not be stable at speeds...

30 CFR 717.14 - Backfilling and grading of road cuts, mine entry area cuts, and other surface work areas.

Code of Federal Regulations, 2012 CFR

2012-07-01

... order to prevent water pollution and sustained combustion, and to minimize adverse effects on plant growth and land uses. Where necessary to protect against upward migration of salts, exposure by erosion, to provide an adequate depth for plant growth, or to otherwise meet local conditions, the regulatory...

30 CFR 717.14 - Backfilling and grading of road cuts, mine entry area cuts, and other surface work areas.

Code of Federal Regulations, 2014 CFR

2014-07-01

... order to prevent water pollution and sustained combustion, and to minimize adverse effects on plant growth and land uses. Where necessary to protect against upward migration of salts, exposure by erosion, to provide an adequate depth for plant growth, or to otherwise meet local conditions, the regulatory...

30 CFR 717.14 - Backfilling and grading of road cuts, mine entry area cuts, and other surface work areas.

Code of Federal Regulations, 2013 CFR

2013-07-01

... order to prevent water pollution and sustained combustion, and to minimize adverse effects on plant growth and land uses. Where necessary to protect against upward migration of salts, exposure by erosion, to provide an adequate depth for plant growth, or to otherwise meet local conditions, the regulatory...

36 CFR 251.114 - Criteria, terms and conditions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... required to construct new roads or reconstruct existing roads to bring the roads to a safe and adequate standard. A landowner also may be required to provide for the operation and maintenance of the road. This may be done by arranging for such road to be made part of the local public road system, or formation...

Crossing the Line: Transitioning from Auditor to Researcher

ERIC Educational Resources Information Center

Raiskums, Bernadine W.

2006-01-01

What does a very active and successful auditor/accountant do when she is about to retire with adequate means but inadequate interest in traveling or golfing? She might decide to expand her adjunct work as instructor at the local university. To complement her professional knowledge of accounting and auditing, she might decide to take a few courses…

A Case Study Investigating Teachers' Knowledge and Implementation of Response to Intervention

ERIC Educational Resources Information Center

Sims, Regina

2013-01-01

The local school district in the current study was struggling to meet adequate yearly progress (AYP) targets in reading because secondary students were scoring below the basic level in reading and their content area teachers had little or no training in reading deficiencies. What had been speculated, yet never tested, was the utility of teacher…

Personal Income Taxation. National Education Association Search.

ERIC Educational Resources Information Center

National Education Association, Washington, DC. Research Div.

The second in a series on school finance, this report describes the principles of fair and adequate state and local income taxation. The political setting is discussed, and the nature of indiviudal income taxes is explained by examining which states tax income and what income they tax. Tables 2, 3, and 4 demonstrate the expanding school financing…

Developing and Implementing Effective Communications Systems: Improving SEA Communication with LEAs, Partners/Vendors, and the Public. Benchmark. No. 2

ERIC Educational Resources Information Center

Brasiel, S.; Nafziger, D.

2013-01-01

State education agencies (SEAs) are central players in initiating and leading new reform efforts and in supporting and implementing Federal initiatives. Traditional approaches to providing public information are not adequate for producing public awareness and support and in supporting program implementation at the local level. With limited…

SEA Strategic Communications: A Stakeholder Approach to Prioritize Communications Efforts. Solutions. Issue No. 5

ERIC Educational Resources Information Center

Matta-Barrera, Romanita; Nafziger, Kristin E.

2013-01-01

State education agencies (SEAs) are central players in initiating and leading new reform efforts. However, traditional approaches to providing public information are not adequate for producing the necessary awareness and support to implement reforms statewide and at the local level. SEAs often have very few staff or other resources devoted to…

The response of native oaks from California and Israel to drought

Treesearch

Douglas McCreary; Jose M. Gruzweig; Yohay Carmel; Curtis H. Flather

2008-01-01

California and Israel are both characterized by Mediterranean climates, and the native oaks growing in these two locales occupy similar ecological niches. However, in California certain oak species are having difficulty regenerating adequately, while in Israel this is not a problem. From 2004 to 2006, a series of greenhouse studies were conducted in both Israel and...

Calibration Study of POWER Performance Levels to the CASAS Scale. Research Brief No. 5

ERIC Educational Resources Information Center

Posey, Virginia

2005-01-01

The Adult Education and Family Literacy Act, as part of the Workforce Investment Act of 1998, requires programs to use standardized assessments to report learning gains for students in adult education programs. In addition, local and state agencies need an accountability tool for students who are difficult to assess adequately with a…

Local Understanding of Fish Consumption Advisory Risks in Michigan's Upper Peninsula: The Role of Structure, Culture, and Agency

ERIC Educational Resources Information Center

Habron, Geoffrey; Barbier, Melanie; Kinnunen, Ronald

2008-01-01

Fish consumption advisories fail to adequately help communities address the benefits and risks of eating potentially contaminated fish. We engaged community members and relevant institutions in identifying and implementing more effective risk communication in Michigan's rural Upper Peninsula. In 2004-2005, we collected data in four Michigan…

Carried or Defeated? Examining the Factors Associated with Passing School District Bond Elections in Texas, 1997-2009

ERIC Educational Resources Information Center

Bowers, Alex J.; Lee, Jooyoung

2013-01-01

Purpose: Across the United States, a large percentage of school districts are in need of facility improvements to provide safe and adequate buildings to facilitate student learning. To finance new construction, school districts traditionally have put proposals before local voters to fund construction through issuing long-term bonds to finance…

Essential Civil Support Tasks

DTIC Science & Technology

2010-12-01

food, water, beds , bedding , clothing, and temporary shelters. They utilized vacant warehouses and parking lots to enable receipt, storage, and...Adequate Water Provide Food Provide Clothing and Bedding Provide Beds Develop National and Local Logistics Infrastructure for Receipt, Storage...Defense Support of Civil Authorities FEMA Federal Emergency Management Agency FM Field Manual JTF Joint Task Force NRF National Response Framework

PROCEDURE FOR THE ESTABLISHMENT OF COMMUNITY JUNIOR COLLEGES IN ARKANSAS.

ERIC Educational Resources Information Center

Arkansas State Commission on Coordination of Higher Educational Finance, Little Rock.

CRITERIA FOR ESTABLISHMENT OF JUNIOR COLLEGE DISTRICTS IN ARKANSAS INCLUDE (1) A PROJECTED ENROLLMENT OF AT LEAST 300 FULL TIME EQUIVALENT STUDENTS IN THE THIRD YEAR OF OPERATION, (2) ASSESSED VALUATION ADEQUATE TO PROVIDE FROM LOCAL PROPERTY TAXES ONE-THIRD OF THE ANNUAL OPERATING COST AND THE TOTAL DEBT SERVICE REQUIREMENTS FOR CAPITAL OUTLAY,…

Securing the Human: The Journey Toward World Law and Justice. The Whole Earth Papers, No. 14.

ERIC Educational Resources Information Center

Mische, Patricia; And Others

The document contains a variety of papers that examine the linkages between local concerns and global concerns and explore alternative world futures. An introductory article, "Securing the Human," discusses how the world community needs to develop adequate means to deal with crimes against humans. These means include sound analysis, spiritual…

Effect of mandibular mobilization on electromyographic signals in muscles of mastication and static balance in individuals with temporomandibular disorder: study protocol for a randomized controlled trial

PubMed Central

2013-01-01

Background The stomatognathic system and dysfunction in this system may be related to postural control. The proposal of the present study is to assess the effect of mandibular mobilization in individuals with temporomandibular disorder using surface electromyography of the muscles of mastication and stabilometric variables. Methods/Design A randomized, controlled, blind, clinical trial will be carried out, with the participants divided into three groups: 1) facial massage therapy (control group), 2) nonspecific mandibular mobilization and 3) specific mandibular mobilization. All groups will be assessed before and after treatment using the Research Diagnostic Criteria for Temporomandibular Disorders, surface electromyography of the masseter and temporal muscles and stabilometry. This study is registered with the Brazilian Registry of Clinical Trials (RBR9x8ssz). Discussion A large number of studies have employed surface electromyography to investigate the function/dysfunction of the muscles of mastication and associations with signs and symptoms of temporomandibular disorders. However, it has not yet been determined whether stabilometric variables offer adequate reliability in patients with this disorder. The results of the proposed study will help determine whether specific and/or nonspecific mandibular mobilization exerts an effect on the muscles of mastication and postural control. Moreover, if an effect is detected, the methodology defined in the proposed study will allow identifying whether the effect is local (found only in the muscles of mastication), global (found only in postural control) or generalized. PMID:24083628

21 CFR 226.58 - Laboratory controls.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Laboratory controls. Laboratory controls shall include the establishment of adequate specifications and test... establishment of master records containing appropriate specifications and a description of the test procedures... necessary laboratory test procedures to check such specifications. (c) Assays which shall be made of...

Nebulized antibiotics. An adequate option for treating ventilator-associated respiratory infection?

PubMed

Rodríguez, A; Barcenilla, F

2015-03-01

Ventilator-associated tracheobronchitis (VAT) is a frequent complication in critical patients. The 90% of those who develop it receive broad-spectrum antibiotic (ATB) treatment, without any strong evidence of its favorable impact. The use of nebulized ATB could be a valid treatment option, to reduce the use of systemic ATB and the pressure of selection on the local flora. Several studies suggest that an adequate nebulization technique can ensure high levels of ATB even in areas of lung consolidation, and to obtain clinical and microbiological cure. New studies are needed to properly assess the impact of treatment with nebulized ATB on the emergence of resistance. Copyright © 2014 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

The Experience of a District General Hospital with a Large Outdoor Music Festival in England.

PubMed

Kamour, A; Yardley, R; Longshaw, M; Stuart, J

2017-01-01

To assess the impact of the Parklife annual music festival on the local hospital, North Manchester General. Data was obtained retrospectively by analysis of emergency department records during the weekend of Parklife 2015. 32 patients were identified, 56% reported taking drugs. 34% were admitted for overnight observation. 4 patients presented with methaemoglobinaemia following oral ingestion of amyl nitrate. One patient had a methaemoglobin fraction of 90.6%, which is amongst the most extreme recorded in literature. Music festivals can impose a burden on local health services. Organisers should operate an efficient surveillance system in order to prevent the sale and use of recreational drugs, providing adequate on-site health services and working in collaboration with local emergency services.

40 CFR 21.1 - Scope.

Code of Federal Regulations, 2010 CFR

2010-07-01

... and section 8 of the Federal Water Pollution Control Act Amendments of 1972, to the effect that... adequate to comply with requirements established under the Federal Water Pollution Control Act, 33 U.S.C...

40 CFR 21.1 - Scope.

Code of Federal Regulations, 2011 CFR

2011-07-01

... and section 8 of the Federal Water Pollution Control Act Amendments of 1972, to the effect that... adequate to comply with requirements established under the Federal Water Pollution Control Act, 33 U.S.C...

40 CFR 21.1 - Scope.

Code of Federal Regulations, 2013 CFR

2013-07-01

... and section 8 of the Federal Water Pollution Control Act Amendments of 1972, to the effect that... adequate to comply with requirements established under the Federal Water Pollution Control Act, 33 U.S.C...

40 CFR 21.1 - Scope.

Code of Federal Regulations, 2014 CFR

2014-07-01

... and section 8 of the Federal Water Pollution Control Act Amendments of 1972, to the effect that... adequate to comply with requirements established under the Federal Water Pollution Control Act, 33 U.S.C...

Analysis of surgical margins in oral cancer using in situ fluorescence spectroscopy.

PubMed

Francisco, Ana Lucia Noronha; Correr, Wagner Rafael; Pinto, Clóvis Antônio Lopes; Gonçalves Filho, João; Chulam, Thiago Celestino; Kurachi, Cristina; Kowalski, Luiz Paulo

2014-06-01

Oral cancer is a public health problem with high prevalence in the population. Local tumor control is best achieved by complete surgical resection with adequate margins. A disease-free surgical margin correlates with a lower rate of local recurrence and a higher rate of disease-free survival. Fluorescence spectroscopy is a noninvasive diagnostic tool that can aid in real-time cancer detection. The technique, which evaluates the biochemical composition and structure of tissue fluorescence, is relatively simple, fast and, accurate. This study aimed to compare oral squamous cell carcinoma lesions to surgical margins and the mucosa of healthy volunteers by fluorescence spectroscopy. The sample consisted of 56 individuals, 28 with oral squamous cell carcinoma and 28 healthy volunteers with normal oral mucosa. Thirty six cases (64.3%) were male and the mean age was 60.9 years old. The spectra were classified and compared to histopathology to determine fluorescence efficiency for diagnostic discrimination of tumors. In the analysis of the other cases we observed discrimination between normal mucosa, injury and margins. At two-year follow up, three individuals had local recurrence, and in two cases investigation fluorescence in the corresponding area showed qualitative differences in spectra between the recurrence area and the area without recurrence at the same anatomical site in the same patient. In situ analysis of oral mucosa showed the potential of fluorescence spectroscopy as a diagnostic tool that can aid in discrimination of altered mucosa and normal mucosa. Copyright © 2014 Elsevier Ltd. All rights reserved.

12 CFR 618.8430 - Internal controls.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 12 Banks and Banking 7 2012-01-01 2012-01-01 false Internal controls. 618.8430 Section 618.8430 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM GENERAL PROVISIONS Internal Controls § 618.8430 Internal controls. Each Farm Credit institution's board of directors must adopt an internal control policy, providing adequate direction to...

Should we reconsider the routine use of placebo controls in clinical research?

PubMed

Avins, Andrew L; Cherkin, Daniel C; Sherman, Karen J; Goldberg, Harley; Pressman, Alice

2012-04-27

Modern clinical-research practice favors placebo controls over usual-care controls whenever a credible placebo exists. An unrecognized consequence of this preference is that clinicians are more limited in their ability to provide the benefits of the non-specific healing effects of placebos in clinical practice. We examined the issues in choosing between placebo and usual-care controls. We considered why placebo controls place constraints on clinicians and the trade-offs involved in the choice of control groups. We find that, for certain studies, investigators should consider usual-care controls, even if an adequate placebo is available. Employing usual-care controls would be of greatest value for pragmatic trials evaluating treatments to improve clinical care and for which threats to internal validity can be adequately managed without a placebo-control condition. Intentionally choosing usual-care controls, even when a satisfactory placebo exists, would allow clinicians to capture the value of non-specific therapeutic benefits that are common to all interventions. The result could be more effective, patient-centered care that makes the best use of both specific and non-specific benefits of medical interventions.

Subcostal Transverse Abdominis Plane Block for Acute Pain Management: A Review.

PubMed

Soliz, Jose M; Lipski, Ian; Hancher-Hodges, Shannon; Speer, Barbra Bryce; Popat, Keyuri

2017-10-01

The subcostal transverse abdominis plane (SCTAP) block is the deposition of local anesthetic in the transverse abdominis plane inferior and parallel to the costal margin. There is a growing consensus that the SCTAP block provides better analgesia for upper abdominal incisions than the traditional transverse abdominis plane block. In addition, when used as part of a four-quadrant transverse abdominis plane block, the SCTAP block may provide adequate analgesia for major abdominal surgery. The purpose of this review is to discuss the SCTAP block, including its indications, technique, local anesthetic solutions, and outcomes.

[Role of intraosteal administration of antibiotics in treatment of local oral mucinous carcinoma].

PubMed

Ivanov, V M; Ivanova, O V; Sheĭkin, M V

2013-01-01

The problems of prophylaxis of infectious complications in the treatment of oral local mucinous carcinoma are considered relevant to 204 respective cases. More favourable results of the combined and complex treatment of the patients were shown when a multidisciplinary approach was used with obligatory participation of stomatologists. Special stomatologic prophylactic and therapeutic procedures with using reamberin orally and intravenously in the chemo- and radiotherapy and adequate antibiotic therapy during the surgical operation resulted in less frequent infectious complications, that was in favour of the patients life quality. Intraosteal administration of antibiotics was shown preferable.

Review of interventions to relieve postpartum pain from perineal trauma.

PubMed

Petersen, Melanie Robin

2011-01-01

As an increased risk for infection and potentially significant source of pain, perineal trauma can negatively impact a mother's postpartum recovery. A variety of nursing interventions aimed at relieving perineal pain are largely based on localized cooling. Unfortunately, these interventions may not follow best practice for providing adequate pain relief or preventing perineal postpartum infection. This article provides a review of the literature related to utilizing localized cooling for postpartum perineal pain relief, suggests clinical guidelines for safe implementation of these measures, and calls for further research for evidence of nursing interventions to relieve pain caused by perineal trauma.

Compensation opportunities and waste-to-energy plants

NASA Astrophysics Data System (ADS)

Rada, E. C.; Castagna, G.; Adami, L.; Torretta, V.; Ragazzi, M.

2018-05-01

Compensations are part of the pathway of design of a thermochemical plant. The evolution of the technology of this sector, integrated with adequate mitigations, can allow reaching a level of environmental impact that can be negligible locally. In spite of that, the local acceptance of modern plants is still critical. The global impact on the environment is more complex to define because of the variability of input of the plants. In this context, the role of compensations is very important, opening also to interesting opportunities for the territory, as demonstrated by the analysis reported in this article.

An error criterion for determining sampling rates in closed-loop control systems

NASA Technical Reports Server (NTRS)

Brecher, S. M.

1972-01-01

The determination of an error criterion which will give a sampling rate for adequate performance of linear, time-invariant closed-loop, discrete-data control systems was studied. The proper modelling of the closed-loop control system for characterization of the error behavior, and the determination of an absolute error definition for performance of the two commonly used holding devices are discussed. The definition of an adequate relative error criterion as a function of the sampling rate and the parameters characterizing the system is established along with the determination of sampling rates. The validity of the expressions for the sampling interval was confirmed by computer simulations. Their application solves the problem of making a first choice in the selection of sampling rates.

30 CFR 74.6 - Quality control.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Quality control. 74.6 Section 74.6 Mineral... control. The applicant shall describe the way in which each lot of components will be sampled and tested... of the CMDPSU will be maintained in production through adequate quality control procedures, MSHA and...

30 CFR 74.6 - Quality control.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Quality control. 74.6 Section 74.6 Mineral... control. The applicant shall describe the way in which each lot of components will be sampled and tested... of the CMDPSU will be maintained in production through adequate quality control procedures, MSHA and...

30 CFR 74.6 - Quality control.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Quality control. 74.6 Section 74.6 Mineral... control. The applicant shall describe the way in which each lot of components will be sampled and tested... of the CMDPSU will be maintained in production through adequate quality control procedures, MSHA and...

A Preliminary Analysis of the Flying Qualities of the Consolidated Vultee MX-813 Delta-Wing Airplane Configuration at Transonic and Low Supersonic Speeds as Determined from Flights of Rocket-Powered Models

NASA Technical Reports Server (NTRS)

Mitcham, Grady L.

1949-01-01

A preliminary analysis of the flying qualities of the Consolidated Vultee MX-813 delta-wing airplane configuration has been made based on the results obtained from the first two 1/8 scale models flown at the NACA Pilotless Aircraft Research Station, Wallop's Island, VA. The Mach number range covered in the tests was from 0.9 to 1.2. The analysis indicates adequate elevator control for trim in level flight over the speed range investigated. Through the transonic range there is a mild trim change with a slight tucking-under tendency. The elevator control effectiveness in the supersonic range is reduced to about one-half the subsonic value although sufficient control for maneuvering is available as indicated by the fact that 10 deg elevator deflection produced 5g acceleration at Mach number of 1.2 at 40,000 feet.The elevator control forces are high and indicate the power required of the boost system. The damping. of the short-period oscillation is adequate at sea-level but is reduced at 40,000 feet. The directional stability appears adequate for the speed range and angles of attack covered.

Continuous microbial cultures maintained by electronically-controlled device

NASA Technical Reports Server (NTRS)

Eisler, W. J., Jr.; Webb, R. B.

1967-01-01

Photocell-controlled instrument maintains microbial culture. It uses commercially available chemostat glassware, provides adequate aeration through bubbling of the culture, maintains the population size and density, continuously records growth rates over small increments of time, and contains a simple, sterilizable nutrient control mechanism.

A QUALITATIVE RETROSPECTIVE ANALYSIS OF POSITIVE CONTROL DATA IN DEVELOPMENTAL NEUROTOXICITY STUDIES.

EPA Science Inventory

A manuscript reviews positive control data submitted by registrants in support of Developmental Neurotoxicity (DNT) guideline studies. Adequate positive control data are needed to evaluate laboratory proficiency in detecting changes in the structure and function of the developin...

Serum albumin-adjusted glycated albumin is an adequate indicator of glycemic control in patients with Cushing's syndrome.

PubMed

Kitamura, Tetsuhiro; Otsuki, Michio; Tamada, Daisuke; Tabuchi, Yukiko; Mukai, Kosuke; Morita, Shinya; Kasayama, Soji; Bando, Yukihiro; Shimomura, Iichiro; Koga, Masafumi

2014-12-01

We recently reported that glycated albumin (GA) in patients with Cushing's syndrome is low. In the present study, we examined whether serum albumin (SA)-adjusted GA (SAaGA) is an adequate indicator of glycemic control in patients with Cushing's syndrome. We studied 26 patients with Cushing's syndrome (13 patients without diabetes and 13 patients with diabetes). Twenty six non-diabetic subjects and 26 patients with type 2 diabetes mellitus matched for age, sex and BMI were used as the controls. SAaGA was calculated using the regression formula between SA and GA in non-diabetic patients with Cushing's syndrome and non-diabetic subjects. SA showed a significant correlation with GA in non-diabetic patients with Cushing's syndrome and non-diabetic subjects. GA, but not SAaGA, in non-diabetic patients with Cushing's syndrome was significantly lower than that in the non-diabetic controls. Furthermore, the GA/HbA1c ratio, but not the SAaGA/HbA1c ratio, in diabetic patients with Cushing's syndrome was significantly lower than that in the diabetic controls. The measured GA in the patients with Cushing's syndrome was significantly lower than the estimated GA, but there was no difference between SAaGA and the estimated GA. The present findings suggest that SAaGA is an adequate indicator of the glycemic control in patients with Cushing's syndrome. Copyright © 2014 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

A practical application of practice-based learning: development of an algorithm for empiric antibiotic coverage in ventilator-associated pneumonia.

PubMed

Miller, Preston R; Partrick, Matthew S; Hoth, J Jason; Meredith, J Wayne; Chang, Michael C

2006-04-01

Development of practice-based learning (PBL) is one of the core competencies required for resident education by the Accreditation Council for Graduate Medical Education, and specialty organizations including the American College of Surgeons have formed task forces to understand and disseminate information on this important concept. However, translating this concept into daily practice may be difficult. Our goal was to describe the successful application of PBL to patient care improvement with development of an algorithm for the empiric therapy of ventilator-associated pneumonia (VAP). The algorithm development occurred in two phases. In phase 1, the microbiology and timing of VAP as diagnosed by bronchoalveolar lavage was reviewed over a 2-year period to allow for recognition of patterns of infection. In phase 2, based on these data, an algorithm for empiric antibiotic coverage that would ensure that the large majority of patients with VAP received adequate initial empiric therapy was developed and put into practice. The period of algorithm use was then examined to determine rate of adequate coverage and outcome. : In Phase 1, from January 1, 2000 to December 31 2001, 110 patients were diagnosed with VAP. Analysis of microbiology revealed a sharp increase in the recovery of nosocomial pathogens on postinjury day 7 (19% < day 7 versus 47% > or = day 7, p = 0.003). Adequate initial antibiotic coverage was seen in 74%. In Phase 2, an algorithm employing ampicillin- sulbactam for coverage of community- acquired pathogens before day 7 and cefipime for nosocomial coverage > or =day 7 was then employed from January 1, 2002 to December 31, 2003. Evaluation of 186 VAP cases during this interval revealed a similar distribution of nosocomial cases (13% < day 7 versus 64% > or = day 7, p < 0.0001). Empiric antibiotic therapy was adequate in 82% of cases or =day 7: overall accuracy improved to 83% (p = 0.05). Mortality from phase 1 to phase 2 trended toward a decrease (21% versus 13%, p = 0.1). Application of the concept of PBL allowed for identification of local patterns of infection and development of an institution specific treatment algorithm that resulted in >80% adequate initial empiric coverage for VAP with a trend toward decreased mortality. PBL allows for alteration in practice based on local patterns and outcomes and has the potential to improve patient care.

Control of diarrheal diseases.

PubMed

Taylor, C E; Greenough, W B

1989-01-01

The tremendous advances made in the control of diarrheal diseases in the past few years indicate what more can be achieved. Even though the lives of an estimated three quarters of a million children are being saved each year, over three million children are still dying from readily preventable diarrheal disease. The challenge is to build on the successes thus far, to learn from experience, to promote changes in health habits that will prevent diarrhea, and to make all of these activities sustainable. From this analysis, we have three specific recommendations for CDD programs in the next decade. 1. ORT programs should move strongly toward promoting home treatment, building on local traditions of giving food-based preparations, with ORS available from health workers and health facilities for those who need it. Local assessment of people's beliefs and practices in caring for diarrhea should lead to simple methods of adapting ORT preparations that are culturally acceptable. Most of these traditional preparations have adequate amounts of the proteins and starches that are now being shown to produce better clinical results than the glucose in the standard ORS formula. Usually, the main change needed is more precision in the quantity of sodium added. Education of parents can then focus simply on how to make these adapted preparations, on starting rehydration early, and on replacing fluid volume as it is lost. The use of ORS packets in health facilities should continue, but the main indicator of progress in CDD should be ORT use including home solutions. Every packet of ORS should have printed on it the locally recommended formula for home ORT. 2. Nutritional support is just as important as rehydration. Diarrhea precipitates and accelerates the progression of malnutrition, which lowers resistance and increases the duration of diarrhea. Nutritional support through continued breast feeding and improved weaning practices using high density, easily digestible, local foods is especially important during and after episodes of diarrhea. 3. For long-term prevention, breaking the transmission cycles of the many common pathogens that cause diarrhea will be necessary. The most immediate preventive impact can be achieved by promoting hand washing with soap. Priority should also continue to be given to improving water supply, sanitation, and excreta control, especially of childrens' stools. Even with the great progress of recent years, the Child Survival and Development Revolution has just begun.

Establishing pediatric surgical services in emerging countries: What the first world can learn from Vanuatu.

PubMed

Leodoro, Basil M; Beasley, Spencer W; Maoate, Kiki

2015-05-01

Conventional surgical aid to emerging countries often does little to build capacity or infrastructure. An evolving model in the South Pacific has been designed to promote local expertise by training local surgeons to a high standard and helping establish sustainable pediatric surgical services in those regions. This review identifies the key elements required to improve and expand local specialist pediatric surgical capacity in Vanuatu. It highlights some of the challenges that face external agencies in helping to create sufficient local infrastructure to achieve these goals and describes how the impediments can be overcome. We conducted a review of the program that provides a sustainable pediatric surgical service to the small and poor Pacific nation of Vanuatu through the involvement and support of the Pacific Island Project administered by the Royal Australasian College of Surgeons. A needs assessment must be done from the recipient's perspective and can be achieved by collaboration between an external agency and existing local surgeons. The key to a sustainable service is identifying and training high quality young indigenous doctors early and providing mentorship and support, including after their return. A sustainable and viable service requires an adequately resourced position for the new surgeons(s) within a framework of a long term strategic plan for the specialty and adequate infrastructure in place on their return. Development of rapport with government and influencing strategic health priorities is a prerequisite of a new national specialty service. (1) Establishing long term viable pediatric surgical capability can only be achieved through the local health system with local leadership and ownership. (2) Internal capability includes governance, alignment with ministry of health priorities and policies, and effective clinical leadership. (3) Selection of person(s) to be trained is best done early, and he/she must be supported throughout training and afterwards. (4) Long term dependence on a single person makes the service vulnerable. (5) Ultimately, a service configuration that ensures children have timely access to quality specialist advice and which reflects the needs of the population is the main determinant of clinical outcomes. Copyright © 2015 Elsevier Inc. All rights reserved.

Multilevel en bloc spondylectomy for tumors of the thoracic and lumbar spine is challenging but rewarding.

PubMed

Luzzati, Alessandro Davide; Shah, Sambhav; Gagliano, Fabio; Perrucchini, Giuseppe; Scotto, Gennaro; Alloisio, Marco

2015-03-01

Over the years, en bloc spondylectomy has proven its efficacy in controlling spinal tumors and improving survival rates. However, there are few reports of large series that critically evaluate the results of multilevel en bloc spondylectomies for spinal neoplasms. Using data from a large spine tumor center, we answered the following questions: (1) Does multilevel total en bloc spondylectomy result in acceptable function, survival rates, and local control in spinal neoplasms? (2) Is reconstruction after this procedure feasible? (3) What complications are associated with this procedure? (4) is it possible to achieve adequate surgical margins with this procedure? We retrospectively investigated 38 patients undergoing multilevel total en bloc spondylectomy by a single surgeon (AL) from 1994 to 2011. Indications for this procedure were primary spinal sarcomas, solitary metastases, and aggressive primary benign tumors involving multiple segments of the thoracic or lumbar spine. Patients had to be medically fit and have no visceral metastases. Analysis was by chart and radiographic review. Margin quality was classified into intralesional, marginal, and wide. Radiographs, MR images, and CT scans were studied for local recurrence. Graft healing and instrumentation failures at subsequent followup were assessed. Complications were divided into major or minor and further classified as intraoperative and early and late postoperative. We evaluated the oncologic status using cumulative disease-specific and metastases-free survival analysis. Minimum followup was 24 months (mean, 39 months; range, 24-124 months). Of the 38 patients, 34 (89%) were alive and walking without support at final followup. Thirty-one (81%) had no evidence of disease. Two patients died postoperatively and another two died of systemic disease (without local recurrence). Only three patients (8%) had a local recurrence. There were 14 major complications and 22 minor complications in 25 patients (65%). Only one patient required revision of implants secondary to mechanical failure. Two cases of cage subsidence were noted but had no clinical significance. Wide margins were achieved in nine patients (23%), marginal in 25 (66%), and intralesional in four (11%). In patients with multisegmental spinal tumors, oncologic resections were achieved by multilevel en bloc spondylectomy and led to an acceptable survival rate with reasonable local control. Multilevel en bloc surgery was associated with a high complication rate; however, most patients recovered from their complications. Although the surgical procedure is challenging, our encouraging mid-term results clearly favor and validate this technique. Level IV, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.

Vaccine cold chain: Part 2. Training personnel and program management.

PubMed

Rogers, Bonnie; Dennison, Kim; Adepoju, Nikki; Dowd, Shelia; Uedoi, Kenneth

2010-09-01

The Centers for Disease Control and Prevention reports that professionals in clinic settings may not be adequately storing and handling vaccine, leading to insufficient immunity of vaccinated individuals. Part 2 of this article provides information about the importance of adequate personnel training and program management policies and procedures needed to implement and maintain an effective vaccine cold chain program. Copyright 2010, SLACK Incorporated.

Use of an intravascular fluorescent continuous glucose sensor in subjects with type 1 diabetes mellitus.

PubMed

Romey, Matthew; Jovanovič, Lois; Bevier, Wendy; Markova, Kateryna; Strasma, Paul; Zisser, Howard

2012-11-01

Stress hyperglycemia in the critically ill is associated with increased morbidity and mortality. Continuous glucose monitoring offers a solution to the difficulties of dosing intravenous insulin properly to maintain glycemic control. The purpose of this study was to evaluate an intravascular continuous glucose monitoring (IV-CGM) system with a sensing element based on the concept of quenched fluorescence. A second-generation intravascular continuous glucose sensor was evaluated in 13 volunteer subjects with type 1 diabetes mellitus. There were 21 study sessions of up to 24 h in duration. Sensors were inserted into peripheral veins of the upper extremity, up to two sensors per subject per study session. Sensor output was compared with temporally correlated reference measurements obtained from venous samples on a laboratory glucose analyzer. Data were obtained from 23 sensors in 13 study sessions with 942 paired reference values. Fourteen out of 23 sensors (60.9%) had a mean absolute relative difference ≤ 10%. Eighty-nine percent of paired points were in the clinically accurate A zone of the Clarke error grid and met ISO 15197 performance criteria. Adequate venous blood flow was identified as a necessary condition for accuracy when local sensor readings are compared with venous blood glucose. The IV-CGM system was capable of achieving a high level of glucose measurement accuracy. However, superficial peripheral veins may not provide adequate blood flow for reliable indwelling blood glucose monitoring. © 2012 Diabetes Technology Society.

Use of an Intravascular Fluorescent Continuous Glucose Sensor in Subjects with Type 1 Diabetes Mellitus

PubMed Central

Romey, Matthew; Jovanovič, Lois; Bevier, Wendy; Markova, Kateryna; Strasma, Paul; Zisser, Howard

2012-01-01

Background Stress hyperglycemia in the critically ill is associated with increased morbidity and mortality. Continuous glucose monitoring offers a solution to the difficulties of dosing intravenous insulin properly to maintain glycemic control. The purpose of this study was to evaluate an intravascular continuous glucose monitoring (IV-CGM) system with a sensing element based on the concept of quenched fluorescence. Method A second-generation intravascular continuous glucose sensor was evaluated in 13 volunteer subjects with type 1 diabetes mellitus. There were 21 study sessions of up to 24 h in duration. Sensors were inserted into peripheral veins of the upper extremity, up to two sensors per subject per study session. Sensor output was compared with temporally correlated reference measurements obtained from venous samples on a laboratory glucose analyzer. Results Data were obtained from 23 sensors in 13 study sessions with 942 paired reference values. Fourteen out of 23 sensors (60.9%) had a mean absolute relative difference ≤ 10%. Eighty-nine percent of paired points were in the clinically accurate A zone of the Clarke error grid and met ISO 15197 performance criteria. Adequate venous blood flow was identified as a necessary condition for accuracy when local sensor readings are compared with venous blood glucose. Conclusions The IV-CGM system was capable of achieving a high level of glucose measurement accuracy. However, superficial peripheral veins may not provide adequate blood flow for reliable indwelling blood glucose monitoring. PMID:23294770

Is the Berg Balance Scale an effective tool for the measurement of early postural control impairments in patients with Parkinson's disease? Evidence from Rasch analysis.

PubMed

La Porta, F; Giordano, A; Caselli, S; Foti, C; Franchignoni, F

2015-12-01

It is unclear whether the BBS is an effective tool for the measurement of early postural control impairments in patients with Parkinson's disease (PD). The aim of this paper was to evaluate BBS' content validity, internal construct validity, reliability and targeting in patients with PD within the Rasch analysis framework. Observational, cross-sectional study. Outpatient Rehabilitation Unit. A sample of 285 outpatients with PD. The content validity of the BBS was assessed using standard linking techniques. The BBS was administered by trained physiotherapists. The data collected then underwent Rasch analysis. Content validity analysis showed a lack of items assessing postural responses to tripping and slips and stability during walking. On Rasch analysis, the BBS failed the requirements of monotonicity, local independence, unidimensionality and invariance. After rescoring 7 items, grouping of locally dependent items into testlets, and deletion of the static sitting balance item because mistargeted and underdiscriminating, the Rasch-modified BBS for PD (BBS-PD) showed adequate internal construct validity (χ(2)24=39.693; P=0.023), including absence of differential item functioning (DIF) across gender and age, and was, as a whole, sufficiently precise for individual person measurement (PSI=0.894). However, the scale was not well targeted to the sample in view of the prevalence of higher scores. This study demonstrated the internal construct validity and reliability of the BBS-PD as a measurement tool for patients with PD within the Rasch analysis framework. However, the lack of items critical to the assessment of postural control impairments typical of PD, affected negatively the targeting, so that a significant percentage of patients was located in the higher ability range of the measurement continuum, where precision of measurement is reduced. These findings suggest that the BBS, even if modified, may not be an effective tool for the measurement of early postural control in patients with PD.

Cordyceps sinensis extracts attenuate aortic transplant arteriosclerosis in rats.

PubMed

Zhang, Yan; Yang, Mei; Gong, Shuwen; Yang, Yu; Chen, Bicheng; Cai, Yong; Zheng, Shaoling; Yang, Yirong; Xia, Peng

2012-06-01

Transplant arteriosclerosis is a hallmark of chronic rejection and is still the major limiting factor affecting the success of long-term organ transplants. Development of transplant arteriosclerosis is refractory to conventional immunosuppressive drugs, and adequate therapy is not yet available. The aim of this study was to determine the role of Cordyceps sinensis extracts in reducing the formation of transplant arteriosclerosis in a rat aortic transplant model. Lewis rat aortic allografts were transplanted into Brown-Norway recipient rats. Recipients received 0.5, 1, 2, and 5 mg/kg of Cordyceps sinensis extracts (or control saline) daily via intragastric injection for 60 d. Grafts were harvested 60 d post-transplantation and intimal thickness determined microscopically following hematoxylin and eosin (H and E) staining and abdominal aorta protein profiles determined by Western blot analysis. Cellular localization was assessed by histology and immunohistochemistry and the serum analyzed for tumor necrosis factor alpha (TNF-α) and intercellular adhesion molecule-1 (ICAM-1) by enzyme-linked immunosorbent assay (ELISA). C. sinensis administration resulted in a significant reduction in neointimal formation (neointimal thickness 8.27 ± 1.95 μm [0.5 mg/kg], 3.69 ± 1.43 μm [1 mg/kg], 3.69 ± 1.43 μm [1 mg/kg], 3.69 ± 1.43 μm [1 mg/kg] versus 11.42 ± 2.67 μm [control]) and in the proliferative activity of vascular smooth muscle cells. In addition, localized expression of TNF-α and ICAM-1 in transplant aortas was characterized by immunohistochemistry and immunoblot analyses demonstrating that C. sinensis treatment significantly reduced TNF-α and ICAM-1 levels compared with levels observed in controls (P < 0.05). Serum TNF-α and ICAM-1 levels were significantly reduced in C. sinensis-treated animals compared with controls (P < 0.05). C. sinensis treatment effectively reduced the formation of transplant arteriosclerosis in a rat aortic transplant model. Copyright © 2012 Elsevier Inc. All rights reserved.

The local lymph node assay and skin sensitization: a cut-down screen to reduce animal requirements?

PubMed

Kimber, Ian; Dearman, Rebecca J; Betts, Catherine J; Gerberick, G Frank; Ryan, Cindy A; Kern, Petra S; Patlewicz, Grace Y; Basketter, David A

2006-04-01

The local lymph node assay (LLNA), an alternative approach to skin-sensitizing testing, has made a significant contribution to animal welfare by permitting a reduction and refinement of animal use. Although there is clearly an aspiration to eliminate the use of animals in such tests, it is appropriate also to consider other opportunities for refinement and reduction of animal use. We have therefore explored the use of a modified version of the LLNA for screening purposes when there is a need to evaluate the sensitizing activity of a large number of chemicals, as will be the case under the auspices of registration, evaluation and authorization of chemicals (REACH). Using an existing LLNA database of 211 chemicals, we have examined whether a cut-down assay comprising a single high-dose group and a concurrent vehicle control would provide a realistic approach for screening chemicals for sensitizing potential. The analyses reported here suggest this is the case. We speculate that the animal welfare benefits may be enhanced further by reducing the number of animals per experimental group. However, a detailed evaluation will be necessary to provide reassurance that a reduction in group size would provide adequate sensitivity across a range of skin sensitization potencies.

Successful Surface Treatments for Reducing Instabilities in Advanced Nickel-base Superalloys for Turbine Blades

NASA Technical Reports Server (NTRS)

Locci, Ivan E.; MacKay, Rebecca A.; Garg, Anita; Ritzert, Frank J.

2004-01-01

An optimized carburization treatment has been developed to mitigate instabilities that form in the microstructures of advanced turbine airfoil materials. Current turbine airfoils consist of a single crystal superalloy base that provides the mechanical performance of the airfoil, a thermal barrier coating (TBC) that reduces the temperature of the base superalloy, and a bondcoat between the superalloy and the TBC, that improves the oxidation and corrosion resistance of the base superalloy and the spallation resistance of the TBC. Advanced nickel-base superalloys containing high levels of refractory metals have been observed to develop an instability called secondary reaction zone (SRZ), which can form beneath diffusion aluminide bondcoats. This instability between the superalloy and the bondcoat has the potential of reducing the mechanical properties of thin-wall turbine airfoils. Controlled gas carburization treatments combined with a prior stress relief heat treatment and adequate surface preparation have been utilized effectively to minimize the formation of SRZ. These additional processing steps are employed before the aluminide bondcoat is deposited and are believed to change the local chemistry and local stresses of the surface of the superalloy. This paper presents the detailed processing steps used to reduce SRZ between platinum aluminide bondcoats and advanced single crystal superalloys.

[Complications of endonasal surgery of the paranasal sinuses. Special anatomy, pathomechanisms, surgical management].

PubMed

Rauchfuss, A

1990-09-01

Statistics show that there is no significant increase in complications in endonasal sinus surgery of the ethmoid or sphenoid as compared to paranasal or transantral procedures. Exact anatomical knowledge of the nasal cavity, the paranasal sinuses and related structures is essential for assessment and management in iatrogenic complications, which are divided in three groups, according to characteristic topographic implications: orbito-ocular, vascular, encephalomeningeal. Orbito-ocular complications are managed by decompression of the orbit using the paranasal approach. Direct lesions of the optic nerve in ethmoid- or sphenoid-sinus surgery are extremely rare and are due to an abnormal nervous course. Vascular complications in the branches of the external carotid artery require local procedures (e.g. transantral ligature of the sphenopalatine artery). In some cases an intra-arterial embolization using supra-selective angiography is more effective. Massive bleeding from lesions of the internal carotid artery is stopped by placement of a balloon catheter combined with a transfemoral intra-arterial digital subtraction technique. Iatrogenic dura defects in the frontal skull base can be managed easily once the lesion has been exactly and clearly localized. Adequate control of the frontobase including the orbit, optic nerve and related vascular and nervous structures is achieved by the extracranial subfrontal paranasal (Killian incision) approach, if endoscopic or endonasal microscopic repair is ineffective.

75 FR 16235 - Electronic Prescriptions for Controlled Substances

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-31

... 21 of the Code of Federal Regulations (CFR), Parts 1300 to 1399. These regulations are designed to ensure an adequate supply of controlled substances for legitimate medical, scientific, research, and... research or chemical analysis with controlled substances must register with DEA (unless exempt) and comply...

Ares-I-X Stability and Control Flight Test: Analysis and Plans

NASA Technical Reports Server (NTRS)

Brandon, Jay M.; Derry, Stephen D.; Heim, Eugene H.; Hueschen, Richard M.; Bacon, Barton J.

2008-01-01

The flight test of the Ares I-X vehicle provides a unique opportunity to reduce risk of the design of the Ares I vehicle and test out design, math modeling, and analysis methods. One of the key features of the Ares I design is the significant static aerodynamic instability coupled with the relatively flexible vehicle - potentially resulting in a challenging controls problem to provide adequate flight path performance while also providing adequate structural mode damping and preventing adverse control coupling to the flexible structural modes. Another challenge is to obtain enough data from the single flight to be able to conduct analysis showing the effectiveness of the controls solutions and have data to inform design decisions for Ares I. This paper will outline the modeling approaches and control system design to conduct this flight test, and also the system identification techniques developed to extract key information such as control system performance (gain/phase margins, for example), structural dynamics responses, and aerodynamic model estimations.

21 CFR 314.126 - Adequate and well-controlled studies.

Code of Federal Regulations, 2010 CFR

2010-04-01

... permits a valid comparison with a control to provide a quantitative assessment of drug effect. The... data analyses performed. (c) The Director of the Center for Drug Evaluation and Research may, on the...

21 CFR 314.126 - Adequate and well-controlled studies.

Code of Federal Regulations, 2012 CFR

2012-04-01

... permits a valid comparison with a control to provide a quantitative assessment of drug effect. The... data analyses performed. (c) The Director of the Center for Drug Evaluation and Research may, on the...

21 CFR 314.126 - Adequate and well-controlled studies.

Code of Federal Regulations, 2013 CFR

2013-04-01

... permits a valid comparison with a control to provide a quantitative assessment of drug effect. The... data analyses performed. (c) The Director of the Center for Drug Evaluation and Research may, on the...

21 CFR 314.126 - Adequate and well-controlled studies.

Code of Federal Regulations, 2011 CFR

2011-04-01

... permits a valid comparison with a control to provide a quantitative assessment of drug effect. The... data analyses performed. (c) The Director of the Center for Drug Evaluation and Research may, on the...

21 CFR 314.126 - Adequate and well-controlled studies.

Code of Federal Regulations, 2014 CFR

2014-04-01

... permits a valid comparison with a control to provide a quantitative assessment of drug effect. The... data analyses performed. (c) The Director of the Center for Drug Evaluation and Research may, on the...

The Contractor's Role in Competitive Bid Construction.

ERIC Educational Resources Information Center

Toy, G. Arlan

1986-01-01

In a competitive bid situation, the general contractor's first priority is controlling construction costs. The actions the general contractor take focus on adequate control, effective communication, efficient use of resources, and prevention of delays. (MLF)

The Basis for Integrating Local Knowledge into the School Curriculum for Tibetans in Southern Gansu

ERIC Educational Resources Information Center

Fuhai, An

2017-01-01

The school curriculum in Gannan Tibetan Autonomous Prefecture (Gannan) does not adequately consider the interests and needs of Tibetan students or the life options of those who fail to be chosen for a path to "legitimization." Such a curriculum is not only incompatible with what should be the objectives and requirements for transmitting…

Supervisor Assessment of Clinical and Professional Competence of Medical Trainees: A Reliability Study Using Workplace Data and a Focused Analytical Literature Review

ERIC Educational Resources Information Center

McGill, D. A.; van der Vleuten, C. P. M.; Clarke, M. J.

2011-01-01

Even though rater-based judgements of clinical competence are widely used, they are context sensitive and vary between individuals and institutions. To deal adequately with rater-judgement unreliability, evaluating the reliability of workplace rater-based assessments in the local context is essential. Using such an approach, the primary intention…

Donating the Voucher: An Alternative Tax Treatment of Private School Enrollment. Research Briefs in Economic Policy, Number 1

ERIC Educational Resources Information Center

Samwick, Andrew

2014-01-01

In the United States, parents send about 10 percent of elementary and secondary school-age children to private schools, which through their accreditation meet the requirement that students receive an adequate education. By paying out of pocket for their children's private education, these families relieve a financial burden on local, state, and…

Impacts of habitat alterations and predispersal seed predation on the reproductive success of Great Basin forbs

Treesearch

Robert L. Johnson

2008-01-01

Sexual reproductive success in wild plant populations is dependent upon the ability to bank seed for when environmental conditions favor seedling recruitment. Seed production in many plant populations requires the pollination services of local bee populations. A loss in bee diversity as a result of exotic plant invasion or revegetation practices which do not adequately...

Understanding and Implementing Section 2141(c) of the Elementary and Secondary Education Act. Policy-to-Practice Brief

ERIC Educational Resources Information Center

Potemski, Amy

2009-01-01

According to Section 2141(c) of the Elementary and Secondary Education Act (ESEA), as reauthorized by the No Child Left Behind Act (NCLB), local education agencies (LEAs) that fail to meet annual measurable objectives and make adequate yearly progress (AYP) for three consecutive years must enter into an agreement with the state education agency…

Going It Alone: Can California's K-12 School Districts Adequately and Equitably Fund School Facilities? Policy Research Brief

ERIC Educational Resources Information Center

Center for Cities & Schools, 2015

2015-01-01

After\tdecades of dedicated investment, state funding to assist local California school districts in the construction, modernization, and maintenance of their school facilities has come to a halt. As the Governor, the legislature, and other stakeholders debate the future of the state's K-12 school facility funding role, a big unknown exists:…

Preparing to Prevent: Conflict-Related Sexual Violence Mitigation Scenario-Based Training

DTIC Science & Technology

2014-11-26

role in the absence of adequate local authorities? 5) The patrol may have to provide first aid if the children are injured. Longer term assistance...Encounter: Rape Victim 26 5. Patrol Encounter: Report of Abducted Children 28 6. Sexual... Discrimination against Women, women and girls are frequently victims of rape, sexual molestation, culturally-sanctioned oppression, domestic violence

Morale of Teachers in High Poverty Schools: A Post-NCLB Mixed Methods Analysis

ERIC Educational Resources Information Center

Byrd-Blake, Marie; Afolayan, Michael O.; Hunt, John W.; Fabunmi, Martins; Pryor, Brandt W.; Leander, Robert

2010-01-01

This study tested how well Fishbein and Ajzen's Theory of Reasoned Action predicted the attitudes and morale of urban teachers in high poverty schools under the pressures of the No Child Left Behind Act (NCLB). NCLB forced local administrators to target schools that had not made adequately yearly progress (AYP) for two or more consecutive years.…

The Market, the Media and the Family in a School Excursion Rape Case

ERIC Educational Resources Information Center

Gannon, Susanne

2007-01-01

This paper examines a local and specific instance of the effects of neoliberal markets on individual and institutional subjects of schooling. It reviews a court case between a prestigious private girls' school and an ex-student who sued the school for failing to provide adequate supervision on a school trip to Europe during which she was raped. It…

Leading into the Future: Perceptions of School Board Presidents on the Essential Knowledge and Skills for Superintendent Preparation Programs

ERIC Educational Resources Information Center

Tripses, Jenny; Hunt, John; Kim, JoHyun; Watkins, Sandra

2015-01-01

Reports in the media on American public schools are pretty dismal. Accountability measures enacted with the passing of the No Child Left Behind Law of 2002 include federal and state sanctions for school districts not making adequate yearly progress on state assessments. Typically these results are published locally, which only increases the…

Electrochemotherapy under tumescent local anesthesia for the treatment of cutaneous metastases.

PubMed

Kendler, Michael; Micheluzzi, Martin; Wetzig, Tino; Simon, Jan C

2013-07-01

The surgical management of cutaneous metastasis (CM) is challenging, particularly in elderly patients, in whom general anesthesia can be difficult because of comorbidity. To test the effectiveness of tumescent local anesthesia (TLA) to achieve adequate anesthesia during the treatment of extensive CM with electrochemotherapy (ECT), previously only performed under general anesthesia. We conducted five ECT treatments of CM with intralesional bleomycin under TLA. We examined pain scores before, during, and after treatment; analgesic use; and side effects. The intention of the treatment was palliative in all cases. We treated four patients (ages 75-88) with CM with a mean area of 126 cm(2) (range 12-198 cm(2) ) with 356 mL of TLA per treatment (range 180-450 mL). The ECT treatment under TLA demonstrated that anesthesia was adequate, with moderate pain during and slight pain after the procedure as measured on a visual analog scale (VAS). In this proof-of-principle study, we demonstrated that ECT can be performed under TLA; TLA might be a useful new anesthesia option for patients treated with ECT. © 2013 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.

Caregiver's depressive symptoms and asthma control in children from an underserved community.

PubMed

Rioseco, Andrea; Serrano, Carolina; Celedón, Juan C; Padilla, Oslando; Puschel, Klaus; Castro-Rodriguez, Jose A

2017-12-01

Caregiver's or maternal depression has been associated with increased asthma morbidity in children from prosperous nations, but little is known about this link in low and middle-income countries. To examine if caregiver's depressive symptoms are associated with poor asthma control and abnormal immune responses in school-aged children. Case-control study of 87 asthmatic children (aged 4-11 years) attending a primary care clinic in an underserved area of Santiago (Chile). Cases were children with poor asthma control (Child Asthma Control Test [cACT] <20 points) and controls were children with adequate asthma control (cACT ≥20 points). The Beck Depression Inventory-II (BDI) and a locally validated family health vulnerability test (SALUFAM) were used to assess caregivers' depression and family health vulnerability. Serum from participating children was assayed for IFN-γ, IL-4, IL-13, TGF-β, cortisol, and total IgE. The mean (SD) age of study participants was 8.23 (2.15 years), and 55.2% were females. Use of inhaled corticosteroids (ICS), family health vulnerability, and caregiver's depressive symptoms were significantly more common in cases than in controls (65.4% vs. 34.6%, p = 0.003; 41.3% vs. 24.8%, p = 0.07; and 39.1% vs. 19.5%, p = 0.04, respectively). There was no significant difference in the level of any serum biomarkers between groups. In a multivariate analysis, only ICS use was significantly associated with better asthma control (OR = 3.56 [1.34-9.48], p = 0.01). Presence of caregiver's depressive symptoms is associated with poor asthma control among children from an underserved community, but this association was no longer significant after accounting for ICS use.

Possible environmental effects of increased coal use in California

NASA Technical Reports Server (NTRS)

Carey, D. L.

1978-01-01

If coal is to be utilized in California it must be made compatible with the state's drive toward restoring environmental quality. The impacts resulting from coal's mining and transportation, or from water consumption, water quality degradation and electric transmission line routing can probably be adequately mitigated through strong and early planning efforts, the use of improved control and process technologies, and sincere utility commitment. The socioeconomic impacts may prove somewhat more difficult to satisfactorily mitigate. Of greatest concern is adequate control of generated air pollutants and disposal of solid and liquid wastes since acceptable technologies or handling techniques have yet to be conclusively demonstrated.

Psychometric evaluation of the Spanish version of the MPI-SCI.

PubMed

Soler, M D; Cruz-Almeida, Y; Saurí, J; Widerström-Noga, E G

2013-07-01

Postal surveys. To confirm the factor structure of the Spanish version of the MPI-SCI (MPI-SCI-S, Multidimensional Pain Inventory in the SCI population) and to test its internal consistency and construct validity in a Spanish population. Guttmann Institute, Barcelona, Spain. The MPI-SCI-S along with Spanish measures of pain intensity (Numerical Rating Scale), pain interference (Brief Pain Inventory), functional independence (Functional Independence Measure), depression (Beck Depression Inventory), locus of control (Multidimensional health Locus of Control), support (Functional Social Support Questionnaire (Duke-UNC)), psychological well-being (Psychological Global Well-Being Index) and demographic/injury characteristics were assessed in persons with spinal cord injury (SCI) and chronic pain (n=126). Confirmatory factor analysis suggested an adequate factor structure for the MPI-SCI-S. The internal consistency of the MPI-SCI-S subscales ranged from acceptable (r=0.66, Life Control) to excellent (r=0.94, Life Interference). All MPI-SCI-S subscales showed adequate construct validity, with the exception of the Negative and Solicitous Responses subscales. The Spanish version of the MPI-SCI is adequate for evaluating chronic pain impact following SCI in a Spanish-speaking population. Future studies should include additional measures of pain-related support in the Spanish-speaking SCI population.

14 CFR 139.329 - Pedestrians and ground vehicles.

Code of Federal Regulations, 2010 CFR

2010-01-01

... by an employee, tenant, or contractor; (c) When an air traffic control tower is in operation, ensure... between the tower and the pedestrian, vehicle, or escort; (d) When an air traffic control tower is not in operation, or there is no air traffic control tower, provide adequate procedures to control pedestrians and...

40 CFR 152.20 - Exemptions for pesticides adequately regulated by another Federal agency.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Federal agency. (a) Certain biological control agents. (1) Except as provided by paragraphs (a)(3) and (a)(4) of this section, all biological control agents are exempt from FIFRA requirements. (2) If the Agency determines that an individual biological control agent or class of biological control agents is no...

40 CFR 152.20 - Exemptions for pesticides adequately regulated by another Federal agency.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Federal agency. (a) Certain biological control agents. (1) Except as provided by paragraphs (a)(3) and (a)(4) of this section, all biological control agents are exempt from FIFRA requirements. (2) If the Agency determines that an individual biological control agent or class of biological control agents is no...

What Is Asthma Control? Discrepancies between Parents' Perceptions and Official Definitions

ERIC Educational Resources Information Center

Dozier, Ann; Aligne, C. Andrew; Schlabach, Mary Beth

2006-01-01

National guidelines define asthma control as the prevention of asthma symptoms rather than the treatment of asthma exacerbations. We hypothesized that we would find a discrepancy between what parents consider adequate control compared to what health care professionals mean by "control." Data from a telephone survey conducted for the…

36 CFR 72.36 - Land ownership, control and conversion.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 36 Parks, Forests, and Public Property 1 2010-07-01 2010-07-01 false Land ownership, control and..., Rehabilitation and Innovation § 72.36 Land ownership, control and conversion. Section 1010 of the Act provides...-grantee must demonstrate, at the time of grant approval, that it has adequate tenure and control of the...

36 CFR 72.36 - Land ownership, control and conversion.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 36 Parks, Forests, and Public Property 1 2014-07-01 2014-07-01 false Land ownership, control and..., Rehabilitation and Innovation § 72.36 Land ownership, control and conversion. Section 1010 of the Act provides...-grantee must demonstrate, at the time of grant approval, that it has adequate tenure and control of the...

36 CFR 72.36 - Land ownership, control and conversion.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 36 Parks, Forests, and Public Property 1 2013-07-01 2013-07-01 false Land ownership, control and..., Rehabilitation and Innovation § 72.36 Land ownership, control and conversion. Section 1010 of the Act provides...-grantee must demonstrate, at the time of grant approval, that it has adequate tenure and control of the...

36 CFR 72.36 - Land ownership, control and conversion.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 36 Parks, Forests, and Public Property 1 2011-07-01 2011-07-01 false Land ownership, control and..., Rehabilitation and Innovation § 72.36 Land ownership, control and conversion. Section 1010 of the Act provides...-grantee must demonstrate, at the time of grant approval, that it has adequate tenure and control of the...

36 CFR 72.36 - Land ownership, control and conversion.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 36 Parks, Forests, and Public Property 1 2012-07-01 2012-07-01 false Land ownership, control and..., Rehabilitation and Innovation § 72.36 Land ownership, control and conversion. Section 1010 of the Act provides...-grantee must demonstrate, at the time of grant approval, that it has adequate tenure and control of the...

Sampling versus systematic full lymphatic dissection in surgical treatment of non-small cell lung cancer.

PubMed

Koulaxouzidis, Georgios; Karagkiouzis, Grigorios; Konstantinou, Marios; Gkiozos, Ioannis; Syrigos, Konstantinos

2013-04-22

The extent of mediastinal lymph node assessment during surgery for non-small cell cancer remains controversial. Different techniques are used, ranging from simple visual inspection of the unopened mediastinum to an extended bilateral lymph node dissection. Furthermore, different terms are used to define these techniques. Sampling is the removal of one or more lymph nodes under the guidance of pre-operative findings. Systematic (full) nodal dissection is the removal of all mediastinal tissue containing the lymph nodes systematically within anatomical landmarks. A Medline search was conducted to identify articles in the English language that addressed the role of mediastinal lymph node resection in the treatment of non-small cell lung cancer. Opinions as to the reasons for favoring full lymphatic dissection include complete resection, improved nodal staging and better local control due to resection of undetected micrometastasis. Arguments against routine full lymphatic dissection are increased morbidity, increase in operative time, and lack of evidence of improved survival. For complete resection of non-small cell lung cancer, many authors recommend a systematic nodal dissection as the standard approach during surgery, and suggest that this provides both adequate nodal staging and guarantees complete resection. Whether extending the lymph node dissection influences survival or recurrence rate is still not known. There are valid arguments in favor in terms not only of an improved local control but also of an improved long-term survival. However, the impact of lymph node dissection on long-term survival should be further assessed by large-scale multicenter randomized trials.

Online process monitoring at quasi-simultaneous laser transmission welding using a 3D-scanner with integrated pyrometer

NASA Astrophysics Data System (ADS)

Schmailzl, A.; Steger, S.; Dostalek, M.; Hierl, S.

2016-03-01

Quasi-simultaneous laser transmission welding is a well-known joining technique for thermoplastics and mainly used in the automotive as well as in the medical industry. For process control usually the so called set-path monitoring is used, where the weld is specified as "good" if the irradiation time is inside a defined confidence interval. However, the detection of small-sized gaps or thermal damaged zones is not possible with this technique. The analyzation of the weld seam temperature during welding offers the possibility to overcome this problem. In this approach a 3D-scanner is used instead of a scanner with flat-field optic. By using a pyrometer in combination with a 3D-scanner no color-corrected optic is needed in order to provide that laser- and detection-spot are concentric. Experimental studies on polyethylene T-joints have shown that the quality of the signal is adequate, despite the use of an optical setup with a long working distance and a small optical aperture. The effects on temperature are studied for defects like a gap in the joining zone. Therefore a notch was milled into the absorbent polymer. In case of producing housings for electronic parts the effect of an electrical wire between the joining partners is also investigated. Both defects can be identified by a local temperature deviation even at a feed rate of four meters per second. Furthermore a strategy for signal-processing is demonstrated. By this, remaining defects can be identified. Consequently an online detection of local defects is possible, which makes a dynamic process control feasible.

Root-coverage procedures for the treatment of localized recession-type defects: a Cochrane systematic review.

PubMed

Chambrone, Leandro; Sukekava, Flávia; Araújo, Maurício G; Pustiglioni, Francisco E; Chambrone, Luiz Armando; Lima, Luiz A

2010-04-01

The purpose of this review is to evaluate the effectiveness of different root-coverage procedures in the treatment of recession-type defects. The Cochrane Oral Health Group Trials Register, Cochrane Central Register of Controlled Trials, MEDLINE, and EMBASE were searched for entries up to October 2008. There were no restrictions regarding publication status or the language of publication. Only clinical randomized controlled trials (RCTs) with a duration > or = 6 months that evaluated recession areas (Miller Class I or II > or = 3 mm) that were treated by means of periodontal plastic surgery procedures were included. Twenty-four RCTs provided data. Only one trial was considered to be at low risk of bias. The remaining trials were considered to be at high risk of bias. The results indicated a significantly greater reduction in gingival recession and gain in keratinized tissue for subepithelial connective tissue grafts (SCTGs) compared to guided tissue regeneration (GTR) with bioabsorbable membranes (GTR bms). A significantly greater gain in keratinized tissue was found for enamel matrix protein compared to a coronally advanced flap (0.40 mm) and for SCTGs compared to GTR bms plus bone substitutes. Limited data exist on the changes of esthetic conditions as related to the opinions and preferences of patients for specific procedures. SCTGs, coronally advanced flaps alone or associated with other biomaterial, and GTR may be used as root-coverage procedures for the treatment of localized recession-type defects. In cases where root coverage and gain in keratinized tissue are expected, the use of SCTGs seems to be more adequate.

40 CFR 725.428 - Requirements for the Tier II exemption.

Code of Federal Regulations, 2010 CFR

2010-07-01

... SUBSTANCES CONTROL ACT REPORTING REQUIREMENTS AND REVIEW PROCESSES FOR MICROORGANISMS General Exemptions for... material meets the criteria under § 725.421. (c) Adequate physical containment and control technologies are used. The criteria listed under § 725.422 for physical containment and control technologies of...

Are Substance Use Prevention Programs More Effective in Schools Making Adequate Yearly Progress? A Study of Project ALERT

ERIC Educational Resources Information Center

Clark, Heddy Kovach; Ringwalt, Chris L.; Shamblen, Stephen R.; Hanley, Sean M.; Flewelling, Robert L.

2011-01-01

This exploratory study sought to determine if a popular school-based drug prevention program might be effective in schools that are making adequate yearly progress (AYP). Thirty-four schools with grades 6 through 8 in 11 states were randomly assigned either to receive Project ALERT (n = 17) or to a control group (n = 17); of these, 10 intervention…

Army General Fund Adjustments Not Adequately Documented or Supported

DTIC Science & Technology

2016-07-26

compilation process. Finding The Office of the Assistant Secretary of the Army (Financial Management & Comptroller) (OASA[FM&C]) and the Defense Finance and...statements were unreliable and lacked an adequate audit trail. Furthermore, DoD and Army managers could not rely on the data in their accounting...systems when making management and resource decisions. Until the Army and DFAS Indianapolis correct these control deficiencies, there is considerable

Liposomal bupivacaine for regional anesthesia.

PubMed

Uskova, Anna; O'Connor, Jessica E

2015-10-01

Using a regional block in a multimodal approach to postoperative analgesia management involves addressing, which local anesthetic and how much should be used to ensure adequate pain relief to reduce related morbidity and mortality. This article will review literature surrounding the recently approved formulation of slow release liposomal bupivacaine, define its proven benefits, and identify ongoing studies to further examine the utility of this novel formulation by various routes. Recent Phase II and III clinical trials have demonstrated the ability of liposomal bupivacaine to provide prolonged analgesia, maintain a high safety profile in therapeutic doses, and decrease opioid requirements when compared with placebo in local infiltration applications for up to 24 h. Between 24 and 72 h after study drug administration, there was minimal to no difference between EXPAREL and placebo treatments on mean pain intensity. Conventional bupivacaine or ropivacaine groups (current standard practice in many hospitals in the USA) were not compared. In addition, the analgesic efficacy, cost-effectiveness, and safety profile of liposomal bupivacaine has not thoroughly been studied in various standard clinical settings such as perineural, intrathecal, and epidural administration. Current published data do not provide superior clinical results for EXPAREL over conventional bupivacaine based upon the lack of adequately powered multicentered clinical trials with comparison groups. Further investigation is necessary to identify the analgesic efficacy and safety profile of liposomal bupivacaine versus standard local anesthetics and to define the optimal clinical indication for liposomal bupivacaine administration in regional anesthesia.

Spinal anesthesia: an evergreen technique.

PubMed

Di Cianni, Simone; Rossi, Maria; Casati, Andrea; Cocco, Caterina; Fanelli, Guido

2008-04-01

Spinal anesthesia is a simple technique that provides a deep and fast surgical block through the injection of small doses of local anesthetic solution into the subarachnoid space. The purpose of this review is to provide an overview on recent developments on local anesthetic drugs, side effects, and special techniques of intrathecal anesthesia. Spinal anesthesia can be considered adequately safe, and severe complications are reasonably rare. The cardiovascular effects associated with sympathetic block are more frequent, but successfully treated with volume expansion and administration of vasoactive drugs. It is clear that the total dose of local anesthetic injected into the subarachnoid space is the most important determinant of both therapeutic and unwanted effects of spinal anesthesia. Several studies have also demonstrated the efficacy and safety of using small doses of long acting agents, such as bupivacaine or ropivacaine, to produce an adequately short spinal block in outpatients. Levopivacaine, the pure S(-)-enantiomer of racemic bupivacaine showed a lower risk of cardiovascular and central nervous system (CNS) toxicity than bupivacaine. In the last years we have assisted important changes in the health care organization, with most of the surgical procedures performed on outpatients or on elderly patients with concomitant diseases. This forced us to change the indications and clinical use of intrathecal anesthesia techniques, which have been modified according to the changing needs of surgery. The development of new drugs and special techniques for spinal anesthesia will further improve the clinical use of this old but evergreen technique.

40 CFR 141.522 - How does the State determine whether my system's watershed control requirements are adequate?

Code of Federal Regulations, 2013 CFR

2013-07-01

... WATER REGULATIONS Enhanced Filtration and Disinfection-Systems Serving Fewer Than 10,000 People... has maximized land ownership and/or controlled land use within the watershed. Disinfection Profile ...

40 CFR 141.522 - How does the State determine whether my system's watershed control requirements are adequate?

Code of Federal Regulations, 2011 CFR

2011-07-01

... WATER REGULATIONS Enhanced Filtration and Disinfection-Systems Serving Fewer Than 10,000 People... has maximized land ownership and/or controlled land use within the watershed. Disinfection Profile ...

40 CFR 141.522 - How does the State determine whether my system's watershed control requirements are adequate?

Code of Federal Regulations, 2012 CFR

2012-07-01

... WATER REGULATIONS Enhanced Filtration and Disinfection-Systems Serving Fewer Than 10,000 People... has maximized land ownership and/or controlled land use within the watershed. Disinfection Profile ...

40 CFR 141.522 - How does the State determine whether my system's watershed control requirements are adequate?

Code of Federal Regulations, 2014 CFR

2014-07-01

... WATER REGULATIONS Enhanced Filtration and Disinfection-Systems Serving Fewer Than 10,000 People... has maximized land ownership and/or controlled land use within the watershed. Disinfection Profile ...

Breaking down patient and physician barriers to optimize glycemic control in type 2 diabetes.

PubMed

Ross, Stuart A

2013-09-01

Approximately half of patients with type 2 diabetes (T2D) do not achieve globally recognized blood glucose targets, despite the availability of a wide range of effective glucose-lowering therapies. Failure to maintain good glycemic control increases the risk of diabetes-related complications and long-term health care costs. Patients must be brought under glycemic control to improve treatment outcomes, but existing barriers to optimizing glycemic control must first be overcome, including patient nonadherence to treatment, the failure of physicians to intensify therapy in a timely manner, and inadequacies in the health care system itself. The reasons for such barriers include treatment side effects, complex treatment regimens, needle anxiety, poor patient education, and the absence of an adequate patient care plan; however, newer therapies and devices, combined with comprehensive care plans involving adequate patient education, can help to minimize barriers and improve treatment outcomes. Copyright © 2013 Elsevier Inc. All rights reserved.

Differentiating snail intermediate hosts of Schistosoma spp. using molecular approaches: fundamental to successful integrated control mechanism in Africa.

PubMed

Abe, Eniola Michael; Guan, Wei; Guo, Yun-Hai; Kassegne, Kokouvi; Qin, Zhi-Qiang; Xu, Jing; Chen, Jun-Hu; Ekpo, Uwem Friday; Li, Shi-Zhu; Zhou, Xiao-Nong

2018-03-26

Snail intermediate hosts play active roles in the transmission of snail-borne trematode infections in Africa. A good knowledge of snail-borne diseases epidemiology particularly snail intermediate host populations would provide the necessary impetus to complementing existing control strategy. This review highlights the importance of molecular approaches in differentiating snail hosts population structure and the need to provide adequate information on snail host populations by updating snail hosts genome database for Africa, in order to equip different stakeholders with adequate information on the ecology of snail intermediate hosts and their roles in the transmission of different diseases. Also, we identify the gaps and areas where there is need for urgent intervention to facilitate effective integrated control of schistosomiasis and other snail-borne trematode infections. Prioritizing snail studies, especially snail differentiation using molecular tools will boost disease surveillance and also enhance efficient schistosomaisis control programme in Africa.

Select state inland wetland protection laws. A review of the state laws and their natural resource data requirements

NASA Technical Reports Server (NTRS)

Klein, S. B.

1980-01-01

Although many states afford some measure of protection for wetland areas through flood-plain regulations or through programs for coastal areas, shorelands, scenic and wild rivers or pollution control, few states have programs that adequately deal with conservation of wetlands. Only 16 states have legislation specifically regulating development or use of wetlands. Most of the wetland acts apply only to coastal wetlands, several to inland wetlands and three acts apply to both. Many other states are still regulating wetland use through the dredge and fill and/or critical area program. Several offer tax incentives to property owners to encourage protection of wetlands or broader open spaces. Many states have acquired wetlands for park and wildlife purposes and a large measure of wetland protection is achieved by the very restrictive controls applied to floodways areas. Direct floodplain or floodway regulations or state standards for local regulations were adopted in 24 states but protection of ecological values of wetlands is rarely an explicit objective of these programs. Scenic and wild river programs adopted in one half of the states provide some protection for wetland areas.

Modal Parameters Evaluation in a Full-Scale Aircraft Demonstrator under Different Environmental Conditions Using HS 3D-DIC.

PubMed

Molina-Viedma, Ángel Jesús; López-Alba, Elías; Felipe-Sesé, Luis; Díaz, Francisco A; Rodríguez-Ahlquist, Javier; Iglesias-Vallejo, Manuel

2018-02-02

In real aircraft structures the comfort and the occupational performance of crewmembers and passengers are affected by the presence of noise. In this sense, special attention is focused on mechanical and material design for isolation and vibration control. Experimental characterization and, in particular, experimental modal analysis, provides information for adequate cabin noise control. Traditional sensors employed in the aircraft industry for this purpose are invasive and provide a low spatial resolution. This paper presents a methodology for experimental modal characterization of a front fuselage full-scale demonstrator using high-speed 3D digital image correlation, which is non-invasive, ensuring that the structural response is unperturbed by the instrumentation mass. Specifically, full-field measurements on the passenger window area were conducted when the structure was excited using an electrodynamic shaker. The spectral analysis of the measured time-domain displacements made it possible to identify natural frequencies and full-field operational deflection shapes. Changes in the modal parameters due to cabin pressurization and the behavior of different local structural modifications were assessed using this methodology. The proposed full-field methodology allowed the characterization of relevant dynamic response patterns, complementing the capabilities provided by accelerometers.

The role of cold plasma and its composition on the growth of electromagnetic ion cyclotron waves in the inner magnetosphere

NASA Astrophysics Data System (ADS)

Snelling, J. M.; Johnson, J.; Engebretson, M. J.; Kim, E. H.; Tian, S.

2017-12-01

While it is currently well accepted that the free energy for growth of electromagnetic ion cyclotron (EMIC) waves in Earth's magnetosphere comes from unstable configurations of hot anisotropic ions that are injected into the ring current, several questions remain about what controls the instability. A recent study of the occurrence of EMIC waves relative to the plasmapause in Vallen Probes Data showed that plasma density gradients or enhancements were not the dominant factor in determining the site of EMIC wave generation [Tetrick et al. 2017]. However, the factors that control wave growth on each of the branches are not fully understood. For example, in some cases, the measured anisotropy is not adequate to explain local instability, and the relative importance of the density and composition of a cold plasma population is still uncertain. Several intervals of EMIC wave activity are analyzed to determine the role of a cold population in driving instability on each of the wave branches. This study utilizes the WHAMP (Waves in Homogeneous Anisotropic Magnetized Plasma) stability code with plasma distributions optimized to fit the observed distributions including temperature anisotropy, loss cone, and ring beam populations.

Modal Parameters Evaluation in a Full-Scale Aircraft Demonstrator under Different Environmental Conditions Using HS 3D-DIC

PubMed Central

López-Alba, Elías; Felipe-Sesé, Luis; Díaz, Francisco A.; Rodríguez-Ahlquist, Javier; Iglesias-Vallejo, Manuel

2018-01-01

In real aircraft structures the comfort and the occupational performance of crewmembers and passengers are affected by the presence of noise. In this sense, special attention is focused on mechanical and material design for isolation and vibration control. Experimental characterization and, in particular, experimental modal analysis, provides information for adequate cabin noise control. Traditional sensors employed in the aircraft industry for this purpose are invasive and provide a low spatial resolution. This paper presents a methodology for experimental modal characterization of a front fuselage full-scale demonstrator using high-speed 3D digital image correlation, which is non-invasive, ensuring that the structural response is unperturbed by the instrumentation mass. Specifically, full-field measurements on the passenger window area were conducted when the structure was excited using an electrodynamic shaker. The spectral analysis of the measured time-domain displacements made it possible to identify natural frequencies and full-field operational deflection shapes. Changes in the modal parameters due to cabin pressurization and the behavior of different local structural modifications were assessed using this methodology. The proposed full-field methodology allowed the characterization of relevant dynamic response patterns, complementing the capabilities provided by accelerometers. PMID:29393897

Highly localized laser-induced vascular responses

NASA Astrophysics Data System (ADS)

Stiukhina, Elena S.; Kurochkin, Maxim A.; Fedosov, Ivan V.; Postnov, Dmitry E.

2018-04-01

The assessment of functioning microcirculatory network implies usage of adequate tools for testing the network responses on local changes of vessels state. While there are well-developed and widely used methods, such as focal application of vasoactive substances, or electric stimulation, there is a need for a non-destructive (and ideally - non-contact) and local method of impact a single vessel in order to trigger the network responce. In this paper, we investigate the possibility of applying the effect of a reversible change in the diameter of a blood vessel caused by laser radiation as a functional test of a microcirculatory system. For this purpose, we combine this effect with the method of micro-PIV (particle image velocimetry), which provides information on both the dynamics of blood flow in neighboring segments and the changes in their diameters.

Data Acquisition for Land Subsidence Control

NASA Astrophysics Data System (ADS)

Zhu, Y.; Balke, K.

2009-12-01

For controlling land subsidence caused by groundwater over-exploitation, loading of engineered structures, mining and other anthropogenic activities in this fast changing world, a large variety of different data of various scales of concerning areas are needed for scientific study and administrative operational purposes. The economical, social and environmental impacts of anthropogenic land subsidence have long been recognized by many scientific institutions and management authorities based on results of monitoring and analysis at an interdisciplinary level. The land subsidence information systems composed of the surface and subsurface monitoring nets (monitoring and development wells, GPS stations and other facilities) and local data processing centers as a system management tool in Shanghai City was started with the use of GPS technology to monitor land subsidence in 1998. After years of experiences with a set of initiatives by adopting adequate countermeasures, the particular attention given to new improved methodologies to monitor and model the process of land subsidence in a simple and timely way, this is going to be promoted in the whole Yangtze River Delta region in China, where land subsidence expands in the entire region of urban cluster. The Delta land subsidence monitoring network construction aims to establish an efficient and coordinated water resource management system. The land subsidence monitoring network records "living history" of land subsidence, produces detailed scheduled reports and environmental impact statements. For the different areas with local factors and site characteristics, parallel packages need to be designed for predicting changes, land sensitivity and uncertainty analysis, especially for the risk analysis in the rapid growth of megacities and urban areas. In such cases, the new models with new types of local data and the new ways of data acquisition provide the best information for the decision makers for their mitigating decisions. The problems with outputs to professional and non-professional users, planning vs exploitation conflicts, 3D modeling and visualization are not yet solved due to the complex issues.

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

Hanna, Samir Abdallah, E-mail: samir.hanna@hsl.org.br; Simões Dornellas de Barros, Alfredo Carlos; Martins de Andrade, Felipe Eduardo

Purpose: To present local control, complications, and cosmetic outcomes of intraoperative radiation therapy (IORT) for early breast cancer, as well as technical aspects related to the use of a nondedicated linear accelerator. Methods and Materials: This prospective trial began in May of 2004. Eligibility criteria were biopsy-proven breast-infiltrating ductal carcinoma, age >40 years, tumor <3 cm, and cN0. Exclusion criteria were in situ or lobular types, multicentricity, skin invasion, any contraindication for surgery and/or radiation therapy, sentinel lymph node involvement, metastasis, or another malignancy. Patients underwent classic quadrantectomy with intraoperative sentinel lymph node and margins evaluation. If both free, the patient wasmore » transferred from operative suite to linear accelerator room, and IORT was delivered (21 Gy). Primary endpoint: local recurrence (LR); secondary endpoints: toxicities and aesthetics. Quality assurance involved using a customized shield for chest wall protection, applying procedures to minimize infection caused by patient transportation, and using portal films to check collimator-shield alignment. Results: A total of 152 patients were included, with at least 1 year follow-up. Median age (range) was 58.3 (40-85.4) years, and median follow-up time was 50.7 (12-110.5) months. The likelihood of 5-year local recurrence was 3.7%. There were 3 deaths, 2 of which were cancer related. The Kaplan-Meier 5-year actuarial estimates of overall, disease-free, and local recurrence-free survivals were 97.8%, 92.5%, and 96.3%, respectively. The overall incidences of acute and late toxicities were 12.5% and 29.6%, respectively. Excellent, good, fair, and bad cosmetic results were observed in 76.9%, 15.8%, 4.3%, and 2.8% of patients, respectively. Most treatments were performed with a 5-cm collimator, and in 39.8% of the patients the electron-beam energy used was ≥12 MeV. All patients underwent portal film evaluation, and the shielding was repositioned in 39.9% of cases. No infection or anesthesia complications were observed. Conclusions: Local control with IORT was adequate, with low complication rates and good cosmetic outcomes. More than one-third of patients benefited from the “image-guidance” approach, and almost 40% benefited from the option of higher electron beam energies.« less

The adequacy of current import and export controls on sealed radioactive sources.

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

Longley, Susan W.; Cochran, John Russell; Price, Laura L.

2003-10-01

Millions of sealed radioactive sources (SRSs) are being used for a wide variety of beneficial purposes throughout the world. Security experts are now concerned that these beneficial SRSs could be used in a radiological dispersion device to terrorize and disrupt society. The greatest safety and security threat is from those highly radioactive Category 1 and 2 SRSs. Without adequate controls, it may be relatively easy to legally purchase a Category 1 or 2 SRS on the international market under false pretenses. Additionally, during transfer, SRSs are particularly susceptible to theft since the sources are in a shielded and mobile configuration,more » transportation routes are predictable, and shipments may not be adequately guarded. To determine if government controls on SRS are adequate, this study was commissioned to review the current SRS import and export controls of six countries. Canada, the Russian Federation, and South Africa were selected as the exporting countries, and Egypt, the Philippines, and the United States were selected as importing countries. A detailed review of the controls in each country is presented. The authors found that Canada and Russia are major exporters, and are exporting highly radioactive SRSs without first determining if the recipient is authorized by the receiving country to own and use the SRSs. Available evidence was used to estimate that on average there are tens to possibly hundreds of intercountry transfers of highly radioactive SRSs each day. Based on these and other findings, this reports recommends stronger controls on the export and import of highly radioactive SRSs.« less

14 CFR 460.11 - Environmental control and life support systems.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Environmental control and life support... Crew § 460.11 Environmental control and life support systems. (a) An operator must provide atmospheric conditions adequate to sustain life and consciousness for all inhabited areas within a vehicle. The operator...

30 CFR 74.6 - Quality control.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Quality control. 74.6 Section 74.6 Mineral... of the CMDPSU will be maintained in production through adequate quality control procedures, MSHA and... DUST SAMPLING DEVICES Approval Requirements for Coal Mine Dust Personal Sampler Unit § 74.6 Quality...

Subthalamic Nucleus Deep Brain Stimulation Changes Velopharyngeal Control in Parkinson's Disease

ERIC Educational Resources Information Center

Hammer, Michael J.; Barlow, Steven M.; Lyons, Kelly E.; Pahwa, Rajesh

2011-01-01

Purpose: Adequate velopharyngeal control is essential for speech, but may be impaired in Parkinson's disease (PD). Bilateral subthalamic nucleus deep brain stimulation (STN DBS) improves limb function in PD, but the effects on velopharyngeal control remain unknown. We tested whether STN DBS would change aerodynamic measures of velopharyngeal…

40 CFR 160.47 - Facilities for handling test, control, and reference substances.

Code of Federal Regulations, 2011 CFR

2011-07-01

... the test systems and shall be adequate to preserve the identity, strength, purity, and stability of... 40 Protection of Environment 24 2011-07-01 2011-07-01 false Facilities for handling test, control... for handling test, control, and reference substances. (a) As necessary to prevent contamination or...

40 CFR 160.47 - Facilities for handling test, control, and reference substances.

Code of Federal Regulations, 2013 CFR

2013-07-01

... the test systems and shall be adequate to preserve the identity, strength, purity, and stability of... 40 Protection of Environment 25 2013-07-01 2013-07-01 false Facilities for handling test, control... for handling test, control, and reference substances. (a) As necessary to prevent contamination or...

40 CFR 160.47 - Facilities for handling test, control, and reference substances.

Code of Federal Regulations, 2014 CFR

2014-07-01

... the test systems and shall be adequate to preserve the identity, strength, purity, and stability of... 40 Protection of Environment 24 2014-07-01 2014-07-01 false Facilities for handling test, control... for handling test, control, and reference substances. (a) As necessary to prevent contamination or...

40 CFR 160.47 - Facilities for handling test, control, and reference substances.

Code of Federal Regulations, 2012 CFR

2012-07-01

... the test systems and shall be adequate to preserve the identity, strength, purity, and stability of... 40 Protection of Environment 25 2012-07-01 2012-07-01 false Facilities for handling test, control... for handling test, control, and reference substances. (a) As necessary to prevent contamination or...

40 CFR 79.64 - In vivo micronucleus assay.

Code of Federal Regulations, 2011 CFR

2011-07-01

... number and sex. At least five female and five male animals per experimental/sample and control group... control group. A single concentration of a compound known to produce micronuclei in vivo is adequate as a... in bone marrow from treated animals compared to that of control animals. The visualization of...

40 CFR 79.64 - In vivo micronucleus assay.

Code of Federal Regulations, 2014 CFR

2014-07-01

... number and sex. At least five female and five male animals per experimental/sample and control group... control group. A single concentration of a compound known to produce micronuclei in vivo is adequate as a... in bone marrow from treated animals compared to that of control animals. The visualization of...

40 CFR 79.64 - In vivo micronucleus assay.

Code of Federal Regulations, 2012 CFR

2012-07-01

... number and sex. At least five female and five male animals per experimental/sample and control group... control group. A single concentration of a compound known to produce micronuclei in vivo is adequate as a... in bone marrow from treated animals compared to that of control animals. The visualization of...

40 CFR 79.64 - In vivo micronucleus assay.

Code of Federal Regulations, 2010 CFR

2010-07-01

... number and sex. At least five female and five male animals per experimental/sample and control group... control group. A single concentration of a compound known to produce micronuclei in vivo is adequate as a... in bone marrow from treated animals compared to that of control animals. The visualization of...

40 CFR 79.64 - In vivo micronucleus assay.

Code of Federal Regulations, 2013 CFR

2013-07-01

... number and sex. At least five female and five male animals per experimental/sample and control group... control group. A single concentration of a compound known to produce micronuclei in vivo is adequate as a... in bone marrow from treated animals compared to that of control animals. The visualization of...

77 FR 58330 - Airworthiness Directives; The Boeing Company Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-20

... requires repetitive inspections of the aft attach lugs of the elevator tab control mechanisms, and replacement of any discrepant elevator tab control mechanism. Since we issued that AD, Boeing has developed a modification of the aft attach lugs of the elevator tab control mechanisms, which will adequately address the...

14 CFR 460.11 - Environmental control and life support systems.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 4 2013-01-01 2013-01-01 false Environmental control and life support... Crew § 460.11 Environmental control and life support systems. (a) An operator must provide atmospheric conditions adequate to sustain life and consciousness for all inhabited areas within a vehicle. The operator...

Program control for mission success

NASA Technical Reports Server (NTRS)

Longanecker, G. W.

1994-01-01

This article suggests that in order to be able to exercise control over a particular program, the program itself must be controllable. A controllable program therefore, according to the author, is one that has been properly scoped technically, realistically scheduled, and adequately budgeted. The article delves indepth into each of the above aspects of a controllable program and discusses both the pros and cons of each.

Adhesion characterization and defect sizing of sandwich honeycomb composites.

PubMed

Ndiaye, Elhadji Barra; Maréchal, Pierre; Duflo, Hugues

2015-09-01

Defects may appear in composite structures during their life cycle. A 10MHz 128 elements phased array transducer was investigated to characterize join bonds and defects in sandwich honeycomb composite structures. An adequate focal law throughout the composite skin gives the ultrasonic dispersive properties of the composite skin and glue layer behind. The resulting B-scan cartographies allow characterizing locally the honeycomb adhesion. Experimental measurements are compared in good agreement with the Debye Series Method (DSM). In the processed C-scan image, flaws are detectable and measurable, localized both in the scanning plane and in the thickness of the composite skin. Copyright © 2015 Elsevier B.V. All rights reserved.

The importance of localizing pulmonary veins in atrial septal defect closure!

PubMed Central

2011-01-01

An 8-year-old girl was admitted for a simple closure of echocardiographically diagnosed Atrial Septal Defect (ASD). During the operation the right pulmonary veins orifices were not detected in the left atrium and attempt to localize them led to the discovery of three additional anomalies, namely Interrupted Inferior Vena Cava (IIVC), Scimitar syndrome, and systemic arterial supply of the lung. Postoperatively these finding were confirmed by CT angiography. This case report emphasizes the need for adequate preoperative diagnosis and presents a very rare constellation of four congenital anomalies that to the best of our knowledge is not reported before. PMID:21450090

Rare etiological factor of maxillofacial injury: Case series seen and managed in a tertiary referral centre

PubMed Central

Braimah, Ramat Oyebunmi; Ibikunle, Adebayo Aremu; Taiwo, Abdurrazaq Olanrewaju

2016-01-01

Entanglement injury from local milling/grinding machine with a conveyor belt is a rare etiology of maxillofacial injuries. While there is abundant literature on industrial cause of trauma, entanglement injury as a mechanism has not been reported in the literature. We present two cases of maxillofacial injury secondary to entanglement of the loose apparel into the conveyor belt of the local grinding machine. The community should be aware of this rare cause of trauma, and adequate protection of children using these facilities should be enforced. One of such measure is to provide physical barriers to guard against these machines. PMID:27162440

Rare etiological factor of maxillofacial injury: Case series seen and managed in a tertiary referral centre.

PubMed

Braimah, Ramat Oyebunmi; Ibikunle, Adebayo Aremu; Taiwo, Abdurrazaq Olanrewaju

2016-01-01

Entanglement injury from local milling/grinding machine with a conveyor belt is a rare etiology of maxillofacial injuries. While there is abundant literature on industrial cause of trauma, entanglement injury as a mechanism has not been reported in the literature. We present two cases of maxillofacial injury secondary to entanglement of the loose apparel into the conveyor belt of the local grinding machine. The community should be aware of this rare cause of trauma, and adequate protection of children using these facilities should be enforced. One of such measure is to provide physical barriers to guard against these machines.

Flight Dynamics Modeling and Simulation of a Damaged Transport Aircraft

NASA Technical Reports Server (NTRS)

Shah, Gautam H.; Hill, Melissa A.

2012-01-01

A study was undertaken at NASA Langley Research Center to establish, demonstrate, and apply methodology for modeling and implementing the aerodynamic effects of MANPADS damage to a transport aircraft into real-time flight simulation, and to demonstrate a preliminary capability of using such a simulation to conduct an assessment of aircraft survivability. Key findings from this study include: superpositioning of incremental aerodynamic characteristics to the baseline simulation aerodynamic model proved to be a simple and effective way of modeling damage effects; the primary effect of wing damage rolling moment asymmetry may limit minimum airspeed for adequate controllability, but this can be mitigated by the use of sideslip; combined effects of aerodynamics, control degradation, and thrust loss can result in significantly degraded controllability for a safe landing; and high landing speeds may be required to maintain adequate control if large excursions from the nominal approach path are allowed, but high-gain pilot control during landing can mitigate this risk.

Economic impact of stimulated technological activity. Part 3: Case study, knowledge additions and earth links from space crew systems

NASA Technical Reports Server (NTRS)

1971-01-01

A case study of knowledge contributions from the crew life support aspect of the manned space program is reported. The new information needed to be learned, the solutions developed, and the relation of new knowledge gained to earthly problems were investigated. Illustrations are given in the following categories: supplying atmosphere for spacecraft; providing carbon dioxide removal and recycling; providing contaminant control and removal; maintaining the body's thermal balance; protecting against the space hazards of decompression, radiation, and meteorites; minimizing fire and blast hazards; providing adequate light and conditions for adequate visual performance; providing mobility and work physiology; and providing adequate habitability.

Ultraviolet light exposure, skin cancer risk and vitamin D production.

PubMed

Rivas, Miguel; Rojas, Elisa; Araya, María C; Calaf, Gloria M

2015-10-01

The danger of overexposure to solar ultraviolet radiation has been widely reviewed since the 1980s due to the depletion of the ozone layer. However, the benefits of mild exposure of the skin to ultraviolet (UV) light have not been widely investigated. Numerous reports have demonstrated that an association exists between low light exposure to the sun, non-melanoma skin cancer and a lack of vitamin D synthesis. As vitamin D synthesis in the body depends on skin exposure to UVB radiation from the sun (wavelength, 290-320 nm), experimental measurements for this type of solar radiation are important. The present study analyzed data obtained from a laboratory investigating UV radiation from the sun at the University of Tarapacá (Arica, Chile), where systematic experimental UVB measurements had been performed using a calibrated biometer instrument since 2006. These data were compared with skin cancer data from the local population. The results demonstrated that the incidence of skin cancer systematically increased from 7.4 to 18.7 in men and from 10.0 to 21.7 in women between 2000 and 2006 in Arica, respectively; this increase may be due to multiple factors, including the lack of adequate levels of vitamin D in risk groups such as post-menopausal women and senior age. This marked increase may also be due to the high levels of UV radiation measured in this region throughout the year. However, it is not certain that the local population has adequate vitamin D levels, nor that their skin has been predominantly exposed to artificial light that does not allow adequate vitamin D synthesis. Thus, the current study presents the association between skin type IV, the time to induce solar erythema and the time required to produce 1,000 international units of vitamin D.

Ultraviolet light exposure, skin cancer risk and vitamin D production

PubMed Central

RIVAS, MIGUEL; ROJAS, ELISA; ARAYA, MARÍA C.; CALAF, GLORIA M.

2015-01-01

The danger of overexposure to solar ultraviolet radiation has been widely reviewed since the 1980s due to the depletion of the ozone layer. However, the benefits of mild exposure of the skin to ultraviolet (UV) light have not been widely investigated. Numerous reports have demonstrated that an association exists between low light exposure to the sun, non-melanoma skin cancer and a lack of vitamin D synthesis. As vitamin D synthesis in the body depends on skin exposure to UVB radiation from the sun (wavelength, 290–320 nm), experimental measurements for this type of solar radiation are important. The present study analyzed data obtained from a laboratory investigating UV radiation from the sun at the University of Tarapacá (Arica, Chile), where systematic experimental UVB measurements had been performed using a calibrated biometer instrument since 2006. These data were compared with skin cancer data from the local population. The results demonstrated that the incidence of skin cancer systematically increased from 7.4 to 18.7 in men and from 10.0 to 21.7 in women between 2000 and 2006 in Arica, respectively; this increase may be due to multiple factors, including the lack of adequate levels of vitamin D in risk groups such as post-menopausal women and senior age. This marked increase may also be due to the high levels of UV radiation measured in this region throughout the year. However, it is not certain that the local population has adequate vitamin D levels, nor that their skin has been predominantly exposed to artificial light that does not allow adequate vitamin D synthesis. Thus, the current study presents the association between skin type IV, the time to induce solar erythema and the time required to produce 1,000 international units of vitamin D. PMID:26622830

Investigating the Effects of a Structured Writing Program in a Math Classroom: A Quantitative Study

ERIC Educational Resources Information Center

Girsa, Heather

2016-01-01

In a northeastern state eighth grade math students are struggling with meeting adequate yearly progress in math. The state's math proficiency in the school year 2013-2014 for eighth grade students showed that only 56% scored at grade level or above. The local problem addressed in this study is that 44% of a northeastern state's eighth graders are…

Chemoprevention of Ovarian Cancer

DTIC Science & Technology

2006-10-01

negotiated with Ortho-McNeil to formulate had expired. We then had to work with the local drug representative to find adequate amounts of drug for the...difficulty in accessing the ovaries in their intraperitoneal location, and, unlike the uterine cervix or endometrium, the necessity for an anesthetic ...a palatable treat by a veterinary phar- macist. Doses of 4HPR (Fenretide: RW Johnson Pharmaceutical Research Institute, San Diego, Calif.) and OCP

The Rewarding Challenge: Welcoming Re-Entry Women Students to the Small College.

ERIC Educational Resources Information Center

Midland Lutheran Coll., Fremont, NE.

This handbook was designed to offer a low-cost, local, and practical approach to working with re-entry women college students. It is intended for use by staff in small colleges (under 1,000 students) where women's centers and on-campus child care are rare and where the needs of re-entry students have not been adequately addressed. The information…

Going It Alone: Can California's K-12 School Districts Adequately and Equitably Fund School Facilities? Policy Research Working Paper

ERIC Educational Resources Information Center

Vincent, Jeffrey M.; Jain, Liz S.

2015-01-01

After\tmore\tthan a decade of dedicated investment, state funding to assist local California school\tdistricts in the construction, modernization, and maintenance of their school facilities has come to a halt. As the Governor, the legislature, and other stakeholders debate the future of the state's K-12 school facility funding role, a big unknown…

Mutagenic Potential of 4-Nitrophenyl Monochloromethyl (Phenyl) Phosphinate Using the Drosophila melanogaster Sex-Linked Recessive Lethal Test.

DTIC Science & Technology

1983-08-01

chromosomes were tested from the concurrent negative control. This sample size was adequate for analysis using the Fisher’s Exact test ( personal communication...study may be regarded as adequate ( personal communication - Dr. Gildengorin, Statistician, Information Sciences, Letterman Army Institute of Research...Health Sciences 0917 Arlington Road Bethesda MD 20014 CM nd Commander US Army Euvaoomens Hygine Agency US Army Research Institute Abardan Proving Ground MD

Sleep time and pattern of adult individuals in primary care in an Asian urbanized community

PubMed Central

Tan, Ngiap Chuan; Tan, Mui Suan; Hwang, Siew Wai; Teo, Chia Chia; Lee, Zhi Kang Niccol; Soh, Jing Yao Jonathan; Koh, Yi Ling Eileen; How, Choon How

2016-01-01

Abstract Sleep norms vary between individuals, being affected by personal, communal, and socioeconomic factors. Individuals with sleep time which deviate from the population norm are at risks of adverse mental, cardiovascular, and metabolic health. Sleep-related issues are common agenda for consultation in primary care. This study aimed to determine the sleep time, pattern, and behavior of multiethnic Asian individuals who attended public primary care clinics in an urban metropolitan city-state. Standardized questionnaires were assistant-administered to adult Asian individuals who visited 2 local public primary care clinics in north-eastern and southern regions of Singapore. The questionnaire included questions on demographic characteristics, self-reported sleep time, patterns, and behavior and those originated from the American National Sleep Foundation Sleep Diary. The data were collated, audited, rectified, and anonymized before being analyzed by the biostatistician. Individuals with 7 h sleep time or longer were deemed getting adequate sleep. Chi-squared or Fisher exact test was used to test the association between the demographic and behavioral variables and sleep time. Next, regression analysis was performed to identify key factors associated with their sleep time. A total of 350 individuals were recruited, with higher proportion of those of Chinese ethnicity reporting adequate sleep. Almost half (48.1%) of those who slept <7 h on weekdays tended to sleep ≥7 h on weekends. More individuals who reported no difficulty falling asleep, had regular sleep hours and awakening time, tended to sleep adequately. Those who slept with children, studied, read leisurely, used computer or laptops in their bedrooms, drank caffeinated beverages or smoked had inadequate sleep. Those who perceived sufficient sleep and considered 8 h as adequate sleep time had weekday and weekend sleep adequacy. Sleep time varied according to ethnicity, employment status, personal behavior, and perception of sleep sufficiency. Awareness of sleep time and pattern allows the local physicians to contextualize the discussion of sleep adequacy with their patients during consultation, which is a prerequisite to resolve their sleep-related issues. PMID:27583923

Sleep time and pattern of adult individuals in primary care in an Asian urbanized community: A cross-sectional study.

PubMed

Tan, Ngiap Chuan; Tan, Mui Suan; Hwang, Siew Wai; Teo, Chia Chia; Lee, Zhi Kang Niccol; Soh, Jing Yao Jonathan; Koh, Yi Ling Eileen; How, Choon How

2016-08-01

Sleep norms vary between individuals, being affected by personal, communal, and socioeconomic factors. Individuals with sleep time which deviate from the population norm are at risks of adverse mental, cardiovascular, and metabolic health. Sleep-related issues are common agenda for consultation in primary care. This study aimed to determine the sleep time, pattern, and behavior of multiethnic Asian individuals who attended public primary care clinics in an urban metropolitan city-state.Standardized questionnaires were assistant-administered to adult Asian individuals who visited 2 local public primary care clinics in north-eastern and southern regions of Singapore. The questionnaire included questions on demographic characteristics, self-reported sleep time, patterns, and behavior and those originated from the American National Sleep Foundation Sleep Diary. The data were collated, audited, rectified, and anonymized before being analyzed by the biostatistician. Individuals with 7 h sleep time or longer were deemed getting adequate sleep. Chi-squared or Fisher exact test was used to test the association between the demographic and behavioral variables and sleep time. Next, regression analysis was performed to identify key factors associated with their sleep time.A total of 350 individuals were recruited, with higher proportion of those of Chinese ethnicity reporting adequate sleep. Almost half (48.1%) of those who slept <7 h on weekdays tended to sleep ≥7 h on weekends. More individuals who reported no difficulty falling asleep, had regular sleep hours and awakening time, tended to sleep adequately. Those who slept with children, studied, read leisurely, used computer or laptops in their bedrooms, drank caffeinated beverages or smoked had inadequate sleep. Those who perceived sufficient sleep and considered 8 h as adequate sleep time had weekday and weekend sleep adequacy.Sleep time varied according to ethnicity, employment status, personal behavior, and perception of sleep sufficiency. Awareness of sleep time and pattern allows the local physicians to contextualize the discussion of sleep adequacy with their patients during consultation, which is a prerequisite to resolve their sleep-related issues.

Rural health centres, communities and malaria case detection in Zambia using mobile telephones: a means to detect potential reservoirs of infection in unstable transmission conditions.

PubMed

Kamanga, Aniset; Moono, Petros; Stresman, Gillian; Mharakurwa, Sungano; Shiff, Clive

2010-04-15

Effective malaria control depends on timely acquisition of information on new cases, their location and their frequency so as to deploy supplies, plan interventions or focus attention on specific locations appropriately to intervene and prevent an upsurge in transmission. The process is known as active case detection, but because the information is time sensitive, it is difficult to carry out. In Zambia, the rural health services are operating effectively and for the most part are provided with adequate supplies of rapid diagnostic tests (RDT) as well as effective drugs for the diagnosis and treatment of malaria. The tests are administered to all prior to treatment and appropriate records are kept. Data are obtained in a timely manner and distribution of this information is important for the effective management of malaria control operations. The work reported here involves combining the process of positive diagnoses in rural health centres (passive case detection) to help detect potential outbreaks of malaria and target interventions to foci where parasite reservoirs are likely to occur. Twelve rural health centres in the Choma and Namwala Districts were recruited to send weekly information of rapid malaria tests used and number of positive diagnoses to the Malaria Institute at Macha using mobile telephone SMS. Data were entered in excel, expressed as number of cases per rural health centre and distributed weekly to interested parties. These data from each of the health centres which were mapped using geographical positioning system (GPS) coordinates were used in a time sensitive manner to plot the patterns of malaria case detection in the vicinity of each location. The data were passed on to the appropriate authorities. The seasonal pattern of malaria transmission associated with local ecological conditions can be seen in the distribution of cases diagnosed. Adequate supplies of RDT are essential in health centres and the system can be expanded throughout the country to support strategic targeting of interventions by the National Malaria Control Programme. Participation by the health centre staff was excellent.

Leaching kinetics of As, Mo, and Se from acidic coal fly ash samples

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

Neupane, Ghanashyam; Donahoe, Rona J.; Bhattacharyya, Siddhartha

Annually, coal-fired electric power plants produce large volumes potentially hazardous coal combustion products (CCPs) including fly ash. Since majority of the coal fly ash and other CCPs deposited in dry land fills or wet lagoons, they pose risk of contamination to local environment and hydrogeology. In this study, we present results of leaching kinetics for As, Mo, and Se from three acidic fly ash samples. This study shows that the leachate concentrations of As, Mo, and Se increase over time. Three kinetics equations, pseudo-second order, Elovich, and power-function, are able to adequately describe the experimental leaching kinetics data. Experimental leachingmore » data and modeling results indicate that the rate limiting leaching of As, Mo, and Se is largely controlled by the dissolution of the fly ash particles. Furthermore, it is important to adopt effective containment/treatment schemes to avoid potential and persistent dispersion of trace elements from ash disposal facilities to surrounding environment for a long time.« less

Leaching kinetics of As, Mo, and Se from acidic coal fly ash samples

DOE PAGES

Neupane, Ghanashyam; Donahoe, Rona J.; Bhattacharyya, Siddhartha; ...

2017-07-03

Annually, coal-fired electric power plants produce large volumes potentially hazardous coal combustion products (CCPs) including fly ash. Since majority of the coal fly ash and other CCPs deposited in dry land fills or wet lagoons, they pose risk of contamination to local environment and hydrogeology. In this study, we present results of leaching kinetics for As, Mo, and Se from three acidic fly ash samples. This study shows that the leachate concentrations of As, Mo, and Se increase over time. Three kinetics equations, pseudo-second order, Elovich, and power-function, are able to adequately describe the experimental leaching kinetics data. Experimental leachingmore » data and modeling results indicate that the rate limiting leaching of As, Mo, and Se is largely controlled by the dissolution of the fly ash particles. Furthermore, it is important to adopt effective containment/treatment schemes to avoid potential and persistent dispersion of trace elements from ash disposal facilities to surrounding environment for a long time.« less

The fishery resources of the Mississippi River: A model for conservation and management

USGS Publications Warehouse

Schramm, Harold L.

2017-01-01

The Mississippi River is a multijurisdictional and multiuse resource that has been variously altered and is foremost managed for navigation and flood control throughout much of its 3,734‐km passage from its origin at Lake Itasca, Minnesota, to its outlet at the Gulf of Mexico. Despite alterations summarized herein, the native fish fauna remains largely intact and only five nonnative species have colonized segments of the river. Diverse habitats still remain, but loss of habitat, declining habitat suitability, and reduced floodplain functionality warrant concern. Fisheries monitoring and assessment, ecological research, and habitat rehabilitation vary from adequate in the upper reaches of the river to minimal in the lower reaches of the river, and these efforts parallel the recreational use, local values, and visibility of the river. A conceptual model is proposed to depict the value of the social, economic, and many ecosystem services the Mississippi River ecosystem offers that can be used to achieve the social and economic support needed to conserve and restore this valuable fishery resource.

Blood-brain barrier-supported neurogenesis in healthy and diseased brain.

PubMed

Pozhilenkova, Elena A; Lopatina, Olga L; Komleva, Yulia K; Salmin, Vladimir V; Salmina, Alla B

2017-05-24

Adult neurogenesis is one of the most important mechanisms contributing to brain development, learning, and memory. Alterations in neurogenesis underlie a wide spectrum of brain diseases. Neurogenesis takes place in highly specialized neurogenic niches. The concept of neurogenic niches is becoming widely accepted due to growing evidence of the important role of the microenvironment established in the close vicinity to stem cells in order to provide adequate control of cell proliferation, differentiation, and apoptosis. Neurogenic niches represent the platform for tight integration of neurogenesis and angiogenesis supported by specific properties of cerebral microvessel endothelial cells contributing to establishment of partially compromised blood-brain barrier (BBB) for the adjustment of local conditions to the current metabolic needs of stem and progenitor cells. Here, we review up-to-date data on microvascular dynamics in activity-dependent neurogenesis, specific properties of BBB in neurogenic niches, endothelial-driven mechanisms of clonogenic activity, and future perspectives for reconstructing the neurogenic niches in vitro.

Sources of lead exposure in Mexico City.

PubMed Central

Romieu, I; Palazuelos, E; Hernandez Avila, M; Rios, C; Muñoz, I; Jimenez, C; Cahero, G

1994-01-01

Many countries, including Mexico, are facing a largely unrecognized epidemic of low-level lead poisoning. Mexico is the sixth largest lead-producing country in the world, and 40% of its production is used locally in different industrial processes that cause lead contamination of the environment. The major sources and pathways of lead exposure among the Mexican population are gasoline emissions, lead-glazed ceramics, leaded paint, and lead in canned foods and beverages. In this paper we present evidence for the presence of lead in different environmental media and its impact on blood lead levels of the Mexican population. Although during the last few years important measures have been implemented to decrease lead exposure, our findings suggest that lead poisoning is still an important problem in Mexico. There is an urgent need for regulatory policies that implement stricter control to protect the Mexican population. There is also a need to develop adequate programs to reduce the lead burden and the associated health effects in the population that has been chronically exposed. Images Figure 1. PMID:7523102

Adjuvant helical IMRT by tomotherapy for bulky adrenocortical carcinoma operated with positive margins: a case report.

PubMed

Delmastro, Elena; Garibaldi, Elisabetta; Gabriele, Domenico; Bresciani, Sara; Cattari, Gabriella; Dia, Amalia Di; Manini, Claudia; Collura, Devis; Redda, Maria Grazia Ruo; Gabriele, Pietro

2016-11-11

Adrenocortical carcinoma (ACC) is a rare tumor in the adult. The main therapy is surgery but in some cases radiotherapy may be needed to control the disease locally. A patient with a surgically removed bulky ACC and pathologic finding of a positive margin was treated at our center by adjuvant mitotane and radiotherapy using an intensity-modulated radiation therapy (IMRT)/image-guided radiotherapy (IGRT) technique by tomotherapy. Dose prescriptions were 63 Gy on the surgical bed and 50.4 Gy on the lymphatic drainage in 28 sessions. Patient compliance was good with no evidence of acute or late toxicities. Thirty months after radiotherapy, the patient is alive without evidence of disease checked by 18F-fluorodeoxyglucose positron emission tomography/computed tomography and without any complication. In patients with adverse prognostic features, the delivery of adequate adjuvant radiotherapy doses with IMRT and daily IGRT is feasible and safe and could result in an improved outcome for patients with ACC.

Prediction of hydrocarbon surface seepage potential using infiltrometer data

NASA Astrophysics Data System (ADS)

Connors, J. J.; Jackson, J. L.; Engle, R. A.; Connors, J. L.

2017-12-01

Environmental regulations addressing above-ground storage tank (AST) spill control activities typically require owners/operators to demonstrate that local soil permeability values are low enough to adequately contain released liquids while emergency-response procedures are conducted. Frequently, geotechnical borings and soil samples/analyses, and/or monitoring well slug-test analyses, are used to provide hydraulic conductivity data for the required calculations. While these techniques are useful in assessing hydrological characteristics of the subsurface, they do not always assess the uppermost surface soil layer, where the bulk of the containment can occur. This layer may have been subject to long-term permeability-reduction by activities such as compaction by vehicular and foot traffic, micro-coatings by hydrophobic pollutants, etc. This presentation explores the usefulness of dual-ring infiltrometers, both in field and bench-scale tests, to rapidly acquire actual hydraulic conductivity values of surficial soil layers, which can be much lower than subsurface values determined using more traditional downhole geotechnical and hydrogeological approaches.

Sources of lead exposure in Mexico City

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

Romieu, I.; Palazuelos, E.; Cahero, G.

Many countries, including Mexico, are facing a largely unrecognized epidemic of low-level lead poisoning. Mexico is the sixth largest lead-producing country in the world, and 40% of its production is used locally in different industrial processes that cause lead contamination of the environment. The major sources and pathways of lead exposure among the Mexican population are gasoline emissions, lead-glazed ceramics, leaded paint, and lead in canned foods and beverages. In this paper we present evidence for the presence of lead in different environmental media and its impact on blood lead levels of the Mexican population. Although during the last fewmore » years important measures have been implemented problem in Mexico. There is an urgent need for regulatory policies that implement stricter control to protect the Mexican Population. There is also a need to develop adequate programs to reduce the lead burden and the associated health effects in the population that has been chronically exposed. 37 refs., 1 fig., 8 tabs.« less

The 'green whistle': a novel method of analgesia for transrectal prostate biopsy.

PubMed

Grummet, Jeremy; Huang, Sean; Konstantatos, Alex; Frydenberg, Mark

2012-12-01

• Patients undergoing TRUS-guided biopsies were each given a Penthrox inhaler to self-administer during the procedure and instructed in its use. • Immediately after the procedure, patients were asked to rate their pain using a verbal rating scale from 0 to 10. • In all, 42 consecutive men underwent a TRUS-guided biopsy. • The median pain score was 3. • All 42 patients stated they would be happy to undergo the same procedure again. The only adverse effects reported by patients were brief light-headedness and a sickly sweet taste. • This study of our initial experience using Penthrox suggests that it may have a role in analgesia for TRUS-guided biopsy. • It may provide safe, adequate analgesia that is easy for urologists to use and avoids excessive use of resources. • Planning for a randomised control trial comparing Penthrox to the current 'gold standard' of prostatic infiltration of local anaesthetic is presently underway. © 2012 THE AUTHORS. BJU INTERNATIONAL © 2012 BJU INTERNATIONAL.

Current and future medical treatments for patients with acromegaly.

PubMed

Maffezzoni, Filippo; Formenti, Anna Maria; Mazziotti, Gherardo; Frara, Stefano; Giustina, Andrea

2016-08-01

Acromegaly is a relatively rare condition of growth hormone (GH) excess associated with significant morbidity and, when left untreated, high mortality. Therapy for acromegaly is targeted at decreasing GH and insulin-like growth hormone 1 levels, ameliorating patients' symptoms and decreasing any local compressive effects of the pituitary adenoma. The therapeutic options for acromegaly include surgery, medical therapies (such as dopamine agonists, somatostatin receptor ligands and the GH receptor antagonist pegvisomant) and radiotherapy. However, despite all these treatments option, approximately 50% of patients are not adequately controlled. In this paper, the authors discuss: 1) efficacy and safety of current medical therapy 2) the efficacy and safety of the new multireceptor-targeted somatostatin ligand pasireotide 3) medical treatments currently under clinical investigation (oral octreotide, ITF2984, ATL1103), and 4) preliminary data on the use of new injectable and transdermal/transmucosal formulations of octreotide. This expert opinion supports the need for new therapeutic agents and modalities for patients with acromegaly.

Relationships between Contextual and Task Performance and Interrater Agreement: Are There Any?

PubMed

Díaz-Vilela, Luis F; Delgado Rodríguez, Naira; Isla-Díaz, Rosa; Díaz-Cabrera, Dolores; Hernández-Fernaud, Estefanía; Rosales-Sánchez, Christian

2015-01-01

Work performance is one of the most important dependent variables in Work and Organizational Psychology. The main objective of this paper was to explore the relationships between citizenship performance and task performance measures obtained from different appraisers and their consistency through a seldom-used methodology, intraclass correlation coefficients. Participants were 135 public employees, the total staff in a local government department. Jobs were clustered into job families through a work analysis based on standard questionnaires. A task description technique was used to develop a performance appraisal questionnaire for each job family, with three versions: self-, supervisor-, and peer-evaluation, in addition to a measure of citizenship performance. Only when the self-appraisal bias is controlled, significant correlations appeared between task performance rates. However, intraclass correlations analyses show that only self- (contextual and task) performance measures are consistent, while interrater agreement disappears. These results provide some interesting clues about the procedure of appraisal instrument development, the role of appraisers, and the importance of choosing adequate consistency analysis methods.

Relationships between Contextual and Task Performance and Interrater Agreement: Are There Any?

PubMed Central

Díaz-Cabrera, Dolores; Hernández-Fernaud, Estefanía; Rosales-Sánchez, Christian

2015-01-01

Work performance is one of the most important dependent variables in Work and Organizational Psychology. The main objective of this paper was to explore the relationships between citizenship performance and task performance measures obtained from different appraisers and their consistency through a seldom-used methodology, intraclass correlation coefficients. Participants were 135 public employees, the total staff in a local government department. Jobs were clustered into job families through a work analysis based on standard questionnaires. A task description technique was used to develop a performance appraisal questionnaire for each job family, with three versions: self-, supervisor-, and peer-evaluation, in addition to a measure of citizenship performance. Only when the self-appraisal bias is controlled, significant correlations appeared between task performance rates. However, intraclass correlations analyses show that only self- (contextual and task) performance measures are consistent, while interrater agreement disappears. These results provide some interesting clues about the procedure of appraisal instrument development, the role of appraisers, and the importance of choosing adequate consistency analysis methods. PMID:26473956

The management of scabies outbreaks in residential care facilities for the elderly in England: a review of current health protection guidelines.

PubMed

White, L C J; Lanza, S; Middleton, J; Hewitt, K; Freire-Moran, L; Edge, C; Nicholls, M; Rajan-Iyer, J; Cassell, J A

2016-11-01

Commonly thought of as a disease of poverty and overcrowding in resource-poor settings globally, scabies is also an important public health issue in residential care facilities for the elderly (RCFE) in high-income countries such as the UK. We compared and contrasted current local Health Protection Team (HPT) guidelines for the management of scabies outbreaks in RCFE throughout England. We performed content analysis on 20 guidelines, and used this to create a quantitative report of their variation in key dimensions. Although the guidelines were generally consistent on issues such as the treatment protocols for individual patients, there was substantial variation in their recommendations regarding the prophylactic treatment of contacts, infection control measures and the roles and responsibilities of individual stakeholders. Most guidelines did not adequately address the logistical challenges associated with mass treatment in this setting. We conclude that the heterogeneous nature of the guidelines reviewed is an argument in favour of national guidelines being produced.

Enrofloxacin enhances the effects of chemotherapy in canine osteosarcoma cells with mutant and wild-type p53

PubMed Central

York, D.; Withers, S. S.; Watson, K. D.; Seo, K. W.; Rebhun, R. B.

2016-01-01

Adjuvant chemotherapy improves survival time in dogs receiving adequate local control for appendicular osteosarcoma, but most dogs ultimately succumb to metastatic disease. The fluoroquinolone antibiotic enrofloxacin has been shown to inhibit survival and proliferation of canine osteosarcoma cells in vitro. Others have reported that fluoroquinolones may modulate cellular responses to DNA damaging agents and that these effects may be differentially mediated by p53 activity. We therefore determined p53 status and activity in three canine osteosarcoma cell lines and examined the effects of enrofloxacin when used alone or in combination with doxorubicin or carboplatin chemotherapy. Moresco and Abrams canine osteosarcoma cell lines contained mutations in p53, while no mutations were identified in the D17 cells or in a normal canine osteoblast cell line. The addition of enrofloxacin to either doxorubicin or carboplatin resulted in further reductions in osteosarcoma cell viability; this effect was apparent regardless of p53 mutational status or downstream activity. PMID:27333821

Enrofloxacin enhances the effects of chemotherapy in canine osteosarcoma cells with mutant and wild-type p53.

PubMed

York, D; Withers, S S; Watson, K D; Seo, K W; Rebhun, R B

2017-09-01

Adjuvant chemotherapy improves survival time in dogs receiving adequate local control for appendicular osteosarcoma, but most dogs ultimately succumb to metastatic disease. The fluoroquinolone antibiotic enrofloxacin has been shown to inhibit survival and proliferation of canine osteosarcoma cells in vitro. Others have reported that fluoroquinolones may modulate cellular responses to DNA damaging agents and that these effects may be differentially mediated by p53 activity. We therefore determined p53 status and activity in three canine osteosarcoma cell lines and examined the effects of enrofloxacin when used alone or in combination with doxorubicin or carboplatin chemotherapy. Moresco and Abrams canine osteosarcoma cell lines contained mutations in p53, while no mutations were identified in the D17 cells or in a normal canine osteoblast cell line. The addition of enrofloxacin to either doxorubicin or carboplatin resulted in further reductions in osteosarcoma cell viability; this effect was apparent regardless of p53 mutational status or downstream activity. © 2016 John Wiley & Sons Ltd.

Magnetically assisted slip casting of bioinspired heterogeneous composites

NASA Astrophysics Data System (ADS)

Le Ferrand, Hortense; Bouville, Florian; Niebel, Tobias P.; Studart, André R.

2015-11-01

Natural composites are often heterogeneous to fulfil functional demands. Manufacturing analogous materials remains difficult, however, owing to the lack of adequate and easily accessible processing tools. Here, we report an additive manufacturing platform able to fabricate complex-shaped parts exhibiting bioinspired heterogeneous microstructures with locally tunable texture, composition and properties, as well as unprecedentedly high volume fractions of inorganic phase (up to 100%). The technology combines an aqueous-based slip-casting process with magnetically directed particle assembly to create programmed microstructural designs using anisotropic stiff platelets in a ceramic, metal or polymer functional matrix. Using quantitative tools to control the casting kinetics and the temporal pattern of the applied magnetic fields, we demonstrate that this approach is robust and can be exploited to design and fabricate heterogeneous composites with thus far inaccessible microstructures. Proof-of-concept examples include bulk composites with periodic patterns of microreinforcement orientation, and tooth-like bilayer parts with intricate shapes exhibiting site-specific composition and texture.

Sources of lead exposure in Mexico City.

PubMed

Romieu, I; Palazuelos, E; Hernandez Avila, M; Rios, C; Muñoz, I; Jimenez, C; Cahero, G

1994-04-01

Many countries, including Mexico, are facing a largely unrecognized epidemic of low-level lead poisoning. Mexico is the sixth largest lead-producing country in the world, and 40% of its production is used locally in different industrial processes that cause lead contamination of the environment. The major sources and pathways of lead exposure among the Mexican population are gasoline emissions, lead-glazed ceramics, leaded paint, and lead in canned foods and beverages. In this paper we present evidence for the presence of lead in different environmental media and its impact on blood lead levels of the Mexican population. Although during the last few years important measures have been implemented to decrease lead exposure, our findings suggest that lead poisoning is still an important problem in Mexico. There is an urgent need for regulatory policies that implement stricter control to protect the Mexican population. There is also a need to develop adequate programs to reduce the lead burden and the associated health effects in the population that has been chronically exposed.

Temporal changes of spatial soil moisture patterns: controlling factors explained with a multidisciplinary approach

NASA Astrophysics Data System (ADS)

Martini, Edoardo; Wollschläger, Ute; Kögler, Simon; Behrens, Thorsten; Dietrich, Peter; Reinstorf, Frido; Schmidt, Karsten; Weiler, Markus; Werban, Ulrike; Zacharias, Steffen

2016-04-01

Characterizing the spatial patterns of soil moisture is critical for hydrological and meteorological models, as soil moisture is a key variable that controls matter and energy fluxes and soil-vegetation-atmosphere exchange processes. Deriving detailed process understanding at the hillslope scale is not trivial, because of the temporal variability of local soil moisture dynamics. Nevertheless, it remains a challenge to provide adequate information on the temporal variability of soil moisture and its controlling factors. Recent advances in wireless sensor technology allow monitoring of soil moisture dynamics with high temporal resolution at varying scales. In addition, mobile geophysical methods such as electromagnetic induction (EMI) have been widely used for mapping soil water content at the field scale with high spatial resolution, as being related to soil apparent electrical conductivity (ECa). The objective of this study was to characterize the spatial and temporal pattern of soil moisture at the hillslope scale and to infer the controlling hydrological processes, integrating well established and innovative sensing techniques, as well as new statistical methods. We combined soil hydrological and pedological expertise with geophysical measurements and methods from digital soil mapping for designing a wireless soil moisture monitoring network. For a hillslope site within the Schäfertal catchment (Central Germany), soil water dynamics were observed during 14 months, and soil ECa was mapped on seven occasions whithin this period of time using an EM38-DD device. Using the Spearman rank correlation coefficient, we described the temporal persistence of a dry and a wet characteristic state of soil moisture as well as the switching mechanisms, inferring the local properties that control the observed spatial patterns and the hydrological processes driving the transitions. Based on this, we evaluated the use of EMI for mapping the spatial pattern of soil moisture under different hydrologic conditions and the factors controlling the temporal variability of the ECa-soil moisture relationship. The approach provided valuable insight into the time-varying contribution of local and nonlocal factors to the characteristic spatial patterns of soil moisture and the transition mechanisms. The spatial organization of soil moisture was controlled by different processes in different soil horizons, and the topsoil's moisture did not mirror processes that take place within the soil profile. Results show that, for the Schäfertal hillslope site which is presumed to be representative for non-intensively managed soils with moderate clay content, local soil properties (e.g., soil texture and porosity) are the major control on the spatial pattern of ECa. In contrast, the ECa-soil moisture relationship is small and varies over time indicating that ECa is not a good proxy for soil moisture estimation at the investigated site.Occasionally observed stronger correlations between ECa and soil moisture may be explained by background dependencies of ECa to other state variables such as pore water electrical conductivity. The results will help to improve conceptual understanding for hydrological model studies at similar or smaller scales, and to transfer observation concepts and process understanding to larger or less instrumented sites, as well as to constrain the use of EMI-based ECa data for hydrological applications.

Environmental Assessment -- Hydrothermal Geothermal Subprogram

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

None

1979-06-01

This environmental impact assessment addresses the design, construction, and operation of an electric generating plant (3 to 4 MWe) and research station (Hawaii Geothermal Research Station (HGRS)) in the Puna district on the Island of Hawaii. The facility will include control and support buildings, parking lots, cooling towers, settling and seepage ponds, the generating plant, and a visitors center. Research activities at the facility will evaluate the ability of a successfully flow-tested well (42-day flow test) to provide steam for power generation over an extended period of time (two years). In future expansion, research activities may include direct heat applicationsmore » such as aquaculture and the effects of geothermal fluids on various plant components and specially designed equipment on test modules. Construction-related impacts would be relatively minor. Construction of the facility will require the distance of about 1.7 ha (4.1 acres). No further disturbance is anticipated, unless it becomes necessary to replace the seepage pond with an injection well, because the production well is in service and adjacent roads and transmission lines are adequate. Disruption of competing land uses will be minimal, and loss of wildlife habitat will be acceptable. Noise should not significantly affect wildlife and local residents; the most noise activities (well drilling and flow testing) have been completed. Water use during construction will not be large, and impacts on competing uses are unlikely. Socio-economic impacts will be small because the project will not employ a large number of local residents and few construction workers will need to find local housing.« less

Pilot Study of Adding Vincristine, Topotecan, and Cyclophosphamide to Interval-Compressed Chemotherapy in Newly Diagnosed Patients With Localized Ewing Sarcoma: A Report From the Children's Oncology Group.

PubMed

Mascarenhas, Leo; Felgenhauer, Judy L; Bond, Mason C; Villaluna, Doojduen; Femino, Joseph Dominic; Laack, Nadia N; Ranganathan, Sarangarajan; Meyer, James; Womer, Richard B; Gorlick, Richard; Krailo, Mark D; Marina, Neyssa

2016-03-01

The combination of topotecan and cyclophosphamide is active in relapsed Ewing sarcoma family of tumors (ESFT). The feasibility of adding these agents combined with vincristine (vincristine-topotecan-cyclophosphamide [VTc]) to standard five-drug chemotherapy with vincristine-doxorubicin-cyclophosphamide (VDC) and ifosfamide-etoposide (IE) administered in an interval-compressed (2-week instead of 3-week intervals) schedule was investigated. Newly diagnosed patients with localized ESFT < 31 years, with good performance status and adequate organ function were eligible. Seventeen alternating cycles of chemotherapy with VTc, VDC, and IE were administered at 2-week intervals. Local control (LC) of the primary tumor occurred following six cycles. Primary endpoints were the ability to deliver chemotherapy in an interval-compressed schedule, and the rate of grade 3 or greater nonhematologic toxicity and grade 4 hematologic toxicity, which delayed chemotherapy by ≥2 weeks. Secondary endpoints were event-free survival (EFS) and overall survival (OS). Thirty-five patients with a median age of 11 years were enrolled. The mean time to last dose of chemotherapy prior to LC was 12.6 ± 1.4 weeks and 45.5% of patients received intended chemotherapy without any delay prior to LC. There were no toxic deaths or unexpected toxicities. Five-year EFS was 79.6% (95% confidence interval [CI]: 61.8-89.7%) and 5-year OS was 88% (95% CI: 71.4-95.3%). The addition of VTc to standard therapy was tolerable with sufficient interval compression compared to historical standard 3-week cycles. © 2015 Wiley Periodicals, Inc.

Dynamics and controls working group summary

NASA Technical Reports Server (NTRS)

Oglevie, R. E.

1984-01-01

The technology status of the dynamics and controls discipline as it applies to energy storage wheel systems was evaluated. No problems were identified for which an adequate solution could not be proposed. Design issues that influence control were addressed. The dynamics and control aspects associated with the energy storage system concept and its various constituent parts, and the control tasks attendant to large, manned spacecraft are discussed.

Pain Management After Outpatient Anterior Cruciate Ligament Reconstruction: A Systematic Review of Randomized Controlled Trials.

PubMed

Secrist, Eric S; Freedman, Kevin B; Ciccotti, Michael G; Mazur, Donald W; Hammoud, Sommer

2016-09-01

Effective pain management after anterior cruciate ligament (ACL) reconstruction improves patient satisfaction and function. To collect and evaluate the available evidence from randomized controlled trials (RCTs) on pain control after ACL reconstruction. Systematic review. A systematic literature review was performed using PubMed, Medline, Google Scholar, UpToDate, Cochrane Reviews, CINAHL, and Scopus following PRISMA guidelines (July 2014). Only RCTs comparing a method of postoperative pain control to another method or placebo were included. A total of 77 RCTs met inclusion criteria: 14 on regional nerve blocks, 21 on intra-articular injections, 4 on intramuscular/intravenous injections, 12 on multimodal regimens, 6 on oral medications, 10 on cryotherapy/compression, 6 on mobilization, and 5 on intraoperative techniques. Single-injection femoral nerve blocks provided superior analgesia to placebo for up to 24 hours postoperatively; however, this also resulted in a quadriceps motor deficit. Indwelling femoral catheters utilized for 2 days postoperatively provided superior analgesia to a single-injection femoral nerve block. Local anesthetic injections at the surgical wound site or intra-articularly provided equivalent analgesia to regional nerve blocks. Continuous-infusion catheters of a local anesthetic provided adequate pain relief but have been shown to cause chondrolysis. Cryotherapy improved analgesia compared to no cryotherapy in 4 trials, while in 4 trials, ice water and water at room temperature provided equivalent analgesic effects. Early weightbearing decreased pain compared to delayed weightbearing. Oral gabapentin given preoperatively and oral zolpidem given for the first week postoperatively each decreased opioid consumption as compared to placebo. Ibuprofen reduced pain compared to acetaminophen. Oral ketorolac reduced pain compared to hydrocodone-acetaminophen. Regional nerve blocks and intra-articular injections are both effective forms of analgesia. Cryotherapy-compression appears to be beneficial, provided that intra-articular temperatures are sufficiently decreased. Early mobilization reduces pain symptoms. Gabapentin, zolpidem, ketorolac, and ibuprofen decrease opioid consumption. Despite the vast amount of high-quality evidence on this topic, further research is needed to determine the optimal multimodal approach that can maximize recovery while minimizing pain and opioid consumption. These results provide the best available evidence from RCTs on pain control regimens after ACL reconstruction. © 2015 The Author(s).

Cost-Effective Control Systems for Colleges and Universities: A New Paradigm.

ERIC Educational Resources Information Center

Hubbell, Loren Loomis; Dougherty, Jennifer Dowling

This report addresses the issue of maintaining adequate controls within a streamlined or restructured financial affairs environment at an institution of higher education. It presents a new paradigm for control structures designed to more effectively meet administrators' needs--both in terms of cost and risk management. The first section: (1)…

21 CFR 1301.73 - Physical security controls for non-practitioners; compounders for narcotic treatment programs...

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Physical security controls for non-practitioners..., DISTRIBUTORS, AND DISPENSERS OF CONTROLLED SUBSTANCES Security Requirements § 1301.73 Physical security... adequate security for the area or building. If such security requires an alarm, such alarm, upon...

21 CFR 212.50 - What production and process controls must I have?

Code of Federal Regulations, 2012 CFR

2012-04-01

... must have adequate production and process controls to ensure the consistent production of a PET drug... all steps in the PET drug production process. The master production and control records must include the following information: (1) The name and strength of the PET drug; (2) If applicable, the name and...

21 CFR 212.50 - What production and process controls must I have?

Code of Federal Regulations, 2014 CFR

2014-04-01

... must have adequate production and process controls to ensure the consistent production of a PET drug... all steps in the PET drug production process. The master production and control records must include the following information: (1) The name and strength of the PET drug; (2) If applicable, the name and...