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…

Ares-I Bending Filter Design using a Constrained Optimization Approach

NASA Technical Reports Server (NTRS)

Hall, Charles; Jang, Jiann-Woei; Hall, Robert; Bedrossian, Nazareth

2008-01-01

The Ares-I launch vehicle represents a challenging flex-body structural environment for control system design. Software filtering of the inertial sensor output is required to ensure adequate stable response to guidance commands while minimizing trajectory deviations. This paper presents a design methodology employing numerical optimization to develop the Ares-I bending filters. The design objectives include attitude tracking accuracy and robust stability with respect to rigid body dynamics, propellant slosh, and flex. Under the assumption that the Ares-I time-varying dynamics and control system can be frozen over a short period of time, the bending filters are designed to stabilize all the selected frozen-time launch control systems in the presence of parameter uncertainty. To ensure adequate response to guidance command, step response specifications are introduced as constraints in the optimization problem. Imposing these constrains minimizes performance degradation caused by the addition of the bending filters. The first stage bending filter design achieves stability by adding lag to the first structural frequency to phase stabilize the first flex mode while gain stabilizing the higher modes. The upper stage bending filter design gain stabilizes all the flex bending modes. The bending filter designs provided here have been demonstrated to provide stable first and second stage control systems in both Draper Ares Stability Analysis Tool (ASAT) and the MSFC MAVERIC 6DOF nonlinear time domain simulation.

Effects of Commuting Distance on Participation Rates for Obligated Selected Marine Corps Reserves

DTIC Science & Technology

2017-12-01

be beneficial to gather feedback on if the Marine feels the compensation for their time and travel is adequate. This feedback could help shape what...regions, I would recommend increasing the reimbursement program cap to assist in the compensation for time and travel . 37 LIST OF REFERENCES...reporting burden for this collection of information is estimated to average 1 hour per response, including the time for reviewing instruction, searching

How gender and task difficulty affect a sport-protective response in young adults

PubMed Central

Lipps, David B.; Eckner, James T.; Richardson, James K.; Ashton-Miller, James A.

2013-01-01

We tested the hypotheses that gender and task difficulty affect the reaction, movement, and total response times associated with performing a head protective response. Twenty-four healthy young adults (13 females) performed a protective response of raising their hands from waist level to block a foam ball fired at their head from an air cannon. Participants initially stood 8.25 m away from the cannon (‘low difficulty’), and were moved successively closer in 60 cm increments until they failed to block at least 5 of 8 balls (‘high difficulty’). Limb motion was quantified using optoelectronic markers on the participants’ left wrist. Males had significantly faster total response times (p = 0.042), a trend towards faster movement times (p = 0.054), and faster peak wrist velocity (p < .001) and acceleration (p = 0.032) than females. Reaction time, movement time, and total response time were significantly faster under high difficulty conditions for both genders (p < .001). This study suggests that baseball and softball pitchers and fielders should have sufficient time to protect their head from a batted ball under optimal conditions if they are adequately prepared for the task. PMID:23234296

78 FR 67326 - Safety and Environmental Management System Requirements for Vessels on the U.S. Outer Continental...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-12

... 1625-AC05 Safety and Environmental Management System Requirements for Vessels on the U.S. Outer... ``Safety and Environmental Management System Requirements for Vessels on the U.S. Outer Continental Shelf... of industry to ensure stakeholders have adequate time to submit complete responses. DATES: Comments...

Waterborne aripiprazole blunts the stress response in zebrafish

NASA Astrophysics Data System (ADS)

Barcellos, Heloísa Helena De Alcantara; Kalichak, Fabiana; da Rosa, João Gabriel Santos; Oliveira, Thiago Acosta; Koakoski, Gessi; Idalencio, Renan; de Abreu, Murilo Sander; Giacomini, Ana Cristina Varrone; Fagundes, Michele; Variani, Cristiane; Rossini, Mainara; Piato, Angelo L.; Barcellos, Leonardo José Gil

2016-11-01

Here we provide, at least to our knowledge, the first evidence that aripiprazole (APPZ) in the water blunts the stress response of exposed fish in a concentration ten times lower than the concentration detected in the environment. Although the mechanism of APPZ in the neuroendocrine axis is not yet determined, our results highlight that the presence of APPZ residues in the environment may interfere with the stress responses in fish. Since an adequate stress response is crucial to restore fish homeostasis after stressors, fish with impaired stress response may have trouble to cope with natural and/or imposed stressors with consequences to their welfare and survival.

Administration of time-expired yellow fever vaccine: public health response and results of a serological investigation.

PubMed

Allen, K W; Nguyen-Van-Tam, J S; Howells, J

1999-06-01

The discovery that a local travel clinic had administered 101 doses of time-expired yellow fever vaccine over a six month period prompted an immediate investigation in order to advise vaccinees about to travel to areas where yellow fever is endemic. No data were available to provide adequate reassurance about the potential efficacy of time-expired vaccine, so a rapid serological investigation was conducted, which provided evidence that the yellow fever vaccine had remained potent beyond its expiry date.

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.

Sources of uncertanity as a basis to fill the information gap in a response to flood

NASA Astrophysics Data System (ADS)

Kekez, Toni; Knezic, Snjezana

2016-04-01

Taking into account uncertainties in flood risk management remains a challenge due to difficulties in choosing adequate structural and/or non-structural risk management options. Despite stated measures wrong decisions are often being made when flood occurs. Parameter and structural uncertainties which include model and observation errors as well as lack of knowledge about system characteristics are the main considerations. Real time flood risk assessment methods are predominantly based on measured water level values and vulnerability as well as other relevant characteristics of flood affected area. The goal of this research is to identify sources of uncertainties and to minimize information gap between the point where the water level is measured and the affected area, taking into consideration main uncertainties that can affect risk value at the observed point or section of the river. Sources of uncertainties are identified and determined using system analysis approach and relevant uncertainties are included in the risk assessment model. With such methodological approach it is possible to increase response time with more effective risk assessment which includes uncertainty propagation model. Response phase could be better planned with adequate early warning systems resulting in more time and less costs to help affected areas and save human lives. Reliable and precise information is necessary to raise emergency operability level in order to enhance safety of citizens and reducing possible damage. The results of the EPISECC (EU funded FP7) project are used to validate potential benefits of this research in order to improve flood risk management and response methods. EPISECC aims at developing a concept of a common European Information Space for disaster response which, among other disasters, considers the floods.

Experimental study of the transient hydrogen jet - Using a fast response probe

NASA Astrophysics Data System (ADS)

Tanabe, H.; Ohnishi, M.; Sato, G. T.; Fujimoto, H.

Mixing processes of a transient hydrogen jet, such as those of a hydrogen-injection internal combustion engine, are studied by means of a concentration probe having a response time of less than 200 microsec. Hydrogen was injected into quiescent air by means of (1) a single-shot device, in order to study the air interactions of the jet with schlieren photography and smoke wire methods, and (2) a hydrogen diesel engine injection nozzle to determine jet shape with high speed schlieren photography. The concentration probe's response time was found to be adequate for the very short injection period, and it was determined that air-hydrogen mixing in the case of high jet momentum is governed by eddy diffusion.

Risk factors for inadequate antibody response to primary rabies vaccination in dogs under one year of age

PubMed Central

Wallace, Ryan M.; Pees, Anna; Blanton, Jesse B.

2017-01-01

Ensuring the adequacy of response to rabies vaccination in dogs is important, particularly in the context of pet travel. Few studies have examined the factors associated with dogs’ failure to achieve an adequate antibody titer after vaccination (0.5 IU/ml). This study evaluated rabies antibody titers in dogs after primary vaccination. Dogs under one year of age whose serum was submitted to a reference laboratory for routine diagnostics, and which had no prior documented history of vaccination were enrolled (n = 8,011). Geometric mean titers (GMT) were calculated and univariate analysis was performed to assess factors associated with failure to achieve 0.5 IU/mL. Dogs vaccinated at >16 weeks of age had a significantly higher GMT compared to dogs vaccinated at a younger age (1.64 IU/ml, 1.57–1.72, ANOVA p < 0.01). There was no statistical difference in GMT between dogs vaccinated <12 weeks and dogs vaccinated 12–16 weeks (1.22 IU/ml and 1.21 IU/ml). The majority of dogs failed to reach an adequate titer within the first 3 days of primary vaccination; failure rates were also high if the interval from vaccination to titer check was greater than 90 days. Over 90% of dogs that failed primary vaccination were able to achieve adequate titers after booster vaccination. The ideal timing for blood draw is 8–30 days after primary vaccination. In the event of a failure, most dogs will achieve an adequate serologic response upon a repeat titer (in the absence of booster vaccination). Booster vaccination after failure provided the highest probability of an acceptable titer. PMID:28759602

Risk factors for inadequate antibody response to primary rabies vaccination in dogs under one year of age.

PubMed

Wallace, Ryan M; Pees, Anna; Blanton, Jesse B; Moore, Susan M

2017-07-01

Ensuring the adequacy of response to rabies vaccination in dogs is important, particularly in the context of pet travel. Few studies have examined the factors associated with dogs' failure to achieve an adequate antibody titer after vaccination (0.5 IU/ml). This study evaluated rabies antibody titers in dogs after primary vaccination. Dogs under one year of age whose serum was submitted to a reference laboratory for routine diagnostics, and which had no prior documented history of vaccination were enrolled (n = 8,011). Geometric mean titers (GMT) were calculated and univariate analysis was performed to assess factors associated with failure to achieve 0.5 IU/mL. Dogs vaccinated at >16 weeks of age had a significantly higher GMT compared to dogs vaccinated at a younger age (1.64 IU/ml, 1.57-1.72, ANOVA p < 0.01). There was no statistical difference in GMT between dogs vaccinated <12 weeks and dogs vaccinated 12-16 weeks (1.22 IU/ml and 1.21 IU/ml). The majority of dogs failed to reach an adequate titer within the first 3 days of primary vaccination; failure rates were also high if the interval from vaccination to titer check was greater than 90 days. Over 90% of dogs that failed primary vaccination were able to achieve adequate titers after booster vaccination. The ideal timing for blood draw is 8-30 days after primary vaccination. In the event of a failure, most dogs will achieve an adequate serologic response upon a repeat titer (in the absence of booster vaccination). Booster vaccination after failure provided the highest probability of an acceptable titer.

Responses of single cells in cat visual cortex to prolonged stimulus movement: neural correlates of visual aftereffects.

PubMed

Vautin, R G; Berkley, M A

1977-09-01

1. The activity of single cortical cells in area 17 of anesthetized and unanesthetized cats was recorded in response to prolonged stimulation with moving stimuli. 2. Under the appropriate conditions, all cells observed showed a progressive response decrement during the stimulation period, regardless of cell classification, i.e., simple, complex, or hypercomplex. 3. The observed response decrement was shown to be largely cortical in origin and could be adequately described with an exponential function of the form R = Rf +(R1-Rf)e-t/T. Time constants derived from such calculations yielded values ranging from 1.92 to 12.45 s under conditions of optimal-stimulation. 4. Most cells showed poststimulation effects, usually a brief period of reduced responsiveness that recovered exponentially. Recovery was essentially complete in about 5-35 s. 5. The degree to which stimuli were effective at inducing response was shown to have significant effects on the magnitude of the response decrement. 6. Several cells showed neural patterns of response and recovery that suggested the operation of intracortical inhibitory mechanisms. 7. A simple two-process model that adequately describes the behavior of all the studied cells is presented. 8. Because the properties of the cells studied correlate well with human psychophysical measures of contour and movement adaptation and recovery, a causal relationship to similar neural mechanisms in humans is suggested.

Brief Report: Integrating Social-Emotional Learning with Literacy Instruction--An Intervention for Children at Risk for Emotional and Behavioral Disorders

ERIC Educational Resources Information Center

Daunic, Ann; Corbett, Nancy; Smith, Stephen; Barnes, Tia; Santiago-Poventud, Lourdes; Chalfant, Pam; Pitts, Donna; Gleaton, Jeisha

2013-01-01

It is widely believed that children's social-emotional growth and academic learning are inextricably connected. Pressured by high-stakes assessments, however, school professionals find it difficult to devote adequate time to children's social/behavioral development. As a response, we developed and piloted Social-Emotional Learning Foundations…

78 FR 50394 - Fisheries of the Caribbean, Gulf of Mexico, and South Atlantic; Snapper-Grouper Fishery off the...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-19

... published in the Federal Register on August 2, 2013, regarding the implementation of management measures described in Amendment 22 to the Fishery Management Plan for the Snapper-Grouper Fishery in the South... to ensure there is adequate time to submit complete responses. DATES: This correction is effective...

Contractor-Invoiced Costs Were Accurate, but DoD Did Not Adequately Track Funding

DTIC Science & Technology

2012-03-08

costs were unallowable: • $30 in local mileage overcharges, • $53 for a hotel pet fee, and • $35 for a credit card annual fee. Employee Time ...specified amount. 1Uv1 tracks the status of those accounts as funds are spent . Before an order for products or services is placed, the RM Certifying...hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and

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

Poverty, global health, and infectious disease: lessons from Haiti and Rwanda.

PubMed

Alsan, Marcella M; Westerhaus, Michael; Herce, Michael; Nakashima, Koji; Farmer, Paul E

2011-09-01

Poverty and infectious diseases interact in complex ways. Casting destitution as intractable, or epidemics that afflict the poor as accidental, erroneously exonerates us from responsibility for caring for those most in need. Adequately addressing communicable diseases requires a biosocial appreciation of the structural forces that shape disease patterns. Most health interventions in resource-poor settings could garner support based on cost/benefit ratios with appropriately lengthy time horizons to capture the return on health investments and an adequate accounting of externalities; however, such a calculus masks the suffering of inaction and risks eroding the most powerful incentive to act: redressing inequality. Copyright © 2011 Elsevier Inc. All rights reserved.

Social Justice through Quantitative Literacy: A Course Connecting Numeracy, Engaged Citizenship, and a Just Society

ERIC Educational Resources Information Center

Root, Rob

2009-01-01

Concern in the United States for adequate public school education in mathematics dates back at least to the response to Sputnik in 1957, but at that time focused on preparing a cadre of students for quantitatively demanding careers in science and engineering. More recently, however, there has been increasing appreciation of the value of broadly…

Contemporary Issues Necessitating Reform in Higher Education Programs and Curricula in Response to Challenges of Employability

ERIC Educational Resources Information Center

Adebisi, M. A.; Akinkuowo, F. O.

2015-01-01

Learning at the tertiary level of education could be described as being effective and functional, if it results in bringing about the expected transformation in the lives of its graduates over a period of time. Moreover effective learning should produce graduates who are adequately informed and technically equipped to become productive workers and…

Effects of Response to Intervention on Student Achievement

ERIC Educational Resources Information Center

Light, Heather

2014-01-01

All states test students at specified times as required by the No Child Left Behind Act, but the results of these tests indicate that many students do not meet adequate yearly progress (AYP). This problem was evident in a school district in Missouri in which 3rd-grade students in 2 of the 3 elementary schools did not meet AYP on the communication…

Measuring soil frost depth in forest ecosystems with ground penetrating radar

Treesearch

John R. Butnor; John L. Campbell; James B. Shanley; Stanley Zarnoch

2014-01-01

Soil frost depth in forest ecosystems can be variable and depends largely on early winter air temperatures and the amount and timing of snowfall. A thorough evaluation of ecological responses to seasonally frozen ground is hampered by our inability to adequately characterize the frequency, depth, duration and intensity of soil frost events. We evaluated the use of...

48 CFR 52.216-29 - Time-and-Materials/Labor-Hour Proposal Requirements-Non-Commercial Item Acquisition With Adequate...

Code of Federal Regulations, 2010 CFR

2010-10-01

...-Hour Proposal Requirements-Non-Commercial Item Acquisition With Adequate Price Competition. 52.216-29... Proposal Requirements—Non-Commercial Item Acquisition With Adequate Price Competition (FEB 2007) (a) The... Time-and-Materials/Labor-Hour Proposal Requirements—Non-Commercial Item Acquisition With Adequate Price...

A Connection Admission Control Method for Web Server Systems

NASA Astrophysics Data System (ADS)

Satake, Shinsuke; Inai, Hiroshi; Saito, Tomoya; Arai, Tsuyoshi

Most browsers establish multiple connections and download files in parallel to reduce the response time. On the other hand, a web server limits the total number of connections to prevent from being overloaded. That could decrease the response time, but would increase the loss probability, the probability of which a newly arriving client is rejected. This paper proposes a connection admission control method which accepts only one connection from a newly arriving client when the number of connections exceeds a threshold, but accepts new multiple connections when the number of connections is less than the threshold. Our method is aimed at reducing the response time by allowing as many clients as possible to establish multiple connections, and also reducing the loss probability. In order to reduce spending time to examine an adequate threshold for web server administrators, we introduce a procedure which approximately calculates the loss probability under a condition that the threshold is given. Via simulation, we validate the approximation and show effectiveness of the admission control.

Interactive Book Reading to Accelerate Word Learning by Kindergarten Children With Specific Language Impairment: Identifying an Adequate Intensity and Variation in Treatment Response.

PubMed

Storkel, Holly L; Voelmle, Krista; Fierro, Veronica; Flake, Kelsey; Fleming, Kandace K; Romine, Rebecca Swinburne

2017-01-01

This study sought to identify an adequate intensity of interactive book reading for new word learning by children with specific language impairment (SLI) and to examine variability in treatment response. An escalation design adapted from nontoxic drug trials (Hunsberger, Rubinstein, Dancey, & Korn, 2005) was used in this Phase I/II preliminary clinical trial. A total of 27 kindergarten children with SLI were randomized to 1 of 4 intensities of interactive book reading: 12, 24, 36, or 48 exposures. Word learning was monitored through a definition task and a naming task. An intensity response curve was examined to identify the adequate intensity. Correlations and classification accuracy were used to examine variation in response to treatment relative to pretreatment and early treatment measures. Response to treatment improved as intensity increased from 12 to 24 to 36 exposures, and then no further improvements were observed as intensity increased to 48 exposures. There was variability in treatment response: Children with poor phonological awareness, low vocabulary, and/or poor nonword repetition were less likely to respond to treatment. The adequate intensity for this version of interactive book reading was 36 exposures, but further development of the treatment is needed to increase the benefit for children with SLI.

Interactive Book Reading to Accelerate Word Learning by Kindergarten Children With Specific Language Impairment: Identifying an Adequate Intensity and Variation in Treatment Response

PubMed Central

Voelmle, Krista; Fierro, Veronica; Flake, Kelsey; Fleming, Kandace K.; Romine, Rebecca Swinburne

2017-01-01

Purpose This study sought to identify an adequate intensity of interactive book reading for new word learning by children with specific language impairment (SLI) and to examine variability in treatment response. Method An escalation design adapted from nontoxic drug trials (Hunsberger, Rubinstein, Dancey, & Korn, 2005) was used in this Phase I/II preliminary clinical trial. A total of 27 kindergarten children with SLI were randomized to 1 of 4 intensities of interactive book reading: 12, 24, 36, or 48 exposures. Word learning was monitored through a definition task and a naming task. An intensity response curve was examined to identify the adequate intensity. Correlations and classification accuracy were used to examine variation in response to treatment relative to pretreatment and early treatment measures. Results Response to treatment improved as intensity increased from 12 to 24 to 36 exposures, and then no further improvements were observed as intensity increased to 48 exposures. There was variability in treatment response: Children with poor phonological awareness, low vocabulary, and/or poor nonword repetition were less likely to respond to treatment. Conclusion The adequate intensity for this version of interactive book reading was 36 exposures, but further development of the treatment is needed to increase the benefit for children with SLI. PMID:28036410

Coordinating management disciplines to build operational resilience in response to a major crisis situation.

PubMed

Drachal, Marcin

2017-01-01

Using case studies of the Ebola outbreak in Western Africa in 2014, and the terrorist attacks in Paris and Brussels in 2015 and 2016 respectively, this paper demonstrates how various resilience-related corporate functions contributed to effective crisis response. This paper describes the logical order of actions taken in each of the cases, and how the organisation prioritised its assets and coordinated activities to ensure the response was adequate, efficient and timely. The article demonstrates how business continuity, physical security, threat management, security intelligence and incident management worked together to support the organisation's crisis management structures in complex crisis situations.

Statistical optimization of process parameters for lipase-catalyzed synthesis of triethanolamine-based esterquats using response surface methodology in 2-liter bioreactor.

PubMed

Masoumi, Hamid Reza Fard; Basri, Mahiran; Kassim, Anuar; Abdullah, Dzulkefly Kuang; Abdollahi, Yadollah; Abd Gani, Siti Salwa; Rezaee, Malahat

2013-01-01

Lipase-catalyzed production of triethanolamine-based esterquat by esterification of oleic acid (OA) with triethanolamine (TEA) in n-hexane was performed in 2 L stirred-tank reactor. A set of experiments was designed by central composite design to process modeling and statistically evaluate the findings. Five independent process variables, including enzyme amount, reaction time, reaction temperature, substrates molar ratio of OA to TEA, and agitation speed, were studied under the given conditions designed by Design Expert software. Experimental data were examined for normality test before data processing stage and skewness and kurtosis indices were determined. The mathematical model developed was found to be adequate and statistically accurate to predict the optimum conversion of product. Response surface methodology with central composite design gave the best performance in this study, and the methodology as a whole has been proven to be adequate for the design and optimization of the enzymatic process.

Production and characterization of cowpea protein hydrolysate with optimum nitrogen solubility by enzymatic hydrolysis using pepsin.

PubMed

Mune Mune, Martin Alain; Minka, Samuel René

2017-06-01

Cowpea is a source of low-cost and good nutritional quality protein for utilization in food formulations in replacement of animal proteins. Therefore it is necessary that cowpea protein exhibits good functionality, particularly protein solubility which affects the other functional properties. The objective of this study was to produce cowpea protein hydrolysate exhibiting optimum solubility by the adequate combination of hydrolysis parameters, namely time, solid/liquid ratio (SLR) and enzyme/substrate ratio (ESR), and to determine its functional properties and molecular characteristics. A Box-Behnken experimental design was used for the experiments, and a second-order polynomial to model the effects of hydrolysis time, SLR and ESR on the degree of hydrolysis and nitrogen solubility index. The optimum hydrolysis conditions of time 208.61 min, SLR 1/15 (w/w) and ESR 2.25% (w/w) yielded a nitrogen solubility of 75.71%. Protein breakdown and the peptide profile following enzymatic hydrolysis were evaluated by sodium dodecyl sulfate polyacrylamide gel electrophoresis and size exclusion chromatography. Cowpea protein hydrolysate showed higher oil absorption capacity, emulsifying activity and foaming ability compared with the concentrate. The solubility of cowpea protein hydrolysate was adequately optimized by response surface methodology, and the hydrolysate showed adequate functionality for use in food. © 2016 Society of Chemical Industry. © 2016 Society of Chemical Industry.

Prenatal zinc supplementation of zinc-adequate rats adversely affects immunity in offspring.

PubMed

Sharkar, Mohammad T K; Jou, Ming-Yu; Hossain, Mohammad B; Lönnerdal, Bo; Stephensen, Charles B; Raqib, Rubhana

2011-08-01

We previously showed that zinc (Zn) supplementation of Zn-adequate dams induced immunosuppressive effects that persist in the offspring after weaning. We investigated whether the immunosuppressive effects were due to in utero exposure and/or mediated via milk using a cross-fostering design. Pregnant rats with adequate Zn nutriture were supplemented with either Zn (1.5 mg Zn in 10% sucrose) or placebo (10% sucrose) during pregnancy (3 times/wk). At postnatal d 3, 4 pups of Zn-supplemented dams (Zn-P) were exchanged with 4 of placebo-supplemented dams (P-Zn). The remaining pups continued with their biological mothers (Zn-Zn and P-P). Pups were orally immunized with dinitrophenol ovalbumin-BSA and/or cholera toxin B subunit (CTB), and serum Zn concentrations and cellular and humoral responses were assessed. Pups of Zn-supplemented dams had higher serum Zn when fostered either by placebo- or Zn-supplemented dams compared to pups of placebo-supplemented dams (P < 0.01). Postnatal Zn exposure reduced the number of Peyer's patches in both the Zn-Zn and P-Zn groups (P < 0.01). Prenatal Zn exposure suppressed CTB- (P = 0.05) and BSA-specific proliferation response of Peyer's Patch lymphocytes (P = 0.07). Prenatal Zn exposure effects on the splenocyte cytokine response were differently influenced by fostering mothers' Zn status. Antigen presenting cell (APC) activity of splenocytes was lower in the Zn-Zn group than in the P-P group (P < 0.08). In conclusion, prenatal Zn exposure increases serum Zn levels in pups and suppresses antigen-specific proliferation and antibody responses and APC function, whereas postnatal exposure may suppress the mucosal immune reservoir.

Economic Analysis of Waterfront Area Services at Naval Station, Long Beach

DTIC Science & Technology

1991-06-01

the Gradall for waterfront area services, would result in improved responsiveness and timely service. Customer satisfaction and overall customer ...overall cost. Hence, both quality and efficiency will improve leading to greater customer satisfaction . 58 VII. RECOMMENDATIONS FOR ACTION RECOMMENDATION 1...prompting the need for improved efficiency. To ensure adequate future support can be provided to its customers , Naval Station Long Beach (Navsta) is

Virtual Guidance Ultrasound: A Tool to Obtain Diagnostic Ultrasound for Remote Environments

NASA Technical Reports Server (NTRS)

Caine,Timothy L.; Martin David S.; Matz, Timothy; Lee, Stuart M. C.; Stenger, Michael B.; Platts, Steven H.

2012-01-01

Astronauts currently acquire ultrasound images on the International Space Station with the assistance of real-time remote guidance from an ultrasound expert in Mission Control. Remote guidance will not be feasible when significant communication delays exist during exploration missions beyond low-Earth orbit. For example, there may be as much as a 20- minute delay in communications between the Earth and Mars. Virtual-guidance, a pre-recorded audio-visual tutorial viewed in real-time, is a viable modality for minimally trained scanners to obtain diagnostically-adequate images of clinically relevant anatomical structures in an autonomous manner. METHODS: Inexperienced ultrasound operators were recruited to perform carotid artery (n = 10) and ophthalmic (n = 9) ultrasound examinations using virtual guidance as their only instructional tool. In the carotid group, each each untrained operator acquired two-dimensional, pulsed, and color Doppler of the carotid artery. In the ophthalmic group, operators acquired representative images of the anterior chamber of the eye, retina, optic nerve, and nerve sheath. Ultrasound image quality was evaluated by independent imaging experts. RESULTS: Eight of the 10 carotid studies were judged to be diagnostically adequate. With one exception the quality of all the ophthalmic images were adequate to excellent. CONCLUSION: Diagnostically-adequate carotid and ophthalmic ultrasound examinations can be obtained by untrained operators with instruction only from an audio/video tutorial viewed in real time while scanning. This form of quick-response-guidance, can be developed for other ultrasound examinations, represents an opportunity to acquire important medical and scientific information for NASA flight surgeons and researchers when trained medical personnel are not present. Further, virtual guidance will allow untrained personnel to autonomously obtain important medical information in remote locations on Earth where communication is difficult or absent.

"Something Adequate"? In Memoriam Seamus Heaney, Sister Quinlan, Nirbhaya

ERIC Educational Resources Information Center

Parker, Jan

2014-01-01

Seamus Heaney talked of poetry's responsibility to represent the "bloody miracle", the "terrible beauty" of atrocity; to create "something adequate". This article asks, what is adequate to the burning and eating of a nun and the murderous gang rape and evisceration of a medical student? It considers Njabulo Ndebele's…

Low-dimensional chaos in magnetospheric activity from AE time series

NASA Technical Reports Server (NTRS)

Vassiliadis, D. V.; Sharma, A. S.; Eastman, T. E.; Papadopoulos, K.

1990-01-01

The magnetospheric response to the solar-wind input, as represented by the time-series measurements of the auroral electrojet (AE) index, has been examined using phase-space reconstruction techniques. The system was found to behave as a low-dimensional chaotic system with a fractal dimension of 3.6 and has Kolmogorov entropy less than 0.2/min. These indicate that the dynamics of the system can be adequately described by four independent variables, and that the corresponding intrinsic time scale is of the order of 5 min. The relevance of the results to magnetospheric modeling is discussed.

Challenges in responding to the ebola epidemic - four rural counties, Liberia, August-November 2014.

PubMed

Summers, Aimee; Nyenswah, Tolbert G; Montgomery, Joel M; Neatherlin, John; Tappero, Jordan W; T, Nyenswah; M, Fahnbulleh; M, Massaquoi

2014-12-19

The first cases of Ebola virus disease (Ebola) in West Africa were identified in Guinea on March 22, 2014. On March 30, the first Liberian case was identified in Foya Town, Lofa County, near the Guinean border. Because the majority of early cases occurred in Lofa and Montserrado counties, resources were concentrated in these counties during the first several months of the response, and these counties have seen signs of successful disease control. By October 2014, the epidemic had reached all 15 counties of Liberia. During August 27-September 10, 2014, CDC in collaboration with the Liberian Ministry of Health and Social Welfare assessed county Ebola response plans in four rural counties (Grand Cape Mount, Grand Bassa, Rivercess, and Sinoe, to identify county-specific challenges in executing their Ebola response plans, and to provide recommendations and training to enhance control efforts. Assessments were conducted through interviews with county health teams and health care providers and visits to health care facilities. At the time of assessment, county health teams reported lacking adequate training in core Ebola response strategies and reported facing many challenges because of poor transportation and communication networks. Development of communication and transportation network strategies for communities with limited access to roads and limited means of communication in addition to adequate training in Ebola response strategies is critical for successful management of Ebola in remote areas.

45 CFR 1159.15 - Who has the responsibility for maintaining adequate technical, physical, and security safeguards...

Code of Federal Regulations, 2010 CFR

2010-10-01

... disclosure or destruction of manual and automatic record systems. These security safeguards shall apply to... use of records contained in a system of records are adequately trained to protect the security and... adequate technical, physical, and security safeguards to prevent unauthorized disclosure or destruction of...

The U.S. Air Force Academy Lacked Effective Controls Over Heritage Assets and Guest House Inventories, and Inappropriately Solicited and Accepted Monetary Gifts

DTIC Science & Technology

2013-09-23

during that time frame. Finding B 10 │ DODIG-2013-138 Finding B USAFA Heritage Program Lacked Adequate Controls USAFA officials did not have effective ...E M B E R 2 3 , 2 0 1 3 Report No. DODIG-2013-138 The U.S. Air Force Academy Lacked Effective Controls Over Heritage Assets and Guest House...for the collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data

Potentialities of mass spectrometry (ICP-MS) for actinides determination in urine.

PubMed

Bouvier-Capely, C; Ritt, J; Baglan, N; Cossonnet, C

2004-05-01

The applicability of inductively coupled plasma-mass spectrometry (ICP-MS) for determining actinides in urine was investigated. Performances of ICP-MS including detection limit and analysis time were studied and compared with alpha spectrometry performances. In the field of individual monitoring of workers, the comparison chart obtained in this study can be used as a guide for medical laboratories to select the most adequate procedure to be carried out depending on the case in question (the radioisotope to be measured, the required sensitivity, and the desired response time).

Summary of the effects of engine throttle response on airplane formation-flying qualities

NASA Technical Reports Server (NTRS)

Walsh, Kevin R.

1992-01-01

A flight evaluation as conducted to determine the effect of engine throttle response characteristics on precision formation-flying qualities. A variable electronic throttle control system was developed and flight-tested on a TF-104G airplane with a J79-11B engine at the NASA Dryden Flight Research Facility. Ten research flights were flown to evaluate the effects of throttle gain, time delay, and fuel control rate limiting on engine handling qualities during a demanding precision wing formation task. Handling quality effects of lag filters and lead compensation time delays were also evaluated. Data from pilot ratings and comments indicate that throttle control system time delays and rate limits cause significant degradations in handling qualities. Threshold values for satisfactory (level 1) and adequate (level 2) handling qualities of these key variables are presented.

48 CFR 16.601 - Time-and-materials contracts.

Code of Federal Regulations, 2010 CFR

2010-10-01

... awarded without adequate price competition (see 15.403-1(c)(1)), the contract shall specify separate fixed...-Commercial Item Acquisitions With Adequate Price Competition, in solicitations contemplating use of a Time... based on adequate price competition. If authorized by agency procedures, the contracting officer may...

Clinical use of serum parvovirus and distemper virus antibody titers for determining revaccination strategies in healthy dogs.

PubMed

Twark, L; Dodds, W J

2000-10-01

To assess whether serum canine parvovirus (CPV) and canine distemper virus (CDV) antibody titers can be used to determine revaccination protocols in healthy dogs. Case series. 1,441 dogs between 6 weeks and 17 years old. CPV and CDV antibody titers in serum samples submitted to a commercial diagnostic laboratory were measured by use of indirect fluorescent antibody (IFA) tests. On the basis of parallel measurements of CPV and CDV serum antibody titers in 61 paired serum samples determined by use of hemagglutination inhibition and serum neutralization methods, respectively, we considered titers > or = 1:5 (IFA test) indicative of an adequate antibody response. Age, breed, and sex were not significantly associated with adequate CPV- or CDV-specific antibody responses. Of 1,441 dogs, 1,370 (95.1%) had adequate and 71 (4.9%) had inadequate antibody responses to CPV, whereas 1,346 of 1,379 (97.6%) dogs had adequate and 33 (2.4%) had inadequate responses to CDV. Vaccination histories were available for 468 dogs (468 for CPV, 457 for CDV). Interval between last vaccination and antibody measurement was 1 to 2 years for the majority (281/468; 60.0%) of dogs and 2 to 7 years for 142 of 468 (30.3%) dogs. Interval was < 1 year in only 45 of 468 (9.6%) dogs. The high prevalence of adequate antibody responses (CPV, 95.1%; CDV, 97.6%) in this large population of dogs suggests that annual revaccination against CPV and CDV may not be necessary.

Study on Response Function of Organic Liquid Scintillator for High-Energy Neutrons

NASA Astrophysics Data System (ADS)

Satoh, Daiki; Sato, Tatsuhiko; Endo, Akira; Yamaguchi, Yasuhiro; Takada, Masashi; Ishibashi, Kenji

2005-05-01

Response functions of liquid organic scintillator for neutrons up to 800 MeV have been measured at the Heavy-Ion Medical Accelerator in Chiba (HIMAC) of National Institute of Radiological Sciences (NIRS). 800-MeV/u Si ions and 400-MeV/u C ions bombarded a thick carbon target to produce neutrons. The kinetic energies of emitted neutrons were determined by the time-of-flight (TOF) method. Light output for neutrons was evaluated by eliminating events due to gamma-rays and charged particles. The measured response functions were compared with calculations using SCINFUL-QMD and CECIL codes. It was found that SCINFUL-QMD reproduced our experimental data adequately.

Study on Response Function of Organic Liquid Scintillator for High-Energy Neutrons

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

Satoh, Daiki; Sato, Tatsuhiko; Endo, Akira

2005-05-24

Response functions of liquid organic scintillator for neutrons up to 800 MeV have been measured at the Heavy-Ion Medical Accelerator in Chiba (HIMAC) of National Institute of Radiological Sciences (NIRS). 800-MeV/u Si ions and 400-MeV/u C ions bombarded a thick carbon target to produce neutrons. The kinetic energies of emitted neutrons were determined by the time-of-flight (TOF) method. Light output for neutrons was evaluated by eliminating events due to gamma-rays and charged particles. The measured response functions were compared with calculations using SCINFUL-QMD and CECIL codes. It was found that SCINFUL-QMD reproduced our experimental data adequately.

Maternal child-feeding practices and dietary inadequacy of 4-year-old children.

PubMed

Durão, Catarina; Andreozzi, Valeska; Oliveira, Andreia; Moreira, Pedro; Guerra, António; Barros, Henrique; Lopes, Carla

2015-09-01

This study aimed to evaluate the association between maternal perceived responsibility and child-feeding practices and dietary inadequacy of 4-year-old children. We studied 4122 mothers and children enrolled in the population-based birth cohort - Generation XXI (Porto, Portugal). Mothers self-completed the Child Feeding Questionnaire and a scale on covert and overt control, and answered to a food frequency questionnaire in face-to-face interviews. Using dietary guidelines for preschool children, adequacy intervals were defined: fruit and vegetables (F&V) 4-7 times/day; dairy 3-5 times/day; meat and eggs 5-10 times/week; fish 2-4 times/week. Inadequacy was considered as below or above these cut-points. For energy-dense micronutrient-poor foods and beverages (EDF), a tolerable limit was defined (<6 times/week). Associations between maternal perceived responsibility and child-feeding practices (restriction, monitoring, pressure to eat, overt and covert control) and children's diet were examined by logistic regression models. After adjustment for maternal BMI, education, and diet, and children's characteristics (sex, BMI z-scores), restriction, monitoring, overt and covert control were associated with 11-18% lower odds of F&V consumption below the interval defined as adequate. Overt control was also associated with 24% higher odds of their consumption above it. Higher perceived responsibility was associated with higher odds of children consuming F&V and dairy above recommendations. Pressure to eat was positively associated with consumption of dairy above the adequate interval. Except for pressure to eat, maternal practices were associated with 14-27% lower odds of inadequate consumption of EDF. In conclusion, children whose mothers had higher levels of covert control, monitoring, and restriction were less likely to consume F&V below recommendations and EDF above tolerable limits. Higher overt control and pressure to eat were associated, respectively, with higher possibility of children consuming F&V and dairy above recommendations. Copyright © 2015 Elsevier Ltd. All rights reserved.

Parametric and energy consumption optimization of Basic Red 2 removal by electrocoagulation/egg shell adsorption coupling using response surface methodology in a batch system.

PubMed

de Carvalho, Helder Pereira; Huang, Jiguo; Zhao, Meixia; Liu, Gang; Yang, Xinyu; Dong, Lili; Liu, Xingjuan

2016-01-01

In this study, response surface methodology (RSM) model was applied for optimization of Basic Red 2 (BR2) removal using electrocoagulation/eggshell (ES) coupling process in a batch system. Central composite design was used to evaluate the effects and interactions of process parameters including current density, reaction time, initial pH and ES dosage on the BR2 removal efficiency and energy consumption. The analysis of variance revealed high R(2) values (≥85%) indicating that the predictions of RSM models are adequately applicable for both responses. The optimum conditions when the dye removal efficiency of 93.18% and energy consumption of 0.840 kWh/kg were observed were 11.40 mA/cm(2) current density, 5 min and 3 s reaction time, 6.5 initial pH and 10.91 g/L ES dosage.

Response variables for evaluation of the effectiveness of conservation corridors.

PubMed

Gregory, Andrew J; Beier, Paul

2014-06-01

Many studies have evaluated effectiveness of corridors by measuring species presence in and movement through small structural corridors. However, few studies have assessed whether these response variables are adequate for assessing whether the conservation goals of the corridors have been achieved or considered the costs or lag times involved in measuring the response variables. We examined 4 response variables-presence of the focal species in the corridor, interpatch movement via the corridor, gene flow, and patch occupancy--with respect to 3 criteria--relevance to conservation goals, lag time (fewest generations at which a positive response to the corridor might be evident with a particular variable), and the cost of a study when applying a particular variable. The presence variable had the least relevance to conservation goals, no lag time advantage compared with interpatch movement, and only a moderate cost advantage over interpatch movement or gene flow. Movement of individual animals between patches was the most appropriate response variable for a corridor intended to provide seasonal migration, but it was not an appropriate response variable for corridor dwellers, and for passage species it was only moderately relevant to the goals of gene flow, demographic rescue, and recolonization. Response variables related to gene flow provided a good trade-off among cost, relevance to conservation goals, and lag time. Nonetheless, the lag time of 10-20 generations means that evaluation of conservation corridors cannot occur until a few decades after a corridor has been established. Response variables related to occupancy were most relevant to conservation goals, but the lag time and costs to detect corridor effects on occupancy were much greater than the lag time and costs to detect corridor effects on gene flow. © 2014 Society for Conservation Biology.

Analysis of frequency shifting in seismic signals using Gabor-Wigner transform

NASA Astrophysics Data System (ADS)

Kumar, Roshan; Sumathi, P.; Kumar, Ashok

2015-12-01

A hybrid time-frequency method known as Gabor-Wigner transform (GWT) is introduced in this paper for examining the time-frequency patterns of earthquake damaged buildings. GWT is developed by combining the Gabor transform (GT) and Wigner-Ville distribution (WVD). GT and WVD have been used separately on synthetic and recorded earthquake data to identify frequency shifting due to earthquake damages, but GT is prone to windowing effect and WVD involves ambiguity function. Hence to obtain better clarity and to remove the cross terms (frequency interference), GT and WVD are judiciously combined and the resultant GWT used to identify frequency shifting. Synthetic seismic response of an instrumented building and real-time earthquake data recorded on the building were investigated using GWT. It is found that GWT offers good accuracy for even slow variations in frequency, good time-frequency resolution, and localized response. Presented results confirm the efficacy of GWT when compared with GT and WVD used separately. Simulation results were quantified by the Renyi entropy measures and GWT shown to be an adequate technique in identifying localized response for structural damage detection.

Interactive Book Reading to Accelerate Word Learning by Kindergarten Children with Specific Language Impairment: Identifying an Adequate Intensity and Variation in Treatment Response

ERIC Educational Resources Information Center

Storkel, Holly L.; Voelmle, Krista; Fierro, Veronica; Flake, Kelsey; Fleming, Kandace K.; Romine, Rebecca Swinburne

2017-01-01

Purpose: This study sought to identify an adequate intensity of interactive book reading for new word learning by children with specific language impairment (SLI) and to examine variability in treatment response. Method: An escalation design adapted from nontoxic drug trials (Hunsberger, Rubinstein, Dancey, & Korn, 2005) was used in this Phase…

Heat Stroke: Role of the Systemic Inflammatory Response

DTIC Science & Technology

2010-06-01

data indicate that current clinical markers of heat stroke recovery may not adequately reflect heat stroke recovery in all cases. Currently heat stroke...cause of mortality, and recent experimental data indicate that current clinical markers of heat stroke recovery may not adequately reflect heat stroke...hyperthermia in patients was regarded as a compensatory peripheral vasoconstriction response to cooling of the skin surface with ice packs, whereas

The N-end rule pathway regulates pathogen responses in plants

PubMed Central

de Marchi, Rémi; Sorel, Maud; Mooney, Brian; Fudal, Isabelle; Goslin, Kevin; Kwaśniewska, Kamila; Ryan, Patrick T.; Pfalz, Marina; Kroymann, Juergen; Pollmann, Stephan; Feechan, Angela; Wellmer, Frank; Rivas, Susana; Graciet, Emmanuelle

2016-01-01

To efficiently counteract pathogens, plants rely on a complex set of immune responses that are tightly regulated to allow the timely activation, appropriate duration and adequate amplitude of defense programs. The coordination of the plant immune response is known to require the activity of the ubiquitin/proteasome system, which controls the stability of proteins in eukaryotes. Here, we demonstrate that the N-end rule pathway, a subset of the ubiquitin/proteasome system, regulates the defense against a wide range of bacterial and fungal pathogens in the model plant Arabidopsis thaliana. We show that this pathway positively regulates the biosynthesis of plant-defense metabolites such as glucosinolates, as well as the biosynthesis and response to the phytohormone jasmonic acid, which plays a key role in plant immunity. Our results also suggest that the arginylation branch of the N-end rule pathway regulates the timing and amplitude of the defense program against the model pathogen Pseudomonas syringae AvrRpm1. PMID:27173012

Adequacy of Fixed-Dose Heparin Infusions for Venous Thromboembolism Prevention after Microsurgical Procedures.

PubMed

Bertolaccini, Corinne M; Prazak, Ann Marie B; Agarwal, Jayant; Goodwin, Isak A; Rockwell, W Bradford; Pannucci, Christopher J

2018-05-22

 In microvascular surgery, patients often receive unfractionated heparin infusions to minimize risk for microvascular thrombosis. Patients who receive intravenous (IV) heparin are believed to have adequate prophylaxis against venous thromboembolism (VTE). Whether a fixed dose of IV heparin provides detectable levels of anticoagulation, or whether the "one size fits all" approach provides adequate prophylaxis against VTE remains unknown. This study examined the pharmacodynamics of fixed-dose heparin infusions and the effects of real-time, anti-factor Xa (aFXa) level driven heparin dose adjustments.  This prospective clinical trial recruited adult microvascular surgery patients placed on a fixed-dose (500 units/h) unfractionated heparin infusion during their initial microsurgical procedure. Steady-state aFXa levels, a marker of unfractionated heparin efficacy and safety, were monitored. Patients with out-of-range aFXa levels received protocol-driven real-time dose adjustments. Outcomes of interest included aFXa levels in response to heparin 500 units/h, number of dose adjustments required to achieve goal aFXa levels, time to reach goal aFXa level, and 90-day clinically relevant bleeding and VTE.  Twenty patients were recruited prospectively. None of 20 patients had any detectable level of anticoagulation in response to heparin infusions at 500 units/h. The median number of dose adjustments required to reach goal level was five, and median weight-based dose to reach goal level was 11.8 units/kg/h. Real-time dose adjustments significantly increased the proportion of patients with in-range levels (60 vs. 0%, p  = 0.0001). The 90-day VTE rate was 5% and 90-day clinically relevant bleeding rate was 5%.  Fixed-dose heparin infusions at a rate of 500 units/h do not provide a detectable level of anticoagulation after microsurgical procedures and are insufficient for the majority of patients who require VTE prophylaxis. Weight-based heparin infusions at 10 to 12 units/kg/h deserve future study in patients undergoing microsurgical procedures to increase the proportion of patients receiving adequate VTE prophylaxis. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Pretreatment levels of the fatty acid handling proteins H-FABP and CD36 predict response to olanzapine in recent-onset schizophrenia patients.

PubMed

Tomasik, Jakub; Schwarz, Emanuel; Lago, Santiago G; Rothermundt, Matthias; Leweke, F Markus; van Beveren, Nico J M; Guest, Paul C; Rahmoune, Hassan; Steiner, Johann; Bahn, Sabine

2016-02-01

Traditional schizophrenia pharmacotherapy remains a subjective trial and error process involving administration, titration and switching of drugs multiple times until an adequate response is achieved. Despite this time-consuming and costly process, not all patients show an adequate response to treatment. As a consequence, relapse is a common occurrence and early intervention is hampered. Here, we have attempted to identify candidate blood biomarkers associated with drug response in 121 initially antipsychotic-free recent-onset schizophrenia patients treated with widely-used antipsychotics, namely olanzapine (n=40), quetiapine (n=23), risperidone (n=30) and a mixture of these drugs (n=28). Patients were recruited and investigated as two separate cohorts to allow biomarker validation. Data analysis showed the most significant relationship between pre-treatment levels of heart-type fatty acid binding protein (H-FABP) and response to olanzapine (p=0.008, F=8.6, β=70.4 in the discovery cohort and p=0.003, F=15.2, β=24.4 in the validation cohort, adjusted for relevant confounding variables). In a functional follow-up analysis of this finding, we tested an independent cohort of 10 patients treated with olanzapine and found that baseline levels of plasma H-FABP and expression of the binding partner for H-FABP, fatty acid translocase (CD36), on monocytes predicted the reduction of psychotic symptoms (p=0.040, F=6.0, β=116.3 and p=0.012, F=11.9, β=-0.0054, respectively). We also identified a set of serum molecules changed after treatment with antipsychotic medication, in particular olanzapine. These molecules are predominantly involved in cellular development and metabolism. Taken together, our findings suggest an association between biomarkers involved in fatty acid metabolism and response to olanzapine, while other proteins may serve as surrogate markers associated with drug efficacy and side effects. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Will General Practitioners Be Adequately Prepared to Meet the Complexities of Enhanced Dementia Screening for People with Learning Disabilities and Down Syndrome: Key Considerations

ERIC Educational Resources Information Center

Rowe, Michelle

2016-01-01

This article provides a timely response in regard to the Department of Health's current initiative to financially reward GPs to prioritise and undertake dementia screening for people with learning disabilities over the age of 50 years and for people with Down syndrome over the age of 40 years. Whilst GPs are becoming increasingly aware of their…

The continuous measurement of hydrogen chloride in the ambient atmosphere using the dual isotope infrared absorption technique

NASA Technical Reports Server (NTRS)

Williams, K. G.

1974-01-01

The results of a program to develop a prototype gas filter correlation NDIR analyzer capable of providing the required HCl measurement capability, while maintaining an adequate rejection of any other gases anticipated in the atmosphere are presented. Examples of the performance of the prototype analyzer are presented which show an rms noise equivalent concentration of 0.06 ppm of HCl was achieved while maintaining an electronically determined 10% to 90% time response to gas samples of about 2 seconds. No measureable response was observed to CO2, CO, and H2O while maintaining an adequate rejection of the hydrocarbons, for example CH4 and n-hexane. The experiments were performed which demonstrate that the span stability of the HCl gas filter correlation analyzer is unaffected by the presence of water vapor and which support the belief that the incorporation of a relatively open-volume, multiple path sample cell into the instrument would enable ground station as well as airborne measurements of trace quantities of HCl in the ambient atmosphere to be performed.

The Initial Response to the Boston Marathon Bombing

PubMed Central

Gates, Jonathan D.; Arabian, Sandra; Biddinger, Paul; Blansfield, Joe; Burke, Peter; Chung, Sarita; Fischer, Jonathan; Friedman, Franklin; Gervasini, Alice; Goralnick, Eric; Gupta, Alok; Larentzakis, Andreas; McMahon, Maria; Mella, Juan; Michaud, Yvonne; Mooney, David; Rabinovici, Reuven; Sweet, Darlene; Ulrich, Andrew; Velmahos, George; Weber, Cheryl; Yaffe, Michael B.

2017-01-01

Objective We discuss the strengths of the medical response to the Boston Marathon bombings that led to the excellent outcomes. Potential shortcomings were recognized, and lessons learned will provide a foundation for further improvements applicable to all institutions. Background Multiple casualty incidents from natural or man-made incidents remain a constant global threat. Adequate preparation and the appropriate alignment of resources with immediate needs remain the key to optimal outcomes. Methods A collaborative effort among Boston’s trauma centers (2 level I adult, 3 combined level I adult/pediatric, 1 freestanding level I pediatric) examined the details and outcomes of the initial response. Each center entered its respective data into a central database (REDCap), and the data were analyzed to determine various prehospital and early in-hospital clinical and logistical parameters that collectively define the citywide medical response to the terrorist attack. Results A total of 281 people were injured, and 127 patients received care at the participating trauma centers on that day. There were 3 (1%) immediate fatalities at the scene and no in-hospital mortality. A majority of the patients admitted (66.6%) suffered lower extremity soft tissue and bony injuries, and 31 had evidence for exsanguinating hemorrhage, with field tourniquets in place in 26 patients. Of the 75 patients admitted, 54 underwent urgent surgical intervention and 12 (22%) underwent amputation of a lower extremity. Conclusions Adequate preparation, rapid logistical response, short transport times, immediate access to operating rooms, methodical multidisciplinary care delivery, and good fortune contributed to excellent outcomes. PMID:25386862

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

Tan, Jin; Zhang, Yingchen; Krad, Ibrahim

Power system frequency needs to be maintained close to its nominal value at all times to avoid machine damage, under-frequency load-shedding and even blackouts. Adequate primary frequency response and secondary frequency response are the primary forces to correct an energy imbalance at the second to minute level. As wind energy becomes a larger portion of the world's energy portfolio, there are greater oppotunities for wind to provide frequency response services. This paper addresses one area of frequency control that has been missing in previous work - the reliabilty impacts and interactions between primary and secondary frequency control. The lack ofmore » a commercially available tools to simulate the interaction of these two responses has limited the energy industry's understanding of when the depletion of primary control reserve will impact the performance of secondary conrol response or vice versa. To investigate this issue, in this paper we develop a multi-area frequency response integration model with combined primary and secondary frequency control capabilities.« less

High dietary iron increases oxidative stress and radiosensitivity in the rat retina and vasculature after exposure to fractionated gamma radiation

PubMed Central

Theriot, Corey A; Westby, Christian M; Morgan, Jennifer L L; Zwart, Sara R; Zanello, Susana B

2016-01-01

Radiation exposure in combination with other space environmental factors including microgravity, nutritional status, and deconditioning is a concern for long-duration space exploration missions. Astronauts experience altered iron homeostasis due to adaptations to microgravity and an iron-rich food system. Iron intake reaches three to six times the recommended daily allowance due to the use of fortified foods on the International Space Station. Iron is associated with certain optic neuropathies and can potentiate oxidative stress. This study examined the response of eye and vascular tissue to gamma radiation exposure (3 Gy fractionated at 37.5 cGy per day every other day for 8 fractions) in rats fed an adequate-iron diet or a high-iron diet. Twelve-week-old Sprague-Dawley rats were assigned to one of four experimental groups: adequate-iron diet/no radiation (CON), high-iron diet/no radiation (IRON), adequate-iron diet/radiation (RAD), and high-iron diet/radiation (IRON+RAD). Animals were maintained on the corresponding iron diet for 2 weeks before radiation exposure. As previously published, the high-iron diet resulted in elevated blood and liver iron levels. Dietary iron overload altered the radiation response observed in serum analytes, as evidenced by a significant increase in catalase levels and smaller decrease in glutathione peroxidase and total antioxidant capacity levels. 8-OHdG immunostaining, showed increased intensity in the retina after radiation exposure. Gene expression profiles of retinal and aortic vascular samples suggested an interaction between the response to radiation and high dietary iron. This study suggests that the combination of gamma radiation and high dietary iron has deleterious effects on retinal and vascular health and physiology. PMID:28725729

Nitric oxide selective electrodes.

PubMed

Davies, Ian R; Zhang, Xueji

2008-01-01

Since nitric oxide (NO) was identified as the endothelial-derived relaxing factor in the late 1980s, many approaches have attempted to provide an adequate means for measuring physiological levels of NO. Although several techniques have been successful in achieving this aim, the electrochemical method has proved the only technique that can reliably measure physiological levels of NO in vitro, in vivo, and in real time. We describe here the development of electrochemical sensors for NO, including the fabrication of sensors, the detection principle, calibration, detection limits, selectivity, and response time. Furthermore, we look at the many experimental applications where NO selective electrodes have been successfully used.

Skylab: A beginning. [astronaut performance in extended space exploration

NASA Technical Reports Server (NTRS)

Dietlein, L. F.

1974-01-01

Skylab biomedical experience indicates that man adapts well to and functions effectively in the space environment for time periods approaching three months. Appropriate dietary intake coupled with adequate, programmed exercise, sleep, work and recreation periods are essential to crew health and well being. No untoward physiological responses have been noted that would preclude longer duration space flights, but more research is required in order to understand the mechanisms involved in the observed responses. Remedial or preventive measures may be required for Mars-type missions, and further study of man in earth orbit for an uninterrupted six-month period should ideally precede this Mars-type mission.

[The use of antibiotics at the outpatient clinic of the "Salvador Zubirán" National Institute of Nutrition].

PubMed

García-Rubí, E; Sierra Madero, J G; Ponce De León Rosales, S

1991-01-01

We conducted a survey of the prescription of antibiotics among the outpatient clinics of the Instituto Nacional de la Nutrición "Salvador Zubirán", a third level hospital in México City. We made an auditory of the medical record and prescriptions given to every patient treated for an infectious episode, accounting for at least six questions to evaluate the quality of the prescription: 1) if the patient should had received antibiotics; 2) if the antibiotic prescribed was adequate; 3) if the dose was sufficient; 4) if the frequency of administration was correct; 5) if the route of administration was adequate; and 6) if the length of the treatment was sufficient. We validated the concordance among two evaluators and found that it was 89% for the whole questionnaire. In the evaluation we found that the patients should had received antibiotic 94% of the time: the antibiotic selected was a right choice 80% of the time; the dose was adequate 45% of the time; the frequency of administration was adequate 70% of the time; the route of administration was adequate 79% of the time; and the length of treatment was adequate 38% of the time. The worst findings were seen in two of the most important issues of antibiotic prescription which directly affect the appearance of antibiotic resistance.

Me, the intruder: revisited and rethought.

PubMed

Rodríguez Muñoz, Sarbelio; Ataz Orihuela, Maria; Arberas Díez, Beatriz

2018-04-01

I have read Dr. Luzón's article (1) and have shared his opinions for a long time. As I indicated in my letter 13 years ago (2), all of our patients need to receive adequate sedation in endoscopic explorations, including ERCP. It is also our obligation as the person responsible for the procedure, to ensure that this is so. At present and without renouncing any of my beliefs, I think it is necessary to ask ourselves several questions:  .

Effect of diet phase change, dietary Ca and P level and phytase on bird performance and real-time gizzard pH measurements.

PubMed

Lee, S A; Dunne, J; Mottram, T; Bedford, M R

2017-06-01

In this study, a novel capsule technique was used to capture real-time pH readings from the gizzard over several hours, in response to different dietary treatments. 1. The first experiment was a preliminary study into capsule administration and pH recordings using 9 male Ross 308 broilers from 20 d. In the second experiment, broilers (576) were fed in two phases (0-21 and 21-42 d) with 4 treatment groups; low and adequate Ca and AvP diets with and without Quantum Blue phytase (1500 FTU/kg). Capsules were administered to 8 birds from each treatment group, pre and post diet phase change, with readings captured over a 2.5 h period. 2. Phytase addition improved body weight gain (BWG) and feed conversion ratio (FCR) of birds fed low dietary Ca, while having no significant effect on birds fed adequate Ca diets. Unexpectantly, diets with higher Ca levels gave a lower average gizzard pH compared to the low Ca diet. Phytase addition, irrespective of Ca level, increased average gizzard pH. Fluctuations in gizzard pH (0.6-3.8) were observed across all treatment groups. Higher frequencies of pH readings below pH 1.0 were seen in birds fed an adequate Ca diet and with phytase supplementation of a low Ca diet. 3. These results signify the potential use of capsule techniques to monitor real-time pH changes. The implication on gastric protein and fibre hydrolysis as a result of large fluctuations in pH should be considered.

Summary of the effects of engine throttle response on airplane formation-flying qualities

NASA Technical Reports Server (NTRS)

Walsh, Kevin R.

1993-01-01

A flight evaluation was conducted to determine the effect of engine throttle response characteristics on precision formation-flying qualities. A variable electronic throttle control system was developed and flight-tested on a TF-104G airplane with a J79-11B engine at the NASA Dryden Flight Research Facility. This airplane was chosen because of its known, very favorable thrust response characteristics. Ten research flights were flown to evaluate the effects of throttle gain, time delay, and fuel control rate limiting on engine handling qualities during a demanding precision wing formation task. Handling quality effects of lag filters and lead compensation time delays were also evaluated. The Cooper and Harper Pilot Rating Scale was used to assign levels of handling quality. Data from pilot ratings and comments indicate that throttle control system time delays and rate limits cause significant degradations in handling qualities. Threshold values for satisfactory (level 1) and adequate (level 2) handling qualities of these key variables are presented. These results may provide engine manufacturers with guidelines to assure satisfactory handling qualities in future engine designs.

The question of nonlinearity in the dose-response relation between particulate matter air pollution and mortality: can Akaike's Information Criterion be trusted to take the right turn?

PubMed

Roberts, Steven; Martin, Michael A

2006-12-15

The shape of the dose-response relation between particulate matter air pollution and mortality is crucial for public health assessment, and departures of this relation from linearity could have important regulatory consequences. A number of investigators have studied the shape of the particulate matter-mortality dose-response relation and concluded that the relation could be adequately described by a linear model. Some of these researchers examined the hypothesis of linearity by comparing Akaike's Information Criterion (AIC) values obtained under linear, piecewise linear, and spline alternative models. However, at the current time, the efficacy of the AIC in this context has not been assessed. The authors investigated AIC as a means of comparing competing dose-response models, using data from Cook County, Illinois, for the period 1987-2000. They found that if nonlinearities exist, the AIC is not always successful in detecting them. In a number of the scenarios considered, AIC was equivocal, picking the correct simulated dose-response model about half of the time. These findings suggest that further research into the shape of the dose-response relation using alternative model selection criteria may be warranted.

Pharmacy Students' Knowledge Assessment of Naegleria fowleri Infection

PubMed Central

Shakeel, Sadia; Iffat, Wajiha; Khan, Madeeha

2016-01-01

A cross-sectional study was conducted from April to August 2015 to assess the knowledge of pharmacy students towards Naegleria fowleri infection. A questionnaire was distributed to senior pharmacy students in different private and public sector universities of Karachi. Descriptive statistics were used to demonstrate students' demographic information and their responses to the questionnaire. Pearson chi-square test was adopted to assess the relationship between independent variables and responses of students. The study revealed that pharmacy students were having adequate awareness of Naegleria fowleri infection and considered it as a serious health issue that necessitates instantaneous steps by the government to prevent the general public from the fatal neurological infection. The students recommended that appropriate methods should be projected in the community from time to time that increases public awareness about the associated risk factors. PMID:26981318

Critical scales to explain urban hydrological response: an application in Cranbrook, London

NASA Astrophysics Data System (ADS)

Cristiano, Elena; ten Veldhuis, Marie-Claire; Gaitan, Santiago; Ochoa Rodriguez, Susana; van de Giesen, Nick

2018-04-01

Rainfall variability in space and time, in relation to catchment characteristics and model complexity, plays an important role in explaining the sensitivity of hydrological response in urban areas. In this work we present a new approach to classify rainfall variability in space and time and we use this classification to investigate rainfall aggregation effects on urban hydrological response. Nine rainfall events, measured with a dual polarimetric X-Band radar instrument at the CAESAR site (Cabauw Experimental Site for Atmospheric Research, NL), were aggregated in time and space in order to obtain different resolution combinations. The aim of this work was to investigate the influence that rainfall and catchment scales have on hydrological response in urban areas. Three dimensionless scaling factors were introduced to investigate the interactions between rainfall and catchment scale and rainfall input resolution in relation to the performance of the model. Results showed that (1) rainfall classification based on cluster identification well represents the storm core, (2) aggregation effects are stronger for rainfall than flow, (3) model complexity does not have a strong influence compared to catchment and rainfall scales for this case study, and (4) scaling factors allow the adequate rainfall resolution to be selected to obtain a given level of accuracy in the calculation of hydrological response.

Temporal trends in receipt of adequate lymphadenectomy in bladder cancer 1988 to 2010.

PubMed

Cole, Alexander P; Dalela, Deepansh; Hanske, Julian; Mullane, Stephanie A; Choueiri, Toni K; Meyer, Christian P; Nguyen, Paul L; Menon, Mani; Kibel, Adam S; Preston, Mark A; Bellmunt, Joaquim; Trinh, Quoc-Dien

2015-12-01

The importance of pelvic lymphadenectomy (LND) for diagnostic and therapeutic purposes at the time of radical cystectomy (RC) for bladder cancer is well documented. Although some debate remains on the optimal number of lymph nodes removed, 10 nodes has been proposed as constituting an adequate LND. We used data from the Surveillance, Epidemiology, and End Results database to examine predictors and temporal trends in the receipt of an adequate LND at the time of RC for bladder cancer. Within the Surveillance, Epidemiology, and End Results database, we extracted data on all patients with nonmetastatic bladder cancer receiving RC in the years 1988 to 2010. First, we assess the proportion of individuals undergoing RC who received an adequate LND (≥10 nodes removed) over time. Second, we calculate odds ratios (ORs) of receiving an adequate LND using logistic regression modeling to compare study periods. Covariates included sex, race, age, region, tumor stage, urban vs. rural location, and insurance status. Among the 5,696 individuals receiving RC during the years 1988 to 2010, 2,576 (45.2%) received an adequate LND. Over the study period, the proportion of individuals receiving an adequate LND increased from 26.4% to 61.3%. The odds of receiving an adequate LND increased over the study period; a patient undergoing RC in 2008 to 2010 was over 4-fold more likely to receive an adequate LND relative to a patient treated in 1988 to 1991 (OR = 4.63, 95% CI: 3.32-6.45). In addition to time of surgery, tumor stage had a positive association with receipt of adequate LND (OR = 1.49 for stage IV [T4 N1 or N0] vs. stage I [T1 or Tis], 95% CI: 1.22-1.82). Age, sex, marital status, and race were not significant predictors of adequate LND. Adequacy of pelvic LND remains an important measure of surgical quality in bladder cancer. Our data show that over the years 1988 to 2010, the likelihood of receiving an adequate LND has increased substantially; however, a substantial minority of patients still does not receive LND. Further study into factors leading to adequate LND is needed to increase the use of this important technique. Copyright © 2015 Elsevier Inc. All rights reserved.

A critical point: the problems associated with the variety of criteria to quantify the antioxidant capacity.

PubMed

Prieto, M A; Vázquez, J A; Murado, M A

2014-06-18

The oxidant action implies interfering in an autocatalytic process, in which no less than five chemical species are present (oxygen, oxidizable substrate, radicals, antioxidants, and oxidation products); furthermore, reactions of first and second order can take place, and interactions can occur, at several levels of the process. The common and incorrect practice is to use the single-time dose-response of an established antioxidant as a calibration curve to compute the equivalent antioxidant capacity of a sample, which is only tested at one single time-dose, assuming too many false aspects as true. Its use is unreasonable, given the availability of computational applications and instrumental equipment that, combined, provide the adequate tools to work with different variables in nonlinear models. The evaluation of the dose-time dependency of the response of the β-carotene method as a case study, using the combination of strong quantification procedures and a high amount of results with lower experimental error (applying microplate readers), reveals the lack of meaning of single-time criteria. Also, it demonstrates that, in most of the reactions, the time-dependent response in the oxidation process is inherently nonlinear and should not be standardized at one single time, because it would lead to unreliable results, hiding the real aspects of the response. In food matrices, the application of single-time criteria causes deficiencies in the control of the antioxidant content. Therefore, it is logical that, in the past decade, researchers have claimed consensus to increase the determination and effectiveness of antioxidant responses.

Tool use for corpse cleaning in chimpanzees

NASA Astrophysics Data System (ADS)

van Leeuwen, Edwin J. C.; Cronin, Katherine A.; Haun, Daniel B. M.

2017-03-01

For the first time, chimpanzees have been observed using tools to clean the corpse of a deceased group member. A female chimpanzee sat down at the dead body of a young male, selected a firm stem of grass, and started to intently remove debris from his teeth. This report contributes novel behaviour to the chimpanzee’s ethogram, and highlights how crucial information for reconstructing the evolutionary origins of human mortuary practices may be missed by refraining from developing adequate observation techniques to capture non-human animals’ death responses.

Aligning the Mountain and the Molehill: How the Combatant Commander Coordinates his Theater Security Cooperation Plan with the State Department

DTIC Science & Technology

2005-02-14

hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed , and...the national level, the National Security Act of 1947 (NSA 47) mandates the need for interagency cooperation.6 In this regard, the National Security...within DoD, it lacks a central body or mechanism to provide the overarching, truly ’global’ oversight and guidance needed to ensure adequate interagency

A natural language based search engine for ICD10 diagnosis encoding.

PubMed

Baud, Robert

2004-01-01

We have developed a multiple step process for implementing an ICD10 search engine. The complexity of the task has been shown and we recommend collecting adequate expertise before starting any implementation. Underestimation of the expert time and inadequate data resources are probable reasons for failure. We also claim that when all conditions are met in term of resource and availability of the expertise, the benefits of a responsive ICD10 search engine will be present and the investment will be successful.

Does Size Matter? Atmospheric CO2 May Be a Stronger Driver of Stomatal Closing Rate Than Stomatal Size in Taxa That Diversified under Low CO2.

PubMed

Elliott-Kingston, Caroline; Haworth, Matthew; Yearsley, Jon M; Batke, Sven P; Lawson, Tracy; McElwain, Jennifer C

2016-01-01

One strategy for plants to optimize stomatal function is to open and close their stomata quickly in response to environmental signals. It is generally assumed that small stomata can alter aperture faster than large stomata. We tested the hypothesis that species with small stomata close faster than species with larger stomata in response to darkness by comparing rate of stomatal closure across an evolutionary range of species including ferns, cycads, conifers, and angiosperms under controlled ambient conditions (380 ppm CO2; 20.9% O2). The two species with fastest half-closure time and the two species with slowest half-closure time had large stomata while the remaining three species had small stomata, implying that closing rate was not correlated with stomatal size in these species. Neither was response time correlated with stomatal density, phylogeny, functional group, or life strategy. Our results suggest that past atmospheric CO2 concentration during time of taxa diversification may influence stomatal response time. We show that species which last diversified under low or declining atmospheric CO2 concentration close stomata faster than species that last diversified in a high CO2 world. Low atmospheric [CO2] during taxa diversification may have placed a selection pressure on plants to accelerate stomatal closing to maintain adequate internal CO2 and optimize water use efficiency.

Does Size Matter? Atmospheric CO2 May Be a Stronger Driver of Stomatal Closing Rate Than Stomatal Size in Taxa That Diversified under Low CO2

PubMed Central

Elliott-Kingston, Caroline; Haworth, Matthew; Yearsley, Jon M.; Batke, Sven P.; Lawson, Tracy; McElwain, Jennifer C.

2016-01-01

One strategy for plants to optimize stomatal function is to open and close their stomata quickly in response to environmental signals. It is generally assumed that small stomata can alter aperture faster than large stomata. We tested the hypothesis that species with small stomata close faster than species with larger stomata in response to darkness by comparing rate of stomatal closure across an evolutionary range of species including ferns, cycads, conifers, and angiosperms under controlled ambient conditions (380 ppm CO2; 20.9% O2). The two species with fastest half-closure time and the two species with slowest half-closure time had large stomata while the remaining three species had small stomata, implying that closing rate was not correlated with stomatal size in these species. Neither was response time correlated with stomatal density, phylogeny, functional group, or life strategy. Our results suggest that past atmospheric CO2 concentration during time of taxa diversification may influence stomatal response time. We show that species which last diversified under low or declining atmospheric CO2 concentration close stomata faster than species that last diversified in a high CO2 world. Low atmospheric [CO2] during taxa diversification may have placed a selection pressure on plants to accelerate stomatal closing to maintain adequate internal CO2 and optimize water use efficiency. PMID:27605929

[Moral specificity of the work of stomatologists].

PubMed

Gajda, Z

1989-01-01

The ethical problems in the work of the stomatologists are presented by the author in three aspects: has the stomatologist sufficiently good will? has he/she sufficient knowledge and skill? has he/she sufficient possibilities, that is sufficient time to give to the patient, adequate equipment and adequate remuneration. The author believes that the first factor is in the greatest degree dependent on the stomatologist, while the second factor is less dependent, and the third is least (in the national health service system). This means that the responsibility of the stomatologist is greatest in the first case, only half as great in the second case, and least or nearly none in the third case. Attention is called to the shortcomings in the university education of the stomatologists, and lack of continuous postgraduate training. Stress is laid also on inadequate technical equipment and overworking of the dentists. The specific moral problems of various stomatological specialities are mentioned.

Characterization Of Improved Binary Phase-Only Filters In A Real-Time Coherent Optical Correlation System

NASA Astrophysics Data System (ADS)

Flannery, D.; Keller, P.; Cartwright, S.; Loomis, J.

1987-06-01

Attractive correlation system performance potential is possible using magneto-optic spatial light modulators (SLM) to implement binary phase-only reference filters at high rates, provided the correlation performance of such reduced-information-content filters is adequate for the application. In the case studied here, the desired filter impulse response is a rectangular shape, which cannot be achieved with the usual binary phase-only filter formulation. The correlation application problem is described and techniques for synthesizing improved filter impulse response are considered. A compromise solution involves the cascading of a fixed amplitude-only weighting mask with the binary phase-only SLM. Based on simulations presented, this approach provides improved impulse responses and good correlation performance, while retaining the critical feature of real-time variations of the size, shape, and orientation of the rectangle by electronic programming of the phase pattern in the SLM. Simulations indicate that, for at least one very challenging input scene clutter situation, these filters provide higher correlation signal-to-noise than does "ideal" correlation, i.e. using a perfect rectangle filter response.

The influence of age, muscle strength and speed of information processing on recovery responses to external perturbations in gait.

PubMed

Senden, R; Savelberg, H H C M; Adam, J; Grimm, B; Heyligers, I C; Meijer, K

2014-01-01

Dynamic imbalance caused by external perturbations to gait can successfully be counteracted by adequate recovery responses. The current study investigated how the recovery response is moderated by age, walking speed, muscle strength and speed of information processing. The gait pattern of 50 young and 45 elderly subjects was repeatedly perturbed at 20% and 80% of the first half of the swing phase using the Timed Rapid impact Perturbation (TRiP) set-up. Recovery responses were identified using 2D cameras. Muscular factors (dynamometer) and speed of information processing parameters (computer-based reaction time task) were determined. The stronger, faster reacting and faster walking young subjects recovered more often by an elevating strategy than elderly subjects. Twenty three per cent of the differences in recovery responses were explained by a combination of walking speed (B=-13.85), reaction time (B=-0.82), maximum extension strength (B=0.01) and rate of extension moment development (B=0.19). The recovery response that subjects employed when gait was perturbed by the TRiP set-up was modified by several factors; the individual contribution of walking speed, muscle strength and speed of information processing was small. Insight into remaining modifying factors is needed to assist and optimise fall prevention programmes. Copyright © 2013 Elsevier B.V. All rights reserved.

IVF twins: buy one get one free?

PubMed

Ismail, Laura; Mittal, Monica; Kalu, Emmanuel

2012-10-01

There has been an overall increase in the incidence of multiple pregnancies and assisted reproduction technology is largely responsible for this rise. Although twins may appeal to couples undergoing in vitro fertilisation (IVF), they have been associated with serious health consequences to the babies, their mothers and the family unit, as well as having massive financial implications for the National Health Service. Transfer of more than one embryo during IVF is mainly responsible for IVF twins, and elective transfer of a single embryo at a time with cryopreservation of surplus embryos for later transfer has been shown to be an effective strategy to minimise the risk of twins without compromising IVF success rates. Factors that will impact on the success of the policy of elective single embryo transfer (eSET) include improvement in embryo selection for transfer, better cryopreservation techniques and adequate state funding for IVF. However, in implementing the policy of eSET it is important that each case is assessed on an individual basis since in some situations (e.g. in older women) the transfer of two embryos may be more cost effective. Adequate and continuous education of all stakeholders is essential if the policy of eSET is to be successful in the UK.

In vivo imaging of the neurovascular unit in CNS disease

PubMed Central

Merlini, Mario; Davalos, Dimitrios; Akassoglou, Katerina

2014-01-01

The neurovascular unit—comprised of glia, pericytes, neurons and cerebrovasculature—is a dynamic interface that ensures physiological central nervous system (CNS) functioning. In disease dynamic remodeling of the neurovascular interface triggers a cascade of responses that determine the extent of CNS degeneration and repair. The dynamics of these processes can be adequately captured by imaging in vivo, which allows the study of cellular responses to environmental stimuli and cell-cell interactions in the living brain in real time. This perspective focuses on intravital imaging studies of the neurovascular unit in stroke, multiple sclerosis (MS) and Alzheimer disease (AD) models and discusses their potential for identifying novel therapeutic targets. PMID:25197615

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...

Nephrology training in Australia and New Zealand: A survey of outcomes and adequacy.

PubMed

Beaton, Thomas J; Krishnasamy, Rathika; Toussaint, Nigel D; Phoon, Richard K; Gray, Nicholas A

2017-01-01

Advanced training programmes in nephrology should provide broad exposure to all aspects of nephrology. In Australia and New Zealand (ANZ), the Advanced Training Committee in Nephrology oversees training, and recent increases in trainee numbers have led to concern about dilution of experience. To investigate early career paths of nephrologists in ANZ and determine the adequacy of training by comparing self-determined competency and skill relevance among recently graduated nephrologists. In 2015, the Advanced Training Committee in Nephrology administered an online survey during the annual subscription for members of the Australian and New Zealand Society of Nephrology. Nephrologists who were awarded Fellowship after 2002 were invited to participate. The survey was completed by 113 Fellows with 8 respondents excluded (response rate 44.1%). Initial post-Fellowship work included full-time public hospital appointments (34.3%) or undertaking full-time higher research degrees (41.9%). The majority reported securing their desired employment. Respondents indicated adequate training in most clinical skills; however, responses of 'well trained' in home haemodialysis (41.8%), conservative care (42.9%), automated peritoneal dialysis (38.8%), and assessment of kidney transplant recipients (48%) and living kidney donors (34.7%) were less adequate. Although considered highly relevant to current practice, responses of 'well trained' were low for management and research skills, including complaint management (16.3%), private practice management (2%), health system knowledge (14.3%) and regulations (6.1%), ethics approval (23.5%), research funding (11.2%) and quality assurance (26.5%). Nephrology training in ANZ generally meets clinical needs and most secure their desired employment. Training in management and research are areas for improvement. © 2016 Asian Pacific Society of Nephrology.

Optimal design of clinical trials with biologics using dose-time-response models.

PubMed

Lange, Markus R; Schmidli, Heinz

2014-12-30

Biologics, in particular monoclonal antibodies, are important therapies in serious diseases such as cancer, psoriasis, multiple sclerosis, or rheumatoid arthritis. While most conventional drugs are given daily, the effect of monoclonal antibodies often lasts for months, and hence, these biologics require less frequent dosing. A good understanding of the time-changing effect of the biologic for different doses is needed to determine both an adequate dose and an appropriate time-interval between doses. Clinical trials provide data to estimate the dose-time-response relationship with semi-mechanistic nonlinear regression models. We investigate how to best choose the doses and corresponding sample size allocations in such clinical trials, so that the nonlinear dose-time-response model can be precisely estimated. We consider both local and conservative Bayesian D-optimality criteria for the design of clinical trials with biologics. For determining the optimal designs, computer-intensive numerical methods are needed, and we focus here on the particle swarm optimization algorithm. This metaheuristic optimizer has been successfully used in various areas but has only recently been applied in the optimal design context. The equivalence theorem is used to verify the optimality of the designs. The methodology is illustrated based on results from a clinical study in patients with gout, treated by a monoclonal antibody. Copyright © 2014 John Wiley & Sons, Ltd.

Is the level of knowledge a predictor of rational antibiotic use in Serbia?

PubMed

Horvat, Olga J; Tomas, Ana D; Paut Kusturica, Milica M; Savkov, Alisa V; Bukumirić, Dragica U; Tomić, Zdenko S; Sabo, Ana J

2017-01-01

The objective of this study was to investigate the knowledge, attitudes and behavior regarding antibiotics of the general population. The study sample consisted of adult subjects who consulted general practitioners at health centers in Serbia and agreed to complete the questionnaire. A total of 668 questionnaires were distributed; 500 respondents completed the entire questionnaire (response rate 74.85%). The average age was 51.65 ± 16.56 years, 60.80% of the respondents were women. The median antibiotic knowledge score was 9. Predictors of adequate antibiotic knowledge were higher education level and a family member whose ocuppation was related to health-care. Overall, 58.4% of respondents believed that antibiotics could be used to treat common cold. Around a half of the respondents (47.2%) self-medicated with antibiotics at least once during their life-time, and around a quarter (24.2%) during the last treatment of infection. Patients with inadequate knowledge had 3 times higher chances of self-medicating with antibiotics compared to those with adequate knowledge. Although 98.20% of respondents claimed that antibiotic treatment should be started after a visit to a doctor and receiving a prescription, only 65.8% obtained antibiotics with prescription from a doctor during the last infection. Although these results demonstrate that respondents had a relatively adequate level of knowledge regarding antibiotics use, some areas of misconceptions and improper behavior were identified. Therefore, further rationalization should be focused on educational campaigns targeting the behavior of patients with regard to antibiotic use.

Hybrid response surface methodology-artificial neural network optimization of drying process of banana slices in a forced convective dryer.

PubMed

Taheri-Garavand, Amin; Karimi, Fatemeh; Karimi, Mahmoud; Lotfi, Valiullah; Khoobbakht, Golmohammad

2018-06-01

The aim of the study is to fit models for predicting surfaces using the response surface methodology and the artificial neural network to optimize for obtaining the maximum acceptability using desirability functions methodology in a hot air drying process of banana slices. The drying air temperature, air velocity, and drying time were chosen as independent factors and moisture content, drying rate, energy efficiency, and exergy efficiency were dependent variables or responses in the mentioned drying process. A rotatable central composite design as an adequate method was used to develop models for the responses in the response surface methodology. Moreover, isoresponse contour plots were useful to predict the results by performing only a limited set of experiments. The optimum operating conditions obtained from the artificial neural network models were moisture content 0.14 g/g, drying rate 1.03 g water/g h, energy efficiency 0.61, and exergy efficiency 0.91, when the air temperature, air velocity, and drying time values were equal to -0.42 (74.2 ℃), 1.00 (1.50 m/s), and -0.17 (2.50 h) in the coded units, respectively.

Public health incident management: Logistical and operational aspects of the 2009 initial outbreak of H1N1 influenza in Mexico.

PubMed

Cruz, Miguel A; Hawk, Nicole M; Poulet, Christopher; Rovira, Jose; Rouse, Edward N

2015-01-01

Hosting an international outbreak response team can pose a challenge to jurisdictions not familiar with incident management frameworks. Basic principles of team forming, organizing, and executing mission critical activities require simple and flexible communication that can be easily understood by the host country's public health leadership and international support agencies. Familiarity with incident command system principles before a public health emergency could save time and effort during the initial phases of the response and aid in operationalizing and sustaining complex field activities throughout the response. The 2009 initial outbreak of H1N1 in Mexico highlighted the importance of adequately organizing and managing limited resources and expertise using incident management principles. This case study describes logistical and operational aspects of the response and highlights challenges faced during this response that may be relevant to the organization of public health responses and incidents requiring international assistance and cooperation.

Public health incident management: logistical and operational aspects of the 2009 initial outbreak of H1N1 influenza in Mexico.

PubMed

Cruz, Miguel A; Hawk, Nicole M; Poulet, Christopher; Rovira, Jose; Rouse, Edward N

2015-01-01

Hosting an international outbreak response team can pose a challenge to jurisdictions not familiar with incident management frameworks. Basic principles of team forming, organizing, and executing mission critical activities require simple and flexible communication that can be easily understood by the host country's public health leadership and international support agencies. Familiarity with incident command system principles before a public health emergency could save time and effort during the initial phases of the response and aid in operationalizing and sustaining complex field activities throughout the response. The 2009 initial outbreak of H1N1 in Mexico highlighted the importance of adequately organizing and managing limited resources and expertise using incident management principles. This case study describes logistical and operational aspects of the response and highlights challenges faced during this response that may be relevant to the organization of public health responses and incidents requiring international assistance and cooperation.

Selective suppression of the incorrect response implementation in choice behavior assessed by transcranial magnetic stimulation.

PubMed

Tandonnet, Christophe; Garry, Michael I; Summers, Jeffery J

2011-04-01

Selecting the adequate alternative in choice situations may involve an inhibition process. Here we assessed response implementation during the reaction time of a between-hand choice task with single- or paired-pulse (3 or 15 ms interstimulus intervals [ISIs]) transcranial magnetic stimulation of the motor cortex. The amplitude of the single-pulse motor evoked potential (MEP) initially increased for both hands. At around 130 ms, the single-pulse MEP kept increasing for the responding hand and decreased for the nonresponding hand. The paired-pulse MEP revealed a similar pattern for both ISIs with no effect on short intracortical inhibition and intracortical facilitation measures. The results suggest that the incorrect response implementation was selectively suppressed before execution of the correct response, preventing errors in choice context. The results favor models assuming that decision making involves an inhibition process. Copyright © 2010 Society for Psychophysiological Research.

Synthesis and characterization of stimuli-responsive polypropylene containing N-vinylcaprolactam and N-vinylimidazole obtained by ionizing radiation.

PubMed

Zavala-Lagunes, Edgar; Ruiz, Juan-Carlos; Varca, Gustavo H C; Bucio, Emilio

2016-10-01

Polypropylene films were grafted with thermo-responsive N-vinylcaprolactam and pH-responsive N-vinylimidazole polymers by means of gamma radiation using pre-irradiation and direct methods, in order to functionalize the films with thermo- and/or pH-responsiveness. The dependence of grafting yield on parameters such as co-monomer concentration, pre-irradiation dose, temperature, and reaction time was evaluated. The samples were characterized by Fourier transform infrared and X-ray photoelectron spectroscopies, differential scanning calorimetry, thermogravimetric analysis, swelling studies in different solvents, and water contact angle. The grafted copolymers presented thermo- and pH-sensitiveness, highlighting their potential as advanced biomaterials, capable of providing adequate environment for hosting and sustained release of antimicrobial drugs bearing cationic moieties, such as groups of diclofenac, while still exhibiting good cytocompatibility. Copyright © 2016 Elsevier B.V. All rights reserved.

Cognitive Profiles Associated with Responsiveness to Fraction Intervention

ERIC Educational Resources Information Center

Krowka, Sarah K.; Fuchs, Lynn S.

2017-01-01

This study examined differences in cognitive processing between 4th-grade students who respond adequately, as opposed to inadequately, to intervention on 3 fraction outcomes: number-line estimation, calculation, and word problems. Students were assessed on 7 cognitive processes and on the 3 fraction outcomes. Students were grouped as adequate or…

4 CFR 200.14 - Responsibility for maintaining adequate safeguards.

Code of Federal Regulations, 2010 CFR

2010-01-01

... identifiable personal data and automated systems shall be adequately trained in the security and privacy of... the security and privacy of such records. (5) The disposal and destruction of identifiable personal....14 Section 200.14 Accounts RECOVERY ACCOUNTABILITY AND TRANSPARENCY BOARD PRIVACY ACT OF 1974 § 200...

10 CFR 1304.114 - Responsibility for maintaining adequate safeguards.

Code of Federal Regulations, 2010 CFR

2010-01-01

... the security and privacy of personal data. (4) The disposal and disposition of identifiable personal... contained in a system of records are adequately trained to protect the security and privacy of such records....114 Section 1304.114 Energy NUCLEAR WASTE TECHNICAL REVIEW BOARD PRIVACY ACT OF 1974 § 1304.114...

4 CFR 200.14 - Responsibility for maintaining adequate safeguards.

Code of Federal Regulations, 2011 CFR

2011-01-01

... identifiable personal data and automated systems shall be adequately trained in the security and privacy of....14 Section 200.14 Accounts RECOVERY ACCOUNTABILITY AND TRANSPARENCY BOARD PRIVACY ACT OF 1974 § 200... records in which identifiable personal data are processed or maintained, including all reports and output...

Leadership Style and Adequate Yearly Progress: A Correlational Study of Effective Principal Leadership

ERIC Educational Resources Information Center

Leapley-Portscheller, Claudia Iris

2008-01-01

Principals are responsible for leading efforts to reach increasingly higher levels of student academic proficiency in schools associated with adequate yearly progress (AYP) requirements. The purpose of this quantitative, correlational study was to identify the degree to which perceptions of principal transformational, transactional, and…

Knowledge of Dentists on the Management of Tooth Avulsion Injuries in Rio de Janeiro, Brazil.

PubMed

Menezes, Mariana Cezário; Carvalho, Ricardo G; Accorsi-Mendonça, Thais; De-Deus, Gustavo; Moreira, Edson J L; Silva, Emmanuel J N L

2015-01-01

To evaluate dentists' professional experience and knowledge of emergency management of tooth avulsion injuries in Rio de Janeiro, Brazil. A total of 100 questionnaires were evaluated. The first part of the questionnaire consisted of questions regarding personal information. The second part evaluated dentists' knowledge of emergency management in cases of dental avulsion. The responses for each question were counted and expressed as percentages. All dentists had a college degree or above. Only three dentists had a Master's or PhD degree. Most of the dentists (94.5%) considered time and storage media important for the prognosis of avulsed teeth. However, the dentists did not show consistent responses about the adequate time and ideal storage media to transport avulsed teeth. The study highlighted Brazilian dentists' need for continuing education in order to improve current knowledge in emergency management of avulsed teeth.

Hemodynamic signal changes during saliva and water swallowing: a near-infrared spectroscopy study

NASA Astrophysics Data System (ADS)

Kober, Silvia Erika; Wood, Guilherme

2018-01-01

Here, we compared the hemodynamic response observed during swallowing of water or saliva using near-infrared spectroscopy (NIRS). Sixteen healthy adults swallowed water or saliva in a randomized order. Relative concentration changes in oxygenated and deoxygenated hemoglobin during swallowing were assessed. Both swallowing tasks led to the strongest NIRS signal change over the bilateral inferior frontal gyrus. Water swallowing led to a stronger activation over the right hemisphere while the activation focus for saliva swallowing was stronger left lateralized. The NIRS time course also differed between both swallowing tasks especially at the beginning of the tasks, which might be a sign of differences in task effort. Our results show that NIRS is a sensitive measure to reveal differences in the topographical distribution and time course of the hemodynamic response between distinct swallowing tasks and might be therefore an adequate diagnostic and therapy tool for swallowing difficulties.

Randomised clinical trial: rifaximin versus placebo for the treatment of functional dyspepsia.

PubMed

Tan, V P Y; Liu, K S H; Lam, F Y F; Hung, I F N; Yuen, M F; Leung, W K

2017-03-01

Gut dysbiosis may contribute to pain and bloating in patients with functional gastrointestinal disease. To determine if treatment with rifaximin would improve the symptoms of functional dyspepsia in Chinese patients in a double-blinded, randomised, placebo-controlled trial. Consecutive subjects with a diagnosis of functional dyspepsia as per the Rome III criteria were randomised to receive rifaximin 400 mg or placebo, all taken three times daily for 2 weeks. The investigators and study subjects were blinded to the treatment allocation. Subjects were followed up for 8 weeks. The primary end point was adequate relief of global dyspeptic symptoms (GDS). Secondary endpoints were relief of individual dyspeptic symptoms. Eighty-six subjects were recruited. At week 8, there were significantly more subjects in the rifaximin than in the placebo group who experienced adequate relief of GDS (78% vs. 52%, P = 0.02). A trend favouring rifaximin group was also noted in the preceding 4 weeks. Rifaximin was also superior to placebo in providing adequate relief of belching and post-prandial fullness/bloating (PPF) in subjects at week 4. Subgroup analysis revealed that female subjects had more significant response to rifaximin treatment (adequate relief of GDS at week 4: 76% vs. 42%, P = 0.006; week 8: 79% vs. 47%, P = 0.008), as well as improvements in their belching and PPF at week 4. The incidences of adverse effects were similar in both groups. Treatment with 2 weeks of rifaximin led to adequate relief of global dyspeptic symptoms, belching and post-prandial fullness/bloating in subjects with functional dyspepsia. The difference was more marked in females. (clinicaltrials.org NCT01643083). © 2017 John Wiley & Sons Ltd.

Transitioning from adequate to inadequate sleep duration associated with higher smoking rate and greater nicotine dependence in a population sample

PubMed Central

Patterson, Freda; Grandner, Michael A.; Lozano, Alicia; Satti, Aditi; Ma, Grace

2017-01-01

Introduction Inadequate sleep (≤6 and ≥9 h) is more prevalent in smokers than non-smokers but the extent to which sleep duration in smokers relates to smoking behaviors and cessation outcomes, is not yet clear. To begin to address this knowledge gap, we investigated the extent to which sleep duration predicted smoking behaviors and quitting intention in a population sample. Methods Data from current smokers who completed the baseline (N=635) and 5-year follow-up (N=477) assessment in the United Kingdom Biobank cohort study were analyzed. Multivariable regression models using smoking behavior outcomes (cigarettes per day, time to first cigarette, difficulty not smoking for a day, quitting intention) and sleep duration (adequate (7–8 h) versus inadequate (≤6 and ≥9 h) as the predictor were generated. All models adjusted for age, sex, race, and education. Results Worsening sleep duration (adequate to inadequate) predicted a more than three-fold higher odds in increased cigarettes per day (OR =3.18; 95% CI =1.25–8.06), a more than three-fold increased odds of not smoking for the day remaining difficult (OR =3.90; 95% CI =1.27–12.01), and a > 8-fold increased odds of higher nicotine dependence (OR= 8.98; 95% CI =2.81–28.66). Improving sleep duration (i.e., inadequate to adequate sleep) did not predict reduced cigarette consumption or nicotine dependence in this population sample. Conclusion Transitioning from adequate to inadequate sleep duration may be a risk factor for developing a more “hard-core” smoking profile. The extent to which achieving healthy sleep may promote, or optimize smoking cessation treatment response, warrants investigation. PMID:28950118

Prevalence and Predictors of Immunological Failure among HIV Patients on HAART in Southern Ethiopia.

PubMed

Yirdaw, Kesetebirhan Delele; Hattingh, Susan

2015-01-01

Immunological monitoring is part of the standard of care for patients on antiretroviral treatment. Yet, little is known about the routine implementation of immunological laboratory monitoring and utilization in clinical care in Ethiopia. This study assessed the pattern of immunological monitoring, immunological response, level of immunological treatment failure and factors related to it among patients on antiretroviral therapy in selected hospitals in southern Ethiopia. A retrospective longitudinal analytic study was conducted using documents of patients started on antiretroviral therapy. Adequacy of timely immunological monitoring was assessed every six months the first year and every one year thereafter. Immunological response was assessed every six months at cohort level. Immunological failure was based on the criteria: fall of follow-up CD4 cell count to baseline (or below), or CD4 levels persisting below 100 cells/mm3, or 50% fall from on-treatment peak value. A total of 1,321 documents of patients reviewed revealed timely immunological monitoring were inadequate. There was adequate immunological response, with pediatric patients, females, those with less advanced illness (baseline WHO Stage I or II) and those with higher baseline CD4 cell count found to have better immunological recovery. Thirty-nine patients (3%) were not evaluated for immunological failure because they had frequent treatment interruption. Despite overall adequate immunological response at group level, the prevalence of those who ever experienced immunological failure was 17.6% (n=226), while after subsequent re-evaluation it dropped to 11.5% (n=147). Having WHO Stage III/IV of the disease or a higher CD4 cell count at baseline was identified as a risk for immunological failure. Few patients with confirmed failure were switched to second line therapy. These findings highlight the magnitude of the problem of immunological failure and the gap in management. Prioritizing care for high risk patients may help in effective utilization of meager resources.

Prevalence and Predictors of Immunological Failure among HIV Patients on HAART in Southern Ethiopia

PubMed Central

2015-01-01

Immunological monitoring is part of the standard of care for patients on antiretroviral treatment. Yet, little is known about the routine implementation of immunological laboratory monitoring and utilization in clinical care in Ethiopia. This study assessed the pattern of immunological monitoring, immunological response, level of immunological treatment failure and factors related to it among patients on antiretroviral therapy in selected hospitals in southern Ethiopia. A retrospective longitudinal analytic study was conducted using documents of patients started on antiretroviral therapy. Adequacy of timely immunological monitoring was assessed every six months the first year and every one year thereafter. Immunological response was assessed every six months at cohort level. Immunological failure was based on the criteria: fall of follow-up CD4 cell count to baseline (or below), or CD4 levels persisting below 100 cells/mm3, or 50% fall from on-treatment peak value. A total of 1,321 documents of patients reviewed revealed timely immunological monitoring were inadequate. There was adequate immunological response, with pediatric patients, females, those with less advanced illness (baseline WHO Stage I or II) and those with higher baseline CD4 cell count found to have better immunological recovery. Thirty-nine patients (3%) were not evaluated for immunological failure because they had frequent treatment interruption. Despite overall adequate immunological response at group level, the prevalence of those who ever experienced immunological failure was 17.6% (n=226), while after subsequent re-evaluation it dropped to 11.5% (n=147). Having WHO Stage III/IV of the disease or a higher CD4 cell count at baseline was identified as a risk for immunological failure. Few patients with confirmed failure were switched to second line therapy. These findings highlight the magnitude of the problem of immunological failure and the gap in management. Prioritizing care for high risk patients may help in effective utilization of meager resources. PMID:25961732

Population density and racial differences in the performance of emergency medical services.

PubMed

David, Guy; Harrington, Scott E

2010-07-01

This paper analyzes the existence and scope of possible racial differences/disparities in the provision of emergency medical services (EMS) response capability (time from dispatch to arrival at the scene and level of training of the responding team) using data on approximately 120,000 cardiac incidents in the state of Mississippi during 1995-2004. The conceptual framework and empirical analysis focus on the likely effects of population density on the efficient production of EMS as a local public good subject to congestion, and on the need to control adequately for population density to avoid bias in testing for racial differences. Models that control for aggregate population density at the county-level indicate "reverse" disparities: faster estimated response times for African-Americans than for whites. When a refined county-level measure of population density is used that incorporates differences in African-American and white population density by Census tract, the reverse disparity in response times disappears. There also is little or no evidence of race-related differences in the certification level of EMS responders. However, there is evidence that, controlling for response time, African-Americans on average were significantly more likely to be deceased than whites upon EMS arrival at the scene. The overall results are germane to the debate over the scope of conditioning variables that should be included when testing for racial disparities in health care.

Computationally efficient optimization of radiation drives

NASA Astrophysics Data System (ADS)

Zimmerman, George; Swift, Damian

2017-06-01

For many applications of pulsed radiation, the temporal pulse shape is designed to induce a desired time-history of conditions. This optimization is normally performed using multi-physics simulations of the system, adjusting the shape until the desired response is induced. These simulations may be computationally intensive, and iterative forward optimization is then expensive and slow. In principle, a simulation program could be modified to adjust the radiation drive automatically until the desired instantaneous response is achieved, but this may be impracticable in a complicated multi-physics program. However, the computational time increment is typically much shorter than the time scale of changes in the desired response, so the radiation intensity can be adjusted so that the response tends toward the desired value. This relaxed in-situ optimization method can give an adequate design for a pulse shape in a single forward simulation, giving a typical gain in computational efficiency of tens to thousands. This approach was demonstrated for the design of laser pulse shapes to induce ramp loading to high pressure in target assemblies where different components had significantly different mechanical impedance, requiring careful pulse shaping. This work was performed under the auspices of the U.S. Department of Energy by Lawrence Livermore National Laboratory under Contract DE-AC52-07NA27344.

Efficient preloading of the ventricles by a properly timed atrial contraction underlies stroke work improvement in the acute response to cardiac resynchronization therapy

PubMed Central

Hu, Yuxuan; Gurev, Viatcheslav; Constantino, Jason; Trayanova, Natalia

2013-01-01

Background The acute response to cardiac resynchronization therapy (CRT) has been shown to be due to three mechanisms: resynchronization of ventricular contraction, efficient preloading of the ventricles by a properly timed atrial contraction, and mitral regurgitation reduction. However, the contribution of each of the three mechanisms to the acute response of CRT, specifically stroke work improvement, has not been quantified. Objective The goal of this study was to use an MRI-based anatomically accurate 3D model of failing canine ventricular electromechanics to quantify the contribution of each of the three mechanisms to stroke work improvement and identify the predominant mechanisms. Methods An MRI-based electromechanical model of the failing canine ventricles assembled previously by our group was further developed and modified. Three different protocols were used to dissect the contribution of each of the three mechanisms to stroke work improvement. Results Resynchronization of ventricular contraction did not lead to significant stroke work improvement. Efficient preloading of the ventricles by a properly timed atrial contraction was the predominant mechanism underlying stroke work improvement. Stroke work improvement peaked at an intermediate AV delay, as it allowed ventricular filling by atrial contraction to occur at a low diastolic LV pressure but also provided adequate time for ventricular filling before ventricular contraction. Diminution of mitral regurgitation by CRT led to stroke work worsening instead of improvement. Conclusion Efficient preloading of the ventricles by a properly timed atrial contraction is responsible for significant stroke work improvement in the acute CRT response. PMID:23928177

The Relationship between Adequate Yearly Progress and the Quality of Professional Development

ERIC Educational Resources Information Center

Wolff, Lori A.; McClelland, Susan S.; Stewart, Stephanie E.

2010-01-01

Based on publicly available data, the study examined the relationship between adequate yearly progress status and teachers' perceptions of the quality of their professional development. The sample included responses of 5,558 teachers who completed the questionnaire in the 2005-2006 school year. Results of the statistical analysis show a…

45 CFR 1182.15 - Institute responsibility for maintaining adequate technical, physical, and security safeguards to...

Code of Federal Regulations, 2010 CFR

2010-10-01

... record systems. These security safeguards shall apply to all systems in which identifiable personal data... data and automated systems shall be adequately trained in the security and privacy of personal data. (4... technical, physical, and security safeguards to prevent unauthorized disclosure or destruction of manual and...

45 CFR 2508.10 - Who has the responsibility for maintaining adequate technical, physical, and security safeguards...

Code of Federal Regulations, 2010 CFR

2010-10-01

... record systems. These security safeguards shall apply to all systems in which identifiable personal data... the security and privacy of such records. (7) The disposal and destruction of records within a system... adequate technical, physical, and security safeguards to prevent unauthorized disclosure or destruction of...

Response of western larch to site preparation

Treesearch

R. T. Graham; A. E. Harvey; M. F. Jurgensen; D. S. Page-Dumroese; J. R. Tonn; T. B. Jain

1995-01-01

Western larch (Larix occidentalis Nutt.) regenerates and grows adequately on a variety of soils and sites. Mineral soil and burned-over surfaces are excellent for natural regeneration, but organic surfaces also provide adequate seedbeds. Planted western larch are aggressive root producers especially in moist soils. Best development occurs in soils with high organic...

Experimental investigation of the unsteady response of premixed flame fronts to acoustic pressure waves

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

Wangher, Athena; Searby, Geoff; Quinard, Joel

Using OH{sup *} chemiluminescence, we measure the experimental unsteady response of a 1-D premixed flame to an acoustic pressure wave for a range of frequencies below and above the inverse of the flame transit time. We find that the response is positive and, at low frequency, the order of magnitude is comparable with existing theoretical analyses. However, if it is assumed that the chemiluminescence is proportional to the mass consumption rate, despite some uncertainty in the interpretation of the chemiluminescence signal we find that the frequency dependence of the measured response is not compatible with the predictions of the standardmore » flame model for one-step Arrhenius kinetics. A better, but not perfect, correlation is obtained for the heat release rate. We conclude that the standard model does not provide an adequate description of the unsteady response of real flames and that it is necessary to investigate more realistic chemical models. (author)« less

Motor responses to a steady beat.

PubMed

Schaefer, Rebecca S; Overy, Katie

2015-03-01

It is increasingly well established that music containing an isochronous pulse elicits motor responses at the levels of both brain and behavior. Such motor responses are often used in pedagogical and clinical practice to induce movement, particularly where motor functions are impaired. However, the complex nature of such apparently universal human responses has, arguably, not received adequate research attention to date. In particular, it should be noted that many adults, including those with disabilities, find it somewhat difficult to synchronize their movements with a beat with perfect accuracy; indeed, perfecting the skill of being musically "in time" can take years of training during childhood. Further research is needed on the nature of both the specificity and range of motor responses that can arise from the perception of a steady auditory pulse, with different populations, musical stimuli, conditions, and required levels of accuracy in order to better understand and capture the potential value of the musical beat as a pedagogical and therapeutic tool. © 2015 New York Academy of Sciences.

Neighbor detection at the leaf tip adaptively regulates upward leaf movement through spatial auxin dynamics

PubMed Central

Reinen, Emilie; Anten, Niels P. R.

2017-01-01

Vegetation stands have a heterogeneous distribution of light quality, including the red/far-red light ratio (R/FR) that informs plants about proximity of neighbors. Adequate responses to changes in R/FR are important for competitive success. How the detection and response to R/FR are spatially linked and how this spatial coordination between detection and response affects plant performance remains unresolved. We show in Arabidopsis thaliana and Brassica nigra that localized FR enrichment at the lamina tip induces upward leaf movement (hyponasty) from the petiole base. Using a combination of organ-level transcriptome analysis, molecular reporters, and physiology, we show that PIF-dependent spatial auxin dynamics are key to this remote response to localized FR enrichment. Using computational 3D modeling, we show that remote signaling of R/FR for hyponasty has an adaptive advantage over local signaling in the petiole, because it optimizes the timing of leaf movement in response to neighbors and prevents hyponasty caused by self-shading. PMID:28652357

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

Zhang, Yingchen; Tan, Jin; Krad, Ibrahim

Power system frequency needs to be maintained close to its nominal value at all times to successfully balance load and generation and maintain system reliability. Adequate primary frequency response and secondary frequency response are the primary forces to correct an energy imbalance at the second-to-minute level. As wind energy becomes a larger portion of the world's energy portfolio, there is an increased need for wind to provide frequency response. This paper addresses one of the major concerns about using wind for frequency regulation: the unknown factor of the interaction between primary and secondary reserves. The lack of a commercially availablemore » tool to model this has limited the energy industry's understanding of when the depletion of primary reserves will impact the performance of secondary response or vice versa. This paper investigates the issue by developing a multi-area frequency response integration tool with combined primary and secondary capabilities. The simulation is conducted in close coordination with economical energy scheduling scenarios to ensure credible simulation results.« less

Shape and Steepness of Toxicological Dose-Response Relationships of Continuous Endpoints

EPA Science Inventory

A re-analysis of a large number of historical dose-response data for continuous endpoints indicates that an exponential or a Hill model with four parameters both adequately describe toxicological dose-responses. The four parameters relate to the background response, the potency o...

Selective processing of auditory evoked responses with iterative-randomized stimulation and averaging: A strategy for evaluating the time-invariant assumption.

PubMed

Valderrama, Joaquin T; de la Torre, Angel; Medina, Carlos; Segura, Jose C; Thornton, A Roger D

2016-03-01

The recording of auditory evoked potentials (AEPs) at fast rates allows the study of neural adaptation, improves accuracy in estimating hearing threshold and may help diagnosing certain pathologies. Stimulation sequences used to record AEPs at fast rates require to be designed with a certain jitter, i.e., not periodical. Some authors believe that stimuli from wide-jittered sequences may evoke auditory responses of different morphology, and therefore, the time-invariant assumption would not be accomplished. This paper describes a methodology that can be used to analyze the time-invariant assumption in jittered stimulation sequences. The proposed method [Split-IRSA] is based on an extended version of the iterative randomized stimulation and averaging (IRSA) technique, including selective processing of sweeps according to a predefined criterion. The fundamentals, the mathematical basis and relevant implementation guidelines of this technique are presented in this paper. The results of this study show that Split-IRSA presents an adequate performance and that both fast and slow mechanisms of adaptation influence the evoked-response morphology, thus both mechanisms should be considered when time-invariance is assumed. The significance of these findings is discussed. Crown Copyright © 2016. Published by Elsevier B.V. All rights reserved.

Better Oversight Needed for Safety and Health Activities at DOE’s Nuclear Facilities.

DTIC Science & Technology

1981-08-04

States Acca !3ion Tor Kl. ; BRA&I DTIC TAi \\ • inounced Jusl Lfii I "• ’ DiStril on/ r\\ D i Avai3 i - ’•ity Coi a j...m*d——I—^1 I —* Even DOE’s audit report tracking system failed to adequately document corrective actions taken or planned. This system was...designed by DOE to ensure that corrective actions on audit report recommendations are responsive, timely and complete. Audit re- ports, such as ours

‘Once upon a time …’: Orphanhood, childhood studies and the depoliticisation of childhood poverty in southern Africa

PubMed Central

Ansell, Nicola

2015-01-01

Policy, interventions and research concerning southern African children remain dominated by a focus on AIDS-related orphanhood, although the association between orphanhood and disadvantage is highly questionable. I argue that the trope of the AIDS orphan serves a range of agendas, including for academic research. In particular, orphans represent the quintessential child-agent, celebrated in fairytales and fiction. Finally, I examine how this has led to a policy response – education bursaries – that cannot adequately address childhood poverty in the region. PMID:27217616

Biowarfare and bioterrorism.

PubMed

Christian, Michael D

2013-07-01

Bioterrorism is not only a reality of the times in which we live but bioweapons have been used for centuries. Critical care physicians play a major role in the recognition of and response to a bioterrorism attack. Critical care clinicians must be familiar with the diagnosis and management of the most likely bioterrorism agents, and also be adequately prepared to manage a mass casualty situation. This article reviews the epidemiology, diagnosis, and treatment of the most likely agents of biowarfare and bioterrorism. Crown Copyright © 2013. Published by Elsevier Inc. All rights reserved.

Norepinephrine and impulsivity: Effects of acute yohimbine

PubMed Central

Swann, Alan C.; Lijffijt, Marijn; Lane, Scott D.; Cox, Blake; Steinberg, Joel L.; Moeller, F. Gerard

2013-01-01

Rationale Rapid-response impulsivity, characterized by inability to withhold response to a stimulus until it is adequately appraised, is associated with risky behavior and may be increased in a state-dependent manner by norepinephrine. Objective We assessed effects of yohimbine, which increases norepinephrine release by blocking alpha-2 noradrenergic receptors, on plasma catecholamine metabolites, blood pressure, subjective symptoms, and laboratory-measured rapid-response impulsivity. Methods Subjects were twenty-three healthy controls recruited from the community, with normal physical examination and ECG, and negative history for hypertension, cardiovascular illness, and Axis I or II disorder. Blood pressure, pulse, and behavioral measures were obtained before and periodically after 0.4 mg/kg oral yohimbine or placebo in a randomized, counterbalanced design. Metabolites of norepinephrine (3-methoxy-4-hydroxyphenylglycol, MHPG; vanillylmandelic acid, VMA) and dopamine (homovanillic acid, HVA) were measured by high pressure liquid chromatography with electrochemical detection. Rapid-response impulsivity was measured by commission errors and reaction times on the Immediate Memory Task (IMT), a continuous performance test designed to measure impulsivity and attention. Results Yohimbine increased plasma MHPG and VMA but not HVA. Yohimbine increased systolic and diastolic blood pressure and pulse rate. On the IMT, yohimbine increased impulsive errors and impulsive response bias and accelerated reaction times. Yohimbine-associated increase in plasma MHPG correlated with increased impulsive response rates. Time courses varied; effects on blood pressure generally preceded those on metabolites and test performance. Conclusions These effects are consistent with increased rapid-response impulsivity after pharmacological noradrenergic stimulation in healthy controls. Labile noradrenergic responses, or increased sensitivity to norepinephrine, may increase risk for impulsive behavior. PMID:23559222

On pads and filters: Processing strong-motion data

USGS Publications Warehouse

Boore, D.M.

2005-01-01

Processing of strong-motion data in many cases can be as straightforward as filtering the acceleration time series and integrating to obtain velocity and displacement. To avoid the introduction of spurious low-frequency noise in quantities derived from the filtered accelerations, however, care must be taken to append zero pads of adequate length to the beginning and end of the segment of recorded data. These padded sections of the filtered acceleration need to be retained when deriving velocities, displacements, Fourier spectra, and response spectra. In addition, these padded and filtered sections should also be included in the time series used in the dynamic analysis of structures and soils to ensure compatibility with the filtered accelerations.

Stressed photoconductive detector for far-infrared space applications

NASA Technical Reports Server (NTRS)

Wang, J.-Q.; Richards, P. L.; Beeman, J. W.; Haller, E. E.

1987-01-01

An optimized leaf-spring apparatus for applying uniaxial stress to a Ge:Ga far-IR photoconductor has been designed and tested. This design has significant advantages for space applications which require high quantum efficiency and stable operation over long periods of time. The important features include adequate spring deflection with relatively small overall size, torque-free stress, easy measurement of applied stress, and a detector configuration with high responsivity. One-dimensional arrays of stressed photoconductors can be constructed using this design. A peak responsivity of 38 A/W is achieved in a detector with a cutoff wavelength of 200 microns, which was operated at a temperature of 2.0 K and a bias voltage equal to one-half of the breakdown voltage.

48 CFR 252.216-7002 - Alternate A, Time-and-Materials/Labor-Hour Proposal Requirements-Non-Commercial Item Acquisition...

Code of Federal Regulations, 2010 CFR

2010-10-01

...-Materials/Labor-Hour Proposal Requirements-Non-Commercial Item Acquisition With Adequate Price Competition... Requirements—Non-Commercial Item Acquisition With Adequate Price Competition. As prescribed in 216.601(e...-and-Materials/Labor-Hour Proposal Requirements—Non-Commercial Item Acquisition With Adequate Price...

Soil moisture mediates alpine life form and community productivity responses to warming.

PubMed

Winkler, Daniel E; Chapin, Kenneth J; Kueppers, Lara M

2016-06-01

Climate change is expected to alter primary production and community composition in alpine ecosystems, but the direction and magnitude of change is debated. Warmer, wetter growing seasons may increase productivity; however, in the absence of additional precipitation, increased temperatures may decrease soil moisture, thereby diminishing any positive effect of warming. Since plant species show individual responses to environmental change, responses may depend on community composition and vary across life form or functional groups. We warmed an alpine plant community at Niwot Ridge, Colorado continuously for four years to test whether warming increases or decreases productivity of life form groups and the whole community. We provided supplemental water to a subset of plots to alleviate the drying effect of warming. We measured annual above-ground productivity and soil temperature and moisture, from which we calculated soil degree days and adequate soil moisture days. Using an information-theoretic approach, we observed that positive productivity responses to warming at the community level occur only when warming is combined with supplemental watering; otherwise we observed decreased productivity. Watering also increased community productivity in the absence of warming. Forbs accounted for the majority of the productivity at the site and drove the contingent community response to warming, while cushions drove the generally positive response to watering and graminoids muted the community response. Warming advanced snowmelt and increased soil degree days, while watering increased adequate soil moisture days. Heated and watered plots had more adequate soil moisture days than heated plots. Overall, measured changes in soil temperature and moisture in response to treatments were consistent with expected productivity responses. We found that available soil moisture largely determines the responses of this forb-dominated alpine community to simulated climate warming. © 2016 by the Ecological Society of America.

A diagnostic for quantifying heat flux from a thermite spray

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

E. P. Nixon; M. L. Pantoya; D. J. Prentice

2010-02-01

Characterizing the combustion behaviors of energetic materials requires diagnostic tools that are often not readily or commercially available. For example, a jet of thermite spray provides a high temperature and pressure reaction that can also be highly corrosive and promote undesirable conditions for the survivability of any sensor. Developing a diagnostic to quantify heat flux from a thermite spray is the objective of this study. Quick response sensors such as thin film heat flux sensors cannot survive the harsh conditions of the spray, but more rugged sensors lack the response time for the resolution desired. A sensor that will allowmore » for adequate response time while surviving the entire test duration was constructed. The sensor outputs interior temperatures of the probes at known locations and utilizes an inverse heat conduction code to calculate heat flux values. The details of this device are discussed and illustrated. Temperature and heat flux measurements of various thermite sprays are reported. Results indicate that this newly designed heat flux sensor provides quantitative data with good repeatability suitable for characterizing energetic material combustion.« less

QUANTIFICATION OF HEAT FLUX FROM A REACTING THERMITE SPRAY

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

Eric Nixon; Michelle Pantoya

2009-07-01

Characterizing the combustion behaviors of energetic materials requires diagnostic tools that are often not readily or commercially available. For example, a jet of thermite spray provides a high temperature and pressure reaction that can also be highly corrosive and promote undesirable conditions for the survivability of any sensor. Developing a diagnostic to quantify heat flux from a thermite spray is the objective of this study. Quick response sensors such as thin film heat flux sensors can not survive the harsh conditions of the spray, but more rugged sensors lack the response time for the resolution desired. A sensor that willmore » allow for adequate response time while surviving the entire test duration was constructed. The sensor outputs interior temperatures of the probes at known locations and utilizes an inverse heat conduction code to calculate heat flux values. The details of this device are discussed and illustrated. Temperature and heat flux measurements of various thermite spray conditions are reported. Results indicate that this newly developed energetic material heat flux sensor provides quantitative data with good repeatability.« less

Biochemical responses to dietary α-linolenic acid restriction proceed differently among brain regions in mice.

PubMed

Miyazawa, Daisuke; Yasui, Yuko; Yamada, Kazuyo; Ohara, Naoki; Okuyama, Harumi

2011-08-01

Previously, we noted that the dietary restriction of α-linolenic acid (ALA, n-3) for 4 weeks after weaning brought about significant decreases in the BDNF content and p38 MAPK activity in the striatum of mice, but not in the other regions of the brain, compared with an ALA- and linoleic acid (LNA, n-6)-adequate diet. In this study, we examined whether a prolonged dietary manipulation induces biochemical changes in other regions of the brain as well. Mice were fed a safflower oil (SAF) diet (ALA-restricted, LNA-adequate) or a perilla oil (PER) diet (containing adequate amounts of ALA and LNA) for 8 weeks from weaning. The docosahexaenoic acid (DHA, 22:6n-3) contents and p38 MAPK activities in the cerebral cortex, striatum and hippocampus were significantly lower in the SAF group. The BDNF contents and protein kinase C (PKC) activities in the cerebral cortex as well as in the striatum, but not in the hippocampus, were significantly lower in the SAF group. These data indicate that the biochemical changes induced by the dietary restriction of ALA have a time lag in the striatum and cortex, suggesting that the signal is transmitted through decreased p38 MAPK activity and BDNF content and ultimately decreased PKC activity.

48 CFR 52.216-30 - Time-and-Materials/Labor-Hour Proposal Requirements-Non-Commercial Item Acquisition without...

Code of Federal Regulations, 2010 CFR

2010-10-01

...-Hour Proposal Requirements-Non-Commercial Item Acquisition without Adequate Price Competition. 52.216... Price Competition. As prescribed in 16.601(e)(2), insert the following provision: Time-and-Materials/Labor-Hour Proposal Requirements—Non-Commercial Item Acquisition Without Adequate Price Competition (FEB...

23 CFR 710.201 - State responsibilities.

Code of Federal Regulations, 2010 CFR

2010-04-01

... responsibilities. (b) Program oversight. The STD shall have overall responsibility for the acquisition, management... acquisitions and disposals by a State agency are made in compliance with legal requirements of State and... maintain adequate records of its acquisition and property management activities. (1) Acquisition records...

Naphthalene biodegradation in temperate and arctic marine microcosms.

PubMed

Bagi, Andrea; Pampanin, Daniela M; Lanzén, Anders; Bilstad, Torleiv; Kommedal, Roald

2014-02-01

Naphthalene, the smallest polycyclic aromatic hydrocarbon (PAH), is found in abundance in crude oil, its major source in marine environments. PAH removal occurs via biodegradation, a key process determining their fate in the sea. Adequate estimation of PAH biodegradation rates is essential for environmental risk assessment and response planning using numerical models such as the oil spill contingency and response (OSCAR) model. Using naphthalene as a model compound, biodegradation rate, temperature response and bacterial community composition of seawaters from two climatically different areas (North Sea and Arctic Ocean) were studied and compared. Naphthalene degradation was followed by measuring oxygen consumption in closed bottles using the OxiTop(®) system. Microbial communities of untreated and naphthalene exposed samples were analysed by polymerase chain reaction denaturing gradient gel electrophoresis (PCR-DGGE) and pyrosequencing. Three times higher naphthalene degradation rate coefficients were observed in arctic seawater samples compared to temperate, at all incubation temperatures. Rate coefficients at in situ temperatures were however, similar (0.048 day(-1) for temperate and 0.068 day(-1) for arctic). Naphthalene biodegradation rates decreased with similar Q10 ratios (3.3 and 3.5) in both seawaters. Using the temperature compensation method implemented in the OSCAR model, Q10 = 2, biodegradation in arctic seawater was underestimated when calculated from the measured temperate k1 value, showing that temperature difference alone could not predict biodegradation rates adequately. Temperate and arctic untreated seawater communities were different as revealed by pyrosequencing. Geographic origin of seawater affected the community composition of exposed samples.

The effect of pathophysiology on pharmacokinetics in the critically ill patient--concepts appraised by the example of antimicrobial agents.

PubMed

Blot, Stijn I; Pea, Federico; Lipman, Jeffrey

2014-11-20

Critically ill patients are at high risk for development of life-threatening infection leading to sepsis and multiple organ failure. Adequate antimicrobial therapy is pivotal for optimizing the chances of survival. However, efficient dosing is problematic because pathophysiological changes associated with critical illness impact on pharmacokinetics of mainly hydrophilic antimicrobials. Concentrations of hydrophilic antimicrobials may be increased because of decreased renal clearance due to acute kidney injury. Alternatively, antimicrobial concentrations may be decreased because of increased volume of distribution and augmented renal clearance provoked by systemic inflammatory response syndrome, capillary leak, decreased protein binding and administration of intravenous fluids and inotropes. Often multiple conditions that may influence pharmacokinetics are present at the same time thereby excessively complicating the prediction of adequate concentrations. In general, conditions leading to underdosing are predominant. Yet, since prediction of serum concentrations remains difficult, therapeutic drug monitoring for individual fine-tuning of antimicrobial therapy seems the way forward. Copyright © 2014. Published by Elsevier B.V.

Primary Care Practices' Abilities And Challenges In Using Electronic Health Record Data For Quality Improvement.

PubMed

Cohen, Deborah J; Dorr, David A; Knierim, Kyle; DuBard, C Annette; Hemler, Jennifer R; Hall, Jennifer D; Marino, Miguel; Solberg, Leif I; McConnell, K John; Nichols, Len M; Nease, Donald E; Edwards, Samuel T; Wu, Winfred Y; Pham-Singer, Hang; Kho, Abel N; Phillips, Robert L; Rasmussen, Luke V; Duffy, F Daniel; Balasubramanian, Bijal A

2018-04-01

Federal value-based payment programs require primary care practices to conduct quality improvement activities, informed by the electronic reports on clinical quality measures that their electronic health records (EHRs) generate. To determine whether EHRs produce reports adequate to the task, we examined survey responses from 1,492 practices across twelve states, supplemented with qualitative data. Meaningful-use participation, which requires the use of a federally certified EHR, was associated with the ability to generate reports-but the reports did not necessarily support quality improvement initiatives. Practices reported numerous challenges in generating adequate reports, such as difficulty manipulating and aligning measurement time frames with quality improvement needs, lack of functionality for generating reports on electronic clinical quality measures at different levels, discordance between clinical guidelines and measures available in reports, questionable data quality, and vendors that were unreceptive to changing EHR configuration beyond federal requirements. The current state of EHR measurement functionality may be insufficient to support federal initiatives that tie payment to clinical quality measures.

Primary Care Practices’ Abilities And Challenges In Using Electronic Health Record Data For Quality Improvement

PubMed Central

Cohen, Deborah J.; Dorr, David A.; Knierim, Kyle; DuBard, C. Annette; Hemler, Jennifer R.; Hall, Jennifer D.; Marino, Miguel; Solberg, Leif I.; McConnell, K. John; Nichols, Len M.; Nease, Donald E.; Edwards, Samuel T.; Wu, Winfred Y.; Pham-Singer, Hang; Kho, Abel N.; Phillips, Robert L.; Rasmussen, Luke V.; Duffy, F. Daniel; Balasubramanian, Bijal A.

2018-01-01

Federal value-based payment programs require primary care practices to conduct quality improvement activities, informed by the electronic reports on clinical quality measures that their electronic health records (EHRs) generate. To determine whether EHRs produce reports adequate to the task, we examined survey responses from 1,492 practices across twelve states, supplemented with qualitative data. Meaningful-use participation, which requires the use of a federally certified EHR, was associated with the ability to generate reports—but the reports did not necessarily support quality improvement initiatives. Practices reported numerous challenges in generating adequate reports, such as difficulty manipulating and aligning measurement time frames with quality improvement needs, lack of functionality for generating reports on electronic clinical quality measures at different levels, discordance between clinical guidelines and measures available in reports, questionable data quality, and vendors that were unreceptive to changing EHR configuration beyond federal requirements. The current state of EHR measurement functionality may be insufficient to support federal initiatives that tie payment to clinical quality measures. PMID:29608365

Clinical radiological aspects of primary endodontic lesions with secondary periodontal involvement

PubMed Central

Jivoinovici, R; Suciu, Ileana; Gheorghiu, I; Suciu, Ioana

2017-01-01

Damage of pulp tissue usually begins in the coronal pulp. Its mistreatment or its lack of on time detection determines the progressive inclusion of the whole endodontic space in its evolution, opening the way of its expansion in the surrounding tissues of the tooth, and on the marginal apical tissue. Aim. The goal of this study was to highlight that the primary endodontic lesions with secondary periodontal implication healed and bone repair was obtained due to a proper disinfection and an adequate sealing of the endodontic system. In primary endodontic lesion with secondary periodontal involvement, endodontic treatment is required in the first stage followed by specific periodontal treatment. The prognosis is good if an appropriate endodontic approach is chosen, depending on the stage of the periodontal disease and the treatment response. The identification of the etiological factors is the most important to establish the appropriate treatment. In all clinical cases selected in this article, the healing tendency was noticed after an adequate disinfection and sealing of the endodontic system. PMID:28255382

Interval timing under a behavioral microscope: Dissociating motivational and timing processes in fixed-interval performance.

PubMed

Daniels, Carter W; Sanabria, Federico

2017-03-01

The distribution of latencies and interresponse times (IRTs) of rats was compared between two fixed-interval (FI) schedules of food reinforcement (FI 30 s and FI 90 s), and between two levels of food deprivation. Computational modeling revealed that latencies and IRTs were well described by mixture probability distributions embodying two-state Markov chains. Analysis of these models revealed that only a subset of latencies is sensitive to the periodicity of reinforcement, and prefeeding only reduces the size of this subset. The distribution of IRTs suggests that behavior in FI schedules is organized in bouts that lengthen and ramp up in frequency with proximity to reinforcement. Prefeeding slowed down the lengthening of bouts and increased the time between bouts. When concatenated, latency and IRT models adequately reproduced sigmoidal FI response functions. These findings suggest that behavior in FI schedules fluctuates in and out of schedule control; an account of such fluctuation suggests that timing and motivation are dissociable components of FI performance. These mixture-distribution models also provide novel insights on the motivational, associative, and timing processes expressed in FI performance. These processes may be obscured, however, when performance in timing tasks is analyzed in terms of mean response rates.

Factors associated with adequate weekly reporting for disease surveillance data among health facilities in Nairobi County, Kenya, 2013.

PubMed

Mwatondo, Athman Juma; Ng'ang'a, Zipporah; Maina, Caroline; Makayotto, Lyndah; Mwangi, Moses; Njeru, Ian; Arvelo, Wences

2016-01-01

Kenya adopted the Integrated Disease Surveillance and Response (IDSR) strategy in 1998 to strengthen disease surveillance and epidemic response. However, the goal of weekly surveillance reporting among health facilities has not been achieved. We conducted a cross-sectional study to determine the prevalence of adequate reporting and factors associated with IDSR reporting among health facilities in one Kenyan County. Health facilities (public and private) were enrolled using stratified random sampling from 348 facilities prioritized for routine surveillance reporting. Adequately-reporting facilities were defined as those which submitted >10 weekly reports during a twelve-week period and a poor reporting facilities were those which submitted <10 weekly reports. Multivariate logistic regression with backward selection was used to identify risk factors associated with adequate reporting. From September 2 through November 30, 2013, we enrolled 175 health facilities; 130(74%) were private and 45(26%) were public. Of the 175 health facilities, 77 (44%) facilities classified as adequate reporting and 98 (56%) were reporting poorly. Multivariate analysis identified three factors to be independently associated with weekly adequate reporting: having weekly reporting forms at visit (AOR19, 95% CI: 6-65], having posters showing IDSR functions (AOR8, 95% CI: 2-12) and having a designated surveillance focal person (AOR7, 95% CI: 2-20). The majority of health facilities in Nairobi County were reporting poorly to IDSR and we recommend that the Ministry of Health provide all health facilities in Nairobi County with weekly reporting tools and offer specific trainings on IDSR which will help designate a focal surveillance person.

Accounting for the influence of salt water in the physics required for processing underwater UXO EMI signals

NASA Astrophysics Data System (ADS)

Shubitidze, Fridon; Barrowes, Benjamin E.; Shamatava, Irma; Sigman, John; O'Neill, Kevin A.

2018-05-01

Processing electromagnetic induction signals from subsurface targets, for purposes of discrimination, requires accurate physical models. To date, successful approaches for on-land cases have entailed advanced modeling of responses by the targets themselves, with quite adequate treatment of instruments as well. Responses from the environment were typically slight and/or were treated very simply. When objects are immersed in saline solutions, however, more sophisticated modeling of the diffusive EMI physics in the environment is required. One needs to account for the response of the environment itself as well as the environment's frequency and time-dependent effects on both primary and secondary fields, from sensors and targets, respectively. Here we explicate the requisite physics and identify its effects quantitatively via analytical, numerical, and experimental investigations. Results provide a path for addressing the quandaries posed by previous underwater measurements and indicate how the environmental physics may be included in more successful processing.

Countermeasures to Neurobehavioral Deficits from Cumulative Partial Sleep Deprivation During Space Flight

NASA Technical Reports Server (NTRS)

Dinges, David F.

1999-01-01

This project is concerned with identifying ways to prevent neurobehavioral and physical deterioration due to inadequate sleep in astronauts during long-duration manned space flight. The performance capability of astronauts during extended-duration space flight depends heavily on achieving recovery through adequate sleep. Even with appropriate circadian alignment, sleep loss can erode fundamental elements of human performance capability including vigilance, cognitive speed and accuracy, working memory, reaction time, and physiological alertness. Adequate sleep is essential during manned space flight not only to ensure high levels of safe and effective human performance, but also as a basic regulatory biology critical to healthy human functioning. There is now extensive objective evidence that astronaut sleep is frequently restricted in space flight to averages between 4 hr and 6.5 hr/day. Chronic sleep restriction during manned space flight can occur in response to endogenous disturbances of sleep (motion sickness, stress, circadian rhythms), environmental disruptions of sleep (noise, temperature, light), and curtailment of sleep due to the work demands and other activities that accompany extended space flight operations. The mechanism through which this risk emerges is the development of cumulative homeostatic pressure for sleep across consecutive days of inadequate sleep. Research has shown that the physiological sleepiness and performance deficits engendered by sleep debt can progressively worsen (i.e., accumulate) over consecutive days of sleep restriction, and that sleep limited to levels commonly experienced by astronauts (i.e., 4 - 6 hr per night) for as little as 1 week, can result in increased lapses of attention, degradation of response times, deficits in complex problem solving, reduced learning, mood disturbance, disruption of essential neuroendocrine, metabolic, and neuroimmune responses, and in some vulnerable persons, the emergence of uncontrolled sleep attacks. The prevention of cumulative performance deficits and neuroendocrine disruption from sleep restriction during extended duration space flight involves finding the most effective ways to obtain sleep in order to maintain the high-level cognitive and physical performance functions required for manned space flight. There is currently a critical deficiency in knowledge of the effects of how variations in sleep duration and timing relate to the most efficient return of performance per unit time invested in sleep during long-duration missions, and how the nature of sleep physiology (i.e., sleep stages, sleep electroencephalographic [EEG] power spectral analyses) change as a function of sleep restriction and performance degradation. The primary aim of this project is to meet these critical deficiencies through utilization of a response surface experimental paradigm, testing in a dose-response manner, varying combinations of sleep duration and timing, for the purpose of establishing how to most effectively limit the cumulative adverse effects on human performance and physiology of chronic sleep restriction in space operations.

What Response Rates Are Needed to Make Reliable Inferences from Student Evaluations of Teaching?

ERIC Educational Resources Information Center

Zumrawi, Abdel Azim; Bates, Simon P.; Schroeder, Marianne

2014-01-01

This paper addresses the determination of statistically desirable response rates in students' surveys, with emphasis on assessing the effect of underlying variability in the student evaluation of teaching (SET). We discuss factors affecting the determination of adequate response rates and highlight challenges caused by non-response and lack of…

Response-to-Intervention: Understanding General Education Teacher Knowledge and Implementation

ERIC Educational Resources Information Center

Benjamin, Elissa M.

2011-01-01

The new IDEIA (2004) mandates regarding the implementation of Response-to-Intervention (RtI) present challenges for general education teachers. The law dictates the implementation of Response-to-Intervention, which requires the application of a pyramid of interventions for students failing to make adequate yearly progress in response to general…

Orphan care in Botswana's working households: growing responsibilities in the absence of adequate support.

PubMed

Miller, Candace M; Gruskin, Sofia; Subramanian, S V; Rajaraman, Divya; Heymann, S Jody

2006-08-01

Botswana has one of the world's highest HIV-prevalence rates and the world's highest percentages of orphaned children among its population. We assessed the ability of income-earning households in Botswana to adequately care for orphans. We used data from the Botswana Family Health Needs Study (2002), a sample of 1033 working adults with caregiving responsibilities who used public services, to assess whether households with orphan-care responsibilities encountered financial and other difficulties. Thirty-seven percent of respondents provided orphan care, usually to extended family members. We applied logistic regression models to determine the factors associated with experiencing problems related to orphan caregiving. Nearly half of working households with orphan-care responsibilities reported experiencing financial and other difficulties because of orphan care. Issues of concern included caring for multiple orphans, caring for sick adults and orphans simultaneously, receiving no assistance, and low income. The orphan crisis is impoverishing even working households, where caregivers lack sufficient resources to provide basic needs. Neither the public sector nor communities provide adequate safety nets. International assistance is critical to build capacity within the social welfare infrastructure and to fund community-level activities that support households. Lessons from Botswana's orphan crisis can provide valuable insights to policymakers throughout sub-Saharan Africa.

Inadequate peak expiratory flow meter characteristics detected by a computerised explosive decompression device.

PubMed

Miller, M R; Atkins, P R; Pedersen, O F

2003-05-01

Recent evidence suggests that the frequency response requirements for peak expiratory flow (PEF) meters are higher than was first thought and that the American Thoracic Society (ATS) waveforms to test PEF meters may not be adequate for the purpose. The dynamic response of mini-Wright (MW), Vitalograph (V), TruZone (TZ), MultiSpiro (MS) and pneumotachograph (PT) flow meters was tested by delivering two differently shaped flow-time profiles from a computer controlled explosive decompression device fitted with a fast response solenoid valve. These profiles matched population 5th and 95th centiles for rise time from 10% to 90% of PEF and dwell time of flow above 90% PEF. Profiles were delivered five times with identical chamber pressure and solenoid aperture at PEF. Any difference in recorded PEF for the two profiles indicates a poor dynamic response. The absolute (% of mean) flow differences in l/min for the V, MW, and PT PEF meters were 25 (4.7), 20 (3.9), and 2 (0.3), respectively, at PEF approximately 500 l/min, and 25 (10.5), 20 (8.7) and 6 (3.0) at approximately 200 l/min. For TZ and MS meters at approximately 500 l/min the differences were 228 (36.1) and 257 (39.2), respectively, and at approximately 200 l/min they were 51 (23.9) and 1 (0.5). All the meters met ATS accuracy requirements when tested with their waveforms. An improved method for testing the dynamic response of flow meters detects marked overshoot (underdamping) of TZ and MS responses not identified by the 26 ATS waveforms. This error could cause patient misclassification when using such meters with asthma guidelines.

Adaptive allocation of decisionmaking responsibility between human and computer in multitask situations

NASA Technical Reports Server (NTRS)

Chu, Y.-Y.; Rouse, W. B.

1979-01-01

As human and computer come to have overlapping decisionmaking abilities, a dynamic or adaptive allocation of responsibilities may be the best mode of human-computer interaction. It is suggested that the computer serve as a backup decisionmaker, accepting responsibility when human workload becomes excessive and relinquishing responsibility when workload becomes acceptable. A queueing theory formulation of multitask decisionmaking is used and a threshold policy for turning the computer on/off is proposed. This policy minimizes event-waiting cost subject to human workload constraints. An experiment was conducted with a balanced design of several subject runs within a computer-aided multitask flight management situation with different task demand levels. It was found that computer aiding enhanced subsystem performance as well as subjective ratings. The queueing model appears to be an adequate representation of the multitask decisionmaking situation, and to be capable of predicting system performance in terms of average waiting time and server occupancy. Server occupancy was further found to correlate highly with the subjective effort ratings.

Identification of Nonfatal Strangulation by 911 Dispatchers: Suggestions for Advances Toward Evidence-Based Prosecution.

PubMed

Reckdenwald, Amy; Nordham, Chelsea; Pritchard, Adam; Francis, Brielle

2017-06-01

Research highlights the need for systematic law enforcement training on nonfatal strangulation in domestic violence situations to improve evidence-based prosecution of these violent felonies. However, most of this research focuses on the role of police officers in the safety response. Although often overlooked, this research examines the role of 911 dispatchers, who are many times the first person the victim calls for assistance. This study examines official domestic violence records, gathered through a partnership with a County Sheriff's agency, to determine whether domestic violence strangulation is being adequately identified and documented by first responders. This research highlights the need for considering 911 dispatchers as having a potentially critical role in a comprehensive response to domestic violence strangulation from initial screening to eventual prosecution.

Barriers to implementing infection prevention and control guidelines during crises: experiences of health care professionals.

PubMed

Timen, Aura; Hulscher, Marlies E J L; Rust, Laura; van Steenbergen, Jim E; Akkermans, Reinier P; Grol, Richard P T M; van der Meer, Jos W M

2010-11-01

Communicable disease crises can endanger the health care system and often require special guidelines. Understanding reasons for nonadherence to crisis guidelines is needed to improve crisis management. We identified and measured barriers and conditions for optimal adherence as perceived by 4 categories of health care professionals. In-depth interviews were performed (n = 26) to develop a questionnaire for a cross-sectional survey of microbiologists (100% response), infection preventionists (74% response), public health physicians (96% response), and public health nurses (82% response). The groups were asked to appraise barriers encountered during 4 outbreaks (severe acute respiratory syndrome [SARS], Clostridium difficile ribotype 027, rubella, and avian influenza) according to a 5-point Likert scale. When at least 33% of the participants responded "strongly agree," "agree," or "rather agree than disagree," a barrier was defined as "often experienced." The common ("generic") barriers were included in a univariate and multivariate model. Barriers specific to the various groups were studied as well. Crisis guidelines were found to have 4 generic barriers to adherence: (1) lack of imperative or precise wording, (2) lack of easily identifiable instructions specific to each profession, (3) lack of concrete performance targets, and (4) lack of timely and adequate guidance on personal protective equipment and other safety measures. The cross-sectional study also yielded profession-specific sets of often-experienced barriers. To improve adherence to crisis guidelines, the generic barriers should be addressed when developing guidelines, irrespective of the infectious agent. Profession-specific barriers require profession-specific strategies to change attitudes, ensure organizational facilities, and provide an adequate setting for crisis management. Copyright © 2010 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

[Limits of conventional oral and transdermal medication in Parkinson's disease].

PubMed

García-Ruiz, Pedro J; Luquin, M Rosario

2012-01-01

At the present time, we have effective and potent antiparkinsonian drugs available which allow patients to have an acceptable functional capacity during the early years of Parkinson's disease. Yet, as time goes by, motor and functional deterioration develop, partly due to the presence of motor and non-motor complications. The conventional medication is unable to provide an adequate response if the motor fluctuations are beyond 3-4 hours of duration. At this point, it is reasonable to consider other therapies; among them subcutaneous apomorphine injection must be taken into account due to its simplicity and efficacy and later on, subcutaneous apomorphine infusion. Apomorphine is a very effective and clearly underused drug in the treatment of advanced Parkinson's disease.

Statistical analysis and isotherm study of uranium biosorption by Padina sp. algae biomass.

PubMed

Khani, Mohammad Hassan

2011-06-01

The application of response surface methodology is presented for optimizing the removal of U ions from aqueous solutions using Padina sp., a brown marine algal biomass. Box-Wilson central composite design was employed to assess individual and interactive effects of the four main parameters (pH and initial uranium concentration in solutions, contact time and temperature) on uranium uptake. Response surface analysis showed that the data were adequately fitted to second-order polynomial model. Analysis of variance showed a high coefficient of determination value (R (2)=0.9746) and satisfactory second-order regression model was derived. The optimum pH and initial uranium concentration in solutions, contact time and temperature were found to be 4.07, 778.48 mg/l, 74.31 min, and 37.47°C, respectively. Maximized uranium uptake was predicted and experimentally validated. The equilibrium data for biosorption of U onto the Padina sp. were well represented by the Langmuir isotherm, giving maximum monolayer adsorption capacity as high as 376.73 mg/g.

Being PREPaREd for Crisis in Northern Colorado

ERIC Educational Resources Information Center

Hancock, Kathy; Malvey, Michelle; Rastatter, Dennis

2010-01-01

The Thompson School District recognized after the Columbine incident in the spring of 1999 that it was lacking an adequate plan for crisis response. Colorado legislation led to a mandate for having a crisis response plan so the district purchased a "canned" crisis response plan that served the needs of response in a very immediate but…

Sepsis and Septic Shock Strategies.

PubMed

Armstrong, Bracken A; Betzold, Richard D; May, Addison K

2017-12-01

Three therapeutic principles most substantially improve organ dysfunction and survival in sepsis: early, appropriate antimicrobial therapy; restoration of adequate cellular perfusion; timely source control. The new definitions of sepsis and septic shock reflect the inadequate sensitivity, specify, and lack of prognostication of systemic inflammatory response syndrome criteria. Sequential (sepsis-related) organ failure assessment more effectively prognosticates in sepsis and critical illness. Inadequate cellular perfusion accelerates injury and reestablishing perfusion limits injury. Multiple organ systems are affected by sepsis and septic shock and an evidence-based multipronged approach to systems-based therapy in critical illness results in improve outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

[Significance of bad habits in orthodontics].

PubMed

Tarján, Ildikó

2002-08-01

The author is concerned with the etiological role of bad habits in the development. Disturbances caused by pacifier habits, finger sucking, various forms of swallowing habits and their therapeutical possibilities are discussed. The role of mouth breathing, nail biting, bruxism and self-mutilation in development of anomalies and their therapy are also mentioned. The attention is called to the fact that dentists have responsibility and task to diagnose as early as can be the oral bad habits and that the adequate therapy in time in co-operation with other specialists helping the child get out of bad habits, preventing the development of severe anomaly.

First "glass" education: telementored cardiac ultrasonography using Google Glass- a pilot study.

PubMed

Russell, Patrick M; Mallin, Michael; Youngquist, Scott T; Cotton, Jennifer; Aboul-Hosn, Nael; Dawson, Matt

2014-11-01

The objective of this study was to determine the feasibility of telementored instruction in bedside ultrasonography (US) using Google Glass. The authors sought to examine whether first-time US users could obtain adequate parasternal long axis (PSLA) views to approximate ejection fraction (EF) using Google Glass telementoring. This was a prospective, randomized, single-blinded study. Eighteen second-year medical students were randomized into three groups and tasked with obtaining PSLA cardiac imaging. Group A received real-time telementored education through Google Glass via Google Hangout from a remotely located expert. Group B received bedside education from the same expert. Group C represented the control and received no instruction. Each subject was given 3 minutes to obtain a best PSLA cardiac imaging using a portable GE Vscan. Image clips obtained by each subject were stored. A second expert, blinded to instructional mode, evaluated images for adequacy and assigned an image quality rating on a 0 to 10 scale. Group A was able to obtain adequate images six out of six times (100%) with a median image quality rating of 7.5 (interquartile range [IQR] = 6 to 10) out of 10. Group B was also able to obtain adequate views six out of six times (100%), with a median image quality rating of 8 (IQR = 7 to 9). Group C was able to obtain adequate views one out of six times (17%), with a median image quality of 0 (IQR = 0 to 2). There were no statistically significant differences between Group A and Group B in the achievement of adequate images for E-point septal separation measurement or in image quality. In this pilot/feasibility study, novice US users were able to obtain adequate imaging to determine a healthy patient's EF through telementored education using Google Glass. These preliminary data suggest telementoring as an adequate means of medical education in bedside US. This conclusion will need to be validated with larger, more powerful studies including evaluation of pathologic findings and varying body habitus among models. © 2014 by the Society for Academic Emergency Medicine.

Interaural time sensitivity of high-frequency neurons in the inferior colliculus.

PubMed

Yin, T C; Kuwada, S; Sujaku, Y

1984-11-01

Recent psychoacoustic experiments have shown that interaural time differences provide adequate cues for lateralizing high-frequency sounds, provided the stimuli are complex and not pure tones. We present here physiological evidence in support of these findings. Neurons of high best frequency in the cat inferior colliculus respond to interaural phase differences of amplitude modulated waveforms, and this response depends upon preservation of phase information of the modulating signal. Interaural phase differences were introduced in two ways: by interaural delays of the entire waveform and by binaural beats in which there was an interaural frequency difference in the modulating waveform. Results obtained with these two methods are similar. Our results show that high-frequency cells can respond to interaural time differences of amplitude modulated signals and that they do so by a sensitivity to interaural phase differences of the modulating waveform.

Factors associated with adequate weekly reporting for disease surveillance data among health facilities in Nairobi County, Kenya, 2013

PubMed Central

Mwatondo, Athman Juma; Ng'ang'a, Zipporah; Maina, Caroline; Makayotto, Lyndah; Mwangi, Moses; Njeru, Ian; Arvelo, Wences

2016-01-01

Introduction Kenya adopted the Integrated Disease Surveillance and Response (IDSR) strategy in 1998 to strengthen disease surveillance and epidemic response. However, the goal of weekly surveillance reporting among health facilities has not been achieved. We conducted a cross-sectional study to determine the prevalence of adequate reporting and factors associated with IDSR reporting among health facilities in one Kenyan County. Methods Health facilities (public and private) were enrolled using stratified random sampling from 348 facilities prioritized for routine surveillance reporting. Adequately-reporting facilities were defined as those which submitted >10 weekly reports during a twelve-week period and a poor reporting facilities were those which submitted <10 weekly reports. Multivariate logistic regression with backward selection was used to identify risk factors associated with adequate reporting. Results From September 2 through November 30, 2013, we enrolled 175 health facilities; 130(74%) were private and 45(26%) were public. Of the 175 health facilities, 77 (44%) facilities classified as adequate reporting and 98 (56%) were reporting poorly. Multivariate analysis identified three factors to be independently associated with weekly adequate reporting: having weekly reporting forms at visit (AOR19, 95% CI: 6-65], having posters showing IDSR functions (AOR8, 95% CI: 2-12) and having a designated surveillance focal person (AOR7, 95% CI: 2-20). Conclusion The majority of health facilities in Nairobi County were reporting poorly to IDSR and we recommend that the Ministry of Health provide all health facilities in Nairobi County with weekly reporting tools and offer specific trainings on IDSR which will help designate a focal surveillance person. PMID:27303581

Analytical Investigation of a Flicker-Type Roll Control for a Mach Number 6 Missile with Aerodynamic Controls Over An Altitude Range of 82,000 to 282,000 feet

NASA Technical Reports Server (NTRS)

Lundstrom, Reginald R.; Whitman, Ruth I.

1959-01-01

An analytical investigation has been carried out to determine the responses of a flicker-type roll control incorporated in a missile which traverses a range of Mach number of 6.3 at an altitude of 82,000 feet to 5.26 at an altitude of 282,000 feet. The missile has 80 deg delta wings in a cruciform arrangement with aerodynamic controls attached to the fuselage near the wing trailing edge and indexed 450 to the wings. Most of the investigation was carried out on an analog computer. Results showed that roll stabilization that may be adequate for many cases can be obtained over the altitude range considered, providing that the rate factor can be changed with altitude. The response would be improved if the control deflection were made larger at the higher altitudes. lag times less than 0.04 second improve the response appreciably. Asymmetries that produce steady rolling moments can be very detrimental to the response in some cases. The wing damping made a negligible contribution to the response.

Predictive and Prognostic Molecular Biomarkers for Response to Neoadjuvant Chemoradiation in Rectal Cancer.

PubMed

Dayde, Delphine; Tanaka, Ichidai; Jain, Rekha; Tai, Mei Chee; Taguchi, Ayumu

2017-03-07

The standard of care in locally advanced rectal cancer is neoadjuvant chemoradiation (nCRT) followed by radical surgery. Response to nCRT varies among patients and pathological complete response is associated with better outcome. However, there is a lack of effective methods to select rectal cancer patients who would or would not have a benefit from nCRT. The utility of clinicopathological and radiological features are limited due to lack of adequate sensitivity and specificity. Molecular biomarkers have the potential to predict response to nCRT at an early time point, but none have currently reached the clinic. Integration of diverse types of biomarkers including clinicopathological and imaging features, identification of mechanistic link to tumor biology, and rigorous validation using samples which represent disease heterogeneity, will allow to develop a sensitive and cost-effective molecular biomarker panel for precision medicine in rectal cancer. Here, we aim to review the recent advance in tissue- and blood-based molecular biomarker research and illustrate their potential in predicting nCRT response in rectal cancer.

The Maternity Care Nurse Workforce in Rural U.S. Hospitals.

PubMed

Henning-Smith, Carrie; Almanza, Jennifer; Kozhimannil, Katy B

To describe the maternity care nurse staffing in rural U.S. hospitals and identify key challenges and opportunities in maintaining an adequate nursing workforce. Cross-sectional survey study. Maternity care units within rural hospitals in nine U.S. states. Maternity care unit managers. We calculated descriptive statistics to characterize the rural maternity care nursing workforce by hospital birth volume and nursing staff model. We used simple content analysis to analyze responses to open-ended questions and identified themes related to challenges and opportunities for maternity care nursing in rural hospitals. Of the 263 hospitals, 51% were low volume (<300 annual births) and 49% were high volume (≥300 annual births). Among low-volume hospitals, 78% used a shared nurse staff model. In contrast, 31% of high-volume hospitals used a shared nurse staff model. Respondents praised the teamwork, dedication, and skill of their maternity care nurses. They did, however, identify significant challenges related to recruiting nurses, maintaining adequate staffing during times of census variability, orienting and training nurses, and retaining experienced nurses. Rural maternity care unit managers recognize the importance of nursing and have varied staffing needs. Policy implementation and programmatic support to ameliorate challenges may help ensure that an adequate nursing staff can be maintained, even in small-volume rural hospitals. Copyright © 2017 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

Facial Recognition of Happiness Is Impaired in Musicians with High Music Performance Anxiety.

PubMed

Sabino, Alini Daniéli Viana; Camargo, Cristielli M; Chagas, Marcos Hortes N; Osório, Flávia L

2018-01-01

Music performance anxiety (MPA) can be defined as a lasting and intense apprehension connected with musical performance in public. Studies suggest that MPA can be regarded as a subtype of social anxiety. Since individuals with social anxiety have deficits in the recognition of facial emotion, we hypothesized that musicians with high levels of MPA would share similar impairments. The aim of this study was to compare parameters of facial emotion recognition (FER) between musicians with high and low MPA. 150 amateur and professional musicians with different musical backgrounds were assessed in respect to their level of MPA and completed a dynamic FER task. The outcomes investigated were accuracy, response time, emotional intensity, and response bias. Musicians with high MPA were less accurate in the recognition of happiness ( p  = 0.04; d  = 0.34), had increased response bias toward fear ( p  = 0.03), and increased response time to facial emotions as a whole ( p  = 0.02; d  = 0.39). Musicians with high MPA displayed FER deficits that were independent of general anxiety levels and possibly of general cognitive capacity. These deficits may favor the maintenance and exacerbation of experiences of anxiety during public performance, since cues of approval, satisfaction, and encouragement are not adequately recognized.

The clinical syndrome of specific antibody deficiency in children.

PubMed

Boyle, R J; Le, C; Balloch, A; Tang, M L-K

2006-12-01

Specific antibody deficiency (SAD) is an immune deficiency which has been reported in adults and children with recurrent respiratory tract infections; however, the clinical features of SAD are not well described. This study evaluated formally the clinical syndrome of SAD, by comparing the clinical features of children with SAD and those of children with recurrent infection but normal immune function tests. SAD was defined as an adequate IgG antibody response to less than 50% of 12 pneumococcal serotypes tested following 23-valent unconjugated pneumococcal immunization. An adequate IgG antibody response was defined as a post-immunization titre of >or= 1.3 microg/ml or >or= four times the preimmunization value. Seventy-four children with recurrent infection were evaluated where immune deficiencies other than SAD had been excluded. Eleven (14.9%) of these children had SAD. Clinical features differed between the group with SAD and the group with normal antibody responses. A history of otitis media, particularly in association with chronic otorrhoea was associated with SAD [relative risk (RR) of SAD in those with chronic otorrhoea 4.64 (P = 0.02)]. SAD was associated with allergic disease, particularly allergic rhinitis [RR of SAD in those with allergic rhinitis 3.77 (P = 0.04)]. These two clinical associations of SAD were independent in this study [RR of chronic otorrhoea in those with allergic rhinitis 0.85 (P = 0.28)]. SAD was not an age-related phenomenon in this population. SAD has a distinct clinical phenotype, presenting as recurrent infection associated with chronic otorrhoea and/or allergic disease, and the condition should be sought in children with these features.

Methods for Measuring Student Response to Stimulant Medication: A Meta-Analytic Review

ERIC Educational Resources Information Center

Someki, Fumio; Burns, Matthew K.

2009-01-01

Measuring student response to interventions has become an important role for school psychologists. Children with Attention-Deficit/Hyperactivity Disorder (ADHD) are frequently treated with stimulant medication, but the response to the treatment is rarely adequately assessed. The current study examined the sensitivity of measures used to assess the…

Switching to Another SSRI or to Venlafaxine With or Without Cognitive Behavioral Therapy for Adolescents With SSRI-Resistant Depression

PubMed Central

Brent, David; Emslie, Graham; Clarke, Greg; Wagner, Karen Dineen; Asarnow, Joan Rosenbaum; Keller, Marty; Vitiello, Benedetto; Ritz, Louise; Iyengar, Satish; Abebe, Kaleab; Birmaher, Boris; Ryan, Neal; Kennard, Betsy; Hughes, Carroll; DeBar, Lynn; McCracken, James; Strober, Michael; Suddath, Robert; Spirito, Anthony; Leonard, Henrietta; Melhem, Nadine; Porta, Giovanna; Onorato, Matthew; Zelazny, Jamie

2008-01-01

Context Only about 60% of adolescents with depression will show an adequate clinical response to an initial treatment trial with a selective serotonin reuptake inhibitor (SSRI). There are no data to guide clinicians on subsequent treatment strategy. Objective To evaluate the relative efficacy of 4 treatment strategies in adolescents who continued to have depression despite adequate initial treatment with an SSRI. Design, Setting, and Participants Randomized controlled trial of a clinical sample of 334 patients aged 12 to 18 years with a primary diagnosis of major depressive disorder that had not responded to a 2-month initial treatment with an SSRI, conducted at 6 US academic and community clinics from 2000–2006. Interventions Twelve weeks of: (1) switch to a second, different SSRI (paroxetine, citalopram, or fluoxetine, 20–40 mg); (2) switch to a different SSRI plus cognitive behavioral therapy; (3) switch to venlafaxine (150–225 mg); or (4) switch to venlafaxine plus cognitive behavioral therapy. Main Outcome Measures Clinical Global Impressions-Improvement score of 2 or less (much or very much improved) and a decrease of at least 50% in the Children’s Depression Rating Scale-Revised (CDRS-R); and change in CDRS-R over time. Results Cognitive behavioral therapy plus a switch to either medication regimen showed a higher response rate (54.8%; 95% confidence interval [CI], 47%–62%) than a medication switch alone (40.5%; 95% CI, 33%–48%; P=.009), but there was no difference in response rate between venlafaxine and a second SSRI (48.2%; 95% CI, 41%–56% vs 47.0%; 95% CI, 40%–55%; P=.83). There were no differential treatment effects on change in the CDRS-R, self-rated depressive symptoms, suicidal ideation, or on the rate of harm-related or any other adverse events. There was a greater increase in diastolic blood pressure and pulse and more frequent occurrence of skin problems during venlafaxine than SSRI treatment. Conclusions For adolescents with depression not responding to an adequate initial treatment with an SSRI, the combination of cognitive behavioral therapy and a switch to another antidepressant resulted in a higher rate of clinical response than did a medication switch alone. However, a switch to another SSRI was just as efficacious as a switch to venlafaxine and resulted in fewer adverse effects. PMID:18314433

Communication gaps in nursing home transfers to the ED: impact on turnaround time, disposition, and diagnostic testing.

PubMed

Nelson, Drew; Washton, Danae; Jeanmonod, Rebecca

2013-04-01

This study aims to determine the source of communication gaps in history of present illness (HPI), medical history, and advanced directives in nursing home (NH) patients transferred to the emergency department (ED). We also attempt to determine if these gaps create differences in patient turnaround time (TAT), disposition decision, or diagnostic testing. A convenience sample of patients transferred from NHs to a level 1 community trauma center was enrolled by the physicians caring for them. The physicians assessed the adequacy and source of the history for each patient. The patient's chart was then retrospectively reviewed to determine disposition, ED TAT, and diagnostic tests ordered. One hundred patients were enrolled. Physicians found that NH paperwork contained adequate HPI 35% of the time. Patients could provide their own HPI 28% of the time. In 32% of patients, adequate HPI could not be obtained from the patient, NH paperwork, or NH personnel. Comparing patients in whom adequate HPI was available (n = 68) to those in whom HPI was not available (n = 32), there was no difference in TAT (146 vs 173 minutes, P = .22), admissions (60% vs 66%, P = .66), or diagnostic testing (P = .89-1.0). Emergency department physicians often do not have adequate HPI in patients transferred from NHs. The absence of adequate information does not affect patient TAT, disposition decision, or ED diagnostic testing. Copyright © 2013 Elsevier Inc. All rights reserved.

32 CFR 148.13 - Responsibilities.

Code of Federal Regulations, 2013 CFR

2013-07-01

... POLICY AND IMPLEMENTATION OF RECIPROCITY OF FACILITIES Guidelines for the Implementation and Oversight of the Policy on Reciprocity of use and Inspections of Facilities § 148.13 Responsibilities. (a) Each Senior Agency Official shall ensure that adequate reciprocity provisions are incorporated within his or...

32 CFR 148.13 - Responsibilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... POLICY AND IMPLEMENTATION OF RECIPROCITY OF FACILITIES Guidelines for the Implementation and Oversight of the Policy on Reciprocity of use and Inspections of Facilities § 148.13 Responsibilities. (a) Each Senior Agency Official shall ensure that adequate reciprocity provisions are incorporated within his or...

32 CFR 148.13 - Responsibilities.

Code of Federal Regulations, 2014 CFR

2014-07-01

... POLICY AND IMPLEMENTATION OF RECIPROCITY OF FACILITIES Guidelines for the Implementation and Oversight of the Policy on Reciprocity of use and Inspections of Facilities § 148.13 Responsibilities. (a) Each Senior Agency Official shall ensure that adequate reciprocity provisions are incorporated within his or...

32 CFR 148.13 - Responsibilities.

Code of Federal Regulations, 2012 CFR

2012-07-01

... POLICY AND IMPLEMENTATION OF RECIPROCITY OF FACILITIES Guidelines for the Implementation and Oversight of the Policy on Reciprocity of use and Inspections of Facilities § 148.13 Responsibilities. (a) Each Senior Agency Official shall ensure that adequate reciprocity provisions are incorporated within his or...

32 CFR 148.13 - Responsibilities.

Code of Federal Regulations, 2011 CFR

2011-07-01

... POLICY AND IMPLEMENTATION OF RECIPROCITY OF FACILITIES Guidelines for the Implementation and Oversight of the Policy on Reciprocity of use and Inspections of Facilities § 148.13 Responsibilities. (a) Each Senior Agency Official shall ensure that adequate reciprocity provisions are incorporated within his or...

6 CFR 7.11 - Components' responsibilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... INFORMATION Administration § 7.11 Components' responsibilities. Each DHS component shall appoint a security... security information; (b) Report violations of the provisions of this regulation to the Chief Security... component acquire adequate security education and training, as required by the DHS classified information...

Calibration and validation of a physiologically based model for soman intoxication in the rat, marmoset, guinea pig and pig.

PubMed

Chen, Kaizhen; Seng, Kok-Yong

2012-09-01

A physiologically based pharmacokinetic and pharmacodynamic (PBPK/PD) model has been developed for low, medium and high levels of soman intoxication in the rat, marmoset, guinea pig and pig. The primary objective of this model was to describe the pharmacokinetics of soman after intravenous, intramuscular and subcutaneous administration in the rat, marmoset, guinea pig, and pig as well as its subsequent pharmacodynamic effects on blood acetylcholinesterase (AChE) levels, relating dosimetry to physiological response. The reactions modelled in each physiologically realistic compartment are: (1) partitioning of C(±)P(±) soman from the blood into the tissue; (2) inhibition of AChE and carboxylesterase (CaE) by soman; (3) elimination of soman by enzymatic hydrolysis; (4) de novo synthesis and degradation of AChE and CaE; and (5) aging of AChE-soman and CaE-soman complexes. The model was first calibrated for the rat, then extrapolated for validation in the marmoset, guinea pig and pig. Adequate fits to experimental data on the time course of soman pharmacokinetics and AChE inhibition were achieved in the mammalian models. In conclusion, the present model adequately predicts the dose-response relationship resulting from soman intoxication and can potentially be applied to predict soman pharmacokinetics and pharmacodynamics in other species, including human. Copyright © 2011 John Wiley & Sons, Ltd.

Powdered ZELIAC augmented sequencing batch reactors (SBR) process for co-treatment of landfill leachate and domestic wastewater.

PubMed

Mojiri, Amin; Aziz, Hamidi Abdul; Zaman, Nastaein Q; Aziz, Shuokr Qarani; Zahed, Mohammad Ali

2014-06-15

Sequencing batch reactor (SBR) is one of the various methods of biological treatments used for treating wastewater and landfill leachate. This study investigated the treatment of landfill leachate and domestic wastewater by adding a new adsorbent (powdered ZELIAC; PZ) to the SBR technique. ZELIAC consists of zeolite, activated carbon, lime stone, rice husk ash, and Portland cement. The response surface methodology and central composite design were used to elucidate the nature of the response surface in the experimental design and describe the optimum conditions of the independent variables, including aeration rate (L/min), contact time (h), and ratio of leachate to wastewater mixture (%; v/v), as well as their responses (dependent variables). Appropriate conditions of operating variables were also optimized to predict the best value of responses. To perform an adequate analysis of the aerobic process, four dependent parameters, namely, chemical oxygen demand (COD), color, ammonia-nitrogen (NH3-N), and phenols, were measured as responses. The results indicated that the PZ-SBR showed higher performance in removing certain pollutants compared with SBR. Given the optimal conditions of aeration rate (1.74 L/min), leachate to wastewater ratio (20%), and contact time (10.31 h) for the PZ-SBR, the removal efficiencies for color, NH3-N, COD, and phenols were 84.11%, 99.01%, 72.84%, and 61.32%, respectively. Copyright © 2014 Elsevier Ltd. All rights reserved.

Efficacy and toxicity of carboplatin and cytarabine chemotherapy for dogs with relapsed or refractory lymphoma (2000-2013).

PubMed

Gillem, J; Giuffrida, M; Krick, E

2017-06-01

Medical records of 22 dogs treated with carboplatin (n = 8) or carboplatin and cytarabine (n = 14) chemotherapy for relapsed or refractory lymphoma between 2000 and 2013 were retrospectively reviewed. The clinical response rate was 18.2% (4/22). Median time to progression was 18 days (56 for responders; 12 for non-responders, P = 0.0006). Median overall survival time was 28 days (109 for responders; 21 for non-responders, P = 0.0007). Thrombocytopenia and neutropenia occurred in 84.2% (16/19) and 52.6% (10/19), respectively. Grade IV thrombocytopenia and neutropenia occurred in 56.3% (9/16) and 60.0% (6/10), respectively. Dogs that received both drugs were more likely to become neutropenic (P = 0.022) or thrombocytopenic (P = 0.001) than dogs receiving carboplatin alone. All responders received both drugs giving a 28.6% (4/14) response rate for the combination. Although some dogs responded to the combination, toxicity was high and the responses were not durable. With adequate supportive care, this protocol may be an acceptable rescue option for some dogs. © 2015 John Wiley & Sons Ltd.

Quantitative cancer risk assessment for occupational exposures to asphalt fumes during built-up roofing asphalt (BURA) operations.

PubMed

Rhomberg, Lorenz R; Mayfield, David B; Goodman, Julie E; Butler, Eric L; Nascarella, Marc A; Williams, Daniel R

2015-01-01

The International Agency for Research on Cancer qualitatively characterized occupational exposure to oxidized bitumen emissions during roofing as probably carcinogenic to humans (Group 2A). We examine chemistry, exposure, epidemiology and animal toxicity data to explore quantitative risks for roofing workers applying built-up roofing asphalt (BURA). Epidemiology studies do not consistently report elevated risks, and generally do not have sufficient exposure information or adequately control for confounders, precluding their use for dose-response analysis. Dermal carcinogenicity bioassays using mice report increased tumor incidence with single high doses. In order to quantify potential cancer risks, we develop time-to-tumor model methods [consistent with U.S. Environmental Protection Agency (EPA) dose-response analysis and mixtures guidelines] using the dose-time-response shape of concurrent exposures to benzo[a]pyrene (B[a]P) as concurrent controls (which had several exposure levels) to infer presumed parallel dose-time-response curves for BURA-fume condensate. We compare EPA relative potency factor approaches, based on observed relative potency of BURA to B[a]P in similar experiments, and direct observation of the inferred BURA dose-time-response (scaled to humans) as means for characterizing a dermal unit risk factor. We apply similar approaches to limited data on asphalt-fume inhalation and respiratory cancers in rats. We also develop a method for adjusting potency estimates for asphalts that vary in composition using measured fluorescence. Overall, the various methods indicate that cancer risks to roofers from both dermal and inhalation exposure to BURA are within a range typically deemed acceptable within regulatory frameworks. The approaches developed may be useful in assessing carcinogenic potency of other complex mixtures of polycyclic aromatic compounds.

A comparative study on visual choice reaction time for different colors in females.

PubMed

Balakrishnan, Grrishma; Uppinakudru, Gurunandan; Girwar Singh, Gaur; Bangera, Shobith; Dutt Raghavendra, Aswini; Thangavel, Dinesh

2014-01-01

Reaction time is one of the important methods to study a person's central information processing speed and coordinated peripheral movement response. Visual choice reaction time is a type of reaction time and is very important for drivers, pilots, security guards, and so forth. Previous studies were mainly on simple reaction time and there are very few studies on visual choice reaction time. The aim of our study was to compare the visual choice reaction time for red, green, and yellow colors of 60 healthy undergraduate female volunteers. After giving adequate practice, visual choice reaction time was recorded for red, green, and yellow colors using reaction time machine (RTM 608, Medicaid, Chandigarh). Repeated measures of ANOVA and Bonferroni multiple comparison were used for analysis and P < 0.05 was considered statistically significant. The results showed that both red and green had significantly less choice visual choice reaction (P values <0.0001 and 0.0002) when compared with yellow. This could be because individual color mental processing time for yellow color is more than red and green.

Response of the solar atmosphere to a simple flare burst: UV emission from the flare transition layer.

NASA Astrophysics Data System (ADS)

Shmeleva, O. P.

The flare transition layer exists as a relatively steady formation even during impulsive heating. It is maintained by a heat flow from the high-temperature plasma, where the major part of the electron beam energy is absorbed. The lifetime of this plasma is much greater than the impulsive heating time. Intensities of resonance UV lines are calculated using both the model of impulsive nonthermal heating by energetic electrons and the model of continuous thermal heating. The calculated line intensity is almost constant during a long time. The line Doppler shifts predicted by the former model match observations. This suggests that the model represents sufficiently well the actual dynamics of the flare plasma. The flare transition layer is a thin formation, its thickness being Δξ = 1021m-2. It is therefore described adequately within the p = const approximation though the picture of hydrodynamic response of the solar atmosphere to the impulsive heating by energy flows is rather complicated and nonsteady, of course. The intensities of the C IV λλ154.8, 155.1 nm and O VI λλ103.2, 103.8 nm lines are calculated within the scope of the model of continuous thermal heating, in which the conductive heating of the flare transition layer is balanced by radiative cooling. The line intensities are proportional to the pressure in the layer, which permits the pressure to be found from the observed line intensities. The analysis reveals that both heating models adequately represent the actual structure and dynamics of plasma in a flare. In the flare transition layer, the classical heat conduction always does work.

Registered nurses' attitudes towards the role of the healthcare assistant.

PubMed

Alcorn, Jason; Topping, Anne Elizabeth

To elicit the views of registered nurses (RNs), working in the surgical directorate of an acute NHS trust, concerning the responsibilities of RNs to healthcare assistants (HCAs), specifically in relation to delegation, development and accountability. A survey using a 24-item questionnaire and a six-point Likert scale design was administered to a convenience sample of 219 RNs working within the surgical directorate. A total of 148 completed questionnaires were returned, giving a 68% response rate. The results suggested that the majority of RNs were aware of their responsibilities regarding accountability for delegated tasks, believe that HCAs should be regulated and, once prepared adequately, held individually accountable for their actions. RNs should undertake appropriate skill development in pre-registration programmes and be provided with preceptorship to ensure they are equipped adequately to supervise and delegate work to HCAs.

Emergencies planning and response: Coupling an exposure model with different atmospheric dispersion models

NASA Astrophysics Data System (ADS)

Sanchez, E. Y.; Colman Lerner, J. E.; Porta, A.; Jacovkis, P. M.

2013-11-01

Information on spatial and time dependent concentration patterns of hazardous substances, as well as on the potential effects on population, is necessary to assist in chemical emergency planning and response. To that end, some models predict transport and dispersion of hazardous substances, and others estimate potential effects upon exposed population. Taken together, both groups constitute a powerful tool to estimate vulnerable regions and to evaluate environmental impact upon affected populations. The development of methodologies and models with direct application to the context in which we live allows us to draft a more clear representation of the risk scenario and, hence, to obtain the adequate tools for an optimal response. By means of the recently developed DDC (Damage Differential Coupling) exposure model, it was possible to optimize, from both the qualitative and the quantitative points of view, the estimation of the population affected by a toxic cloud, because the DDC model has a very good capacity to couple with different atmospheric dispersion models able to provide data over time. In this way, DDC analyzes the different concentration profiles (output from the transport model) associating them with some reference concentration to identify risk zones. In this work we present a disaster scenario in Chicago (USA), by coupling DDC with two transport models of different complexity, showing the close relationship between a representative result and the run time of the models. In the same way, it becomes evident that knowing the time evolution of the toxic cloud and of the affected regions significantly improves the probability of taking the correct decisions on planning and response facing the emergency.

Predicting the Best Fit: A Comparison of Response Surface Models for Midazolam and Alfentanil Sedation in Procedures With Varying Stimulation.

PubMed

Liou, Jing-Yang; Ting, Chien-Kun; Mandell, M Susan; Chang, Kuang-Yi; Teng, Wei-Nung; Huang, Yu-Yin; Tsou, Mei-Yung

2016-08-01

Selecting an effective dose of sedative drugs in combined upper and lower gastrointestinal endoscopy is complicated by varying degrees of pain stimulation. We tested the ability of 5 response surface models to predict depth of sedation after administration of midazolam and alfentanil in this complex model. The procedure was divided into 3 phases: esophagogastroduodenoscopy (EGD), colonoscopy, and the time interval between the 2 (intersession). The depth of sedation in 33 adult patients was monitored by Observer Assessment of Alertness/Scores. A total of 218 combinations of midazolam and alfentanil effect-site concentrations derived from pharmacokinetic models were used to test 5 response surface models in each of the 3 phases of endoscopy. Model fit was evaluated with objective function value, corrected Akaike Information Criterion (AICc), and Spearman ranked correlation. A model was arbitrarily defined as accurate if the predicted probability is <0.5 from the observed response. The effect-site concentrations tested ranged from 1 to 76 ng/mL and from 5 to 80 ng/mL for midazolam and alfentanil, respectively. Midazolam and alfentanil had synergistic effects in colonoscopy and EGD, but additivity was observed in the intersession group. Adequate prediction rates were 84% to 85% in the intersession group, 84% to 88% during colonoscopy, and 82% to 87% during EGD. The reduced Greco and Fixed alfentanil concentration required for 50% of the patients to achieve targeted response Hierarchy models performed better with comparable predictive strength. The reduced Greco model had the lowest AICc with strong correlation in all 3 phases of endoscopy. Dynamic, rather than fixed, γ and γalf in the Hierarchy model improved model fit. The reduced Greco model had the lowest objective function value and AICc and thus the best fit. This model was reliable with acceptable predictive ability based on adequate clinical correlation. We suggest that this model has practical clinical value for patients undergoing procedures with varying degrees of stimulation.

Cognitive systems in electronic warfare

NASA Astrophysics Data System (ADS)

Kulpa, Krzysztof; Szczepankiewicz, Michał; Żywek, Marcin; Malanowski, Mateusz; Misiurewicz, Jacek; Samczyński, Piotr

2017-04-01

Electronic warfare (EW) techniques were invented 70 years ago and are still being developed, all the time with a key role played by their operators. However, a human operator responds far too slowly for the on-going needs since to be adequate to current threats the EW system reaction should be within 1 ms or less. Too slow reaction defers an achievement of the objectives, and generally may lead to disclosure of the applied strategy and to waste of resources. Developing the adequate response to the threat is a multifaceted matter that requires considerable experience and knowledge on the one hand, and thorough observation of outcomes of the applied strategy on the other hand. Such action requires the use of not only intelligence but also more complex algorithms for automatic control than the classical ones, and it heavily builds on the experience. It is therefore a cognitive task in its nature, and a human operator acts naturally this way. Consequently, a proper training and experience gained are what really matters. As a result of tests and actions in EW the operator builds his own knowledge base, thus, gains a capability of responding to the known threats in a balanced way. New threats, however, are much more challenging since they should be handled as fast as possible but in a fresh and creative manner. To this end, adapting the algorithms of radar jamming protection for the new conditions of the battlefield is an example of such challenging tasks. At present, such adjustments are done in a long feedback loop when the operator, after recognizing the problem, notifies the equipment manufacturers, and then, their engineers work on required solutions accordingly. Thus, the reaction time is counted in years, not a single milliseconds or seconds. Speeding up the response time is therefore the key issue, and a solution to it would be feasible only when cognitive systems were used. A concept of such cognitive system is presented in this paper.

Patient perspectives on the promptness and quality of care of road traffic incident victims in Peru: a cross-sectional, active surveillance study.

PubMed

Miranda, J Jaime; Rosales-Mayor, Edmundo; Quistberg, D Alex; Paca-Palao, Ada; Gianella, Camila; Perel, Pablo; Lopez, Luis; Luna, Diego; Best, Pablo; Huicho, Luis

2013-01-01

Road injuries are the second-leading cause of disease and injury in the Andean region of South America. Adequate management of road traffic crash victims is important to prevent and reduce deaths and serious long-term injuries. To evaluate the promptness of health care services provided to those injured in road traffic incidents (RTIs) and the satisfaction with those services during the pre-hospital and hospital periods. We conducted a cross-sectional study with active surveillance to recruit participants in emergency departments at eight health care facilities in three Peruvian cities: a large metropolitan city (Lima) and two provincial cities (an urban center in the southern Andes and an urban center in the rainforest region), between August and September 2009. The main outcomes of interest were promptness of care, measured by time between injury and each service offered, as well as patient satisfaction measured by the Service Quality (SERVQUAL) survey. We explored the association between outcomes and city, type of health care facility (HCF), and type of provider. We recruited 644 adults seeking care for RTIs. This active surveillance strategy yielded 34% more events than anticipated, suggesting under-reporting in traditional registries. Median response time between a RTI and any care at a HCF was 33 minutes overall and only 62% of participants received professional care during the initial "golden" hour after the RTI. After adjustment for various factors, there was strong evidence of higher global dissatisfaction levels among those receiving care at public HCFs compared to private ones (odds ratio (OR) 5.05, 95% confidence interval (CI) 1.88-13.54). This difference was not observed when provincial sites were compared to Lima (OR 1.41, 95% CI 0.42-4.70). Response time to RTIs was adequate overall, though a large proportion of RTI victims could have received more prompt care. Overall, dissatisfaction was high, mainly at public institutions indicating much need for improvements in service provision.

Interpretation of environmental tracers in groundwater systems with stagnant water zones.

PubMed

Maloszewski, Piotr; Stichler, Willibald; Zuber, Andrzej

2004-03-01

Lumped-parameter models are commonly applied for determining the age of water from time records of transient environmental tracers. The simplest models (e.g. piston flow or exponential) are also applicable for dating based on the decay or accumulation of tracers in groundwater systems. The models are based on the assumption that the transit time distribution function (exit age distribution function) of the tracer particles in the investigated system adequately represents the distribution of flow lines and is described by a simple function. A chosen or fitted function (called the response function) describes the transit time distribution of a tracer which would be observed at the output (discharge area, spring, stream, or pumping wells) in the case of an instantaneous injection at the entrance (recharge area). Due to large space and time scales, response functions are not measurable in groundwater systems, therefore, functions known from other fields of science, mainly from chemical engineering, are usually used. The type of response function and the values of its parameters define the lumped-parameter model of a system. The main parameter is the mean transit time of tracer through the system, which under favourable conditions may represent the mean age of mobile water. The parameters of the model are found by fitting calculated concentrations to the experimental records of concentrations measured at the outlet. The mean transit time of tracer (often called the tracer age), whether equal to the mean age of water or not, serves in adequate combinations with other data for determining other useful parameters, e.g. the recharge rate or the content of water in the system. The transit time distribution and its mean value serve for confirmation or determination of the conceptual model of the system and/or estimation of its potential vulnerability to anthropogenic pollution. In the interpretation of environmental tracer data with the aid of the lumped-parameter models, the influence of diffusion exchange between mobile water and stagnant or quasi-stagnant water is seldom considered, though it leads to large differences between tracer and water ages. Therefore, the article is focused on the transit time distribution functions of the most common lumped-parameter models, particularly those applicable for the interpretation of environmental tracer data in double-porosity aquifers, or aquifers in which aquitard diffusion may play an important role. A case study is recalled for a confined aquifer in which the diffusion exchange with aquitard most probably strongly influenced the transport of environmental tracers. Another case study presented is related to the interpretation of environmental tracer data obtained from lysimeters installed in the unsaturated zone with a fraction of stagnant water.

A Procedure for Measuring Latencies in Brain-Computer Interfaces

PubMed Central

Wilson, J. Adam; Mellinger, Jürgen; Schalk, Gerwin; Williams, Justin

2011-01-01

Brain-computer interface (BCI) systems must process neural signals with consistent timing in order to support adequate system performance. Thus, it is important to have the capability to determine whether a particular BCI configuration (i.e., hardware, software) provides adequate timing performance for a particular experiment. This report presents a method of measuring and quantifying different aspects of system timing in several typical BCI experiments across a range of settings, and presents comprehensive measures of expected overall system latency for each experimental configuration. PMID:20403781

Same-day breast cancer surgery: a qualitative study of women's lived experiences.

PubMed

Greenslade, M Victoria; Elliott, Barbara; Mandville-Anstey, Sue Ann

2010-03-01

To understand the experiences of women having same-day breast cancer surgery and make recommendations to assist healthcare professionals effect change to enhance quality of care. Thematic analysis of audiotaped interviews. Outpatient departments of two city hospitals on the east coast of Canada. Purposive sample of 13 women who had undergone same-day breast cancer surgery. A constructivist approach with in-depth interviews and comparative analysis to develop and systemically organize data into four major interrelated themes and a connecting essential thread. Women's experiences with same-day breast cancer surgery. The themes of preparation, timing, supports, and community health nursing intervention were of paramount importance for effective coping and recovery. Women who had a positive experience with same-day breast cancer surgery also reported having adequate preparation, appropriate timing of preparation, strong support systems, and sufficient community health nursing intervention. Those reporting a negative experience encountered challenges in one or more of the identified theme areas. Same-day surgery is a sign of the times, and the approach to it is changing. Healthcare systems need to be responsive to such changes. Although same-day surgery for breast cancer is not suitable for every patient, women undergoing this type of surgery should be assessed individually to determine whether it is appropriate for them. Women undergoing breast cancer surgery should be screened for same-day surgery suitability. Those having same-day breast cancer surgery should be prepared adequately with timely education. Most importantly, such women should receive community health nursing follow-up for assessment, continuing education, and psychosocial support.

Health and safety aspects of deployment of Australian disaster medical assistance team members: results of a national survey.

PubMed

Aitken, Peter; Leggat, Peter; Robertson, Andrew; Harley, Hazel; Speare, Richard; Leclercq, Muriel

2009-09-01

Disaster medical assistance teams (DMATs) have responded to numerous international disasters in recent years. As part of a national survey, the present study was designed to evaluate Australian DMAT experience in relation to health and safety aspects of actual deployment. Data were collected via an anonymous mailed survey distributed by State and Territory representatives on the Australian Health Protection Committee, who identified team members associated with Australian DMAT deployments from the time of the 2004 South East Asian tsunami disaster. The response rate for this survey was 50% (59/118). Most of the personnel had deployed to the tsunami affected areas. The DMAT members were quite experienced with 53% of personnel in the 45-55 years age group (31/59) and a mean level of clinical experience of 21 years. 76% of the respondents were male (44/58). Once deployed, most felt that their basic health needs were adequately met. Almost all stated there were adequate shelter (95%, 56/59), adequate food (93%, 55/59) and adequate water (97%, 57/59). A clear majority, felt there were adequate toilet facilities (80%, 47/59), adequate shower facilities (64%, 37/59); adequate hand washing facilities (68%, 40/59) and adequate personal protective equipment (69%, 41/59). While most felt that there were adequate security briefings (73%, 43/59), fewer felt that security itself was adequate (64%, 38/59). 30% (18/59) felt that team members could not be easily identified. The optimum shift period was identified as 12h (66%, 39/59) or possibly 8h (22%, 13/59) with the optimum period of overseas deployment as 14-21 days (46%, 27/59). Missing essential items were just as likely to be related to personal comfort (28%) as clinical care (36%) or logistic support (36%). The most frequently nominated personal items recommended were: suitable clothes (49%, 29/59); toiletries (36%, 22/59); mobile phone (24%, 14/59); insect repellent (17%, 10/59) and a camera (14%, 8/59). The most common personal hardship reported during their deployment was being away from home/problems at home (24%, 14/59); however, most felt that their family was adequately informed of their whereabouts and health status (73%, 43/59). This study of Australian DMAT members suggests that, in the field, attention should be given to basics, such as adequate food, water, shelter and personal hygiene as well as appropriate clothing, sunscreen and vector protection. The inclusion of appropriate personal items can be assisted by provision of a minimum suggested personal equipment list, with local conditions and the nature of the deployment being taken into account. A personal survival kit should also be recommended. There should be medical and psychological support for team members themselves, including the provision of a dedicated team member medical cache. Concern for their own health and ability to communicate with family members at home are major issues for deployed team members and need to be addressed in mission planning. This should also recognise security issues, including briefings, evacuation plans and exit strategies. The team members concerns about adequate security and the risk profile of humanitarian intervention in natural disasters compared with complex humanitarian emergencies may help determine future deployment of civilian or defence based teams.

Region 4: South Carolina Adequate Letter and Response to Comments (6/21/2012)

EPA Pesticide Factsheets

This May 25, 2012 letter from EPA approves South Carolina's reasonable further progress (RFP) plan including the motor vehicle emission budget (MVEB) for volatile organic compounds (VOC) and EPA's response to comments received on the adequacy notification

Predictors of compliance with tornado warnings issued in Joplin, Missouri, in 2011.

PubMed

Paul, Bimal Kanti; Stimers, Mitchel; Caldas, Marcellus

2015-01-01

Joplin, a city in the southwest corner of Missouri, United States, suffered an EF-5 tornado in the late afternoon of 22 May 2011. This event, which claimed the lives of 162 people, represents the deadliest single tornado to strike the US since modern record-keeping began in 1950. This study examines the factors associated with responses to tornado warnings. Based on a post-tornado survey of survivors in Joplin, it reveals that tornado warnings were adequate and timely. Multivariate logistic regression identified four statistically significant determinants of compliance with tornado warnings: number of warning sources, whether respondents were at home when the tornado struck, past tornado experience, and gender. The findings suggest several recommendations, the implementation of which will further improve responses to tornado warnings. © 2014 The Author(s). Disasters © Overseas Development Institute, 2014.

Mathematical modelling of tumour volume dynamics in response to stereotactic ablative radiotherapy for non-small cell lung cancer

NASA Astrophysics Data System (ADS)

Tariq, Imran; Humbert-Vidan, Laia; Chen, Tao; South, Christopher P.; Ezhil, Veni; Kirkby, Norman F.; Jena, Rajesh; Nisbet, Andrew

2015-05-01

This paper reports a modelling study of tumour volume dynamics in response to stereotactic ablative radiotherapy (SABR). The main objective was to develop a model that is adequate to describe tumour volume change measured during SABR, and at the same time is not excessively complex as lacking support from clinical data. To this end, various modelling options were explored, and a rigorous statistical method, the Akaike information criterion, was used to help determine a trade-off between model accuracy and complexity. The models were calibrated to the data from 11 non-small cell lung cancer patients treated with SABR. The results showed that it is feasible to model the tumour volume dynamics during SABR, opening up the potential for using such models in a clinical environment in the future.

ICASE/LaRC Symposium on Visualizing Time-Varying Data

NASA Technical Reports Server (NTRS)

Banks, D. C. (Editor); Crockett, T. W. (Editor); Stacy, K. (Editor)

1996-01-01

Time-varying datasets present difficult problems for both analysis and visualization. For example, the data may be terabytes in size, distributed across mass storage systems at several sites, with time scales ranging from femtoseconds to eons. In response to these challenges, ICASE and NASA Langley Research Center, in cooperation with ACM SIGGRAPH, organized the first symposium on visualizing time-varying data. The purpose was to bring the producers of time-varying data together with visualization specialists to assess open issues in the field, present new solutions, and encourage collaborative problem-solving. These proceedings contain the peer-reviewed papers which were presented at the symposium. They cover a broad range of topics, from methods for modeling and compressing data to systems for visualizing CFD simulations and World Wide Web traffic. Because the subject matter is inherently dynamic, a paper proceedings cannot adequately convey all aspects of the work. The accompanying video proceedings provide additional context for several of the papers.

Hypothalamic-pituitary-adrenal (HPA) axis function in the California mouse (Peromyscus californicus): Changes in baseline activity, reactivity, and fecal excretion of glucocorticoids across the diurnal cycle

PubMed Central

Harris, Breanna N.; Saltzman, Wendy; de Jong, Trynke R.; Milnes, Matthew R.

2012-01-01

The California mouse, Peromyscus californicus, is an increasingly popular animal model in behavioral, neural, and endocrine studies, but little is known about its baseline hypothalamicpituitary-adrenal (HPA) axis activity or HPA responses to stressors. We characterized plasma corticosterone (CORT) concentrations in P. californicus under baseline conditions across the diurnal cycle, in response to pharmacological manipulation of the HPA axis, and in response to a variety of stressors at different times of day. In addition, we explored the use of fecal samples to monitor adrenocortical activity non-invasively. California mice have very high baseline levels of circulating CORT that change markedly over 24 hours, but that do not differ between the sexes. This species may be somewhat glucocorticoid-resistant in comparison to other rodents as a relatively high dose of dexamethasone (5 mg/kg, s.c.) was required to suppress plasma CORT for 8 h post-injection. CORT responses to stressors and ACTH injection differed with time of day, as CORT concentrations were elevated more readily during the morning (inactive period) than in the evening (active period) when compared to time-matched control. Data from 3H-CORT injection studies show that the time course for excretion of fecal CORT, or glucocorticoid metabolites, differs with time of injection. Mice injected in the evening excreted the majority of fecal radioactivity 2–4 h post-injection whereas mice injected during the morning did so at 14–16 h post-injection. Unfortunately, the antibody we used does not adequately bind the most prevalent fecal glucocorticoid metabolites and therefore we could not validate its use for fecal assays. PMID:23026495

Responses of the pulp, periradicular and soft tissues following trauma to the permanent teeth.

PubMed

Yu, C Y; Abbott, P V

2016-03-01

Trauma to the permanent teeth involves not only the teeth but also the pulp, the periodontal ligament, alveolar bone, gingiva and other associated structures. There are many variations in the types of injuries with varying severity and often a tooth may sustain more than one injury at the same time. In more severe trauma cases, there are many different cellular systems of mineralized hard and unmineralized soft tissues involved, each with varying potential for healing. Furthermore, the responses of the different tissues may be interrelated and dependent on each other. Hence, healing subsequent to dental trauma has long been known to be very complex. Because of this complexity, tissue responses and the consequences following dental trauma have been confusing and puzzling for many clinicians. In this review, the tissue responses are described under the tissue compartments typically involved following dental trauma: the pulp, periradicular and associated soft tissues. The factors involved in the mechanisms of trauma are analysed for their effects on the tissue responses. A thorough understanding of the possible tissue responses is imperative for clinicians to overcome the confusion and manage dental trauma adequately and conservatively in order to minimize the consequences following trauma. © 2016 Australian Dental Association.

Association of Sleep Adequacy With More Healthful Food Choices and Positive Workplace Experiences Among Motor Freight Workers

PubMed Central

Quintiliani, Lisa M.; Yang, May H.; Ebbeling, Cara B.; Stoddard, Anne M.; Pereira, Lesley K.; Sorensen, Glorian

2009-01-01

Objectives. We assessed whether adequate sleep is linked to more healthful eating behaviors among motor freight workers and whether it mediates the effects of workplace experiences. Methods. Data were derived from a baseline survey and assessment of permanent employees at 8 trucking terminals. Bivariate and multivariate regression models were used to examine relationships between work environment, sleep adequacy, and dietary choices. Results. The sample (n = 542) was 83% White, with a mean age of 49 years and a mean body mass index of 30 kg/m2. Most of the participants were satisfied with their job (87.5%) and reported adequate sleep (51%); 30% reported job strain. In our first model, lack of job strain and greater supervisor support were significantly associated with adequate sleep. In our second model, educational level, age, and adequate sleep were significantly associated with at least 2 of the 3 healthful eating choices assessed (P < .05). However, work experiences were not significant predictors of healthful food choices when adequate sleep was included. Conclusions. Adequate sleep is associated with more healthful food choices and may mediate the effects of workplace experiences. Thus, workplace health programs should be responsive to workers' sleep patterns. PMID:19890169

Endo-periodontal lesion--endodontic approach.

PubMed

Jivoinovici, R; Suciu, I; Dimitriu, B; Perlea, P; Bartok, R; Malita, M; Ionescu, C

2014-01-01

Endo-perio lesions might be interdependent because of the vascular and anatomic connections between the pulp and the periodontium. The aim of this study is to emphasise that primary endodontic lesion heals after a proper instrumentation, disinfection and sealing of the endodontic space. The primary endodontic lesion with a secondary periodontal involvement first requires an endodontic therapy and, in the second stage, a periodontal therapy. The prognosis is good, with an adequate root canal treatment; it depends on the severity of the periodontal disease, appropriate healing time and the response to the treatment. A correct diagnosis is sometimes difficult; an accurate identification of the etiologic factors is important for an adequate treatment. Primary perio-endo lesion may heal after a proper disinfection and sealing of the endodontic system, the one-year follow-up radiograph showing bonny repair. Invasive periodontal procedures should be avoided at that moment. The microorganisms and by-products from the infected root canal may cross accessory and furcal canals and determine sinus tract and loss of attachment. In both clinical cases presented in this article, successful healing was obtained after a proper disinfection and sealing of the endodontic system.

A survey of attitudes toward two motivating factors.

PubMed

Marty, J

1977-07-01

A survey was conducted to determine the attitudes clinical laboratory workers in Utah had toward two intrinsic aspects of work, challenge or appeal of work and self-fulfillment. Questionnaires were distributed to all major hospitals in Utah. Frequency distributions were obtained and Chisquare tests were performed to determine if significant differences existed in relationship to demographic variables. Respondents indicated that work was interesting, challenging, required thinking, and enabled them to make good use of past training, skills, and abilities. Findings showed they also responded positively to statements involving ample responsibility given for the position held, contribution to patient care, enjoyment of work, and feeling of self-importance. Negative attitudes were noted toward statements dealing with advancement in medical technology, adequate opportunities for continuing education at employer expense, and participation in decision making. The Chi-square test revealed workers in the hospitals surveyed differed significantly in their opinions about having adequate opportunities to attend workshops, etc., on employer time and expense, and also that personnel with varying educational levels felt significantly different about making suggestions concerning the laboratory.

Progress on Background-Limited Membrane-Isolated TES Bolometers for Far-IR/Submillimeter Spectroscopy

NASA Technical Reports Server (NTRS)

Kenyon, M.; Day, P. K.; Bradford, C. M.; Bock, J. J.; Leduc, H. G.

2006-01-01

To determine the lowest attainable phonon noise equivalent power (NEP) for membrane-isolation bolometers, we fabricated and measured the thermal conductance of suspended Si3N4 beams with different geometries via a noise thermometry technique. We measured beam cross-sectional areas ranging from 0.35 x 0.5 (micro)m(sup 2) to 135 x 1.0 (micro)m(sup 2) and beam lengths ranging from (micro)m to 8300 (micro)m. The measurements directly imply that membrane-isolation bolometers are capable of reaching a phonon noise equivalent power (NEP) of 4 x 10(sup -20)W/Hz(sup 1)/O . This NEP adequate for the Background-Limited Infrared-Submillimeter Spectrograph (BLISS) proposed for the Japanese SPICA observatory, and adequate for NASA's SAFIR observatory, a 10-meter, 4 K telescope to be deployed at L2. Further, we measured the heat capacity of a suspended Si3N4 membrane and show how this result implies that one can make membrane-isolation bolometers with a response time which is fast enough for BLISS.

Model Choice and Sample Size in Item Response Theory Analysis of Aphasia Tests

ERIC Educational Resources Information Center

Hula, William D.; Fergadiotis, Gerasimos; Martin, Nadine

2012-01-01

Purpose: The purpose of this study was to identify the most appropriate item response theory (IRT) measurement model for aphasia tests requiring 2-choice responses and to determine whether small samples are adequate for estimating such models. Method: Pyramids and Palm Trees (Howard & Patterson, 1992) test data that had been collected from…

A Rescorla-Wagner drift-diffusion model of conditioning and timing

PubMed Central

Alonso, Eduardo

2017-01-01

Computational models of classical conditioning have made significant contributions to the theoretic understanding of associative learning, yet they still struggle when the temporal aspects of conditioning are taken into account. Interval timing models have contributed a rich variety of time representations and provided accurate predictions for the timing of responses, but they usually have little to say about associative learning. In this article we present a unified model of conditioning and timing that is based on the influential Rescorla-Wagner conditioning model and the more recently developed Timing Drift-Diffusion model. We test the model by simulating 10 experimental phenomena and show that it can provide an adequate account for 8, and a partial account for the other 2. We argue that the model can account for more phenomena in the chosen set than these other similar in scope models: CSC-TD, MS-TD, Learning to Time and Modular Theory. A comparison and analysis of the mechanisms in these models is provided, with a focus on the types of time representation and associative learning rule used. PMID:29095819

Region 9: Nevada Adequate Letter (1/26/2002), Response to Comments, and Adequacy Review Table

EPA Pesticide Factsheets

A letter from Jack Broadbent, Director, to Allen Biaggi Regarding Nevada's PMlO State Implementation Plan for Clark County; EPA's response regarding the adequacy of the PM10 Transportation Conformity budgets Contained in Clark County's PM10 Attainment

Pollution Response Systems Analysis

DOT National Transportation Integrated Search

1978-01-01

This study was initiated as part of the U.S. Coast Guard effort to provide adequate response within six hours for a spill of up to 100,000 ton of oil in U.S. waters. The guidelines and assumptions for the study are described, and partial results are ...

Perceptions of Recent Graduates of the Adequacy of Anesthesia Training Programs.

ERIC Educational Resources Information Center

Spielman, Fred J.; Bowe, Edwin A.

1983-01-01

A survey examined physician attitudes toward operating room, nonoperating room, and nonpatient care responsibilities in their residencies. Training for operating room responsibilities was deemed adequate by most, and nonoperating room training inadequate. Recommendations include: hospital cooperation, more effective sessions, and supplementary…

Key Response Planning Factors for the Aftermath of Nuclear Terrorism

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

Buddemeier, B R; Dillon, M B

Despite hundreds of above-ground nuclear tests and data gathered from Hiroshima and Nagasaki, the effects of a ground-level, low-yield nuclear detonation in a modern urban environment are still the subject of considerable scientific debate. Extensive review of nuclear weapon effects studies and discussions with nuclear weapon effects experts from various federal agencies, national laboratories, and technical organizations have identified key issues and bounded some of the unknowns required to support response planning for a low-yield, ground-level nuclear detonation in a modern U.S. city. This study, which is focused primarily upon the hazards posed by radioactive fallout, used detailed fallout predictionsmore » from the advanced suite of three-dimensional (3-D) meteorology and plume/fallout models developed at Lawrence Livermore National Laboratory (LLNL), including extensive global Key Response Planning Factors for the Aftermath of Nuclear Terrorism geographical and real-time meteorological databases to support model calculations. This 3-D modeling system provides detailed simulations that account for complex meteorology and terrain effects. The results of initial modeling and analysis were presented to federal, state, and local working groups to obtain critical, broad-based review and feedback on strategy and messaging. This effort involved a diverse set of communities, including New York City, National Capitol Regions, Charlotte, Houston, Portland, and Los Angeles. The largest potential for reducing casualties during the post-detonation response phase comes from reducing exposure to fallout radiation. This can be accomplished through early, adequate sheltering followed by informed, delayed evacuation.B The response challenges to a nuclear detonation must be solved through multiple approaches of public education, planning, and rapid response actions. Because the successful response will require extensive coordination of a large number of organizations, supplemented by appropriate responses by local responders and the general population within the hazard zones, regional planning is essential to success. The remainder of this Executive Summary provides summary guidance for response planning in three areas: (1) Public Protection Strategy details the importance of early, adequate shelter followed by informed evacuation. (2) Responder Priorities identify how to protect response personnel, perform regional situational assessment, and support public safety. (3) Key Planning Considerations refute common myths and provide important information on planning how to respond in the aftermath of nuclear terrorism.« less

EMuJoy: software for continuous measurement of perceived emotions in music.

PubMed

Nagel, Frederik; Kopiez, Reinhard; Grewe, Oliver; Altenmüller, Eckart

2007-05-01

An adequate study of emotions in music and film should be based on the real-time measurement of self-reported data using a continuous-response method. The recording system discussed in this article reflects two important aspects of such research: First, for a better comparison of results, experimental and technical standards for continuous measurement should be taken into account, and second, the recording system should be open to the inclusion of multimodal stimuli. In light of these two considerations, our article addresses four basic principles of the continuous measurement of emotions: (1) the dimensionality of the emotion space, (2) data acquisition (e.g., the synchronization of media and the self-reported data), (3) interface construction for emotional responses, and (4) the use of multiple stimulus modalities. Researcher-developed software (EMuJoy) is presented as a freeware solution for the continuous measurement of responses to different media, along with empirical data from the self-reports of 38 subjects listening to emotional music and viewing affective pictures.

Nurse Leaders' Response to Civil Unrest in the Urban Core.

PubMed

Lavin, Roberta; Goodwin Veenema, Tener; Calvert, Wilma J; Grigsby, Sheila R; Cobbina, Jennifer

Inequalities in society, culture, and finance have resulted in civil unrest, rioting, and intentional violence throughout our history. Nowhere is this currently more apparent than in the cities of Ferguson and Baltimore. It is not the civil unrest itself, but the resulting rioting and intentional violence that can create a disaster situation. This increases the care burden of health care providers during times when the governmental structure may be overwhelmed or functioning in a less than optimal manner. Beginning with the death of Michael Brown, civil unrest over the last 2 years has necessitated a closer examination of the role nurse leaders play in preparing their staff and facilities for potential results of this civil unrest. The similarities between the results of rioting and violence and natural disaster are obvious, but the differences are significant. Without adequate preparation, providers may not offer the appropriate response. Attention to the 10 "musts" for preparedness for civil unrest will facilitate a planning process and provide for a better response and recovery when communities face these issues.

14 CFR 142.15 - Facilities.

Code of Federal Regulations, 2014 CFR

2014-01-01

... adequate periods of time and at a location approved by the Administrator, adequate flight training equipment and courseware, including at least one flight simulator or advanced flight training device. [Doc... significant distractions caused by flight operations and maintenance operations at the airport. (b) An...

14 CFR 142.15 - Facilities.

Code of Federal Regulations, 2011 CFR

2011-01-01

... adequate periods of time and at a location approved by the Administrator, adequate flight training equipment and courseware, including at least one flight simulator or advanced flight training device. [Doc... significant distractions caused by flight operations and maintenance operations at the airport. (b) An...

14 CFR 142.15 - Facilities.

Code of Federal Regulations, 2013 CFR

2013-01-01

... adequate periods of time and at a location approved by the Administrator, adequate flight training equipment and courseware, including at least one flight simulator or advanced flight training device. [Doc... significant distractions caused by flight operations and maintenance operations at the airport. (b) An...

14 CFR 142.15 - Facilities.

Code of Federal Regulations, 2012 CFR

2012-01-01

... adequate periods of time and at a location approved by the Administrator, adequate flight training equipment and courseware, including at least one flight simulator or advanced flight training device. [Doc... significant distractions caused by flight operations and maintenance operations at the airport. (b) An...

Winnicott's response to Klein.

PubMed

Ehrlich, Robert

2004-04-01

The author suggests that, although Donald Winnicott presented some important criticisms of Melanie Klein's work, at times he tried to advance his perspectives too definitively without adequately considering her own. Because of this, he failed to acknowledge sufficiently that he was offering a model of human nature and development that could be revised. The fact that his differences with Klein arose in the context of a complex relationship in which each played numerous roles for the other, especially in the context of their affiliation with the British Psychoanalytical Society, periodically made it difficult for him to present his ideas more carefully and in his more characteristically open manner.

Accessing directorships: comparison of views of Canadian and Australian women directors.

PubMed

Sheridan, Alison

2002-02-01

Compared are views of Canadian and Australian women directors concerning the difficulties women face in accessing the most privileged level of management-directorships of companies. The Canadian data are from a study of 278 women directors of corporate boards in Canada while the Australian results are from a study of 47 women directors of publicly listed companies in Australia. Despite the different time periods and geographical locations in which the studies were carried out, the profiles and responses of the two groups are quite similar. Both groups believe the current mix of directors is not adequate and that barriers still exist in nominating women to boards.

Temporal Treatment of a Thermal Response for Defect Depth Estimation

NASA Technical Reports Server (NTRS)

Plotnikov, Y. A.; Winfree, W. P.

2004-01-01

Transient thermography, which employs pulse surface heating of an inspected component followed by acquisition of the thermal decay stage, is gaining wider acceptance as a result of its remoteness and rapidness. Flaws in the component s material may induce a thermal contrast in surface thermograms. An important issue in transient thermography is estimating the depth of a subsurface flaw from the thermal response. This improves the quantitative ability of the thermal evaluation: from one scan it is possible to locate regions of anomalies in thickness (caused by corrosion) and estimate the implications of the flaw on the integrity of the structure. Our research focuses on thick composite aircraft components. A long square heating pulse and several minutes observation period are required to receive an adequate thermal response from such a component. Application of various time-related informative parameters of the thermal response for depth estimation is discussed. A three-dimensional finite difference model of heat propagation in solids in Cartesian coordinates is used to simulate the thermographic process. Typical physical properties of polymer graphite composites are assumed for the model.

Optimum Design of a Helicopter Rotor for Low Vibration Using Aeroelastic Analysis and Response Surface Methods

NASA Astrophysics Data System (ADS)

Ganguli, R.

2002-11-01

An aeroelastic analysis based on finite elements in space and time is used to model the helicopter rotor in forward flight. The rotor blade is represented as an elastic cantilever beam undergoing flap and lag bending, elastic torsion and axial deformations. The objective of the improved design is to reduce vibratory loads at the rotor hub that are the main source of helicopter vibration. Constraints are imposed on aeroelastic stability, and move limits are imposed on the blade elastic stiffness design variables. Using the aeroelastic analysis, response surface approximations are constructed for the objective function (vibratory hub loads). It is found that second order polynomial response surfaces constructed using the central composite design of the theory of design of experiments adequately represents the aeroelastic model in the vicinity of the baseline design. Optimization results show a reduction in the objective function of about 30 per cent. A key accomplishment of this paper is the decoupling of the analysis problem and the optimization problems using response surface methods, which should encourage the use of optimization methods by the helicopter industry.

Real-Time Simulation for Verification and Validation of Diagnostic and Prognostic Algorithms

NASA Technical Reports Server (NTRS)

Aguilar, Robet; Luu, Chuong; Santi, Louis M.; Sowers, T. Shane

2005-01-01

To verify that a health management system (HMS) performs as expected, a virtual system simulation capability, including interaction with the associated platform or vehicle, very likely will need to be developed. The rationale for developing this capability is discussed and includes the limited capability to seed faults into the actual target system due to the risk of potential damage to high value hardware. The capability envisioned would accurately reproduce the propagation of a fault or failure as observed by sensors located at strategic locations on and around the target system and would also accurately reproduce the control system and vehicle response. In this way, HMS operation can be exercised over a broad range of conditions to verify that it meets requirements for accurate, timely response to actual faults with adequate margin against false and missed detections. An overview is also presented of a real-time rocket propulsion health management system laboratory which is available for future rocket engine programs. The health management elements and approaches of this lab are directly applicable for future space systems. In this paper the various components are discussed and the general fault detection, diagnosis, isolation and the response (FDIR) concept is presented. Additionally, the complexities of V&V (Verification and Validation) for advanced algorithms and the simulation capabilities required to meet the changing state-of-the-art in HMS are discussed.

30 CFR 254.44 - Calculating response equipment effective daily recovery capacities.

Code of Federal Regulations, 2014 CFR

2014-07-01

..., DEPARTMENT OF THE INTERIOR OFFSHORE OIL-SPILL RESPONSE REQUIREMENTS FOR FACILITIES LOCATED SEAWARD OF THE... operations due to available daylight, sea state, temperature, viscosity, and emulsification of the oil being... specific oil recovery devices, you must submit evidence to substantiate that efficiency factor. Adequate...

30 CFR 254.44 - Calculating response equipment effective daily recovery capacities.

Code of Federal Regulations, 2012 CFR

2012-07-01

..., DEPARTMENT OF THE INTERIOR OFFSHORE OIL-SPILL RESPONSE REQUIREMENTS FOR FACILITIES LOCATED SEAWARD OF THE... operations due to available daylight, sea state, temperature, viscosity, and emulsification of the oil being... specific oil recovery devices, you must submit evidence to substantiate that efficiency factor. Adequate...

Tsunami evacuation analysis, modelling and planning: application to the coastal area of El Salvador

NASA Astrophysics Data System (ADS)

Gonzalez-Riancho, Pino; Aguirre-Ayerbe, Ignacio; Aniel-Quiroga, Iñigo; Abad Herrero, Sheila; González Rodriguez, Mauricio; Larreynaga, Jeniffer; Gavidia, Francisco; Quetzalcoalt Gutiérrez, Omar; Álvarez-Gómez, Jose Antonio; Medina Santamaría, Raúl

2014-05-01

Advances in the understanding and prediction of tsunami impacts allow the development of risk reduction strategies for tsunami-prone areas. Conducting adequate tsunami risk assessments is essential, as the hazard, vulnerability and risk assessment results allow the identification of adequate, site-specific and vulnerability-oriented risk management options, with the formulation of a tsunami evacuation plan being one of the main expected results. An evacuation plan requires the analysis of the territory and an evaluation of the relevant elements (hazard, population, evacuation routes, and shelters), the modelling of the evacuation, and the proposal of alternatives for those communities located in areas with limited opportunities for evacuation. Evacuation plans, which are developed by the responsible authorities and decision makers, would benefit from a clear and straightforward connection between the scientific and technical information from tsunami risk assessments and the subsequent risk reduction options. Scientifically-based evacuation plans would translate into benefits for the society in terms of mortality reduction. This work presents a comprehensive framework for the formulation of tsunami evacuation plans based on tsunami vulnerability assessment and evacuation modelling. This framework considers (i) the hazard aspects (tsunami flooding characteristics and arrival time), (ii) the characteristics of the exposed area (people, shelters and road network), (iii) the current tsunami warning procedures and timing, (iv) the time needed to evacuate the population, and (v) the identification of measures to improve the evacuation process, such as the potential location for vertical evacuation shelters and alternative routes. The proposed methodological framework aims to bridge the gap between risk assessment and risk management in terms of tsunami evacuation, as it allows for an estimation of the degree of evacuation success of specific management options, as well as for the classification and prioritization of the gathered information, in order to formulate an optimal evacuation plan. The framework has been applied to the El Salvador case study through the project "Tsunami Hazard and Risk Assessment in El Salvador", funded by AECID during the period 2009-12, demonstrating its applicability to site-specific response times and population characteristics.

Normalization methods in time series of platelet function assays

PubMed Central

Van Poucke, Sven; Zhang, Zhongheng; Roest, Mark; Vukicevic, Milan; Beran, Maud; Lauwereins, Bart; Zheng, Ming-Hua; Henskens, Yvonne; Lancé, Marcus; Marcus, Abraham

2016-01-01

Abstract Platelet function can be quantitatively assessed by specific assays such as light-transmission aggregometry, multiple-electrode aggregometry measuring the response to adenosine diphosphate (ADP), arachidonic acid, collagen, and thrombin-receptor activating peptide and viscoelastic tests such as rotational thromboelastometry (ROTEM). The task of extracting meaningful statistical and clinical information from high-dimensional data spaces in temporal multivariate clinical data represented in multivariate time series is complex. Building insightful visualizations for multivariate time series demands adequate usage of normalization techniques. In this article, various methods for data normalization (z-transformation, range transformation, proportion transformation, and interquartile range) are presented and visualized discussing the most suited approach for platelet function data series. Normalization was calculated per assay (test) for all time points and per time point for all tests. Interquartile range, range transformation, and z-transformation demonstrated the correlation as calculated by the Spearman correlation test, when normalized per assay (test) for all time points. When normalizing per time point for all tests, no correlation could be abstracted from the charts as was the case when using all data as 1 dataset for normalization. PMID:27428217

In-Band Asymmetry Compensation for Accurate Time/Phase Transport over Optical Transport Network

PubMed Central

Siu, Sammy; Hu, Hsiu-fang; Lin, Shinn-Yan; Liao, Chia-Shu; Lai, Yi-Liang

2014-01-01

The demands of precise time/phase synchronization have been increasing recently due to the next generation of telecommunication synchronization. This paper studies the issues that are relevant to distributing accurate time/phase over optical transport network (OTN). Each node and link can introduce asymmetry, which affects the adequate time/phase accuracy over the networks. In order to achieve better accuracy, protocol level full timing support is used (e.g., Telecom-Boundary clock). Due to chromatic dispersion, the use of different wavelengths consequently causes fiber link delay asymmetry. The analytical result indicates that it introduces significant time error (i.e., phase offset) within 0.3397 ns/km in C-band or 0.3943 ns/km in L-band depending on the wavelength spacing. With the proposed scheme in this paper, the fiber link delay asymmetry can be compensated relying on the estimated mean fiber link delay by the Telecom-Boundary clock, while the OTN control plane is responsible for processing the fiber link delay asymmetry to determine the asymmetry compensation in the timing chain. PMID:24982948

A Review of Player Monitoring Approaches in Basketball: Current Trends and Future Directions.

PubMed

Fox, Jordan L; Scanlan, Aaron T; Stanton, Robert

2017-07-01

Fox, JL, Scanlan, AT, and Stanton, R. A review of player monitoring approaches in basketball: current trends and future directions. J Strength Cond Res 31(7): 2021-2029, 2017-Effective monitoring of players in team sports such as basketball requires an understanding of the external demands and internal responses, as they relate to training phases and competition. Monitoring of external demands and internal responses allows coaching staff to determine the dose-response associated with the imposed training load (TL), and subsequently, if players are adequately prepared for competition. This review discusses measures reported in the literature for monitoring the external demands and internal responses of basketball players during training and competition. The external demands of training and competition were primarily monitored using time-motion analysis, with limited use of microtechnology being reported. Internal responses during training were typically measured using hematological markers, heart rate, various TL models, and perceptual responses such as rating of perceived exertion (RPE). Heart rate was the most commonly reported indicator of internal responses during competition with limited reporting of hematological markers or RPE. These findings show a large discrepancy between the reporting of external and internal measures and training and competition demands. Microsensors, however, may be a practical and convenient method of player monitoring in basketball to overcome the limitations associated with current approaches while allowing for external demands and internal responses to be recorded simultaneously. The triaxial accelerometers of microsensors seem well suited for basketball and warrant validation to definitively determine their place in the monitoring of basketball players. Coaching staff should make use of this technology by tracking individual player responses across the annual plan and using real-time monitoring to minimize factors such as fatigue and injury risk.

Exercise in Young Adulthood with Simultaneous and Future Changes in Fruit and Vegetable Intake.

PubMed

Jayawardene, Wasantha P; Torabi, Mohammad R; Lohrmann, David K

2016-01-01

Regarding weight management, changes in exercise behavior can also influence nutrition behavior by application of self-regulatory psychological resources across behaviors (transfer effect). This study aimed to determine: (1) if changes in exercise frequency in young adulthood predict simultaneous changes in fruit/vegetable intake (transfer as co-occurrence); and (2) if exercise frequency affects future fruit/vegetable intake (transfer as carry-over). 6244 respondents of the National Longitudinal Survey of Youth 1997 were followed at ages 18-22 (Time-1), 23-27 (Time-2), and 27-31 (Time-3). Repeated measures analysis of variance and hierarchical multiple regression determined if the change in exercise frequency between Time-1 and Time-2 was associated with simultaneous and sequential changes in fruit/vegetable intake frequency, controlling for sex, race/ethnicity, education, income, body mass index, and baseline fruit/vegetable intake. Only 9% continued exercising for 30 minutes more than 5 days/week, while 15% transitioned to adequate exercise and another 15% transitioned to inadequate exercise; for both fruits and vegetables, intake of once per day or more increased with age. Males were more likely to exercise adequately and females to consume fruits/vegetables adequately. Exercise frequency transition was linearly associated with concurrent fruit/vegetable intake during Time-1 and Time-2. The highest increase in mean fruit/vegetable intake occurred for participants who transitioned from inadequate to adequate exercise. A significant Time-2 exercise frequency effect on Time-3 fruit/vegetable intake emerged, after accounting for baseline intake. Increase in Time-2 exercise by one day/week resulted in increased Time-3 fruit and vegetable intakes by 0.17 and 0.13 times/week, respectively. Transfer effects, although usually discussed in interventions, may also be applicable to voluntary behavior change processes. Newly engaging in and continuing exercise behavior over time may establish exercise habits that facilitate improved fruit/vegetable consumption. Interventions that facilitate transferring resources across behaviors likely will enhance this effect.

Repeated sugammadex reversal of muscle relaxation during lumbar spine surgery with intraoperative neurophysiological multimodal monitoring.

PubMed

Errando, C L; Blanco, T; Díaz-Cambronero, Ó

2016-11-01

Intraoperative neurophysiological monitoring during spine surgery is usually acomplished avoiding muscle relaxants. A case of intraoperative sugammadex partial reversal of the neuromuscular blockade allowing adequate monitoring during spine surgery is presented. A 38 year-old man was scheduled for discectomy and vertebral arthrodesis throughout anterior and posterior approaches. Anesthesia consisted of total intravenous anesthesia plus rocuronium. Intraoperatively monitoring was needed, and the muscle relaxant reverted twice with low dose sugammadex in order to obtain adequate responses. The doses of sugammadex used were conservatively selected (0.1mg/kg boluses increases, total dose needed 0.4mg/kg). Both motor evoqued potentials, and electromyographic responses were deemed adequate by the neurophysiologist. If muscle relaxation was needed in the context described, this approach could be useful to prevent neurological sequelae. This is the first study using very low dose sugammadex to reverse rocuronium intraoperatively and to re-establish the neuromuscular blockade. Copyright © 2016 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

Expressing the sense of the Congress that the lack of adequate housing must be addressed as a barrier to effective HIV prevention, treatment, and care, and that the United States should make a commitment to providing adequate funding for developing housing as a response to the AIDS pandemic.

THOMAS, 111th Congress

Rep. Nadler, Jerrold [D-NY-8

2009-06-02

Senate - 05/25/2010 Received in the Senate and referred to the Committee on Banking, Housing, and Urban Affairs. (All Actions) Tracker: This bill has the status Agreed to in HouseHere are the steps for Status of Legislation:

Does nutrition support have a role in managing cancer cachexia?

PubMed

Laviano, Alessandro; Di Lazzaro Giraldi, Gianluca; Koverech, Angela

2016-12-01

Cachexia is a negative prognostic factor in cancer patients. The pathogenesis is related to a variable combination of reduced food intake and metabolic changes. However, whether nutritional support may contribute to effectively prevent and treat cachexia remains a debated issue. Consistent evidence demonstrates that anabolic windows of opportunity occur during the clinical trajectory of cancer patients. Also, the use of specific nutrients, namely omega-3 fatty acids, may enhance the efficacy of nutritional support when tumor-driven inflammatory response is high. Of greater interest, it is now becoming clearer that the use of nutritional support at key time points in the clinical journey of cancer patients (i.e., perioperative period) may extend its clinical benefits beyond those on nutritional status. Nutritional support plays a role in managing cancer cachexia, when it is timely delivered, when it provides adequate amounts of calories and proteins, and when it is part of a concurrent palliative care approach. Specific nutrients, that is, omega-3 fatty acids, may help in those cancer patients with high-inflammatory response, and may also contribute to positively influence long-term clinical outcomes.

Response surface methodology for cadmium biosorption on Pseudomonas aeruginosa.

PubMed

Ahmady-Asbchin, Salman

2016-01-01

In this research the effects of various physicochemical factors on Cd(2+) biosorption such as initial metal concentration, pH and contact exposure time were studied. This study has shown a Cd(2+) biosorption, equilibrium time of about 5 min for Pseudomonas aeruginosa and the adsorption equilibrium data were well described by Langmuir equation. The maximum capacity for biosorption has been extrapolated to 0.56 mmol.g(-1) for P. aeruginosa. The thermodynamic properties ΔG(0), ΔH(0), and ΔS(0) of Cd(2+) for biosorption were analyzed by the equilibrium constant value obtained from experimented data at different temperatures. The results show that biosorption of Cd(2+) by P. aeruginosa are endothermic and spontaneous with ΔH value of 36.35 J.mol(-1). By response surface methodology, the quadratic model has adequately described the experimental data based on the adjusted determination coefficient (R(2) = 0.98). The optimum conditions for maximum uptake onto the biosorbent were established at 0.5 g.l(-1) biosorbent concentration, pH 6 for the aqueous solution, and a temperature of 30 °C.

The willingness of private-sector doctors to manage public-sector HIV/AIDS patients in the eThekwini metropolitan region of KwaZulu-Natal

PubMed Central

Jinabhai, Champaklal C.; Taylor, Myra

2010-01-01

ABSTRACT Background South Africa is severely affected by the AIDS pandemic and this has resulted in an already under-resourced public sector being placed under further stress, while there remains a vibrant private sector. To address some of the resource and personnel shortages facing the public sector in South Africa, partnerships between the public and private sectors are slowly being forged. However, little is known about the willingness of private-sector doctors in the eThekwini Metropolitan (Metro) region of KwaZulu-Natal, South Africa to manage public-sector HIV and AIDS patients. Objectives To gauge the willingness of private-sector doctor to manage public-sector HIV and AIDS patients and to describe factors that may influence their responses. Method A descriptive cross-sectional study was undertaken among private-sector doctors, both general practitioners (GPs) and specialists, working in the eThekwini Metro, using an anonymous, structured questionnaire to investigate their willingness to manage public-sector HIV and AIDS patients and the factors associated with their responses. Chi-square and independent t-tests were used to evaluate associations. Odds ratios were determined using a binary logistic regression model. A p value < 0.05 was considered statistically significant. Results Most of the doctors were male GPs aged 30–50 years who had been in practice for more than 10 years. Of these, 133 (77.8%) were willing to manage public-sector HIV and AIDS patients, with 105 (78.9%) reporting adequate knowledge, 99 (74.4%) adequate time, and 83 (62.4%) adequate infrastructure. Of the 38 (22.2%) that were unwilling to manage these patients, more than 80% cited a lack of time, knowledge and infrastructure to manage them. Another reason cited by five doctors (3.8%) who were unwilling, was the distance from public-sector facilities. Of the 33 specialist doctors, 14 (42.4%) indicated that they would not be willing to manage public-sector HIV and AIDS patients, compared with only 24 (17.4%) of the 138 GPs (p < 0.01). Conclusion Many private-sector doctors are willing to manage public-sector HIV and AIDS patients in the eThekwini Metro, potentially removing some of the current burden on the public health sector.

Real-time monitoring of a microbial electrolysis cell using an electrical equivalent circuit model.

PubMed

Hussain, S A; Perrier, M; Tartakovsky, B

2018-04-01

Efforts in developing microbial electrolysis cells (MECs) resulted in several novel approaches for wastewater treatment and bioelectrosynthesis. Practical implementation of these approaches necessitates the development of an adequate system for real-time (on-line) monitoring and diagnostics of MEC performance. This study describes a simple MEC equivalent electrical circuit (EEC) model and a parameter estimation procedure, which enable such real-time monitoring. The proposed approach involves MEC voltage and current measurements during its operation with periodic power supply connection/disconnection (on/off operation) followed by parameter estimation using either numerical or analytical solution of the model. The proposed monitoring approach is demonstrated using a membraneless MEC with flow-through porous electrodes. Laboratory tests showed that changes in the influent carbon source concentration and composition significantly affect MEC total internal resistance and capacitance estimated by the model. Fast response of these EEC model parameters to changes in operating conditions enables the development of a model-based approach for real-time monitoring and fault detection.

Clinicians' perspectives on patient satisfaction in adult congenital heart disease clinics--a dimension of health care quality whose time has come.

PubMed

Rozenblum, Ronen; Gianola, Ann; Ionescu-Ittu, Raluca; Verstappen, Amy; Landzberg, Michael; Gurvitz, Michelle; Jenkins, Kathy; Bates, David W; Marelli, Ariane J

2015-01-01

Patient-centered care and patient satisfaction represent key dimensions of health care quality. This is relevant for the growing number of patients with life-long conditions. In the present study, our goal was to examine clinicians' attitudes and behavior with respect to patient satisfaction in adult congenital heart disease outpatient clinics. A 34-question survey was developed to assess adult congenital heart disease clinicians' awareness, attitudes, and behavior relative to patient satisfaction and administered in-person or online to clinicians from the largely U.S.-based Adult Congenital Heart Association's database of adult congenital heart disease health care providers. Overall, 267 questionnaires were filled out: 108 were collected in person (79% response rate) and 159 online (17.5% response rate). Responses were received from physicians (161); nurses (73); physician assistants (20); and others (13). Although 85% of clinicians believed it was important to inquire about patient satisfaction, only 28% reported routinely inquiring about this dimension of care. Only 34% claimed they had adequate training to cope with varying levels of patient satisfaction, 44% stated that their department utilized patient satisfaction surveys, and 37% received feedback from the hospital management in the preceding 12 months. In multivariate analyses, clinicians that received feedback from the hospital management and had adequate training were more likely to inquire about patient satisfaction. Although patient satisfaction is perceived as an important dimension of quality care by adult congenital heart disease clinicians, most of them reported insufficient institutional support to achieve this. Our findings suggest that clinicians would benefit from health care organizations engaging them in the delivery of this dimension of health care quality. © 2014 Wiley Periodicals, Inc.

Lack of association between stroke symptom knowledge and intent to call 911: a population-based survey.

PubMed

Fussman, Chris; Rafferty, Ann P; Lyon-Callo, Sarah; Morgenstern, Lewis B; Reeves, Mathew J

2010-07-01

Excessive prehospital delay between acute stroke onset and hospital arrival is an ongoing problem. Translating knowledge of stroke warning signs into appropriate action is critical to decrease prehospital delay. Our objectives were to estimate the proportion of Michigan adults who would react appropriately by calling 911 when presented with hypothetical stroke-related scenarios and to examine the association between knowledge of warning signs and calling 911. In 2004, questions regarding initial response to health-related scenarios were added to the Michigan Behavioral Risk Factor Survey, a population-based telephone survey of adults. We calculated the proportion of respondents who would call 911 in response to 3 stroke-related scenarios and examined the association between stroke warning sign knowledge and 911 activation. Among 4841 adults, 27.6% (95% CI, 26.2 to 29.0) had adequate knowledge of stroke warning signs (defined as reporting 3 correct warning signs), and 14.0% (95% CI, 12.9 to 15.1) reported they would call 911 for all 3 stroke-related scenarios. Knowledge of specific stroke warning signs was only modestly associated with calling 911 in response to medical scenarios that involved the same stroke symptom (OR, 1.17 to 1.39). Even among those with adequate knowledge of stroke warning signs, only 17.6% (95% CI, 15.5 to 20.0) would call 911 for all 3 stroke scenarios. In this population-based survey, stroke symptom knowledge was not associated with the intent to call 911 for stroke. This study emphasizes the critical role of motivation in addition to symptom knowledge to reducing delay time to hospital arrival for stroke.

Dietary Zinc Deficiency Exaggerates Ethanol-Induced Liver Injury in Mice: Involvement of Intrahepatic and Extrahepatic Factors

PubMed Central

Sun, Xinguo; Song, Zhenyuan; McClain, Craig J.; Zhou, Zhanxiang

2013-01-01

Clinical studies have demonstrated that alcoholics have a lower dietary zinc intake compared to health controls. The present study was undertaken to determine the interaction between dietary zinc deficiency and ethanol consumption in the pathogenesis of alcoholic liver disease. C57BL/6N mice were subjected to 8-week feeding of 4 experimental liquid diets: (1) zinc adequate diet, (2) zinc adequate diet plus ethanol, (3) zinc deficient diet, and (4) zinc deficient diet plus ethanol. Ethanol exposure with adequate dietary zinc resulted in liver damage as indicated by elevated plasma alanine aminotransferase level and increased hepatic lipid accumulation and inflammatory cell infiltration. Dietary zinc deficiency alone increased hepatic lipid contents, but did not induce hepatic inflammation. Dietary zinc deficiency showed synergistic effects on ethanol-induced liver damage. Dietary zinc deficiency exaggerated ethanol effects on hepatic genes related to lipid metabolism and inflammatory response. Dietary zinc deficiency worsened ethanol-induced imbalance between hepatic pro-oxidant and antioxidant enzymes and hepatic expression of cell death receptors. Dietary zinc deficiency exaggerated ethanol-induced reduction of plasma leptin, although it did not affect ethanol-induced reduction of white adipose tissue mass. Dietary zinc deficiency also deteriorated ethanol-induced gut permeability increase and plasma endotoxin elevation. These results demonstrate, for the first time, that dietary zinc deficiency is a risk factor in alcoholic liver disease, and multiple intrahepatic and extrahepatic factors may mediate the detrimental effects of zinc deficiency. PMID:24155903

Distributed nestmate recognition in ants.

PubMed

Esponda, Fernando; Gordon, Deborah M

2015-05-07

We propose a distributed model of nestmate recognition, analogous to the one used by the vertebrate immune system, in which colony response results from the diverse reactions of many ants. The model describes how individual behaviour produces colony response to non-nestmates. No single ant knows the odour identity of the colony. Instead, colony identity is defined collectively by all the ants in the colony. Each ant responds to the odour of other ants by reference to its own unique decision boundary, which is a result of its experience of encounters with other ants. Each ant thus recognizes a particular set of chemical profiles as being those of non-nestmates. This model predicts, as experimental results have shown, that the outcome of behavioural assays is likely to be variable, that it depends on the number of ants tested, that response to non-nestmates changes over time and that it changes in response to the experience of individual ants. A distributed system allows a colony to identify non-nestmates without requiring that all individuals have the same complete information and helps to facilitate the tracking of changes in cuticular hydrocarbon profiles, because only a subset of ants must respond to provide an adequate response.

Cross-omics comparison of stress responses in mesothelial cells exposed to heat- versus filter-sterilized peritoneal dialysis fluids.

PubMed

Kratochwill, Klaus; Bender, Thorsten O; Lichtenauer, Anton M; Herzog, Rebecca; Tarantino, Silvia; Bialas, Katarzyna; Jörres, Achim; Aufricht, Christoph

2015-01-01

Recent research suggests that cytoprotective responses, such as expression of heat-shock proteins, might be inadequately induced in mesothelial cells by heat-sterilized peritoneal dialysis (PD) fluids. This study compares transcriptome data and multiple protein expression profiles for providing new insight into regulatory mechanisms. Two-dimensional difference gel electrophoresis (2D-DIGE) based proteomics and topic defined gene expression microarray-based transcriptomics techniques were used to evaluate stress responses in human omental peritoneal mesothelial cells in response to heat- or filter-sterilized PD fluids. Data from selected heat-shock proteins were validated by 2D western-blot analysis. Comparison of proteomics and transcriptomics data discriminated differentially regulated protein abundance into groups depending on correlating or noncorrelating transcripts. Inadequate abundance of several heat-shock proteins following exposure to heat-sterilized PD fluids is not reflected on the mRNA level indicating interference beyond transcriptional regulation. For the first time, this study describes evidence for posttranscriptional inadequacy of heat-shock protein expression by heat-sterilized PD fluids as a novel cytotoxic property. Cross-omics technologies introduce a novel way of understanding PDF bioincompatibility and searching for new interventions to reestablish adequate cytoprotective responses.

Trial by Fire (and Tornado) Taught Us to Plan for Crises.

ERIC Educational Resources Information Center

Caylor, Mary Jane

1991-01-01

Based on Huntsville (Alabama) schools' experience with a devastating fire, the superintendent later ensured adequate fire insurance coverage, promoted regular fire drills, and developed an emergency response plan that delineated staff responsibilities, communication modes, and training and updating procedures. The plan served the district well…

Filtered Life Satisfaction and Its Socioeconomic Determinants in Hong Kong

ERIC Educational Resources Information Center

Cheung, Chau-kiu; Ngan, Raymond Man-hung

2012-01-01

Filtering the measure of life satisfaction through the bias of social desirability and response styles would furnish an adequate analysis of socioeconomic impacts on the filtered life satisfaction. The filtering is necessary because social desirability and the response styles of acquiescence, extremity, and centrality are likely to contaminate the…

Potential concerns for tree response from stem injection

Treesearch

Kevin T. Smith; Phillip A. Lewis

2005-01-01

Stem injection of imidacloprid is an available component of management strategies for hemlock woolly adelgid. Preliminary observations of similar treatments of maple and ash show that the injury sustained by injection warrants investigation of the wound response in eastern hemlock. Such investigations need adequate experimental controls to identify the role of...

Emergency response networks for disaster monitoring and detection from space

NASA Astrophysics Data System (ADS)

Vladimirova, Tanya; Sweeting, Martin N.; Vitanov, Ivan; Vitanov, Valentin I.

2009-05-01

Numerous man-made and natural disasters have stricken mankind since the beginning of the new millennium. The scale and impact of such disasters often prevent the collection of sufficient data for an objective assessment and coordination of timely rescue and relief missions on the ground. As a potential solution to this problem, in recent years constellations of Earth observation small satellites and in particular micro-satellites (<100 kg) in low Earth orbit have emerged as an efficient platform for reliable disaster monitoring. The main task of the Earth observation satellites is to capture images of the Earth surface using various techniques. For a large number of applications the resulting delay between image capture and delivery is not acceptable, in particular for rapid response remote sensing aiming at disaster monitoring and detection. In such cases almost instantaneous data availability is a strict requirement to enable an assessment of the situation and instigate an adequate response. Examples include earthquakes, volcanic eruptions, flooding, forest fires and oil spills. The proposed solution to this issue are low-cost networked distributed satellite systems in low Earth orbit capable of connecting to terrestrial networks and geostationary Earth orbit spacecraft in real time. This paper discusses enabling technologies for rapid response disaster monitoring and detection from space such as very small satellite design, intersatellite communication, intelligent on-board processing, distributed computing and bio-inspired routing techniques.

Energy Consumption Information Services for Smart Home Inhabitants

NASA Astrophysics Data System (ADS)

Schwanzer, Michael; Fensel, Anna

We investigate services giving users an adequate insight on his or her energy consumption habits in order to optimize it in the long run. The explored energy awareness services are addressed to inhabitants of smart homes, equipped with smart meters, advanced communication facilities, sensors and actuators. To analyze the potential of such services, a game at a social network Facebook has been designed and implemented, and the information about players' responses and interactions within the game environment has been collected and analyzed. The players have had their virtual home energy usage visualized in different ways, and had to optimize the energy consumption basing on their own perceptions of the consumption information. Evaluations reveal, in particular, that users are specifically responsive to information shown as a real-time graph and as costs in Euro, and are able to produce and share with each other policies for managing their smart home environments.

Immunization of children with secondary immunodeficiency.

PubMed

Esposito, Susanna; Prada, Elisabetta; Lelii, Mara; Castellazzi, Luca

2015-01-01

The main causes of secondary immunodeficiency at a pediatric age include infectious diseases (mainly HIV infection), malignancies, haematopoietic stem cell or solid organ transplantation and autoimmune diseases. Children with secondary immunodeficiency have an increased risk of severe infectious diseases that could be prevented by adequate vaccination coverage, but vaccines administration can be associated with reduced immune response and an increased risk of adverse reactions. The immunogenicity of inactivated and recombinant vaccines is comparable to that of healthy children at the moment of vaccination, but it undergoes a progressive decline over time, and in the absence of a booster, the patients remain at risk of developing vaccine-preventable infections. However, the administration of live attenuated viral vaccines is controversial because of the risk of the activation of vaccine viruses. A specific immunization program should be administered according to the clinical and immunological status of each of these conditions to ensure a sustained immune response without any risks to the patients' health.

Challenges of Generating and Maintaining Protective Vaccine-Induced Immune Responses for Foot-and-Mouth Disease Virus in Pigs

PubMed Central

Lyons, Nicholas A.; Lyoo, Young S.; King, Donald P.; Paton, David J.

2016-01-01

Vaccination can play a central role in the control of outbreaks of foot-and-mouth disease (FMD) by reducing both the impact of clinical disease and the extent of virus transmission between susceptible animals. Recent incursions of exotic FMD virus lineages into several East Asian countries have highlighted the difficulties of generating and maintaining an adequate immune response in vaccinated pigs. Factors that impact vaccine performance include (i) the potency, antigenic payload, and formulation of a vaccine; (ii) the antigenic match between the vaccine and the heterologous circulating field strain; and (iii) the regime (timing, frequency, and herd-level coverage) used to administer the vaccine. This review collates data from studies that have evaluated the performance of foot-and-mouth disease virus vaccines at the individual and population level in pigs and identifies research priorities that could provide new insights to improve vaccination in the future. PMID:27965966

Study of sensor spectral responses and data processing algorithms and architectures for onboard feature identification

NASA Technical Reports Server (NTRS)

Huck, F. O.; Davis, R. E.; Fales, C. L.; Aherron, R. M.

1982-01-01

A computational model of the deterministic and stochastic processes involved in remote sensing is used to study spectral feature identification techniques for real-time onboard processing of data acquired with advanced earth-resources sensors. Preliminary results indicate that: Narrow spectral responses are advantageous; signal normalization improves mean-square distance (MSD) classification accuracy but tends to degrade maximum-likelihood (MLH) classification accuracy; and MSD classification of normalized signals performs better than the computationally more complex MLH classification when imaging conditions change appreciably from those conditions during which reference data were acquired. The results also indicate that autonomous categorization of TM signals into vegetation, bare land, water, snow and clouds can be accomplished with adequate reliability for many applications over a reasonably wide range of imaging conditions. However, further analysis is required to develop computationally efficient boundary approximation algorithms for such categorization.

Semi-empirical study of ortho-cresol photo degradation in manganese-doped zinc oxide nanoparticles suspensions

PubMed Central

2012-01-01

The optimization processes of photo degradation are complicated and expensive when it is performed with traditional methods such as one variable at a time. In this research, the condition of ortho-cresol (o-cresol) photo degradation was optimized by using a semi empirical method. First of all, the experiments were designed with four effective factors including irradiation time, pH, photo catalyst’s amount, o-cresol concentration and photo degradation % as response by response surface methodology (RSM). The RSM used central composite design (CCD) method consists of 30 runs to obtain the actual responses. The actual responses were fitted with the second order algebraic polynomial equation to select a model (suggested model). The suggested model was validated by a few numbers of excellent statistical evidences in analysis of variance (ANOVA). The used evidences include high F-value (143.12), very low P-value (<0.0001), non-significant lack of fit, the determination coefficient (R2 = 0.99) and the adequate precision (47.067). To visualize the optimum, the validated model simulated the condition of variables and response (photo degradation %) be using a few number of three dimensional plots (3D). To confirm the model, the optimums were performed in laboratory. The results of performed experiments were quite close to the predicted values. In conclusion, the study indicated that the model is successful to simulate the optimum condition of o-cresol photo degradation under visible-light irradiation by manganese doped ZnO nanoparticles. PMID:22909072

Preparedness of Entering Pediatric Dentistry Residents: Advanced Pediatric Program Directors' and First-Year Residents' Perspectives.

PubMed

Rutkauskas, John; Seale, N Sue; Casamassimo, Paul; Rutkauskas, John S

2015-11-01

For children to receive needed oral health care, adequate training at both the predoctoral and postdoctoral levels of dental education is required, but previous studies have found inadequacies in predoctoral education that lead to general dentists' unwillingness to treat certain young populations. As another way of assessing predoctoral preparation, the aim of this study was to determine the perspectives of first-year residents and pediatric program directors about residents' preparedness to enter advanced education programs in pediatric dentistry. Surveys were sent to all 74 U.S. program directors and 360 first-year residents. The survey focused on procedures related to prevention, behavior management, restorative procedures, pulp therapy, sedation, and surgery, as well as treating patients funded by Medicaid and with special health care needs. Among the first-year residents, 173 surveys were returned for a 48% response rate; 61 directors returned surveys for an 82% response rate. Only half of the residents (55%) reported feeling adequately prepared for their first year in residency; less than half cited adequate preparation to place stainless steel crowns (SSCs) (42%) and perform pulpotomies (45%). Far fewer felt adequately prepared to provide treatment for children six months to three years of age, including examinations (29%), infant oral exams (27%), and children with severe caries (37%). The program directors were even less positive about the adequacy of residents' preparation. Only 17% deemed them adequately prepared to place SSCs and 13% to perform pulpotomies. Approximately half reported their first-year residents were inadequately prepared to treat very young children and children with severe caries (55% each). This study found that the perceived inadequacy of predoctoral education in pediatric dentistry was consistent at both the learner and educator levels, supporting previous studies identifying inadequacies in this area.

Artesunate + amodiaquine versus artemether-lumefantrine for the treatment of uncomplicated Plasmodium falciparum malaria in the Colombian Pacific region: a noninferiority trial.

PubMed

De la Hoz Restrepo, Fernando; Porras Ramírez, Alexandra; Rico Mendoza, Alejandro; Córdoba, Freddy; Rojas, Diana Patricia

2012-12-01

In Colombia, there are no published studies for the treatment of uncomplicated Plasmodium falciparum malaria comparing artemisinin combination therapies. Hence, it is intended to demonstrate the non-inferior efficacy/safety profiles of artesunate + amodiaquine versus artemether-lumefantrine treatments. A randomized, controlled, open-label, noninferiority (Δ≤5%) clinical trial was performed in adults with uncomplicated P. falciparum malaria using the 28-day World Health Organization validated design/definitions. Patients were randomized 1:1 to either oral artesunate + amodiaquine or artemether-lumefantrine. The primary efficacy endpoint: adequate clinical and parasitological response; secondary endpoints: - treatment failures defined per the World Health Organization. assessed through adverse events. A total of 105 patients was included in each group: zero censored observations. Mean (95%CI - Confidence interval) adequate clinical and parasitological response rates: 100% for artesunate + amodiaquine and 99% for artemether-lumefantrine; the noninferiority criteria was met (Δ=1.7%). There was one late parasitological therapeutic failure (1%; artemether-lumefantrine group), typified by polymerase chain reaction as the MAD20 MSP1 allele. The fever clearance time (artesunate + amodiaquine group) was significantly shorter (p=0.002). Respectively, abdominal pain for artesunate + amodiaquine and artemether-lumefantrine was 1.9% and 3.8% at baseline (p=0.68) and 1% and 13.3% after treatment (p<0.001). Uncomplicated P. falciparum malaria treatment with artesunate + amodiaquine is noninferior to the artemether-lumefantrine standard treatment. The efficacy/safety profiles grant further studies in this and similar populations.

Evaluation of the CEAS model for barley yields in North Dakota and Minnesota

NASA Technical Reports Server (NTRS)

Barnett, T. L. (Principal Investigator)

1981-01-01

The CEAS yield model is based upon multiple regression analysis at the CRD and state levels. For the historical time series, yield is regressed on a set of variables derived from monthly mean temperature and monthly precipitation. Technological trend is represented by piecewise linear and/or quadriatic functions of year. Indicators of yield reliability obtained from a ten-year bootstrap test (1970-79) demonstrated that biases are small and performance as indicated by the root mean square errors are acceptable for intended application, however, model response for individual years particularly unusual years, is not very reliable and shows some large errors. The model is objective, adequate, timely, simple and not costly. It considers scientific knowledge on a broad scale but not in detail, and does not provide a good current measure of modeled yield reliability.

Warning Alert HITL Experiment Results

NASA Technical Reports Server (NTRS)

Monk, Kevin J.; Ferm, Lisa; Roberts, Zach

2018-01-01

Minimum Operational Performance Standards (MOPS) are being developed to support the integration of Unmanned Aircraft Systems (UAS) in the National Airspace (NAS). Input from subject matter experts and multiple research studies have informed display requirements for Detect-and-Avoid (DAA) systems aimed at supporting timely and appropriate pilot responses to collision hazards. Phase 1 DAA MOPS alerting is designed to inform pilots if an avoidance maneuver is necessary; the two highest alert levels - caution and warning - indicate how soon pilot action is required and whether there is adequate time to coordinate with the air traffic controller (ATC). Additional empirical support is needed to clarify the extent to which warning-level alerting impacts DAA task performance. The present study explores the differential effects of the auditory and visual cues provided by the DAA Warning alert, and performance implications compared to caution-only alerting are discussed.

Living in a Flexible Space

NASA Astrophysics Data System (ADS)

Canepa, Simona

2017-10-01

How long does a space or an object have to last? If in the past an object or a building manufacturing was designed to last as much as possible, nowadays it is designed to have a life related to the time in which it will be used. Flexibility is what characterizes a space, it’s the ability to be variable and adaptable to changes in the lives of users or in relation to the use which these will make over time. The evolution of the labour market, the difficulty of inserting within it and the need to push more and more frequent move today in the trial of living space models increasingly flexible: people, especially young people, are forced to move on territory outlining a new condition to which the flexible nomadic dwellings offer an adequate response, ensuring high functional performance in confined spaces.

Application of phosphorescence quenching by O2 to the investigation of O2 delivery to ocular tissues

NASA Astrophysics Data System (ADS)

Chamot, Stephane R.; Petrig, Benno L.; Pournaras, Constantin J.; Percicot, Christine L.; Lambrou, George N.; Riva, Charles E.

2001-10-01

The technique of phosphorescence quenching by O2 (PQ) allows the non-invasive measurement of the partial pressure of oxygen in blood (pO2blood). This technique and its application to the investigation of the pO2blood in the microvasculature of the retina and optic nerve head (ONH) of two animal species is described. Using the imaging mode of PQ, 2-dimensional pO2blood maps were obtained to investigate the response of the pO2blood to various physiological stimuli in miniature pigs and the effect of experimental glaucoma in monkeys. Applied in its focal mode, PQ allows measurements of the pO2blood with a time resolution of 1 second and is adequate to investigate the pO2blood time course during light stimulation.

Dynamic slip of polydisperse linear polymers using partitioned plate

NASA Astrophysics Data System (ADS)

Ebrahimi, Marzieh; Konaganti, Vinod Kumar; Hatzikiriakos, Savvas G.

2018-03-01

The slip velocity of an industrial grade high molecular weight high-density polyethylene (HDPE) is studied in steady and dynamic shear experiments using a stress/strain controlled rotational rheometer equipped with a parallel partitioned plate geometry. Moreover, fluoroalkyl silane-based coating is used to understand the effect of surface energy on slip in steady and dynamic conditions. The multimode integral Kaye-Bernstein-Kearsley-Zapas constitutive model is applied to predict the transient shear response of the HDPE melt obtained from rotational rheometer. It is found that a dynamic slip model with a slip relaxation time is needed to adequately predict the experimental data at large shear deformations. Comparison of the results before and after coating shows that the slip velocity is largely affected by surface energy. Decreasing surface energy by coating increases slip velocity and decreases the slip relaxation time.

48 CFR 216.601 - Time-and-materials contracts.

Code of Federal Regulations, 2010 CFR

2010-10-01

...-Hour Proposal Requirements—Non-Commercial Item Acquisition with Adequate Price Competition, with 252... contract type for non-commercial items if the price is expected to be based on adequate competition. [71 FR... of the contract or order; establishing fixed prices for portions of the requirement); and (D...

Flow cells for bioanalytical and bioprocess applications with optimized dynamic response and flow characteristics

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

Lancaster, V.R.; Modlin, D.N.

1994-12-31

In this study, the authors present a method for design and characterization of flow cells developed for minimum flow volume and optimal dynamic response with a given central observation area. The dynamic response of a circular shaped dual ported flow cell was compared to that obtained from a flow cell whose optimized shape was determined using this method. In the optimized flow cell design, the flow rate at the nominal operating pressure increased by 50% whereas the flow cell volume was reduced by 70%. In addition, the dynamic response of the new flow cell was found to be 200% fastermore » than the circular flow cell. The fluid dynamic analysis included simple graphical techniques utilizing free stream vorticity functions and Hagen-Poiseuille relationships. The flow cell dynamic response was measured using a fluorescence detection system. The fluoresce in emission from a 400{micro}m spot located at the exit port was measured as a function of time after switching the input to the flow cell between fluorescent and non-fluorescent solutions. Analysis of results revealed the system could be reasonably characterized as a first order dynamic system. Although some evidence of second order behavior was also observed, it is reasonable to assume that a first order model will provide adequate predictive capability for many real world applications. Given a set of flow cell requirements, the methods presented in this study can be used to design and characterize flow cells with lower reagent consumption and reduced purging times. These improvements can be readily translated into reduced process times and/or lower usage of high cost reagents.« less

Comparison of Ground-Based and Airborne Function Allocation Concepts for NextGen Using Human-In-The-Loop Simulations

NASA Technical Reports Server (NTRS)

Wing, David J.; Prevot, Thomas; Murdoch, Jennifer L.; Cabrall, Christopher D.; Homola, Jeffrey R.; Martin, Lynne H.; Mercer, Joey S.; Hoadley, Sherwood T.; Wilson, Sara R.; Hubbs, Clay E.;

Maximising the potential of part-time clinical teachers.

PubMed

Patston, Philip; Holmes, David; Maalhagh-Fard, Ahmad; Ting, Kang; Ziccardi, Vincent B

2010-12-01

A problem faced by health professions education throughout the world is a lack of full-time clinical teachers. This is particularly serious in dentistry and nursing, but is increasingly also true in medicine. To make up for this shortfall there is a growing reliance on part-time clinical teachers. Part-time clinical teachers are essential for the education of students. However, compared with their full-time counterparts, the part-time teachers are often not adequately prepared for their roles as educators within the context of the clinical curriculum. They might not be trained in the latest educational practices, and may be unprepared for the time needed to excel as teachers and mentors. As part-time teachers take on more responsibility, it is important that they take part in orientation and training sessions to assist them in developing the skills they need to succeed. This will require a significant commitment from the institution as well as the part-time teacher, but is critical for maintaining the academic quality of the clinical training programmes. This also represents an untapped area for research into how to ensure the success of part-time clinical teachers. © Blackwell Publishing Ltd 2010.

Safety and effectiveness of olanzapine in monotherapy: a multivariate analysis of a naturalistic study.

PubMed

Ciudad, Antonio; Gutiérrez, Miguel; Cañas, Fernando; Gibert, Juan; Gascón, Josep; Carrasco, José-Luis; Bobes, Julio; Gómez, Juan-Carlos; Alvarez, Enrique

2005-07-01

This study investigated safety and effectiveness of olanzapine in monotherapy compared with conventional antipsychotics in treatment of acute inpatients with schizophrenia. This was a prospective, comparative, nonrandomized, open-label, multisite, observational study of Spanish inpatients with an acute episode of schizophrenia. Data included safety assessments with an extrapyramidal symptoms (EPS) questionnaire and the report of spontaneous adverse events, plus clinical assessments with the Brief Psychiatric Rating Scale (BPRS) and the Clinical Global Impressions-Severity of Illness (CGI-S). A multivariate methodology was used to more adequately determine which factors can influence safety and effectiveness of olanzapine in monotherapy. 339 patients treated with olanzapine in monotherapy (OGm) and 385 patients treated with conventional antipsychotics (CG) were included in the analysis. Treatment-emergent EPS were significantly higher in the CG (p<0.0001). Response rate was significantly higher in the OGm (p=0.005). Logistic regression analyses revealed that the only variable significantly correlated with treatment-emergent EPS and clinical response was treatment strategy, with patients in OGm having 1.5 times the probability of obtaining a clinical response and patients in CG having 5 times the risk of developing EPS. In this naturalistic study olanzapine in monotherapy was better-tolerated and at least as effective as conventional antipsychotics.

Dynamic pressure probe response tests for robust measurements in periodic flows close to probe resonating frequency

NASA Astrophysics Data System (ADS)

Ceyhun Şahin, Fatma; Schiffmann, Jürg

2018-02-01

A single-hole probe was designed to measure steady and periodic flows with high fluctuation amplitudes and with minimal flow intrusion. Because of its high aspect ratio, estimations showed that the probe resonates at a frequency two orders of magnitude lower than the fast response sensor cut-off frequencies. The high fluctuation amplitudes cause a non-linear behavior of the probe and available models are neither adequate for a quantitative estimation of the resonating frequencies nor for predicting the system damping. Instead, a non-linear data correction procedure based on individual transfer functions defined for each harmonic contribution is introduced for pneumatic probes that allows to extend their operating range beyond the resonating frequencies and linear dynamics. This data correction procedure was assessed on a miniature single-hole probe of 0.35 mm inner diameter which was designed to measure flow speed and direction. For the reliable use of such a probe in periodic flows, its frequency response was reproduced with a siren disk, which allows exciting the probe up to 10 kHz with peak-to-peak amplitudes ranging between 20%-170% of the absolute mean pressure. The effect of the probe interior design on the phase lag and amplitude distortion in periodic flow measurements was investigated on probes with similar inner diameters and different lengths or similar aspect ratios (L/D) and different total interior volumes. The results suggest that while the tube length consistently sets the resonance frequency, the internal total volume affects the non-linear dynamic response in terms of varying gain functions. A detailed analysis of the introduced calibration methodology shows that the goodness of the reconstructed data compared to the reference data is above 75% for fundamental frequencies up to twice the probe resonance frequency. The results clearly suggest that the introduced procedure is adequate to capture non-linear pneumatic probe dynamics and to reproduce time-resolved data far above probe resonant frequency.

Advances in the RXTE Proportional Counter Array Calibration: Nearing the Statistical Limit

NASA Technical Reports Server (NTRS)

Shaposhnikov, Nikolai; Jahoda, Keith; Markwardt, Craig; Swank, Jean; Strohmayer, Tod

2012-01-01

During its 16 years of service Rossi X-ray Timing Explorer (RXTE) mission has provided an extensive archive of data, which will serve as a primary source of high cadence observation of variable X-ray sources for fast timing studies. It is, therefore, very important to have the most reliable calibration of RXTE instruments. The Proportional Counter Array (PCA) is the primary instrument on-board RXTE which provides data in 2-50 keY with higher than millisecond time resolution in up to 256 energy channels. In 2009 RXTE team revised the response residual minimization method used to derive the parameters of the PCA physical model. The procedure is now based on the residual minimization between the model spectrum for Crab nebula emission and a calibration data set consisting of a number of spectra from the Crab and the on-board Am241 calibration source, uniformly covering a whole RXTE span. The new method led to a much more effective model convergence and allowed for better understanding of the behavior of the PCA energy-to-channel relationship. It greatly improved the response matrix performance. We describe the new version of the RXTE/PCA response generator PCARMF vll.7 along with the corresponding energy-to-channel conversion table (version e05v04) and their difference from the previous releases of PCA calibration. The new PCA response adequately represents the spectrum of the calibration sources and successfully predicts the energy of the narrow iron emission line in Cas-A throughout the RXTE mission.

The psychopharmacology algorithm project at the Harvard South Shore Program: an update on schizophrenia.

PubMed

Osser, David N; Roudsari, Mohsen Jalali; Manschreck, Theo

2013-01-01

This article is an update of the algorithm for schizophrenia from the Psychopharmacology Algorithm Project at the Harvard South Shore Program. A literature review was conducted focusing on new data since the last published version (1999-2001). The first-line treatment recommendation for new-onset schizophrenia is with amisulpride, aripiprazole, risperidone, or ziprasidone for four to six weeks. In some settings the trial could be shorter, considering that evidence of clear improvement with antipsychotics usually occurs within the first two weeks. If the trial of the first antipsychotic cannot be completed due to intolerance, try another until one of the four is tolerated and given an adequate trial. There should be evidence of bioavailability. If the response to this adequate trial is unsatisfactory, try a second monotherapy. If the response to this second adequate trial is also unsatisfactory, and if at least one of the first two trials was with risperidone, olanzapine, or a first-generation (typical) antipsychotic, then clozapine is recommended for the third trial. If neither trial was with any these three options, a third trial prior to clozapine should occur, using one of those three. If the response to monotherapy with clozapine (with dose adjusted by using plasma levels) is unsatisfactory, consider adding risperidone, lamotrigine, or ECT. Beyond that point, there is little solid evidence to support further psychopharmacological treatment choices, though we do review possible options.

A Rapid and Accurate Extraction Procedure for Analysing Free Amino Acids in Meat Samples by GC-MS

PubMed Central

Barroso, Miguel A.; Ruiz, Jorge; Antequera, Teresa

2015-01-01

This study evaluated the use of a mixer mill as the homogenization tool for the extraction of free amino acids in meat samples, with the main goal of analyzing a large number of samples in the shortest time and minimizing sample amount and solvent volume. Ground samples (0.2 g) were mixed with 1.5 mL HCl 0.1 M and homogenized in the mixer mill. The final biphasic system was separated by centrifugation. The supernatant was deproteinized, derivatized and analyzed by gas chromatography. This procedure showed a high extracting ability, especially in samples with high free amino acid content (recovery = 88.73–104.94%). It also showed a low limit of detection and quantification (3.8 · 10−4–6.6 · 10−4  μg μL−1 and 1.3 · 10−3–2.2 · 10−2  μg μL−1, resp.) for most amino acids, an adequate precision (2.15–20.15% for run-to-run), and a linear response for all amino acids (R 2 = 0.741–0.998) in the range of 1–100 µg mL−1. Moreover, it takes less time and requires lower amount of sample and solvent than conventional techniques. Thus, this is a cost and time efficient tool for homogenizing in the extraction procedure of free amino acids from meat samples, being an adequate option for routine analysis. PMID:25873963

[Anesthesia with isoflurane in air and with isoflurane and nitrous oxide].

PubMed

Girardi, G; Rossi, R; Cellai, M P; Pieraccioli, E; Novelli, G P

1994-06-01

The aim of this study is to control the depth, the quality of recovery of total inhalation isoflurane anesthesia with or without nitrous oxide. Controlled comparative study was carried out on 51 patients, aged 40-54 yr, ASA 1, undergoing saphenectomy, in an University Clinic. Induction: thiopental (3.5 mg kg), atracurium (0.6 mg kg) i.v. Patients were randomly assigned to: group 1 (26 patients), 5% isoflurane in air, by mask; group 2 (25 patients), 3% isoflurane and 60% N2O, by mask. Maintenance: group 1, 2% isoflurane in air; group 2, 1.2% isoflurane and 60% N2O. During anesthesia, consciousness and analgesia level were monitored by EEG Compressed Spectral Array, and clinical signs of pain by Evans' test; arousal time evaluation by "Time to correct response test". The subjective impressions, eventual dreams and recalls were collected using a standard set of questions one hour after the end of anesthesia and 24 hours later. One hour before anesthesia and two hours after the end of surgical procedures, a psychomotor performance recovery evaluation was performed using Zazzo's "deux barrages" test. Student's "t" test. Adequate anesthetic depth was documented in all patients. Recovery time was statistically longer in isoflurane group (group 1 16.7 sd 2.2 minutes vs 10.3 sd 1.9 minutes group 2, p < 0.01). No patient reported recalls relative to anesthetic period. Two hours after recovery no significant differences in psychomotor performance tests were recorded. Isoflurane anesthesia in air, in adequate concentrations, provides a sufficient level of analgesia, hypnosis, amnesia, without clinical side effects.

12 CFR Appendix A to Part 570 - Interagency Guidelines Establishing Standards for Safety and Soundness

Code of Federal Regulations, 2010 CFR

2010-01-01

... risk assessment; 3. Timely and accurate financial, operational and regulatory reports; 4. Adequate... asset concentrations; and 6. Provide periodic asset reports with adequate information for management and... profile of the institution's assets and operations; 3. Assess the source, volatility, and sustainability...

12 CFR Appendix A to Part 30 - Interagency Guidelines Establishing Standards for Safety and Soundness

Code of Federal Regulations, 2010 CFR

2010-01-01

... risk assessment; 3. Timely and accurate financial, operational and regulatory reports; 4. Adequate... asset concentrations; and 6. Provide periodic asset reports with adequate information for management and... profile of the institution's assets and operations; 3. Assess the source, volatility, and sustainability...

23 CFR 645.117 - Cost development and reimbursement.

Code of Federal Regulations, 2010 CFR

2010-04-01

... of any alternate costing method should consider the factors listed in paragraphs (b) through (g) of... worked on the project are reimbursable when supported by adequate records. This includes labor associated... the utility may be reimbursed for the time worked directly on the project when supported by adequate...

Using realist evaluation to assess primary healthcare teams' responses to intimate partner violence in Spain.

PubMed

Goicolea, Isabel; Hurtig, Anna-Karin; San Sebastian, Miguel; Marchal, Bruno; Vives-Cases, Carmen

2015-01-01

Few evaluations have assessed the factors triggering an adequate health care response to intimate partner violence. This article aimed to: 1) describe a realist evaluation carried out in Spain to ascertain why, how and under what circumstances primary health care teams respond to intimate partner violence, and 2) discuss the strengths and challenges of its application. We carried out a series of case studies in four steps. First, we developed an initial programme theory (PT1), based on interviews with managers. Second, we refined PT1 into PT2 by testing it in a primary healthcare team that was actively responding to violence. Third, we tested the refined PT2 by incorporating three other cases located in the same region. Qualitative and quantitative data were collected and thick descriptions were produced and analysed using a retroduction approach. Fourth, we analysed a total of 15 cases, and identified combinations of contextual factors and mechanisms that triggered an adequate response to violence by using qualitative comparative analysis. There were several key mechanisms -the teams' self-efficacy, perceived preparation, women-centred care-, and contextual factors -an enabling team environment and managerial style, the presence of motivated professionals, the use of the protocol and accumulated experience in primary health care- that should be considered to develop adequate primary health-care responses to violence. The full application of this realist evaluation was demanding, but also well suited to explore a complex intervention reflecting the situation in natural settings. Copyright © 2015 SESPAS. Published by Elsevier Espana. All rights reserved.

Orienting Schools toward Equity: Subgroup Accountability Pressure and School-Level Responses

ERIC Educational Resources Information Center

Garver, Rachel

2017-01-01

This article examines school-level responses to subgroup accountability pressure through an ethnographic case study of a school cited for failing to make adequate yearly progress for student subgroups. Concerns about the calculations and measures used to derive the citation and reservations about acting on accountability data delegitimized the…

Developing Medical Students as Teachers: An Anatomy-Based Student-as-Teacher Program with Emphasis on Core Teaching Competencies

ERIC Educational Resources Information Center

Jay, Erie Andrew; Starkman, Sidney J.; Pawlina, Wojciech; Lachman, Nirusha

2013-01-01

Teaching is an increasingly recognized responsibility of the resident physician. Residents, however, often assume teaching responsibilities without adequate preparation. Consequently, many medical schools have implemented student-as-teacher (SAT) programs that provide near-peer teaching opportunities to senior medical students. Near-peer teaching…

Agreement among Response to Intervention Criteria for Identifying Responder Status

ERIC Educational Resources Information Center

Barth, Amy E.; Stuebing, Karla K.; Anthony, Jason L.; Denton, Carolyn A.; Mathes, Patricia G.; Fletcher, Jack M.; Francis, David J.

2008-01-01

In order to better understand the extent to which operationalizations of response to intervention (RTI) overlap and agree in identifying adequate and inadequate responders, an existing database of 399 first grade students was evaluated in relation to cut-points, measures, and methods frequently cited for the identification of inadequate responders…

25 CFR 30.100 - What is the purpose of this part?

Code of Federal Regulations, 2010 CFR

2010-04-01

... definition of “Adequate Yearly Progress (AYP).” Nothing in this part: (a) Diminishes the Secretary's trust responsibility for Indian education or any statutory rights in law; (b) Affects in any way the sovereign rights of tribes; or (c) Terminates or changes the trust responsibility of the United States to Indian...

Deployment Requirements for U.S. Coast Guard Pollution Response Equipment : Volume II. Appendixes.

DOT National Transportation Integrated Search

1978-02-01

This report presents the results of a study to examine the siting and equipment requirements that would have to be met by the U.S. Coast Guard to provide an adequate response within six hours for spills of up to 10,000 tons (28,000,000 gals.)of oil i...

Deployment Requirements for U.S. Coast Guard Pollution Response Equipment. Volume I. Analysis.

DOT National Transportation Integrated Search

1979-02-01

This report presents the results of a study to examine the siting and equipment requirements that would have to be met by the U.S. Coast Guard to provide an adequate response within six hours for spills of up to 10,000 tons (28,000,000 gals.)of oil i...

Deployment Requirements for U.S. Coast Guard Pollution Response Equipment : Volume I. Analysis.

DOT National Transportation Integrated Search

1978-02-01

This report presents the results of a study to examine the siting and equipment requirements that would have to be met by the U.S. Coast Guard to provide an adequate response within six hours for spills of up to 10,000 tons (28,000,000 gals.)of oil i...

76 FR 28934 - Approval and Disapproval and Promulgation of State Implementation Plan Revisions; Infrastructure...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-19

... implementation of any SIP provision, the state has responsibility for ensuring adequate implementation of such... Responsibilities of Department. The Montana Board of Environmental Review (BER) oversees the Montana DEQ, including... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R08-OAR-2010-0298; FRL-9308-5] Approval and...

Toward a psychology of human survival: Psychological approaches to contemporary global threats

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

Walsh, R.

Nuclear weapons, population explosion, resource and food-supply depletion, and environmental deterioration have been posing increasing threats to human survival. Moreover, for the first time in history, all these major global threats are human caused and can, therefore, be traced in large part to psychological origins. After a brief overview of the nature and extent of current threats, this paper suggests criteria for an adequate psychology of human survival. The causes and effects of the threats are examined from various psychological perspectives and the psychological principles underlying effective responses are deduced. The ways in which mental health professionals may contribute tomore » this most crucial task are discussed. 76 references.« less

Implantable self-powered detector for on-line determination of neutron flux in patients during NCT treatment.

PubMed

Miller, M E; Mariani, L E; Gonçalves-Carralves, M L Sztejnberg; Skumanic, M; Thorp, S I

2004-11-01

A novel system to determine thermal neutron flux in real time during NCT treatments was developed in the National Atomic Energy Commission of Argentina. The system is based on a special self-powered detector that can be implanted in patients owing to its small size and biocompatibility. High voltage is not required to operate this kind of detectors, which is a considerable advantage in terms of medical uses. By choosing the appropriate materials, it was possible to obtain a prototype with thermal neutron sensitivity providing for an adequate signal level in typical NCT thermal fluxes. It was also possible to minimize gamma response in order to neglect its contribution.

An Inherited Platelet Function Defect in Basset Hounds

PubMed Central

Johnstone, I. B.; Lotz, F.

1979-01-01

An inherited platelet function defect occurring in a family of basset hounds has been described. The trait is transmitted as an autosomal characteristic and appears to be expressed clinically only in the homozygous state. The characteristics of this platelet defect include: 1) marked bleeding tendencies and prolonged skin bleeding times in either male or female dogs. 2) normal blood coagulation mechanism. 3) adequate numbers of circulating platelets which appear morphologically normal by light microscopy. 4) normal whole blood clot retraction. 5) deficient in vivo platelet consumption and in vitro platelet retention in glass bead columns. 6) defective ADP-induced platelet aggregation in homozygotes, apparently normal ADP response in heterozygotes, and defective collagen-induced platelet aggregation in both. PMID:509382

[Transcultural psychiatry or ethnopsychiatry].

PubMed

Serce, A; Davatz, U

1993-08-17

Dr. med. Ursula Davatz is heading the socio-psychiatric service at the psychiatric clinic of Königsfelden. She has trained as a family therapist according to M. Bowen. Dr. med. Adnan Serce is as turkish speaking physician responsive for the "transcultural" psychiatric domain in this service. The authors describe their experiences and difficulties in treating turkish and kurdish psychiatric patients. The language barrier, a divergent cultural background and the tendency of patients and somatic physicians to ascribe psychic problems to somatic causes or symptoms impede, according to the authors, a timely and adequate psychiatric treatment. A dialogue-oriented introspective therapeutic approach is often met by unsurmountable difficulties. Therapeutic success is, however, not excluded as the following examples demonstrate.

Shock effects in particle beam fusion targets

NASA Astrophysics Data System (ADS)

Sweeney, M. A.; Perry, F. C.; Asay, J. R.; Widner, M. M.

1982-04-01

At Sandia National Laboratorics we are assessing the response of fusion target materials to shock loading with the particle beam accelerators HYDRA and PROTO I and the gas gun facility. Nonlinear shock-accelerated unstable growth of fabriction irregularities has been demonstrated, and jetting is found to occur in imploding targets because of asymmetric beam deposition. Cylindrical ion targets display an instability due either to beam or target nonuniformity. However, the data suggest targets with aspect ratios of 30 may implode stably. The first time- and space-resolved measurements of shock-induced vaporization have been made. A homogeneous mixed phase EOS model cannot adequately explain the results because of the kinetic effects of vapor formation and expansion.

Sexual abuses.

PubMed

Abel, G G; Rouleau, J L

1995-03-01

The sexual abuses described in this article are occurring so frequently that they constitute a public health problem. Superficially they appear to be quite dissimilar because they involve individuals of different ages, different settings, and different power relationships. Basic to each of them, however, is an absence of consent by the victim and the misuse of power by the perpetrator in order to accomplish the abuse. We now have an adequate understanding of each of these abuses and it is now time to make a concerted effort to stop these abuses. This will require the combined efforts of the education of the public, improved identification of the abuses, treatment of the victims, and an appropriate criminal justice response combined with treatment of the perpetrator.

Psychophysiological Responses to Salsa Dance

PubMed Central

Emerenziani, Gian Pietro; Meucci, Marco; Saavedra, Francisco; Gallotta, Maria Chiara; Baldari, Carlo

2015-01-01

Speculation exists whether dance provides physiological stimuli adequate to promote health and fitness benefits. Unfortunately, research to date has not addressed the affective and exertional responses to dance. These responses are of interest as positive affective and exertional responses experienced during physical activity may play an important role in predicting adherence. The present study aims to examine the psychophysiological responses of different Salsa dance styles. Ten pairs of dancers performed two different structured lessons of Salsa dance, including Typical Salsa and Rueda de Casino lessons, and a non-structured Salsa dance at a night club. Physiological responses (i.e., percent of heart rate reserve; %HRR) were continuously assessed and perceived exertion and affective valence were rated every 15 min throughout the trials. %HRR responses differed between the Salsa dance styles (%HRR from 41.3 to 51.9%), and participants were dancing at intensities near their ventilatory threshold. Specifically, Typical Salsa lesson elicited lower %HRR responses than Rueda de Casino lesson (p < 0.05), but similar %HRR responses to Salsa dance at a night club condition (p > 0.05). Surprisingly, exertional (from 8 to 11) and affective (from +3 to +5) responses were unaffected by Salsa dance styles (p > 0.05). These data support that different Salsa dance styles provide physiological stimuli adequate to promote health and fitness benefits, and perhaps more importantly, produce pleasurable experiences, which in turn might lead to an increase in adherence to Salsa dancing which likely provides exercise-like health benefits. PMID:25860568

21 CFR 201.5 - Drugs; adequate directions for use.

Code of Federal Regulations, 2011 CFR

2011-04-01

...) Frequency of administration or application. (d) Duration of administration or application. (e) Time of administration or application (in relation to time of meals, time of onset of symptoms, or other time factors...

21 CFR 201.5 - Drugs; adequate directions for use.

Code of Federal Regulations, 2010 CFR

2010-04-01

...) Frequency of administration or application. (d) Duration of administration or application. (e) Time of administration or application (in relation to time of meals, time of onset of symptoms, or other time factors...

Examining the Predictive Validity of a Dynamic Assessment of Decoding to Forecast Response to Tier 2 Intervention

ERIC Educational Resources Information Center

Cho, Eunsoo; Compton, Donald L.; Fuchs, Douglas; Fuchs, Lynn S.; Bouton, Bobette

2014-01-01

The purpose of this study was to examine the role of a dynamic assessment (DA) of decoding in predicting responsiveness to Tier 2 small-group tutoring in a response-to-intervention model. First grade students (n = 134) who did not show adequate progress in Tier 1 based on 6 weeks of progress monitoring received Tier 2 small-group tutoring in…

European Policies to Promote Children's Rights and Combat Child Poverty.

PubMed

Sandbæk, Mona

2017-07-26

The upbringing of children relies heavily on shared responsibilities between parents and society. The Council of Europe Recommendation (2006) 19 on Policy to Support Positive Parenting and the European Commission Recommendation (2013) Investing in Children: Breaking the Cycle of Disadvantage, both aim at supporting parents to care and provide for their children in accordance with the UN Convention on the Rights of the Child. By means of a document analysis this article examines what kind of parental practices and provision to parents the recommendations suggest to safeguard children's rights in the family. Three findings are highlighted: first, both recommendations reflect a commitment to respecting children's rights while at the same time acknowledging parents as children's primary caregivers. Second, both recognize parents' rights to work, while also recognizing the necessity of adequate income support if work is not available or income too low. Third, adequate resources are defined as a combination of universal policies and services, which guarantee a minimum level for all, and targeted measures reaching out to the most disadvantaged. The recommendations' emphasis on children and parents as partners and on the families' economic situations are valuable for future development of family and child policy and support programs.

Endo-periodontal lesion – endodontic approach

PubMed Central

Jivoinovici, R; Suciu, I; Dimitriu, B; Perlea, P; Bartok, R; Malita, M; Ionescu, C

2014-01-01

Endo-perio lesions might be interdependent because of the vascular and anatomic connections between the pulp and the periodontium. The aim of this study is to emphasise that primary endodontic lesion heals after a proper instrumentation, disinfection and sealing of the endodontic space. The primary endodontic lesion with a secondary periodontal involvement first requires an endodontic therapy and, in the second stage, a periodontal therapy. The prognosis is good, with an adequate root canal treatment; it depends on the severity of the periodontal disease, appropriate healing time and the response to the treatment. A correct diagnosis is sometimes difficult; an accurate identification of the etiologic factors is important for an adequate treatment. Primary perio-endo lesion may heal after a proper disinfection and sealing of the endodontic system, the one-year follow-up radiograph showing bonny repair. Invasive periodontal procedures should be avoided at that moment. The microorganisms and by-products from the infected root canal may cross accessory and furcal canals and determine sinus tract and loss of attachment. In both clinical cases presented in this article, successful healing was obtained after a proper disinfection and sealing of the endodontic system. PMID:25713618

European Policies to Promote Children’s Rights and Combat Child Poverty

PubMed Central

Sandbæk, Mona

2017-01-01

The upbringing of children relies heavily on shared responsibilities between parents and society. The Council of Europe Recommendation (2006) 19 on Policy to Support Positive Parenting and the European Commission Recommendation (2013) Investing in Children: Breaking the Cycle of Disadvantage, both aim at supporting parents to care and provide for their children in accordance with the UN Convention on the Rights of the Child. By means of a document analysis this article examines what kind of parental practices and provision to parents the recommendations suggest to safeguard children’s rights in the family. Three findings are highlighted: first, both recommendations reflect a commitment to respecting children’s rights while at the same time acknowledging parents as children’s primary caregivers. Second, both recognize parents’ rights to work, while also recognizing the necessity of adequate income support if work is not available or income too low. Third, adequate resources are defined as a combination of universal policies and services, which guarantee a minimum level for all, and targeted measures reaching out to the most disadvantaged. The recommendations’ emphasis on children and parents as partners and on the families’ economic situations are valuable for future development of family and child policy and support programs. PMID:28933743

Solid waste management in Kolkata, India: practices and challenges.

PubMed

Hazra, Tumpa; Goel, Sudha

2009-01-01

This paper presents an overview of current solid waste management (SWM) practices in Kolkata, India and suggests solutions to some of the major problems. More than 2920ton/d of solid waste are generated in the Kolkata Municipal Corporation (KMC) area and the budget allocation for 2007-2008 was Rs. 1590 million (US$40 million), which amounts to Rs. 265/cap-y (US$6.7/cap-d) on SWM. This expenditure is insufficient to provide adequate SWM services. Major deficiencies were found in all elements of SWM. Despite 70% of the SWM budget being allocated for collection, collection efficiency is around 60-70% for the registered residents and less than 20% for unregistered residents (slum dwellers). The collection process is deficient in terms of manpower and vehicle availability. Bin capacity provided is adequate but locations were found to be inappropriate, thus contributing to the inefficiency of the system. At this time, no treatment is provided to the waste and waste is dumped on open land at Dhapa after collection. Lack of suitable facilities (equipment and infrastructure) and underestimates of waste generation rates, inadequate management and technical skills, improper bin collection, and route planning are responsible for poor collection and transportation of municipal solid wastes.

Does Initial Learning about the Meaning of Fractions Present Similar Challenges for Students with and without Adequate Whole-Number Skill?

PubMed

Namkung, Jessica M; Fuchs, Lynn S; Koziol, Natalie

2018-01-01

The purposes of this study were to (a) explore whether early fractions understanding at 4 th grade is differentially challenging for students with versus without adequate whole-number competence and (b) identify specific whole-number skill associated with difficulty in fractions understanding. Based on initial whole-number competence, 1,108 4 th graders were classified as having (a) adequate whole-number competence ( n = 775), (b) less severe whole-number difficulty ( n = 201), and (c) severe whole-number difficulty ( n = 132). At the end of 4 th grade, they were assessed on fractions understanding and further classified as with versus without difficulty in fractions understanding. Multi-level logistic regression indicated that compared to students with adequate whole-number competence, those with less severe whole-number difficulty were almost 5 times as likely to experience difficulty with fractions understanding whereas those with severe whole-number difficulty were about 32 times as likely to experience difficulty with fractions understanding. Students with severe whole-number difficulty were about 7 times as likely to experience difficulty with fractions understanding compared to those with less severe whole-number difficulty. Among students with adequate whole-number competence, the pretest whole-number skill distinguishing those with versus without difficulty in fractions understanding was basic division facts (i.e., 2-digit dividend ÷ 1-digit divisor) and simple multiplication (i.e., 3-digit × 1-digit without regrouping). The role of whole-number competence in developing initial fractions understanding and implications for instruction are discussed.

Does Initial Learning about the Meaning of Fractions Present Similar Challenges for Students with and without Adequate Whole-Number Skill?

PubMed Central

Namkung, Jessica M.; Fuchs, Lynn S.; Koziol, Natalie

2017-01-01

The purposes of this study were to (a) explore whether early fractions understanding at 4th grade is differentially challenging for students with versus without adequate whole-number competence and (b) identify specific whole-number skill associated with difficulty in fractions understanding. Based on initial whole-number competence, 1,108 4th graders were classified as having (a) adequate whole-number competence (n = 775), (b) less severe whole-number difficulty (n = 201), and (c) severe whole-number difficulty (n = 132). At the end of 4th grade, they were assessed on fractions understanding and further classified as with versus without difficulty in fractions understanding. Multi-level logistic regression indicated that compared to students with adequate whole-number competence, those with less severe whole-number difficulty were almost 5 times as likely to experience difficulty with fractions understanding whereas those with severe whole-number difficulty were about 32 times as likely to experience difficulty with fractions understanding. Students with severe whole-number difficulty were about 7 times as likely to experience difficulty with fractions understanding compared to those with less severe whole-number difficulty. Among students with adequate whole-number competence, the pretest whole-number skill distinguishing those with versus without difficulty in fractions understanding was basic division facts (i.e., 2-digit dividend ÷ 1-digit divisor) and simple multiplication (i.e., 3-digit × 1-digit without regrouping). The role of whole-number competence in developing initial fractions understanding and implications for instruction are discussed. PMID:29276363

Wastewater Biosolid Composting Optimization Based on UV-VNIR Spectroscopy Monitoring

PubMed Central

Temporal-Lara, Beatriz; Melendez-Pastor, Ignacio; Gómez, Ignacio; Navarro-Pedreño, Jose

2016-01-01

Conventional wastewater treatment generates large amounts of organic matter–rich sludge that requires adequate treatment to avoid public health and environmental problems. The mixture of wastewater sludge and some bulking agents produces a biosolid to be composted at adequate composting facilities. The composting process is chemically and microbiologically complex and requires an adequate aeration of the biosolid (e.g., with a turner machine) for proper maturation of the compost. Adequate (near) real-time monitoring of the compost maturity process is highly difficult and the operation of composting facilities is not as automatized as other industrial processes. Spectroscopic analysis of compost samples has been successfully employed for compost maturity assessment but the preparation of the solid compost samples is difficult and time-consuming. This manuscript presents a methodology based on a combination of a less time-consuming compost sample preparation and ultraviolet, visible and short-wave near-infrared spectroscopy. Spectroscopic measurements were performed with liquid compost extract instead of solid compost samples. Partial least square (PLS) models were developed to quantify chemical fractions commonly employed for compost maturity assessment. Effective regression models were obtained for total organic matter (residual predictive deviation—RPD = 2.68), humification ratio (RPD = 2.23), total exchangeable carbon (RPD = 2.07) and total organic carbon (RPD = 1.66) with a modular and cost-effective visible and near infrared (VNIR) spectroradiometer. This combination of a less time-consuming compost sample preparation with a versatile sensor system provides an easy-to-implement, efficient and cost-effective protocol for compost maturity assessment and near-real-time monitoring. PMID:27854280

Wastewater Biosolid Composting Optimization Based on UV-VNIR Spectroscopy Monitoring.

PubMed

Temporal-Lara, Beatriz; Melendez-Pastor, Ignacio; Gómez, Ignacio; Navarro-Pedreño, Jose

2016-11-15

Conventional wastewater treatment generates large amounts of organic matter-rich sludge that requires adequate treatment to avoid public health and environmental problems. The mixture of wastewater sludge and some bulking agents produces a biosolid to be composted at adequate composting facilities. The composting process is chemically and microbiologically complex and requires an adequate aeration of the biosolid (e.g., with a turner machine) for proper maturation of the compost. Adequate (near) real-time monitoring of the compost maturity process is highly difficult and the operation of composting facilities is not as automatized as other industrial processes. Spectroscopic analysis of compost samples has been successfully employed for compost maturity assessment but the preparation of the solid compost samples is difficult and time-consuming. This manuscript presents a methodology based on a combination of a less time-consuming compost sample preparation and ultraviolet, visible and short-wave near-infrared spectroscopy. Spectroscopic measurements were performed with liquid compost extract instead of solid compost samples. Partial least square (PLS) models were developed to quantify chemical fractions commonly employed for compost maturity assessment. Effective regression models were obtained for total organic matter (residual predictive deviation-RPD = 2.68), humification ratio (RPD = 2.23), total exchangeable carbon (RPD = 2.07) and total organic carbon (RPD = 1.66) with a modular and cost-effective visible and near infrared (VNIR) spectroradiometer. This combination of a less time-consuming compost sample preparation with a versatile sensor system provides an easy-to-implement, efficient and cost-effective protocol for compost maturity assessment and near-real-time monitoring.

Virtual guidance as a tool to obtain diagnostic ultrasound for spaceflight and remote environments.

PubMed

Martin, David S; Caine, Timothy L; Matz, Timothy; Lee, Stuart M C; Stenger, Michael B; Sargsyan, Ashot E; Platts, Steven H

2012-10-01

With missions planned to travel greater distances from Earth at ranges that make real-time two-way communication impractical, astronauts will be required to perform autonomous medical diagnostic procedures during future exploration missions. Virtual guidance is a form of just-in-time training developed to allow novice ultrasound operators to acquire diagnostically-adequate images of clinically relevant anatomical structures using a prerecorded audio/visual tutorial viewed in real-time. Individuals without previous experience in ultrasound were recruited to perform carotid artery (N = 10) and ophthalmic (N = 9) ultrasound examinations using virtual guidance as their only training tool. In the carotid group, each untrained operator acquired two-dimensional, pulsed and color Doppler of the carotid artery. In the ophthalmic group, operators acquired representative images of the anterior chamber of the eye, retina, optic nerve, and nerve sheath. Ultrasound image quality was evaluated by independent imaging experts. Of the studies, 8 of the 10 carotid and 17 of 18 of the ophthalmic images (2 images collected per study) were judged to be diagnostically adequate. The quality of all but one of the ophthalmic images ranged from adequate to excellent. Diagnostically-adequate carotid and ophthalmic ultrasound examinations can be obtained by previously untrained operators with assistance from only an audio/video tutorial viewed in real time while scanning. This form of just-in-time training, which can be applied to other examinations, represents an opportunity to acquire important information for NASA flight surgeons and researchers when trained medical personnel are not available or when remote guidance is impractical.

Teachers' self-assessed levels of preparation

NASA Astrophysics Data System (ADS)

White, Susan C.

2016-02-01

Every four years we survey a nationally representative sample of high school physics teachers. We define anyone who teaches at least one physics class to be a "physics teacher." About 40% of these teachers teach a majority of their classes in subjects other than physics. We also ask teachers to rate how well prepared they felt in various aspects of teaching. The response choices are "not adequately prepared," "adequately prepared," and "very well prepared." The accompanying figure shows the proportion of teachers who reported feeling adequately or very well prepared in the following aspects of teaching: • Basic physics knowledge, • Other science knowledge, • Application of physics to everyday experience, • Use of demonstrations, • Instructional laboratory design, • Use of computers in physics instruction and labs, and • Recent developments in physics.

Protective response in renal transplantation: no clinical or molecular differences between open and laparoscopic donor nephrectomy.

PubMed

Machado, Christiano; Malheiros, Denise Maria Avancini Costa; Adamy, Ari; Santos, Luiz Sergio; Silva Filho, Agenor Ferreira da; Nahas, William Carlos; Lemos, Francine Brambate Carvalhinho

2013-04-01

Prolonged warm ischemia time and increased intra-abdominal pressure caused by pneumoperitoneum during a laparoscopic donor nephrectomy could enhance renal ischemia reperfusion injury. For this reason, laparoscopic donor nephrectomy may be associated with a slower graft function recovery. However, an adequate protective response may balance the ischemia reperfusion damage. This study investigated whether laparoscopic donor nephrectomy modified the protective response of renal tissue during kidney transplantation. Patients undergoing live renal transplantation were prospectively analyzed and divided into two groups based on the donor nephrectomy approach used: 1) the control group, recipients of open donor nephrectomy (n = 29), and 2) the study group, recipients of laparoscopic donor nephrectomy (n = 26). Graft biopsies were obtained at two time points: T-1 = after warm ischemia time and T+1 = 45 minutes after kidney reperfusion. The samples were analyzed by immunohistochemistry for the Bcl-2 and HO-1 proteins and by real-time polymerase chain reaction for the mRNA expression of Bcl-2, HO-1 and vascular endothelial growth factor. The area under the curve for creatinine and delayed graft function were similar in both the laparoscopic and open groups. There was no difference in the protective gene expression between the laparoscopic donor nephrectomy and open donor nephrectomy groups. The protein expression of HO-1 and Bcl-2 were similar between the open and laparoscopic groups. Furthermore, the gene expression of B-cell lymphoma 2 correlated with the warm ischemia time in the open group (p = 0.047) and that of vascular endothelial growth factor with the area under the curve for creatinine in the laparoscopic group (p = 0.01). The postoperative renal function and protective factor expression were similar between laparoscopic donor nephrectomy and open donor nephrectomy. These findings ensure laparoscopic donor nephrectomy utilization in renal transplantation.

The temporal spectrum of adult mosquito population fluctuations: conceptual and modeling implications.

PubMed

Jian, Yun; Silvestri, Sonia; Brown, Jeff; Hickman, Rick; Marani, Marco

2014-01-01

An improved understanding of mosquito population dynamics under natural environmental forcing requires adequate field observations spanning the full range of temporal scales over which mosquito abundance fluctuates in natural conditions. Here we analyze a 9-year daily time series of uninterrupted observations of adult mosquito abundance for multiple mosquito species in North Carolina to identify characteristic scales of temporal variability, the processes generating them, and the representativeness of observations at different sampling resolutions. We focus in particular on Aedes vexans and Culiseta melanura and, using a combination of spectral analysis and modeling, we find significant population fluctuations with characteristic periodicity between 2 days and several years. Population dynamical modelling suggests that the observed fast fluctuations scales (2 days-weeks) are importantly affected by a varying mosquito activity in response to rapid changes in meteorological conditions, a process neglected in most representations of mosquito population dynamics. We further suggest that the range of time scales over which adult mosquito population variability takes place can be divided into three main parts. At small time scales (indicatively 2 days-1 month) observed population fluctuations are mainly driven by behavioral responses to rapid changes in weather conditions. At intermediate scales (1 to several month) environmentally-forced fluctuations in generation times, mortality rates, and density dependence determine the population characteristic response times. At longer scales (annual to multi-annual) mosquito populations follow seasonal and inter-annual environmental changes. We conclude that observations of adult mosquito populations should be based on a sub-weekly sampling frequency and that predictive models of mosquito abundance must include behavioral dynamics to separate the effects of a varying mosquito activity from actual changes in the abundance of the underlying population.

Theta EEG dynamics of the error-related negativity.

PubMed

Trujillo, Logan T; Allen, John J B

2007-03-01

The error-related negativity (ERN) is a response-locked brain potential (ERP) occurring 80-100ms following response errors. This report contrasts three views of the genesis of the ERN, testing the classic view that time-locked phasic bursts give rise to the ERN against the view that the ERN arises from a pure phase-resetting of ongoing theta (4-7Hz) EEG activity and the view that the ERN is generated - at least in part - by a phase-resetting and amplitude enhancement of ongoing theta EEG activity. Time-domain ERP analyses were augmented with time-frequency investigations of phase-locked and non-phase-locked spectral power, and inter-trial phase coherence (ITPC) computed from individual EEG trials, examining time courses and scalp topographies. Simulations based on the assumptions of the classic, pure phase-resetting, and phase-resetting plus enhancement views, using parameters from each subject's empirical data, were used to contrast the time-frequency findings that could be expected if one or more of these hypotheses adequately modeled the data. Error responses produced larger amplitude activity than correct responses in time-domain ERPs immediately following responses, as expected. Time-frequency analyses revealed that significant error-related post-response increases in total spectral power (phase- and non-phase-locked), phase-locked power, and ITPC were primarily restricted to the theta range, with this effect located over midfrontocentral sites, with a temporal distribution from approximately 150-200ms prior to the button press and persisting up to 400ms post-button press. The increase in non-phase-locked power (total power minus phase-locked power) was larger than phase-locked power, indicating that the bulk of the theta event-related dynamics were not phase-locked to response. Results of the simulations revealed a good fit for data simulated according to the phase-locking with amplitude enhancement perspective, and a poor fit for data simulated according to the classic view and the pure phase-resetting view. Error responses produce not only phase-locked increases in theta EEG activity, but also increases in non-phase-locked theta, both of which share a similar topography. The findings are thus consistent with the notion advanced by Luu et al. [Luu P, Tucker DM, Makeig S. Frontal midline theta and the error-related negativity; neurophysiological mechanisms of action regulation. Clin Neurophysiol 2004;115:1821-35] that the ERN emerges, at least in part, from a phase-resetting and phase-locking of ongoing theta-band activity, in the context of a general increase in theta power following errors.

7 CFR 1436.8 - Security for loan.

Code of Federal Regulations, 2010 CFR

2010-01-01

... adequate size and value at the time of the application as determined by the county committee to adequately... such collateral except for prior liens on the underlying real estate that by operation of law attach to the collateral if it is or will become a fixture. If any such prior lien on the real estate will...

7 CFR 1436.8 - Security for loan.

Code of Federal Regulations, 2011 CFR

2011-01-01

... adequate size and value at the time of the application as determined by the county committee to adequately... such collateral except for prior liens on the underlying real estate that by operation of law attach to the collateral if it is or will become a fixture. If any such prior lien on the real estate will...

14 CFR 91.1029 - Flight scheduling and locating requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... program manager must establish and use an adequate system to schedule and release program aircraft. (b) Except as provided in paragraph (d) of this section, each program manager must have adequate procedures... manager with at least the information required to be included in a VFR flight plan; (2) Provide for timely...

10 CFR 1021.200 - DOE planning.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false DOE planning. 1021.200 Section 1021.200 Energy DEPARTMENT... Decisionmaking § 1021.200 DOE planning. (a) DOE shall provide for adequate and timely NEPA review of DOE... accordance with 40 CFR 1501.2 and this section. In its planning for each proposal, DOE shall include adequate...

Patient counseling materials: The effect of patient health literacy on the comprehension of printed prescription drug information.

PubMed

Patel, Amit; Bakina, Daria; Kirk, Jim; von Lutcken, Scott; Donnelly, Tom; Stone, William; Ashley-Collins, Heather; Tibbals, Karen; Ricker, Lynn; Adler, Jeffrey; Ewing, John; Blechman, Michelle; Fox, Sherry; Leopold, Will; Ryan, Daniel; Wray, Donna; Turkoz, Heather

2018-05-16

Counseling patients with written materials relies equally on patients' health literacy to understand their disease and its treatment, and the written materials' effectiveness communicating clearly in accessible and actionable ways. Only about 12% of the US population is adequately health literate. To explore the impact of reducing the health literacy demands of written patient health information. 805 patients were screened for health literacy, and recruited for balanced cohorts of adequate and low literacy, and high and normal blood pressure. Half of each patient cohort received either standard or "health literacy-friendly" drug summaries (i.e. Patient Package Inserts, or PPIs or "leaflets") along with a standardized health literacy assessment scale. The literacy-friendly drug summary improved comprehension of drug-related information overall from 50% to 71% correct responses. Adequate literacy patients improved from 58% correct to 90%, while lower literacy patients improved from 42% to 52% correct in response to the health literacy-friendly PPIs. Health literacy demands require special attention in developing and using written drug summary materials. Additionally, pharmacists should be provided additional information and counseling support materials to facilitate communications with low health literacy level patients. Copyright © 2018 Elsevier Inc. All rights reserved.

The natech events during the 17 August 1999 Kocaeli earthquake: aftermath and lessons learned

NASA Astrophysics Data System (ADS)

Girgin, S.

2011-04-01

Natural-hazard triggered technological accidents (natechs) at industrial facilities have been recognized as an emerging risk. Adequate preparedness, proper emergency planning, and effective response are crucial for the prevention of natechs and mitigation of the consequences. Under the conditions of a natural disaster, the limited resources, the possible unavailability of mitigation measures, and the lack of adequate communication complicate the management of natechs. The analysis of past natechs is crucial for learning lessons and for preventing or preparing for future natechs. The 17 August 1999, Kocaeli earthquake, which was a devastating disaster hitting one of the most industrialized regions of Turkey, offers opportunities in this respect. Among many natechs that occurred due to the earthquake, the massive fire at the TUPRAS Izmit refinery and the acrylonitrile spill at the AKSA acrylic fiber production plant were especially important and highlight problems in the consideration of natechs in emergency planning, response to industrial emergencies during natural hazards, and information to the public during and following the incidents. The analysis of these events shows that even the largest and seemingly well-prepared facilities can be vulnerable to natechs if risks are not considered adequately.

Tool for Predicting Medical Student Burnout From Sustained Stress Levels: Factor Analysis of the Medical Education Hassles Scale-R.

PubMed

Johnson, Jane C; Degenhardt, Brian F; Smith, Carol K; Wolf, Thomas M; Peterson, D Fred

2018-03-01

Acute stress during medical school affects the health of students and is associated with burnout. The Medical Education Hassles Scale-R (MEHS-R) is designed to measure acute stress among medical students. Researchers using the MEHS-R primarily report overall hassles scores, which are unable to discriminate between different categories of hassles encountered. The present study examined the factor structure of the MEHS-R to identify subscales that would be useful to categorize hassles for research and assessment purposes. Longitudinal, observational study. Two osteopathic medical schools. Five hundred six first-year medical students. The MEHS-R was administered at orientation and 9 to 10 times throughout the first year, classified into examination, vacation, and routine medical school activity periods. Students rated the 101 items on a 4-point scale (0=none to 3=a great deal) to indicate how much of a hassle each item had been during the previous week. Demographic subgroups were males, females, married students, single students, whites, and ethnic minorities. Exploratory factor analysis was conducted on data collected at the first school during orientation. Seven subscales were identified: Academic and Time Pressures, Financial, Social, External Influences, Day-to-Day Functioning, Relationships With Immediate Family, and Health. Cronbach α were ≥0.75. Stability of these subscales was examined using confirmatory factor analysis. Both of the fit indices used indicated the 7-subscale model for the MEHS-R adequately fit the data obtained during examination and routine medical school activity periods, one fit index indicated adequate fit for the vacation period, and neither indicated adequate fit for the data from the second school. Of the 7 subscales, 5 had a strong correspondence with categories identified by the scale developers. Fit indices also indicated the 7-subscale model was adequately generalizable to the demographic subgroups with the exception of the ethnic minorities subgroup. Exploratory factor analysis performed on the MEHS-R supported formation of subscales similar to categories identified during MEHS-R development. Results of the current study supported the use of the MEHS-R for the investigation of acute stress in medical students. In future research, targeted wellness interventions for medical students may be developed based on student responses to this instrument.

Ares I Flight Control System Design

NASA Technical Reports Server (NTRS)

Jang, Jiann-Woei; Alaniz, Abran; Hall, Robert; Bedrossian, Nazareth; Hall, Charles; Ryan, Stephen; Jackson, Mark

2010-01-01

The Ares I launch vehicle represents a challenging flex-body structural environment for flight control system design. This paper presents a design methodology for employing numerical optimization to develop the Ares I flight control system. The design objectives include attitude tracking accuracy and robust stability with respect to rigid body dynamics, propellant slosh, and flex. Under the assumption that the Ares I time-varying dynamics and control system can be frozen over a short period of time, the flight controllers are designed to stabilize all selected frozen-time launch control systems in the presence of parametric uncertainty. Flex filters in the flight control system are designed to minimize the flex components in the error signals before they are sent to the attitude controller. To ensure adequate response to guidance command, step response specifications are introduced as constraints in the optimization problem. Imposing these constraints minimizes performance degradation caused by the addition of the flex filters. The first stage bending filter design achieves stability by adding lag to the first structural frequency to phase stabilize the first flex mode while gain stabilizing the higher modes. The upper stage bending filter design gain stabilizes all the flex bending modes. The flight control system designs provided here have been demonstrated to provide stable first and second stage control systems in both Draper Ares Stability Analysis Tool (ASAT) and the MSFC 6DOF nonlinear time domain simulation.

An audit of bronchoscopy practice in the United Kingdom: a survey of adherence to national guidelines

PubMed Central

Honeybourne, D.; Neumann, C. S.

1997-01-01

BACKGROUND: Both patient and staff safety are of major importance during the procedure of fibreoptic bronchoscopy. Patient safety depends partly on adequate disinfection of instruments and accessories used as well as careful monitoring during the procedure. Adequate facilities, manpower and training are also essential. Staff safety depends partly on adequate procedures to minimise any risks of sensitisation to agents such as glutaraldehyde. An audit was carried out of bronchoscopy procedures in hospitals in the UK and the findings were compared with published guidelines on good practice and clinical consensus. METHODS: A postal questionnaire was sent to 218 bronchoscopy units in the UK. Findings were then compared with published evidence of good practice in the areas of disinfection, including the use of glutaraldehyde, patient monitoring, manpower, facilities, and training. RESULTS: A 73% response rate was obtained. Recommended minimum disinfection times before and after routine bronchoscopies were not achieved by 35% of units. No disinfection was carried out in 34% of units before emergency bronchoscopies and in 19% of units after suspected cases of tuberculosis. Adequate rinsing of the bronchoscope with sterile or filtered water was not carried out by 43% of units. Contrary to recommendations, 31% of departments were still using glutaraldehyde in the patient examination room and inadequate room ventilation was common. Protective clothing was often not worn by staff during bronchoscopy. Inadequate intravenous access and use of supplementary oxygen were found in many units. Practice standards were higher in departments where dedicated bronchoscopy/endoscopy units of the hospital were used, and also where staff had been on external training courses. CONCLUSIONS: This audit has shown that many units do not adhere to guidelines on disinfection procedures and patient monitoring. Unnecessary potential risks due to staff exposure to glutaraldehyde were apparent. National guidelines on good practice are not being followed in areas which may potentially affect patient and staff safety. 


 PMID:9337830

Rescue Pharmacotherapy With Duloxetine for Selective Serotonin Reuptake Inhibitor Nonresponders in Late-Life Depression: Outcome and Tolerability

PubMed Central

Karp, Jordan F.; Whyte, Ellen M.; Lenze, Eric J.; Dew, Mary A.; Begley, Amy; Miller, Mark D.; Reynolds, Charles F.

2010-01-01

Background Up to 50% of depressed older adults either do not adequately respond to or are unable to tolerate treatment with a serotonin-specific reuptake inhibitor. On the basis of previous experience with serotonin-norepinephrine reuptake inhibitors, we predicted at least a 50% response rate to open-label treatment with duloxetine in subjects who were resistant to treatment with the selective serotonin reuptake inhibitor (SSRI) escitalopram. Method Community-dwelling subjects aged 65 years or older with current nonpsychotic major depressive disorder as established by the Structured Clinical Interview for DSM-IV received escitalopram under protocolized conditions between April 2004 and September 2006. Subjects who failed to meet response criteria or relapsed after achieving an initial response were subsequently switched to open treatment with duloxetine up to 120 mg/day. Side effects were assessed at every visit. Results Subjects (N = 40) switched to duloxetine had a mean (SD) age of 74.4 (7.0) years and a baseline (before escitalopram) 17-item Hamilton Rating Scale for Depression (HAM-D-17) score of 20.0 (3.5) and were predominantly female (65.0%) and white (82.5%). The mean (SD) maximum dose of duloxetine was 93.0 (27.8) mg/day. Subjects received this maximum dose for a median duration of 6.9 weeks. Fifty percent of subjects (N = 20) met criteria for full response, 17.5% (N = 7) were partial responders, and 32.5% (N = 13) did not respond. The median time to response was 12.0 weeks (95% CI = 8.4 to 14.6). Five of the subjects (12.5%) discontinued duloxetine because of intolerable side effects. Discussion These open-label data suggest that duloxetine at doses up to 120 mg/day is a well-tolerated and potentially effective treatment for older adults who fail to respond to an adequate trial of an SSRI. These results are preliminary, and future controlled studies are required to test the efficacy of rescue pharmacotherapy with duloxetine. Trial Registration clinicaltrials.gov Identifier: NCT00177671 PMID:18251622

23 CFR 635.121 - Contract time and contract time extensions.

Code of Federal Regulations, 2013 CFR

2013-04-01

... time extensions. (a) The STD should have adequate written procedures for the determination of contract... of the effective date of this Final Rule. (b) Contract time extensions granted by a STD shall be...

23 CFR 635.121 - Contract time and contract time extensions.

Code of Federal Regulations, 2014 CFR

2014-04-01

... time extensions. (a) The STD should have adequate written procedures for the determination of contract... of the effective date of this Final Rule. (b) Contract time extensions granted by a STD shall be...

23 CFR 635.121 - Contract time and contract time extensions.

Code of Federal Regulations, 2012 CFR

2012-04-01

... time extensions. (a) The STD should have adequate written procedures for the determination of contract... of the effective date of this Final Rule. (b) Contract time extensions granted by a STD shall be...

23 CFR 635.121 - Contract time and contract time extensions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... time extensions. (a) The STD should have adequate written procedures for the determination of contract... of the effective date of this Final Rule. (b) Contract time extensions granted by a STD shall be...

21 CFR 801.5 - Medical devices; adequate directions for use.

Code of Federal Regulations, 2011 CFR

2011-04-01

... application. (e) Time of administration or application, in relation to time of meals, time of onset of symptoms, or other time factors. (f) Route or method of administration or application. (g) Preparation for...

21 CFR 801.5 - Medical devices; adequate directions for use.

Code of Federal Regulations, 2010 CFR

2010-04-01

... application. (e) Time of administration or application, in relation to time of meals, time of onset of symptoms, or other time factors. (f) Route or method of administration or application. (g) Preparation for...

A model for a PC-based, universal-format, multimedia digitization system: moving beyond the scanner.

PubMed

McEachen, James C; Cusack, Thomas J; McEachen, John C

2003-08-01

Digitizing images for use in case presentations based on hardcopy films, slides, photographs, negatives, books, and videos can present a challenging task. Scanners and digital cameras have become standard tools of the trade. Unfortunately, use of these devices to digitize multiple images in many different media formats can be a time-consuming and in some cases unachievable process. The authors' goal was to create a PC-based solution for digitizing multiple media formats in a timely fashion while maintaining adequate image presentation quality. The authors' PC-based solution makes use of off-the-shelf hardware applications to include a digital document camera (DDC), VHS video player, and video-editing kit. With the assistance of five staff radiologists, the authors examined the quality of multiple image types digitized with this equipment. The authors also quantified the speed of digitization of various types of media using the DDC and video-editing kit. With regard to image quality, the five staff radiologists rated the digitized angiography, CT, and MR images as adequate to excellent for use in teaching files and case presentations. With regard to digitized plain films, the average rating was adequate. As for performance, the authors recognized a 68% improvement in the time required to digitize hardcopy films using the DDC instead of a professional quality scanner. The PC-based solution provides a means for digitizing multiple images from many different types of media in a timely fashion while maintaining adequate image presentation quality.

Adequate Th2-Type Response Associates with Restricted Bacterial Growth in Latent Mycobacterial Infection of Zebrafish

PubMed Central

Hammarén, Milka Marjut; Luukinen, Bruno Vincent; Pesu, Marko; Rämet, Mika; Parikka, Mataleena

2014-01-01

Tuberculosis is still a major health problem worldwide. Currently it is not known what kind of immune responses lead to successful control and clearance of Mycobacterium tuberculosis. This gap in knowledge is reflected by the inability to develop sufficient diagnostic and therapeutic tools to fight tuberculosis. We have used the Mycobacterium marinum infection model in the adult zebrafish and taken advantage of heterogeneity of zebrafish population to dissect the characteristics of adaptive immune responses, some of which are associated with well-controlled latency or bacterial clearance while others with progressive infection. Differences in T cell responses between subpopulations were measured at the transcriptional level. It was discovered that a high total T cell level was usually associated with lower bacterial loads alongside with a T helper 2 (Th2)-type gene expression signature. At late time points, spontaneous reactivation with apparent symptoms was characterized by a low Th2/Th1 marker ratio and a substantial induction of foxp3 reflecting the level of regulatory T cells. Characteristic gata3/tbx21 has potential as a biomarker for the status of mycobacterial disease. PMID:24968056

Volunteer First Responders for Optimizing Management of Mass Casualty Incidents.

PubMed

Yafe, Eli; Walker, Blake Byron; Amram, Ofer; Schuurman, Nadine; Randall, Ellen; Friger, Michael; Adini, Bruria

2018-06-04

Rapid response to a trauma incident is vital for saving lives. However, in a mass casualty incident (MCI), there may not be enough resources (first responders and equipment) to adequately triage, prepare, and evacuate every injured person. To address this deficit, a Volunteer First Responder (VFR) program was established. This paper describes the organizational structure and roles of the VFR program, outlines the geographical distribution of volunteers, and evaluates response times to 3 MCIs for both ambulance services and VFRs in 2000 and 2016. When mapped, the spatial distribution of VFRs and ambulance stations closely and deliberately reflects the population distribution of Israel. We found that VFRs were consistently first to arrive at the scene of an MCI and greatly increased the number of personnel available to assist with MCI management in urban, suburban, and rural settings. The VFR program provides an important and effective life-saving resource to supplement emergency first response. Given the known importance of rapid response to trauma, VFRs likely contribute to reduced trauma mortality, although further research is needed in order to examine this question specifically. (Disaster Med Public Health Preparedness. 2018;page 1 of 8).

Watching ultrafast responses of structure and magnetism in condensed matter with momentum-resolved probes

PubMed Central

Johnson, S. L.; Savoini, M.; Beaud, P.; Ingold, G.; Staub, U.; Carbone, F.; Castiglioni, L.; Hengsberger, M.; Osterwalder, J.

2017-01-01

We present a non-comprehensive review of some representative experimental studies in crystalline condensed matter systems where the effects of intense ultrashort light pulses are probed using x-ray diffraction and photoelectron spectroscopy. On an ultrafast (sub-picosecond) time scale, conventional concepts derived from the assumption of thermodynamic equilibrium must often be modified in order to adequately describe the time-dependent changes in material properties. There are several commonly adopted approaches to this modification, appropriate in different experimental circumstances. One approach is to treat the material as a collection of quasi-thermal subsystems in thermal contact with each other in the so-called “N-temperature” models. On the other extreme, one can also treat the time-dependent changes as fully coherent dynamics of a sometimes complex network of excitations. Here, we present examples of experiments that fall into each of these categories, as well as experiments that partake of both models. We conclude with a discussion of the limitations and future potential of these concepts. PMID:29308418

Biodegradation of PCE and TCE in landfill leachate predicted from concentrations of molecular hydrogen: a case study.

PubMed

Gonsoulin, Mary E; Wilson, Barbara H; Wilson, John T

2004-12-01

The Refuse Hideaway Landfill (23-acre) received municipal, commercial, and industrial waste between 1974 and 1988. It was designed as a "natural attenuation" landfill and no provision was made to collect and treat contaminated water. Natural biological degradation through sequential reductive dechlorination had been an important mechanism for natural attenuation at the site. We used the concentration of hydrogen to forecast whether reductive dechlorination would continue over time at particular locations in the plume. Based on published literature, reductive dechlorination and natural attenuation of PCE, TCE, and cis-DCE can be expected in the aquifer if the concentration of molecular hydrogen in monitoring wells are adequate (> 1 nanomolar). Reductive dechlorination can be expected to continue as the ground water moves down gradient. Natural attenuation through reductive dechlorination is not expected in flow paths that originate at down gradient monitoring wells with low concentrations of molecular hydrogen (< 1 nanomolar). In three monitoring wells at the margin of the landfill and in five monitoring wells down gradient of the landfill, ground water maintained a molecular hydrogen concentration, ranging from 1.30 to 9.17 nanomolar, that is adequate for reductive dechlorination. In three of the monitoring wells far down gradient of the landfill, the concentration of molecular hydrogen (0.33 to 0.83 nanomolar) was not adequate to support reductive dechlorination. In wells with adequate concentrations of hydrogen, the concentrations of chlorinated volatile organic compounds were attenuated over time, or concentrations of chlorinated volatile organics were below the detection limit. In wells with inadequate concentrations of hydrogen, the concentrations of chlorinated organic compounds attenuated at a slower rate over time. In wells with adequate hydrogen the first order rate of attenuation of PCE, TCE, cis-DCE and total chlorinated volatile organic compounds varies from 0.38 to 0.18 per year. In wells without adequate hydrogen the rate varies from 0.015 to 0.006 per year.

Nurse Leaders' Response to Civil Unrest in the Urban Core

PubMed Central

Goodwin Veenema, Tener; Calvert, Wilma J.; Grigsby, Sheila R.; Cobbina, Jennifer

2017-01-01

Inequalities in society, culture, and finance have resulted in civil unrest, rioting, and intentional violence throughout our history. Nowhere is this currently more apparent than in the cities of Ferguson and Baltimore. It is not the civil unrest itself, but the resulting rioting and intentional violence that can create a disaster situation. This increases the care burden of health care providers during times when the governmental structure may be overwhelmed or functioning in a less than optimal manner. Beginning with the death of Michael Brown, civil unrest over the last 2 years has necessitated a closer examination of the role nurse leaders play in preparing their staff and facilities for potential results of this civil unrest. The similarities between the results of rioting and violence and natural disaster are obvious, but the differences are significant. Without adequate preparation, providers may not offer the appropriate response. Attention to the 10 “musts” for preparedness for civil unrest will facilitate a planning process and provide for a better response and recovery when communities face these issues. PMID:28263274

The Physiology of Bed Rest. Chapter 39

NASA Technical Reports Server (NTRS)

Fortney, Suzanne M.; Schneider, Victor S.; Greenleaf, John E.

1996-01-01

Prolonged rest in bed has been utilized by physicians and other health-care workers to immobilize and confine patients for rehabilitation and restoration of health since time immemorial. The sitting or horizontal position is sought by the body to relieve the strain of the upright or vertical postures, for example during syncopal situations, bone fractures, muscle injuries, fatigue, and probably also to reduce energy expenditure. Most health-care personnel are aware that adaptive responses occurring during bed rest proceed concomitantly with the healing process; signs and symptoms associated with the former should be differentiated from those of the latter. Not all illnesses and infirmities benefit from prolonged bed rest. Considerations in prescribing bed rest for patients-including duration, body position, mode and duration of exercise, light-dark cycles, temperature, and humidity-have not been investigated adequately. More recently, adaptive physiological responses have been measured in normal, healthy subjects in the horizontal or slightly head-down postures during prolonged bed rest as analogs for the adaptive responses of astronauts exposed to the microgravity environment of outer and bed-rest research.

Development of a Deltoid Shoulder Muscle Model for Rhesus Monkey Spaceflight Studies

NASA Technical Reports Server (NTRS)

Riley, Danny A.; Macias, Melissa Y.; Anders, Scott; Slocum, Glenn R.

1995-01-01

The acromiodeltoid shoulder muscle was demonstrated to be a suitable model for spaceflight studies. The muscle contains a mixture of fast and slow fibers, permitting analysis of muscle fiber type specific changes. Two biopsy sites per muscle were identified that provided samples not degraded by the biopsy procedure. Both sites contained sufficient numbers fibers for determining changes in fiber type percentages and size. There was adequate bilateral symmetry regarding fiber type composition in the left and right muscles such that a total of four times points can be compared. The ESOP cage did not cause atrophy of deltoid muscle fibers; this means that microgravity-induced atrophy should be detectable. As expected, muscle excision stimulated muscle IgM and IgG muscle autoantibody production. Nonrestrained control animals suppressed this response whereas restrained monkeys showed an abnormally pronounced response indicative a compromised immune system. The presence of ESOP cage-induced changes in the immune response may mask spaceflight-induced effects. The ESOP cage modified the dominant hand operation of the PTS. These results demonstrate the importance of high fidelity ground based controls.

Dose/Exposure‐Response Modeling to Support Dosing Recommendation for Phase III Development of Baricitinib in Patients with Rheumatoid Arthritis

PubMed Central

Chua, Laiyi; Ernest, Charles; Macias, William; Rooney, Terence; Tham, Lai San

2017-01-01

Baricitinib is an oral inhibitor of Janus kinases (JAKs), selective for JAK1 and 2. It demonstrated dose‐dependent efficacy in patients with moderate‐to‐severe rheumatoid arthritis (RA) in a phase IIb study up to 24 weeks. Population pharmacokinetic/pharmacodynamic (PopPK/PD) models were developed to characterize concentration‐time profiles and dose/exposure‐response (D/E‐R) relationships for the key efficacy (proportion of patients achieving American College of Rheumatology 20%, 50%, or 70% response rate) and safety endpoints (incidence of anemia) for the phase IIb study. The modeling suggested that 4 mg q.d. was likely to offer the optimum risk/benefit balance, whereas 2 mg q.d. had the potential for adequate efficacy. In addition, at the same total daily dose, a twice‐daily regimen is not expected to provide an advantage over q.d. dosing for the efficacy or safety endpoints. The model‐based simulations formed the rationale for key aspects of dosing, such as dose levels and dosing frequency for phase III development. PMID:28891251

Semantic search during divergent thinking.

PubMed

Hass, Richard W

2017-09-01

Divergent thinking, as a method of examining creative cognition, has not been adequately analyzed in the context of modern cognitive theories. This article casts divergent thinking responding in the context of theories of memory search. First, it was argued that divergent thinking tasks are similar to semantic fluency tasks, but are more constrained, and less well structured. Next, response time distributions from 54 participants were analyzed for temporal and semantic clustering. Participants responded to two prompts from the alternative uses test: uses for a brick and uses for a bottle, for two minutes each. Participants' cumulative response curves were negatively accelerating, in line with theories of search of associative memory. However, results of analyses of semantic and temporal clustering suggested that clustering is less evident in alternative uses responding compared to semantic fluency tasks. This suggests either that divergent thinking responding does not involve an exhaustive search through a clustered memory trace, but rather that the process is more exploratory, yielding fewer overall responses that tend to drift away from close associates of the divergent thinking prompt. Copyright © 2017 Elsevier B.V. All rights reserved.

[Hierarchy in surgery. An antiquated system?].

PubMed

Muhr, G

1999-01-01

Medical responsibility and hospital management, competency for resident's training and decision making in therapy are better performed in a system of hierarchy than other kinds of organisation of a surgical department. If all the duties and responsibilities are concentrated to a head of the department, it is also necessary to give him the adequate instruments for leadership, to stay alive.

A Systematic Approach to Audience Response to Film.

ERIC Educational Resources Information Center

Kleinhans, Charles; Lesage, Julia

This paper is divided into three parts, the first discussing the necessary conditions for an adequate response to Godard and Gorin's film "Vent d'Est." It is suggested that the film demands both cinematic and political sophistication on the part of the viewer and that the audience must accept the flatness, the "deconstruction" of the cinematic…

Preservice and Inservice Science Teachers' Responses and Reasoning about the Nature of Science

ERIC Educational Resources Information Center

Buaraphan, Khajornsak

2009-01-01

An adequate understanding of the nature of science (NOS) is essential for science teachers. The Myths of Science Questionnaire (MOSQ) consisting of 14 items, which comprised both optional and written types of response, was utilized to explore 113 Thai preservice and 101 inservice science teachers' understanding and reasoning about the NOS,…

A Case Study of Culturally Sensitive Mail Survey Methods for Understanding Walking within an Orthodox Jewish Community

ERIC Educational Resources Information Center

Kahan, David

2006-01-01

Adequate response to mail health surveys by minority populations has proved problematic. The impact of mail survey design features utilized to promote Orthodox Jews' responses (N = 138; 82 eligible synagogue member households) to a mailed questionnaire used to measure walking behavior are described and assessed. An examination of response…

78 FR 27891 - Promulgation of State Implementation Plan Revisions; Infrastructure Requirements for the 1997 and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-13

... provision, the state has responsibility for ensuring adequate implementation of such plan provision. a... implementation of any plan provision are provided in MCA 75-2-112, Power and Responsibilities of Department. The... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R08-OAR-2011-0724; FRL-9812-9] Promulgation of...

45 CFR 640.4 - Responsibilities and procedures for preparation of an environmental assessment.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Welfare (Continued) NATIONAL SCIENCE FOUNDATION COMPLIANCE WITH THE NATIONAL ENVIRONMENTAL POLICY ACT... policy officials must assure that adequate analysis is being made. (b) Where appropriate, programs...

45 CFR 640.4 - Responsibilities and procedures for preparation of an environmental assessment.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Welfare (Continued) NATIONAL SCIENCE FOUNDATION COMPLIANCE WITH THE NATIONAL ENVIRONMENTAL POLICY ACT... policy officials must assure that adequate analysis is being made. (b) Where appropriate, programs...

45 CFR 640.4 - Responsibilities and procedures for preparation of an environmental assessment.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Welfare (Continued) NATIONAL SCIENCE FOUNDATION COMPLIANCE WITH THE NATIONAL ENVIRONMENTAL POLICY ACT... policy officials must assure that adequate analysis is being made. (b) Where appropriate, programs...

45 CFR 640.4 - Responsibilities and procedures for preparation of an environmental assessment.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Welfare (Continued) NATIONAL SCIENCE FOUNDATION COMPLIANCE WITH THE NATIONAL ENVIRONMENTAL POLICY ACT... policy officials must assure that adequate analysis is being made. (b) Where appropriate, programs...

45 CFR 640.4 - Responsibilities and procedures for preparation of an environmental assessment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Welfare (Continued) NATIONAL SCIENCE FOUNDATION COMPLIANCE WITH THE NATIONAL ENVIRONMENTAL POLICY ACT... policy officials must assure that adequate analysis is being made. (b) Where appropriate, programs...

Factors governing long-term adherence to a gluten-free diet in adult patients with coeliac disease.

PubMed

Villafuerte-Galvez, J; Vanga, R R; Dennis, M; Hansen, J; Leffler, D A; Kelly, C P; Mukherjee, R

2015-09-01

A strict gluten-free diet is the cornerstone of treatment for coeliac disease. Studies of gluten-free diet adherence have rarely used validated instruments. There is a paucity of data on long-term adherence to the gluten-free diet in the adult population. To determine the long-term adherence to the gluten-free diet and potential associated factors in a large coeliac disease referral centre population. We performed a mailed survey of adults with clinically, serologically and histologically confirmed coeliac disease diagnosed ≥5 years prior to survey. The previously validated Celiac Disease Adherence Test was used to determine adherence. Demographic, socio-economic and potentially associated factors were analysed with adherence as the outcome. The response rate was 50.1% of 709 surveyed, the mean time on a gluten-free diet 9.9 ± 6.4 years. Adequate adherence (celiac disease adherence test score <13) was found in 75.5% of respondents. A higher level of education was associated with adequate adherence (P = 0.002) even after controlling for household income (P = 0.0220). Perceptions of cost, effectiveness of the gluten-free diet, knowledge of the gluten-free diet and self-effectiveness at following the gluten-free diet correlated with adherence scores (P < 0.001). Long-term adherence to a gluten-free diet was adequate in >75% of respondents. Perceived cost remains a barrier to adherence. Perceptions of effectiveness of gluten-free diet as well as its knowledge, are potential areas for intervention. © 2015 John Wiley & Sons Ltd.

Outcome Measures in Myasthenia Gravis: Incorporation Into Clinical Practice.

PubMed

Muppidi, Srikanth

2017-03-01

The development of validated assessment tools for evaluating disease status and response to interventions in patients with myasthenia gravis (MG) has been driven by clinical studies of emerging MG therapies. However, only a small proportion of MG-focused neurology practices have adopted these assessment tools for routine clinical use. This article reviews the suitability of 5 assessment instruments for incorporation into clinical practice, which should be driven by their ability to contribute to improved patient outcomes, and to be implemented within practice personnel and resource constraints. It is recommended that assessments based on both physician-evaluated and patient-reported outcomes be selected, to adequately evaluate both point-in-time symptom load and functional impact of MG symptoms over time. Provider resource allocation and reimbursement issues may be the most significant roadblocks to successful ongoing use of these tools; to that end, the addition of regular assessments to MG standards of care is recommended.

Composition and energy spectra of low energy ions observed upstream of the earth's bow shock on ISEE-1

NASA Technical Reports Server (NTRS)

Ipavich, F. M.; Galvin, A. B.; Gloeckler, G.; Hovestadt, D.; Klecker, B.; Scholer, M.; Fan, C. Y.; Fisk, L. A.; Ogallagher, J. J.

1980-01-01

The characteristics of eleven locally accelerated particle events in the energy range from 30 to 125 keV/Q observed upstream of the earth's bow shock have been determined, including composition, energy spectra, and intensity versus time profiles. The measurements were made with the Ultra Low Energy Charge Analyzer sensor on ISEE-1. The composition in these events is similar to that of the solar wind, with a He to proton ratio of 8% and a CNO to He ratio of 6%. The composition is reasonably constant only when evaluated at equal energy per charge. The energy spectra cannot be adequately fit by a single power law in energy; an exponential or Maxwellian in energy per charge gives a satisfactory representation of the spectra. The time-intensity profiles of these upstream events show an inverse velocity dispersion, which may provide clues to the responsible acceleration mechanism.

Sirt3 modulation may be beneficial in the treatment of ejaculation dysfunction.

PubMed

Mandava, Sree Harsha; Hellstrom, Wayne J G

2013-09-01

Disorders of ejaculation are the most common form of sexual dysfunction. The ejaculatory reflex consists of two phases: emission and expulsion. Premature ejaculation (PE) can arise from overactivity of the smooth muscles responsible for ejaculation. On the other side of the spectrum, delayed ejaculation occurs when an individual is unable to either reach orgasm within an adequate time frame or experiences no ejaculation. While premature ejaculation and to a lesser degree delayed ejaculation have been recognized for quite some time, no FDA approved treatment has been developed. Since both types of ejaculatory dysfunction have an underlying neuro-muscular component, this may be a target for future treatment strategies. We thereby hypothesize that modulation of the rhythmic contraction of the ejaculatory smooth muscles with either a Sirt3 activator or inhibitor may prove beneficial in treating either premature or delayed ejaculation. Copyright © 2013 Elsevier Ltd. All rights reserved.

Core components of a comprehensive quality assurance program in anatomic pathology.

PubMed

Nakhleh, Raouf E

2009-11-01

In this article the core components of a comprehensive quality assurance and improvement plan are outlined. Quality anatomic pathology work comes with focus on accurate, timely, and complete reports. A commitment to continuous quality improvement and a systems approach with a persistent effort helps to achieve this end. Departments should have a quality assurance and improvement plan that includes a risk assessment of real and potential problems facing the laboratory. The plan should also list the individuals responsible for carrying out the program with adequate resources, a defined timetable, and annual assessment for progress and future directions. Quality assurance monitors should address regulatory requirements and be organized by laboratory division (surgical pathology, cytology, etc) as well as 5 segments (preanalytic, analytic, postanalytic phases of the test cycle, turn-around-time, and customer satisfaction). Quality assurance data can also be used to evaluate individual pathologists using multiple parameters with peer group comparison.

Patient perspectives on the promptness and quality of care of road traffic incident victims in Peru: a cross-sectional, active surveillance study

PubMed Central

Miranda, J Jaime

2013-01-01

Background: Road injuries are the second-leading cause of disease and injury in the Andean region of South America. Adequate management of road traffic crash victims is important to prevent and reduce deaths and serious long-term injuries. Objective: To evaluate the promptness of health care services provided to those injured in road traffic incidents (RTIs) and the satisfaction with those services during the pre-hospital and hospital periods. Methods: We conducted a cross-sectional study with active surveillance to recruit participants in emergency departments at eight health care facilities in three Peruvian cities: a large metropolitan city (Lima) and two provincial cities (an urban center in the southern Andes and an urban center in the rainforest region), between August and September 2009. The main outcomes of interest were promptness of care, measured by time between injury and each service offered, as well as patient satisfaction measured by the Service Quality (SERVQUAL) survey. We explored the association between outcomes and city, type of health care facility (HCF), and type of provider. Results: We recruited 644 adults seeking care for RTIs. This active surveillance strategy yielded 34% more events than anticipated, suggesting under-reporting in traditional registries. Median response time between a RTI and any care at a HCF was 33 minutes overall and only 62% of participants received professional care during the initial “golden” hour after the RTI. After adjustment for various factors, there was strong evidence of higher global dissatisfaction levels among those receiving care at public HCFs compared to private ones (odds ratio (OR) 5.05, 95% confidence interval (CI) 1.88-13.54). This difference was not observed when provincial sites were compared to Lima (OR 1.41, 95% CI 0.42-4.70). Conclusions: Response time to RTIs was adequate overall, though a large proportion of RTI victims could have received more prompt care. Overall, dissatisfaction was high, mainly at public institutions indicating much need for improvements in service provision. PMID:24358877

Increased colonic bile acid exposure: a relevant factor for symptoms and treatment in IBS.

PubMed

Bajor, Antal; Törnblom, Hans; Rudling, Mats; Ung, Kjell-Arne; Simrén, Magnus

2015-01-01

Bile acids may play a role in the pathogenesis of IBS. We investigated the potential effects of bile acids entering the colon and its role in the symptom pattern in IBS. We measured 75Se-labelled homocholic acid-taurine (75SeHCAT) retention, and serum levels of 7α-hydroxy-4-cholesten-3-one (C4) and fibroblast growth factor (FGF) 19 in patients with IBS (n=141) and control subjects (75SeHCAT n=29; C4 and FGF19 n=435). In patients with IBS stool frequency and form, as well as GI symptom severity were registered, and in a proportion of patients colonic transit time and rectal sensitivity were measured (n=66). An 8-week open-label treatment with colestipol was offered to patients with 75SeHCAT <20%, and the effect of treatment was evaluated with IBS severity scoring system and adequate relief of IBS symptoms. Compared with controls, patients with IBS had lower 75SeHCAT values (p=0.005), higher C4c levels (C4 corrected for cholesterol) (p<0.001), but similar FGF19 levels. Abnormal 75SeHCAT retention (<10%) was seen in 18% of patients, whereas 23% had elevated C4c levels. Patients with IBS with 75SeHCAT retention <10% had more frequent stools, accelerated colonic transit time, rectal hyposensitivity, a higher body mass index, higher C4c and lower FGF19 levels. Colestipol treatment improved IBS symptoms (IBS severity scoring system 220±109 vs. 277±106; p<0.01), and 15/27 patients fulfilled criteria for treatment response (adequate relief ≥50% of weeks 5-8). Increased colonic bile acid exposure influences bowel habit and colonic transit time in patients with IBS. A high response rate to open label treatment with colestipol supports this, but placebo-controlled studies are warranted. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Development of measures from the theory of planned behavior applied to leisure-time physical activity.

PubMed

Kerner, Matthew S

2005-06-01

Using the theory of planned behavior as a conceptual framework, scales assessing Attitude to Leisure-time Physical Activity, Expectations of Others, Perceived Control, and Intention to Engage in Leisure-time Physical Activity were developed for use among middle-school students. The study sample included 349 boys and 400 girls, 10 to 14 years of age (M=11.9 yr., SD=.9). Unipolar and bipolar scales with seven response choices were developed, with each scale item phrased in a Likert-type format. Following revisions, 22 items were retained in the Attitude to Leisure-time Physical Activity Scale, 10 items in the Expectations of Others Scale, 3 items in the Perceived Control Scale, and 17 items in the Intention to Engage in Leisure-time Physical Activity Scale. Adequate internal consistency was indicated by standardized coefficients alpha ranging from .75 to .89. Current results must be extended to assess discriminant and predictive validities and to check various reliabilities with new samples, then evaluation of intervention techniques for promotion of positive attitudes about leisure-time physical activity, including perception of control and intentions to engage in leisure-time physical activity.

Radiation Hazards and Countermeasures for Human Space Flight

NASA Technical Reports Server (NTRS)

Adams, James H., Jr.

2004-01-01

Protection of the astronauts from space radiation is NASA's moral and legal responsibility. There can be no manned deep space missions without adequate protection from the ionizing radiation in space. There are tow parts to radiation protection, determining the effects of space radiation on humans so that adequate exposure limits can be set and providing radiation protection that insures those limits will not be exceeded. This talk will review the status of work on these two parts and identify areas that are currently being investigated and gaps in the research that have been identified.

Developing an adequate "pneumatraumatology": understanding the spiritual impacts of traumatic injury.

PubMed

Bidwell, Duane R

2002-01-01

Psychosocial interventions and systematic theology are primary resources for chaplains and congregational pastors who care for victims of physical trauma. Yet these resources may not be adequate to address the spiritual impacts of trauma. This article proposes a preliminary "pneumatraumatology," drawing on early Christian asceticism and Buddhist mysticism to describe one way of understanding the spiritual impacts of traumatic injury. It also suggests possible responses to these impacts informed by narrative/constructionist perspectives and Breggemann's understanding of the dimensions of spiritual transformation in the Hebrew Bible.

Feasibility study of respiratory questionnaire and peak flow recordings in autobody shop workers exposed to isocyanate-containing spray paint: observations and limitations.

PubMed

Cullen, M R; Redlich, C A; Beckett, W S; Weltmann, B; Sparer, J; Jackson, G; Ruff, T; Rubinstein, E; Holden, W

1996-06-01

Diisocyanates, highly reactive monomers which cross-link polyurethane, are the most widely recognized causes of occupational asthma. Many exposed workers are end-users, including autobody spray painters who form a large population at risk. Neither the factors which determine incidence rate nor strategies for control have been adequately studied in this setting. We have conducted a cross-sectional survey of 23 (about one in five) autobody shops in the New Haven area to determine the feasibility of clinical epidemiological studies in this population. Among 102 workers, there was a high rate of airway symptoms consistent with occupational asthma (19.6%). Symptoms were most prevalent among those with the greatest opportunity for exposure (dedicated spray painters) and least among office workers; part-time painters had intermediate rates. Atopy was not associated with risk while smoking seemed to correlate with symptoms. Regular use of air-supplied respirators appeared to be associated with lower risk among workers who painted part- or full-time. We were unable to validate the questionnaire responses with peak expiratory flow record data attempted on a 1/3 sample of the workers. Despite intensive training and effort, subject compliance was limited. Among those who provided adequate data (24 of 38), only two demonstrated unequivocal evidence of labile airways; two others demonstrated lesser changes consistent with an occupational effect on flow rates. There was no clear association between these findings and either questionnaire responses or exposure classification. Overall, the survey suggests that there is a high prevalence of airway symptoms among workers in autobody shops, at least in part due to work-related asthma. However, there is need for both methodological and substantive research in this setting to document rates of occupational asthma and to develop a scientific basis for its effective control.

Using serology to assist with complicated post-exposure prophylaxis for rabies and Australian bat lyssavirus.

PubMed

Conroy, Niall; Vlack, Susan; Williams, Julian M; Patten, John J; Horvath, Robert L; Lambert, Stephen B

2013-01-01

Australia uses a protocol combining human rabies immunoglobulin (HRIG) and rabies vaccine for post-exposure prophylaxis (PEP) of rabies and Australian bat lyssavirus (ABLV), with the aim of achieving an antibody titre of ≥0.5 IU/ml, as per World Health Organization (WHO) guidelines, as soon as possible. We present the course of PEP administration and serological testing for four men with complex requirements. Following dog bites in Thailand, two men (62 years old, 25 years old) received no HRIG and had delayed vaccine courses: 23 days between dose two and three, and 18 days between dose one and two, respectively. Both seroconverted following dose four. Another 62-year-old male, who was HIV-positive (normal CD4 count), also suffered a dog bite and had delayed care receiving i.m. rabies vaccine on days six and nine in Thailand. Back in Australia, he received three single and one double dose i.m. vaccines followed by another double dose of vaccine, delivered intradermally and subcutaneously, before seroconverting. A 23-year-old male with a history of allergies received simultaneous HRIG and vaccine following potential ABLV exposure, and developed rash, facial oedema and throat tingling, which was treated with a parenteral antihistamine and tapering dose of steroids. Serology showed he seroconverted following dose four. These cases show that PEP can be complicated by exposures in tourist settings where reliable prophylaxis may not be available, where treatment is delayed or deviates from World Health Organization recommendations. Due to the potentially short incubation time of rabies/ABLV, timely prophylaxis after a potential exposure is needed to ensure a prompt and adequate immune response, particularly in patients who are immune-suppressed or who have not received HRIG. Serology should be used to confirm an adequate response to PEP when treatment is delayed or where a concurrent immunosuppressing medical condition or therapy exists.

Identification of the dominant runoff pathways from data-based mechanistic modelling of nested catchments in temperate UK

NASA Astrophysics Data System (ADS)

Ockenden, M. C.; Chappell, N. A.

2011-05-01

SummaryUnderstanding hydrological flow pathways is important for modelling stream response, in order to address a range of environmental problems such as flood prediction, prediction of chemical loads and identification of contaminant pathways for subsequent remediation. This paper describes the use of parametrically efficient, low order models to identify the dominant modes of stream response for catchments within the Upper Eden, UK. A first order linear model adequately identified the dominant mode in all but one of the sub-catchments. A consistent pattern of time constants and pure time delays between catchments was observed over different periods of data. In the nested catchments, time constants increased as the catchment size increased from 1.1 km 2 at Gais Gill (2-7 h) to 69.4 km 2 at Kirkby Stephen (5-10 h) to 223.4 km 2 at Great Musgrave (7-16 h) to 616.4 km 2 at Temple Sowerby (11-22 h), but Blind Beck (a small catchment 8.8 km 2, time constants 11-21 h) had time constants most similar to Temple Sowerby. This was attributed to a combination of the storage role of permeable rock strata, where present, and the effect of scale on sub-surface and channel routing. A first order model could not be identified for the 1.0 km 2 Low Hall catchment, which comprises permeable sandstone overlain by Quaternary sediments. A second-order model of Low Hall stream showed a higher proportion of water taking a slower pathway (76% via a slow pathway; time constant 252 h) than a model with the same structure for the 8.8 km 2 Blind Beck (46% via slow pathway; time constant 60 h), where only 38% of the basin was underlain by the same permeable sandstone. This highlights the need to quantify the role of deep pathways through permeable rock, where present, in addition to the effect of catchment size on response times.

Evaluation of the Clinical Impact of the Biofire Filmarray® Rapid Multiplex PCR Assay in Blood Culture Identification Combined with Antimicrobial Stewardship Intervention

PubMed Central

Andujar-Vazquez, Gabriela M; Gardiner, Bradley; Magro, Francis; Beaulac, Kirthana R; Doron, Shira; Snydman, David R

2017-01-01

Abstract Background Bloodstream infections are a major cause of morbidity and mortality worldwide, with favorable clinical outcomes associated with early optimal antibiotic selection. Rapid diagnostics have become a key part in achieving this. Biofire Filmarray® was introduced at our institution for rapid blood culture (BC) identification, coupled with antimicrobial stewardship (AS) interventions. We aimed to assess the impact of this test on time to adequate antimicrobial therapy in a setting with pre-existing effective AS interventions. Methods An observational retrospective chart review, pre and post study was performed. We reviewed adult positive BC before and after implementation of Biofire. Outcomes were: (1) time from BC result reported to health care provider to start of adequate antimicrobial therapy,(2) time to stopping antimicrobial therapy in BC thought to be contaminants, (3) time to any change in antimicrobial therapy and (4) a composite outcome of outcomes 1 and 2. A univariate Cox proportional hazards model was performed. Results 326 positive BC were analyzed, 173 before and 153 after Biofire implementation. At the time of healthcare provider notification, 77 were not on adequate antimicrobials, with median time to adequate therapy of 6.98 hours. (IQR 3.93–23.96) before and 6.1 hours. (IQR 1.84–20.95) after implementation, P = 0.48. There were 75 BC classified as contaminants and median time to stopping antimicrobials was 48.28 (IQR 18.56–89.36) vs. 45.25 hours. (IQR 15.12–100.60), P = 0.61. Time to any change in any antimicrobial therapy was similar with a median of 13.05 (IQR 4.00–36.77) vs. 10.90 hours. (IQR 2.97–31.10), P = 0.87. Analysis of the composite outcome revealed a median of 23.95 (6.29–58.50) vs. 14.82 (IQR 4.07–44.79) hours. (Hazard ratio 1.33, 95% confidence interval 0.96–1.84, P = 0.09). Conclusion Implementation of the Biofire Filmarray® did not have a statistically significant effect on our composite outcome of time to adequate therapy and time to discontinuation in the case of contaminants. Our findings suggests that when added to other effective AS surveillance and interventions, the magnitude of the clinical impact of rapid PCR diagnostics for BC identification is minimal. Disclosures D. R. Snydman, Merck: Scientific Advisor, Consulting fee; Shire: Scientific Advisor, Consulting fee

Risk factors for heat illness among British soldiers in the hot Collective Training Environment

PubMed Central

Moore, Alice C; Stacey, M J; Bailey, K G H; Bunn, R J; Woods, D R; Haworth, K J; Brett, S J; Folkes, S E F

2016-01-01

Background Heat illness is a preventable disorder in military populations. Measures that protect vulnerable individuals and contribute to effective Immediate Treatment may reduce the impact of heat illness, but depend upon adequate understanding and awareness among Commanders and their troops. Objective To assess risk factors for heat illness in British soldiers deployed to the hot Collective Training Environment (CTE) and to explore awareness of Immediate Treatment responses. Methods An anonymous questionnaire was distributed to British soldiers deployed in the hot CTEs of Kenya and Canada. Responses were analysed to determine the prevalence of individual (Intrinsic) and Command-practice (Extrinsic) risk factors for heat illness and the self-reported awareness of key Immediate Treatment priorities (recognition, first aid and casualty evacuation). Results The prevalence of Intrinsic risk factors was relatively low in comparison with Extrinsic risk factors. The majority of respondents were aware of key Immediate Treatment responses. The most frequently reported factors in each domain were increased risk by body composition scoring, inadequate time for heat acclimatisation and insufficient briefing about casualty evacuation. Conclusions Novel data on the distribution and scale of risk factors for heat illness are presented. A collective approach to risk reduction by the accumulation of ‘marginal gains’ is proposed for the UK military. This should focus on limiting Intrinsic risk factors before deployment, reducing Extrinsic factors during training and promoting timely Immediate Treatment responses within the hot CTE. PMID:26036822

Comparison of Measured Flapwise Structural Bending Moments on a Teetering Rotor Blade With Results Calculated From the Measured Pressure Distribution

NASA Technical Reports Server (NTRS)

Mayo, Alton P.

1959-01-01

Flapwise bending moments were calculated for a teetering rotor blade using a reasonably rapid theoretical method in which airloads obtained from wind-tunnel tests were employed. The calculated moments agreed reasonably well with those measured with strain gages under the same test conditions. The range of the tests included one hovering and two forward-flight conditions. The rotor speed for the test was very near blade resonance, and difficult-to-calculate resonance effects apparently were responsible for the largest differences between the calculated and measured harmonic components of blade bending moments. These differences, moreover, were largely nullified when the harmonic components were combined to give a comparison of the calculated and measured blade total- moment time histories. The degree of agreement shown is therefore considered adequate to warrant the use of the theoretical method in establishing and applying methods of prediction of rotor-blade fatigue loads. At the same time, the validity of the experimental methods of obtaining both airload and blade stress measurement is also indicated to be adequate for use in establishing improved methods for prediction of rotor-blade fatigue loads during the design stage. The blade stiffnesses and natural frequencies were measured and found to be in close agreement with calculated values; however, for a condition of blade resonance the use of the experimental stiffness values resulted in better agreement between calculated and measured blade stresses.

12 CFR 1710.15 - Conduct and responsibilities of board of directors.

Code of Federal Regulations, 2010 CFR

2010-01-01

... in place adequate policies and procedures to assure its oversight of, among other matters, the following: (1) Corporate strategy, major plans of action, risk policy, programs for legal and regulatory...

Mitigation/adaptation and health: health policymaking in the global response to climate change and implications for other upstream determinants.

PubMed

Wiley, Lindsay F

2010-01-01

The time is ripe for innovation in global health governance if we are to achieve global health and development objectives in the face of formidable challenges. Integration of global health concerns into the law and governance of other, related disciplines should be given high priority. This article explores opportunities for health policymaking in the global response to climate change. Climate change and environmental degradation will affect weather disasters, food and water security, infectious disease patterns, and air pollution. Although scientific research has pointed to the interdependence of the global environment and human health, policymakers have been slow to integrate their approaches to environmental and health concerns. A robust response to climate change will require improved integration on two fronts: health concerns must be given higher priority in the response to climate change and threats associated with climate change and environmental degradation must be more adequately addressed by global health law and governance. The mitigation/adaptation response paradigm developing within and beyond the United Nations Framework Convention on Climate Change provides a useful framework for thinking about global health law and governance with respect to climate change, environmental degradation, and possibly other upstream determinants of health as well. © 2010 American Society of Law, Medicine & Ethics, Inc.

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.

Smart active pilot-in-the-loop systems

NASA Astrophysics Data System (ADS)

Thomas, Segun

1995-04-01

Representation of on-orbit microgravity environment in a 1-g environment is a continuing problem in space engineering analysis, procedures development and crew training. A way of adequately depicting weightlessness in the performance of on-orbit tasks is by a realistic (or real-time) computer based representation that provides the look, touch, and feel of on-orbit operation. This paper describes how a facility, the Systems Engineering Simulator at the Johnson Space Center, is utilizing recent advances in computer processing power and multi- processing capability to intelligently represent all systems, sub-systems and environmental elements associated with space flight operations. It first describes the computer hardware and interconnection between processors; the computer software responsible for task scheduling, health monitoring, sub-system and environment representation; control room and crew station. It then describes, the mathematical models that represent the dynamics of contact between the Mir and the Space Shuttle during the upcoming US and Russian Shuttle/Mir space mission. Results are presented comparing the response of the smart, active pilot-in-the-loop system to non-time critical CRAY model. A final example of how these systems are utilized is given in the development that supported the highly successful Hubble Space Telescope repair mission.

Guaiphenesin-ketamine-xylazine infusion to maintain anesthesia in mules undergoing field castration.

PubMed

Vullo, Cecilia; Carluccio, Augusto; Robbe, Domenico; Meligrana, Marina; Petrucci, Linda; Catone, Giuseppe

2017-10-11

In order to determine whether a combination of guaiphenesin, ketamine and xylazine can induce safe and satisfactory anaesthesia in mules undergoing field castration, eight healthy adult intact male mules were employed. They were premedicated with intravenous (IV) xylazine (1.3 mg/kg); an additional dose of xylazine (0.3 mg/kg IV) was administered in case of inadequate depth of sedation. Anaesthesia was induced with IV thiopental (6 mg/kg). The quality of sedation and induction was recorded. Anaesthesia was maintained with an infusion of guaiphenesin (50 mg/mL), ketamine (2 mg/mL) and xylazine (1 mg/mL) (GKX). The spermatic cord of each testis was infiltrated with 5 mL of 2% lidocaine. During anaesthesia heart rate (HR), respiratory rate (RR), rectal temperature (RT) and haemoglobin oxygen saturation (SpO 2 ) were measured every 5 min. The data were analysed with simple one-way analysis of variance (ANOVA). A P value < 0.05 was considered statistically significant. Time of anesthesia, time of surgery and time of recovery were recorded. Only one mule required an additional dose of xylazine to achieve a satisfactory depth of sedation. Thiopental at the dose of 6 mg/kg IV resulted in smooth induction and lateral recumbency in all animals. GKX provided adequate anaesthesia to perform castration in all mules. Muscle relaxation was deemed adequate and physiological variables remained stable and within references values during the anaesthesia and did not change in response to surgical stimulation. Time (mean ± standard deviation) from the end of the infusion to sternal recumbency and time from sternal recumbency to standing were 27.7 ± 4.6 and 30.1 ± 7.7 min, respectively. The combination of xylazine, thiopental and GKX provides satisfactory short-term anaesthesia in mules undergoing field castration.

Predicting clinical outcomes in chordoma patients receiving immunotherapy: a comparison between volumetric segmentation and RECIST.

PubMed

Fenerty, Kathleen E; Folio, Les R; Patronas, Nicholas J; Marté, Jennifer L; Gulley, James L; Heery, Christopher R

2016-08-23

The Response Evaluation Criteria in Solid Tumors (RECIST) are the current standard for evaluating disease progression or therapy response in patients with solid tumors. RECIST 1.1 calls for axial, longest-diameter (or perpendicular short axis of lymph nodes) measurements of a maximum of five tumors, which limits clinicians' ability to adequately measure disease burden, especially in patients with irregularly shaped tumors. This is especially problematic in chordoma, a disease for which RECIST does not always adequately capture disease burden because chordoma tumors are typically irregularly shaped and slow-growing. Furthermore, primary chordoma tumors tend to be adjacent to vital structures in the skull or sacrum that, when compressed, lead to significant clinical consequences. Volumetric segmentation is a newer technology that allows tumor burden to be measured in three dimensions on either MR or CT. Here, we compared the ability of RECIST measurements and tumor volumes to predict clinical outcomes in a cohort of 21 chordoma patients receiving immunotherapy. There was a significant difference in radiologic time to progression Kaplan-Meier curves between clinical outcome groups using volumetric segmentation (P = 0.012) but not RECIST (P = 0.38). In several cases, changes in volume were earlier and more sensitive reflections of clinical status. RECIST is a useful evaluation method when obvious changes are occurring in patients with chordoma. However, in many cases, RECIST does not detect small changes, and volumetric assessment was capable of detecting changes and predicting clinical outcome earlier than RECIST. Although this study was small and retrospective, we believe our results warrant further research in this area.

Transcriptomic analysis of molecular responses in Malus domestica 'M26' roots affected by apple replant disease.

PubMed

Weiß, Stefan; Bartsch, Melanie; Winkelmann, Traud

2017-06-01

Gene expression studies in roots of apple replant disease affected plants suggested defense reactions towards biotic stress to occur which did not lead to adequate responses to the biotic stressors. Apple replant disease (ARD) leads to growth inhibition and fruit yield reduction in replanted populations and results in economic losses for tree nurseries and fruit producers. The etiology is not well understood on a molecular level and causal agents show a great diversity indicating that no definitive cause, which applies to the majority of cases, has been found out yet. Hence, it is pivotal to gain a better understanding of the molecular and physiological reactions of the plant when affected by ARD and later to overcome the disease, for example by developing tolerant rootstocks. For the first time, gene expression was investigated in roots of ARD affected plants employing massive analysis of cDNA ends (MACE) and RT-qPCR. In reaction to ARD, genes in secondary metabolite production as well as plant defense, regulatory and signaling genes were upregulated whereas for several genes involved in primary metabolism lower expression was detected. For internal verification of MACE data, candidate genes were tested via RT-qPCR and a strong positive correlation between both datasets was observed. Comparison of apple 'M26' roots cultivated in ARD soil or γ-irradiated ARD soil suggests that typical defense reactions towards biotic stress take place in ARD affected plants but they did not allow responding to the biotic stressors attack adequately, leading to the observed growth depressions in ARD variants.

Columbia River White Sturgeon (Acipenser Transmontanus) Enhancement, May 1-December 31, 1983 Final Report.

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

Brannon, E.L.

1984-12-01

Studies were undertaken to examine and define the early life history characteristics of Columbia River white sturgeon as a working base from which enhancement measures could be developed. Adult sturgeon were captured and held for spawning at Covert's Landing, the site of the hatchery facilities below Bonneville Dam. Pituitary hormones stimulated ovulation; ripe females were live spawned surgically and the eggs incubated in hatching jars. Larvae were either reared at the hatchery site after incubation to advanced fingerling stages or transferred to the University laboratory for more detailed study. Displacement downstream occurs as a means of distribution and can lastmore » several days before a strong substrate preference is manifested. Once bottom contact is sought by the larvae, displacement is abated, and a general preference for sandy surface appears to predominate. Since potentially extensive displacement downstream could result in the distribution of larvae in saltwater, the tolerance of young sturgeon to saltwater was examined. The responsiveness of young sturgeon to artificial feed was positive. With these results, the original concern for identifying an adequate diet and food source that would be readily accepted by fry was greatly attenuated. The readiness of young fry to initiate feeding on the artificial diet made further study on feeding stimulants unnecessary. Examination of the feeding response suggested that as long as the diet used in the present study was initiated at the proper time and with adequate frequency, the fry would feed quite well and survive. 6 refs., 10 figs., 5 tabs.« less

Cryptochrome 2 expression level is critical for adrenocorticotropin stimulation of cortisol production in the capuchin monkey adrenal.

PubMed

Torres-Farfan, C; Abarzua-Catalan, L; Valenzuela, F J; Mendez, N; Richter, H G; Valenzuela, G J; Serón-Ferré, M

2009-06-01

Timely production of glucocorticoid hormones in response to ACTH is essential for survival by coordinating energy intake and expenditure and acting as homeostatic regulators against stress. Adrenal cortisol response to ACTH is clock time dependent, suggesting that an intrinsic circadian oscillator in the adrenal cortex contributes to modulate the response to ACTH. Circadian clock gene expression has been reported in the adrenal cortex of several species. However, there are no reports accounting for potential involvement of adrenal clock proteins on cortisol response to ACTH. Here we explored whether the clock protein cryptochrome 2 (CRY2) knockdown modifies the adrenal response to ACTH in a primate. Adrenal gland explants from adult capuchin monkey (n = 5) were preincubated for 6 h with transfection vehicle (control) or with two different Cry2 antisense and sense probes followed by 48 h incubation in medium alone (no ACTH) or with 100 nm ACTH. Under control and sense conditions, ACTH increased cortisol production, whereas CRY2 suppression inhibited ACTH-stimulated cortisol production. Expression of the steroidogenic enzymes steroidogenic acute regulatory protein and 3beta-hydroxysteroid dehydrogenase at 48 h of incubation was increased by ACTH in control explants and suppressed by Cry2 knockdown. Additionally, we found that Cry2 knockdown decreased the expression of the clock gene brain and muscle aryl hydrocarbon receptor nuclear translocator-like protein (Bmal1) at the mRNA and protein levels. Altogether these results strongly support that the clock protein CRY2 is involved in the mechanism by which ACTH increases the expression of steroidogenic acute regulatory protein and 3beta-hydroxysteroid dehydrogenase. Thus, adequate expression levels of components of the adrenal circadian clock are required for an appropriate cortisol response to ACTH.

Use of intraspecific variation in thermal responses for estimating an elevational cline in the timing of cold hardening in a sub-boreal conifer.

PubMed

Ishizuka, W; Ono, K; Hara, T; Goto, S

2015-01-01

To avoid winter frost damage, evergreen coniferous species develop cold hardiness with suitable phenology for the local climate regime. Along the elevational gradient, a genetic cline in autumn phenology is often recognised among coniferous populations, but further quantification of evolutionary adaptation related to the local environment and its responsible signals generating the phenological variation are poorly understood. We evaluated the timing of cold hardening among populations of Abies sachalinensis, based on time series freezing tests using trees derived from four seed source populations × three planting sites. Furthermore, we constructed a model to estimate the development of hardening from field temperatures and the intraspecific variations occurring during this process. An elevational cline was detected such that high-elevation populations developed cold hardiness earlier than low-elevation populations, representing significant genetic control. Because development occurred earlier at high-elevation planting sites, the genetic trend across elevation overlapped with the environmental trend. Based on the trade-off between later hardening to lengthen the active growth period and earlier hardening to avoid frost damage, this genetic cline would be adaptive to the local climate. Our modelling approach estimated intraspecific variation in two model components: the threshold temperature, which was the criterion for determining whether the trees accumulated the thermal value, and the chilling requirement for trees to achieve adequate cold hardiness. A higher threshold temperature and a lower chilling requirement could be responsible for the earlier phenology of the high-elevation population. These thermal responses may be one of the important factors driving the elevation-dependent adaptation of A. sachalinensis. © 2014 German Botanical Society and The Royal Botanical Society of the Netherlands.

Momentary Associations Between Reported Craving and Valuing Health in Daily Smokers.

PubMed

MacLean, Robert Ross; Martino, Steve; Carroll, Kathleen M; Smyth, Joshua M; Pincus, Aaron L; Wilson, Stephen J

2017-06-01

Research suggests that a blunted response to nondrug rewards, especially under conditions associated with strong cigarette cravings, is associated with reduced abstinence motivation in daily smokers. One limitation of previous studies is that they have largely focused on monetary rewards as broad representative of nondrug rewards. It remains unclear whether craving dampens responses to more abstract nondrug rewards, such as personal values. Personal values often have a positive valence and are frequently assumed to remain stable across time and situations. However, there may be time-varying and contextual influences on smokers' appraisal of values in daily life. Characterizing fluctuations in value importance in relation to relapse precipitants (eg, craving) may inform interventions that leverage personal values as motivation for cessation. Daily smokers (n = 18) completed ecological momentary assessment surveys measuring the importance of specific personal values and smoking-related variables during 8 days of monetarily reinforced cigarette abstinence. We hypothesized that value ratings would demonstrate adequate within-person heterogeneity for multilevel modeling and that within-person fluctuations in craving would be negatively related to valuing personal health. All values demonstrated adequate within-person variability for multilevel modeling. Within-person craving was negatively related to health valuation (p = .012) and a cross-level interaction (p > .0001) suggested this effect is stronger for individuals who report greater overall craving. Greater craving is associated with decreased importance of personal health in the moment, particularly for those with high average levels of craving. Timely interventions that bolster importance of health during moments of elevated craving can potentially improve cessation outcomes. This study builds on research highlighting the positive influence of personal values in motivating behavior change. Values are an often used, but poorly studied, construct that has considerable utility in smoking cessation. Valuing personal health is frequently reported as a primary motivator for a quit attempt. Inasmuch as personal health is a distal nondrug reward used to motivate smoking abstinence, naturalistic evaluation of health importance, and motivators for continued smoking (ie, craving) could inform the timing and content of smoking treatment. This study is among the first to evaluate momentary assessment of personal values and craving within daily life. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Health Information Needs and Health Seeking Behavior During the 2014-2016 Ebola Outbreak: A Twitter Content Analysis.

PubMed

Odlum, Michelle; Yoon, Sunmoo

2018-03-23

For effective public communication during major disease outbreaks like the 2014-2016 Ebola epidemic, health information needs of the population must be adequately assessed. Through content analysis of social media data, like tweets, public health information needs can be effectively assessed and in turn provide appropriate health information to address such needs. The aim of the current study was to assess health information needs about Ebola, at distinct epidemic time points, through longitudinal tracking. Natural language processing was applied to explore public response to Ebola over time from July 2014 to March 2015. A total 155,647 tweets (unique 68,736, retweet 86,911) mentioning Ebola were analyzed and visualized with infographics. Public fear, frustration, and health information seeking regarding Ebola-related global priorities were observed across time. Our longitudinal content analysis revealed that due to ongoing health information deficiencies, resulting in fear and frustration, social media was at times an impediment and not a vehicle to support health information needs. Content analysis of tweets effectively assessed Ebola information needs. Our study also demonstrates the use of Twitter as a method for capturing real-time data to assess ongoing information needs, fear, and frustration over time.

Determinants of vitamin D status in adult Crohn's disease patients, with particular emphasis on supplemental vitamin D use.

PubMed

Gilman, J; Shanahan, F; Cashman, K D

2006-07-01

To investigate determinants (pathophysiologic and physiologic, behavioural and lifestyle) of vitamin D status in Irish Crohn's disease (CD) patients. A cross-sectional observational study. Cork City, Ireland (52 degrees N). Crohn's Disease patients (n=58; mean age 38.1 years) were recruited from Cork University Hospital. Fifty and nineteen percent of Irish CD patients were vitamin D deficient (defined by serum 25 hydroxyvitamin (OH) D levels <50 nmol/l) during winter and summer, respectively. Multiple regression analysis showed that summer-time serum 25 (OH) D levels were positively associated with use of vitamin D supplements (P=0.033) and negatively associated with smoking (P=0.006) and being male (P=0.063). During winter-time, use of vitamin D supplements (P=0.041) and sun habits (P=0.066) were positively associated, whereas small intestinal involvement (P=0.005) and body mass index (BMI) (P=0.083) were negatively associated with serum 25 (OH) D levels. There was no significant association between other non-pathophysiologic (age, dietary calcium or vitamin D) or pathophysiologic factors (steroid use, resection), and serum 25 (OH) D levels, at either season. Approximately 41 and 60% of the total variation in summer- and winter-time serum 25 (OH) D, respectively, was explained by this model. A high proportion of Irish CD patents had some level of vitamin D deficiency (<50 nmol/l) during late-wintertime. Use of regular low-dose supplemental vitamin D, particularly by patients with small intestinal involvement, cessation of smoking and adequate, but responsible, exposure to summer sunlight as well as maintaining BMI in the normal range could help maintain adequate vitamin D levels during wintertime.

Automatic Car Identification - an Evaluation

DOT National Transportation Integrated Search

1972-03-01

In response to a Federal Railroad Administration request, the Transportation Systems Center evaluated the Automatic Car Identification System (ACI) used on the nation's railroads. The ACI scanner was found to be adequate for reliable data output whil...

43 CFR 2.56 - Disclosure of records.

Code of Federal Regulations, 2010 CFR

2010-10-01

... responsible for the system in which the record is maintained with advance adequate written assurance that the record will be used solely as a statistical research or reporting record, and the record is to be...

How Much Do Additional Mailings and Telephone Calls Contribute to Response Rates in a Survey of Medicare Beneficiaries?

ERIC Educational Resources Information Center

Burkhart, Q.; Haviland, Amelia M.; Kallaur, Paul N.; Edwards, Carol A.; Brown, Julie A.; Elliott, Marc N.

2015-01-01

Surveys often spend substantial money on multiple mailings and telephone calls to ensure high overall response rates and adequate representation of hard-to-reach demographic subgroups. We examine the extent to which an additional mailing and additional sets of telephone calls are effective in attaining these goals across a variety of subgroups in…

Replacing Property Taxes with Sales Taxes Is the Wrong Answer for Texas Families and Public Schools

ERIC Educational Resources Information Center

Center for Public Policy Priorities, 2012

2012-01-01

Public education is the foundation of our democracy and the engine of our economy, and Texans have a collective responsibility to ensure that public education is adequately supported. This responsibility needs to be fairly distributed among Texas families in a way that supports economic growth. Recently, some have proposed that Texas replace local…

Training Teachers to Use Pivotal Response Training with Children with Autism: Coaching as a Critical Component

ERIC Educational Resources Information Center

Suhrheinrich, Jessica

2011-01-01

Although evidence-based practices (EBPs) for educating children with autism, such as pivotal response training (PRT), exist, teachers often lack adequate training to use these practices. The current investigation examined the efficacy of a 6-hour group workshop plus individual coaching for training 20 teachers to use PRT. Results indicate that the…

Measurement of breastfeeding initiation: Ethiopian mothers' perception about survey questions assessing early initiation of breastfeeding.

PubMed

Salasibew, Mihretab Melesse; Filteau, Suzanne; Marchant, Tanya

2014-01-01

Although breastfeeding is almost universal in Ethiopia, only 52% newborns benefited from early initiation in 2011. Early initiation is one of the recommended interventions for saving newborn lives but its potential seems not yet realized for Ethiopian newborns and there is a need for continued efforts to increase coverage. To do so, it is also relevant to focus on consistent and accurate reporting of coverage in early initiation. WHO recommends the question "how long after birth did you first put [name] to the breast?" in order to assess coverage in early initiation. It is designed to measure the time after birth when the mother attempted to initiate breastfeeding regardless of whether breast milk had arrived or not. However, it is unclear how mothers perceive this question and what their responses of time refer to. In this study, we assessed Ethiopian mothers' perception about the question assessing early initiation. Cognitive interviews were conducted between April and May 2013 with eligible mothers in Basona and Debrebirhan woredas (districts), 120 km away from Addis Ababa, Ethiopia. A total of 49 mothers, most from Basona (n = 36) and the rest from Debrebirhan woredas (n = 13) were interviewed. No probes or follow on questions were required for mothers to understand what the WHO recommended question was about. However, further probing was needed to ascertain what maternal responses of time refer to. Accordingly, mothers' response about the timing of early initiation was related to the first time the newborn received breast milk rather than their first attempt to initiate breastfeeding. In addition, considerable probing was required to approximate and code responses of time based on the WHO coding format because some mothers were unable to assess time in minutes or hours. The existing question is not adequate to identify intended attempts of mothers to initiate breastfeeding. We recommend revising the question as "how long after birth did you first put [name] to the breast even if your breast milk did not arrive yet?" Standard probes or follow on questions are required to avoid subjective interpretation of the indicator.

Endpoint design for future renal denervation trials - Novel implications for a new definition of treatment response to renal denervation.

PubMed

Lambert, Thomas; Nahler, Alexander; Rohla, Miklos; Reiter, Christian; Grund, Michael; Kammler, Jürgen; Blessberger, Hermann; Kypta, Alexander; Kellermair, Jörg; Schwarz, Stefan; Starnawski, Jennifer A; Lichtenauer, Michael; Weiss, Thomas W; Huber, Kurt; Steinwender, Clemens

2016-10-01

Defining an adequate endpoint for renal denervation trials represents a major challenge. A high inter-individual and intra-individual variability of blood pressure levels as well as a partial or total non-adherence on antihypertensive drugs hamper treatment evaluations after renal denervation. Blood pressure measurements at a single point in time as used as primary endpoint in most clinical trials on renal denervation, might not be sufficient to discriminate between patients who do or do not respond to renal denervation. We compared the traditional responder classification (defined as systolic 24-hour blood pressure reduction of -5mmHg six months after renal denervation) with a novel definition of an ideal respondership (based on a 24h blood pressure reduction at no point in time, one, or all follow-up timepoints). We were able to re-classify almost a quarter of patients. Blood pressure variability was substantial in patients traditionally defined as responders. On the other hand, our novel classification of an ideal respondership seems to be clinically superior in discriminating sustained from pseudo-response to renal denervation. Based on our observations, we recommend that the traditional response classification should be reconsidered and possibly strengthened by using a composite endpoint of 24h-BP reductions at different follow-up-visits. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Speed of spinal vs general anaesthesia for category-1 caesarean section: a simulation and clinical observation-based study.

PubMed

Kathirgamanathan, A; Douglas, M J; Tyler, J; Saran, S; Gunka, V; Preston, R; Kliffer, P

2013-07-01

Controversy exists as to whether effective spinal anaesthesia can be achieved as quickly as general anaesthesia for a category-1 caesarean section. Sixteen consultants and three fellows in obstetric anaesthesia were timed performing spinal and general anaesthesia for category-1 caesarean section on a simulator. The simulation time commenced upon entry of the anaesthetist into the operating theatre and finished for the spinal anaesthetic at the end of intrathecal injection and for the general anaesthetic when the anaesthetist was happy for surgery to start. In the second clinical part of the study, the time from intrathecal administration to 'adequate surgical anaesthesia' (defined as adequate for start of a category-1 caesarean section) was estimated in 100 elective (category-4) caesarean sections. The median (IQR [range]) times (min:s) for spinal procedure, onset of spinal block and general anaesthesia were 2:56 (2:32-3:32 [1:22-3:50]), 5:56 (4:23-7:39 [2:9-13:32]) and 1:56 (1:39-2:9 [1:13-3:12]), respectively. The limiting factor in urgent spinal anaesthesia is the unpredictable time needed for adequate surgical block to develop. Anaesthesia © 2013 The Association of Anaesthetists of Great Britain and Ireland.

Implementation of selective prevention for cardiometabolic diseases; are Dutch general practices adequately prepared?

PubMed

Stol, Daphne M; Hollander, Monika; Nielen, Markus M J; Badenbroek, Ilse F; Schellevis, François G; de Wit, Niek J

2018-03-01

Current guidelines acknowledge the need for cardiometabolic disease (CMD) prevention and recommend five-yearly screening of a targeted population. In recent years programs for selective CMD-prevention have been developed, but implementation is challenging. The question arises if general practices are adequately prepared. Therefore, the aim of this study is to assess the organizational preparedness of Dutch general practices and the facilitators and barriers for performing CMD-prevention in practices currently implementing selective CMD-prevention. Observational study. Dutch primary care. General practices. Organizational characteristics. General practices implementing selective CMD-prevention are more often organized as a group practice (49% vs. 19%, p = .000) and are better organized regarding chronic disease management compared to reference practices. They are motivated for performing CMD-prevention and can be considered as 'frontrunners' of Dutch general practices with respect to their practice organization. The most important reported barriers are a limited availability of staff (59%) and inadequate funding (41%). The organizational infrastructure of Dutch general practices is considered adequate for performing most steps of selective CMD-prevention. Implementation of prevention programs including easily accessible lifestyle interventions needs attention. All stakeholders involved share the responsibility to realize structural funding for programmed CMD-prevention. Aforementioned conditions should be taken into account with respect to future implementation of selective CMD-prevention. Key Points   There is need for adequate CMD prevention. Little is known about the organization of selective CMD prevention in general practices.   • The organizational infrastructure of Dutch general practices is adequate for performing most steps of selective CMD prevention.   • Implementation of selective CMD prevention programs including easily accessible services for lifestyle support should be the focus of attention.   • Policy makers, health insurance companies and healthcare professionals share the responsibility to realize structural funding for selective CMD prevention.

Research information knowledge, perceived adequacy, and understanding in cancer clinical trial participants.

PubMed

Biedrzycki, Barbara A

2011-07-01

To describe the adequacy of research information among people with cancer at the time they accept or decline participation in a cancer clinical trial. Cross-sectional, descriptive. An urban, academic, National Cancer Institute-designated comprehensive cancer center. 197 patients with advanced gastrointestinal cancer. Mailed survey; self-reported data. Adequacy of research information (actual knowledge, perceived adequacy of information, and perceived understanding), cancer clinical trial participation, and satisfaction with the decision to participate. Most respondents (88%) perceived themselves as having adequate information to make an informed decision regarding cancer clinical trial participation. In addition, 35% demonstrated adequate knowledge of basic clinical research. Patients decide to accept or decline cancer clinical trials without having adequate knowledge. Nurses have an important role in educating patients regarding cancer clinical trials. The ideal teachable moment may not occur at the time of diagnosis; other less stressful opportunities may present when the patient is more receptive.

NBS work on neutron resonance radiography

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

Schrack, R.A.

1987-01-01

NBS has been engaged in a wide-ranging program in Neutron Resonance Radiography utilizing both one- and two-dimensional position-sensitive neutron detectors. The ability to perform a position-sensitive assay of up to 16 isotopes in a complex matrix has been demonstrated for a wide variety of sample types, including those with high gamma activity. A major part of the program has been the development and application of the microchannel-plate-based position-sensitive neutron detector. This detector system has high resolution and sensitivity, together with adequate speed of response to be used with neutron time-of-flight techniques. This system has demonstrated the ability to simultaneously imagemore » three isotopes in a sample with no interference.« less

Quantification of soil mapping by digital analysis of LANDSAT data. [Clinton County, Indiana

NASA Technical Reports Server (NTRS)

Kirschner, F. R.; Kaminsky, S. A.; Hinzel, E. J.; Sinclair, H. R.; Weismiller, R. A.

1977-01-01

Soil survey mapping units are designed such that the dominant soil represents the major proportion of the unit. At times, soil mapping delineations do not adequately represent conditions as stated in the mapping unit descriptions. Digital analysis of LANDSAT multispectral scanner (MSS) data provides a means of accurately describing and quantifying soil mapping unit composition. Digital analysis of LANDSAT MSS data collected on 9 June 1973 was used to prepare a spectral soil map for a 430-hectare area in Clinton County, Indiana. Fifteen spectral classes were defined, representing 12 soil and 3 vegetation classes. The 12 soil classes were grouped into 4 moisture regimes based upon their spectral responses; the 3 vegetation classes were grouped into one all-inclusive class.

Integrating an MR head into a peak detection channel

NASA Astrophysics Data System (ADS)

Curland, Nathan; Machelski, Russell J.

1994-03-01

Integrating a magnetoresistive (MR) head into a peak detection channel requires the engineer to deal with basic differences between MR and thin film heads. These differences result from nonlinear sensor response, separate write and read elements, and having an active element at the air bearing surface (ABS). A simple model for flux superposition can adequately address nonlinear effects and be used for equalization design. Timing budgets can be developed which demonstrate the dominance of media noise for present day systems. Single threshold qualification can handle most current system requirements. Separate read/write elements mean that more attention needs to be paid to offtrack equalization design and head dimensional tolerancing. An active element at the ABS requires better control of the head-disc potential and leakage currents.

Semantic Ambiguity Effects in L2 Word Recognition.

PubMed

Ishida, Tomomi

2018-06-01

The present study examined the ambiguity effects in second language (L2) word recognition. Previous studies on first language (L1) lexical processing have observed that ambiguous words are recognized faster and more accurately than unambiguous words on lexical decision tasks. In this research, L1 and L2 speakers of English were asked whether a letter string on a computer screen was an English word or not. An ambiguity advantage was found for both groups and greater ambiguity effects were found for the non-native speaker group when compared to the native speaker group. The findings imply that the larger ambiguity advantage for L2 processing is due to their slower response time in producing adequate feedback activation from the semantic level to the orthographic level.

Balancing practicality and hydrologic realism: a parsimonious approach for simulating rapid groundwater recharge via unsaturated-zone preferential flow

USGS Publications Warehouse

Mirus, Benjamin B.; Nimmo, J.R.

2013-01-01

The impact of preferential flow on recharge and contaminant transport poses a considerable challenge to water-resources management. Typical hydrologic models require extensive site characterization, but can underestimate fluxes when preferential flow is significant. A recently developed source-responsive model incorporates film-flow theory with conservation of mass to estimate unsaturated-zone preferential fluxes with readily available data. The term source-responsive describes the sensitivity of preferential flow in response to water availability at the source of input. We present the first rigorous tests of a parsimonious formulation for simulating water table fluctuations using two case studies, both in arid regions with thick unsaturated zones of fractured volcanic rock. Diffuse flow theory cannot adequately capture the observed water table responses at both sites; the source-responsive model is a viable alternative. We treat the active area fraction of preferential flow paths as a scaled function of water inputs at the land surface then calibrate the macropore density to fit observed water table rises. Unlike previous applications, we allow the characteristic film-flow velocity to vary, reflecting the lag time between source and deep water table responses. Analysis of model performance and parameter sensitivity for the two case studies underscores the importance of identifying thresholds for initiation of film flow in unsaturated rocks, and suggests that this parsimonious approach is potentially of great practical value.

Treatment of latent syphilis.

PubMed

Jaffe, H W

1976-12-01

The studies in the English language of the treatment of latent syphillis suffer from a variety of problems. Investigators have failed to define cases adequately and, in some instances, have combined results of several treatment regimens, and have not followed patients for an adequate period of time. It may be wisest to recommend that regimens considered effective for asymptomatic neurosyphilis also be used for latent syphilis.

Trans-pacific glacial response to the Antarctic Cold Reversal in the southern mid-latitudes

NASA Astrophysics Data System (ADS)

Sagredo, Esteban A.; Kaplan, Michael R.; Araya, Paola S.; Lowell, Thomas V.; Aravena, Juan C.; Moreno, Patricio I.; Kelly, Meredith A.; Schaefer, Joerg M.

2018-05-01

Elucidating the timing and regional extent of abrupt climate events during the last glacial-interglacial transition (∼18-11.5 ka) is critical for identifying spatial patterns and mechanisms responsible for large-magnitude climate events. The record of climate change in the Southern Hemisphere during this time period, however, remains scarce and unevenly distributed. We present new geomorphic, chronological, and equilibrium line altitude (ELA) data from a climatically sensitive mountain glacier at Monte San Lorenzo (47°S), Central Patagonia. Twenty-four new cosmogenic 10Be exposure ages from moraines provide a comprehensive glacial record in the mid-latitudes of South America, which constrain the timing, spatial extent and magnitude of glacial fluctuations during the Antarctic Cold Reversal (ACR, ∼14.5-12.9 ka). Río Tranquilo glacier advanced and reached a maximum extent at 13.9 ± 0.7 ka. Three additional inboard moraines afford statistically similar ages, indicating repeated glacier expansions or marginal fluctuations over the ACR. Our record represents the northernmost robust evidence of glacial fluctuations during the ACR in southern South America, documenting not only the timing of the ACR maximum, but also the sequence of glacier changes within this climate event. Based on ELA reconstructions, we estimate a cooling of >1.6-1.8 °C at the peak of the ACR. The Río Tranquilo record along with existing glacial reconstructions from New Zealand (43°S) and paleovegetation records from northwestern (41°S) and central-west (45°S) Patagonia, suggest an uniform trans-Pacific glacier-climate response to an ACR trigger across the southern mid-latitudes. We posit that the equatorial migration of the southern westerly winds provides an adequate mechanism to propagate a common ACR signal across the Southern Hemisphere.

Recommendations for Optimizing Tuberculosis Treatment: Therapeutic Drug Monitoring, Pharmacogenetics, and Nutritional Status Considerations

PubMed Central

Choi, Rihwa; Jeong, Byeong-Ho

2017-01-01

Although tuberculosis is largely a curable disease, it remains a major cause of morbidity and mortality worldwide. Although the standard 6-month treatment regimen is highly effective for drug-susceptible tuberculosis, the use of multiple drugs over long periods of time can cause frequent adverse drug reactions. In addition, some patients with drug-susceptible tuberculosis do not respond adequately to treatment and develop treatment failure and drug resistance. Response to tuberculosis treatment could be affected by multiple factors associated with the host-pathogen interaction including genetic factors and the nutritional status of the host. These factors should be considered for effective tuberculosis control. Therefore, therapeutic drug monitoring (TDM), which is individualized drug dosing guided by serum drug concentrations during treatment, and pharmacogenetics-based personalized dosing guidelines of anti-tuberculosis drugs could reduce the incidence of adverse drug reactions and increase the likelihood of successful treatment outcomes. Moreover, assessment and management of comorbid conditions including nutritional status could improve anti-tuberculosis treatment response. PMID:28028995

Treatment effect on biases in size estimation in spider phobia.

PubMed

Shiban, Youssef; Fruth, Martina B; Pauli, Paul; Kinateder, Max; Reichenberger, Jonas; Mühlberger, Andreas

2016-12-01

The current study investigates biases in size estimations made by spider-phobic and healthy participants before and after treatment. Forty-one spider-phobic and 20 healthy participants received virtual reality (VR) exposure treatment and were then asked to rate the size of a real spider immediately before and, on average, 15days after the treatment. During the VR exposure treatment skin conductance response was assessed. Prior to the treatment, both groups tended to overestimate the size of the spider, but this size estimation bias was significantly larger in the phobic group than in the control group. The VR exposure treatment reduced this bias, which was reflected in a significantly smaller size rating post treatment. However, the size estimation bias was unrelated to the skin conductance response. Our results confirm the hypothesis that size estimation by spider-phobic patients is biased. This bias is not stable over time and can be decreased with adequate treatment. Copyright © 2016 Elsevier B.V. All rights reserved.

How states, tribes and localities are re-defining systems of care.

PubMed

Pires, Sheila A

2010-02-01

The original definition of system of care was developed 20 years ago largely in response to the fragmented services experienced by children with serious emotional disorders and their families, who, typically, were involved in multiple systems and/or receiving services from different providers. Over time, in response to national funders' pursuing system of care for different populations and their own experience, states, tribes and localities have applied system of care principles, values and operational characteristics to other populations (children and adults). The definition offered by Hodges et al., has an unintended effect of constraining the properties (and potential) of system of care in its limitation to a single population. This paper argues that the adaptations made to the original Stroul and Friedman definition in the training curriculum Building Systems of Care: A Primer adequately encompass properties that reflect state, tribal and local implementation experience and are specific to planning, implementing and evaluating a system of care, without limiting system of care to any one population.

Immunization of children with secondary immunodeficiency

PubMed Central

Esposito, Susanna; Prada, Elisabetta; Lelii, Mara; Castellazzi, Luca

2015-01-01

ABSTRACT The main causes of secondary immunodeficiency at a pediatric age include infectious diseases (mainly HIV infection), malignancies, haematopoietic stem cell or solid organ transplantation and autoimmune diseases. Children with secondary immunodeficiency have an increased risk of severe infectious diseases that could be prevented by adequate vaccination coverage, but vaccines administration can be associated with reduced immune response and an increased risk of adverse reactions. The immunogenicity of inactivated and recombinant vaccines is comparable to that of healthy children at the moment of vaccination, but it undergoes a progressive decline over time, and in the absence of a booster, the patients remain at risk of developing vaccine-preventable infections. However, the administration of live attenuated viral vaccines is controversial because of the risk of the activation of vaccine viruses. A specific immunization program should be administered according to the clinical and immunological status of each of these conditions to ensure a sustained immune response without any risks to the patients' health. PMID:26176360

A glycerol-free process to produce biodiesel by supercritical methyl acetate technology: an optimization study via Response Surface Methodology.

PubMed

Tan, Kok Tat; Lee, Keat Teong; Mohamed, Abdul Rahman

2010-02-01

In this study, fatty acid methyl esters (FAME) have been successfully produced from transesterification reaction between triglycerides and methyl acetate, instead of alcohol. In this non-catalytic supercritical methyl acetate (SCMA) technology, triacetin which is a valuable biodiesel additive is produced as side product rather than glycerol, which has lower commercial value. Besides, the properties of the biodiesel (FAME and triacetin) were found to be superior compared to those produced from conventional catalytic reactions (FAME only). In this study, the effects of various important parameters on the yield of biodiesel were optimized by utilizing Response Surface Methodology (RSM) analysis. The mathematical model developed was found to be adequate and statistically accurate to predict the optimum yield of biodiesel. The optimum conditions were found to be 399 degrees C for reaction temperature, 30 mol/mol of methyl acetate to oil molar ratio and reaction time of 59 min to achieve 97.6% biodiesel yield.

The Effect of Mental Rotation on Surgical Pathological Diagnosis.

PubMed

Park, Heejung; Kim, Hyun Soo; Cha, Yoon Jin; Choi, Junjeong; Minn, Yangki; Kim, Kyung Sik; Kim, Se Hoon

2018-05-01

Pathological diagnosis involves very delicate and complex consequent processing that is conducted by a pathologist. The recognition of false patterns might be an important cause of misdiagnosis in the field of surgical pathology. In this study, we evaluated the influence of visual and cognitive bias in surgical pathologic diagnosis, focusing on the influence of "mental rotation." We designed three sets of the same images of uterine cervix biopsied specimens (original, left to right mirror images, and 180-degree rotated images), and recruited 32 pathologists to diagnose the 3 set items individually. First, the items found to be adequate for analysis by classical test theory, Generalizability theory, and item response theory. The results showed statistically no differences in difficulty, discrimination indices, and response duration time between the image sets. Mental rotation did not influence the pathologists' diagnosis in practice. Interestingly, outliers were more frequent in rotated image sets, suggesting that the mental rotation process may influence the pathological diagnoses of a few individual pathologists. © Copyright: Yonsei University College of Medicine 2018.

Ethical education in software engineering: responsibility in the production of complex systems.

PubMed

Génova, Gonzalo; González, M Rosario; Fraga, Anabel

2007-12-01

Among the various contemporary schools of moral thinking, consequence-based ethics, as opposed to rule-based, seems to have a good acceptance among professionals such as software engineers. But naïve consequentialism is intellectually too weak to serve as a practical guide in the profession. Besides, the complexity of software systems makes it very hard to know in advance the consequences that will derive from professional activities in the production of software. Therefore, following the spirit of well-known codes of ethics such as the ACM/IEEE's, we advocate for a more solid position in the ethical education of software engineers, which we call 'moderate deontologism', that takes into account both rules and consequences to assess the goodness of actions, and at the same time pays an adequate consideration to the absolute values of human dignity. In order to educate responsible professionals, however, this position should be complemented with a pedagogical approach to virtue ethics.

How is animal welfare addressed in Canada's emergency response plans?

PubMed

Wittnich, Carin; Belanger, Michael

2008-01-01

In 2005, Hurricanes Katrina and Rita clearly revealed that even in the United States the welfare of companion animals and nonhuman animals in the wild, zoo, or aquarium was not considered within the evacuation plans for their human caretakers (owners). The lack of proper planning and trained individuals resulted in a huge loss of animal life as well as suffering and trauma to both animals and their owners. The present Canadian Federal Emergency Response Plan does not have adequate procedures for the evacuation of animals together with their owners, nor do Canada or the provinces and territories have a plan in place that consists of properly trained and equipped individuals to respond to this aspect of disaster management. The Canadian Veterinary Reserve (CVR) was thus organized at a national level to respond properly to disasters or emergencies of all types and thereby reduce animal suffering and loss of life. This article describes the formation of the CVR and its anticipated national role in addressing animal welfare during times of catastrophic need.

Recommendations for Optimizing Tuberculosis Treatment: Therapeutic Drug Monitoring, Pharmacogenetics, and Nutritional Status Considerations.

PubMed

Choi, Rihwa; Jeong, Byeong Ho; Koh, Won Jung; Lee, Soo Youn

2017-03-01

Although tuberculosis is largely a curable disease, it remains a major cause of morbidity and mortality worldwide. Although the standard 6-month treatment regimen is highly effective for drug-susceptible tuberculosis, the use of multiple drugs over long periods of time can cause frequent adverse drug reactions. In addition, some patients with drug-susceptible tuberculosis do not respond adequately to treatment and develop treatment failure and drug resistance. Response to tuberculosis treatment could be affected by multiple factors associated with the host-pathogen interaction including genetic factors and the nutritional status of the host. These factors should be considered for effective tuberculosis control. Therefore, therapeutic drug monitoring (TDM), which is individualized drug dosing guided by serum drug concentrations during treatment, and pharmacogenetics-based personalized dosing guidelines of anti-tuberculosis drugs could reduce the incidence of adverse drug reactions and increase the likelihood of successful treatment outcomes. Moreover, assessment and management of comorbid conditions including nutritional status could improve anti-tuberculosis treatment response.

Role of phase instabilities in the early response of bulk fused silica during laser-induced breakdown

NASA Astrophysics Data System (ADS)

Demange, P.; Negres, R. A.; Raman, R. N.; Colvin, J. D.; Demos, S. G.

2011-08-01

We report on the experimental and hydrocode modeling investigation of the early material response to localized energy deposition via nanosecond laser pulses in bulk fused silica. A time-resolved microscope system was used to acquire transient images with adequate spatial and temporal resolution to resolve the material behavior from the onset of the process. These images revealed a high-pressure shock front propagating at twice the speed of sound at ambient conditions and bounding a region of modified material at delays up to one nanosecond. Hydrocode simulations matching the experimental conditions were also performed and indicated initial pressures of ˜40 GPa and temperatures of ˜1 eV at the absorption region. Both the simulations and the image data show a clear boundary between distinct material phases, a hot plasma and solid silica, with a suggestion that growth of perturbations at the Rayleigh-Taylor unstable interface between the two phases is the seed mechanism for the growth of cracks into the stressed solid.

Analysis of rubber supply in Sri Lanka

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

Hartley, M.J.; Nerlove, M.; Peters, R.K. Jr.

1987-11-01

An analysis of the supply response for perennial crops is undertaken for rubber in Sir Lanka, focusing on the uprooting-replanting decision and disaggregating the typical reduced-form supply response equation into several structural relationships. This approach is compared and contrasted with Dowling's analysis of supply response for rubber in Thailand, which is based upon a sophisticated reduced-form supply function developed by Wickens and Greenfield for Brazilian coffee. Because the uprooting-replanting decision is central to understanding rubber supply response in Sri Lanka and for other perennial crops where replanting activities dominate new planting, the standard approaches do not adequately capture supply response.

23 CFR 635.121 - Contract time and contract time extensions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... TRAFFIC OPERATIONS CONSTRUCTION AND MAINTENANCE Contract Procedures § 635.121 Contract time and contract time extensions. (a) The STD should have adequate written procedures for the determination of contract... 23 Highways 1 2010-04-01 2010-04-01 false Contract time and contract time extensions. 635.121...

40 CFR 51.491 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... strategies are strategies for which adequate procedures to quantify emissions reductions or specify a program... goals. Such programs are categorized into the following three categories: Emission-limiting, market-response, and directionally-sound strategies. Emission-limiting strategies are strategies that directly...

Environment-dependent regulation of spliceosome activity by the LSM2-8 complex in Arabidopsis.

PubMed

Carrasco-López, Cristian; Hernández-Verdeja, Tamara; Perea-Resa, Carlos; Abia, David; Catalá, Rafael; Salinas, Julio

2017-07-07

Spliceosome activity is tightly regulated to ensure adequate splicing in response to internal and external cues. It has been suggested that core components of the spliceosome, such as the snRNPs, would participate in the control of its activity. The experimental indications supporting this proposition, however, remain scarce, and the operating mechanisms poorly understood. Here, we present genetic and molecular evidence demonstrating that the LSM2-8 complex, the protein moiety of the U6 snRNP, regulates the spliceosome activity in Arabidopsis, and that this regulation is controlled by the environmental conditions. Our results show that the complex ensures the efficiency and accuracy of constitutive and alternative splicing of selected pre-mRNAs, depending on the conditions. Moreover, miss-splicing of most targeted pre-mRNAs leads to the generation of nonsense mediated decay signatures, indicating that the LSM2-8 complex also guarantees adequate levels of the corresponding functional transcripts. Interestingly, the selective role of the complex has relevant physiological implications since it is required for adequate plant adaptation to abiotic stresses. These findings unveil an unanticipated function for the LSM2-8 complex that represents a new layer of posttranscriptional regulation in response to external stimuli in eukaryotes. © The Author(s) 2017. Published by Oxford University Press on behalf of Nucleic Acids Research.

Evaluating community pharmacists' HIV testing knowledge: A cross-sectional survey.

PubMed

Pineda, Larry J; Mercier, Renee-Claude; Dilworth, Thomas; Iandiorio, Michelle; Rankin, Shannon; Jakeman, Bernadette

2015-01-01

To assess community pharmacists' knowledge of human immunodeficiency virus (HIV), antiretroviral therapy, and new in-home oral fluid HIV test. A cross-sectional questionnaire administered to pharmacists, student pharmacists, and technicians before an education program at the New Mexico Pharmacists Association 2013 Mid-Winter Meeting in Albuquerque, NM. The main outcome measure was community pharmacists' correct response rate of 75% or more. Overall survey response rate of attendees was 89% (173/194 attendees). Among them 87 participants were community pharmacists; 87% of community pharmacists responded correctly when asked how HIV antiretroviral medications work and 84.3% correctly identified known sources of HIV infection. The 75% predefined adequate knowledge threshold was not met on any HIV screening or in-home HIV test knowledge items. Only 65.1% of community pharmacists correctly identified the minimum number of antiretroviral drugs that should be included in an ideal HIV treatment regimen. The only variable that positively influenced pharmacists' knowledge was age. An inverse relationship between pharmacist age and HIV knowledge was observed among study participants. Community pharmacists from urban and rural areas in New Mexico possessed adequate basic HIV knowledge, but did not demonstrate adequate HIV screening or in-home HIV test knowledge. Future educational interventions aimed at improving pharmacist knowledge in this area are warranted.

The power to detect trends in Missouri River fish populations within the Pallid Sturgeon Population Assessment Program

USGS Publications Warehouse

Bryan, Janice L.; Wildhaber, Mark L.; Gladish, Dan; Holan, Scott; Ellerseick, Mark

2010-01-01

As with all large rivers in the United States, the Missouri River has been altered, with approximately 32.5 percent of the main stem length impounded and 32.5 percent channelized. These physical alterations to the environment have had effects on the fisheries, but studies examining the effects of alterations have been localized and for short periods of time. In response to the U.S. Fish and Wildlife Service biological opinion, the U.S. Army Corps of Engineers initiated monitoring of the fish community of the Missouri River in 2003. The goal of the Pallid Sturgeon Population Assessment Program is to provide information to detect changes in populations and habitat preferences with time for pallid sturgeon (Scaphirhynchus albus) and native target species in the Missouri River Basin. To determine statistical power of the Pallid Sturgeon Population Assessment Program, a power analysis was conducted using a normal linear mixed model with variance component estimates based on the first 3 years of data (2003 to 2005). In cases where 3 years of data were unavailable, estimates were obtained using those data. It was determined that at least 20 years of data, sampling 12 bends with 8 subsamples per bend, would be required to detect a 5 percent annual decline in most of the target fish populations. Power varied between Zones. Zone 1 (upstream from Lake Sakakawea) did not have any species/gear type combinations with adequate power, whereas Zone 3 (downstream from Gavins Point Dam) had 19 species/gear type combinations with adequate power. With a slight increase in the sampling effort to 12 subsamples per bend, the Pallid Sturgeon Population Assessment Program has adequate power to detect declines in shovelnose sturgeon (S. platorynchus) throughout the entire Missouri River because of large catch rates. The lowest level of non-occurrence (in other words, zero catches) at the bend level for pallid sturgeon was 0.58 using otter trawls in Zone 1. Consequently, the power of the pallid sturgeon models was not as high as other species at the current level of sampling, but an increase in the sampling effort to 16 subsamples for each of 24 bends for 20 years would generate adequate power for the pallid sturgeon in all Zones. Since gear types are selective in their species efficiency, the strength of the Pallid Sturgeon Population Assessment Program approach is using multiple gears that have statistical power to detect population trends at the same time in different fish species within the Missouri River. As often is the case with monitoring studies involving endangered species, the data used to conduct the analyses exhibit some departures from the parametric model assumptions; however, preliminary simulations indicate that the results of this study are appropriate.

Human development of the ability to learn from bad news.

PubMed

Moutsiana, Christina; Garrett, Neil; Clarke, Richard C; Lotto, R Beau; Blakemore, Sarah-Jayne; Sharot, Tali

2013-10-08

Humans show a natural tendency to discount bad news while incorporating good news into beliefs (the "good news-bad news effect"), an effect that may help explain seemingly irrational risk taking. Understanding how this bias develops with age is important because adolescents are prone to engage in risky behavior; thus, educating them about danger is crucial. We reveal a striking valence-dependent asymmetry in how belief updating develops with age. In the ages tested (9-26 y), younger age was associated with inaccurate updating of beliefs in response to undesirable information regarding vulnerability. In contrast, the ability to update beliefs accurately in response to desirable information remained relatively stable with age. This asymmetry was mediated by adequate computational use of positive but not negative estimation errors to alter beliefs. The results are important for understanding how belief formation develops and might help explain why adolescents do not respond adequately to warnings.

Perceiving interpersonally-mediated risk in virtual environments

PubMed Central

Portnoy, David B.; Smoak, Natalie D.; Marsh, Kerry L.

2009-01-01

Using virtual reality (VR) to examine risky behavior that is mediated by interpersonal contact, such as agreeing to have sex, drink, or smoke with someone, offers particular promise and challenges. Social contextual stimuli that might trigger impulsive responses can be carefully controlled in virtual environments (VE), and yet manipulations of risk might be implausible to participants if they do not feel sufficiently immersed in the environment. The current study examined whether individuals can display adequate evidence of presence in a VE that involved potential interpersonally-induced risk: meeting a potential dating partner. Results offered some evidence for the potential of VR for the study of such interpersonal risk situations. Participants’ reaction to the scenario and risk-associated responses to the situation suggested that the embodied nature of virtual reality override the reality of the risk’s impossibility, allowing participants to experience adequate situational embedding, or presence. PMID:20228871

Perceiving interpersonally-mediated risk in virtual environments.

PubMed

Portnoy, David B; Smoak, Natalie D; Marsh, Kerry L

2010-03-01

Using virtual reality (VR) to examine risky behavior that is mediated by interpersonal contact, such as agreeing to have sex, drink, or smoke with someone, offers particular promise and challenges. Social contextual stimuli that might trigger impulsive responses can be carefully controlled in virtual environments (VE), and yet manipulations of risk might be implausible to participants if they do not feel sufficiently immersed in the environment. The current study examined whether individuals can display adequate evidence of presence in a VE that involved potential interpersonally-induced risk: meeting a potential dating partner. Results offered some evidence for the potential of VR for the study of such interpersonal risk situations. Participants' reaction to the scenario and risk-associated responses to the situation suggested that the embodied nature of virtual reality override the reality of the risk's impossibility, allowing participants to experience adequate situational embedding, or presence.

Human development of the ability to learn from bad news

PubMed Central

Moutsiana, Christina; Garrett, Neil; Clarke, Richard C.; Lotto, R. Beau; Blakemore, Sarah-Jayne; Sharot, Tali

2013-01-01

Humans show a natural tendency to discount bad news while incorporating good news into beliefs (the “good news–bad news effect”), an effect that may help explain seemingly irrational risk taking. Understanding how this bias develops with age is important because adolescents are prone to engage in risky behavior; thus, educating them about danger is crucial. We reveal a striking valence-dependent asymmetry in how belief updating develops with age. In the ages tested (9–26 y), younger age was associated with inaccurate updating of beliefs in response to undesirable information regarding vulnerability. In contrast, the ability to update beliefs accurately in response to desirable information remained relatively stable with age. This asymmetry was mediated by adequate computational use of positive but not negative estimation errors to alter beliefs. The results are important for understanding how belief formation develops and might help explain why adolescents do not respond adequately to warnings. PMID:24019466

Towards an inventory of methane emissions from manure management that is responsive to changes on Canadian farms

NASA Astrophysics Data System (ADS)

VanderZaag, A. C.; MacDonald, J. D.; Evans, L.; Vergé, X. P. C.; Desjardins, R. L.

2013-09-01

Methane emissions from manure management represent an important mitigation opportunity, yet emission quantification methods remain crude and do not contain adequate detail to capture changes in agricultural practices that may influence emissions. Using the Canadian emission inventory methodology as an example, this letter explores three key aspects for improving emission quantification: (i) obtaining emission measurements to improve and validate emission model estimates, (ii) obtaining more useful activity data, and (iii) developing a methane emission model that uses the available farm management activity data. In Canada, national surveys to collect manure management data have been inconsistent and not designed to provide quantitative data. Thus, the inventory has not been able to accurately capture changes in management systems even between manure stored as solid versus liquid. To address this, we re-analyzed four farm management surveys from the past decade and quantified the significant change in manure management which can be linked to the annual agricultural survey to create a continuous time series. In the dairy industry of one province, for example, the percentage of manure stored as liquid increased by 300% between 1991 and 2006, which greatly affects the methane emission estimates. Methane emissions are greatest from liquid manure, but vary by an order of magnitude depending on how the liquid manure is managed. Even if more complete activity data are collected on manure storage systems, default Intergovernmental Panel on Climate Change (IPCC) guidance does not adequately capture the impacts of management decisions to reflect variation among farms and regions in inventory calculations. We propose a model that stays within the IPCC framework but would be more responsive to farm management by generating a matrix of methane conversion factors (MCFs) that account for key factors known to affect methane emissions: temperature, retention time and inoculum. This MCF matrix would be populated using a mechanistic emission model verified with on-farm emission measurements. Implementation of these MCF values will require re-analysis of farm surveys to quantify liquid manure emptying frequency and timing, and will rely on the continued collection of this activity data in the future. For model development and validation, emission measurement campaigns will be needed on representative farms over at least one full year, or manure management cycle (whichever is longer). The proposed approach described in this letter is long-term, but is required to establish baseline data for emissions from manure management systems. With these improvements, the manure management emission inventory will become more responsive to the changing practices on Canadian livestock farms.

Urinary tract cancers: An overview for general practice

PubMed Central

Yaxley, Julian P.

2016-01-01

Urinary tract cancers are common and comprise a gamut of lesions ranging from small benign tumors to aggressive neoplasms with high mortality. The predominant urinary tract malignancy is bladder cancer. The clinical challenge is early detection and adequate follow-up because recurrence is high and delayed diagnosis is associated with poor prognosis. Primary care physicians form a key part of the management apparatus for these patients and may be responsible for ensuring adequate ongoing surveillance. This article aims to outline the evaluation of patients in whom urinary tract cancer is suspected and briefly review the general principles of treatment. PMID:28217578

Prospective, randomized comparison between pulsatile GnRH therapy and combined gonadotropin (FSH+LH) treatment for ovulation induction in women with hypothalamic amenorrhea and underlying polycystic ovary syndrome.

PubMed

Dubourdieu, Sophie; Fréour, Thomas; Dessolle, Lionel; Barrière, Paul

2013-05-01

To compare the efficacy of pulsatile GnRH therapy versus combined gonadotropins for ovulation induction in women with both hypothalamic amenorrhoea and polycystic ovarian syndrome (HA/PCOS) according to their current hypothalamic status. This single-centre, prospective, randomized study was conducted in the Nantes University Hospital, France. Thirty consecutive patients were treated for ovulation induction with either pulsatile GnRH therapy or combined gonadotropins (rFSH+rLH). Frequency of adequate ovarian response (mono- or bi-follicular) and clinical pregnancy rate were then compared between both groups. Ovarian response was similar in both groups with comparable frequency of adequate ovarian response (73% vs 60%), but the clinical pregnancy rate was significantly higher in the pulsatile GnRH therapy group than in the combined gonadotropin group (46% vs 0%). HA/PCOS is a specific subgroup of infertile women. Pulsatile GnRH therapy is an effective and safe method of ovulation induction that can be used successfully in these patients. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

A survey of of uses and value of space weather information

NASA Astrophysics Data System (ADS)

Schrijver, C. J.; Rabanal, J.

2013-12-01

We analyze some 2,800 responses to a survey among subscribers of NOAA's Space Weather Prediction Center email services. Interest in, anticipated impacts from, and responses to solar flares, energetic particle events, and geomagnetic storms are quite uniform across societal sectors. Approximately 40% of the respondents expect serious to very serious impacts from space weather events if no action were taken to mitigate or in the absence of adequate space weather information. The impacts of space weather are deemed to be substantially reduced because of the availability of, and the response to, space-weather forecasts and alerts. Space weather information is primarily used as aid to understand anomalies, to implement mitigating strategies designed to avoid impacts on operations, and to prepare for potential contingencies related directly or indirectly to space weather. Current and near-future space-weather conditions are generally highly valued, considered useful, and generally, though not fully, adequate to avoid or mitigate societal impacts (related most frequently to human safety and reliability of operations). We conclude that even among those receiving space weather information, there is considerable uncertainty about how to act on the information provided.

Contribution of Slovenian community pharmacist counseling to patients' knowledge about their prescription medicines: a cross-sectional study.

PubMed

Horvat, Nejc; Kos, Mitja

2015-02-01

To assess patients' knowledge about prescription medicines they are taking and their view on how much community pharmacist counseling contributed to their knowledge. An observational study was designed to obtain information about patients' knowledge, their view on pharmacist counseling, and physicians'/pharmacists' provision of information. This study used a specifically designed questionnaire, which served as an interview guide. 400 patients picking up a prescription medicine were structurally interviewed upon leaving one of the 20 randomly chosen Slovenian pharmacies. The interviews took place in November and December 2013. Patients were familiar with general information about the medicines and their application (93%-100% of patients). Knowledge about considerations (16% of patients) and adverse effects (20% of patients) was limited. Factors associated with patient knowledge were physicians'/pharmacists' adequate provision of information (β=0.259), patient's age (β=- 0.149), patient's education (β=0.100), and prescription type (β=-0.104). Patients' responses were mostly consistent with the Summaries of Product Characteristics (72%-96% of responses). However, 42% of responses to the question about taking medicine with meals were incorrect. Pharmacists routinely informed the patients about medication purpose, dose, application rate, and timing of medication (in 72%, 89%, 89%, and 77% of cases, respectively). Other information was rarely offered. Patients with new prescriptions received significantly more counseling (pharmacist counseling score 5.9, 5.2, and 4.7 of maximum 10 for new, regular, and refill prescriptions, respectively, P=0.001) and obtained adequate labeling (69%, 26%, and 17% of patients for new, regular and refill prescriptions, respectively, P<0.001) than patients with regular or refill prescriptions. Patients were familiar with basic information about administration of their prescription medicines, but lacked knowledge about medication safety. This could be attributed to pharmacist counseling, which primarily focused on medicine use instructions.

Contribution of Slovenian community pharmacist counseling to patients’ knowledge about their prescription medicines: a cross-sectional study

PubMed Central

Horvat, Nejc; Kos, Mitja

2015-01-01

Aim To assess patients’ knowledge about prescription medicines they are taking and their view on how much community pharmacist counseling contributed to their knowledge. Methods An observational study was designed to obtain information about patients’ knowledge, their view on pharmacist counseling, and physicians’/pharmacists’ provision of information. This study used a specifically designed questionnaire, which served as an interview guide. 400 patients picking up a prescription medicine were structurally interviewed upon leaving one of the 20 randomly chosen Slovenian pharmacies. The interviews took place in November and December 2013. Results Patients were familiar with general information about the medicines and their application (93%-100% of patients). Knowledge about considerations (16% of patients) and adverse effects (20% of patients) was limited. Factors associated with patient knowledge were physicians’/pharmacists’ adequate provision of information (β = 0.259), patient’s age (β = - 0.149), patient’s education (β = 0.100), and prescription type (β = -0.104). Patients’ responses were mostly consistent with the Summaries of Product Characteristics (72%-96% of responses). However, 42% of responses to the question about taking medicine with meals were incorrect. Pharmacists routinely informed the patients about medication purpose, dose, application rate, and timing of medication (in 72%, 89%, 89%, and 77% of cases, respectively). Other information was rarely offered. Patients with new prescriptions received significantly more counseling (pharmacist counseling score 5.9, 5.2, and 4.7 of maximum 10 for new, regular, and refill prescriptions, respectively, P = 0.001) and obtained adequate labeling (69%, 26%, and 17% of patients for new, regular and refill prescriptions, respectively, P < 0.001) than patients with regular or refill prescriptions. Conclusion Patients were familiar with basic information about administration of their prescription medicines, but lacked knowledge about medication safety. This could be attributed to pharmacist counseling, which primarily focused on medicine use instructions. PMID:25727041

Impact of Physical and Sexual Abuse on Treatment Response in the Treatment of Resistant Depression in Adolescent Study (TORDIA)

ERIC Educational Resources Information Center

Shamseddeen, Wael; Asarnow, Joan Rosenbaum; Clarke, Gregory; Vitiello, Benedetto; Wagner, Karen Dineen; Birmaher, Boris; Keller, Martin B.; Emslie, Graham; Iyengar, Satish; Ryan, Neal D.; McCracken, James T.; Porta, Giovanna; Mayes, Taryn; Brent, David A.

2011-01-01

Objective: We previously reported that a history of abuse was associated with a poorer response to combination treatment in the Treatment of Resistant Depression in Adolescents study (TORDIA). We now report on the nature and correlates of abuse that might explain these findings. Method: Youth who did not benefit from an adequate selective…

12 CFR 713.2 - What are the responsibilities of a credit union's board of directors under this section?

Code of Federal Regulations, 2010 CFR

2010-01-01

... insurance coverage to ensure that it is adequate in relation to the potential risks facing the credit union... 12 Banks and Banking 6 2010-01-01 2010-01-01 false What are the responsibilities of a credit union's board of directors under this section? 713.2 Section 713.2 Banks and Banking NATIONAL CREDIT UNION...

Replacing Property Taxes with Sales Taxes Would Be Bad for Texas Businesses, Families, and Public Education. Policy Page. No. 07-307

ERIC Educational Resources Information Center

Center for Public Policy Priorities, 2007

2007-01-01

Public education is the foundation of our democracy and the engine of our economy. Texans have a collective responsibility to ensure that public education is adequately supported. This responsibility needs to be fairly distributed among Texas families in a way that supports economic growth. Recently, some have proposed that Texas replace local…

A comprehensive health program in a manganese ore mining community in the Amazon region of Brazil.

PubMed

Gusmão, H H

1980-05-01

It is clear that organizations which conduct operations in undeveloped areas lacking medical and sanitary facilities must assume responsibilities in broad areas of health service and environmental control. These responsibilities go far beyond those of traditional occupational medicine. In addition, adequate provision must be made to counteract stresses which may be associated with radical cultural and situational change.

[Effect of general magnetotherapy on specific activity of blood phagocytes in patients with ischemic heart disease].

PubMed

Ishutin, I S; Klemenkov, S V; Lesovskaia, M I; Spiridonova, M S; Krotova, T K; Ishutin, E I; Tsyganova, O B

2007-01-01

In general magnetotherapy for patients with hyporeactive phagocytes (less than 67% from the level of normal chelicoluminescent response) the adequate level of magnetic induction is 1 mT, for patients with normoreactive phagocytes--0.5 mT and for patients with hyperreactive phagocytes (more than 133% from the level of normal chelicoluminescent response)--0.75 mT daily.

Vasovagal response secondary to permanent contraception device in pulmonary arterial hypertension

PubMed Central

Cope, Jessica; Alnuaimat, Hassan

2015-01-01

Abstract Adequate contraception is an essential component of managing pulmonary hypertension in women of childbearing age. Intrauterine devices are a popular contraceptive choice for many women but are associated with a risk of vagal response upon placement in certain patients with pulmonary hypertension, which may not be well tolerated. More recently, newer permanent contraception devices have emerged in the market, such as the Essure. We describe the first case, to our knowledge, of vagal-associated response due to an Essure device placement. PMID:26697184

Vitamin D: the light side of sunshine.

PubMed

Mason, R S; Sequeira, V B; Gordon-Thomson, C

2011-09-01

Under normal circumstances, vitamin D is mainly obtained from skin through the action of ultraviolet B irradiation on 7-dehydrocholesterol. It is further metabolized to 25-hydroxyvitamin D (25OHD), the major circulating vitamin D compound, and then to 1,25-dihydroxyvitamin D, the hormonal form. The major function of vitamin D compounds is to enhance active absorption of ingested calcium (and phosphate). This assists in building bone at younger ages and ensures that despite obligatory urinary losses, bone does not need to be resorbed to maintain blood calcium concentrations. Vitamin D compounds appear to have direct effects to improve bone and muscle function, and there is good, although not entirely consistent, evidence that supplemental vitamin D and calcium together reduce falls and fractures in older individuals. On the basis of calcium control and musculoskeletal function, target levels for 25OHD in blood are at least 50-60 nmol/l and there may be a case for higher targets of 75-80 nmol/l. There are vitamin D receptors in most nucleated cells and some evidence, although not consistent, that adequate vitamin D levels may be important in reducing the incidence of, or mortality from, some cancers and in reducing autoimmune disease. Adequate vitamin D may also allow for a normal innate immune response to pathogens, improve cardiovascular function and mortality and increase insulin responsiveness. Vitamin D levels are maintained better in the presence of adequate calcium intakes, more exercise and less obesity. Genetic variation may have an effect on vitamin D blood levels and response to treatment with vitamin D.

Control of acceleration during sudden ankle supination in people with unstable ankles.

PubMed

Vaes, P; Van Gheluwe, B; Duquet, W

2001-12-01

Comparative study of differences in functional control during ankle supination in the standing position in matched stable and unstable ankles (ex post facto design). To document acceleration and deceleration during ankle supination in the standing position and to determine differences in control of supination perturbation between stable and unstable ankles. Repetitive ankle sprain can be explained by mechanical instability only in a minority of cases. Exercise therapy for ankle instability is based on clinical experience. Joint stability has not yet been measured in dynamic situations that are similar to the situations leading to a traumatic sprain. The process of motor control during accelerating ankle supination has not been adequately addressed in the literature. Patients with complaints of ankle instability (16 unstable ankles) and nonimpaired controls (18 stable ankles) were examined (N = 17 subjects, 10 women and 7 men). The average age was 23.7 +/- 5.0 years (range, 20-41 y). Control of supination speed was studied during 50 degrees of ankle supination in the standing position using accelerometry (total supination time and deceleration times) and electromyography (latency time). Timing of motor response was estimated by measuring electromechanical delay. The presence of an early, sudden, and presumably passive slowdown of ankle supination in the standing position was observed. Peroneal muscle motor response was detected before the end of the supination. Unstable ankles showed significantly shorter total supination time (109.3 ms versus 124.1 ms) and significantly longer latency time (58.9 ms versus 47.7 ms). Functional control in unstable ankles is less efficient in decelerating the ankle during the supination test procedures used in our study. Our conclusions are based on significantly faster total supination and significantly slower electromyogram response in unstable ankles. The results support the hypothesis that both decelerating the total supination movement during balance disturbance and enhancing the speed of evertor activation through exercise can be specific therapy goals.

Intramolecular charge transfer of 4-(dimethylamino)benzonitrile probed by time-resolved fluorescence and transient absorption: No evidence for two ICT states and a {pi}{sigma}{sup *} reaction intermediate

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

Zachariasse, Klaas A.; Druzhinin, Sergey I.; Senyushkina, Tamara

2009-12-14

For the double exponential fluorescence decays of the locally excited (LE) and intramolecular charge transfer (ICT) states of 4-(dimethylamino)benzonitrile (DMABN) in acetonitrile (MeCN) the same times {tau}{sub 1} and {tau}{sub 2} are observed. This means that the reversible LE<-->ICT reaction, starting from the initially excited LE state, can be adequately described by a two state mechanism. The most important factor responsible for the sometimes experimentally observed differences in the nanosecond decay time, with {tau}{sub 1}(LE)<{tau}{sub 1}(ICT), is photoproduct formation. By employing a global analysis of the LE and ICT fluorescence response functions with a time resolution of 0.5 ps/channel inmore » 1200 channels reliable kinetic and thermodynamic data can be obtained. The arguments presented in the literature in favor of a {pi}{sigma}* state with a bent CN group as an intermediate in the ICT reaction of DMABN are discussed. From the appearance of an excited state absorption (ESA) band in the spectral region between 700 and 800 nm in MeCN for N,N-dimethylanilines with CN, Br, F, CF{sub 3}, and C(=O)OC{sub 2}H{sub 2} p-substituents, it is concluded that this ESA band cannot be attributed to a {pi}{sigma}{sup *} state, as only the C-C{identical_to}N group can undergo the required 120 deg. bending.« less

Pharmacokinetic-pharmacodynamic modeling of the antihypertensive interaction between azilsartan medoxomil and chlorthalidone in spontaneously hypertensive rats.

PubMed

Kumar Puttrevu, Santosh; Ramakrishna, Rachumallu; Bhateria, Manisha; Jain, Moon; Hanif, Kashif; Bhatta, Rabi Sankar

2017-05-01

A pharmacokinetic-pharmacodynamic (PK-PD) model was developed to describe the time course of blood pressure following oral administration of azilsartan medoxomil (AZM) and/or chlorthalidone (CLT) in spontaneously hypertensive (SH) rats. The drug concentration and pharmacological effects, including systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured by liquid chromatography-tandem mass spectrometry (LC-MS/MS) and tail-cuff manometry, respectively. Sequential PK-PD analysis was performed, wherein the plasma concentration-time data was modeled by one compartmental analysis. Subsequently PD parameters were calculated to describe the time-concentration-response relationship using indirect response (IDR) PK-PD model. The combination of AZ and CLT had greater BP lowering effect compared to AZ or CLT alone, despite of no pharmacokinetic interaction between two drugs. These findings suggest synergistic antihypertensive pharmacodynamic interaction between AZ and CLT noncompetitively, which was simulated by inhibitory function of AZ and stimulatory function of CLT after concomitant administration of the two drugs. The present model was able to capture the turnover of blood pressure adequately at different time points at two different dose levels. The current PK-PD model was successfully utilized in the simulation of PD effect at a dose combination of 0.5 and 2.5 mg/kg for AZ and CLT, respectively. The developed preclinical PK-PD model may provide guidance in the optimization of dose ratio of individual drugs in the combined pharmacotherapy of AZ and CLT at clinical situations.

The institutionalization of River Basin Management as politics of scale - Insights from Mongolia

NASA Astrophysics Data System (ADS)

Houdret, Annabelle; Dombrowsky, Ines; Horlemann, Lena

2014-11-01

River Basin Management (RBM) as an approach to sustainable water use has become the dominant model of water governance. Its introduction, however, entails a fundamental realignment and rescaling of water-sector institutions along hydrological boundaries. Creating such a new governance scale is inherently political, and is being described as politics of scale. This paper analyzes how the politics of scale play out in the institutionalization of RBM in Mongolia. It furthermore scrutinizes the role of the broader political decentralization process in the introduction of RBM, an issue that has so far received little attention. Finally, it assesses whether the river basin is an adequate water management scale in Mongolia. This article finds that institutionalizing RBM in Mongolia is indeed a highly political negotiation process that does not only concern the choice of the governance scale, but also its detailed institutional design. It furthermore reveals that Mongolia's incomplete political decentralization process has for a long time negatively impacted the decentralization of water-related tasks and the implementation of RBM. However, the 2011 Budget Law and the 2012 Water Law provide for a fiscal strengthening of local governments and clearer sharing of responsibilities among the various different institutions involved in water management. Nevertheless, only if the 2012 Water Law is complemented by adequate by-laws - and if the newly created river basin institutions are adequately equipped - can RBM be effectively put into practice. This article confirms the usefulness of a politics-of-scale approach to understand scalar practices and changes in water management. However, the article also argues for a broadening of the analytical perspective to take the interdependencies between changes in water governance and other political processes, such as decentralization, into account.

Immunogenicity and safety of yellow fever vaccine among 115 HIV-infected patients after a preventive immunisation campaign in Mali.

PubMed

Sidibe, Mariam; Yactayo, Sergio; Kalle, Abdoulaye; Sall, Amadou A; Sow, Samba; Ndoutabe, Modjirom; Perea, William; Avokey, Fenella; Lewis, Rosamund F; Veit, Olivia

2012-07-01

The immune response to yellow fever (YF) vaccine and its safety among HIV-infected individuals living in YF endemic areas is not well understood. Following a national YF preventive immunisation campaign in Mali in April 2008, we assessed the immunogenicity and safety of 17D yellow fever vaccine (17DV) among HIV-infected patients in two HIV treatment centres in Bamako, Mali, by testing for neutralising antibodies and identifying serious adverse events following immunisation (AEFI). A YF neutralisation titre (NT) of 1:≥20 was considered to be adequate and protective. A serious AEFI included hospitalisation, any life-threatening condition, or death, occurring within 30 days following 17DV administration. Of 115 HIV-infected patients who reported having received 17DV, 110 (96%) were on combination antiretroviral therapy and 83 patients were tested for neutralising antibodies. Around the time of vaccination, median CD4 cell count was 389 cells/mm(3) (IQR 227-511cells/mm(3)); HIV-RNA was undetectable in 24 of 46 patients tested. Seventy-six (92%) of 83 participants had adequate immune titres 9 months after the immunisation campaign. Previous vaccination or flavivirus exposure could contribute to this finding. No serious AEFI was found in the 115 participants. In this small series, YF vaccine appeared to be immunogenic with a favourable safety profile in HIV-infected patients on antiretroviral therapy. Higher CD4 cell counts and suppressed HIV-RNA were associated with the presence of an adequate immune titre and higher NTs. Copyright © 2012 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved.

Duration of untreated illness as a predictor of treatment response and clinical course in generalized anxiety disorder.

PubMed

Altamura, A C; Dell'osso, Bernardo; D'Urso, Nazario; Russo, Michela; Fumagalli, Sara; Mundo, Emanuela

2008-05-01

The aim of the present study was to investigate the impact of the duration of untreated illness (DUI)-defined as the time elapsing between the onset of generalized anxiety disorder (GAD) and the first adequate pharmacologic treatment-on treatment response and clinical course in a sample of subjects with GAD. One hundred patients with GAD, diagnosed according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-Text Revision criteria, were enrolled and their main demographic and clinical features collected. Patients were then treated with selective serotonin reuptake inhibitors or venlafaxine for 8 weeks in open-label conditions. Treatment response and other clinical variables were analyzed after dividing the sample into two groups according to DUI (DUI 12 months). When the DUI was computed with respect to the first antidepressant treatment (DUI-AD), a higher improvement (Clinical Global Impressions-Severity of Illness scale) after the pharmacologic treatment was found in the group with a shorter DUI (analysis of variance with repeated measures: time effect F=654.975, P<.001; group effect: F=4.369, P=.039). When computed with respect to the first treatment with benzodiazepines (DUI-BDZ), the two groups did not show any significant difference in treatment response (time effect: F=652.183, P<.001; group effect: F=0.009, P=.924). In addition, patients with a longer DUI (DUI-BDZ or DUI-AD) showed an earlier age at onset, a longer duration of illness and a higher rate of comorbid psychiatric disorders with onset later than GAD. Results from this preliminary study seem to suggest that a shorter DUI-AD may determine a better response to pharmacologic treatment in patients with GAD, and that a longer DUI (DUI-BDZ and DUI-AD) may be associated to a worse clinical course. Further investigation on the relationship between DUI and GAD is needed.

Evaluation of sensors for use inside chemical protective suits

NASA Astrophysics Data System (ADS)

Russell, Derrick A.; Duncan, E. J. S.; Hunt, Stephen; Gudgin Dickson, Eva F.; Weagle, Glenn E.

1999-11-01

Organizations such as the military, hazardous materials units, first responders and industries involved in the processing and manufacture of chemicals all have requirements for specialized whole body protection for those people in their organizations whose job it is to work with toxic chemicals on a day to day basis or in emergency situations. Currently, excluding chemical biological (CB) challenge scenarios, there is no routine monitoring of the possible ingress of toxic chemicals within chemical protective suits. Under existing national standards, swatches of the protective suit fabric are usually tested for chemical breakthrough and if they meet certain criteria, the suit is considered to provide adequate protection to the individual. Despite advances in protection level research provided by full system protective clothing tests, inexpensive, real-time, sensitive and robust chemical monitoring systems for use both under protective clothing and within a challenge environment, remains a technologically deficient area. This paper presents the results of a preliminary assessment of the feasibility of miniature detectors for monitoring real-time volatile organic chemical (VOC) challenges under chemical protective clothing and in closed environments where such suits are used. Nine gas sensors of n-type semiconductor design (Figaro Engineering Inc) were assessed for their response to a dichloromethane concentration of 560 ppm at a temperature of 23 degrees Celsius and relative humidity of 20%. Absolute voltage output, speed of response to dichloromethane exposure, and time required to return to zero, were considered. The top ranked sensor was further evaluated for its calibration response to a range of dichloromethane concentrations up to 560 ppm. Variables that were considered include effect of temperature and relative humidity, hysteresis and repeatability. Increasing RH causes an increase in the zero output of the sensor with an approximate linear relationship. The sensor response was characterized by minimal hysteresis, indicating that calibration values over the short term are very stable. Calibration responses measured on different days were in excellent agreement.

Solid waste management in Kolkata, India: Practices and challenges

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

Hazra, Tumpa; Goel, Sudha

2009-01-15

This paper presents an overview of current solid waste management (SWM) practices in Kolkata, India and suggests solutions to some of the major problems. More than 2920 ton/d of solid waste are generated in the Kolkata Municipal Corporation (KMC) area and the budget allocation for 2007-2008 was Rs. 1590 million (US$40 million), which amounts to Rs. 265/cap-y (US$6.7/cap-d) on SWM. This expenditure is insufficient to provide adequate SWM services. Major deficiencies were found in all elements of SWM. Despite 70% of the SWM budget being allocated for collection, collection efficiency is around 60-70% for the registered residents and less thanmore » 20% for unregistered residents (slum dwellers). The collection process is deficient in terms of manpower and vehicle availability. Bin capacity provided is adequate but locations were found to be inappropriate, thus contributing to the inefficiency of the system. At this time, no treatment is provided to the waste and waste is dumped on open land at Dhapa after collection. Lack of suitable facilities (equipment and infrastructure) and underestimates of waste generation rates, inadequate management and technical skills, improper bin collection, and route planning are responsible for poor collection and transportation of municipal solid wastes.« less

Meditation as a Potential Therapy for Autism: A Review

PubMed Central

Sequeira, Sonia; Ahmed, Mahiuddin

2012-01-01

Autism is a chronic neurodevelopmental disorder of unknown cause that affects approximately 1–3 percent of children and four times more boys than girls. Its prevalence is global and its social impact is devastating. In autism, the brain is unable to process sensory information normally. Instead, simple stimuli from the outside world are experienced as overwhelmingly intense and strain the emotional centers of the brain. A stress response to the incoming information is initiated that destabilizes cognitive networks and short-circuits adequate behavioral output. As a result, the child is unable to respond adequately to stimulation and initiate social behavior towards family, friends, and peers. In addition, these children typically face immune-digestive disorders that heighten social fears, anxieties, and internal conflicts. While it is critical to treat the physical symptoms, it is equally vital to offer an evidence-based holistic solution that harmonizes both their emotional and physical well-being as they move from childhood into adult life. Here, we summarize evidence from clinical studies and neuroscience research that suggests that an approach built on yogic principles and meditative tools is worth pursuing. Desired outcomes include relief of clinical symptoms of the disease, greater relaxation, and facilitated expression of feelings and skills, as well as improved family and social quality of life. PMID:22937260

Performance evaluation of an infrared thermocouple.

PubMed

Chen, Chiachung; Weng, Yu-Kai; Shen, Te-Ching

2010-01-01

The measurement of the leaf temperature of forests or agricultural plants is an important technique for the monitoring of the physiological state of crops. The infrared thermometer is a convenient device due to its fast response and nondestructive measurement technique. Nowadays, a novel infrared thermocouple, developed with the same measurement principle of the infrared thermometer but using a different detector, has been commercialized for non-contact temperature measurement. The performances of two-kinds of infrared thermocouples were evaluated in this study. The standard temperature was maintained by a temperature calibrator and a special black cavity device. The results indicated that both types of infrared thermocouples had good precision. The error distribution ranged from -1.8 °C to 18 °C as the reading values served as the true values. Within the range from 13 °C to 37 °C, the adequate calibration equations were the high-order polynomial equations. Within the narrower range from 20 °C to 35 °C, the adequate equation was a linear equation for one sensor and a two-order polynomial equation for the other sensor. The accuracy of the two kinds of infrared thermocouple was improved by nearly 0.4 °C with the calibration equations. These devices could serve as mobile monitoring tools for in situ and real time routine estimation of leaf temperatures.

[Physicians' attitudes toward pain in newborn infants. Preliminary results of a cross-sectional national survey].

PubMed

Jadamus-Niebrój, Danuta; Zejda, Jan E; Niebrój, Lesław; Brozek, Grzegorz; Swietliński, Janusz; Musialik-Swietlińska, Ewa; Migdał, Marek

2008-01-01

Since 1980s, the problem of pain experienced by newborns has met with increasing interest both in research work and in clinical practice. It is worth noting that significant progress in neurophysiologic basis of pain and in diagnostic and therapeutic methods have occurred during that time. This study primarily aims at describing opinions of the doctors who work in the neonatal wards and neonatal intensive care units in Poland regarding the management of pain in newborns. The respondents of this survey were heads (or persons appointed by them) of 302 neonatal and paediatric intensive care hospital wards, in Poland. The questionnaire prepared for this purpose was used. The respondents demonstrated that essentially they possessed correct knowledge regarding the neurophysiology of pain, the diagnostic and therapeutic methods used in the management of pain in the newborns. The majority of respondents claimed that adequate pain management was used in their daily practice. They felt responsible for the parents' health education concerning the problem of pain in newborns. On the other hand, they complain about the lack of adequate training courses for physicians regarding this subject matter. It is recommended to organize specialized courses for doctors regarding pain in the newborn, and, in particular, regarding the principles of using opioids in the pain management of newborns.

Fact Sheet: Risk Management Plan (RMP) Audit Program

EPA Pesticide Factsheets

Risk management programs, which consist of a hazard assessment, a prevention program, and an emergency response program; must be periodically audited to assess whether the plans are adequate or need to be revised to comply with the regulation.

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.

Validation of source approval of HMA surface mix aggregate : research summary.

DOT National Transportation Integrated Search

2016-04-01

Pavement surfaces must maintain an adequate level of friction in order to provide a : safe surface for vehicles. The Maryland State Highway Administration (SHA) is : responsible for ensuring that flexible pavement construction, using hot mix asphalt ...

36 CFR 1275.22 - Security.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 36 Parks, Forests, and Public Property 3 2011-07-01 2011-07-01 false Security. 1275.22 Section... THE NIXON ADMINISTRATION Preservation and Protection § 1275.22 Security. The Archivist is responsible for providing adequate security for the Presidential historical materials. ...

36 CFR 1275.22 - Security.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Security. 1275.22 Section... THE NIXON ADMINISTRATION Preservation and Protection § 1275.22 Security. The Archivist is responsible for providing adequate security for the Presidential historical materials. ...

36 CFR 1275.22 - Security.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 36 Parks, Forests, and Public Property 3 2012-07-01 2012-07-01 false Security. 1275.22 Section... THE NIXON ADMINISTRATION Preservation and Protection § 1275.22 Security. The Archivist is responsible for providing adequate security for the Presidential historical materials. ...

36 CFR 1275.22 - Security.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 36 Parks, Forests, and Public Property 3 2014-07-01 2014-07-01 false Security. 1275.22 Section... THE NIXON ADMINISTRATION Preservation and Protection § 1275.22 Security. The Archivist is responsible for providing adequate security for the Presidential historical materials. ...

Report: EPA Needs to Fulfill Its Designated Responsibilities to Ensure Effective BioWatch Program

EPA Pesticide Factsheets

Report #2005-P-00012, March 23, 2005. EPA did not provide adequate oversight of the sampling operations to ensure quality assurance guidance was adhered to, potentially affecting the quality of the samples taken.

5 CFR 1312.22 - Responsibilities.

Code of Federal Regulations, 2012 CFR

2012-01-01

... computer systems meeting the appropriate security criteria. (a) EOP Security Officer. In cooperation with..., DECLASSIFICATION AND SAFEGUARDING OF NATIONAL SECURITY INFORMATION Control and Accountability of Classified... duty by employees will do much to ensure the adequate security of classified information in the...

5 CFR 1312.22 - Responsibilities.

Code of Federal Regulations, 2013 CFR

2013-01-01

... computer systems meeting the appropriate security criteria. (a) EOP Security Officer. In cooperation with..., DECLASSIFICATION AND SAFEGUARDING OF NATIONAL SECURITY INFORMATION Control and Accountability of Classified... duty by employees will do much to ensure the adequate security of classified information in the...

5 CFR 1312.22 - Responsibilities.

Code of Federal Regulations, 2011 CFR

2011-01-01

... computer systems meeting the appropriate security criteria. (a) EOP Security Officer. In cooperation with..., DECLASSIFICATION AND SAFEGUARDING OF NATIONAL SECURITY INFORMATION Control and Accountability of Classified... duty by employees will do much to ensure the adequate security of classified information in the...

5 CFR 1312.22 - Responsibilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... computer systems meeting the appropriate security criteria. (a) EOP Security Officer. In cooperation with..., DECLASSIFICATION AND SAFEGUARDING OF NATIONAL SECURITY INFORMATION Control and Accountability of Classified... duty by employees will do much to ensure the adequate security of classified information in the...

5 CFR 1312.22 - Responsibilities.

Code of Federal Regulations, 2014 CFR

2014-01-01

... computer systems meeting the appropriate security criteria. (a) EOP Security Officer. In cooperation with..., DECLASSIFICATION AND SAFEGUARDING OF NATIONAL SECURITY INFORMATION Control and Accountability of Classified... duty by employees will do much to ensure the adequate security of classified information in the...

Improved Endpoints for Cancer Immunotherapy Trials

PubMed Central

Eggermont, Alexander M. M.; Janetzki, Sylvia; Hodi, F. Stephen; Ibrahim, Ramy; Anderson, Aparna; Humphrey, Rachel; Blumenstein, Brent; Wolchok, Jedd

2010-01-01

Unlike chemotherapy, which acts directly on the tumor, cancer immunotherapies exert their effects on the immune system and demonstrate new kinetics that involve building a cellular immune response, followed by changes in tumor burden or patient survival. Thus, adequate design and evaluation of some immunotherapy clinical trials require a new development paradigm that includes reconsideration of established endpoints. Between 2004 and 2009, several initiatives facilitated by the Cancer Immunotherapy Consortium of the Cancer Research Institute and partner organizations systematically evaluated an immunotherapy-focused clinical development paradigm and created the principles for redefining trial endpoints. On this basis, a body of clinical and laboratory data was generated that supports three novel endpoint recommendations. First, cellular immune response assays generate highly variable results. Assay harmonization in multicenter trials may minimize variability and help to establish cellular immune response as a reproducible biomarker, thus allowing investigation of its relationship with clinical outcomes. Second, immunotherapy may induce novel patterns of antitumor response not captured by Response Evaluation Criteria in Solid Tumors or World Health Organization criteria. New immune-related response criteria were defined to more comprehensively capture all response patterns. Third, delayed separation of Kaplan–Meier curves in randomized immunotherapy trials can affect results. Altered statistical models describing hazard ratios as a function of time and recognizing differences before and after separation of curves may allow improved planning of phase III trials. These recommendations may improve our tools for cancer immunotherapy trials and may offer a more realistic and useful model for clinical investigation. PMID:20826737

Evaluation of the tip-bending response in clinically used endoscopes.

PubMed

Rozeboom, Esther D; Reilink, Rob; Schwartz, Matthijs P; Fockens, Paul; Broeders, Ivo A M J

2016-04-01

Endoscopic interventions require accurate and precise control of the endoscope tip. The endoscope tip response depends on a cable pulling system, which is known to deliver a significantly nonlinear response that eventually reduces control. It is unknown whether the current technique of endoscope tip control is adequate for a future of high precision procedures, steerable accessories, and add-on robotics. The aim of this study was to determine the status of the tip response of endoscopes used in clinical practice. We evaluated 20 flexible colonoscopes and five gastroscopes, used in the endoscopy departments of a Dutch university hospital and two Dutch teaching hospitals, in a bench top setup. First, maximal tip bending was determined manually. Next, the endoscope navigation wheels were rotated individually in a motor setup. Tip angulation was recorded with a USB camera. Cable slackness was derived from the resulting hysteresis plot. Only two of the 20 colonoscopes (10 %) and none of the five gastroscopes reached the maximal tip angulation specified by the manufacturer. Four colonoscopes (20 %) and none of the gastroscopes demonstrated the recommended cable tension. Eight colonoscopes (40 %) had undergone a maintenance check 1 month before the measurements were made. The tip responses of these eight colonoscopies did not differ significantly from the tip responses of the other colonoscopes. This study suggests that the majority of clinically used endoscopes are not optimally tuned to reach maximal bending angles and demonstrate adequate tip responses. We suggest a brief check before procedures to predict difficulties with bending angles and tip responses.

Evaluation of the tip-bending response in clinically used endoscopes

PubMed Central

Rozeboom, Esther D.; Reilink, Rob; Schwartz, Matthijs P.; Fockens, Paul; Broeders, Ivo A. M. J.

2016-01-01

Background and study aims: Endoscopic interventions require accurate and precise control of the endoscope tip. The endoscope tip response depends on a cable pulling system, which is known to deliver a significantly nonlinear response that eventually reduces control. It is unknown whether the current technique of endoscope tip control is adequate for a future of high precision procedures, steerable accessories, and add-on robotics. The aim of this study was to determine the status of the tip response of endoscopes used in clinical practice. Materials and methods: We evaluated 20 flexible colonoscopes and five gastroscopes, used in the endoscopy departments of a Dutch university hospital and two Dutch teaching hospitals, in a bench top setup. First, maximal tip bending was determined manually. Next, the endoscope navigation wheels were rotated individually in a motor setup. Tip angulation was recorded with a USB camera. Cable slackness was derived from the resulting hysteresis plot. Results: Only two of the 20 colonoscopes (10 %) and none of the five gastroscopes reached the maximal tip angulation specified by the manufacturer. Four colonoscopes (20 %) and none of the gastroscopes demonstrated the recommended cable tension. Eight colonoscopes (40 %) had undergone a maintenance check 1 month before the measurements were made. The tip responses of these eight colonoscopies did not differ significantly from the tip responses of the other colonoscopes. Conclusion: This study suggests that the majority of clinically used endoscopes are not optimally tuned to reach maximal bending angles and demonstrate adequate tip responses. We suggest a brief check before procedures to predict difficulties with bending angles and tip responses. PMID:27092330

American College of Sports Medicine position stand. Nutrition and athletic performance.

PubMed

Rodriguez, Nancy R; Di Marco, Nancy M; Langley, Susie

2009-03-01

It is the position of the American Dietetic Association, Dietitians of Canada, and the American College of Sports Medicine that physical activity, athletic performance, and recovery from exercise are enhanced by optimal nutrition. These organizations recommend appropriate selection of foods and fluids, timing of intake, and supplement choices for optimal health and exercise performance. This updated position paper couples a rigorous, systematic, evidence-based analysis of nutrition and performance-specific literature with current scientific data related to energy needs, assessment of body composition, strategies for weight change, nutrient and fluid needs, special nutrient needs during training and competition, the use of supplements and ergogenic aids, nutrition recommendations for vegetarian athletes, and the roles and responsibilities of the sports dietitian. Energy and macronutrient needs, especially carbohydrate and protein, must be met during times of high physical activity to maintain body weight, replenish glycogen stores, and provide adequate protein to build and repair tissue. Fat intake should be sufficient to provide the essential fatty acids and fat-soluble vitamins and to contribute energy for weight maintenance. Although exercise performance can be affected by body weight and composition, these physical measures should not be a criterion for sports performance and daily weigh-ins are discouraged. Adequate food and fluid should be consumed before, during, and after exercise to help maintain blood glucose concentration during exercise, maximize exercise performance, and improve recovery time. Athletes should be well hydrated before exercise and drink enough fluid during and after exercise to balance fluid losses. Sports beverages containing carbohydrates and electrolytes may be consumed before, during, and after exercise to help maintain blood glucose concentration, provide fuel for muscles, and decrease risk of dehydration and hyponatremia. Vitamin and mineral supplements are not needed if adequate energy to maintain body weight is consumed from a variety of foods. However, athletes who restrict energy intake, use severe weight-loss practices, eliminate one or more food groups from their diet, or consume unbalanced diets with low micronutrient density may require supplements. Because regulations specific to nutritional ergogenic aids are poorly enforced, they should be used with caution and only after careful product evaluation for safety, efficacy, potency, and legality. A qualified sports dietitian and, in particular, the Board Certified Specialist in Sports Dietetics in the United States, should provide individualized nutrition direction and advice after a comprehensive nutrition assessment.

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.

Impacts of variability in geomechanical properties on hydrate bearing sediment responses

NASA Astrophysics Data System (ADS)

Lin, J. S.; Uchida, S.; Choi, J. H.; Seol, Y.

2017-12-01

Hydrate bearing sediments (HBS) may become unstable during the gas production operation, or from natural processes such as change in the landform or temperature. The geomechanical modeling is a rational way to assess HBS stability regardless of the process involved. At the present time, such modeling is laced with uncertainties. The uncertainties come from many sources that include the adequacy of a modeling framework to accurately project the response of HBS, the gap in the available field information, and the variability in the laboratory test results from limited samples. For a reasonable stability assessment, the impact of the various uncertainties have to be addressed. This study looks into one particular aspect of the uncertainty, namely, the uncertainty caused by the scatter in the laboratory tests and the ability of a constitutive model to adequately represent them. Specifically this study focuses on the scatter in the results from laboratory tests on high quality pressured core samples from a marine site, and use a critical state constitutive model to represent them. The study investigates how the HBS responses shift when the parameters of the constitutive model are varied to reflect the different aspects of experimental results. Also investigated are impacts on the responses by altering certain formulations of the constitutive model to suit particular sets of results.

A prospective study of ketamine versus haloperidol for severe prehospital agitation.

PubMed

Cole, Jon B; Moore, Johanna C; Nystrom, Paul C; Orozco, Benjamin S; Stellpflug, Samuel J; Kornas, Rebecca L; Fryza, Brandon J; Steinberg, Lila W; O'Brien-Lambert, Alex; Bache-Wiig, Peter; Engebretsen, Kristin M; Ho, Jeffrey D

2016-08-01

Ketamine is an emerging drug for the treatment of acute undifferentiated agitation in the prehospital environment, however no prospective comparative studies have evaluated its effectiveness or safety in this clinical setting. We hypothesized 5 mg/kg of intramuscular ketamine would be superior to 10 mg of intramuscular haloperidol for severe prehospital agitation, with time to adequate sedation as the primary outcome measure. This was a prospective open label study of all patients in an urban EMS system requiring chemical sedation for severe acute undifferentiated agitation that were subsequently transported to the EMS system's primary Emergency Department. All paramedics were trained in the Altered Mental Status Scale and prospectively recorded agitation scores on all patients. Two 6-month periods where either ketamine or haloperidol was the first-line therapy for severe agitation were prospectively compared primarily for time to adequate sedation. Secondary outcomes included laboratory data and adverse medication events. 146 subjects were enrolled; 64 received ketamine, 82 received haloperidol. Median time to adequate sedation for the ketamine group was 5 minutes (range 0.4-23) vs. 17 minutes (range 2-84) in the haloperidol group (difference 12 minutes, 95% CI 9-15). Complications occurred in 49% (27/55) of patients receiving ketamine vs. 5% (4/82) in the haloperidol group. Complications specific to the ketamine group included hypersalivation (21/56, 38%), emergence reaction (5/52, 10%), vomiting (5/57, 9%), and laryngospasm (3/55, 5%). Intubation was also significantly higher in the ketamine group; 39% of patients receiving ketamine were intubated vs. 4% of patients receiving haloperidol. Ketamine is superior to haloperidol in terms of time to adequate sedation for severe prehospital acute undifferentiated agitation, but is associated with more complications and a higher intubation rate.

Investigation of Optimal Time for Starting Betamethasone Using Fatigue Scores and Prognostic Nutritional Index in Terminally Ill Patients With Cancer-Related Fatigue.

PubMed

Koyama, Nanako; Matsumura, Chikako; Morii, Hiroaki; Hasegawa, Chiaki; Hira, Daiki; Daigo, Yataro; Terada, Tomohiro; Yano, Yoshitaka

2017-06-01

Corticosteroids are frequently used to treat cancer-related fatigue (CRF), but it is yet to be established as standard care, and few reports have defined the appropriate time to start treatment. We investigated the optimal time for starting betamethasone and evaluated the clinical validity of using the prognostic nutritional index (PNI) for this purpose. Data were retrospectively collected for patients with terminal cancer receiving betamethasone for palliative care. Fatigue strength was evaluated by the daily occurrence of fatigue, using proportion of adequate fatigue, AF(%), defined as the average of the daily score for all treatment days, AF(%) all , the initial 5 days, AF(%) initi5 , or the last 5 days, AF(%) last5 . We examined (1) the relationship between survival time and adequate fatigue for CRF and (2) the correlation between survival time and PNI (based on serum albumin and lymphocytes). Data from 24 patients were included. The AF(%) all was approximately 50% at 42 days before death and gradually decreased as the survival time shortened ( R 2 =.41, P <.001). There was a clear positive correlation between AF(%) all and AF(%) initi5 ( R 2 =.84, P <.001). At 42 days before death, PNI was approximately 30 and significantly correlated with the survival time ( R 2 = .873, P <.001). The adequate fatigue appears to be dependent on survival time, and PNI might be useful for identifying patients that will benefit from betamethasone use. It is hoped that these results will contribute to individualized pharmacotherapy of terminally ill patients with CRF.

Does Wyoming's Core Area Policy Protect Winter Habitats for Greater Sage-Grouse?

PubMed

Smith, Kurt T; Beck, Jeffrey L; Pratt, Aaron C

2016-10-01

Conservation reserves established to protect important habitat for wildlife species are used world-wide as a wildlife conservation measure. Effective reserves must adequately protect year-round habitats to maintain wildlife populations. Wyoming's Sage-Grouse Core Area policy was established to protect breeding habitats for greater sage-grouse (Centrocercus urophasianus). Protecting only one important seasonal habitat could result in loss or degradation of other important habitats and potential declines in local populations. The purpose of our study was to identify the timing of winter habitat use, the extent which individuals breeding in Core Areas used winter habitats, and develop resource selection functions to assess effectiveness of Core Areas in conserving sage-grouse winter habitats in portions of 5 Core Areas in central and north-central Wyoming during winters 2011-2015. We found that use of winter habitats occured over a longer period than current Core Area winter timing stipulations and a substantial amount of winter habitat outside of Core Areas was used by individuals that bred in Core Areas, particularly in smaller Core Areas. Resource selection functions for each study area indicated that sage-grouse were selecting habitats in response to landscapes dominated by big sagebrush and flatter topography similar to other research on sage-grouse winter habitat selection. The substantial portion of sage-grouse locations and predicted probability of selection during winter outside small Core Areas illustrate that winter requirements for sage-grouse are not adequately met by existing Core Areas. Consequently, further considerations for identifying and managing important winter sage-grouse habitats under Wyoming's Core Area Policy are warranted.

Chronobiological considerations for exercise and heart disease.

PubMed

Atkinson, Greg; Drust, Barry; George, Keith; Reilly, Thomas; Waterhouse, Jim

2006-01-01

Although regular physical activity is beneficial for many clinical conditions, an acute bout of exercise might increase the risk of an adverse clinical event, such as sudden cardiac death or myocardial infarction, particularly in vulnerable individuals. Since it is also known that the incidence of these events peaks in the morning and that some cardiac patients prefer to schedule leisure-time physical activity before lunch, the question arises as to whether morning exercise is 'inherently' more risky than physical activity performed at other times of day. We attempt to answer this question by reviewing the relevant epidemiological data as well as the results of chronobiological and exercise-related studies that have concentrated on the pathophysiological mechanisms for sudden cardiac events. We also consider generally how chronobiology might impact on exercise prescription in heart disease. We performed a structured literature search in the PubMed and WEBofSCIENCE databases for relevant studies published between 1981 and 2004. The limited amount of published epidemiological data did not allow us to conclude that a bout of vigorous exercise in the morning increases the relative risk of either primary cardiac events in apparently healthy individuals, or secondary events in cardiac patients enrolled in supervised exercise programmes. Nevertheless, these data are not directly relevant to individuals who have a history of heart disease and perform uncontrolled habitual activities. It appears as though the influence of time of day on the cardiovascular safety of this type of exercise has not been examined in this population. There is evidence that several pathophysiological variables (e.g. blood pressure, endothelial function, fibrinolysis) vary in parallel with typical diurnal changes in freely chosen activity. Nevertheless, few studies have been designed to examine specifically whether such variables respond differently to a 'set' level of exercise in the morning compared with the afternoon or evening. Even fewer researchers have adequately separated the influences of waking from sleep, adopting an upright posture and physical exertion per se on these pathophysiological responses at different times of day. In healthy individuals, exercise is generally perceived as more difficult and functional performance is decreased in the morning hours. These observations have been confirmed for patients with heart disease in only one small study. It has also not been confirmed, using an adequately powered study involving cardiac patients, that the responses of heart rate and oxygen consumption (VO(2)) to a set bout of exercise show the highest reactivity in the afternoon and evening, which is the case with healthy individuals. Confirmation of this circadian variation would be important, since it would mean that exercise might be prescribed at too high an intensity in the morning if heart rate or VO(2) responses are employed as markers of exercise load. We conclude that there is some parallelism between the diurnal changes in physical activity and those in the pathophysiological mechanisms associated with acute cardiac events. Nevertheless, more studies are needed to ascertain whether the responses of endothelial function, fibrinolysis and blood pressure to a set exercise regimen differ according to time of day. The results of epidemiological studies suggest that morning exercise is just as safe as afternoon exercise for cardiac patients enrolled in a supervised rehabilitation programme. Nevertheless, it is unclear whether time of day alters the risk of a cardiac event occurring during spontaneous physical activity performed by individuals with established risk factors for heart disease.

A numerical investigation of pumping-test responses from contiguous aquifers

NASA Astrophysics Data System (ADS)

Rafini, Silvain; Chesnaux, Romain; Ferroud, Anouck

2017-05-01

Adequate groundwater management requires models capable of representing the heterogeneous nature of aquifers. A key point is the theoretical knowledge of flow behaviour in various heterogeneous archetypal conditions, using analytically or numerically based models. This study numerically investigates transient pressure transfers between linearly contiguous homogeneous domains with non-equal hydraulic properties, optionally separated by a conductive fault. Responses to pumping are analysed in terms of time-variant flow dimension, n. Two radial stages are predicted ( n: 2 - 2) with a positive or negative vertical offset depending of the transmissivity ratio between domains. A transitional n = 4 segment occurs when the non-pumped domain is more transmissive ( n: 2 - 4 - 2), and a fractional flow segment occurs when the interface is a fault ( n: 2 - 4 - 1.5 - 2). The hydrodynamics are generally governed by the transmissivity ratio; the storativity ratio impact is limited. The drawdown log-derivative late stabilization, recorded at any well, does not tend to reflect the local transmissivity but rather the higher transmissivity region, possibly distant and blind, as it predominantly supplies groundwater to the well. This study provides insights on the behaviour of non-uniform aquifers and on theoretical responses that can aid practitioners to detect such conditions in nature.

Time to Rethink Refugee and Migrant Health in Europe: Moving from Emergency Response to Integrated and Individualized Health Care Provision for Migrants and Refugees.

PubMed

Puchner, Karl; Karamagioli, Evika; Pikouli, Anastasia; Tsiamis, Costas; Kalogeropoulos, Athanasios; Kakalou, Eleni; Pavlidou, Elena; Pikoulis, Emmanouil

2018-05-28

In the last three years, the European Union (EU) is being confronted with the most significant influx of migrants and refugees since World War II. Although the dimensions of this influx-taking the global scale into account-might be regarded as modest, the institutional response to that phenomenon so far has been suboptimal, including the health sector. While inherent challenges of refugee and migrant (R&M) health are well established, it seems that the EU health response oversees, to a large extend, these aspects. A whole range of emergency-driven health measures have been implemented throughout Europe, yet they are failing to address adequately the changing health needs and specific vulnerabilities of the target population. With the gradual containment of the migratory and refugee waves, three years after the outbreak of the so-called 'refugee crisis', we are, more than ever, in need of a sustainable and comprehensive health approach that is aimed at the integration of all of migrants and refugees-that is, both the new and old population groups that are already residing in Europe-in the respective national health systems.

Effect of abdominopelvic abscess drain size on drainage time and probability of occlusion

PubMed Central

Rotman, Jessica A.; Getrajdman, George I.; Maybody, Majid; Erinjeri, Joseph P.; Yarmohammadi, Hooman; Sofocleous, Constantinos T.; Solomon, Stephen B.; Boas, F. Edward

2016-01-01

Background The purpose of this study is to determine whether larger abdominopelvic abscess drains reduce the time required for abscess resolution, or the probability of tube occlusion. Methods 144 consecutive patients who underwent abscess drainage at a single institution were reviewed retrospectively. Results: Larger initial drain size did not reduce drainage time, drain occlusion, or drain exchanges (p>0.05). Subgroup analysis did not find any type of collection that benefitted from larger drains. A multivariate model predicting drainage time showed that large collections (>200 ml) required 16 days longer drainage time than small collections (<50 ml). Collections with a fistula to bowel required 17 days longer drainage time than collections without a fistula. Initial drain size and the viscosity of the fluid in the collection had no significant effect on drainage time in the multivariate model. Conclusions 8 F drains are adequate for initial drainage of most serous and serosanguineous collections. 10 F drains are adequate for initial drainage of most purulent or bloody collections. PMID:27634422

49 CFR 374.311 - Service responsibility.

Code of Federal Regulations, 2010 CFR

2010-10-01

... points, to serve adequately all points. (b) Continuity of service. No carrier shall change an existing..., any passenger inconvenience it causes by disrupting travel plans. (d) Seating and reservations. A carrier shall provide sufficient buses to meet passengers' normal travel demands, including ordinary...

Continuing the dialogue: a reply to Bernard Gert.

PubMed

Strong, Carson

2006-06-01

Continuing the dialogue begun in the March 2006 issue of the Kennedy Institute of Ethics Journal, I suggest that Bernard Gert's response to my paper does not adequately address the criticisms I make of his theory's application to bioethics cases.

Strengthening district health service management and delivery through internal contracting: lessons from pilot projects in Cambodia.

PubMed

Khim, Keovathanak; Annear, Peter Leslie

2013-11-01

Following a decade of piloting different models of contracting, in mid-2009 the Cambodian Ministry of Health began to test a form of 'internal contracting' for health care delivery in selected health districts (including hospitals and health centers) contracted by the provincial health department as Special Operating Agencies (SOAs) and provided with greater management autonomy. This study assesses the internal contracting approach as a means for improving the management of district health services and strengthening service delivery. While the study may contribute to the emerging field now known as performance-based financing, the lessons deal more broadly with the impact of management reform and increased autonomy in contrast to traditional public sector line-management and budgeting. Carried out during 2011, the study was based on: (i) a review of the literature and of operational documents; (ii) primary data from semi-structured key informant interviews with 20 health officials in two provinces involved in four SOA pilot districts; and (iii) routine data from the 2011 SOA performance monitoring report. Five prerequisites were identified for effective contract management and improved service delivery: a clear understanding of roles and responsibilities by the contracting parties; implementation of clear rules and procedures; effective management of performance; effective monitoring of the contract; and adequate and timely provision of resources. Both the level and allocation of incentives and management bottlenecks at various levels continue to impede implementation. We conclude that, in contracted arrangements like these, the clear separation of contracting functions (purchasing, commissioning, monitoring and regulating), management autonomy where responsibilities are genuinely devolved and accepted, and the provision of resources adequate to meet contract demands are necessary conditions for success. Copyright © 2013 Elsevier Ltd. All rights reserved.

A randomized, placebo-controlled trial of risperidone augmentation for patients with difficult-to-treat unipolar, non-psychotic major depression.

PubMed

Keitner, Gabor I; Garlow, Steven J; Ryan, Christine E; Ninan, Philip T; Solomon, David A; Nemeroff, Charles B; Keller, Martin B

2009-01-01

Patients (30-50%) with non-psychotic major depression will not respond despite an adequate trial of antidepressant medication. This study evaluated risperidone as an augmenting agent for patients who failed or only partially responded to an adequate trial of an antidepressant medication. Ninety-seven patients with unipolar non-psychotic major depression who were not responsive to antidepressant monotherapy were randomized to risperidone (0.5-3mg/day) or placebo augmentation in a four-week, double-blind, placebo controlled treatment trial. The primary outcome measure was remission defined by a score of < or =10 on the Montgomery-Asberg Depression Rating Scale (MADRS). Secondary outcomes measures were the Hamilton Rating Scale for Depression, the Clinician Global Impression of Severity scale and the overall satisfaction item of the Quality of Life and Enjoyment Questionnaire. Subjects in both treatment groups improved significantly over time. The odds of remitting were significantly better for patients in the risperidone vs. placebo arm (OR=3.33, p=.011). At the end of 4 weeks of treatment 52% of the risperidone augmentation group remitted (MADRS< or =10) compared to 24% of the placebo augmentation group (CMH(1)=6.48, p=.011), but the two groups were converging. Patients in the risperidone group also reported significantly more improvement in quality-of-life than patients in the placebo group. There were no between-group differences in the number of adverse events reported, however, weight gain was significantly higher in the group receiving risperidone. Augmentation of an antidepressant with risperidone for patients with difficult-to-treat depression leads to more rapid response and a higher remission rate and better quality-of-life.

Nuclear Waste Disposal: Can Government Cope?

DTIC Science & Technology

1983-12-01

Kansas (1972) and Alpena , Michigan (1975) sites. Less publicized are the increased costs (transaction costs and delayed schedules) which result when...first site focused on by OWI (in 1975) was in Alpena , Michigan. S In response to the criticism that ERDA officials had not consulted adequately with...Congressman Phillip Ruppe, in whose district Alpena lay, of its intention to start exploratory drilling activities. In response to being confronted with what

The development of a survey instrument for community health improvement.

PubMed Central

Bazos, D A; Weeks, W B; Fisher, E S; DeBlois, H A; Hamilton, E; Young, M J

2001-01-01

OBJECTIVE: To develop a survey instrument that could be used both to guide and evaluate community health improvement efforts. DATA SOURCES/STUDY SETTING: A randomized telephone survey was administered to a sample of about 250 residents in two communities in Lehigh Valley, Pennsylvania in the fall of 1997. METHODS: The survey instrument was developed by health professionals representing diverse health care organizations. This group worked collaboratively over a period of two years to (1) select a conceptual model of health as a foundation for the survey; (2) review relevant literature to identify indicators that adequately measured the health constructs within the chosen model; (3) develop new indicators where important constructs lacked specific measures; and (4) pilot test the final survey to assess the reliability and validity of the instrument. PRINCIPAL FINDINGS: The Evans and Stoddart Field Model of the Determinants of Health and Well-Being was chosen as the conceptual model within which to develop the survey. The Field Model depicts nine domains important to the origins and production of health and provides a comprehensive framework from which to launch community health improvement efforts. From more than 500 potential indicators we identified 118 survey questions that reflected the multiple determinants of health as conceptualized by this model. Sources from which indicators were selected include the Behavior Risk Factor Surveillance Survey, the National Health Interview Survey, the Consumer Assessment of Health Plans Survey, and the SF-12 Summary Scales. The work group developed 27 new survey questions for constructs for which we could not locate adequate indicators. Twenty-five questions in the final instrument can be compared to nationally published norms or benchmarks. The final instrument was pilot tested in 1997 in two communities. Administration time averaged 22 minutes with a response rate of 66 percent. Reliability of new survey questions was adequate. Face validity was supported by previous findings from qualitative and quantitative studies. CONCLUSIONS: We developed, pilot tested, and validated a survey instrument designed to provide more comprehensive and timely data to communities for community health assessments. This instrument allows communities to identify and measure critical domains of health that have previously not been captured in a single instrument. PMID:11508639

Inferences and metaphoric comprehension in unilaterally implanted children with adequate formal oral language performance.

PubMed

Nicastri, Maria; Filipo, Roberto; Ruoppolo, Giovanni; Viccaro, Marika; Dincer, Hilal; Guerzoni, Letizia; Cuda, Domenico; Bosco, Ersilia; Prosperini, Luca; Mancini, Patrizia

2014-05-01

To assess skills in inferences during conversations and in metaphors comprehension of unilaterally cochlear implanted children with adequate abilities at the formal language tests, comparing them with well-matched hearing peers; to verify the influence of age of implantation on overall skills. The study was designed as a matched case-control study. 31 deaf children, unilateral cochlear implant users, with normal linguistic competence at formal language tests were compared with 31 normal hearing matched peers. Inferences and metaphor comprehension skills were assessed through the Implicit Meaning Comprehension, Situations and Metaphors subtests of the Italian Standardized Battery of "Pragmatic Language Skills MEDEA". Differences between patient and control groups were tested by the Mann-Whitney U test. Correlations between age at implantation and time of implant use with each subtest were investigated by the Spearman rank correlation coefficient. No significant differences between the two groups were found in inferencing skills (p=0.24 and p=0.011 respectively for Situations and Implicit Meaning Comprehension). Regarding figurative language, unilaterally cochlear implanted children performed significantly below their normal hearing peers in Verbal Metaphor comprehension (p=0.001). Performances were related to age at implantation, but not with time of implant use. Unilaterally cochlear implanted children with normal language level showed responses similar to NH children in discourse inferences, but not in figurative language comprehension. Metaphors still remains a challenge for unilateral implant users and above all when they have not any reference, as demonstrated by the significant difference in verbal rather than figurative metaphors comprehension. Older age at implantation was related to worse performance for all items. These aspects, until now less investigated, had to receive more attention to deeply understand specific mechanisms involved and possible effects of different levels of figurative language complexity (presence or absence of contextual input, degree of transparency and syntactic frozenness). New insight is needed to orient programs in early intervention settings in considering and adequately responding to all these complex communicative need of children with hearing loss. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Health literacy instrument in family medicine: the "newest vital sign" ease of use and correlates.

PubMed

Shah, Lisa Ciccarelli; West, Patricia; Bremmeyr, Katazryna; Savoy-Moore, Ruth T

2010-01-01

Health literacy has been defined as the ability to obtain, process, and understand the basic information needed to make appropriate health decisions. Half of adults lack the health literacy skills needed for our complex health care environment. In 2005, Weiss et al introduced the Newest Vital Sign (NVS), an instrument that can be used to quickly assess health literacy. The purpose of this study was to determine the acceptability and timeliness of using the NVS to measure the level of health literacy in various suburban, urban, and rural primary care settings. A secondary purpose was to determine the influence of taking a health class on one's level of health literacy. In this cross-sectional design, adults were recruited from 4 primary care settings and student athletes were recruited during preparticipation sports physicals. The NVS was administered and health literacy rates were compared with known trends. A subset of 50 patients was timed during test administration, and refusals were logged throughout. The adults and the athletes were analyzed separately. One thousand fourteen patients (including athletes) agreed to participate (response rate, 97.5%). Average time needed to complete the NVS was 2.63 minutes. Of the adults tested, 48.1% demonstrated adequate health literacy. In logistic regression analysis, younger age, more formal education, health class participation, and body mass index were positive predictors of adequate health literacy among adults. An interaction term was used for gender/race, with white women used as the comparator. The gender/race odds ratio negatively affected literacy, with white men at 0.497 (95% CI, 0.328-0.753), non-white women at 0.177 (95% CI, 0.111-0.282), and non-white men at 0.210 (95% CI, 0.110-0.398). Among the participating middle- and high-school athletes, 59.7% had adequate health literacy. In logistic regression of this population, body mass index was a positive predictor whereas gender/race was a negative predictor. The NVS revealed health literacy status in less than 3 minutes, was widely accepted, and provided results comparable to more extensive literacy tests. Particularly, taking a health education class was associated with higher levels of health literacy among adults.

Avoiding stimulus confounds in Implicit Association Tests by using the concepts as stimuli.

PubMed

Steffens, Melanie C; Kirschbaum, Michael; Glados, Petra

2008-06-01

Implicit Association Tests (IATs) are supposed to measure associations between concepts. In order to achieve that aim, participants are required to assign individual stimuli to those concepts under time pressure in two different tasks. Previous research has shown that not only the associations of the concepts with each other, but also the stimuli's cross-category associations influence the observed reaction time difference between these tasks (i.e. the IAT effect). Little is known about adequate stimulus selection. In this article, we introduce a variant of the IAT, the Concept Association Task (CAT) in which the concepts themselves or synonyms of them are used as stimuli. Three experiments on Germans' attitudes towards foreigners yielded evidence for the convergent validity of the CAT: (1) it correlated well with other IAT versions; (2) it correlated higher with spontaneous attitude-related judgements than other IAT versions; and (3) it correlated with response-window priming, another implicit measure based on reaction times. Furthermore, we showed that the CAT yielded reasonable findings when other IAT versions appear to yield distorted ones.

High-quality cardiopulmonary resuscitation.

PubMed

Nolan, Jerry P

2014-06-01

The quality of cardiopulmonary resuscitation (CPR) impacts on outcome after cardiac arrest. This review will explore the factors that contribute to high-quality CPR and the metrics that can be used to monitor performance. A recent consensus statement from North America defined five key components of high-quality CPR: minimizing interruptions in chest compressions, providing compressions of adequate rate and depth, avoiding leaning on the chest between compressions, and avoiding excessive ventilation. Studies have shown that real-time feedback devices improve the quality of CPR and, in one before-and-after study, outcome from out-of-hospital cardiac arrest. There is evidence for increasing survival rates following out-of-hospital cardiac arrest and this is associated with increasing rates of bystander CPR. The quality of CPR provided by healthcare professionals can be improved with real-time feedback devices. The components of high-quality CPR and the metrics that can be measured and fed back to healthcare professionals have been defined by expert consensus. In the future, real-time feedback based on the physiological responses to CPR may prove more effective.

A Particle Representation Model for the Deformation of Homogeneous Turbulence

NASA Technical Reports Server (NTRS)

Kassinos, S. C.; Reynolds, W. C.

1996-01-01

In simple flows, where the mean deformation rates are mild and the turbulence has time to come to equilibrium with the mean flow, the Reynolds stresses are determined by the applied strain rate. Hence in these flows, it is often adequate to use an eddy-viscosity representation. The modern family of kappa-epsilon models has been very useful in predicting near equilibrium turbulent flows, where the rms deformation rate S is small compared to the reciprocal time scale of the turbulence (epsilon/kappa). In modern engineering applications, turbulence models are quite often required to predict flows with very rapid deformations (large S kappa/epsilon). In these flows, the structure takes some time to respond and eddy viscosity models are inadequate. The response of turbulence to rapid deformations is given by rapid distortion theory (RDT). Under RDT the nonlinear effects due to turbulence-turbulence interactions are neglected in the governing equations, but even when linearized in this fashion, the governing equations are unclosed at the one-point level due to the non-locality of the pressure fluctuations.

Towards an implantable bio-sensor platform for continuous real-time monitoring of anti-epileptic drugs.

PubMed

Hammoud, Abbas; Chamseddine, Ahmad; Nguyen, Dang K; Sawan, Mohamad

2016-08-01

The need of continuous real-time monitoring device for in-vivo drug level detection has been widely articulated lately. Such monitoring could guide drug posology and timing of intake, detect low or high drug levels, in order to take adequate measures, and give clinicians a valuable window into patients' health and their response to therapeutics. This paper presents a novel implantable bio-sensor based on impedance measurement capable of continuously monitoring various antiepileptic drug levels. This portable point-of-care microsystem replaces large and stationary conventional macrosystems, and is a one of a kind system designed with an array of electrodes to monitor various anti-epileptic drugs rather than one drug. The micro-system consists of (i) the front-end circuit including an inductive coil to receive energy from an external base station, and to exchange data with the latter; (ii) the power management block; (iii) the readout and control block; and (iv) the biosensor array. The electrical circuitry was designed using the 0.18-um CMOS process technology intended to be miniature and consume ultra-low power.

Beyond cost: 'responsible purchasing' of managed care by employers.

PubMed

Lo Sasso, A T; Perloff, L; Schield, J; Murphy, J J; Mortimer, J D; Budetti, P P

1999-01-01

We explore the extent of "responsible purchasing" by employers--the degree to which employers collect and use nonfinancial information in selecting and managing employee health plans. Most firms believe that they have some responsibility for assessing the quality of the health plans they offer. Some pay attention to plan characteristics such as the ability to provide adequate access to providers and services and scores on enrollee satisfaction surveys. A more limited but still notable number of firms take specific actions based on responsible purchasing information. Because of countervailing pressures, however, it is not clear whether or not the firms most involved in responsible purchasing are signaling a developing trend.

Clinical responsiveness of self-report functional assessment measures for children with juvenile idiopathic arthritis undergoing intraarticular corticosteroid injections.

PubMed

Brown, G Ted; Wright, F Virginia; Lang, Bianca A; Birdi, Nina; Oen, Kim; Stephens, Derek; McComas, Joan; Feldman, Brian M

2005-12-15

The Childhood Health Assessment Questionnaire (CHAQ), Juvenile Arthritis Functional Assessment Report (JAFAR), and Juvenile Arthritis Functional Status Index (JASI) are widely used functional measures for juvenile idiopathic arthritis (JIA) that differ in content, format, and completion time. We compared the responsiveness and child-parent agreement of the JAFAR, CHAQ, and JASI in a prospective, multicenter study. Children and adolescents from 5 rheumatology centers were enrolled. Subjects were about to undergo therapy (intraarticular corticosteroid injections [IAS] and methotrexate or hip surgery (MTX/hip]) expected to produce a functional improvement. All subjects were studied before the intervention and at 6 weeks and 6 months posttreatment. At each study visit, the 3 measures were administered in randomized, balanced order to both parents and children. A total of 92 subjects (mean age 12.8 years) were enrolled in the study, 74 of which were in the IAS group. The responsiveness of all 3 measures was moderate to strong. The standardized response mean at 6 weeks for the IAS group on the JAFAR, CHAQ, and JASI was 0.41 (95% confidence interval [95% CI] 0.18, 0.64), 0.70 (95% CI 0.47, 0.93), and 0.36 (95% CI 0.13, 0.59), respectively. The CHAQ was somewhat more responsive to change at 6 weeks (IAS group: relative efficiency 0.34 [JAFAR], 0.27 [JASI]), but less responsive at 6 months (MTX/hip group: relative efficiency 5.1 [JAFAR], 3.9 [JASI]). All 3 questionnaires showed acceptable parent-child agreement, and overall, there were few differences between the 3 questionnaires. The functional outcome measures currently used for JIA are all adequately responsive for use in trials or in the clinic setting. The choice of which measure to use should therefore be based on the time available for completion, the intended clinical/research use, and the depth of content required.

Achieving Accreditation Council for Graduate Medical Education duty hours compliance within advanced surgical training: a simulation-based feasibility assessment.

PubMed

Obi, Andrea; Chung, Jennifer; Chen, Ryan; Lin, Wandi; Sun, Siyuan; Pozehl, William; Cohn, Amy M; Daskin, Mark S; Seagull, F Jacob; Reddy, Rishindra M

2015-11-01

Certain operative cases occur unpredictably and/or have long operative times, creating a conflict between Accreditation Council for Graduate Medical Education (ACGME) rules and adequate training experience. A ProModel-based simulation was developed based on historical data. Probabilistic distributions of operative time calculated and combined with an ACGME compliant call schedule. For the advanced surgical cases modeled (cardiothoracic transplants), 80-hour violations were 6.07% and the minimum number of days off was violated 22.50%. There was a 36% chance of failure to fulfill any (either heart or lung) minimum case requirement despite adequate volume. The variable nature of emergency cases inevitably leads to work hour violations under ACGME regulations. Unpredictable cases mandate higher operative volume to ensure achievement of adequate caseloads. Publically available simulation technology provides a valuable avenue to identify adequacy of case volumes for trainees in both the elective and emergency setting. Copyright © 2015 Elsevier Inc. All rights reserved.

32 CFR 806.22 - Time limits.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 6 2012-07-01 2012-07-01 false Time limits. 806.22 Section 806.22 National... INFORMATION ACT PROGRAM § 806.22 Time limits. Any FOIA appeals received after the 60-day time limit are not processed, unless the requester provides adequate justification for failing to comply with the time limit...

32 CFR 806.22 - Time limits.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 6 2013-07-01 2013-07-01 false Time limits. 806.22 Section 806.22 National... INFORMATION ACT PROGRAM § 806.22 Time limits. Any FOIA appeals received after the 60-day time limit are not processed, unless the requester provides adequate justification for failing to comply with the time limit...

32 CFR 806.22 - Time limits.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 6 2014-07-01 2014-07-01 false Time limits. 806.22 Section 806.22 National... INFORMATION ACT PROGRAM § 806.22 Time limits. Any FOIA appeals received after the 60-day time limit are not processed, unless the requester provides adequate justification for failing to comply with the time limit...

32 CFR 806.22 - Time limits.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 6 2011-07-01 2011-07-01 false Time limits. 806.22 Section 806.22 National... INFORMATION ACT PROGRAM § 806.22 Time limits. Any FOIA appeals received after the 60-day time limit are not processed, unless the requester provides adequate justification for failing to comply with the time limit...

Febrile ulceronecrotic Mucha-Habermann disease following suspected hemorrhagic chickenpox infection in a 20-month-old boy.

PubMed

Lode, H N; Döring, P; Lauenstein, P; Hoeger, P; Dombrowski, F; Bruns, R

2015-10-01

We present the youngest pediatric patient so far with febrile ulcerative Mucha-Haberman disease (FUMHD) after an admitting clinical picture of hemorrhagic varicella infection. With a time to diagnosis of 25 days, the 20-month-old boy responded to low dose cyclosporine and prednisolone given for 3 months and is free of disease after 4 years of follow up. We describe a polyclonal CD8+ T cell response with elevated pro-inflammatory cytokines and a fivefold upregulation of the high-affinity Fc receptor type I (CD64) on granulocytes. Early consideration of FUMHD in the differential diagnosis of a systemic inflammatory disease combined with a generalized necrotizing rash is important for early and adequate management of children with this rare and challenging disease.

Chemical Weapons Exposures in Iraq: Challenges of a Public Health Response a Decade Later.

PubMed

Baird, Coleen; Mirza, Raul; Sharkey, Jessica M; Teichman, Ron; Longmire, Romarius; Harkins, Deanna; Llanos, Joseph; Abraham, Joseph; McCannon, Charles; Heller, Jack; Tinklepaugh, Carole; Rice, William

2016-01-01

An October 14, 2014 article in The New York Times reported that the US Department of Defense (DoD) concealed, for nearly a decade, circumstances surrounding service members' exposure to chemical warfare agents (CWA) while deployed to Iraq in support of Operations Iraqi Freedom and New Dawn from March 13, 2003, to December 31, 2011, and alleged failure of the DoD to provide expedient and adequate medical care. This report prompted the DoD to devise a public health investigation, with the Army Public Health Center (Provisional) as the lead agency to identify, evaluate, document, and track CWA casualties of the Iraq war. Further, the DoD revisited and revised clinical guidelines and health policies concerning CWA exposure based on current evidence-based guidelines and best practices.

The legacy of fear: is fear impacting fatal and non-fatal drowning of African American children?

PubMed

Irwin, Carol C; Irwin, Richard L; Ryan, Timothy D; Drayer, Joris

2011-01-01

African American children’s rates for fatal and non-fatal drowning events are alarmingly elevated, with some age groups having three times the rate as compared to White peers. Adequate swimming skills are considered a protective agent toward the prevention of drowning, but marginalized youth report limited swimming ability. This research examined minority children’s and parents/caregivers’ fear of drowning as a possible variable associated with limited swimming ability. Results confirmed that there were significant racial differences concerning the fear of drowning, and adolescent African American females were notably more likely to fear drowning while swimming than any other group. The “fear of drowning” responses by parents/ caregivers of minority children were also significantly different from their White counterparts.

The autopsy: a professional responsibility in assuring quality of care.

PubMed

Burton, Elizabeth C

2002-01-01

Forty years ago, the value of autopsies was widely recognized as new diseases were discovered or clarified and scientific technology advanced greatly. Despite the autopsy's strong foundation, its value is not currently being properly conveyed to physicians or patients. Although autopsy-related policy exists, these policies have had little effect on increasing or even maintaining adequate autopsy rates. More recently, the autopsy has fallen on hard times, with US hospital rates now below 5%. The reasons for the decline in rates are multifaceted and include a lack of direct reimbursement for the procedure, lack of defined minimum rate standards, overconfidence in diagnostic technology, and the fear of litigation. Regardless of the reasons for the declining rates, the ethical and professional reasons for increasing the number of autopsies are far more important.

A Pilot Test of the Everyday Stressors Index-Spanish Version in a Sample of Hispanic Women Attending Prenatal Care.

PubMed

Gómez, María L; Ashford, Kristin; Linares, Ana M; Hall, Lynne A

2015-01-01

Prenatal and postpartum psychosocial stress are associated with adverse pregnancy outcomes. Hispanic women experience higher levels of stress during pregnancy. This pilot study assessed the psychometric characteristics of the Everyday Stressors Index-Spanish (ESI-S) version. Secondary analysis in a convenience sample, n = 51 women. The ESI-S showed adequate internal consistency (Cronbach's alpha = .86). Two factors accounted for 40% of the item variance. The greatest sources of stress were "having too many responsibilities" and "not enough money for basics". Higher levels of stressors were associated with older age, living without a partner, and working part or full time. The ESI-S was positively correlated with measures of perinatal depression. Findings support the reliability and validity of the newly translated ESI-S.

New Capabilities With Dry Silver Recording Materials

NASA Astrophysics Data System (ADS)

Morgan, David A.

1987-04-01

Dry Silver technology was discovered at 3M and introduced into various imaging applications in the mid-sixties. In the early 1980's, quality films and papers with extended spectral responses, greater dynamic ranges, and improved sensitivity and edge acuity were introduced into sophisticated imaging systems. These products also have improved shelf life at elevated storage temperatures, and improved print stability. At the present time, 3M is developing a full-color dry silver product. This product has the same rapid-access, easy-to-use characteristics as the black and white dry silver recording materials. It has high resolution, long gray scale, and adequate sensitivity for CRT's and other electronically addressable exposure devices. The product can be processed in the same processors used for the black and white dry silver products.

Flight Test Maneuvers for Efficient Aerodynamic Modeling

NASA Technical Reports Server (NTRS)

Morelli, Eugene A.

2011-01-01

Novel flight test maneuvers for efficient aerodynamic modeling were developed and demonstrated in flight. Orthogonal optimized multi-sine inputs were applied to aircraft control surfaces to excite aircraft dynamic response in all six degrees of freedom simultaneously while keeping the aircraft close to chosen reference flight conditions. Each maneuver was designed for a specific modeling task that cannot be adequately or efficiently accomplished using conventional flight test maneuvers. All of the new maneuvers were first described and explained, then demonstrated on a subscale jet transport aircraft in flight. Real-time and post-flight modeling results obtained using equation-error parameter estimation in the frequency domain were used to show the effectiveness and efficiency of the new maneuvers, as well as the quality of the aerodynamic models that can be identified from the resultant flight data.

Guide for studying and evaluating internal accounting controls. Oil and gas exploration, development and production

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

Not Available

1981-01-01

One of the most important responsibilities of any company's management is to establish and maintain, via periodic evaluations, is adequate internal accounting controls. Arthur Andersen and Co. approaches this problem as it relates to the oil and gas industry by logically dividing the economic events that affect a given company into four groups of activity termed ''business cycles'': treasury, expenditure, conversion (exploration, development, and production), and revenue activities. Independent public accountants can evaluate a company's existing internal controls much more thoroughly by studying only one category of business transactions at a time. Arthur Andersen's guide to reviewing internal controls coversmore » each step of this ''transaction-flow'' method as applied to a typical oil and gas company.« less

Fall detection of elderly through floor vibrations and sound.

PubMed

Litvak, Dima; Zigel, Yaniv; Gannot, Israel

2008-01-01

Falls are very prevalent among the elderly especially in their home. The statistics show that approximately one in every three adults 65 years old or older falls each year. Almost 30% of those falls result in serious injuries. Studies have shown that the medical outcome of a fall is largely dependent upon the response and rescue time. Therefore, reliable and immediate fall detection system is important so that adequate medical support could be delivered. We have developed a unique and inexpensive solution that does not require subjects to wear anything. The solution is based on floor vibration and acoustic sensing, and uses a pattern recognition algorithm to discriminate between human or inanimate object fall events. Using the proposed system we can detect human falls with a sensitivity of 95% and specificity of 95%.

Temporal Specification and Verification of Real-Time Systems.

DTIC Science & Technology

1991-08-30

of concrete real - time systems can be modeled adequately. Specification: We present two conservative extensions of temporal logic that allow for the...logic. We present both model-checking algorithms for the automatic verification of finite-state real - time systems and proof methods for the deductive verification of real - time systems .

Indentation mapping revealed poroelastic, but not viscoelastic, properties spanning native zonal articular cartilage.

PubMed

Wahlquist, Joseph A; DelRio, Frank W; Randolph, Mark A; Aziz, Aaron H; Heveran, Chelsea M; Bryant, Stephanie J; Neu, Corey P; Ferguson, Virginia L

2017-12-01

Osteoarthrosis is a debilitating disease affecting millions, yet engineering materials for cartilage regeneration has proven difficult because of the complex microstructure of this tissue. Articular cartilage, like many biological tissues, produces a time-dependent response to mechanical load that is critical to cell's physiological function in part due to solid and fluid phase interactions and property variations across multiple length scales. Recreating the time-dependent strain and fluid flow may be critical for successfully engineering replacement tissues but thus far has largely been neglected. Here, microindentation is used to accomplish three objectives: (1) quantify a material's time-dependent mechanical response, (2) map material properties at a cellular relevant length scale throughout zonal articular cartilage and (3) elucidate the underlying viscoelastic, poroelastic, and nonlinear poroelastic causes of deformation in articular cartilage. Untreated and trypsin-treated cartilage was sectioned perpendicular to the articular surface and indentation was used to evaluate properties throughout zonal cartilage on the cut surface. The experimental results demonstrated that within all cartilage zones, the mechanical response was well represented by a model assuming nonlinear biphasic behavior and did not follow conventional viscoelastic or linear poroelastic models. Additionally, 10% (w/w) agarose was tested and, as anticipated, behaved as a linear poroelastic material. The approach outlined here provides a method, applicable to many tissues and biomaterials, which reveals and quantifies the underlying causes of time-dependent deformation, elucidates key aspects of material structure and function, and that can be used to provide important inputs for computational models and targets for tissue engineering. Elucidating the time-dependent mechanical behavior of cartilage, and other biological materials, is critical to adequately recapitulate native mechanosensory cues for cells. We used microindentation to map the time-dependent properties of untreated and trypsin treated cartilage throughout each cartilage zone. Unlike conventional approaches that combine viscoelastic and poroelastic behaviors into a single framework, we deconvoluted the mechanical response into separate contributions to time-dependent behavior. Poroelastic effects in all cartilage zones dominated the time-dependent behavior of articular cartilage, and a model that incorporates tension-compression nonlinearity best represented cartilage mechanical behavior. These results can be used to assess the success of regeneration and repair approaches, as design targets for tissue engineering, and for development of accurate computational models. Copyright © 2017 Acta Materialia Inc. All rights reserved.

Measuring the Cognitions, Emotions, and Motivation Associated With Avoidance Behaviors in the Context of Pain: Preliminary Development of the Negative Responsivity to Pain Scales.

PubMed

Jensen, Mark P; Ward, L Charles; Thorn, Beverly E; Ehde, Dawn M; Day, Melissa A

2017-04-01

We recently proposed a Behavioral Inhibition System-Behavioral Activation System (BIS-BAS) model to help explain the effects of pain treatments. In this model, treatments are hypothesized to operate primarily through their effects on the domains within 2 distinct neurophysiological systems that underlie approach (BAS) and avoidance (BIS) behaviors. Measures of the model's domains are needed to evaluate and modify the model. An item pool of negative responses to pain (NRP; hypothesized to be BIS related) and positive responses (PR; hypothesized to be BAS related) were administered to 395 undergraduates, 325 of whom endorsed recurrent pain. The items were administered to 176 of these individuals again 1 week later. Analyses were conducted to develop and validate scales assessing NRP and PR domains. Three NRP scales (Despondent Response to Pain, Fear of Pain, and Avoidant Response to Pain) and 2 PR scales (Happy/Hopeful Responses and Approach Response) emerged. Consistent with the model, the scales formed 2 relatively independent overarching domains. The scales also demonstrated excellent internal consistency, and associations with criterion variables supported their validity. However, whereas the NRP scales evidenced adequate test-retest stability, the 2 PR scales were not adequately stable. The study yielded 3 brief scales assessing NRP, which may be used to further evaluate the BIS-BAS model and to advance research elucidating the mechanisms of psychosocial pain treatments. The findings also provide general support for the BIS-BAS model, while also suggesting that some minor modifications in the model are warranted.

Poor early response to methotrexate portends inadequate long-term outcomes in patients with moderate-to-severe psoriasis: Evidence from 2 phase 3 clinical trials.

PubMed

Gordon, Kenneth B; Betts, Keith A; Sundaram, Murali; Signorovitch, James E; Li, Junlong; Xie, Meng; Wu, Eric Q; Okun, Martin M

2017-12-01

Most methotrexate-treated psoriasis patients do not achieve a long-term PASI75 (75% reduction from baseline Psoriasis Area and Severity Index score) response. Indications of nonresponse can be apparent after only 4 weeks of treatment. To develop a prediction rule to identify patients unlikely to respond adequately to methotrexate. Patient-level data from CHAMPION (NCT00235820, N = 110) was used to construct a prediction model for week 16 PASI75 by using patient baseline characteristics and week 4 PASI25. A prediction rule was determined on the basis of the sensitivity and specificity and validated in terms of week 16 PASI75 response in an independent validation sample from trial M10-255 (NCT00679731, N = 163). PASI25 achievement at week 4 (odds ratio = 8.917) was highly predictive of response with methotrexate at week 16. Patients with a predicted response probability <30% were recommended to discontinue methotrexate. The rates of week 16 PASI75 response were 65.8% and 21.1% (P < .001) for patients recommended to continue and discontinue methotrexate, respectively. The CHAMPION trial excluded patients previously treated with biologics, and the M10-255 trial had no restrictions. A prediction rule was developed and validated to identify patients unlikely to respond adequately to methotrexate. The rule indicates that 4 weeks of methotrexate might be sufficient to predict long-term response with limited safety risk. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Comparison of Registered and Reported Outcomes in Randomized Clinical Trials Published in Anesthesiology Journals.

PubMed

Jones, Philip M; Chow, Jeffrey T Y; Arango, Miguel F; Fridfinnson, Jason A; Gai, Nan; Lam, Kevin; Turkstra, Timothy P

2017-10-01

Randomized clinical trials (RCTs) provide high-quality evidence for clinical decision-making. Trial registration is one of the many tools used to improve the reporting of RCTs by reducing publication bias and selective outcome reporting bias. The purpose of our study is to examine whether RCTs published in the top 6 general anesthesiology journals were adequately registered and whether the reported primary and secondary outcomes corresponded to the originally registered outcomes. Following a prespecified protocol, an electronic database was used to systematically screen and extract data from RCTs published in the top 6 general anesthesiology journals by impact factor (Anaesthesia, Anesthesia & Analgesia, Anesthesiology, British Journal of Anaesthesia, Canadian Journal of Anesthesia, and European Journal of Anaesthesiology) during the years 2007, 2010, 2013, and 2015. A manual search of each journal's Table of Contents was performed (in duplicate) to identify eligible RCTs. An adequately registered trial was defined as being registered in a publicly available trials registry before the first patient being enrolled with an unambiguously defined primary outcome. For adequately registered trials, the outcomes registered in the trial registry were compared with the outcomes reported in the article, with outcome discrepancies documented and analyzed by the type of discrepancy. During the 4 years studied, there were 860 RCTs identified, with 102 RCTs determined to be adequately registered (12%). The proportion of adequately registered trials increased over time, with 38% of RCTs being adequately registered in 2015. The most common reason in 2015 for inadequate registration was registering the RCT after the first patient had already been enrolled. Among adequately registered trials, 92% had at least 1 primary or secondary outcome discrepancy. In 2015, 42% of RCTs had at least 1 primary outcome discrepancy, while 90% of RCTs had at least 1 secondary outcome discrepancy. Despite trial registration being an accepted best practice, RCTs published in anesthesiology journals have a high rate of inadequate registration. While mandating trial registration has increased the proportion of adequately registered trials over time, there is still an unacceptably high proportion of inadequately registered RCTs. Among adequately registered trials, there are high rates of discrepancies between registered and reported outcomes, suggesting a need to compare a published RCT with its trial registry entry to be able to fully assess the quality of the study. If clinicians base their decisions on evidence distorted by primary outcome switching, patient care could be negatively affected.

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.

Dextran hydrogel coated surface plasmon resonance imaging (SPRi) sensor for sensitive and label-free detection of small molecule drugs

NASA Astrophysics Data System (ADS)

Li, Shaopeng; Yang, Mo; Zhou, Wenfei; Johnston, Trevor G.; Wang, Rui; Zhu, Jinsong

2015-11-01

The label-free and sensitive detection of small molecule drugs on SPRi is still a challenging task, mainly due to the limited surface immobilization capacity of the sensor. In this research, a dextran hydrogel-coated gold sensor chip for SPRi was successfully fabricated via photo-cross-linking for enhanced surface immobilization capacity. The density of the dextran hydrogel was optimized for protein immobilization and sensitive small molecule detection. The protein immobilization capacity of the hydrogel was 10 times greater than a bare gold surface, and 20 times greater than an 11-mercaptoundecanoic acid (MUA) surface. Such a drastic improvement in immobilization capacity allowed the SPRi sensor to detect adequate response signals when probing small molecule binding events. The binding signal of 4 nM liquid-phase biotin to streptavidin immobilized on the dextran surface reached 435 RU, while no response was observed on bare gold or MUA surfaces. The dextran hydrogel-coated SPRi sensor was also applied in a kinetic study of the binding between an immunosuppressive drug (FK506) and its target protein (FKBP12) in a high-throughput microarray format. The measured binding affinity was shown to be consistent with reported literature values, and a detection limit of 0.5 nM was achieved.

Modelling effects of diquat under realistic exposure patterns in genetically differentiated populations of the gastropod Lymnaea stagnalis

PubMed Central

Ducrot, Virginie; Péry, Alexandre R. R.; Lagadic, Laurent

2010-01-01

Pesticide use leads to complex exposure and response patterns in non-target aquatic species, so that the analysis of data from standard toxicity tests may result in unrealistic risk forecasts. Developing models that are able to capture such complexity from toxicity test data is thus a crucial issue for pesticide risk assessment. In this study, freshwater snails from two genetically differentiated populations of Lymnaea stagnalis were exposed to repeated acute applications of environmentally realistic concentrations of the herbicide diquat, from the embryo to the adult stage. Hatching rate, embryonic development duration, juvenile mortality, feeding rate and age at first spawning were investigated during both exposure and recovery periods. Effects of diquat on mortality were analysed using a threshold hazard model accounting for time-varying herbicide concentrations. All endpoints were significantly impaired at diquat environmental concentrations in both populations. Snail evolutionary history had no significant impact on their sensitivity and responsiveness to diquat, whereas food acted as a modulating factor of toxicant-induced mortality. The time course of effects was adequately described by the model, which thus appears suitable to analyse long-term effects of complex exposure patterns based upon full life cycle experiment data. Obtained model outputs (e.g. no-effect concentrations) could be directly used for chemical risk assessment. PMID:20921047

Modelling effects of diquat under realistic exposure patterns in genetically differentiated populations of the gastropod Lymnaea stagnalis.

PubMed

Ducrot, Virginie; Péry, Alexandre R R; Lagadic, Laurent

2010-11-12

Pesticide use leads to complex exposure and response patterns in non-target aquatic species, so that the analysis of data from standard toxicity tests may result in unrealistic risk forecasts. Developing models that are able to capture such complexity from toxicity test data is thus a crucial issue for pesticide risk assessment. In this study, freshwater snails from two genetically differentiated populations of Lymnaea stagnalis were exposed to repeated acute applications of environmentally realistic concentrations of the herbicide diquat, from the embryo to the adult stage. Hatching rate, embryonic development duration, juvenile mortality, feeding rate and age at first spawning were investigated during both exposure and recovery periods. Effects of diquat on mortality were analysed using a threshold hazard model accounting for time-varying herbicide concentrations. All endpoints were significantly impaired at diquat environmental concentrations in both populations. Snail evolutionary history had no significant impact on their sensitivity and responsiveness to diquat, whereas food acted as a modulating factor of toxicant-induced mortality. The time course of effects was adequately described by the model, which thus appears suitable to analyse long-term effects of complex exposure patterns based upon full life cycle experiment data. Obtained model outputs (e.g. no-effect concentrations) could be directly used for chemical risk assessment.

Optimisation of Croton gratissimus Oil Extraction by n-Hexane and Ethyl Acetate Using Response Surface Methodology.

PubMed

Jiyane, Phiwe Charles; Tumba, Kaniki; Musonge, Paul

2018-04-01

The extraction of oil from Croton gratissimus seeds was studied using the three-factor five-level full-factorial central composite rotatable design (CCRD) of the response surface methodology (RSM). The effect of the three factors selected, viz., extraction time, extraction temperature and solvent-to-feed ratio on the extraction oil yield was investigated when n-hexane and ethyl acetate were used as extraction solvents. The coefficients of determination (R 2 ) of the models developed were 0.98 for n-hexane extraction and 0.97 for ethyl acetate extraction. These results demonstrated that the models developed adequately represented the processes they described. From the optimized model, maximum extraction yield obtained from n-hexane and ethyl acetate extraction were 23.88% and 23.25%, respectively. In both cases the extraction temperature and solvent-to-feed ratio were 35°C and 5 mL/g, respectively. In n-hexane extraction the maximum conditions were reached only after 6 min whereas in ethyl acetate extraction it took 20 min to get the maximum extraction oil yield. Oil extraction of Croton gratissimus seeds, in this work, favoured the use of n-hexane as an extraction solvent as it offered higher oil yields at low temperatures and reduced residence times.

Effects of Acute Administration of Ketorolac on Mammalian Vestibular Sensory Evoked Potentials

PubMed Central

Gaines, G Christopher; Jones, Timothy A

2013-01-01

The nonsteroidal antiinflammatory drug (NSAID) ketorolac is a candidate for use as a supplemental analgesic during major surgery in anesthetized rodents. The use of ketorolac during surgery is believed to reduce the anesthetic dose required to achieve and maintain an adequate surgical plane, thus improving the physiologic condition and survival of animals during long experimental procedures. Ketorolac has reported side effects that include dizziness, ear pain, hearing loss, tinnitus, and vertigo in humans, but ketorolac has not been reported to affect the vestibular system in animals. To investigate this possibility, we evaluated the acute effects of ketorolac on vestibular compound action potentials in C57BL/6 mice. Linear vestibular sensory-evoked potentials (VsEP) were recorded during the administration of ketorolac at doses 3 to 14 times the effective analgesic dose. VsEP results for ketorolac were compared with those from a control group maintained under anesthesia for the same period. Ketorolac did not significantly affect the temporal profiles of response latencies and amplitudes or the rate of change in response measures over time between controls and ketorolac-treated mice. These findings demonstrate that ketorolac can be used as an analgesic to supplement anesthesia in mice without concerns of modifying the amplitudes and latencies of the linear VsEP. PMID:23562034

The influence of the intestinal microbiome on vaccine responses.

PubMed

Zimmermann, Petra; Curtis, Nigel

2018-06-13

There is substantial variation between individuals in the immune response to vaccinations. The intestinal microbiome plays a crucial rule in the development and regulation of the immune system and therefore its composition might affect how individuals respond to vaccinations. In this review, we summarise studies that investigated the influence of the intestinal microbiome on humoral and cellular vaccine responses. To date, only four studies (three in infants and one in adults) have investigated the influence of the intestinal microbiome on vaccine responses. All found an association between the intestinal microbiome and vaccine responses. Despite the heterogeneity in study designs (including different vaccines, schedules, timing of collection of stool and blood samples, analysis methods and reporting of results on different taxonomic levels), findings across studies were consistent: a higher relative abundance of the phylum Actinobacteria (oral and parenteral vaccines) and Firmicutes (oral vaccines) was associated with both higher humoral and higher cellular vaccine responses, while a higher relative abundance of the phylum Proteobacteria (oral and parenteral vaccines) and Bacteroidetes (oral vaccines) was associated with lower responses. Further, well-designed, adequately powered studies using whole-genome sequencing (to include the influence of viruses, fungi and parasites) are needed to investigate in more detail the influence of the intestinal microbiome on vaccine responses. This will help identify strategies to improve vaccine efficacy and duration of protection, particularly in infancy when the intestinal microbiome is more amenable to external influences and plays an important role in the development of the immune system. Copyright © 2018 Elsevier Ltd. All rights reserved.

Use of automated external defibrillators for in-hospital cardiac arrest : Any time, any place?

PubMed

Wutzler, A; Kloppe, C; Bilgard, A K; Mügge, A; Hanefeld, C

2017-11-07

Acute treatment of in-hospital cardiac arrest (IHCA) is challenging and overall survival rates are low. However, data on the use of public-access automated external defibrillators (AEDs) for IHCA remain controversial. The aim of our study was to evaluate characteristics of patients experiencing IHCA and feasibility of public-access AED use for resuscitation in a university hospital. IHCA events outside the intensive care unit were analysed over a period of 21 months. Patients' characteristics, AED performance, return of spontaneous circulation (ROSC) and 24 h survival were evaluated. Outcomes following adequate and inadequate AED use were compared. During the study period, 59 IHCAs occurred. AED was used in 28 (47.5%) of the cases. However, AED was adequately used in only 42.8% of total AED cases. AED use was not associated with an increased survival rate (12.9 vs. 10.7%, p = 0.8) compared to non-AED use. However, adequate AED use was associated with a higher survival rate (25 vs. 0%, p = 0.034) compared to inadequate AED use. Time from emergency call to application of AED >3 min was the most important factor of inadequate AED use. Adequate AED use was more often observed between 7:30 and 13:30 and in the internal medicine department. AEDs were applied in less than 50% of the IHCA events. Furthermore, AED use was inadequate in the majority of the cases. Since adequate AED use is associated with improved survival, AEDs should be available in hospital areas with patients at high risk of shockable rhythm.

Ionospheric Response to Extremes in the Space Environment: Establishing Benchmarks for the Space Weather Action Plan.

NASA Astrophysics Data System (ADS)

Viereck, R. A.; Azeem, S. I.

2017-12-01

One of the goals of the National Space Weather Action Plan is to establish extreme event benchmarks. These benchmarks are estimates of environmental parameters that impact technologies and systems during extreme space weather events. Quantitative assessment of anticipated conditions during these extreme space weather event will enable operators and users of affected technologies to develop plans for mitigating space weather risks and improve preparedness. The ionosphere is one of the most important regions of space because so many applications either depend on ionospheric space weather for their operation (HF communication, over-the-horizon radars), or can be deleteriously affected by ionospheric conditions (e.g. GNSS navigation and timing, UHF satellite communications, synthetic aperture radar, HF communications). Since the processes that influence the ionosphere vary over time scales from seconds to years, it continues to be a challenge to adequately predict its behavior in many circumstances. Estimates with large uncertainties, in excess of 100%, may result in operators of impacted technologies over or under preparing for such events. The goal of the next phase of the benchmarking activity is to reduce these uncertainties. In this presentation, we will focus on the sources of uncertainty in the ionospheric response to extreme geomagnetic storms. We will then discuss various research efforts required to better understand the underlying processes of ionospheric variability and how the uncertainties in ionospheric response to extreme space weather could be reduced and the estimates improved.

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

Noordewier, B.; Saari, J.T.

This study examined the effects of furosemide (Furo), a Loop diuretic, and amiloride (Am), a potassium (K)-sparing diuretic, on the excretion of sodium (Na) and K in copper-adequate (CuAdeq) and copper-deficient (CuDef) rats. Weanling male Sprague Dawley rats were fed a CuDef or CuAdeq diet ad libitum and given deionized water to drink. After 5 weeks on the diets, rats were assigned to one of four treatment regimens: Furo, Am or Furo + Am. Rats were anesthetized and electrolyte excretion was measured in 2 {times} 15 min control periods followed by 3 {times} 15 min treatment periods. Furo increased Namore » excretion in a dose dependent manner in both the CuAdeq and the CuDef rats. The response of the CuAdeq rats was slightly greater than that of the CuDef rats in each of the 3 treatment groups in which Furo was given. K excretion following Furo increased to the same extent in the CuAdeq and CuDef rats. The natriuretic response to Am alone was slightly greater in the CuDef than the CuAdeq rats. The antikaliuretic response of the CuDef rats was similar to that of the CuAdeq rats whether Am was given alone or in combination with Furo. These data show that CuDef rats respond to Furo and Am in a manner which is similar to that of CuAdeq rats, this indicates that the sensitivity of the Na reabsorption mechanisms to inhibition by diuretics is not markedly affected by copper deficiency.« less

J-curve relation between daytime nap duration and type 2 diabetes or metabolic syndrome: A dose-response meta-analysis

PubMed Central

Yamada, Tomohide; Shojima, Nobuhiro; Yamauchi, Toshimasa; Kadowaki, Takashi

2016-01-01

Adequate sleep is important for good health, but it is not always easy to achieve because of social factors. Daytime napping is widely prevalent around the world. We performed a meta-analysis to investigate the association between napping (or excessive daytime sleepiness: EDS) and the risk of type 2 diabetes or metabolic syndrome, and to quantify the potential dose-response relation using cubic spline models. Electronic databases were searched for articles published up to 2016, with 288,883 Asian and Western subjects. Pooled analysis revealed that a long nap (≥60 min/day) and EDS were each significantly associated with an increased risk of type 2 diabetes versus no nap or no EDS (odds ratio 1.46 (95% CI 1.23–1.74, p < 0.01) for a long nap and 2.00 (1.58–2.53) for EDS). In contrast, a short nap (<60 min/day) was not associated with diabetes (p = 0.75). Dose-response meta-analysis showed a J-curve relation between nap time and the risk of diabetes or metabolic syndrome, with no effect of napping up to about 40 minutes/day, followed by a sharp increase in risk at longer nap times. In summary, longer napping is associated with an increased risk of metabolic disease. Further studies are needed to confirm the benefit of a short nap. PMID:27909305