Research on laser direct metal deposition

NASA Astrophysics Data System (ADS)

Zhang, Yongzhong; Shi, Likai

2003-03-01

Laser direct deposition of metallic parts is a new manufacturing technology, which combines with computer-aided design, laser cladding and rapid prototyping. Fully dense metallic parts can be directly obtained through melting the coaxially fed powders with a high-power laser in a layer-by-layer manner. The process characteristics, system composition as well as some research and advancement on laser direct deposition are presented here. The microstructure and properties observation of laser direct formed 663 copper alloy, 316L stainless steel and Rene'95 nickel super alloy samples indicate that, the as-deposited microstructure is similar to rapidly solidified materials, with homogenous composition and free of defects. Under certain conditions, directionally solidified microstructure can be obtained. The as-formed mechanical properties are equal to or exceed those for casting and wrought annealed materials. At the same time, some sample parts with complicate shape are presented for technology demonstration. The formed parts show good surface quality and dimensional accuracy.

Advance directives as a tool to respect patients' values and preferences: discussion on the case of Alzheimer's disease.

PubMed

Porteri, Corinna

2018-02-20

The proposal of the new criteria for the diagnosis of Alzheimer's disease (AD) based on biomarker data is making possible a diagnosis of AD at the mild cognitive impairment (MCI) or predementia/prodromal- stage. Given the present lack of effective treatments for AD, the opportunity for the individuals to personally take relevant decisions and plan for their future before and if cognitive deterioration occurs is one the main advantages of an early diagnosis. Advance directives are largely seen as an effective tool for planning medical care in the event the subject becomes incompetent. Nevertheless, their value has been questioned with regard to people with dementia by scholars who refer to the arguments of personal identity and of patient's changing interests before and after the onset of dementia. In this paper, I discuss the value of advance directives in Alzheimer's disease and other kind of dementia. Despite critics, I argue that advance directives are especially advisable in dementia and provide reasons in favor of their promotion at an early stage of the disease as a valuable tool to respect patients' values and preferences on medical treatment, including participation in research and end of life decisions. I mainly support advance directives that include both decisions regarding health care and the appointment of an attorney in fact. I conclude that patients with AD at a prodromal or early stage should be offered the opportunity to execute an advance directive, and that not to honor a demented individual's directive would be an unacceptable form of discrimination towards those patients.

Interpreting advance directives: ethical considerations of the interplay between personal and cultural identity.

PubMed

Schicktanz, Silke

2009-06-01

In many industrialized countries ethicists and lawyers favour advance directives as a tool to guarantee patient autonomy in end-of-life-decisions. However, most citizens seem reluctant to adopt the practice; the number of patients who have an advance directive is low across most countries. The article discusses the key argument for seeing such documents as an instrument of self-interpretation and life-planning, which ultimately have to be interpreted by third parties as well. Interpretation by third parties and the process of self-reflection are conceptually linked by a qualitative concept of identity. Identity is conceived here as constructed in a processual dialogue between a personal and a cultural perspective. How the cultural dimension comes into play in understanding the motivation, rejection or content of wished for end-of-life-decisions, is shown by a brief review of empirical and cultural studies. Understanding advance directives as a culturally embedded tool of self-interpretation should help to overcome urgent moral problems in clinical settings: how to interpret such documents, how to deliberate on the content and on the best form.

Identifying the Factors That Facilitate or Hinder Advance Planning by Persons With Dementia

PubMed Central

Hirschman, Karen B.; Kapo, Jennifer M.; Karlawish, Jason H. T.

2009-01-01

We performed semistructured interviews with 30 family members of patients with advanced dementia to identify the factors that facilitate or hinder advance planning by persons with dementia. All interviews were analyzed using qualitative data analysis techniques. The majority (77%) of family members reported that their relative had some form of written advance directive, and at least half reported previous discussions about health care preferences (57%), living situation or placement issues (50%), and finances or estate planning (60%) with the patient. Family members reported some themes that prompted planning and others that were barriers to planning. Events that most often triggered planning were medical, living situation, or financial issues associated with a friend or family member of the patient (57%). Barriers to planning included both passive and active avoidance. The most common form of passive avoidance was not realizing the importance of planning until it was too late to have the discussion (63%). The most common form of active avoidance was avoiding the discussion (53%). These data suggest potentially remediable strategies to address barriers to advance planning discussions. PMID:18580595

Forming giant-sized polymersomes using gel-assisted rehydration

DOE PAGES

Greene, Adrienne C.; Sasaki, Darryl Y.; Bachand, George D.

2016-05-26

Here, we present a protocol to rapidly form giant polymer vesicles ( pGVs). Briefly, polymer solutions are dehydrated on dried agarose films adhered to coverslips. Rehydration of the polymer films results in rapid formation of pGVs. This method greatly advances the preparation of synthetic giant vesicles for direct applications in biomimetic studies.

21 CFR 1313.21 - Requirement of authorization to export.

Code of Federal Regulations, 2011 CFR

2011-04-01

... notification to the Administration as far in advance of the 15 days as possible. (b) A completed DEA Form 486... prior to the exportation. See the Table of DEA Mailing Addresses in § 1321.01 of this chapter for the current mailing address. A copy of the completed DEA Form 486 may be transmitted directly to the Drug...

Use of Advance Directives: A Social Work Perspective on the Myth versus the Reality.

ERIC Educational Resources Information Center

Hoffman, Molly K.

1994-01-01

Considers Directive to Physician, Durable Power of Attorney for Healthcare Decisions, and Medical Ethics Decision Form. Notes importance of process individuals go through in defining what quality of life means to them. Sees current struggle being individual articulation of one's wishes based on personal definition of quality of life set forth in…

New Forming Technologies for Autobody at POSCO

NASA Astrophysics Data System (ADS)

Lee, Hong-Woo; Cha, Myung-Hwan; Choi, Byung-Keun; Kim, Gyo-Sung; Park, Sung-Ho

2011-08-01

As development of car body with light weight and enhanced safety became one of the hottest issues in the auto industry, the advanced high strength steels have been broadly applied to various automotive parts over the last few years. Corresponding to this trend, POSCO has developed various types of cold and hot rolled AHSSs such as DP, TRIP, CP and FB, and continues to develop new types of steel in order to satisfy the requirement of OEMs more extensively. To provide optimal technical supports to customers, POSCO has developed more advanced EVI concept, which includes the concept of CE/SE, VA/VE, VI and PP as well as the conventional EVI strategy. To realize this concept, POSCO not only supports customers with material data, process guideline, and evaluation of formability, weld-ability, paint-ability and performance but also provides parts or sub-assemblies which demand highly advanced technologies. Especially, to accelerate adoption of AHSS in autobody, POSCO has tried to come up with optimal solutions to AHSS forming. Application of conventional forming technologies has been restricted more and more by relatively low formability of AHSS with high tensile-strength. To overcome the limitation in the forming, POSCO has recently developed new forming technologies such as hydro-forming, hot press forming, roll forming and form forming. In this paper, tailored strength HPF, hydroformed torsion beam axle and multi-directional roll forming are introduced as examples of new forming technologies.

75 FR 61853 - Advisory Committee to the Internal Revenue Service; Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-06

... taxation and tax reporting, withholding tax issues, Identity Theft, Form 1099-DIV, Box 10, foreign tax paid... basis allocation for direct rollovers. Last minute agenda changes may preclude advance notice. Due to...

Advance care planning for haemodialysis patients.

PubMed

Lim, Chi Eung Danforn; Ng, Rachel W C; Cheng, Nga Chong Lisa; Cigolini, Maria; Kwok, Cannas; Brennan, Frank

2016-07-26

End-stage kidney disease (ESKD) is a chronic, debilitative and progressive illness that may need interventions such as dialysis, transplantation, dietary and fluid restrictions. Most patients with ESKD will require renal replacement therapy, such as kidney transplantation or maintenance dialysis. Advance care planning traditionally encompass instructions via living wills, and concern patient preferences about interventions such as cardiopulmonary resuscitation and feeding tubes, or circumstances around assigning surrogate decision makers. Most people undergoing haemodialysis are not aware of advance care planning and few patients formalise their wishes as advance directives and of those who do, many do not discuss their decisions with a physician. Advance care planning involves planning for future healthcare decisions and preferences of the patient in advance while comprehension is intact. It is an essential part of good palliative care that likely improves the lives and deaths of haemodialysis patients. The objective of this review was to determine whether advance care planning in haemodialysis patients, compared with no or less structured forms of advance care planning, can result in fewer hospital admissions or less use of treatments with life-prolonging or curative intent, and if patient's wishes were followed at end-of-life. We searched the Cochrane Kidney and Transplant Specialised Register to 27 June 2016 through contact with the Information Specialist using search terms relevant to this review. We also searched the Cumulative Index of Nursing and Allied Health Literature (CINAHL), and Social Work Abstracts (OvidSP). All randomised controlled trials (RCTs) and quasi-RCTs (RCTs in which allocation to treatment was obtained by alternation, use of alternate medical records, date of birth or other predictable methods) looking at advance care planning versus no form of advance care planning in haemodialysis patients was considered for inclusion without language restriction. Data extraction was carried out independently by two authors using standard data extraction forms. Studies reported in non-English language journals were translated before assessment. Where more than one publication of one study exists, reports were grouped together and the publication with the most complete data was used in the analyses. Where relevant outcomes are only published in earlier versions these data were used. Any discrepancies between published versions were highlighted. Non-randomised controlled studies were excluded. We included two studies (three reports) that involved 337 participants which investigated advance care planning for people with ESKD. Neither of the included studies reported outcomes relevant to this review. Study quality was assessed as suboptimal. We found sparse data that were assessed at suboptimal quality and therefore we were unable to formulate conclusions about whether advance care planning can influence numbers of hospital admissions and treatment required by people with ESKD, or if patients' advance care directives were followed at end-of-life. Further well designed and adequately powered RCTs are needed to better inform patient and clinical decision-making about advance care planning and advance directives among people with ESKD who are undergoing dialysis.

Advance directives from haematology departments: the patient's freedom of choice and communication with families. A qualitative analysis of 35 written documents.

PubMed

Trarieux-Signol, S; Bordessoule, D; Ceccaldi, J; Malak, S; Polomeni, A; Fargeas, J B; Signol, N; Pauliat, H; Moreau, S

2018-01-02

In France, advance directives are favourably perceived by most of the population, although the drafting rate is low. This ambivalence is challenging because advance directives are meant to promote the autonomy and freedom of choice of patients. The purpose of this study was to analyse the content of advance directives written by patients suffering from malignant haemopathies to better understand how patients put them into practice. These could be relevant as early as the initial diagnosis of haematological malignancies because of the uncertain course of the disease. This was a multicentre, qualitative, descriptive study. The advance directives written by patients with malignant haemopathies treated in one of the six French hospital departments were included in the study from 01/06/2008 to 15/04/2016. A thematic analysis of the advance directives was performed by two researchers: a senior haematologist and a research assistant. The median age of the patients was 69. Most were women (sex ratio: 0.59), living as a couple (57%), with lymphoid pathologies (66%), who were still alive two years after the instructions were written (63%) and had nominated a health care proxy (88.6%). Free texts (62.9%) were richer in content than pre-defined forms. The advance directives were used in three ways: for a purely legal purpose, to focus on medical treatments or actions, or to communicate a message to the family. Three main themes emerged: (1) refusal of medical treatment (100%), in which patients express refusal of life-sustaining care (97.1%). The actual treatments or the moment when they should be limited or stopped were not always mentioned in detail. (2) A desire for effective pain relief to avoid suffering (57.1%) and (3) messages for their family (34.3%), such as funeral arrangements (17.1%) and messages of love or trust (14.3%). Patients who write advance directives are not necessarily at the end of their lives. Their content mainly conveys treatment wishes, although patients also use them to pass on personal messages to their close family. This emerging role of advance directives to communicate messages within the family should be valued, even if it is not their original purpose.

Lean direct wall fuel injection method and devices

NASA Technical Reports Server (NTRS)

Choi, Kyung J. (Inventor); Tacina, Robert (Inventor)

2000-01-01

A fuel combustion chamber, and a method of and a nozzle for mixing liquid fuel and air in the fuel combustion chamber in lean direct injection combustion for advanced gas turbine engines, including aircraft engines. Liquid fuel in a form of jet is injected directly into a cylindrical combustion chamber from the combustion chamber wall surface in a direction opposite to the direction of the swirling air at an angle of from about 50.degree. to about 60.degree. with respect to a tangential line of the cylindrical combustion chamber and at a fuel-lean condition, with a liquid droplet momentum to air momentum ratio in the range of from about 0.05 to about 0.12. Advanced gas turbines benefit from lean direct wall injection combustion. The lean direct wall injection technique of the present invention provides fast, uniform, well-stirred mixing of fuel and air. In addition, in order to further improve combustion, the fuel can be injected at a venturi located in the combustion chamber at a point adjacent the air swirler.

Advance Directives and Powers of Attorney in Intensive Care Patients.

PubMed

de Heer, Geraldine; Saugel, Bernd; Sensen, Barbara; Rübsteck, Charlotte; Pinnschmidt, Hans O; Kluge, Stefan

2017-06-05

Advance directives and powers of attorney are increasingly common, yet data on their use in clinical situations remain sparse. In this single center cross-sectional study, we collected data by questionnaire from 1004 intensive care patients in a university hospital. The frequencies of advance directives and powers of attorney were determined, and the factors affecting them were studied with multivariate logistic regression analysis. Usable data were obtained from 998 patients. 51.3% stated that they had prepared a document of at least one of these two kinds. Among them, 39.6% stated that they had given the relevant document(s) to the hospital, yet such documents were present in the patient's hospital record for only 23%. 508 patients stated their reasons for preparing an advance directive or a power of attorney: the most common reason (48%) was the fear of being at other people's mercy, of the lack of self-determination, or of medical overtreatment. The most important factors associated with a patient's statement that he/she had prepared such a document were advanced age (advance directive: 1.022 [1.009; 1.036], p = 0.001; power of attorney: 1.027 [1.014; 1.040], p<0.001) and elective admission to the hospital (advance directive: 1.622 [1.138; 2.311], p<0.007; power of attorney: 1.459 [1.049; 2.030], p = 0.025). 39.8% of the advance directives and 44.1% of the powers of attorney that were present in the hospital records were poorly interpretable because of the incomplete filling-out of preprinted forms. Half of the patients who did not have such a document had already thought of preparing one, but had not yet done so. For patients hospitalized in intensive care units, there should be early discussion about the presence or absence of documents of these kinds and early evaluation of the patient's concrete wishes in critical situations. Future studies are needed to determine how best to assure that these documents will be correctly prepared and then given over to hospital staff so that they can take their place in the patient's record.

Advanced high-temperature alloys: Processing and properties; Proceedings of the Nicholas J. Grant Symposium, MIT, Cambridge, MA, June 16-18, 1985

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

Allen, S.M.; Pelloux, R.M.; Widmer, R.

1986-01-01

Historical and advanced methods of producing, forming and polishing alloys in billets and net shapes are explored. Attention is given to the deficiencies in arc furnace melts and to the benefits which are accruing from rapid solidification processing, powder metallurgy and superplastic forming. The techniques employed in these methods for processing materials to desired shapes, mainly for aircraft gas turbine engines, are described, along with the microstructures and mechanical properties which are obtained. The state of the art in casting and forming techniques which yield the most favorable properties in intermetallic compound-based alloys, superalloys, glasses and metacrystals are identified. Finally,more » research directions being pursued to obtain higher purity, enhanced temperature, longer lifetime, damage resistant alloys which can be formed to net shapes are discussed.« less

Propulsion and navigation within the advancing monolayer sheet

PubMed Central

Kim, Jae Hun; Serra-Picamal, Xavier; Tambe, Dhananjay T.; Zhou, Enhua H.; Park, Chan Young; Sadati, Monirosadat; Park, Jin-Ah; Krishnan, Ramaswamy; Gweon, Bomi; Millet, Emil; Butler, James P.; Trepat, Xavier; Fredberg, Jeffrey J.

2013-01-01

As a wound heals, or a body plan forms, or a tumor invades, observed cellular motions within the advancing cell swarm are thought to stem from yet to be observed physical stresses that act in some direct and causal mechanical fashion. Here we show that such a relationship between motion and stress is far from direct. Using monolayer stress microscopy, we probed migration velocities, cellular tractions and intercellular stresses in an epithelial cell sheet advancing towards an island on which cells cannot adhere. We found that cells located near the island exert tractions that pull systematically towards this island regardless of whether the cells approach the island, migrate tangentially along its edge or, paradoxically, recede from it. This unanticipated cell-patterning motif, which we call kenotaxis, represents the robust and systematic mechanical drive of the cellular collective to fill unfilled space. PMID:23793160

Care of Patients at the End of Life: Advance Care Planning.

PubMed

Ackermann, Richard J

2016-08-01

Advance directives are legal documents that give instructions about how to provide care when patients develop life-threatening illnesses and can no longer communicate their wishes. Two types of documents are widely used-a living will and a durable power of attorney for health care. Most states also authorize physician orders for life-sustaining treatment. Physicians should encourage patients, particularly those with severe chronic or terminal conditions, to prepare advance directives. Medicare now reimburses billing codes for advance care consultations. Directions regarding cardiopulmonary resuscitation and artificial ventilation often are included in advance care plans, and use of artificial nutrition and hydration (ANH) also should be addressed, particularly for patients with advanced dementia. Evidence shows that in such patients, ANH does not prolong survival, increase comfort, or improve quality of life. Given the lack of benefit, physicians should recommend against use of ANH for patients with dementia. Finally, physicians should encourage use of hospice services by patients whose life expectancy is 6 months or less. Although Medicare and most other health care insurers cover hospice care, and despite evidence that patient and family satisfaction increase when hospice services are used, many patients do not use these services. Written permission from the American Academy of Family Physicians is required for reproduction of this material in whole or in part in any form or medium.

Medicare Preventive and Screening Services

MedlinePlus

... gov Medicare forms Advance directives & long-term care Electronic prescribing Electronic Health Records (EHRs) Download claims with Medicare’s Blue ... attr("role", "status").addClass("sr-only HiddenText").appendTo(document.body); } } function notify(strFeedback) { setTimeout(function() { var $channel = $(" "). ...

Hydrogen as the solar energy translator. [in photochemical and photovoltaic processes

NASA Technical Reports Server (NTRS)

Kelley, J. H.

1979-01-01

Many concepts are being investigated to convert sunlight to workable energy forms with emphasis on electricity and thermal energy. The electrical alternatives include direct conversion of photons to electricity via photovoltaic solar cells and solar/thermal production of electricity via heat-energy cycles. Solar cells, when commercialized, are expected to have efficiencies of about 12 to 14 percent. The cells would be active about eight hours per day. However, solar-operated water-splitting process research, initiated through JPL, shows promise for direct production of hydrogen from sunlight with efficiencies of up to 35 to 40 percent. The hydrogen, a valuable commodity in itself, can also serve as a storable energy form, easily and efficiently converted to electricity by fuel cells and other advanced-technology devices on a 24-hour basis or on demand with an overall efficiency of 25 to 30 percent. Thus, hydrogen serves as the fundamental translator of energy from its solar form to electrical form more effectively, and possibly more efficiently, than direct conversion. Hydrogen also can produce other chemical energy forms using solar energy.

SOURCES AND RADIATIVE PROPERTIES OF ORGANOSULFATES IN THE ATMOSPHERE

EPA Science Inventory

It is expected that these studies will provide mechanistic insight to how SOA forms under acidic conditions and how it impacts direct and indirect radiative forcing. Understanding the chemical and physical properties of SOA will lead to future advancements in the predictive...

Innovative forming and fabrication technologies : new opportunities.

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

Davis, B.; Hryn, J.; Energy Systems

2008-01-31

The advent of light metal alloys and advanced materials (polymer, composites, etc.) have brought the possibility of achieving important energy reductions into the full life cycle of these materials, especially in transportation applications. 1 These materials have gained acceptance in the aerospace industry but use of light metal alloys needs to gain wider acceptance in other commercial transportation areas. Among the main reasons for the relatively low use of these materials are the lack of manufacturability, insufficient mechanical properties, and increased material costs due to processing inefficiencies. Considering the enormous potential energy savings associated with the use of light metalmore » alloys and advanced materials in transportation, there is a need to identify R&D opportunities in the fields of materials fabrication and forming aimed at developing materials with high specific mechanical properties combined with energy efficient processes and good manufacturability. This report presents a literature review of the most recent developments in the areas of fabrication and metal forming focusing principally on aluminum alloys. In the first section of the document, the different sheet manufacturing technologies including direct chill (DC) casting and rolling, spray forming, spray rolling, thin slab, and strip casting are reviewed. The second section of the document presents recent research on advanced forming processes. The various forming processes reviewed are: superplastic forming, electromagnetic forming, age forming, warm forming, hydroforming, and incremental forming. Optimization of conventional forming processes is also discussed. Potentially interesting light metal alloys for high structural efficiency including aluminum-scandium, aluminum-lithium, magnesium, titanium, and amorphous metal alloys are also reviewed. This section concludes with a discussion on alloy development for manufacturability. The third section of the document reviews the latest developments in fiber-reinforced composite materials. Emerging curing processes are presented along with a discussion on the possible developments in biocomposite materials. The fourth section presents recent developments in the fabrication of bulk nanomaterials and nanoparticles reinforced materials. Advanced joining technologies are presented in the fifth section. Future research is proposed in the last section.« less

Designing Automated Guidance for Concept Diagrams in Inquiry Instruction

ERIC Educational Resources Information Center

Ryoo, Kihyun; Linn, Marcia C.

2016-01-01

Advances in automated scoring technologies have the potential to support student learning during inquiry instruction by providing timely and adaptive guidance on individual students' responses. To identify which forms of automated guidance can be beneficial for inquiry learning, we compared reflective guidance to directive guidance for…

14 CFR 16.223 - Evidence.

Code of Federal Regulations, 2010 CFR

2010-01-01

... shall be submitted in written form in advance of the oral hearing pursuant to the schedule established in the hearing officer's prehearing conference report. Written direct and rebuttal fact testimony... written testimony and evidence. Except in the case of evidence obtained by subpoena, or in the case of a...

Advances in Experiment Design for High Performance Aircraft

NASA Technical Reports Server (NTRS)

Morelli, Engene A.

1998-01-01

A general overview and summary of recent advances in experiment design for high performance aircraft is presented, along with results from flight tests. General theoretical background is included, with some discussion of various approaches to maneuver design. Flight test examples from the F-18 High Alpha Research Vehicle (HARV) are used to illustrate applications of the theory. Input forms are compared using Cramer-Rao bounds for the standard errors of estimated model parameters. Directions for future research in experiment design for high performance aircraft are identified.

Optimizing the Hot-Corrosion Resistance-of-Novel gamma-Ni+gamma-prime-Ni3A1-Based Alloys and Coatings

DTIC Science & Technology

2006-07-01

TBC benefit Substrale limit 1 1 0 0 ---------- .- -.. . . . . . . --- I single crystal S1000 conventlonally cest allos . .- alloy. E directionally...usually heat treated or processed) forms. Developments in casting technologies made it possible to produce directionally-solidified and single - crystal ...advanced single - crystal superalloys with improved strength meant reductions in chromium and silicon contents. The scale growth and spallation rates can be

Rhodamine B in dissolved and nano-bound forms: Indicators for light-based advanced oxidation processes.

PubMed

Shabat-Hadas, Efrat; Mamane, Hadas; Gitis, Vitaly

2017-10-01

Rhodamine B (RhB) is a water-soluble fluorescent dye that is often used to determine flux and flow direction in biotechnological and environmental applications. In the current research, RhB in soluble (termed free) and virus-bound (termed nano-bound) forms was used as an efficiency indicator for three environmental processes. The degradation of free and nano-bound RhB by (i) direct UV photolysis and (ii) UV/H 2 O 2 advanced oxidation process (AOP) was studied in a collimated beam apparatus equipped with medium-pressure mercury vapor lamp. The degradation by (iii) solar light-induced photocatalysis was studied in a solar simulator with titanium dioxide and bismuth photocatalysts. Results showed negligible RhB degradation by direct UV and solar light, and its nearly linear degradation by UV/H 2 O 2 and photocatalysis/photosensitization in the presence of a solid catalyst. Considerable adsorption of free RhB on bismuth-based catalyst vs. no adsorption of nano-bound RhB on this catalyst or of any form of the dye on titanium dioxide produced two important conclusions. First, the better degradation of free RhB by the bismuth catalyst suggests that close proximity of a catalyst hole and the decomposing molecule significantly influences degradation. Second, the soluble form of the dye might not be the best option for its use as an indicator. Nano-bound RhB showed high potential as an AOP indicator, featuring possible separation from water after the analysis. Copyright © 2017 Elsevier Ltd. All rights reserved.

Recursive Directional Ligation Approach for Cloning Recombinant Spider Silks.

PubMed

Dinjaski, Nina; Huang, Wenwen; Kaplan, David L

2018-01-01

Recent advances in genetic engineering have provided a route to produce various types of recombinant spider silks. Different cloning strategies have been applied to achieve this goal (e.g., concatemerization, step-by-step ligation, recursive directional ligation). Here we describe recursive directional ligation as an approach that allows for facile modularity and control over the size of the genetic cassettes. This approach is based on sequential ligation of genetic cassettes (monomers) where the junctions between them are formed without interrupting key gene sequences with additional base pairs.

The evolution and distribution of life in the Precambrian eon-global perspective and the Indian record.

PubMed

Sharma, M; Shukla, Y

2009-11-01

The discovery of Precambrian microfossils in 1954 opened a new vista of investigations in the field of evolution of life. Although the Precambrian encompasses 87% of the earth's history, the pace of organismal evolution was quite slow. The life forms as categorised today in the three principal domains viz. the Bacteria, the Archaea and the Eucarya evolved during this period. In this paper, we review the advancements made in the Precambrian palaeontology and its contribution in understanding the evolution of life forms on earth. These studies have enriched the data base on the Precambrian life. Most of the direct evidence includes fossil prokaryotes, protists, advanced algal fossils, acritarchs, and the indirect evidence is represented by the stromatolites, trace fossils and geochemical fossils signatures. The Precambrian fossils are preserved in the form of compressions, impressions, and permineralized and biomineralized remains.

A Network for the Future: Forming a Partnership beyond Institutional Walls.

ERIC Educational Resources Information Center

Leslie, Judith W.; Wright, Bill

The feasibility of a partnership between educational institutions and data processing companies is explored. The purpose of a partnership would be to advance institutions technologically by utilizing the best resources of business and education. Attention is directed to a framework based upon a succession of paradigms for explaining stages of data…

Application of Advanced Technologies to Small, Short-haul Air Transports

NASA Technical Reports Server (NTRS)

Adcock, C.; Coverston, C.; Knapton, B.

1980-01-01

A study was conducted of the application of advanced technologies to small, short-haul transport aircraft. A three abreast, 30 passenger design for flights of approximately 100 nautical miles was evaluated. Higher wing loading, active flight control, and a gust alleviation system results in improved ride quality. Substantial savings in fuel and direct operating cost are forecast. An aircraft of this configuration also has significant benefits in forms of reliability and operability which should enable it to sell a total of 450 units through 1990, of which 80% are for airline use.

DOE Advanced Scientific Computing Advisory Committee (ASCAC) Subcommittee Report on Scientific and Technical Information

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

Hey, Tony; Agarwal, Deborah; Borgman, Christine

The Advanced Scientific Computing Advisory Committee (ASCAC) was charged to form a standing subcommittee to review the Department of Energy’s Office of Scientific and Technical Information (OSTI) and to begin by assessing the quality and effectiveness of OSTI’s recent and current products and services and to comment on its mission and future directions in the rapidly changing environment for scientific publication and data. The Committee met with OSTI staff and reviewed available products, services and other materials. This report summaries their initial findings and recommendations.

Quality of Dying in Nursing Home Residents Dying with Dementia: Does Advanced Care Planning Matter? A Nationwide Postmortem Study

PubMed Central

Vandervoort, An; Houttekier, Dirk; Vander Stichele, Robert; van der Steen, Jenny T.; Van den Block, Lieve

2014-01-01

Background Advance care planning is considered a central component of good quality palliative care and especially relevant for people who lose the capacity to make decisions at the end of life, which is the case for many nursing home residents with dementia. We set out to investigate to what extent (1) advance care planning in the form of written advance patient directives and verbal communication with patient and/or relatives about future care and (2) the existence of written advance general practitioner orders are related to the quality of dying of nursing home residents with dementia. Methods Cross-sectional study of deaths (2010) using random cluster-sampling. Representative sample of nursing homes in Flanders, Belgium. Deaths of residents with dementia in a three-month period were reported; for each the nurse most involved in care, GP and closest relative completed structured questionnaires. Findings We identified 101 deaths of residents with dementia in 69 nursing homes (58% response rate). A written advance patient directive was present for 17.5%, GP-orders for 56.7%. Controlling for socio-demographic/clinical characteristics in multivariate regression analyses, chances of having a higher mean rating of emotional well-being (less fear and anxiety) on the Comfort Assessment in Dying with Dementia scale were three times higher with a written advance patient directive and more specifically when having a do-not-resuscitate order (AOR 3.45; CI,1.1–11) than for those without either (AOR 2.99; CI,1.1–8.3). We found no association between verbal communication or having a GP order and quality of dying. Conclusion For nursing home residents with dementia there is a strong association between having a written advance directive and quality of dying. Where wishes are written, relatives report lower levels of emotional distress at the end of life. These results underpin the importance of advance care planning for people with dementia and beginning this process as early as possible. PMID:24614884

A Home-Based Palliative Care Consult Service for Veterans.

PubMed

Golden, Adam G; Antoni, Charles; Gammonley, Denise

2016-11-01

We describe the development and implementation of a home-based palliative care consult service for Veterans with advanced illness. A retrospective chart review was performed on 73 Veterans who received a home-based palliative care consult. Nearly one-third were 80 years of age or older, and nearly one-third had a palliative diagnosis of cancer. The most common interventions of the consult team included discussion of advance directives, completion of a "do not resuscitate" form, reduction/stoppage of at least 1 medication, explanation of diagnosis, referral to home-based primary care program, referral to hospice, and assessment/support for caregiver stress. The home-based consult service was therefore able to address clinical and psychosocial issues that can demonstrate a direct benefit to Veterans, families, and referring clinicians. © The Author(s) 2015.

The MAMMOTH project

NASA Technical Reports Server (NTRS)

Gerchar, Tim

1994-01-01

On the surface MAMMOTH is a high performance 5.25-inch half-high 8mm helical scan tape drive that records a native 20 Gigabytes of data on Advanced Metal Evaporated media at a sustained throughput of 3 Megabyte per second over a high speed SCSI interface, that is scheduled for production in the second half of 1995. But it's much more than that. Inside its custom designed sheet metal enclosure lies one of the greatest technical achievements of its kind. Exabyte's strategic direction is to increase throughput and capacity while continuing to improve drive, data and media reliability to its products. MAMMOTH adheres to that direction and the description of its technical advances is described in this paper. MAMMOTH can be broken down into four main functional assemblies: high-performance integrated digital electronics, high-reliability tape transport mechanism, high-performance scanner, and advanced metal evaporated media. All this technology is packaged into a standard 5.25-inch half-high form factor that dissipates only 15 watts.

Direct imaging detectors for electron microscopy

NASA Astrophysics Data System (ADS)

Faruqi, A. R.; McMullan, G.

2018-01-01

Electronic detectors used for imaging in electron microscopy are reviewed in this paper. Much of the detector technology is based on the developments in microelectronics, which have allowed the design of direct detectors with fine pixels, fast readout and which are sufficiently radiation hard for practical use. Detectors included in this review are hybrid pixel detectors, monolithic active pixel sensors based on CMOS technology and pnCCDs, which share one important feature: they are all direct imaging detectors, relying on directly converting energy in a semiconductor. Traditional methods of recording images in the electron microscope such as film and CCDs, are mentioned briefly along with a more detailed description of direct electronic detectors. Many applications benefit from the use of direct electron detectors and a few examples are mentioned in the text. In recent years one of the most dramatic advances in structural biology has been in the deployment of the new backthinned CMOS direct detectors to attain near-atomic resolution molecular structures with electron cryo-microscopy (cryo-EM). The development of direct detectors, along with a number of other parallel advances, has seen a very significant amount of new information being recorded in the images, which was not previously possible-and this forms the main emphasis of the review.

Kenyan Girls as Agents of Peace: Enhancing the Capacity of Future Women Peacebuilders

ERIC Educational Resources Information Center

Zanoni, Katie

2017-01-01

The role of women in peacebuilding efforts has been recognized through various international instruments that have advanced the ability of women to access the peace table. In order for women to act as leaders, they must possess the capacity to disrupt structural, cultural, and direct forms of violence, engage in peacemaking activities, and employ…

Reductionist Approach in Peptide-Based Nanotechnology.

PubMed

Gazit, Ehud

2018-06-20

The formation of ordered nanostructures by molecular self-assembly of proteins and peptides represents one of the principal directions in nanotechnology. Indeed, polyamides provide superior features as materials with diverse physical properties. A reductionist approach allowed the identification of extremely short peptide sequences, as short as dipeptides, which could form well-ordered amyloid-like β-sheet-rich assemblies comparable to supramolecular structures made of much larger proteins. Some of the peptide assemblies show remarkable mechanical, optical, and electrical characteristics. Another direction of reductionism utilized a natural noncoded amino acid, α-aminoisobutryic acid, to form short superhelical assemblies. The use of this exceptional helix inducer motif allowed the fabrication of single heptad repeats used in various biointerfaces, including their use as surfactants and DNA-binding agents. Two additional directions of the reductionist approach include the use of peptide nucleic acids (PNAs) and coassembly techniques. The diversified accomplishments of the reductionist approach, as well as the exciting future advances it bears, are discussed.

Exploiting Advanced Hydrogel Technologies to Address Key Challenges in Regenerative Medicine

PubMed Central

Gentleman, Eileen

2018-01-01

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

The do-not-resuscitate order: associations with advance directives, physician specialty and documentation of discussion 15 years after the Patient Self-Determination Act.

PubMed

Morrell, E D; Brown, B P; Qi, R; Drabiak, K; Helft, P R

2008-09-01

Since the passage of the Patient Self-Determination Act, numerous policy mandates and institutional measures have been implemented. It is unknown to what extent those measures have affected end-of-life care, particularly with regard to the do-not-resuscitate (DNR) order. Retrospective cohort study to assess associations of the frequency and timing of DNR orders with advance directive status, patient demographics, physician's specialty and extent of documentation of discussion on end-of-life care. DNR orders were more frequent for patients on a medical service than on a surgical service (77.34% vs 64.20%, p = 0.02) and were made earlier in the hospital stay for medicine than for surgical patients (adjusted mean ratio of time from DNR orders to death versus total length of stay 0.30 for internists vs 0.21 for surgeons, p = 0.04). 22.18% of all patients had some form of an advance directive in their chart, yet this variable had no impact on the frequency or timing of DNR ordering. Documentation of DNR discussion was significantly associated with the frequency of DNR orders and the time from DNR to death (2.1 days with no or minimal discussion vs 2.8 days with extensive discussion, p<0.01). The physician's specialty continues to have a significant impact on the frequency and timing of DNR orders, while advance directive status still has no measurable impact. Additionally, documentation of end-of-life discussions is significantly associated with varying DNR ordering rates and timing.

Psychiatric Advance Directives in India: What will the future hold?

PubMed

Ratnam, Ashutosh; Rudra, Abhijit; Chatterjee, K; Das, R C

2015-08-01

Psychiatric Advance Directives (PADs) have been incorporated into India's Mental Health Care Bill, 2013. This is the first time any form of Advance Directive stands to receive legal sanction in India. PADs have numerous theoretical and empirically tenable therapeutic and financial advantages. Western experiences have shown high acceptance for the concept among psychiatric patients, and illustrated that most stable patients with severe mental illness retain the capacity to frame PADs consistent with community practice standards. However active psychopathology does impair this capacity, and therein, current subjective assessments of competence performed by Physicians without objective instruments are often inaccurate. Though PADs champion patient autonomy, when applied and studied, they have shown little significant advantage-there is currently not enough data to support evidence-based universal recommendations for PADs. PADs as incorporated into the Mental Health Care Bill model on existing Western statutes, and though many of the strengths of earlier systems have been subsumed, so have several of the shortcomings. The risks, benefits and applicability of PADs in India are complicated by the social re-calibration of patient autonomy, mental-healthcare delivery system weaknesses, and the relatively peripheral role the Psychiatrist is mandated to play in the entire advance directive process. Treating patients within the framework of their pre-stated wishes will be a much more intricate and arduous task than most of modern Psychiatric practice in India, but the difficulties, obstacles and inevitable failures encountered will provide evidence of the delivery system's weaknesses and thereby contribute to its strength. Copyright © 2015 Elsevier B.V. All rights reserved.

Challenges in implementing an advance care planning programme in long-term care.

PubMed

McGlade, Ciara; Daly, Edel; McCarthy, Joan; Cornally, Nicola; Weathers, Elizabeth; O'Caoimh, Rónán; Molloy, D William

2017-02-01

A high prevalence of cognitive impairment and frailty complicates the feasibility of advance care planning in the long-term-care population. Research aim: To identify challenges in implementing the 'Let Me Decide' advance care planning programme in long-term-care. This feasibility study had two phases: (1) staff education on advance care planning and (2) structured advance care planning by staff with residents and families. Participants and research context: long-term-care residents in two nursing homes and one community hospital. Ethical considerations: The local research ethics committee granted ethical approval. Following implementation, over 50% of all residents had completed some form of end-of-life care plan. Of the 70 residents who died in the post-implementation period, 14% had no care plan, 10% (with capacity) completed an advance care directive and lacking such capacity, 76% had an end-of-life care plan completed for them by the medical team, following discussions with the resident (if able) and family. The considerable logistical challenge of releasing staff for training triggered development of an e-learning programme to facilitate training. The challenges encountered were largely concerned with preserving resident's autonomy, avoiding harm and suboptimal or crisis decision-making, and ensuring residents were treated fairly through optimisation of finite resources. Although it may be too late for many long-term-care residents to complete their own advance care directive, the ' Let Me Decide' programme includes a feasible and acceptable option for structured end-of-life care planning for residents with variable capacity to complete an advance care directive, involving discussion with the resident (to the extent they were able) and their family. While end-of-life care planning was time-consuming to deliver, nursing staff were willing to overcome this and take ownership of the programme, once the benefits in improved communication and enhanced peace of mind among all parties involved became apparent in practice.

Supersonic aerodynamic characteristics of an advanced F-16 derivative aircraft configuration

NASA Technical Reports Server (NTRS)

Fox, Mike C.; Forrest, Dana K.

1993-01-01

A supersonic wind tunnel investigation was conducted in the NASA Langley Unitary Plan Wind Tunnel on an advanced derivative configuration of the United States Air Force F-16 fighter. Longitudinal and lateral directional force and moment data were obtained at Mach numbers of 1.60 to 2.16 to evaluate basic performance parameters and control effectiveness. The aerodynamic characteristics for the F-16 derivative model were compared with the data obtained for the F-16C model and also with a previously tested generic wing model that features an identical plan form shape and similar twist distribution.

Predictors of advance directives among nursing home residents with dementia.

PubMed

Huang, Hsiu-Li; Shyu, Yea-Ing Lotus; Weng, Li-Chueh; Chen, Kang-Hua; Hsu, Wen-Chuin

2018-03-01

ABSTRACTBackground:Advance directives are important for nursing home residents with dementia; for those with advanced dementia, surrogates determine medical decisions. However, in Taiwan, little is known about what influences the completion of these advance directives. The purpose of this study was to identify factors, which influence the presence of advance directives for nursing home residents with dementia in Taiwan. Our cross-sectional study analyzed a convenience sample of 143 nursing home dyads comprised of residents with dementia and family surrogates. Documentation of residents' advance directives, physical and cognitive status was obtained from medical charts. Surrogates completed the stress of end-of-life care decision scale and a questionnaire regarding their demographic characteristics. Nursing home characteristics were obtained from each chief administrator. Less than half of the nursing home residents (39.2%) had advance directives and most (96.4%) had been completed by family surrogates. The following were predictors of an advance directive: surrogates had previously signed a do-not-resuscitate as a proxy and had been informed of advance directives by a healthcare provider; nursing homes had policies for advance directives and a religious affiliation. Advance directives were uncommon for nursing home residents with dementia. Presence of an advance directive was associated with surrogate characteristics and the nursing home facilities; there was no association with characteristics of the nursing home resident. Our findings emphasize the need to develop policies and strategies, which ensure that all residents of nursing homes and their surrogates are aware of their right to an advance directive.

Advanced Supersonic Nozzle Concepts: Experimental Flow Visualization Results Paired With LES

NASA Astrophysics Data System (ADS)

Berry, Matthew; Magstadt, Andrew; Stack, Cory; Gaitonde, Datta; Glauser, Mark; Syracuse University Team; The Ohio State University Team

2015-11-01

Advanced supersonic nozzle concepts are currently under investigation, utilizing multiple bypass streams and airframe integration to bolster performance and efficiency. This work focuses on the parametric study of a supersonic, multi-stream jet with aft deck. The single plane of symmetry, rectangular nozzle, displays very complex and unique flow characteristics. Flow visualization techniques in the form of PIV and schlieren capture flow features at various deck lengths and Mach numbers. LES is compared to the experimental results to both validate the computational model and identify limitations of the simulation. By comparing experimental results to LES, this study will help create a foundation of knowledge for advanced nozzle designs in future aircraft. SBIR Phase II with Spectral Energies, LLC under direction of Barry Kiel.

Virus-based Photo-Responsive Nanowires Formed By Linking Site-Directed Mutagenesis and Chemical Reaction

NASA Astrophysics Data System (ADS)

Murugesan, Murali; Abbineni, Gopal; Nimmo, Susan L.; Cao, Binrui; Mao, Chuanbin

2013-05-01

Owing to the genetic flexibility and error-free bulk production, bio-nanostructures such as filamentous phage showed great potential in materials synthesis, however, their photo-responsive behaviour is neither explored nor unveiled. Here we show M13 phage genetically engineered with tyrosine residues precisely fused to the major coat protein is converted into a photo-responsive organic nanowire by a site-specific chemical reaction with an aromatic amine to form an azo dye structure on the surface. The resulting azo-M13-phage nanowire exhibits reversible photo-responsive properties due to the photo-switchable cis-trans isomerisation of the azo unit formed on the phage. This result shows that site-specific display of a peptide on bio-nanostructures through site-directed genetic mutagenesis can be translated into site-directed chemical reaction for developing advanced materials. The photo-responsive properties of the azo-M13-phage nanowires may open the door for the development of light controllable smart devices for use in non-linear optics, holography data storage, molecular antenna, and actuators.

Virus-based Photo-Responsive Nanowires Formed By Linking Site-Directed Mutagenesis and Chemical Reaction

PubMed Central

Murugesan, Murali; Abbineni, Gopal; Nimmo, Susan L.; Cao, Binrui; Mao, Chuanbin

2013-01-01

Owing to the genetic flexibility and error-free bulk production, bio-nanostructures such as filamentous phage showed great potential in materials synthesis, however, their photo-responsive behaviour is neither explored nor unveiled. Here we show M13 phage genetically engineered with tyrosine residues precisely fused to the major coat protein is converted into a photo-responsive organic nanowire by a site-specific chemical reaction with an aromatic amine to form an azo dye structure on the surface. The resulting azo-M13-phage nanowire exhibits reversible photo-responsive properties due to the photo-switchable cis-trans isomerisation of the azo unit formed on the phage. This result shows that site-specific display of a peptide on bio-nanostructures through site-directed genetic mutagenesis can be translated into site-directed chemical reaction for developing advanced materials. The photo-responsive properties of the azo-M13-phage nanowires may open the door for the development of light controllable smart devices for use in non-linear optics, holography data storage, molecular antenna, and actuators. PMID:23673356

Modeling and Modification of the Electromagnetic Properties of Advanced Composite Materials.

DTIC Science & Technology

1980-01-01

Direction 𔃾 into x tpaper L2JI F L TRANSVERSE CONDuCTIVmf !( oDK FIGUR 1-2 ’I I _ _ _ _ _ _ _ _ _ _ _ _ _ _ T-1 14 Pe’u are the electron, hole mobilities and...Otte and Lipsitt [4]. One of the conclusions of (5] is to characterize CYD boron as a collection of small crystallites of the 3-rhombohedral form

Aviation Support Equipment Technician (ASE 3 & 2 and ASM 3 & 2). Volume 1, Basics. Rate Training Manual and Nonresident Career Course.

ERIC Educational Resources Information Center

Grant, Jesse R.; And Others

This Rate Training Manual and Nonresident Career Course (RTM/NRCC) form a self-study package that will enable aviation support equipment personnel to help themselves fulfill the requirements for advancement. Designed for individual study and not formal classroom instruction, the RTM provides subject matter that relates directly to the occupational…

Japanese citizens' attitude toward end-of-life care and advance directives: A qualitative study for members of medical cooperatives.

PubMed

Hirayama, Yoko; Otani, Takashi; Matsushima, Masato

2017-12-01

Japanese citizens are interested in choosing their own end-of-life care, but few have created their own advance directive. This study examined changes among Japanese citizens' attitudes toward end-of-life care and advance directives and explored factors that affected these attitudes. We conducted five focus groups with 48 participants in 2009 and 2010. All participants were members of health cooperatives in Tokyo. We identified many barriers and reasons for creating and writing down advance directives. Experience caring for dying people and having a serious disease affected attitudes toward advance directives. Some participants changed their attitude toward end-of-life care by writing their own advance directive. When someone is writing advance directives, asking about his/her past experience of caring may be helpful. And learning about or filling out advance directives may help to break down resistance to using these documents.

Diverting lava flows in the lab

USGS Publications Warehouse

Dietterich, Hannah; Cashman, Katharine V.; Rust, Alison C.; Lev, Einat

2015-01-01

Recent volcanic eruptions in Hawai'i, Iceland and Cape Verde highlight the challenges of mitigating hazards when lava flows threaten infrastructure. Diversion barriers are the most common form of intervention, but historical attempts to divert lava flows have met with mixed success and there has been little systematic analysis of optimal barrier design. We examine the interaction of viscous flows of syrup and molten basalt with barriers in the laboratory. We find that flows thicken immediately upslope of an obstacle, forming a localized bow wave that can overtop barriers. Larger bow waves are generated by faster flows and by obstacles oriented at a high angle to the flow direction. The geometry of barriers also influences flow behaviour. Barriers designed to split or dam flows will slow flow advance, but cause the flow to widen, whereas oblique barriers can effectively divert flows, but may also accelerate flow advance. We argue that to be successful, mitigation of lava-flow hazards must incorporate the dynamics of lava flow–obstacle interactions into barrier design. The same generalizations apply to the effect of natural topographic features on flow geometry and advance rates.

Fluctuating capacity and advance decision-making in Bipolar Affective Disorder - Self-binding directives and self-determination.

PubMed

Gergel, Tania; Owen, Gareth S

2015-01-01

For people with Bipolar Affective Disorder, a self-binding (advance) directive (SBD), by which they commit themselves to treatment during future episodes of mania, even if unwilling, can seem the most rational way to deal with an imperfect predicament. Knowing that mania will almost certainly cause enormous damage to themselves, their preferred solution may well be to allow trusted others to enforce treatment and constraint, traumatic though this may be. No adequate provision exists for drafting a truly effective SBD and efforts to establish such provision are hampered by very valid, but also paralysing ethical, clinical and legal concerns. Effectively, the autonomy and rights of people with bipolar are being 'protected' through being denied an opportunity to protect themselves. From a standpoint firmly rooted in the clinical context and experience of mania, this article argues that an SBD, based on a patient-centred evaluation of capacity to make treatment decisions (DMC-T) and grounded within the clinician-patient relationship, could represent a legitimate and ethically coherent form of self-determination. After setting out background information on fluctuating capacity, mania and advance directives, this article proposes a framework for constructing such an SBD, and considers common objections, possible solutions and suggestions for future research. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Fluctuating capacity and advance decision-making in Bipolar Affective Disorder — Self-binding directives and self-determination

PubMed Central

Gergel, Tania; Owen, Gareth S.

2015-01-01

For people with Bipolar Affective Disorder, a self-binding (advance) directive (SBD), by which they commit themselves to treatment during future episodes of mania, even if unwilling, can seem the most rational way to deal with an imperfect predicament. Knowing that mania will almost certainly cause enormous damage to themselves, their preferred solution may well be to allow trusted others to enforce treatment and constraint, traumatic though this may be. No adequate provision exists for drafting a truly effective SBD and efforts to establish such provision are hampered by very valid, but also paralysing ethical, clinical and legal concerns. Effectively, the autonomy and rights of people with bipolar are being ‘protected’ through being denied an opportunity to protect themselves. From a standpoint firmly rooted in the clinical context and experience of mania, this article argues that an SBD, based on a patient-centred evaluation of capacity to make treatment decisions (DMC-T) and grounded within the clinician–patient relationship, could represent a legitimate and ethically coherent form of self-determination. After setting out background information on fluctuating capacity, mania and advance directives, this article proposes a framework for constructing such an SBD, and considers common objections, possible solutions and suggestions for future research. PMID:25939286

[Attitudes on euthanasia and medical advance directives].

PubMed

van Oorschot, B; Lipp, V; Tietze, A; Nickel, N; Simon, A

2005-02-11

With regard to medical decisions and measures at the end of life, the values and attitudes of those concerned are crucial. However, they have hardly been taken into account so far in German empirical studies on euthanasia and medical advance directives. Between October 2003 and May 2004, a mail survey of a representative group of internists, anaesthetists and general practitioners from Bavaria, Westphalia-Lippe and Thuringia was conducted. Of 1,557 mailed questionnaires 727 were returned (rate of returns: 46 %). The survey showed, high of appreciation for medical advance directives and, at the same, time scepticism regarding surrogate decision-making by legal guardians and authorized representatives. Furthermore, the survey revealed a considerable amount of uncertainty in the physicians about the application of certain measures at the end of life to the different forms of euthanasia. In practice, many physicians do not comprehend the juridical differentiation between (illegal) active and (legal) passive or indirect euthanasia. In training and further education more scope should be given to the reflection of medical decisions at the end of life. At the same time, the usual, partly counterintuitive legal definitions should be brought more into line with medical decision making, while taking into account developments in English speaking areas. A transdisciplinary discourse is indispensable for the development of medical ethical and legal justifications suitable as guidance for action.

Search for Tensor, Vector, and Scalar Polarizations in the Stochastic Gravitational-Wave Background

NASA Astrophysics Data System (ADS)

Abbott, B. P.; Abbott, R.; Abbott, T. D.; Acernese, F.; Ackley, K.; Adams, C.; Adams, T.; Addesso, P.; Adhikari, R. X.; Adya, V. B.; Affeldt, C.; Afrough, M.; Agarwal, B.; Agathos, M.; Agatsuma, K.; Aggarwal, N.; Aguiar, O. D.; Aiello, L.; Ain, A.; Ajith, P.; Allen, B.; Allen, G.; Allocca, A.; Altin, P. A.; Amato, A.; Ananyeva, A.; Anderson, S. B.; Anderson, W. G.; Angelova, S. V.; Antier, S.; Appert, S.; Arai, K.; Araya, M. C.; Areeda, J. S.; Arnaud, N.; Ascenzi, S.; Ashton, G.; Ast, M.; Aston, S. M.; Astone, P.; Atallah, D. V.; Aufmuth, P.; Aulbert, C.; AultONeal, K.; Austin, C.; Avila-Alvarez, A.; Babak, S.; Bacon, P.; Bader, M. K. M.; Bae, S.; Baker, P. T.; Baldaccini, F.; Ballardin, G.; Ballmer, S. W.; Banagiri, S.; Barayoga, J. C.; Barclay, S. E.; Barish, B. C.; Barker, D.; Barkett, K.; Barone, F.; Barr, B.; Barsotti, L.; Barsuglia, M.; Barta, D.; Bartlett, J.; Bartos, I.; Bassiri, R.; Basti, A.; Batch, J. C.; Bawaj, M.; Bayley, J. C.; Bazzan, M.; Bécsy, B.; Beer, C.; Bejger, M.; Belahcene, I.; Bell, A. S.; Berger, B. K.; Bergmann, G.; Bero, J. J.; Berry, C. P. L.; Bersanetti, D.; Bertolini, A.; Betzwieser, J.; Bhagwat, S.; Bhandare, R.; Bilenko, I. A.; Billingsley, G.; Billman, C. R.; Birch, J.; Birney, R.; Birnholtz, O.; Biscans, S.; Biscoveanu, S.; Bisht, A.; Bitossi, M.; Biwer, C.; Bizouard, M. A.; Blackburn, J. K.; Blackman, J.; Blair, C. D.; Blair, D. G.; Blair, R. M.; Bloemen, S.; Bock, O.; Bode, N.; Boer, M.; Bogaert, G.; Bohe, A.; Bondu, F.; Bonilla, E.; Bonnand, R.; Boom, B. A.; Bork, R.; Boschi, V.; Bose, S.; Bossie, K.; Bouffanais, Y.; Bozzi, A.; Bradaschia, C.; Brady, P. R.; Branchesi, M.; Brau, J. E.; Briant, T.; Brillet, A.; Brinkmann, M.; Brisson, V.; Brockill, P.; Broida, J. E.; Brooks, A. F.; Brown, D. A.; Brown, D. D.; Brunett, S.; Buchanan, C. C.; Buikema, A.; Bulik, T.; Bulten, H. J.; Buonanno, A.; Buskulic, D.; Buy, C.; Byer, R. L.; Cabero, M.; Cadonati, L.; Cagnoli, G.; Cahillane, C.; Calderón Bustillo, J.; Callister, T. A.; Calloni, E.; Camp, J. B.; Canepa, M.; Canizares, P.; Cannon, K. C.; Cao, H.; Cao, J.; Capano, C. D.; Capocasa, E.; Carbognani, F.; Caride, S.; Carney, M. F.; Diaz, J. Casanueva; Casentini, C.; Caudill, S.; Cavaglià, M.; Cavalier, F.; Cavalieri, R.; Cella, G.; Cepeda, C. B.; Cerdá-Durán, P.; Cerretani, G.; Cesarini, E.; Chamberlin, S. J.; Chan, M.; Chao, S.; Charlton, P.; Chase, E.; Chassande-Mottin, E.; Chatterjee, D.; Cheeseboro, B. D.; Chen, H. Y.; Chen, X.; Chen, Y.; Cheng, H.-P.; Chia, H.; Chincarini, A.; Chiummo, A.; Chmiel, T.; Cho, H. S.; Cho, M.; Chow, J. H.; Christensen, N.; Chu, Q.; Chua, A. J. K.; Chua, S.; Chung, A. K. W.; Chung, S.; Ciani, G.; Ciolfi, R.; Cirelli, C. E.; Cirone, A.; Clara, F.; Clark, J. A.; Clearwater, P.; Cleva, F.; Cocchieri, C.; Coccia, E.; Cohadon, P.-F.; Cohen, D.; Colla, A.; Collette, C. G.; Cominsky, L. R.; Constancio, M.; Conti, L.; Cooper, S. J.; Corban, P.; Corbitt, T. R.; Cordero-Carrión, I.; Corley, K. R.; Cornish, N.; Corsi, A.; Cortese, S.; Costa, C. A.; Coughlin, E.; Coughlin, M. W.; Coughlin, S. B.; Coulon, J.-P.; Countryman, S. T.; Couvares, P.; Covas, P. B.; Cowan, E. E.; Coward, D. M.; Cowart, M. J.; Coyne, D. C.; Coyne, R.; Creighton, J. D. E.; Creighton, T. D.; Cripe, J.; Crowder, S. G.; Cullen, T. J.; Cumming, A.; Cunningham, L.; Cuoco, E.; Canton, T. Dal; Dálya, G.; Danilishin, S. L.; D'Antonio, S.; Danzmann, K.; Dasgupta, A.; Da Silva Costa, C. F.; Dattilo, V.; Dave, I.; Davier, M.; Davis, D.; Daw, E. J.; Day, B.; De, S.; DeBra, D.; Degallaix, J.; De Laurentis, M.; Deléglise, S.; Del Pozzo, W.; Demos, N.; Denker, T.; Dent, T.; De Pietri, R.; Dergachev, V.; De Rosa, R.; DeRosa, R. T.; De Rossi, C.; DeSalvo, R.; de Varona, O.; Devenson, J.; Dhurandhar, S.; Díaz, M. C.; Di Fiore, L.; Di Giovanni, M.; Di Girolamo, T.; Di Lieto, A.; Di Pace, S.; Di Palma, I.; Di Renzo, F.; Doctor, Z.; Dolique, V.; Donovan, F.; Dooley, K. L.; Doravari, S.; Dorrington, I.; Douglas, R.; Dovale Álvarez, M.; Downes, T. P.; Drago, M.; Dreissigacker, C.; Driggers, J. C.; Du, Z.; Ducrot, M.; Dupej, P.; Dwyer, S. E.; Edo, T. B.; Edwards, M. C.; Effler, A.; Eggenstein, H.-B.; Ehrens, P.; Eichholz, J.; Eikenberry, S. S.; Eisenstein, R. A.; Essick, R. C.; Estevez, D.; Etienne, Z. B.; Etzel, T.; Evans, M.; Evans, T. M.; Factourovich, M.; Fafone, V.; Fair, H.; Fairhurst, S.; Fan, X.; Farinon, S.; Farr, B.; Farr, W. M.; Fauchon-Jones, E. J.; Favata, M.; Fays, M.; Fee, C.; Fehrmann, H.; Feicht, J.; Fejer, M. M.; Fernandez-Galiana, A.; Ferrante, I.; Ferreira, E. C.; Ferrini, F.; Fidecaro, F.; Finstad, D.; Fiori, I.; Fiorucci, D.; Fishbach, M.; Fisher, R. P.; Fitz-Axen, M.; Flaminio, R.; Fletcher, M.; Fong, H.; Font, J. A.; Forsyth, P. W. F.; Forsyth, S. S.; Fournier, J.-D.; Frasca, S.; Frasconi, F.; Frei, Z.; Freise, A.; Frey, R.; Frey, V.; Fries, E. M.; Fritschel, P.; Frolov, V. V.; Fulda, P.; Fyffe, M.; Gabbard, H.; Gadre, B. U.; Gaebel, S. M.; Gair, J. R.; Gammaitoni, L.; Ganija, M. R.; Gaonkar, S. G.; Garcia-Quiros, C.; Garufi, F.; Gateley, B.; Gaudio, S.; Gaur, G.; Gayathri, V.; Gehrels, N.; Gemme, G.; Genin, E.; Gennai, A.; George, D.; George, J.; Gergely, L.; Germain, V.; Ghonge, S.; Ghosh, Abhirup; Ghosh, Archisman; Ghosh, S.; Giaime, J. A.; Giardina, K. D.; Giazotto, A.; Gill, K.; Glover, L.; Goetz, E.; Goetz, R.; Gomes, S.; Goncharov, B.; González, G.; Gonzalez Castro, J. M.; Gopakumar, A.; Gorodetsky, M. L.; Gossan, S. E.; Gosselin, M.; Gouaty, R.; Grado, A.; Graef, C.; Granata, M.; Grant, A.; Gras, S.; Gray, C.; Greco, G.; Green, A. C.; Gretarsson, E. M.; Groot, P.; Grote, H.; Grunewald, S.; Gruning, P.; Guidi, G. M.; Guo, X.; Gupta, A.; Gupta, M. K.; Gushwa, K. E.; Gustafson, E. K.; Gustafson, R.; Halim, O.; Hall, B. R.; Hall, E. D.; Hamilton, E. Z.; Hammond, G.; Haney, M.; Hanke, M. M.; Hanks, J.; Hanna, C.; Hannam, M. D.; Hannuksela, O. A.; Hanson, J.; Hardwick, T.; Harms, J.; Harry, G. M.; Harry, I. W.; Hart, M. J.; Haster, C.-J.; Haughian, K.; Healy, J.; Heidmann, A.; Heintze, M. C.; Heitmann, H.; Hello, P.; Hemming, G.; Hendry, M.; Heng, I. S.; Hennig, J.; Heptonstall, A. W.; Heurs, M.; Hild, S.; Hinderer, T.; Hoak, D.; Hofman, D.; Holt, K.; Holz, D. E.; Hopkins, P.; Horst, C.; Hough, J.; Houston, E. A.; Howell, E. J.; Hreibi, A.; Hu, Y. M.; Huerta, E. A.; Huet, D.; Hughey, B.; Husa, S.; Huttner, S. H.; Huynh-Dinh, T.; Indik, N.; Inta, R.; Intini, G.; Isa, H. N.; Isac, J.-M.; Isi, M.; Iyer, B. R.; Izumi, K.; Jacqmin, T.; Jani, K.; Jaranowski, P.; Jawahar, S.; Jiménez-Forteza, F.; Johnson, W. W.; Jones, D. I.; Jones, R.; Jonker, R. J. G.; Ju, L.; Junker, J.; Kalaghatgi, C. V.; Kalogera, V.; Kamai, B.; Kandhasamy, S.; Kang, G.; Kanner, J. B.; Kapadia, S. J.; Karki, S.; Karvinen, K. S.; Kasprzack, M.; Katolik, M.; Katsavounidis, E.; Katzman, W.; Kaufer, S.; Kawabe, K.; Kéfélian, F.; Keitel, D.; Kemball, A. J.; Kennedy, R.; Kent, C.; Key, J. S.; Khalili, F. Y.; Khan, I.; Khan, S.; Khan, Z.; Khazanov, E. A.; Kijbunchoo, N.; Kim, Chunglee; Kim, J. C.; Kim, K.; Kim, W.; Kim, W. S.; Kim, Y.-M.; Kimbrell, S. J.; King, E. J.; King, P. J.; Kinley-Hanlon, M.; Kirchhoff, R.; Kissel, J. S.; Kleybolte, L.; Klimenko, S.; Knowles, T. D.; Koch, P.; Koehlenbeck, S. M.; Koley, S.; Kondrashov, V.; Kontos, A.; Korobko, M.; Korth, W. Z.; Kowalska, I.; Kozak, D. B.; Krämer, C.; Kringel, V.; Królak, A.; Kuehn, G.; Kumar, P.; Kumar, R.; Kumar, S.; Kuo, L.; Kutynia, A.; Kwang, S.; Lackey, B. D.; Lai, K. H.; Landry, M.; Lang, R. N.; Lange, J.; Lantz, B.; Lanza, R. K.; Lartaux-Vollard, A.; Lasky, P. D.; Laxen, M.; Lazzarini, A.; Lazzaro, C.; Leaci, P.; Leavey, S.; Lee, C. H.; Lee, H. K.; Lee, H. M.; Lee, H. W.; Lee, K.; Lehmann, J.; Lenon, A.; Leonardi, M.; Leroy, N.; Letendre, N.; Levin, Y.; Li, T. G. F.; Linker, S. D.; Littenberg, T. B.; Liu, J.; Lo, R. K. L.; Lockerbie, N. A.; London, L. T.; Lord, J. E.; Lorenzini, M.; Loriette, V.; Lormand, M.; Losurdo, G.; Lough, J. D.; Lousto, C. O.; Lovelace, G.; Lück, H.; Lumaca, D.; Lundgren, A. P.; Lynch, R.; Ma, Y.; Macas, R.; Macfoy, S.; Machenschalk, B.; MacInnis, M.; Macleod, D. M.; Magaña Hernandez, I.; Magaña-Sandoval, F.; Magaña Zertuche, L.; Magee, R. M.; Majorana, E.; Maksimovic, I.; Man, N.; Mandic, V.; Mangano, V.; Mansell, G. L.; Manske, M.; Mantovani, M.; Marchesoni, F.; Marion, F.; Márka, S.; Márka, Z.; Markakis, C.; Markosyan, A. S.; Markowitz, A.; Maros, E.; Marquina, A.; Martelli, F.; Martellini, L.; Martin, I. W.; Martin, R. M.; Martynov, D. V.; Mason, K.; Massera, E.; Masserot, A.; Massinger, T. J.; Masso-Reid, M.; Mastrogiovanni, S.; Matas, A.; Matichard, F.; Matone, L.; Mavalvala, N.; Mazumder, N.; McCarthy, R.; McClelland, D. E.; McCormick, S.; McCuller, L.; McGuire, S. C.; McIntyre, G.; McIver, J.; McManus, D. J.; McNeill, L.; McRae, T.; McWilliams, S. T.; Meacher, D.; Meadors, G. D.; Mehmet, M.; Meidam, J.; Mejuto-Villa, E.; Melatos, A.; Mendell, G.; Mercer, R. A.; Merilh, E. L.; Merzougui, M.; Meshkov, S.; Messenger, C.; Messick, C.; Metzdorff, R.; Meyers, P. M.; Miao, H.; Michel, C.; Middleton, H.; Mikhailov, E. E.; Milano, L.; Miller, A. L.; Miller, B. B.; Miller, J.; Millhouse, M.; Milovich-Goff, M. C.; Minazzoli, O.; Minenkov, Y.; Ming, J.; Mishra, C.; Mitra, S.; Mitrofanov, V. P.; Mitselmakher, G.; Mittleman, R.; Moffa, D.; Moggi, A.; Mogushi, K.; Mohan, M.; Mohapatra, S. R. P.; Montani, M.; Moore, C. J.; Moraru, D.; Moreno, G.; Morriss, S. R.; Mours, B.; Mow-Lowry, C. M.; Mueller, G.; Muir, A. W.; Mukherjee, Arunava; Mukherjee, D.; Mukherjee, S.; Mukund, N.; Mullavey, A.; Munch, J.; Muñiz, E. A.; Muratore, M.; Murray, P. G.; Napier, K.; Nardecchia, I.; Naticchioni, L.; Nayak, R. K.; Neilson, J.; Nelemans, G.; Nelson, T. J. N.; Nery, M.; Neunzert, A.; Nevin, L.; Newport, J. M.; Newton, G.; Ng, K. K. Y.; Nguyen, T. T.; Nichols, D.; Nielsen, A. B.; Nissanke, S.; Nitz, A.; Noack, A.; Nocera, F.; Nolting, D.; North, C.; Nuttall, L. K.; Oberling, J.; O'Dea, G. D.; Ogin, G. H.; Oh, J. J.; Oh, S. H.; Ohme, F.; Okada, M. A.; Oliver, M.; Oppermann, P.; Oram, Richard J.; O'Reilly, B.; Ormiston, R.; Ortega, L. F.; O'Shaughnessy, R.; Ossokine, S.; Ottaway, D. J.; Overmier, H.; Owen, B. J.; Pace, A. E.; Page, J.; Page, M. A.; Pai, A.; Pai, S. A.; Palamos, J. R.; Palashov, O.; Palomba, C.; Pal-Singh, A.; Pan, Howard; Pan, Huang-Wei; Pang, B.; Pang, P. T. H.; Pankow, C.; Pannarale, F.; Pant, B. C.; Paoletti, F.; Paoli, A.; Papa, M. A.; Parida, A.; Parker, W.; Pascucci, D.; Pasqualetti, A.; Passaquieti, R.; Passuello, D.; Patil, M.; Patricelli, B.; Pearlstone, B. L.; Pedraza, M.; Pedurand, R.; Pekowsky, L.; Pele, A.; Penn, S.; Perez, C. J.; Perreca, A.; Perri, L. M.; Pfeiffer, H. P.; Phelps, M.; Piccinni, O. J.; Pichot, M.; Piergiovanni, F.; Pierro, V.; Pillant, G.; Pinard, L.; Pinto, I. M.; Pirello, M.; Pitkin, M.; Poe, M.; Poggiani, R.; Popolizio, P.; Porter, E. K.; Post, A.; Powell, J.; Prasad, J.; Pratt, J. W. W.; Pratten, G.; Predoi, V.; Prestegard, T.; Prijatelj, M.; Principe, M.; Privitera, S.; Prodi, G. A.; Prokhorov, L. G.; Puncken, O.; Punturo, M.; Puppo, P.; Pürrer, M.; Qi, H.; Quetschke, V.; Quintero, E. A.; Quitzow-James, R.; Raab, F. J.; Rabeling, D. S.; Radkins, H.; Raffai, P.; Raja, S.; Rajan, C.; Rajbhandari, B.; Rakhmanov, M.; Ramirez, K. E.; Ramos-Buades, A.; Rapagnani, P.; Raymond, V.; Razzano, M.; Read, J.; Regimbau, T.; Rei, L.; Reid, S.; Reitze, D. H.; Ren, W.; Reyes, S. D.; Ricci, F.; Ricker, P. M.; Rieger, S.; Riles, K.; Rizzo, M.; Robertson, N. A.; Robie, R.; Robinet, F.; Rocchi, A.; Rolland, L.; Rollins, J. G.; Roma, V. J.; Romano, J. D.; Romano, R.; Romel, C. L.; Romie, J. H.; Rosińska, D.; Ross, M. P.; Rowan, S.; Rüdiger, A.; Ruggi, P.; Rutins, G.; Ryan, K.; Sachdev, S.; Sadecki, T.; Sadeghian, L.; Sakellariadou, M.; Salconi, L.; Saleem, M.; Salemi, F.; Samajdar, A.; Sammut, L.; Sampson, L. M.; Sanchez, E. J.; Sanchez, L. E.; Sanchis-Gual, N.; Sandberg, V.; Sanders, J. R.; Sassolas, B.; Saulson, P. R.; Sauter, O.; Savage, R. L.; Sawadsky, A.; Schale, P.; Scheel, M.; Scheuer, J.; Schmidt, J.; Schmidt, P.; Schnabel, R.; Schofield, R. M. S.; Schönbeck, A.; Schreiber, E.; Schuette, D.; Schulte, B. W.; Schutz, B. F.; Schwalbe, S. G.; Scott, J.; Scott, S. M.; Seidel, E.; Sellers, D.; Sengupta, A. S.; Sentenac, D.; Sequino, V.; Sergeev, A.; Shaddock, D. A.; Shaffer, T. J.; Shah, A. A.; Shahriar, M. S.; Shaner, M. B.; Shao, L.; Shapiro, B.; Shawhan, P.; Sheperd, A.; Shoemaker, D. H.; Shoemaker, D. M.; Siellez, K.; Siemens, X.; Sieniawska, M.; Sigg, D.; Silva, A. D.; Singer, L. P.; Singh, A.; Singhal, A.; Sintes, A. M.; Slagmolen, B. J. J.; Smith, B.; Smith, J. R.; Smith, R. J. E.; Somala, S.; Son, E. J.; Sonnenberg, J. A.; Sorazu, B.; Sorrentino, F.; Souradeep, T.; Spencer, A. P.; Srivastava, A. K.; Staats, K.; Staley, A.; Steinke, M.; Steinlechner, J.; Steinlechner, S.; Steinmeyer, D.; Stevenson, S. P.; Stone, R.; Stops, D. J.; Strain, K. A.; Stratta, G.; Strigin, S. E.; Strunk, A.; Sturani, R.; Stuver, A. L.; Summerscales, T. Z.; Sun, L.; Sunil, S.; Suresh, J.; Sutton, P. J.; Swinkels, B. L.; Szczepańczyk, M. J.; Tacca, M.; Tait, S. C.; Talbot, C.; Talukder, D.; Tanner, D. B.; Tao, D.; Tápai, M.; Taracchini, A.; Tasson, J. D.; Taylor, J. A.; Taylor, R.; Tewari, S. V.; Theeg, T.; Thies, F.; Thomas, E. G.; Thomas, M.; Thomas, P.; Thorne, K. A.; Thrane, E.; Tiwari, S.; Tiwari, V.; Tokmakov, K. V.; Toland, K.; Tonelli, M.; Tornasi, Z.; Torres-Forné, A.; Torrie, C. I.; Töyrä, D.; Travasso, F.; Traylor, G.; Trinastic, J.; Tringali, M. C.; Trozzo, L.; Tsang, K. W.; Tse, M.; Tso, R.; Tsukada, L.; Tsuna, D.; Tuyenbayev, D.; Ueno, K.; Ugolini, D.; Unnikrishnan, C. S.; Urban, A. L.; Usman, S. A.; Vahlbruch, H.; Vajente, G.; Valdes, G.; van Bakel, N.; van Beuzekom, M.; van den Brand, J. F. J.; Van Den Broeck, C.; Vander-Hyde, D. C.; van der Schaaf, L.; van Heijningen, J. V.; van Veggel, A. A.; Vardaro, M.; Varma, V.; Vass, S.; Vasúth, M.; Vecchio, A.; Vedovato, G.; Veitch, J.; Veitch, P. J.; Venkateswara, K.; Venugopalan, G.; Verkindt, D.; Vetrano, F.; Viceré, A.; Viets, A. D.; Vinciguerra, S.; Vine, D. J.; Vinet, J.-Y.; Vitale, S.; Vo, T.; Vocca, H.; Vorvick, C.; Vyatchanin, S. P.; Wade, A. R.; Wade, L. E.; Wade, M.; Walet, R.; Walker, M.; Wallace, L.; Walsh, S.; Wang, G.; Wang, H.; Wang, J. Z.; Wang, W. H.; Wang, Y. F.; Ward, R. L.; Warner, J.; Was, M.; Watchi, J.; Weaver, B.; Wei, L.-W.; Weinert, M.; Weinstein, A. J.; Weiss, R.; Wen, L.; Wessel, E. K.; Weßels, P.; Westerweck, J.; Westphal, T.; Wette, K.; Whelan, J. T.; Whiting, B. F.; Whittle, C.; Wilken, D.; Williams, D.; Williams, R. D.; Williamson, A. R.; Willis, J. L.; Willke, B.; Wimmer, M. H.; Winkler, W.; Wipf, C. C.; Wittel, H.; Woan, G.; Woehler, J.; Wofford, J.; Wong, K. W. K.; Worden, J.; Wright, J. L.; Wu, D. S.; Wysocki, D. M.; Xiao, S.; Yamamoto, H.; Yancey, C. C.; Yang, L.; Yap, M. J.; Yazback, M.; Yu, Hang; Yu, Haocun; Yvert, M.; ZadroŻny, A.; Zanolin, M.; Zelenova, T.; Zendri, J.-P.; Zevin, M.; Zhang, L.; Zhang, M.; Zhang, T.; Zhang, Y.-H.; Zhao, C.; Zhou, M.; Zhou, Z.; Zhu, S. J.; Zhu, X. J.; Zucker, M. E.; Zweizig, J.; LIGO Scientific Collaboration; Virgo Collaboration

2018-05-01

The detection of gravitational waves with Advanced LIGO and Advanced Virgo has enabled novel tests of general relativity, including direct study of the polarization of gravitational waves. While general relativity allows for only two tensor gravitational-wave polarizations, general metric theories can additionally predict two vector and two scalar polarizations. The polarization of gravitational waves is encoded in the spectral shape of the stochastic gravitational-wave background, formed by the superposition of cosmological and individually unresolved astrophysical sources. Using data recorded by Advanced LIGO during its first observing run, we search for a stochastic background of generically polarized gravitational waves. We find no evidence for a background of any polarization, and place the first direct bounds on the contributions of vector and scalar polarizations to the stochastic background. Under log-uniform priors for the energy in each polarization, we limit the energy densities of tensor, vector, and scalar modes at 95% credibility to Ω0T<5.58 ×10-8 , Ω0V<6.35 ×10-8 , and Ω0S<1.08 ×10-7 at a reference frequency f0=25 Hz .

Facilitated Psychiatric Advance Directives: A Randomized Trial of an Intervention to Foster Advance Treatment Planning Among Persons with Severe Mental Illness

PubMed Central

Swanson, Jeffrey W.; Swartz, Marvin S.; Elbogen, Eric B.; Van Dorn, Richard A.; Ferron, Joelle; Wagner, H. Ryan; McCauley, Barbara J.; Kim, Mimi

2013-01-01

Objective Studies show a high potential demand for psychiatric advance directives but low completion rates. The authors conducted a randomized study of a structured, manualized intervention to facilitate completion of psychiatric advance directives. Method A total of 469 patients with severe mental illness were randomly assigned to a facilitated psychiatric advance directive session or a control group that received written information about psychiatric advance directives and referral to resources in the public mental health system. Completion of an advance directive, its structure and content, and its short-term effects on working alliance and treatment satisfaction were recorded. Results Sixty-one percent of participants in the facilitated session completed an advance directive or authorized a proxy decision maker, compared with only 3% of control group participants. Psychiatrists rated the advance directives as highly consistent with standards of community practice. Most participants used the advance directive to refuse some medications and to express preferences for admission to specific hospitals and not others, although none used an advance directive to refuse all treatment. At 1-month follow-up, participants in the facilitated session had a greater working alliance with their clinicians and were more likely than those in the control group to report receiving the mental health services they believed they needed. Conclusions The facilitation session is an effective method of helping patients complete psychiatric advance directives and ensuring that the documents contain useful information about patients’ treatment preferences. Achieving the promise of psychiatric advance directives may require system-level policies to embed facilitation of these instruments in usual-care care settings. PMID:17074946

Enhanced propagation modeling of directional aviation noise: A hybrid parabolic equation-fast field program method

NASA Astrophysics Data System (ADS)

Rosenbaum, Joyce E.

2011-12-01

Commercial air traffic is anticipated to increase rapidly in the coming years. The impact of aviation noise on communities surrounding airports is, therefore, a growing concern. Accurate prediction of noise can help to mitigate the impact on communities and foster smoother integration of aerospace engineering advances. The problem of accurate sound level prediction requires careful inclusion of all mechanisms that affect propagation, in addition to correct source characterization. Terrain, ground type, meteorological effects, and source directivity can have a substantial influence on the noise level. Because they are difficult to model, these effects are often included only by rough approximation. This dissertation presents a model designed for sound propagation over uneven terrain, with mixed ground type and realistic meteorological conditions. The model is a hybrid of two numerical techniques: the parabolic equation (PE) and fast field program (FFP) methods, which allow for physics-based inclusion of propagation effects and ensure the low frequency content, a factor in community impact, is predicted accurately. Extension of the hybrid model to a pseudo-three-dimensional representation allows it to produce aviation noise contour maps in the standard form. In order for the model to correctly characterize aviation noise sources, a method of representing arbitrary source directivity patterns was developed for the unique form of the parabolic equation starting field. With this advancement, the model can represent broadband, directional moving sound sources, traveling along user-specified paths. This work was prepared for possible use in the research version of the sound propagation module in the Federal Aviation Administration's new standard predictive tool.

Asymmetric and speed-dependent contact angle hysteresis and relaxation of a suddenly stopped moving contact line

NASA Astrophysics Data System (ADS)

Guan, Dongshi; Wang, Yong Jian; Charlaix, Elisabeth; Tong, Penger

We report direct atomic-force-microscope measurements of capillary force hysteresis and relaxation of a circular moving contact line (CL) formed on a long micron-sized hydrophobic fiber intersecting a water-air interface. The measured capillary force hysteresis and CL relaxation show a strong asymmetric speed dependence in the advancing and receding directions. A unified model based on force-assisted barrier-crossing is utilized to find the underlying energy barrier Eb and size λ associated with the defects on the fiber surface. The experiment demonstrates that the pinning (relaxation) and depinning dynamics of the CL can be described by a common microscopic frame-work, and the advancing and receding CLs are influenced by two different sets of relatively wetting and non-wetting defects on the fiber surface. Work supported in part by the Research Grants Council of Hong Kong SAR.

Prevalence and predictors of advance directives in Australia.

PubMed

White, B; Tilse, C; Wilson, J; Rosenman, L; Strub, T; Feeney, R; Silvester, W

2014-10-01

Advance care planning is regarded as integral to better patient outcomes, yet little is known about the prevalence of advance directives (AD) in Australia. To determine the prevalence of AD in the Australian population. A national telephone survey about estate and advance planning. Sample was stratified by age (18-45 and >45 years) and quota sampling occurred based on population size in each state and territory. Fourteen per cent of the Australian population has an AD. There is state variation with people from South Australia and Queensland more likely to have an AD than people from other states. Will making and particularly completion of a financial enduring power of attorney are associated with higher rates of AD completion. Standard demographic variables were of limited use in predicting whether a person would have an AD. Despite efforts to improve uptake of advance care planning (including AD), barriers remain. One likely trigger for completing an AD and advance care planning is undertaking a wider future planning process (e.g. making a will or financial enduring power of attorney). This presents opportunities to increase advance care planning, but steps are needed to ensure that planning, which occurs outside the health system, is sufficiently informed and supported by health information so that it is useful in the clinical setting. Variations by state could also suggest that redesign of regulatory frameworks (such as a user-friendly and well-publicised form backed by statute) may help improve uptake of AD. © 2014 The Authors; Internal Medicine Journal © 2014 Royal Australasian College of Physicians.

An incremental strategy for calculating consistent discrete CFD sensitivity derivatives

NASA Technical Reports Server (NTRS)

Korivi, Vamshi Mohan; Taylor, Arthur C., III; Newman, Perry A.; Hou, Gene W.; Jones, Henry E.

1992-01-01

In this preliminary study involving advanced computational fluid dynamic (CFD) codes, an incremental formulation, also known as the 'delta' or 'correction' form, is presented for solving the very large sparse systems of linear equations which are associated with aerodynamic sensitivity analysis. For typical problems in 2D, a direct solution method can be applied to these linear equations which are associated with aerodynamic sensitivity analysis. For typical problems in 2D, a direct solution method can be applied to these linear equations in either the standard or the incremental form, in which case the two are equivalent. Iterative methods appear to be needed for future 3D applications; however, because direct solver methods require much more computer memory than is currently available. Iterative methods for solving these equations in the standard form result in certain difficulties, such as ill-conditioning of the coefficient matrix, which can be overcome when these equations are cast in the incremental form; these and other benefits are discussed. The methodology is successfully implemented and tested in 2D using an upwind, cell-centered, finite volume formulation applied to the thin-layer Navier-Stokes equations. Results are presented for two laminar sample problems: (1) transonic flow through a double-throat nozzle; and (2) flow over an isolated airfoil.

Numerical Control/Computer Aided Manufacturing (NC/CAM), A Descom Study

DTIC Science & Technology

1979-07-01

CAM machines operate directly from computers, but most get instructions in the form of punched tape. The applications of NC/CAM are virtually...Although most NC/CAM equipment is metal working, its applications include electronics manufacturing, glass making, food processing, materiel handling...drafting, woodworking, plastics and inspection, just to name a few. Numerical control, like most technologies, is an advancing and evolutionary process

Advance Directives as Support of Autonomy for Persons with Dementia? A Pilot Study among Persons with Dementia and Their Informal Caregivers.

PubMed

Schmidhuber, Martina; Haeupler, Sandra; Marinova-Schmidt, Velislava; Frewer, Andreas; Kolominsky-Rabas, Peter L

2017-01-01

Advance directives could be an important instrument to support a person's will once he/she is not able to consent anymore - if composed competently. A survey was conducted to identify the level of knowledge concerning possibilities and limits of advance directives. The study was conducted as part of the Bavarian Dementia Survey (BayDem). Data were collected from January 2014 to December 2015 by structured face-to-face interviews. Study participants were persons with dementia and their informal caregivers ( n = 74). In total, 66% reported having written an advance directive. Concerning the participants' knowledge about possibilities and limitations of advance directives, a lack of knowledge was noted about the possibility to revoke an advance directive. Furthermore, 70% of informal caregivers and 56% of persons with dementia were not aware of the possibility to include dementia-specific terms in the advance directive. It is necessary to optimize structures for public information and education concerning the topic of advance directives for persons with dementia.

Advances in the management of malignant mesothelioma.

PubMed

Khalil, Mazen Y; Mapa, Marissa; Shin, Hyung Ju C; Shin, Dong M

2003-07-01

Malignant mesotheliomas are very aggressive tumors that originate from mesothelial cells, which form the serosal lining of the pleura, pericardial, and peritoneal cavities. Finding effective chemotherapeutic treatment for malignant mesothelioma is a challenge. There is no standard treatment because this tumor is relatively resistant to therapy. A resurgence of interest has been expressed in novel therapies and conventional treatments used in different ways. Several treatment modalities have been studied, including chemotherapy, radiotherapy, surgery, and immunotherapy. Chemotherapy can be administered systemically or directly into the pleura. This review presents the results of the most recent trials and highlights the most promising advances in the battle against this aggressive disease.

Advances in the development of new tuberculosis drugs and treatment regimens.

PubMed

Zumla, Alimuddin; Nahid, Payam; Cole, Stewart T

2013-05-01

Despite the introduction 40 years ago of the inexpensive and effective four-drug (isoniazid, rifampicin, pyrazinamide and ethambutol) treatment regimen, tuberculosis (TB) continues to cause considerable morbidity and mortality worldwide. For the first time since the 1960s, new and novel drugs and regimens for all forms of TB are emerging. Such regimens are likely to utilize both repurposed drugs and new chemical entities, and several of these regimens are now progressing through clinical trials. This article covers current concepts and recent advances in TB drug discovery and development, including an update of ongoing TB treatment trials, newer clinical trial designs, TB biomarkers and adjunct host-directed therapies.

Online Statistical Modeling (Regression Analysis) for Independent Responses

NASA Astrophysics Data System (ADS)

Made Tirta, I.; Anggraeni, Dian; Pandutama, Martinus

2017-06-01

Regression analysis (statistical analmodelling) are among statistical methods which are frequently needed in analyzing quantitative data, especially to model relationship between response and explanatory variables. Nowadays, statistical models have been developed into various directions to model various type and complex relationship of data. Rich varieties of advanced and recent statistical modelling are mostly available on open source software (one of them is R). However, these advanced statistical modelling, are not very friendly to novice R users, since they are based on programming script or command line interface. Our research aims to developed web interface (based on R and shiny), so that most recent and advanced statistical modelling are readily available, accessible and applicable on web. We have previously made interface in the form of e-tutorial for several modern and advanced statistical modelling on R especially for independent responses (including linear models/LM, generalized linier models/GLM, generalized additive model/GAM and generalized additive model for location scale and shape/GAMLSS). In this research we unified them in the form of data analysis, including model using Computer Intensive Statistics (Bootstrap and Markov Chain Monte Carlo/ MCMC). All are readily accessible on our online Virtual Statistics Laboratory. The web (interface) make the statistical modeling becomes easier to apply and easier to compare them in order to find the most appropriate model for the data.

Relationship of social support and decisional conflict to advance directives attitude in Korean older adults: A community-based cross-sectional study.

PubMed

Lee, JuHee; Jung, Dukyoo; Choi, MoonKi

2016-01-01

The aim of this study was to clarify the relationship between social support, decisional conflict, and attitude towards advance directives, and determine whether decisional conflict mediates the relation between social support and advance directives attitude among older adults in South Korea. In total, 209 community-based older adults (mean age, 74.82 years) participated in this cross-sectional study. Demographic characteristics, self-perceived health status, social support, decisional conflict, and advance directives attitude were investigated via a structured questionnaire. Data analysis was carried out using Pearson's correlation and path analyses. The mean score of advance directives attitude was 48.01 (range, 35-61). Decisional conflict and social support were both significantly related to advance directives attitude (P < 0.001). Additionally, decisional conflict was a mediator between social support and advance directives attitudes. The results confirmed the importance of social support for reducing decisional conflict and encouraging positive attitudes toward advance directives. Future studies are needed to support the development of culturally sensitive educational approaches regarding advance directives for older adults in Korea. © 2015 The Authors. Japan Journal of Nursing Science © 2015 Japan Academy of Nursing Science.

The efficacy of self-directed modules for clinical learning: advanced competencies in entry-level physical therapy education.

PubMed

Peck, Kirk; Paschal, Karen; Black, Lisa; Nelson, Kelly

2014-01-01

Prior to graduation, students often express an interest to advance clinical and professional skills in teaching, research, administration, and various niche practice areas. The acquisition of advanced education in selected areas of practice is believed to improve employment opportunities, accelerate career advancement including eligibility for professional certifications, and contribute to personal satisfaction in the profession. The purpose of this paper is to (1) describe an innovative model of education, the Directed Practice Experience (DPE) elective, that incorporates a student-initiated learning process designed to achieve student-identified professional goals, and (2) report the outcomes for graduates who have completed the DPE in an entry-level program in physical therapy education. Students who met select criteria were eligible to complete a DPE. Applicants designed a 4- to 6-week clinical education experience consisting of stated rationale for personal and professional growth, examples of leadership and service, and self-directed objectives that are beyond entry-level expectations as measured by the revised Physical Therapist Clinical Performance Instrument, version 2006. Twenty-six students have completed DPEs since 2005. Fifty percent resulted in new academic partnerships. At least 25% of graduates now serve as clinical instructors for the entry-level program. Those who participated in DPEs have also completed post-graduate residencies, attained ABPTS Board certifications, authored peer-reviewed publications, and taught in both PT and residency programs. The DPE model allows qualified students to acquire advanced personal skills and knowledge prior to graduation in areas of professional practice that exceed entry-level expectations. The model is applicable to all CAPTE accredited physical therapy education programs and is especially beneficial for academic programs desiring to form new community partnerships for student clinical education.

Tax-exempt hospitals and community benefit: new directions in policy and practice.

PubMed

Rubin, Daniel B; Singh, Simone R; Young, Gary J

2015-03-18

The current community benefit standard for nonprofit hospital tax exemption has been the subject of mounting criticism. Many different constituencies have advanced the view that in its present form it fails to ensure that nonprofit hospitals provide adequate benefits to their communities in exchange for their tax exemption. In contrast, hospitals have often expressed the concern that the community benefit standard in its current form is vague and therefore difficult to comply with. Various suggestions have been made regarding how the existing community benefit standard could be improved or even replaced. In this article, we first discuss the historical and legal development of the community benefit standard. We then present the key controversies that have emerged in recent years and the policy responses attempted thus far. Finally, we evaluate possible future policy directions, which reform efforts could follow.

Spermidine Suppresses Age-Associated Memory Impairment by Preventing Adverse Increase of Presynaptic Active Zone Size and Release

PubMed Central

Gupta, Varun K.; Pech, Ulrike; Fulterer, Andreas; Ender, Anatoli; Mauermann, Stephan F.; Andlauer, Till F. M.; Beuschel, Christine; Thriene, Kerstin; Quentin, Christine; Schwärzel, Martin; Mielke, Thorsten; Madeo, Frank; Dengjel, Joern; Fiala, André; Sigrist, Stephan J.

2016-01-01

Memories are assumed to be formed by sets of synapses changing their structural or functional performance. The efficacy of forming new memories declines with advancing age, but the synaptic changes underlying age-induced memory impairment remain poorly understood. Recently, we found spermidine feeding to specifically suppress age-dependent impairments in forming olfactory memories, providing a mean to search for synaptic changes involved in age-dependent memory impairment. Here, we show that a specific synaptic compartment, the presynaptic active zone (AZ), increases the size of its ultrastructural elaboration and releases significantly more synaptic vesicles with advancing age. These age-induced AZ changes, however, were fully suppressed by spermidine feeding. A genetically enforced enlargement of AZ scaffolds (four gene-copies of BRP) impaired memory formation in young animals. Thus, in the Drosophila nervous system, aging AZs seem to steer towards the upper limit of their operational range, limiting synaptic plasticity and contributing to impairment of memory formation. Spermidine feeding suppresses age-dependent memory impairment by counteracting these age-dependent changes directly at the synapse. PMID:27684064

Advancing the Theory of Nuclear Reactions with Rare Isotopes: From the Laboratory to the Cosmos

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

Elster, Charlotte

2015-06-01

The mission of the TORUS Topical Collaboration is to develop new methods that will advance nuclear reaction theory for unstable isotopes by using three-body techniques to improve direct-reaction calculations, and, by using a new partial-fusion theory, to integrate descriptions of direct and compound-nucleus reactions. Ohio University concentrates its efforts on the first part of the mission. Since direct measurements are often not feasible, indirect methods, e.g. (d,p) reactions, should be used. Those (d,p) reactions may be viewed as three-body reactions and described with Faddeev techniques. Faddeev equations in momentum space have a long tradition of utilizing separable interactions in ordermore » to arrive at sets of coupled integral equations in one variable. While there exist several separable representations for the nucleon-nucleon interaction, the optical potential between a neutron (proton) and a nucleus is not readily available in separable form. For this reason we first embarked in introducing a separable representation for complex phenomenological optical potentials of Woods-Saxon type.« less

Primary healthcare NZ nurses' experiences of advance directives: understanding their potential role.

PubMed

Davidson, Raewyn; Banister, Elizabeth; de Vries, Kay

2013-07-01

Advance directives are one aspect of advance care planning designed to improve end of life care. The New Zealand Nurses Organisation released their first mission statement in 2010 concerning advance directives suggesting an increase in the use of these. A burgeoning older population, expected to rise over the next few years, places the primary healthcare nurse in a pivotal role to address the challenges in constructing advance directives. While literature supports the role for primary healthcare nurses in promoting advance directives, no research was found on this role in the New Zealand context. This paper presents results of a qualitative study conducted in New Zealand with 13 senior primary healthcare nurses with respect to their knowledge, attitudes, and experiences of advance directives. Results of the analysis revealed a dynamic process involving participants coming to understand their potential role in this area. This process included reflection on personal experience with advance directives; values and ethics related to end of life issues; and professional actions.

Psychiatric Advance Directives: Getting Started

MedlinePlus

... the United States View PDF Type of PADs Federal Law on Advance Directives View PDF “Introducing Psychiatric Advance ... Ph.D., M.L.S. View video (12:08) “Federal Law on Advance Directives: The Patient Self-Determination Act” ...

Advance Directives as Support of Autonomy for Persons with Dementia? A Pilot Study among Persons with Dementia and Their Informal Caregivers

PubMed Central

Schmidhuber, Martina; Haeupler, Sandra; Marinova-Schmidt, Velislava; Frewer, Andreas; Kolominsky-Rabas, Peter L.

2017-01-01

Background Advance directives could be an important instrument to support a person's will once he/she is not able to consent anymore – if composed competently. A survey was conducted to identify the level of knowledge concerning possibilities and limits of advance directives. Methods The study was conducted as part of the Bavarian Dementia Survey (BayDem). Data were collected from January 2014 to December 2015 by structured face-to-face interviews. Study participants were persons with dementia and their informal caregivers (n = 74). Results In total, 66% reported having written an advance directive. Concerning the participants' knowledge about possibilities and limitations of advance directives, a lack of knowledge was noted about the possibility to revoke an advance directive. Furthermore, 70% of informal caregivers and 56% of persons with dementia were not aware of the possibility to include dementia-specific terms in the advance directive. Conclusion It is necessary to optimize structures for public information and education concerning the topic of advance directives for persons with dementia. PMID:29118785

Advance directives: cancer patients' preferences and family-based decision making.

PubMed

Xing, Yan-Fang; Lin, Jin-Xiang; Li, Xing; Lin, Qu; Ma, Xiao-Kun; Chen, Jie; Wu, Dong-Hao; Wei, Li; Yin, Liang-Hong; Wu, Xiang-Yuan

2017-07-11

Advance directives are a sensitive issue among traditional Chinese people, who usually refrain from mentioning this topic until it is imperative. Medical decisions for cancer patients are made by their families, and these decisions might violate patients' personal will. This study aimed to examine the acceptance of advance directives among Chinese cancer patients and their families and patient participation in this procedure and, finally, to analyze the moral risk involved. While 246 patients and their family members refused official discussion of an advance directive, the remaining 166 patients and their families accepted the concept of an advance directive and signed a document agreeing to give up invasive treatment when the anti-cancer treatment was terminated. Of these, only 24 patients participated in the decision making. For 101 patients, anti-cancer therapy was ended prematurely with as many as 37 patients not told about their potential loss of health interests. Participants were 412 adult cancer patients from 9 leading hospitals across China. An advance directive was introduced to the main decision makers for each patient; if they wished to sign it, the advance directive would be systematically discussed. A questionnaire was given to the oncologists in charge of each patient to evaluate the interaction between families and patients, patients' awareness of their disease, and participation in an advance directive. Advance directives were not widely accepted among Chinese cancer patients unless anti-cancer therapy was terminated. Most cancer patients were excluded from the discussion of an advance directive.

Encounters With Health-Care Providers and Advance Directive Completion by Older Adults.

PubMed

Koss, Catheryn

2018-01-01

The Patient Self-Determination Act (PSDA) requires hospitals, home health agencies, nursing homes, and hospice providers to offer new patients information about advance directives. There is little evidence regarding whether encounters with these health-care providers prompt advance directive completion by patients. To examine whether encounters with various types of health-care providers were associated with higher odds of completing advance directives by older patients. Logistic regression using longitudinal data from the 2012 and 2014 waves of the Health and Retirement Study. Participants were 3752 US adults aged 65 and older who reported not possessing advance directives in 2012. Advance directive was defined as a living will and/or durable power of attorney for health care. Four binary variables measured whether participants had spent at least 1 night in a hospital, underwent outpatient surgery, received home health or hospice care, or spent at least one night in a nursing home between 2012 and 2014. Older adults who received hospital, nursing home, or home health/hospice care were more likely to complete advance directives. Outpatient surgery was not associated with advance directive completion. Older adults with no advance directive in 2012 who encountered health-care providers covered by the PSDA were more likely to have advance directives by 2014. The exception was outpatient surgery which is frequently provided in freestanding surgery centers not subject to PSDA mandates. It may be time to consider amending the PSDA to cover freestanding surgery centers.

Investigation into the Fiber Orientation Effect on the Formability of GLARE Materials in the Stamp Forming Process

NASA Astrophysics Data System (ADS)

Liu, Shichen; Lang, Lihui; Sherkatghanad, Ehsan; Wang, Yao; Xu, Wencai

2018-04-01

Glass-reinforced aluminum laminate (GLARE) is a new class of fiber metal laminates (FMLs) which has the advantages such as high tensile strength, outstanding fatigue, impact resistance, and excellent corrosion properties. GLARE has been extensively applied in advanced aerospace and automobile industries. However, the deformation behavior of the glass fiber during forming must be studied to the benefits of the good-quality part we form. In this research, we focus on the effect of fiber layer orientation on the GLARE laminate formability in stamp forming process. Experimental and numerical analysis of stamping a hemisphere part in different fiber orientation is investigated. The results indicate that unidirectional and multi-directional fiber in the middle layer make a significant effect on the thinning and also surface forming quality of the three layer sheet. Furthermore, the stress-strain distribution of the aluminum alloy and the unique anisotropic property of the fiber layer exhibit that fiber layer orientation can also affect the forming depths as well as the fracture modes of the laminate. According to the obtained results, it is revealed that multi-directional fiber layers are a good alternative compared to the unidirectional fibers especially when a better formability is the purpose.

Effective Light Directed Assembly of Building Blocks with Microscale Control.

PubMed

Dinh, Ngoc-Duy; Luo, Rongcong; Christine, Maria Tankeh Asuncion; Lin, Weikang Nicholas; Shih, Wei-Chuan; Goh, James Cho-Hong; Chen, Chia-Hung

2017-06-01

Light-directed forces have been widely used to pattern micro/nanoscale objects with precise control, forming functional assemblies. However, a substantial laser intensity is required to generate sufficient optical gradient forces to move a small object in a certain direction, causing limited throughput for applications. A high-throughput light-directed assembly is demonstrated as a printing technology by introducing gold nanorods to induce thermal convection flows that move microparticles (diameter = 40 µm to several hundreds of micrometers) to specific light-guided locations, forming desired patterns. With the advantage of effective light-directed assembly, the microfluidic-fabricated monodispersed biocompatible microparticles are used as building blocks to construct a structured assembly (≈10 cm scale) in ≈2 min. The control with microscale precision is approached by changing the size of the laser light spot. After crosslinking assembly of building blocks, a novel soft material with wanted pattern is approached. To demonstrate its application, the mesenchymal stem-cell-seeded hydrogel microparticles are prepared as functional building blocks to construct scaffold-free tissues with desired structures. This light-directed fabrication method can be applied to integrate different building units, enabling the bottom-up formation of materials with precise control over their internal structure for bioprinting, tissue engineering, and advanced manufacturing. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Recent Trends in Advance Directives at Nursing Home Admission and One Year after Admission

ERIC Educational Resources Information Center

McAuley, William J.; Buchanan, Robert J.; Travis, Shirley S.; Wang, Suojin; Kim, MyungSuk

2006-01-01

Purpose: Advance directives are important planning and decision-making tools for individuals in nursing homes. Design and Methods: By using the nursing facility Minimum Data Set, we examined the prevalence of advance directives at admission and 12 months post-admission. Results: The prevalence of having any advance directive at admission declined…

22 CFR 72.30 - Provisions in a will or advanced directive regarding disposition of remains.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Provisions in a will or advanced directive... Decreased United States Citizen Or National § 72.30 Provisions in a will or advanced directive regarding disposition of remains. United States state law regarding advance directives, deaths and estates include...

Advance directives: survey of primary care patients.

PubMed

O'Sullivan, Rory; Mailo, Kevin; Angeles, Ricardo; Agarwal, Gina

2015-04-01

To establish the prevalence of patients with advance directives in a family practice, and to describe patients' perspectives on a family doctor's role in initiating discussions about advance directives. A self-administered patient questionnaire. A busy urban family medicine teaching clinic in Hamilton, Ont. A convenience sample of adult patients attending the clinic over the course of a typical business week. The prevalence of advance directives in the patient population was determined, and the patients' expectations regarding the role of their family doctors were elucidated. The survey population consisted of 800 participants (a response rate of 72.5%) well distributed across age groups; 19.7% had written advance directives and 43.8% had previously discussed the topic of advance directives, but only 4.3% of these discussions had occurred with family doctors. In 5.7% of cases, a family physician had raised the issue; 72.3% of respondents believed patients should initiate the discussion. Patients who considered advance directives extremely important were significantly more likely to want their family doctors to start the conversation (odds ratio 3.98; P < .05). Advance directives were not routinely addressed in the family practice. Most patients preferred to initiate the discussion of advance directives. However, patients who considered the subject extremely important wanted their family doctors to initiate the discussion. Copyright© the College of Family Physicians of Canada.

Search for Tensor, Vector, and Scalar Polarizations in the Stochastic Gravitational-Wave Background.

PubMed

Abbott, B P; Abbott, R; Abbott, T D; Acernese, F; Ackley, K; Adams, C; Adams, T; Addesso, P; Adhikari, R X; Adya, V B; Affeldt, C; Afrough, M; Agarwal, B; Agathos, M; Agatsuma, K; Aggarwal, N; Aguiar, O D; Aiello, L; Ain, A; Ajith, P; Allen, B; Allen, G; Allocca, A; Altin, P A; Amato, A; Ananyeva, A; Anderson, S B; Anderson, W G; Angelova, S V; Antier, S; Appert, S; Arai, K; Araya, M C; Areeda, J S; Arnaud, N; Ascenzi, S; Ashton, G; Ast, M; Aston, S M; Astone, P; Atallah, D V; Aufmuth, P; Aulbert, C; AultONeal, K; Austin, C; Avila-Alvarez, A; Babak, S; Bacon, P; Bader, M K M; Bae, S; Baker, P T; Baldaccini, F; Ballardin, G; Ballmer, S W; Banagiri, S; Barayoga, J C; Barclay, S E; Barish, B C; Barker, D; Barkett, K; Barone, F; Barr, B; Barsotti, L; Barsuglia, M; Barta, D; Bartlett, J; Bartos, I; Bassiri, R; Basti, A; Batch, J C; Bawaj, M; Bayley, J C; Bazzan, M; Bécsy, B; Beer, C; Bejger, M; Belahcene, I; Bell, A S; Berger, B K; Bergmann, G; Bero, J J; Berry, C P L; Bersanetti, D; Bertolini, A; Betzwieser, J; Bhagwat, S; Bhandare, R; Bilenko, I A; Billingsley, G; Billman, C R; Birch, J; Birney, R; Birnholtz, O; Biscans, S; Biscoveanu, S; Bisht, A; Bitossi, M; Biwer, C; Bizouard, M A; Blackburn, J K; Blackman, J; Blair, C D; Blair, D G; Blair, R M; Bloemen, S; Bock, O; Bode, N; Boer, M; Bogaert, G; Bohe, A; Bondu, F; Bonilla, E; Bonnand, R; Boom, B A; Bork, R; Boschi, V; Bose, S; Bossie, K; Bouffanais, Y; Bozzi, A; Bradaschia, C; Brady, P R; Branchesi, M; Brau, J E; Briant, T; Brillet, A; Brinkmann, M; Brisson, V; Brockill, P; Broida, J E; Brooks, A F; Brown, D A; Brown, D D; Brunett, S; Buchanan, C C; Buikema, A; Bulik, T; Bulten, H J; Buonanno, A; Buskulic, D; Buy, C; Byer, R L; Cabero, M; Cadonati, L; Cagnoli, G; Cahillane, C; Calderón Bustillo, J; Callister, T A; Calloni, E; Camp, J B; Canepa, M; Canizares, P; Cannon, K C; Cao, H; Cao, J; Capano, C D; Capocasa, E; Carbognani, F; Caride, S; Carney, M F; Diaz, J Casanueva; Casentini, C; Caudill, S; Cavaglià, M; Cavalier, F; Cavalieri, R; Cella, G; Cepeda, C B; Cerdá-Durán, P; Cerretani, G; Cesarini, E; Chamberlin, S J; Chan, M; Chao, S; Charlton, P; Chase, E; Chassande-Mottin, E; Chatterjee, D; Cheeseboro, B D; Chen, H Y; Chen, X; Chen, Y; Cheng, H-P; Chia, H; Chincarini, A; Chiummo, A; Chmiel, T; Cho, H S; Cho, M; Chow, J H; Christensen, N; Chu, Q; Chua, A J K; Chua, S; Chung, A K W; Chung, S; Ciani, G; Ciolfi, R; Cirelli, C E; Cirone, A; Clara, F; Clark, J A; Clearwater, P; Cleva, F; Cocchieri, C; Coccia, E; Cohadon, P-F; Cohen, D; Colla, A; Collette, C G; Cominsky, L R; Constancio, M; Conti, L; Cooper, S J; Corban, P; Corbitt, T R; Cordero-Carrión, I; Corley, K R; Cornish, N; Corsi, A; Cortese, S; Costa, C A; Coughlin, E; Coughlin, M W; Coughlin, S B; Coulon, J-P; Countryman, S T; Couvares, P; Covas, P B; Cowan, E E; Coward, D M; Cowart, M J; Coyne, D C; Coyne, R; Creighton, J D E; Creighton, T D; Cripe, J; Crowder, S G; Cullen, T J; Cumming, A; Cunningham, L; Cuoco, E; Canton, T Dal; Dálya, G; Danilishin, S L; D'Antonio, S; Danzmann, K; Dasgupta, A; Da Silva Costa, C F; Dattilo, V; Dave, I; Davier, M; Davis, D; Daw, E J; Day, B; De, S; DeBra, D; Degallaix, J; De Laurentis, M; Deléglise, S; Del Pozzo, W; Demos, N; Denker, T; Dent, T; De Pietri, R; Dergachev, V; De Rosa, R; DeRosa, R T; De Rossi, C; DeSalvo, R; de Varona, O; Devenson, J; Dhurandhar, S; Díaz, M C; Di Fiore, L; Di Giovanni, M; Di Girolamo, T; Di Lieto, A; Di Pace, S; Di Palma, I; Di Renzo, F; Doctor, Z; Dolique, V; Donovan, F; Dooley, K L; Doravari, S; Dorrington, I; Douglas, R; Dovale Álvarez, M; Downes, T P; Drago, M; Dreissigacker, C; Driggers, J C; Du, Z; Ducrot, M; Dupej, P; Dwyer, S E; Edo, T B; Edwards, M C; Effler, A; Eggenstein, H-B; Ehrens, P; Eichholz, J; Eikenberry, S S; Eisenstein, R A; Essick, R C; Estevez, D; Etienne, Z B; Etzel, T; Evans, M; Evans, T M; Factourovich, M; Fafone, V; Fair, H; Fairhurst, S; Fan, X; Farinon, S; Farr, B; Farr, W M; Fauchon-Jones, E J; Favata, M; Fays, M; Fee, C; Fehrmann, H; Feicht, J; Fejer, M M; Fernandez-Galiana, A; Ferrante, I; Ferreira, E C; Ferrini, F; Fidecaro, F; Finstad, D; Fiori, I; Fiorucci, D; Fishbach, M; Fisher, R P; Fitz-Axen, M; Flaminio, R; Fletcher, M; Fong, H; Font, J A; Forsyth, P W F; Forsyth, S S; Fournier, J-D; Frasca, S; Frasconi, F; Frei, Z; Freise, A; Frey, R; Frey, V; Fries, E M; Fritschel, P; Frolov, V V; Fulda, P; Fyffe, M; Gabbard, H; Gadre, B U; Gaebel, S M; Gair, J R; Gammaitoni, L; Ganija, M R; Gaonkar, S G; Garcia-Quiros, C; Garufi, F; Gateley, B; Gaudio, S; Gaur, G; Gayathri, V; Gehrels, N; Gemme, G; Genin, E; Gennai, A; George, D; George, J; Gergely, L; Germain, V; Ghonge, S; Ghosh, Abhirup; Ghosh, Archisman; Ghosh, S; Giaime, J A; Giardina, K D; Giazotto, A; Gill, K; Glover, L; Goetz, E; Goetz, R; Gomes, S; Goncharov, B; González, G; Gonzalez Castro, J M; Gopakumar, A; Gorodetsky, M L; Gossan, S E; Gosselin, M; Gouaty, R; Grado, A; Graef, C; Granata, M; Grant, A; Gras, S; Gray, C; Greco, G; Green, A C; Gretarsson, E M; Groot, P; Grote, H; Grunewald, S; Gruning, P; Guidi, G M; Guo, X; Gupta, A; Gupta, M K; Gushwa, K E; Gustafson, E K; Gustafson, R; Halim, O; Hall, B R; Hall, E D; Hamilton, E Z; Hammond, G; Haney, M; Hanke, M M; Hanks, J; Hanna, C; Hannam, M D; Hannuksela, O A; Hanson, J; Hardwick, T; Harms, J; Harry, G M; Harry, I W; Hart, M J; Haster, C-J; Haughian, K; Healy, J; Heidmann, A; Heintze, M C; Heitmann, H; Hello, P; Hemming, G; Hendry, M; Heng, I S; Hennig, J; Heptonstall, A W; Heurs, M; Hild, S; Hinderer, T; Hoak, D; Hofman, D; Holt, K; Holz, D E; Hopkins, P; Horst, C; Hough, J; Houston, E A; Howell, E J; Hreibi, A; Hu, Y M; Huerta, E A; Huet, D; Hughey, B; Husa, S; Huttner, S H; Huynh-Dinh, T; Indik, N; Inta, R; Intini, G; Isa, H N; Isac, J-M; Isi, M; Iyer, B R; Izumi, K; Jacqmin, T; Jani, K; Jaranowski, P; Jawahar, S; Jiménez-Forteza, F; Johnson, W W; Jones, D I; Jones, R; Jonker, R J G; Ju, L; Junker, J; Kalaghatgi, C V; Kalogera, V; Kamai, B; Kandhasamy, S; Kang, G; Kanner, J B; Kapadia, S J; Karki, S; Karvinen, K S; Kasprzack, M; Katolik, M; Katsavounidis, E; Katzman, W; Kaufer, S; Kawabe, K; Kéfélian, F; Keitel, D; Kemball, A J; Kennedy, R; Kent, C; Key, J S; Khalili, F Y; Khan, I; Khan, S; Khan, Z; Khazanov, E A; Kijbunchoo, N; Kim, Chunglee; Kim, J C; Kim, K; Kim, W; Kim, W S; Kim, Y-M; Kimbrell, S J; King, E J; King, P J; Kinley-Hanlon, M; Kirchhoff, R; Kissel, J S; Kleybolte, L; Klimenko, S; Knowles, T D; Koch, P; Koehlenbeck, S M; Koley, S; Kondrashov, V; Kontos, A; Korobko, M; Korth, W Z; Kowalska, I; Kozak, D B; Krämer, C; Kringel, V; Królak, A; Kuehn, G; Kumar, P; Kumar, R; Kumar, S; Kuo, L; Kutynia, A; Kwang, S; Lackey, B D; Lai, K H; Landry, M; Lang, R N; Lange, J; Lantz, B; Lanza, R K; Lartaux-Vollard, A; Lasky, P D; Laxen, M; Lazzarini, A; Lazzaro, C; Leaci, P; Leavey, S; Lee, C H; Lee, H K; Lee, H M; Lee, H W; Lee, K; Lehmann, J; Lenon, A; Leonardi, M; Leroy, N; Letendre, N; Levin, Y; Li, T G F; Linker, S D; Littenberg, T B; Liu, J; Lo, R K L; Lockerbie, N A; London, L T; Lord, J E; Lorenzini, M; Loriette, V; Lormand, M; Losurdo, G; Lough, J D; Lousto, C O; Lovelace, G; Lück, H; Lumaca, D; Lundgren, A P; Lynch, R; Ma, Y; Macas, R; Macfoy, S; Machenschalk, B; MacInnis, M; Macleod, D M; Magaña Hernandez, I; Magaña-Sandoval, F; Magaña Zertuche, L; Magee, R M; Majorana, E; Maksimovic, I; Man, N; Mandic, V; Mangano, V; Mansell, G L; Manske, M; Mantovani, M; Marchesoni, F; Marion, F; Márka, S; Márka, Z; Markakis, C; Markosyan, A S; Markowitz, A; Maros, E; Marquina, A; Martelli, F; Martellini, L; Martin, I W; Martin, R M; Martynov, D V; Mason, K; Massera, E; Masserot, A; Massinger, T J; Masso-Reid, M; Mastrogiovanni, S; Matas, A; Matichard, F; Matone, L; Mavalvala, N; Mazumder, N; McCarthy, R; McClelland, D E; McCormick, S; McCuller, L; McGuire, S C; McIntyre, G; McIver, J; McManus, D J; McNeill, L; McRae, T; McWilliams, S T; Meacher, D; Meadors, G D; Mehmet, M; Meidam, J; Mejuto-Villa, E; Melatos, A; Mendell, G; Mercer, R A; Merilh, E L; Merzougui, M; Meshkov, S; Messenger, C; Messick, C; Metzdorff, R; Meyers, P M; Miao, H; Michel, C; Middleton, H; Mikhailov, E E; Milano, L; Miller, A L; Miller, B B; Miller, J; Millhouse, M; Milovich-Goff, M C; Minazzoli, O; Minenkov, Y; Ming, J; Mishra, C; Mitra, S; Mitrofanov, V P; Mitselmakher, G; Mittleman, R; Moffa, D; Moggi, A; Mogushi, K; Mohan, M; Mohapatra, S R P; Montani, M; Moore, C J; Moraru, D; Moreno, G; Morriss, S R; Mours, B; Mow-Lowry, C M; Mueller, G; Muir, A W; Mukherjee, Arunava; Mukherjee, D; Mukherjee, S; Mukund, N; Mullavey, A; Munch, J; Muñiz, E A; Muratore, M; Murray, P G; Napier, K; Nardecchia, I; Naticchioni, L; Nayak, R K; Neilson, J; Nelemans, G; Nelson, T J N; Nery, M; Neunzert, A; Nevin, L; Newport, J M; Newton, G; Ng, K K Y; Nguyen, T T; Nichols, D; Nielsen, A B; Nissanke, S; Nitz, A; Noack, A; Nocera, F; Nolting, D; North, C; Nuttall, L K; Oberling, J; O'Dea, G D; Ogin, G H; Oh, J J; Oh, S H; Ohme, F; Okada, M A; Oliver, M; Oppermann, P; Oram, Richard J; O'Reilly, B; Ormiston, R; Ortega, L F; O'Shaughnessy, R; Ossokine, S; Ottaway, D J; Overmier, H; Owen, B J; Pace, A E; Page, J; Page, M A; Pai, A; Pai, S A; Palamos, J R; Palashov, O; Palomba, C; Pal-Singh, A; Pan, Howard; Pan, Huang-Wei; Pang, B; Pang, P T H; Pankow, C; Pannarale, F; Pant, B C; Paoletti, F; Paoli, A; Papa, M A; Parida, A; Parker, W; Pascucci, D; Pasqualetti, A; Passaquieti, R; Passuello, D; Patil, M; Patricelli, B; Pearlstone, B L; Pedraza, M; Pedurand, R; Pekowsky, L; Pele, A; Penn, S; Perez, C J; Perreca, A; Perri, L M; Pfeiffer, H P; Phelps, M; Piccinni, O J; Pichot, M; Piergiovanni, F; Pierro, V; Pillant, G; Pinard, L; Pinto, I M; Pirello, M; Pitkin, M; Poe, M; Poggiani, R; Popolizio, P; Porter, E K; Post, A; Powell, J; Prasad, J; Pratt, J W W; Pratten, G; Predoi, V; Prestegard, T; Prijatelj, M; Principe, M; Privitera, S; Prodi, G A; Prokhorov, L G; Puncken, O; Punturo, M; Puppo, P; Pürrer, M; Qi, H; Quetschke, V; Quintero, E A; Quitzow-James, R; Raab, F J; Rabeling, D S; Radkins, H; Raffai, P; Raja, S; Rajan, C; Rajbhandari, B; Rakhmanov, M; Ramirez, K E; Ramos-Buades, A; Rapagnani, P; Raymond, V; Razzano, M; Read, J; Regimbau, T; Rei, L; Reid, S; Reitze, D H; Ren, W; Reyes, S D; Ricci, F; Ricker, P M; Rieger, S; Riles, K; Rizzo, M; Robertson, N A; Robie, R; Robinet, F; Rocchi, A; Rolland, L; Rollins, J G; Roma, V J; Romano, J D; Romano, R; Romel, C L; Romie, J H; Rosińska, D; Ross, M P; Rowan, S; Rüdiger, A; Ruggi, P; Rutins, G; Ryan, K; Sachdev, S; Sadecki, T; Sadeghian, L; Sakellariadou, M; Salconi, L; Saleem, M; Salemi, F; Samajdar, A; Sammut, L; Sampson, L M; Sanchez, E J; Sanchez, L E; Sanchis-Gual, N; Sandberg, V; Sanders, J R; Sassolas, B; Saulson, P R; Sauter, O; Savage, R L; Sawadsky, A; Schale, P; Scheel, M; Scheuer, J; Schmidt, J; Schmidt, P; Schnabel, R; Schofield, R M S; Schönbeck, A; Schreiber, E; Schuette, D; Schulte, B W; Schutz, B F; Schwalbe, S G; Scott, J; Scott, S M; Seidel, E; Sellers, D; Sengupta, A S; Sentenac, D; Sequino, V; Sergeev, A; Shaddock, D A; Shaffer, T J; Shah, A A; Shahriar, M S; Shaner, M B; Shao, L; Shapiro, B; Shawhan, P; Sheperd, A; Shoemaker, D H; Shoemaker, D M; Siellez, K; Siemens, X; Sieniawska, M; Sigg, D; Silva, A D; Singer, L P; Singh, A; Singhal, A; Sintes, A M; Slagmolen, B J J; Smith, B; Smith, J R; Smith, R J E; Somala, S; Son, E J; Sonnenberg, J A; Sorazu, B; Sorrentino, F; Souradeep, T; Spencer, A P; Srivastava, A K; Staats, K; Staley, A; Steinke, M; Steinlechner, J; Steinlechner, S; Steinmeyer, D; Stevenson, S P; Stone, R; Stops, D J; Strain, K A; Stratta, G; Strigin, S E; Strunk, A; Sturani, R; Stuver, A L; Summerscales, T Z; Sun, L; Sunil, S; Suresh, J; Sutton, P J; Swinkels, B L; Szczepańczyk, M J; Tacca, M; Tait, S C; Talbot, C; Talukder, D; Tanner, D B; Tao, D; Tápai, M; Taracchini, A; Tasson, J D; Taylor, J A; Taylor, R; Tewari, S V; Theeg, T; Thies, F; Thomas, E G; Thomas, M; Thomas, P; Thorne, K A; Thrane, E; Tiwari, S; Tiwari, V; Tokmakov, K V; Toland, K; Tonelli, M; Tornasi, Z; Torres-Forné, A; Torrie, C I; Töyrä, D; Travasso, F; Traylor, G; Trinastic, J; Tringali, M C; Trozzo, L; Tsang, K W; Tse, M; Tso, R; Tsukada, L; Tsuna, D; Tuyenbayev, D; Ueno, K; Ugolini, D; Unnikrishnan, C S; Urban, A L; Usman, S A; Vahlbruch, H; Vajente, G; Valdes, G; van Bakel, N; van Beuzekom, M; van den Brand, J F J; Van Den Broeck, C; Vander-Hyde, D C; van der Schaaf, L; van Heijningen, J V; van Veggel, A A; Vardaro, M; Varma, V; Vass, S; Vasúth, M; Vecchio, A; Vedovato, G; Veitch, J; Veitch, P J; Venkateswara, K; Venugopalan, G; Verkindt, D; Vetrano, F; Viceré, A; Viets, A D; Vinciguerra, S; Vine, D J; Vinet, J-Y; Vitale, S; Vo, T; Vocca, H; Vorvick, C; Vyatchanin, S P; Wade, A R; Wade, L E; Wade, M; Walet, R; Walker, M; Wallace, L; Walsh, S; Wang, G; Wang, H; Wang, J Z; Wang, W H; Wang, Y F; Ward, R L; Warner, J; Was, M; Watchi, J; Weaver, B; Wei, L-W; Weinert, M; Weinstein, A J; Weiss, R; Wen, L; Wessel, E K; Weßels, P; Westerweck, J; Westphal, T; Wette, K; Whelan, J T; Whiting, B F; Whittle, C; Wilken, D; Williams, D; Williams, R D; Williamson, A R; Willis, J L; Willke, B; Wimmer, M H; Winkler, W; Wipf, C C; Wittel, H; Woan, G; Woehler, J; Wofford, J; Wong, K W K; Worden, J; Wright, J L; Wu, D S; Wysocki, D M; Xiao, S; Yamamoto, H; Yancey, C C; Yang, L; Yap, M J; Yazback, M; Yu, Hang; Yu, Haocun; Yvert, M; Zadrożny, A; Zanolin, M; Zelenova, T; Zendri, J-P; Zevin, M; Zhang, L; Zhang, M; Zhang, T; Zhang, Y-H; Zhao, C; Zhou, M; Zhou, Z; Zhu, S J; Zhu, X J; Zucker, M E; Zweizig, J

2018-05-18

The detection of gravitational waves with Advanced LIGO and Advanced Virgo has enabled novel tests of general relativity, including direct study of the polarization of gravitational waves. While general relativity allows for only two tensor gravitational-wave polarizations, general metric theories can additionally predict two vector and two scalar polarizations. The polarization of gravitational waves is encoded in the spectral shape of the stochastic gravitational-wave background, formed by the superposition of cosmological and individually unresolved astrophysical sources. Using data recorded by Advanced LIGO during its first observing run, we search for a stochastic background of generically polarized gravitational waves. We find no evidence for a background of any polarization, and place the first direct bounds on the contributions of vector and scalar polarizations to the stochastic background. Under log-uniform priors for the energy in each polarization, we limit the energy densities of tensor, vector, and scalar modes at 95% credibility to Ω_{0}^{T}<5.58×10^{-8}, Ω_{0}^{V}<6.35×10^{-8}, and Ω_{0}^{S}<1.08×10^{-7} at a reference frequency f_{0}=25  Hz.

Magnetic control of magnetohydrodynamic instabilities in tokamaks

DOE PAGES

Strait, Edward J.

2014-11-24

Externally applied, non-axisymmetric magnetic fields form the basis of several relatively simple and direct methods to control magnetohydrodynamic (MHD) instabilities in a tokamak, and most present and planned tokamaks now include a set of non-axisymmetric control coils for application of fields with low toroidal mode numbers. Non-axisymmetric applied fields are routinely used to compensate small asymmetries ( δB/B ~ 10 -3 to 10 -4) of the nominally axisymmetric field, which otherwise can lead to instabilities through braking of plasma rotation and through direct stimulus of tearing modes or kink modes. This compensation may be feedback-controlled, based on the magnetic responsemore » of the plasma to the external fields. Non-axisymmetric fields are used for direct magnetic stabilization of the resistive wall mode — a kink instability with a growth rate slow enough that feedback control is practical. Saturated magnetic islands are also manipulated directly with non-axisymmetric fields, in order to unlock them from the wall and spin them to aid stabilization, or position them for suppression by localized current drive. Several recent scientific advances form the foundation of these developments in the control of instabilities. Most fundamental is the understanding that stable kink modes play a crucial role in the coupling of non-axisymmetric fields to the plasma, determining which field configurations couple most strongly, how the coupling depends on plasma conditions, and whether external asymmetries are amplified by the plasma. A major advance for the physics of high-beta plasmas ( β = plasma pressure/magnetic field pressure) has been the understanding that drift-kinetic resonances can stabilize the resistive wall mode at pressures well above the ideal-MHD stability limit, but also that such discharges can be very sensitive to external asymmetries. The common physics of stable kink modes has brought significant unification to the topics of static error fields at low beta and resistive wall modes at high beta. Furthermore, these and other scientific advances, and their application to control of MHD instabilities, will be reviewed with emphasis on the most recent results and their applicability to ITER.« less

Advances in mechanistic understanding of release rate control mechanisms of extended-release hydrophilic matrix tablets.

PubMed

Timmins, Peter; Desai, Divyakant; Chen, Wei; Wray, Patrick; Brown, Jonathan; Hanley, Sarah

2016-08-01

Approaches to characterizing and developing understanding around the mechanisms that control the release of drugs from hydrophilic matrix tablets are reviewed. While historical context is provided and direct physical characterization methods are described, recent advances including the role of percolation thresholds, the application on magnetic resonance and other spectroscopic imaging techniques are considered. The influence of polymer and dosage form characteristics are reviewed. The utility of mathematical modeling is described. Finally, how all the information derived from applying the developed mechanistic understanding from all of these tools can be brought together to develop a robust and reliable hydrophilic matrix extended-release tablet formulation is proposed.

How to Make a Heart Valve: From Embryonic Development to Bioengineering of Living Valve Substitutes

PubMed Central

MacGrogan, Donal; Luxán, Guillermo; Driessen-Mol, Anita; Bouten, Carlijn; Baaijens, Frank; de la Pompa, José Luis

2014-01-01

Cardiac valve disease is a significant cause of ill health and death worldwide, and valve replacement remains one of the most common cardiac interventions in high-income economies. Despite major advances in surgical treatment, long-term therapy remains inadequate because none of the current valve substitutes have the potential for remodeling, regeneration, and growth of native structures. Valve development is coordinated by a complex interplay of signaling pathways and environmental cues that cause disease when perturbed. Cardiac valves develop from endocardial cushions that become populated by valve precursor mesenchyme formed by an epithelial–mesenchymal transition (EMT). The mesenchymal precursors, subsequently, undergo directed growth, characterized by cellular compartmentalization and layering of a structured extracellular matrix (ECM). Knowledge gained from research into the development of cardiac valves is driving exploration into valve biomechanics and tissue engineering directed at creating novel valve substitutes endowed with native form and function. PMID:25368013

Three-dimensional hybrid grid generation using advancing front techniques

NASA Technical Reports Server (NTRS)

Steinbrenner, John P.; Noack, Ralph W.

1995-01-01

A new 3-dimensional hybrid grid generation technique has been developed, based on ideas of advancing fronts for both structured and unstructured grids. In this approach, structured grids are first generate independently around individual components of the geometry. Fronts are initialized on these structure grids, and advanced outward so that new cells are extracted directly from the structured grids. Employing typical advancing front techniques, cells are rejected if they intersect the existing front or fail other criteria When no more viable structured cells exist further cells are advanced in an unstructured manner to close off the overall domain, resulting in a grid of 'hybrid' form. There are two primary advantages to the hybrid formulation. First, generating blocks with limited regard to topology eliminates the bottleneck encountered when a multiple block system is used to fully encapsulate a domain. Individual blocks may be generated free of external constraints, which will significantly reduce the generation time. Secondly, grid points near the body (presumably with high aspect ratio) will still maintain a structured (non-triangular or tetrahedral) character, thereby maximizing grid quality and solution accuracy near the surface.

Difficult end-of-life treatment decisions: do other factors trump advance directives?

PubMed

Hardin, Steven B; Yusufaly, Yasmin A

2004-07-26

Advance directives are widely promoted as a means to plan for patients' decisional incapacity, yet there is little evidence of their effectiveness. We devised a study to assess physicians' compliance with hypothetical advance directives and further examine their clinical reasoning. The study consisted of an analysis of a mailed written survey containing 6 hypothetical cases of seriously ill patients. Each case contained an explicit advance directive with potential conflict between the directive and (1) prognosis, (2) wishes of family or friends, or (3) quality of life. Data were collected on the clinical treatment decisions made by physicians and the reasons for those decisions. Study participants were all internal medicine faculty and resident physicians from a single academic institution. A total of 47% analyzable surveys (117/250) were returned. Decisions by faculty and residents were not consistent with the advance directive in 65% of cases. This inconsistency was similar for faculty and residents (68% and 61%, respectively; P>.05). When physicians made decisions inconsistent with the advance directive, they were more likely to list reasons other than the directive for their decisions (89%; P<.001). Internists frequently made treatment decisions that were not consistent with an explicit advance directive. In difficult clinical situations, internists appear to consider other factors such as prognosis, perceived quality of life, and the wishes of family or friends as more determinative than the directive. Future work needs to explore the generalizability of these findings and examine how strictly patients desire their advance directives to be followed.

The moral courage of nursing students who complete advance directives with homeless persons.

PubMed

Nash, Woods; Mixer, Sandra J; McArthur, Polly M; Mendola, Annette

2016-11-01

Homeless persons in the United States have disproportionately high rates of illness, injury, and mortality and tend to believe that the quality of their end-of-life care will be poor. No studies were found as to whether nurses or nursing students require moral courage to help homeless persons or members of any other demographic complete advance directives. We hypothesized that baccalaureate nursing students require moral courage to help homeless persons complete advance directives. Moral courage was defined as a trait of a person or an action that overcomes fears or other challenges to achieve something of great moral worth. The hypothesis was investigated through a qualitative descriptive study. Aside from the pre-selection of a single variable to study (i.e. moral courage), our investigation was a naturalistic inquiry with narrative hues insofar as it attended to specific words and phrases in the data that were associated with that variable. A total of 15 baccalaureate nursing students at a public university in the United States responded to questionnaires that sought to elicit fears and other challenges that they both expected to experience and actually experienced while helping homeless persons complete advance directives at a local, non-profit service agency. The study was approved by the Internal Review Board of the authors' university, and each participant signed an informed consent form, which stated that the study involved no reasonably foreseeable risks and that participation was voluntary. Before meeting with homeless persons, participants reported that they expected to experience two fears and a challenge: fear of behaving in ways that a homeless person would deem inappropriate, fear of discussing a homeless person's dying and death, and the challenge of adequately conveying the advance directive's meaning and accurately recording a homeless person's end-of-life wishes. In contrast, after their meetings with homeless persons, relatively few participants reported having encountered those obstacles. So, while participants required moral courage to assist homeless persons with advance directives, they required greater moral courage as they anticipated their meetings than during those meetings. Our study breaks new ground at the intersection of nursing, moral courage, and advance directives. It might also have important implications for how to improve the training that US nursing students receive before they provide this service. Our results cannot be generalized, but portions of our approach are likely to be transferable to similar social contexts. For example, because homeless persons are misunderstood and marginalized throughout the United States, our design for training nursing students to provide this service is also likely to be useful across the United States. Internationally, however, it is not yet known whether our participants' fears and the challenge they faced are also experienced by those who assist homeless persons or members of other vulnerable populations in documenting healthcare wishes. © The Author(s) 2015.

Synchronization in neural nets

NASA Technical Reports Server (NTRS)

Vidal, Jacques J.; Haggerty, John

1988-01-01

The paper presents an artificial neural network concept (the Synchronizable Oscillator Networks) where the instants of individual firings in the form of point processes constitute the only form of information transmitted between joining neurons. In the model, neurons fire spontaneously and regularly in the absence of perturbation. When interaction is present, the scheduled firings are advanced or delayed by the firing of neighboring neurons. Networks of such neurons become global oscillators which exhibit multiple synchronizing attractors. From arbitrary initial states, energy minimization learning procedures can make the network converge to oscillatory modes that satisfy multi-dimensional constraints. Such networks can directly represent routing and scheduling problems that consist of ordering sequences of events.

Theoretical Problems in Materials Science

NASA Technical Reports Server (NTRS)

Langer, J. S.; Glicksman, M. E.

1985-01-01

Interactions between theoretical physics and material sciences to identify problems of common interest in which some of the powerful theoretical approaches developed for other branches of physics may be applied to problems in materials science are presented. A unique structure was identified in rapidly quenched Al-14% Mn. The material has long-range directed bonds with icosahedral symmetry which does not form a regular structure but instead forms an amorphous-like quasiperiodic structure. Finite volume fractions of second phase material is advanced and is coupled with nucleation theory to describe the formation and structure of precipitating phases in alloys. Application of the theory of pattern formation to the problem of dendrite formation is studied.

Stars and gas in high redshift galaxies

NASA Astrophysics Data System (ADS)

Pettini, Max

Recent advances in instrumentation and observing techniques have made it possible to begin to study in detail the stellar populations and the interstellar media of galaxies at redshift z=3, when the universe was still in its "teen years". In keeping with the theme of this conference, I show how our knowledge of local star-forming regions can be applied directly to these distant galaxies to deduce their ages, metallicities, initial mass function, and masses. I also discuss areas where current limitations in stellar astrophysics have a direct bearing on the interpretation of the data being gathered, at an ever increasing rate, on the high redshift universe.

How strictly do dialysis patients want their advance directives followed?

PubMed

Sehgal, A; Galbraith, A; Chesney, M; Schoenfeld, P; Charles, G; Lo, B

1992-01-01

The Cruzan case and the Patient Self-Determination Act will encourage patients to specify in advance which life-sustaining treatments they would want if they become mentally incompetent. However, strictly following such advance directives may not always be in a patient's best interests. We sought to determine whether patients differ in how strictly they want advance directives followed. Interview study. Seven outpatient chronic dialysis centers. One hundred fifty mentally competent dialysis patients. Using a structured questionnaire, we asked the subjects whether they would want dialysis continued or stopped if they developed advanced Alzheimer's disease. We then asked how much leeway their physician and surrogate should have to override that advance directive if overriding were in their best interests. Subjects granting leeway were also asked what factors should be considered in making decisions for them. Subjects varied greatly in how much leeway they would give surrogates to override their advance directives: "no leeway" (39%), "a little leeway" (19%), "a lot of leeway" (11%), and "complete leeway" (31%). Subjects also varied in how much they wanted various factors considered in making decisions, such as pain or suffering, quality of life, possibility of a new treatment, indignity caused by continued treatment, financial impact of treatment on family members, and religious beliefs. Strictly following all advance directives may not truly reflect patients' preferences. To improve advance directives, we recommend that physicians explicitly ask patients how strictly they want their advance directives followed and what factors they want considered in making decisions.

Recent advances in developing ophthalmic formulations: a patent review.

PubMed

Lu, Guang Wei

2010-01-01

In an effort to improve the drug solubility, stability and/or ocular bioavailability of ophthalmic formulations,various approaches have been explored in the recent past. Additionally, different formulations have been investigated in order to seek those preservative systems that are more tolerable to the ocular tissue. Over the past ten years, inventions in ophthalmic formulations directed toward front-of-eye instillations have concentrated in the areas of new excipients' applications, novel and combined use of conventional excipients, and developments of novel dosage forms. Among these areas, applications of polymeric excipients, cyclodextrins and stabilized chloride dioxide (SCD) have been the most actively studied fields. In addition, oil-in-water (O/W) emulsions have been becoming more popular as an ophthalmic dosage form due to the potentials in increasing drug solubility, stabilizing active pharmaceutical ingredients (APIs), improving ocular tolerance, and providing palliative effects. Some of these innovations from the past decade have the capability of leading to new commercial products. This patent review has a useful knowledge in the advancement for treating various ophthalmic diseases.

Advances in bionanomaterials for bone tissue engineering.

PubMed

Scott, Timothy G; Blackburn, Gary; Ashley, Michael; Bayer, Ilker S; Ghosh, Anindya; Biris, Alexandru S; Biswas, Abhijit

2013-01-01

Bone is a specialized form of connective tissue that forms the skeleton of the body and is built at the nano and microscale levels as a multi-component composite material consisting of a hard inorganic phase (minerals) in an elastic, dense organic network. Mimicking bone structure and its properties present an important frontier in the fields of nanotechnology, materials science and bone tissue engineering, given the complex morphology of this tissue. There has been a growing interest in developing artificial bone-mimetic nanomaterials with controllable mineral content, nanostructure, chemistry for bone, cartilage tissue engineering and substitutes. This review describes recent advances in bionanomaterials for bone tissue engineering including developments in soft tissue engineering. The significance and basic process of bone tissue engineering along with different bionanomaterial bone scaffolds made of nanocomposites and nanostructured biopolymers/bioceramics and the prerequisite biomechanical functions are described. It also covers latest developments in soft-tissue reconstruction and replacement. Finally, perspectives on the future direction in nanotechnology-enabled bone tissue engineering are presented.

Advance directives and personal identity: what is the problem?

PubMed

Furberg, Elisabeth

2012-02-01

The personal identity problem expresses the worry that due to disrupted psychological continuity, one person's advance directive could be used to determine the care of a different person. Even ethicists, who strongly question the possibility of the scenario depicted by the proponents of the personal identity problem, often consider it to be a very potent objection to the use of advance directives. Aiming to question this assumption, I, in this paper, discuss the personal identity problem's relevance to the moral force of advance directives. By putting the personal identity argument in relation to two different normative frameworks, I aim to show that whether or not the personal identity problem is relevant to the moral force of advance directives, and further, in what way it is relevant, depends entirely on what normative reasons we have for respecting advance directives in the first place.

Methodology for sensitivity analysis, approximate analysis, and design optimization in CFD for multidisciplinary applications

NASA Technical Reports Server (NTRS)

Taylor, Arthur C., III; Hou, Gene W.

1993-01-01

In this study involving advanced fluid flow codes, an incremental iterative formulation (also known as the delta or correction form) together with the well-known spatially-split approximate factorization algorithm, is presented for solving the very large sparse systems of linear equations which are associated with aerodynamic sensitivity analysis. For smaller 2D problems, a direct method can be applied to solve these linear equations in either the standard or the incremental form, in which case the two are equivalent. Iterative methods are needed for larger 2D and future 3D applications, however, because direct methods require much more computer memory than is currently available. Iterative methods for solving these equations in the standard form are generally unsatisfactory due to an ill-conditioning of the coefficient matrix; this problem can be overcome when these equations are cast in the incremental form. These and other benefits are discussed. The methodology is successfully implemented and tested in 2D using an upwind, cell-centered, finite volume formulation applied to the thin-layer Navier-Stokes equations. Results are presented for two sample airfoil problems: (1) subsonic low Reynolds number laminar flow; and (2) transonic high Reynolds number turbulent flow.

Advanced Gas Turbine (AGT) Technology Development Project, ceramic component developments

NASA Technical Reports Server (NTRS)

Teneyck, M. O.; Macbeth, J. W.; Sweeting, T. B.

1987-01-01

The ceramic component technology development activity conducted by Standard Oil Engineered Materials Company while performing as a principal subcontractor to the Garrett Auxiliary Power Division for the Advanced Gas Turbine (AGT) Technology Development Project (NASA Contract DEN3-167) is summarized. The report covers the period October 1979 through July 1987, and includes information concerning ceramic technology work categorized as common and unique. The former pertains to ceramic development applicable to two parallel AGT projects established by NASA contracts DEN3-168 (AGT100) and DEN3-167 (AGT101), whereas the unique work solely pertains to Garrett directed activity under the latter contract. The AGT101 Technology Development Project is sponsored by DOE and administered by NASA-Lewis. Standard Oil directed its efforts toward the development of ceramic materials in the silicon-carbide family. Various shape forming and fabrication methods, and nondestructive evaluation techniques were explored to produce the static structural components for the ceramic engine. This permitted engine testing to proceed without program slippage.

APS SCIENCE 2016

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

Fenner, Richard B.

The Advanced Photon Source (APS) occupies an 80-acre site on the Argonne national laboratory campus, about 25 miles from downtown chicago, illinois. it shares the site with the center for nanoscale materials and the Advanced Protein characterization facility. for directions to Argonne, see http://www.anl.gov/directions-and-visitor-information. The APS, a national synchrotron radiation research facility operated by Argonne for the u.S. department of energy (doe) office of Science, provides this nation’s brightest high-energy x-ray beams for science. research by APS users extends from the center of the earth to outer space, from new information on combustion engines and microcircuits to new drugs andmore » nanotechnologies whose scale is measured in billionths of a meter. The APS helps researchers illuminate answers to the challenges of our high-tech world, from developing new forms of energy, to sustaining our nation’s technological and economic competitiveness, to pushing back against the ravages of disease. research at the APS promises to have far-reaching« less

[Preparation and execution of advance directives and enduring powers of attorney].

PubMed

Rendenbach, Ulrich

2008-01-01

If a person wants to preclude other people making decisions on his/her behalf, this needs to be recorded in a legally relevant form by means of a declaration of intent. For example, the latter could be a contract (nursing home contract) or an advance directive. The circumstances under which a declaration becomes effective have to be exactly and carefully worded. Also, it has to be accurately defined who is to enforce the declaration of intent against defiance and in which situation. Physicians, lawyers, nursing staff, politicians, members of ethics committees, sponsors, relatives--everyone may have a different opinion, and the patient's well-being might easily be ignored. A legal regulation will contribute little to safety at the end of life. The responsibility lies with the physician. The legislator cannot guide the physician's therapeutic decisions, but an invalid patient can who has expressed his desire to die and unmistakably advised his physician on when to refrain from which procedures.

US long distance fiber optic networks: Technology, evolution and advanced concepts. Volume 3: Advanced networks and economics

NASA Technical Reports Server (NTRS)

1986-01-01

This study projects until 2000 the evolution of long distance fiber optic networks in the U.S. Volume 1 is the executive Summary. Volume 2 focuses on fiber optic components and systems that are directly related to the operation of long-haul networks. Optimistic, pessimistic and most likely scenarios of technology development are presented. The activities of national and regional companies implementing fiber long haul networks are also highlighted, along with an analysis of the market and regulatory forces affecting network evolution. Volume 3 presents advanced fiber optic network concept definitions. Inter-LATA traffic is quantified and forms the basis for the construction of 11-, 15-, 17-, and 23-node networks. Using the technology projections from Volume 2, a financial model identifies cost drivers and determines circuit mile costs between any two LATAs. A comparison of fiber optics with alternative transmission concludes the report.

Advancing understanding of executive function impairments and psychopathology: bridging the gap between clinical and cognitive approaches

PubMed Central

Snyder, Hannah R.; Miyake, Akira; Hankin, Benjamin L.

2015-01-01

Executive function (EF) is essential for successfully navigating nearly all of our daily activities. Of critical importance for clinical psychological science, EF impairments are associated with most forms of psychopathology. However, despite the proliferation of research on EF in clinical populations, with notable exceptions clinical and cognitive approaches to EF have remained largely independent, leading to failures to apply theoretical and methodological advances in one field to the other field and hindering progress. First, we review the current state of knowledge of EF impairments associated with psychopathology and limitations to the previous research in light of recent advances in understanding and measuring EF. Next, we offer concrete suggestions for improving EF assessment. Last, we suggest future directions, including integrating modern models of EF with state of the art, hierarchical models of dimensional psychopathology as well as translational implications of EF-informed research on clinical science. PMID:25859234

US long distance fiber optic networks: Technology, evolution and advanced concepts. Volume 3: Advanced networks and economics

NASA Astrophysics Data System (ADS)

1986-10-01

This study projects until 2000 the evolution of long distance fiber optic networks in the U.S. Volume 1 is the executive Summary. Volume 2 focuses on fiber optic components and systems that are directly related to the operation of long-haul networks. Optimistic, pessimistic and most likely scenarios of technology development are presented. The activities of national and regional companies implementing fiber long haul networks are also highlighted, along with an analysis of the market and regulatory forces affecting network evolution. Volume 3 presents advanced fiber optic network concept definitions. Inter-LATA traffic is quantified and forms the basis for the construction of 11-, 15-, 17-, and 23-node networks. Using the technology projections from Volume 2, a financial model identifies cost drivers and determines circuit mile costs between any two LATAs. A comparison of fiber optics with alternative transmission concludes the report.

Engineering Cell-Cell Signaling

PubMed Central

Milano, Daniel F.; Natividad, Robert J.; Asthagiri, Anand R.

2014-01-01

Juxtacrine cell-cell signaling mediated by the direct interaction of adjoining mammalian cells is arguably the mode of cell communication that is most recalcitrant to engineering. Overcoming this challenge is crucial for progress in biomedical applications, such as tissue engineering, regenerative medicine, immune system engineering and therapeutic design. Here, we describe the significant advances that have been made in developing synthetic platforms (materials and devices) and synthetic cells (cell surface engineering and synthetic gene circuits) to modulate juxtacrine cell-cell signaling. In addition, significant progress has been made in elucidating design rules and strategies to modulate juxtacrine signaling based on quantitative, engineering analysis of the mechanical and regulatory role of juxtacrine signals in the context of other cues and physical constraints in the microenvironment. These advances in engineering juxtacrine signaling lay a strong foundation for an integrative approach to utilizing synthetic cells, advanced ‘chassis’ and predictive modeling to engineer the form and function of living tissues. PMID:23856592

Botulism: update and review.

PubMed

Cherington, Michael

2004-06-01

Botulism is both an old and an emerging disease. Over 100 years ago, the classic food-borne type was found to be caused by ingesting contaminated food containing the toxin produced by a bacteria. In the first half of the 20th century a second form, wound botulism, was discovered. Three additional forms (infant, hidden, and inadvertent) were first described in the last quarter of the 20th century. Our understanding of how botulinum toxin blocks the release of acetylcholine at the neuromuscular junction has been clarified in the past 10 years. In the past 20 years, we have witnessed one of the strangest of all ironies in the history of medicine. The very lethal botulinum toxin is now being used as a treatment in an expanding list of disorders. Research is advancing in several directions. These new avenues include improved methods of preventing and treating botulism and additional novel uses of botulinum toxin as a therapeutic agent. In this article, the five clinical forms of botulism, the actions of botulinum toxins, electrodiagnostic methods, treatments, and possible future directions are discussed. Copyright 2004 Thieme Medical Publishers, Inc.

Advance directives outside the USA: are they the best solution everywhere?

PubMed

Sanchez-Gonzalez, M A

1997-09-01

This article evaluates the potential role of advance directives outside of their original North American context. In order to do this, the article first analyses the historical process which has promoted advance directives in recent years. Next, it brings to light certain presuppositions which have given them force: atomistic individualism, contractualism, consumerism and entrepreneurialism, pluralism, proceduralism, and "American moralism." The article next studies certain European cultural peculiarities which could affect advance directives: the importance of virtue versus rights, stoicism versus consumerist utilitarianism, rationalism verus empiricism, statism versus citizens' initiative, and justice versus autonomy. The article concludes by recognising that autonomy has a transcultural value, although it must be balanced with other principles. Advance Directives can have a function in certain cases. But it does not seem adequate to delegate to advance directives more and more medical decisions, and to make them more binding everyday. It is indispensable to develop other decision-making criteria.

Where is the skepticism in animal metacognition?

PubMed Central

Crystal, Jonathon D.

2015-01-01

The comparative analysis of metacognition may answer fundamental questions about the evolution of cognition. Although a substantial amount of research has been directed toward this goal in the last two decades, the recent development of quantitative non-metacognition models has raised questions about the existence of metacognition in nonhumans. Kornell (2013) proposes that advances in animal metacognition may be made by following emerging trends in human metacognition research, namely that animal metacognition may take the form of drawing inferences from metacognitive cues without directly assessing the strength of memories directly. A problem with this approach is noted. Because the metacognitive status of certainty judgments in animals is at the center of the dispute in the field, demonstrations of the inferential view would not provide evidence that putative metacognitive cues are indeed based on metacognition. I argue that any preparation that claims to tap into metacognition needs to be tested against leading non-metacognition hypotheses such as Le Pelley's (2012) reinforcement-learning model. Progress in animal metacognition will come from the development of new assessment techniques that offer predictions contrary to non-metacognition hypotheses. Animal metacognition will advance by applying skepticism about methods and interpretation while letting the animals (and their data) settle the debate. PMID:24866006

Completing advance directives for health care decisions: getting to yes.

PubMed

Shewchuk, T R

1998-09-01

The concept of advance directives for health care decision making has been judicially condoned, legislatively promoted, and systematically implemented by health care institutions, yet the execution rate of advance directives remains low. Physicians should discuss with their patients advance care planning generally and end-of-life issues specifically, preferably when patients are in good health and not when they face an acute medical crisis. The physician-hospital relationship poses particular challenges for the optimal implementation of advance directives that must be addressed. Hospital administrators must improve education of patients and physicians on the value of such documents as well as internal mechanisms to ensure better implementation of directives. Health insurance plans may be better able to ensure optimal gathering and implementation of directives. Patients must become more familiar and more comfortable with advance care planning and the reality of death and dying issues. Full acceptance of the value of directives ultimately rests on achieving full participation of all involved--providers, patients, families, and payors--in this most profound process.

Assessment of competence to complete advance directives: validation of a patient centred approach

PubMed Central

Fazel, Seena; Hope, Tony; Jacoby, Robin

1999-01-01

Objective To develop a patient centred approach for the assessment of competence to complete advance directives (“living wills”) of elderly people with cognitive impairment. Design Semistructured interviews. Setting Oxfordshire. Subjects 50 elderly volunteers living in the community, and 50 patients with dementia on first referral from primary care. Main outcome measures Psychometric properties of competence assessment. Results This patient centred approach for assessing competence to complete advance directives can discriminate between elderly persons living in the community and elderly patients with dementia. The procedure has good interrater (r=0.95) and test-retest (r=0.97) reliability. Validity was examined by relating this approach with a global assessment of competence to complete an advance directive made by two of us (both specialising in old age psychiatry). The data were also used to determine the best threshold score for discriminating between those competent and those incompetent to complete an advance directive. Conclusion A patient centred approach to assess competence to complete advance directives can be reliably and validly used in routine clinical practice. Key messagesAdvance directives could potentially be useful for patients with dementia as a means of extending their autonomy when they become incompetentCompetence to complete an advance directive involves understanding possible future clinical situationsVignettes presenting hypothetical medical problems were tested in 100 elderly people, and were found to validly and reliably discriminate between volunteers living in the community and patients with dementiaWe suggest that two clinical vignettes, each followed by a semistructured interview comprising 10 points, can aid in the assessment of competence to complete advance directives PMID:10024254

Impact of advance directives and a health care proxy on doctors' decisions: a randomized trial.

PubMed

Escher, Monica; Perneger, Thomas V; Rudaz, Sandrine; Dayer, Pierre; Perrier, Arnaud

2014-01-01

Advance directives or proxy designations are widely recommended, but how they affect doctors' decision making is not well known. The aim of this study was to quantify the influence of advance directives and proxy opinions on doctors' decisions. We mailed to all the generalists and internists in French-speaking Switzerland (N = 1962) three vignettes describing difficult decisions involving incapacitated patients. In each case, the advance directive requested that further care be withheld. One vignette tested the impact of a written advance directive vs. a proxy. Another compared the impact of a handwritten directive vs. a formalized document. The third vignette compared the impact of a family member vs. a doctor as a proxy. Each vignette was prepared in three or four versions, including a control version in which no directive or proxy was present. Vignettes were randomly allocated to respondents. We used logistic regression to predict the decision to forgo a medical intervention. Compared with the control condition, the odds of forgoing a medical intervention were increased by the written advance directive (odds ratio [OR] 7.3; P < 0.001), the proxy (OR 7.9; P < 0.001), and the combination of the two (OR 35.7; P < 0.001). The handwritten directive had the same impact (OR 13.3) as the formalized directive (OR 13.8). The effect of proxy opinion was slightly stronger when provided by a doctor (OR 11.3) rather than by family (OR 7.8). Advance directives and proxy opinions are equally effective in influencing doctors' decisions, but having both has the strongest effect. The format of the advance directive and the identity of the proxy have little influence on decisions. Copyright © 2014 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

Biofilm Formation by Cryptococcus neoformans.

PubMed

Martinez, Luis R; Casadevall, Arturo

2015-06-01

The fungus Cryptococcus neoformans possesses a polysaccharide capsule and can form biofilms on medical devices. The increasing use of ventriculoperitoneal shunts to manage intracranial hypertension associated with cryptococcal meningoencephalitis highlights the importance of investigating the biofilm-forming properties of this organism. Like other microbe-forming biofilms, C. neoformans biofilms are resistant to antimicrobial agents and host defense mechanisms, causing significant morbidity and mortality. This chapter discusses the recent advances in the understanding of cryptococcal biofilms, including the role of its polysaccharide capsule in adherence, gene expression, and quorum sensing in biofilm formation. We describe novel strategies for the prevention or eradication of cryptococcal colonization of medical prosthetic devices. Finally, we provide fresh thoughts on the diverse but interesting directions of research in this field that may result in new insights into C. neoformans biology.

19 CFR 4.7 - Inward foreign manifest; production on demand; contents and form; advance filing of cargo...

Code of Federal Regulations, 2011 CFR

2011-04-01

...; contents and form; advance filing of cargo declaration. 4.7 Section 4.7 Customs Duties U.S. CUSTOMS AND... and form; advance filing of cargo declaration. (a) The master of every vessel arriving in the United..., and the following documents: (1) Cargo Declaration, Customs Form 1302, (2) Ship's Stores Declaration...

19 CFR 4.7 - Inward foreign manifest; production on demand; contents and form; advance filing of cargo...

Code of Federal Regulations, 2010 CFR

2010-04-01

...; contents and form; advance filing of cargo declaration. 4.7 Section 4.7 Customs Duties U.S. CUSTOMS AND... and form; advance filing of cargo declaration. (a) The master of every vessel arriving in the United..., and the following documents: (1) Cargo Declaration, Customs Form 1302, (2) Ship's Stores Declaration...

Strong bases. Directed ortho-meta'- and meta-meta'-dimetalations: a template base approach to deprotonation.

PubMed

Martínez-Martínez, Antonio J; Kennedy, Alan R; Mulvey, Robert E; O'Hara, Charles T

2014-11-14

The regioselectivity of deprotonation reactions between arene substrates and basic metalating agents is usually governed by the electronic and/or coordinative characteristics of a directing group attached to the benzene ring. Generally, the reaction takes place in the ortho position, adjacent to the substituent. Here, we introduce a protocol by which the metalating agent, a disodium-monomagnesium alkyl-amide, forms a template that extends regioselectivity to more distant arene sites. Depending on the nature of the directing group, ortho-meta' or meta-meta' dimetalation is observed, in the latter case breaking the dogma of ortho metalation. This concept is elaborated through the characterization of both organometallic intermediates and electrophilically quenched products. Copyright © 2014, American Association for the Advancement of Science.

Nanofiber-Based Bulk-Heterojunction Organic Solar Cells Using Coaxial Electrospinning

DTIC Science & Technology

2012-01-01

chains are likely oriented with the [010] direction, perpendicular to the substrate, in the fi lm device. Glancing incidence X - ray diffraction (GIXD...Electron and X - ray diffraction measurements were per- formed in order to study the structural order in annealed fi bers and devices. For reference... angle X - ray scattering (SAXS/WAXS) beamline 7.3.3 of the Advanced Light Source at Lawrence Berkeley National Laboratory at 10 keV (1.24 Å) from a bend

Airborne electronically steerable phased array. [steerable antennas - systems analysis

NASA Technical Reports Server (NTRS)

Coats, R.

1975-01-01

Results of a study directed to the design of a lightweight high-gain, spaceborne communications array are presented. The array includes simultaneous transmission and receiving, automatic acquisition and tracking of a signal within a 60-degree cone from the array normal, and provides for independent forming of the transmit and receive beams. Application for this array is the space shuttle, space station, or any of the advanced manned (or unmanned) orbital vehicles. Performance specifications are also given.

Impact of Integrated Care Model (ICM) on Direct Medical Costs in Management of Advanced Chronic Obstructive Pulmonary Disease (COPD).

PubMed

Bandurska, Ewa; Damps-Konstańska, Iwona; Popowski, Piotr; Jędrzejczyk, Tadeusz; Janowiak, Piotr; Świętnicka, Katarzyna; Zarzeczna-Baran, Marzena; Jassem, Ewa

2017-06-12

BACKGROUND Chronic obstructive pulmonary disease (COPD) is a commonly diagnosed condition in people older than 50 years of age. In advanced stage of this disease, integrated care (IC) is recommended as an optimal approach. IC allows for holistic and patient-focused care carried out at the patient's home. The aim of this study was to analyze the impact of IC on costs of care and on demand for medical services among patients included in IC. MATERIAL AND METHODS The study included 154 patients diagnosed with advanced COPD. Costs of care (general, COPD, and exacerbations-related) were evaluated for 1 year, including 6-months before and after implementing IC. The analysis included assessment of the number of medical procedures of various types before and after entering IC and changes in medical services providers. RESULTS Direct medical costs of standard care in advanced COPD were 886.78 EUR per 6 months. Costs of care of all types decreased after introducing IC. Changes in COPD and exacerbation-related costs were statistically significant (p=0.012492 and p=0.017023, respectively). Patients less frequently used medical services for respiratory system and cardiovascular diseases. Similarly, the number of hospitalizations and visits to emergency medicine departments decreased (by 40.24% and 8.5%, respectively). The number of GP visits increased after introducing IC (by 7.14%). CONCLUSIONS The high costs of care in advanced COPD indicate the need for new forms of effective care. IC caused a decrease in costs and in the number of hospitalization, with a simultaneous increase in the number of GP visits.

Advance Care Planning in an Accountable Care Organization Is Associated with Increased Advanced Directive Documentation and Decreased Costs.

PubMed

Bond, William F; Kim, Minchul; Franciskovich, Chris M; Weinberg, Jason E; Svendsen, Jessica D; Fehr, Linda S; Funk, Amy; Sawicki, Robert; Asche, Carl V

2018-04-01

Advance care planning (ACP) documents patient wishes and increases awareness of palliative care options. To study the association of outpatient ACP with advanced directive documentation, utilization, and costs of care. This was a case-control study of cases with ACP who died matched 1:1 with controls. We used 12 months of data pre-ACP/prematch and predeath. We compared rates of documentation with logit model regression and conducted a difference-in-difference analysis using generalized linear models for utilization and costs. Medicare beneficiaries attributed to a large rural-suburban-small metro multisite accountable care organization from January 2013 to April 2016, with cross reference to ACP facilitator logs to find cases. The presence of advance directive forms was verified by chart review. Cost analysis included all utilization and costs billed to Medicare. We matched 325 cases and 325 controls (51.1% female and 48.9% male, mean age 81). 320/325 (98.5%) ACP versus 243/325 (74.8%) of controls had a Healthcare Power of Attorney (odds ratio [OR] 21.6, 95% CI 8.6-54.1) and 172/325(52.9%) ACP versus 145/325 (44.6%) controls had Practitioner Orders for Life Sustaining Treatment (OR 1.40, 95% CI 1.02-1.90) post-ACP/postmatch. Adjusted results showed ACP cases had fewer inpatient admissions (-0.37 admissions, 95% CI -0.66 to -0.08), and inpatient days (-3.66 days, 95% CI -6.23 to -1.09), with no differences in hospice, hospice days, skilled nursing facility use, home health use, 30-day readmissions, or emergency department visits. Adjusted costs were $9,500 lower in the ACP group (95% CI -$16,207 to -$2,793). ACP increases documentation and was associated with a reduction in overall costs driven primarily by a reduction in inpatient utilization. Our data set was limited by small numbers of minorities and cancer patients.

Are advance directives helpful for good end of life decision making: a cross sectional survey of health professionals.

PubMed

Peicius, Eimantas; Blazeviciene, Aurelija; Kaminskas, Raimondas

2017-06-05

This paper joins the debate over changes in the role of health professionals when applying advance directives to manage the decision-making process at the end of life care. Issues in relation to advance directives occur in clinical units in Lithuania; however, it remains one of the few countries in the European Union (EU) where the discussion on advance directives is not included in the health-care policy-making agenda. To encourage the discussion of advance directives, a study was designed to examine health professionals' understanding and preferences related to advance directives. In addition, the study sought to explore the views of health care professionals of the application of Advance Directives (AD) in clinical practice in Lithuania. A cross-sectional survey was conducted by interviewing 478 health professionals based at major health care centers in Kaunas district, Lithuania. The design of the study included the use of a questionnaire developed for this study and validated by a pilot study. The collected data were analyzed using standard descriptive statistical methods. The analysis of knowledge about AD revealed some statistically significant differences when comparing the respondents' profession and gender. The analysis also indicated key emerging themes among respondents including tranquility of mind, the longest possible life expectancy and freedom of choice. Further, the study findings revealed that more than half of the study participants preferred to express their will while alive by using advance directives. The study findings revealed a low level of knowledge on advance directives among health professionals. Most health professionals agreed that AD's improved end-of-life decision making while the majority of physicians appreciated AD as the best tool for sharing responsibilities in clinical practice in Lithuania. More physicians than nurses preferred the presence of advance directives to support their decision making in end-of-life situations.

Direct Collapse to Supermassive Black Hole Seeds with Radiative Transfer: Isolated Halos

NASA Astrophysics Data System (ADS)

Luo, Yang; Ardaneh, Kazem; Shlosman, Isaac; Nagamine, Kentaro; Wise, John H.; Begelman, Mitchell C.

2018-05-01

Direct collapse within dark matter haloes is a promising path to form supermassive black hole seeds at high redshifts. The outer part of this collapse remains optically thin. However, the innermost region of the collapse is expected to become optically thick and requires to follow the radiation field in order to understand its evolution. So far, the adiabatic approximation has been used exclusively for this purpose. We apply radiative transfer in the flux-limited diffusion (FLD) approximation to solve the evolution of coupled gas and radiation for isolated haloes. We find that (1) the photosphere forms at 10-6 pc and rapidly expands outwards. (2) A central core forms, with a mass of 1 M⊙, supported by gas pressure gradients and rotation. (3) Growing gas and radiation pressure gradients dissolve it. (4) This process is associated with a strong anisotropic outflow; another core forms nearby and grows rapidly. (5) Typical radiation luminosity emerging from the photosphere is 5 × 1037-5 × 1038 erg s-1, of the order the Eddington luminosity. (6) Two variability time-scales are associated with this process: a long one, which is related to the accretion flow within the central 10-4-10-3 pc, and 0.1 yr, related to radiation diffusion. (7) Adiabatic models evolution differs profoundly from that of the FLD models, by forming a geometrically thick disc. Overall, an adiabatic equation of state is not a good approximation to the advanced stage of direct collapse, because the radiation is capable of escaping due to anisotropy in the optical depth and associated gradients.

Room for improvement: An examination of advance care planning documentation among gynecologic oncology patients.

PubMed

Brown, Alaina J; Shen, Megan Johnson; Urbauer, Diana; Taylor, Jolyn; Parker, Patricia A; Carmack, Cindy; Prescott, Lauren; Kolawole, Elizabeth; Rosemore, Carly; Sun, Charlotte; Ramondetta, Lois; Bodurka, Diane C

2016-09-01

The goals of this study were: (1) to evaluate patients' knowledge regarding advance directives and completion rates of advance directives among gynecologic oncology patients and (2) to examine the association between death anxiety, disease symptom burden, and patient initiation of advance directives. 110 gynecologic cancer patients were surveyed regarding their knowledge and completion of advance directives. Patients also completed the MD Anderson Symptom Inventory (MDASI) scale and Templer's Death Anxiety Scale (DAS). Descriptive statistics were utilized to examine characteristics of the sample. Fisher's exact tests and 2-sample t-tests were utilized to examine associations between key variables. Most patients were white (76.4%) and had ovarian (46.4%) or uterine cancer (34.6%). Nearly half (47.0%) had recurrent disease. The majority of patients had heard about advance directives (75%). Only 49% had completed a living will or medical power of attorney. Older patients and those with a higher level of education were more likely to have completed an advance directive (p<0.01). Higher MDASI Interference Score (higher symptom burden) was associated with patients being less likely to have a living will or medical power of attorney (p=0.003). Higher DAS score (increased death anxiety) was associated with patients being less likely to have completed a living will or medical power of attorney (p=0.03). Most patients were familiar with advance directives, but less than half had created these documents. Young age, lower level of education, disease-related interference with daily activities, and a higher level of death anxiety were associated with decreased rates of advance directive completion, indicating these may be barriers to advance care planning documentation. Young patients, less educated patients, patients with increased disease symptom burden, and patients with increased death anxiety should be targeted for advance care planning discussions as they may be less likely to engage in advance care planning. Copyright © 2016. Published by Elsevier Inc.

Room for Improvement: An Examination of Advance Care Planning Documentation among Gynecologic Oncology Patients

PubMed Central

Brown, Alaina J.; Shen, Megan Johnson; Urbauer, Diana; Taylor, Jolyn; Parker, Patricia A.; Carmack, Cindy; Prescott, Lauren; Kowaloe, Elizabeth; Rosemore, Carly; Sun, Charlotte; Ramondetta, Lois; Bodurka, Diane C.

2017-01-01

Objectives The goals of this study were: (1) to evaluate patients’ knowledge regarding advance directives and completion rates of advance directives among gynecologic oncology patients and (2) to examine the association between death anxiety, disease symptom burden, and patient initiation of advance directives. Methods 110 gynecologic cancer patients were surveyed regarding their knowledge and completion of advance directives. Patients also completed the MD Anderson Symptom Inventory (MDASI) scale and Templer’s Death Anxiety Scale (DAS). Descriptive statistics were utilized to examine characteristics of the sample. Fisher’s exact tests and 2-sample t-tests were utilized to examine associations between key variables. Results Most patients were white (76.4%) and had ovarian (46.4%) or uterine cancer (34.6%). Nearly half (47.0%) had recurrent disease. The majority of patients had heard about advance directives (75%). Only 49% had completed a living will or medical power of attorney. Older patients and those with a higher level of education were more likely to have completed an advance directive (p<0.01). Higher MDASI Interference Score (higher symptom burden) was associated with patients being less likely to have a living will or medical power of attorney (p=0.003). Higher DAS score (increased death anxiety) was associated with patients being less likely to have completed a living will or medical power of attorney (p=0.03). Conclusion Most patients were familiar with advance directives, but less than half had created these documents. Young age, lower level of education, disease-related interference with daily activities, and a higher level of death anxiety were associated with decreased rates of advance directive completion, indicating these may be barriers to advance care planning documentation. Young patients, less educated patients, patients with increased disease symptom burden, and patients with increased death anxiety should be targeted for advance care planning discussions as they may be less likely to engage in advance care planning. PMID:27439968

Advances in compact manufacturing for shape and performance controllability of large-scale components-a review

NASA Astrophysics Data System (ADS)

Qin, Fangcheng; Li, Yongtang; Qi, Huiping; Ju, Li

2017-01-01

Research on compact manufacturing technology for shape and performance controllability of metallic components can realize the simplification and high-reliability of manufacturing process on the premise of satisfying the requirement of macro/micro-structure. It is not only the key paths in improving performance, saving material and energy, and green manufacturing of components used in major equipments, but also the challenging subjects in frontiers of advanced plastic forming. To provide a novel horizon for the manufacturing in the critical components is significant. Focused on the high-performance large-scale components such as bearing rings, flanges, railway wheels, thick-walled pipes, etc, the conventional processes and their developing situations are summarized. The existing problems including multi-pass heating, wasting material and energy, high cost and high-emission are discussed, and the present study unable to meet the manufacturing in high-quality components is also pointed out. Thus, the new techniques related to casting-rolling compound precise forming of rings, compact manufacturing for duplex-metal composite rings, compact manufacturing for railway wheels, and casting-extruding continuous forming of thick-walled pipes are introduced in detail, respectively. The corresponding research contents, such as casting ring blank, hot ring rolling, near solid-state pressure forming, hot extruding, are elaborated. Some findings in through-thickness microstructure evolution and mechanical properties are also presented. The components produced by the new techniques are mainly characterized by fine and homogeneous grains. Moreover, the possible directions for further development of those techniques are suggested. Finally, the key scientific problems are first proposed. All of these results and conclusions have reference value and guiding significance for the integrated control of shape and performance in advanced compact manufacturing.

Law, autonomy and advance directives.

PubMed

Willmott, Lindy; White, Ben; Mathews, Ben

2010-12-01

The principle of autonomy underpins legal regulation of advance directives that refuse life-sustaining medical treatment. The primacy of autonomy in this domain is recognised expressly in the case law, through judicial pronouncement, and implicitly in most Australian jurisdictions, through enactment into statute of the right to make an advance directive. This article seeks to justify autonomy as an appropriate principle for regulating advance directives and relies on three arguments: the necessity of autonomy in a liberal democracy; the primacy of autonomy in medical ethics discourse; and the uncontested importance of autonomy in the law on contemporaneous refusal of medical treatment. This article also responds to key criticisms that autonomy is not an appropriate organising principle to underpin legal regulation of advance directives.

Updated Liquid Secondary Waste Grout Formulation and Preliminary Waste Form Qualification

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

Saslow, Sarah A.; Um, Wooyong; Russell, Renee L.

This report describes the results from liquid secondary waste grout (LSWG) formulation and cementitious waste form qualification tests performed by Pacific Northwest National Laboratory (PNNL) for Washington River Protection Solutions, LLC (WRPS). New formulations for preparing a cementitious waste form from a high-sulfate liquid secondary waste stream simulant, developed for Effluent Management Facility (EMF) process condensates merged with low activity waste (LAW) caustic scrubber, and the release of key constituents (e.g. 99Tc and 129I) from these monoliths were evaluated. This work supports a technology development program to address the technology needs for Hanford Site Effluent Treatment Facility (ETF) liquid secondarymore » waste (LSW) solidification and supports future Direct Feed Low-Activity Waste (DFLAW) operations. High-priority activities included simulant development, LSWG formulation, and waste form qualification. The work contained within this report relates to waste form development and testing and does not directly support the 2017 integrated disposal facility (IDF) performance assessment (PA). However, this work contains valuable information for use in PA maintenance past FY17, and for future waste form development efforts. The provided data should be used by (i) cementitious waste form scientists to further understanding of cementitious dissolution behavior, (ii) IDF PA modelers who use quantified constituent leachability, effective diffusivity, and partitioning coefficients to advance PA modeling efforts, and (iii) the U.S. Department of Energy (DOE) contractors and decision makers as they assess the IDF PA program. The results obtained help fill existing data gaps, support final selection of a LSWG waste form, and improve the technical defensibility of long-term waste form performance estimates.« less

'Vague Oviedo': autonomy, culture and the case of previously competent patients.

PubMed

Pascalev, Assya; Vidalis, Takis

2010-03-01

The paper examines the ethical and legal challenges of making decisions for previously competent patients and the role of advance directives and legal representatives in light of the Oviedo Convention. The paper identifies gaps in the Convention that result in conflicting instructions in cases of a disagreement between the expressed prior wishes of a patient, and the legal representative. The authors also examine the legal and moral status of informally expressed prior wishes of patients unable to consent. The authors argue that positivist legal reasoning is insufficient for a consistent interpretation of the relevant provisions of the Convention and argue that ethical argumentation is needed to provide guidance in such cases. Based on the ethical arguments, the authors propose a way of reconciling the apparent inconsistencies in the Oviedo Convention. They advance a culturally sensitive approach to the application of the Convention at the national level. This approach understands autonomy as a broader, relational consent and emphasizes the social and cultural embeddedness of the individual. Based on their approach, the authors argue that there exists a moral obligation to respect the prior wishes of the patient even in countries without advance directives. Yet it should be left to the national legislations to determine the extent of this obligation and its concrete forms.

The paper crisis: from hospitals to medical practices.

PubMed

Park, Gregory; Neaveill, Rodney S

2009-01-01

Hospitals, not unlike physician practices, are faced with an increasing burden of managing piles of hard copy documents including insurance forms, requests for information, and advance directives. Healthcare organizations are moving to transform paper-based forms and documents into digitized files in order to save time and money and to have those documents available at a moment's notice. The cost of these document management/imaging systems can be easily justified with the significant savings of resources realized from the implementation of these systems. This article illustrates the enormity of the "paper problem" in healthcare and outlines just a few of the required processes that could be improved with the use of automated document management/imaging systems.

On recent advances and future research directions for computational fluid dynamics

NASA Technical Reports Server (NTRS)

Baker, A. J.; Soliman, M. O.; Manhardt, P. D.

1986-01-01

This paper highlights some recent accomplishments regarding CFD numerical algorithm constructions for generation of discrete approximate solutions to classes of Reynolds-averaged Navier-Stokes equations. Following an overview of turbulent closure modeling, and development of appropriate conservation law systems, a Taylor weak-statement semi-discrete approximate solution algorithm is developed. Various forms for completion to the final linear algebra statement are cited, as are a range of candidate numerical linear algebra solution procedures. This development sequence emphasizes the key building blocks of a CFD RNS algorithm, including solution trial and test spaces, integration procedure and added numerical stability mechanisms. A range of numerical results are discussed focusing on key topics guiding future research directions.

76 FR 33397 - 60-Day Notice of Proposed Information Collection: DS-4131 Advance Notification Form: Tourist and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-08

... Advance Notification Form: Tourist and Other Non-Governmental Activities in the Antarctic Treaty Area... of Information Collection: Advance Notification Form: Tourist and Other Non-Governmental Activities... proposed information collection is necessary for the proper performance of our functions. Evaluate the...

Numerical evaluation of longitudinal motions of Wigley hulls advancing in waves by using Bessho form translating-pulsating source Green'S function

NASA Astrophysics Data System (ADS)

Xiao, Wenbin; Dong, Wencai

2016-06-01

In the framework of 3D potential flow theory, Bessho form translating-pulsating source Green's function in frequency domain is chosen as the integral kernel in this study and hybrid source-and-dipole distribution model of the boundary element method is applied to directly solve the velocity potential for advancing ship in regular waves. Numerical characteristics of the Green function show that the contribution of local-flow components to velocity potential is concentrated at the nearby source point area and the wave component dominates the magnitude of velocity potential in the far field. Two kinds of mathematical models, with or without local-flow components taken into account, are adopted to numerically calculate the longitudinal motions of Wigley hulls, which demonstrates the applicability of translating-pulsating source Green's function method for various ship forms. In addition, the mesh analysis of discrete surface is carried out from the perspective of ship-form characteristics. The study shows that the longitudinal motion results by the simplified model are somewhat greater than the experimental data in the resonant zone, and the model can be used as an effective tool to predict ship seakeeping properties. However, translating-pulsating source Green function method is only appropriate for the qualitative analysis of motion response in waves if the ship geometrical shape fails to satisfy the slender-body assumption.

Development, Validation, and Deployment of a Revised Air Traffic Control Color Vision Test: Incorporating Advanced Technologies and Oceanic Procedures and En Route Automation Modernization Systems

DTIC Science & Technology

2013-09-01

through direct sampling of form and content of critical display data. Evidence of construct validity is provided by correlation with the Colour ...measured by the Colour Assessment and Diagnosis (CAD; ARTS Background Colors STARS Background Colors ERAM Background Colors Figure 3...Gelade, G. (1980). A feature-integration theory of attention. Cognitive Psychology , 12, 97–136. Xing, J. & Schroeder, D.J. (2006). Reexamination of

Investigation of Chirality Selection Mechanism of Single Walled Carbon Nanotube

DTIC Science & Technology

2016-12-13

in SiO2 Glasses by Ion Implantation. Jpn. J. Appl. Phys. 1993;32(9R):3892. List of Publications and Significant Collaborations that resulted from...layers using TEM holders showed significant advancement. This involved investigation of the effects of sub- supporting SiO2 layer on the interaction...number density are formed on the Al2O3 layer deposited on the sub-supporting SiO2 layer than that deposited directly on the Si(100) wafer. Based on the

Development and analysis of a STOL supersonic cruise fighter concept

NASA Technical Reports Server (NTRS)

Dollyhigh, S. M.; Foss, W. E., Jr.; Morris, S. J., Jr.; Walkley, K. B.; Swanson, E. E.; Robins, A. W.

1984-01-01

The application of advanced and emerging technologies to a fighter aircraft concept is described. The twin-boom fighter (TBF-1) relies on a two dimensional vectoring/reversing nozzle to provide STOL performance while also achieving efficient long range supersonic cruise. A key feature is that the propulsion package is placed so that the nozzle hinge line is near the aircraft center-of-gravity to allow large vector angles and, thus, provide large values of direct lift while minimizing the moments to be trimmed. The configurations name is derived from the long twin booms extending aft of the engine to the twin vertical tails which have a single horizontal tail mounted atop and between them. Technologies utilized were an advanced engine (1985 state-of-the-art), superplastic formed/diffusion bonded titanium structure, advanced controls/avionics/displays, supersonic wing design, and conformal weapons carriage. The integration of advanced technologies into this concept indicate that large gains in takeoff and landing performance, maneuver, acceleration, supersonic cruise speed, and range can be acieved relative to current fighter concepts.

Progress toward a Semantic eScience Framework; building on advanced cyberinfrastructure

NASA Astrophysics Data System (ADS)

McGuinness, D. L.; Fox, P. A.; West, P.; Rozell, E.; Zednik, S.; Chang, C.

2010-12-01

The configurable and extensible semantic eScience framework (SESF) has begun development and implementation of several semantic application components. Extensions and improvements to several ontologies have been made based on distinct interdisciplinary use cases ranging from solar physics, to biologicl and chemical oceanography. Importantly, these semantic representations mediate access to a diverse set of existing and emerging cyberinfrastructure. Among the advances are the population of triple stores with web accessible query services. A triple store is akin to a relational data store where the basic stored unit is a subject-predicate-object tuple. Access via a query is provided by the W3 Recommendation language specification SPARQL. Upon this middle tier of semantic cyberinfrastructure, we have developed several forms of semantic faceted search, including provenance-awareness. We report on the rapid advances in semantic technologies and tools and how we are sustaining the software path for the required technical advances as well as the ontology improvements and increased functionality of the semantic applications including how they are integrated into web-based portals (e.g. Drupal) and web services. Lastly, we indicate future work direction and opportunities for collaboration.

Study of advanced rotary combustion engines for commuter aircraft

NASA Technical Reports Server (NTRS)

Berkowitz, M.; Jones, C.; Myers, D.

1983-01-01

Performance, weight, size, and maintenance data for advanced rotary aircraft engines suitable for comparative commuter aircraft system evaluation studies of alternate engine candidates are provided. These are turbocharged, turbocompounded, direct injected, stratified charge rotary engines. Hypothetical engines were defined (an RC4-74 at 895 kW and an RC6-87 at 1490 kW) based on the technologies and design approaches used in the highly advanced engine of a study of advanced general aviation rotary engines. The data covers the size range of shaft power from 597 kW (800 hp) to 1865 kW (2500 hp) and is in the form of drawings, tables, curves and written text. These include data on internal geometry and configuration, installation information, turbocharging and turbocompounding arrangements, design features and technologies, engine cooling, fuels, scaling for weight size BSFC and heat rejection for varying horsepower, engine operating and performance data, and TBO and maintenance requirements. The basic combustion system was developed and demonstrated; however the projected power densities and performance efficiencies require increases in engine internal pressures, thermal loading, and rotative speed.

Advance directives and living wills.

PubMed Central

Stewart, K.; Bowker, L.

1998-01-01

Under certain circumstances, living wills or advance directives may carry legal force in the UK. This paper traces the development of advance directives, clarifies their current legal position and discusses potential problems with their use. Case histories are used to illustrate some of the common dilemmas which doctors may face. PMID:9640440

Variations in Consumer Self-Determination within US Psychiatric Advance Directives

ERIC Educational Resources Information Center

Zeman, Laura Dreuth; Swanke, Jayme

2008-01-01

Advance directives are legal documents that formalize consumer psychiatric care preferences. This article examines the statutes and goals of US psychiatric advance directives within the framework of consumer self-determination, a priority in national mental health reform. It seeks to distinguish between state models based on the degree that…

Promoting advance directives among African Americans: a faith-based model.

PubMed

Bullock, Karen

2006-02-01

Studies show that African Americans are less likely than other ethnic groups to complete advance directives. However, what influences African Americans' decisions to complete or not complete advance directives is unclear. Using a faith-based promotion model, 102 African Americans aged 55 years or older were recruited from local churches and community-based agencies to participate in a pilot study to promote advance care planning. Focus groups were used to collect data on participants' preferences for care, desire to make personal choices, values and attitudes, beliefs about death and dying, and advance directives. A standardized interview was used in the focus groups, and the data were organized and analyzed using NUDIST 4 software (QRS Software, Victoria, Australia). Three fourths of the participants refused to complete advance directives. The following factors influenced the participants' decisions about end-of-life care and completion of an advance directive: spirituality; view of suffering, death, and dying; social support networks; barriers to utilization; and mistrust of the health care system. The dissemination of information apprises individuals of their right to self-determine about their care, but educational efforts may not produce a significant change in behavior toward completion of advance care planning. Thus, ongoing efforts are needed to improve the trust that African Americans have in medical and health care providers.

[Advance Directives - Not a Lot of Margin for Error - The Surgeon's View of a Complex Medical-Legal Topic].

PubMed

Slotta, J E; Schilling, M K; Ghadimi, M; Kollmar, O

2015-08-01

Since September 1st, 2009, the most recent version of the German "Betreuungsrechtsänderungsgesetz" has been validated by the legislators. It precisely sets out how physicians and nursing staff have to deal with a written declaration of a patient's will. This new law focuses in a special way on advance directives, describes the precise rules for the authors of an advance directive and shows both its sphere of action and its limitations. This article aims to give an overview on the legal scope of advance directives, and to illustrate potential limitations and conflicts. Furthermore, it shows the commitments and rights of the medical team against the background of an existing advance directive. Georg Thieme Verlag KG Stuttgart · New York.

Abnormal liver function in different patients with Schistosoma japonicum.

PubMed

Ning, An; Wu, Xiaoying; Li, Hongyu; Liang, Jinyi; Gao, Zulu; Shen, Jia; Liu, Zhen; Xu, Jun; Hu, Fei; Wu, Feng; Ji, Pengyu; Wu, Zhongdao; Sun, Xi

2015-01-01

Schistosomiasis japonica, caused by Schistosoma japonicum, is still a serious public health problem in China. It is important for schistosomiasis control to prevent from infection and advanced patients. Recent years, however, the form of the prevalence of schistosomiasis japonica in China was changed these days. Paying attention to the quality of life of these patients already infected with S. japonicum becomes a new objective to schistosomiasis control program. Although most of the chronic infections with S. japonicum will finally appear as liver fibrosis symptoms, it is still unknown liver function abnormalities in patients with severe forms of schistosomiasis, and there is also no evidence whether S. japonicum infection will directly cause damage to liver cells. Thus, this study investigated 494 patients diagnosed with S. japonicum (87.7%) and 69 healthy subjects from a endemic areas belonging to Jiangxi Province of China and aimed to evaluate the liver function abnormalities in patients with severe forms of schistosomiasis and possible associations with coinfection with HBV. The results showed that the hepatic metabolism situation significantly changed in patients infected with S. japonicum; meanwhile, the abnormal rates of ALT and AST in patients with schistosomiasis were significantly higher than that in the control group, which confirmed that patients infected with S. japonicum not only had damaged liver function but also the hepatic cells were directly influenced. And the coinfection of CHB and schistosomiasis japonica can be a risk factor for more serious outcomes in patients from endemic areas. These results give us the advice that in the further treatment of patients infected with S. japonicum, especially these coinfections, we should better give the routine liver-protection treatment in advance.

The Los Alamos Laser Acceleration of Particles Workshop and beginning of the advanced accelerator concepts field

NASA Astrophysics Data System (ADS)

Joshi, C.

2012-12-01

The first Advanced Acceleration of Particles-AAC-Workshop (actually named Laser Acceleration of Particles Workshop) was held at Los Alamos in January 1982. The workshop lasted a week and divided all the acceleration techniques into four categories: near field, far field, media, and vacuum. Basic theorems of particle acceleration were postulated (later proven) and specific experiments based on the four categories were formulated. This landmark workshop led to the formation of the advanced accelerator R&D program in the HEP office of the DOE that supports advanced accelerator research to this day. Two major new user facilities at Argonne and Brookhaven and several more directed experimental efforts were built to explore the advanced particle acceleration schemes. It is not an exaggeration to say that the intellectual breadth and excitement provided by the many groups who entered this new field provided the needed vitality to then recently formed APS Division of Beams and the new online journal Physical Review Special Topics-Accelerators and Beams. On this 30th anniversary of the AAC Workshops, it is worthwhile to look back at the legacy of the first Workshop at Los Alamos and the fine groundwork it laid for the field of advanced accelerator concepts that continues to flourish to this day.

Gold nanocrystals with DNA-directed morphologies.

PubMed

Ma, Xingyi; Huh, June; Park, Wounjhang; Lee, Luke P; Kwon, Young Jik; Sim, Sang Jun

2016-09-16

Precise control over the structure of metal nanomaterials is important for developing advanced nanobiotechnology. Assembly methods of nanoparticles into structured blocks have been widely demonstrated recently. However, synthesis of nanocrystals with controlled, three-dimensional structures remains challenging. Here we show a directed crystallization of gold by a single DNA molecular regulator in a sequence-independent manner and its applications in three-dimensional topological controls of crystalline nanostructures. We anchor DNA onto gold nanoseed with various alignments to form gold nanocrystals with defined topologies. Some topologies are asymmetric including pushpin-, star- and biconcave disk-like structures, as well as more complex jellyfish- and flower-like structures. The approach of employing DNA enables the solution-based synthesis of nanocrystals with controlled, three-dimensional structures in a desired direction, and expands the current tools available for designing and synthesizing feature-rich nanomaterials for future translational biotechnology.

Gold nanocrystals with DNA-directed morphologies

NASA Astrophysics Data System (ADS)

Ma, Xingyi; Huh, June; Park, Wounjhang; Lee, Luke P.; Kwon, Young Jik; Sim, Sang Jun

2016-09-01

Precise control over the structure of metal nanomaterials is important for developing advanced nanobiotechnology. Assembly methods of nanoparticles into structured blocks have been widely demonstrated recently. However, synthesis of nanocrystals with controlled, three-dimensional structures remains challenging. Here we show a directed crystallization of gold by a single DNA molecular regulator in a sequence-independent manner and its applications in three-dimensional topological controls of crystalline nanostructures. We anchor DNA onto gold nanoseed with various alignments to form gold nanocrystals with defined topologies. Some topologies are asymmetric including pushpin-, star- and biconcave disk-like structures, as well as more complex jellyfish- and flower-like structures. The approach of employing DNA enables the solution-based synthesis of nanocrystals with controlled, three-dimensional structures in a desired direction, and expands the current tools available for designing and synthesizing feature-rich nanomaterials for future translational biotechnology.

Approximately One In Three US Adults Completes Any Type Of Advance Directive For End-Of-Life Care.

PubMed

Yadav, Kuldeep N; Gabler, Nicole B; Cooney, Elizabeth; Kent, Saida; Kim, Jennifer; Herbst, Nicole; Mante, Adjoa; Halpern, Scott D; Courtright, Katherine R

2017-07-01

Efforts to promote the completion of advance directives implicitly assume that completion rates of these documents, which help ensure care consistent with people's preferences in the event of incapacity, are undesirably low. However, data regarding completion of advance directives in the United States are inconsistent and of variable quality. We systematically reviewed studies published in the period 2011-16 to determine the proportion of US adults with a completed living will, health care power of attorney, or both. Among the 795,909 people in the 150 studies we analyzed, 36.7 percent had completed an advance directive, including 29.3 percent with living wills. These proportions were similar across the years reviewed. Similar proportions of patients with chronic illnesses (38.2 percent) and healthy adults (32.7 percent) had completed advance directives. The findings provide benchmarks for gauging future policies and practices designed to motivate completion of advance directives, particularly among those people most likely to benefit from having these documents on record. Project HOPE—The People-to-People Health Foundation, Inc.

A superhydrophobic copper mesh as an advanced platform for oil-water separation

NASA Astrophysics Data System (ADS)

Ren, Guina; Song, Yuanming; Li, Xiangming; Zhou, Yanli; Zhang, Zhaozhu; Zhu, Xiaotao

2018-01-01

Improving the separation efficiency and simplifying the separation process would be highly desired for oil-water separation yet still challenging. Herein, to address this challenge, we fabricated a superhydrophobic copper mesh by an immersion process and exploited it as an advanced platform for oil-water separation. To realize oil-water separation efficiently, the obtained mesh was enfolded directly to form a boat-like device, and it could also be mounted on an open end of a glass barrel to form the oil skimmer device. For these devices, they can collect the floating oils through the pores of the copper mesh while repelling water completely, and the oil collection efficiency is up to 99.5%. Oils collected in the devices can be easily sucked out into a container for storing, without requiring mechanical handing for recycling. Importantly, the miniature boat and the oil skimmer devices can retain their enhanced oil collection efficiency even after 10 cycles of oil-water separation. Moreover, exploiting its superhydrophobicity under oil, the obtained copper mesh was demonstrated as a novel platform to remove tiny water droplets from oil.

Emerging indications for extracorporeal membrane oxygenation in adults with respiratory failure.

PubMed

Abrams, Darryl; Brodie, Daniel

2013-08-01

Recent advances in technology have spurred the increasing use of extracorporeal membrane oxygenation (ECMO) in patients with severe hypoxemic respiratory failure. However, this accounts for only a small percentage of patients with respiratory failure. We envision the application of ECMO in many other forms of respiratory failure in the coming years. Patients with less severe forms of acute respiratory distress syndrome, for instance, may benefit from enhanced lung-protective ventilation with the very low tidal volumes made possible by direct carbon dioxide removal from the blood. For those in whom hypercapnia predominates, extracorporeal support will allow for the elimination of invasive mechanical ventilation in some cases. The potential benefits of ECMO may be further enhanced by improved techniques, which facilitate active mobilization. Although ECMO for these and other expanded applications is under active investigation, it has yet to be proven beneficial in these settings in rigorous controlled trials. Ultimately, with upcoming and future technological advances, there is the promise of true destination therapy, which could lead to a major paradigm shift in the management of respiratory failure.

8 CFR 204.3 - Orphan cases under section 101(b)(1)(F) of the Act (non-Convention cases).

Code of Federal Regulations, 2013 CFR

2013-01-01

... advanced processing application (or the advanced processing application concurrently with the orphan... home study preparer and/or fingerprint check. Advanced processing application means Form I-600A (Application for Advanced Processing of Orphan Petition) completed in accordance with the form's instructions...

8 CFR 204.3 - Orphan cases under section 101(b)(1)(F) of the Act (non-Convention cases).

Code of Federal Regulations, 2010 CFR

2010-01-01

... advanced processing application (or the advanced processing application concurrently with the orphan... home study preparer and/or fingerprint check. Advanced processing application means Form I-600A (Application for Advanced Processing of Orphan Petition) completed in accordance with the form's instructions...

8 CFR 204.3 - Orphan cases under section 101(b)(1)(F) of the Act (non-Convention cases).

Code of Federal Regulations, 2014 CFR

2014-01-01

... advanced processing application (or the advanced processing application concurrently with the orphan... home study preparer and/or fingerprint check. Advanced processing application means Form I-600A (Application for Advanced Processing of Orphan Petition) completed in accordance with the form's instructions...

8 CFR 204.3 - Orphan cases under section 101(b)(1)(F) of the Act (non-Convention cases).

Code of Federal Regulations, 2011 CFR

2011-01-01

... advanced processing application (or the advanced processing application concurrently with the orphan... home study preparer and/or fingerprint check. Advanced processing application means Form I-600A (Application for Advanced Processing of Orphan Petition) completed in accordance with the form's instructions...

8 CFR 204.3 - Orphan cases under section 101(b)(1)(F) of the Act (non-Convention cases).

Code of Federal Regulations, 2012 CFR

2012-01-01

... advanced processing application (or the advanced processing application concurrently with the orphan... home study preparer and/or fingerprint check. Advanced processing application means Form I-600A (Application for Advanced Processing of Orphan Petition) completed in accordance with the form's instructions...

High-resolution non-destructive three-dimensional imaging of integrated circuits

NASA Astrophysics Data System (ADS)

Holler, Mirko; Guizar-Sicairos, Manuel; Tsai, Esther H. R.; Dinapoli, Roberto; Müller, Elisabeth; Bunk, Oliver; Raabe, Jörg; Aeppli, Gabriel

2017-03-01

Modern nanoelectronics has advanced to a point at which it is impossible to image entire devices and their interconnections non-destructively because of their small feature sizes and the complex three-dimensional structures resulting from their integration on a chip. This metrology gap implies a lack of direct feedback between design and manufacturing processes, and hampers quality control during production, shipment and use. Here we demonstrate that X-ray ptychography—a high-resolution coherent diffractive imaging technique—can create three-dimensional images of integrated circuits of known and unknown designs with a lateral resolution in all directions down to 14.6 nanometres. We obtained detailed device geometries and corresponding elemental maps, and show how the devices are integrated with each other to form the chip. Our experiments represent a major advance in chip inspection and reverse engineering over the traditional destructive electron microscopy and ion milling techniques. Foreseeable developments in X-ray sources, optics and detectors, as well as adoption of an instrument geometry optimized for planar rather than cylindrical samples, could lead to a thousand-fold increase in efficiency, with concomitant reductions in scan times and voxel sizes.

The Transcription Factor EB Links Cellular Stress to the Immune Response



PubMed Central

Nabar, Neel R.; Kehrl, John H.

2017-01-01

The transcription factor EB (TFEB) is the master transcriptional regulator of autophagy and lysosome biogenesis. Recent advances have led to a paradigm shift in our understanding of lysosomes from a housekeeping cellular waste bin to a dynamically regulated pathway that is efficiently turned up or down based on cellular needs. TFEB coordinates the cellular response to nutrient deprivation and other forms of cell stress through the lysosome system, and regulates a myriad of cellular processes associated with this system including endocytosis, phagocytosis, autophagy, and lysosomal exocytosis. Autophagy and the endolysosomal system are critical to both the innate and adaptive arms of the immune system, with functions in effector cell priming and direct pathogen clearance. Recent studies have linked TFEB to the regulation of the immune response through the endolysosmal pathway and by direct transcriptional activation of immune related genes. In this review, we discuss the current understanding of TFEB’s function and the molecular mechanisms behind TFEB activation. Finally, we discuss recent advances linking TFEB to the immune response that positions lysosomal signaling as a potential target for immune modulation. PMID:28656016

High-resolution non-destructive three-dimensional imaging of integrated circuits.

PubMed

Holler, Mirko; Guizar-Sicairos, Manuel; Tsai, Esther H R; Dinapoli, Roberto; Müller, Elisabeth; Bunk, Oliver; Raabe, Jörg; Aeppli, Gabriel

2017-03-15

Modern nanoelectronics has advanced to a point at which it is impossible to image entire devices and their interconnections non-destructively because of their small feature sizes and the complex three-dimensional structures resulting from their integration on a chip. This metrology gap implies a lack of direct feedback between design and manufacturing processes, and hampers quality control during production, shipment and use. Here we demonstrate that X-ray ptychography-a high-resolution coherent diffractive imaging technique-can create three-dimensional images of integrated circuits of known and unknown designs with a lateral resolution in all directions down to 14.6 nanometres. We obtained detailed device geometries and corresponding elemental maps, and show how the devices are integrated with each other to form the chip. Our experiments represent a major advance in chip inspection and reverse engineering over the traditional destructive electron microscopy and ion milling techniques. Foreseeable developments in X-ray sources, optics and detectors, as well as adoption of an instrument geometry optimized for planar rather than cylindrical samples, could lead to a thousand-fold increase in efficiency, with concomitant reductions in scan times and voxel sizes.

The Transcription Factor EB Links Cellular Stress to the Immune Response

.

PubMed

Nabar, Neel R; Kehrl, John H

2017-06-01

The transcription factor EB (TFEB) is the master transcriptional regulator of autophagy and lysosome biogenesis. Recent advances have led to a paradigm shift in our understanding of lysosomes from a housekeeping cellular waste bin to a dynamically regulated pathway that is efficiently turned up or down based on cellular needs. TFEB coordinates the cellular response to nutrient deprivation and other forms of cell stress through the lysosome system, and regulates a myriad of cellular processes associated with this system including endocytosis, phagocytosis, autophagy, and lysosomal exocytosis. Autophagy and the endolysosomal system are critical to both the innate and adaptive arms of the immune system, with functions in effector cell priming and direct pathogen clearance. Recent studies have linked TFEB to the regulation of the immune response through the endolysosmal pathway and by direct transcriptional activation of immune related genes. In this review, we discuss the current understanding of TFEB's function and the molecular mechanisms behind TFEB activation. Finally, we discuss recent advances linking TFEB to the immune response that positions lysosomal signaling as a potential target for immune modulation.

Protein-Protein Interface Predictions by Data-Driven Methods: A Review

PubMed Central

Xue, Li C; Dobbs, Drena; Bonvin, Alexandre M.J.J.; Honavar, Vasant

2015-01-01

Reliably pinpointing which specific amino acid residues form the interface(s) between a protein and its binding partner(s) is critical for understanding the structural and physicochemical determinants of protein recognition and binding affinity, and has wide applications in modeling and validating protein interactions predicted by high-throughput methods, in engineering proteins, and in prioritizing drug targets. Here, we review the basic concepts, principles and recent advances in computational approaches to the analysis and prediction of protein-protein interfaces. We point out caveats for objectively evaluating interface predictors, and discuss various applications of data-driven interface predictors for improving energy model-driven protein-protein docking. Finally, we stress the importance of exploiting binding partner information in reliably predicting interfaces and highlight recent advances in this emerging direction. PMID:26460190

Fabrication of Microfiber Patterns with Ivy Shoot-Like Geometries Using Improved Electrospinning

PubMed Central

Jeong, Young Hun; Lee, Jongwan

2016-01-01

Fibers and fibrous structures are used extensively in various fields due to their many advantages. Microfibers, as well as nanofibers, are considered to be some of the most valuable forms of advanced materials. Accordingly, various methods for fabricating microfibers have been developed. Electrospinning is a useful fabrication method for continuous polymeric nano- and microfibers with attractive merits. However, this technique has limitations in its ability to control the geometry of fibrous structures. Herein, advanced electrospinning with direct-writing functionality was used to fabricate microfiber patterns with ivy shoot-like geometries after experimentally investigating the effects of the process conditions on the fiber formation. The surface properties of the fibers were also modified by introducing nanoscale pores through the use of higher levels of humidity during the fabrication process. PMID:28773390

Fabrication of Microfiber Patterns with Ivy Shoot-Like Geometries Using Improved Electrospinning.

PubMed

Jeong, Young Hun; Lee, Jongwan

2016-04-01

Fibers and fibrous structures are used extensively in various fields due to their many advantages. Microfibers, as well as nanofibers, are considered to be some of the most valuable forms of advanced materials. Accordingly, various methods for fabricating microfibers have been developed. Electrospinning is a useful fabrication method for continuous polymeric nano- and microfibers with attractive merits. However, this technique has limitations in its ability to control the geometry of fibrous structures. Herein, advanced electrospinning with direct-writing functionality was used to fabricate microfiber patterns with ivy shoot-like geometries after experimentally investigating the effects of the process conditions on the fiber formation. The surface properties of the fibers were also modified by introducing nanoscale pores through the use of higher levels of humidity during the fabrication process.

Inlet flow field investigation. Part 1: Transonic flow field survey

NASA Technical Reports Server (NTRS)

Yetter, J. A.; Salemann, V.; Sussman, M. B.

1984-01-01

A wind tunnel investigation was conducted to determine the local inlet flow field characteristics of an advanced tactical supersonic cruise airplane. A data base for the development and validation of analytical codes directed at the analysis of inlet flow fields for advanced supersonic airplanes was established. Testing was conducted at the NASA-Langley 16-foot Transonic Tunnel at freestream Mach numbers of 0.6 to 1.20 and angles of attack from 0.0 to 10.0 degrees. Inlet flow field surveys were made at locations representative of wing (upper and lower surface) and forebody mounted inlet concepts. Results are presented in the form of local inlet flow field angle of attack, sideflow angle, and Mach number contours. Wing surface pressure distributions supplement the flow field data.

Impact of Integrated Care Model (ICM) on Direct Medical Costs in Management of Advanced Chronic Obstructive Pulmonary Disease (COPD)

PubMed Central

Bandurska, Ewa; Damps-Konstańska, Iwona; Popowski, Piotr; Jędrzejczyk, Tadeusz; Janowiak, Piotr; Świętnicka, Katarzyna; Zarzeczna-Baran, Marzena; Jassem, Ewa

2017-01-01

Background Chronic obstructive pulmonary disease (COPD) is a commonly diagnosed condition in people older than 50 years of age. In advanced stage of this disease, integrated care (IC) is recommended as an optimal approach. IC allows for holistic and patient-focused care carried out at the patient’s home. The aim of this study was to analyze the impact of IC on costs of care and on demand for medical services among patients included in IC. Material/Methods The study included 154 patients diagnosed with advanced COPD. Costs of care (general, COPD, and exacerbations-related) were evaluated for 1 year, including 6-months before and after implementing IC. The analysis included assessment of the number of medical procedures of various types before and after entering IC and changes in medical services providers. Results Direct medical costs of standard care in advanced COPD were 886.78 EUR per 6 months. Costs of care of all types decreased after introducing IC. Changes in COPD and exacerbation-related costs were statistically significant (p=0.012492 and p=0.017023, respectively). Patients less frequently used medical services for respiratory system and cardiovascular diseases. Similarly, the number of hospitalizations and visits to emergency medicine departments decreased (by 40.24% and 8.5%, respectively). The number of GP visits increased after introducing IC (by 7.14%). Conclusions The high costs of care in advanced COPD indicate the need for new forms of effective care. IC caused a decrease in costs and in the number of hospitalization, with a simultaneous increase in the number of GP visits. PMID:28603270

Did you seek assistance for writing your advance directive? A qualitative study.

PubMed

Becker, Matthias; Jaspers, Birgit; King, Claudius; Radbruch, Lukas; Voltz, Raymond; Nauck, Friedemann

2010-11-01

the completion of an advanced directive is paired with a high degree of self-responsibility of the signatory. It requires anticipation of probably complex medical situations. In the literature, the family physician is often seen as the most important person for advice when writing an advance directive. But little is known about whether or not patients want to involve medical advisors and to what extent physicians are willing to give advice. The aim of this study was to analyse whether or not individuals approached advisors for the completion of their advance directive, whom they chose and which reasons were given for seeking or foregoing assistance. semi-structured interviews with healthy individuals, chronically ill individuals and patients in palliative care including questions associated with advice for completing an advance directive (8/2008-7/2009). age 55-70 years and advance directive ≥ 3 months old. The interviews were fully transcribed according to standard transcription rules and analysed applying an inductive category development. interviews were conducted with 53 probands (healthy n = 20, chronically ill n = 17, palliative care patients n = 16); 18 probands were male. Mean age was 63.2 ± 4.4 years (range 55-70 years). Professional advice was sought by 12 probands (physician = 2, nurse = 1, lawyer/notary = 8, self-employed advisor = 1), another 8 probands included family members. In 17 cases, the physician knew the proband's advance directive, 36 probands never told their doctor about its existence. Categories of reasons for seeking or foregoing advice were trust/lack of trust, autonomy, rejection and financial considerations. information about the medical implications concerning patient preferences for end-of-life care seems not to be the main focus of interest when individuals write an advance directive. Autonomy and trust into notarially certified documents seem to be more important matters. If family physicians want to have a role in their patients' completing of an advance directive, they should proactively get in touch with them.

78 FR 8225 - Proposed Collection; Comment Request for Form 1099-H

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-05

... 1099-H AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice and request for comments... Form 1099-H, Health Coverage Tax Credit (HCTC) Advance Payments. DATES: Written comments should be...: 1545-1813. Form Number: Form 1099-H. Abstract: Form 1099-H is used to report advance payments of health...

75 FR 2931 - Proposed Collection; Comment Request for Form 1099-H

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-19

... 1099-H AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice and request for comments... Form 1099-H, Health Coverage Tax Credit (HCTC) Advance Payments. DATES: Written comments should be.... OMB Number: 1545-1813. Form Number: Form 1099-H. Abstract: Form 1099-H is used to report advance...

X-ray Absorption Spectroscopy Reveals an Organometallic Ni–C Bond in the CO-Treated Form of Acetyl-CoA Synthase

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

Can, Mehmet; Giles, Logan J.; Ragsdale, Stephen W.

Acetyl-CoA synthase (ACS) is a key enzyme in the Wood–Ljungdahl pathway of anaerobic CO 2 fixation, which has long been proposed to operate by a novel mechanism involving a series of protein-bound organometallic (Ni–CO, methyl–Ni, and acetyl–Ni) intermediates. Here we report the first direct structural evidence of the proposed metal–carbon bond. We describe the preparation of the highly active metal-replete enzyme and near-quantitative generation of the kinetically competent carbonylated intermediate. This advance has allowed a combination of Ni and Fe K-edge X-ray absorption spectroscopy and extended X-ray absorption fine structure experiments along with density functional theory calculations. The data revealmore » that CO binds to the proximal Ni of the six-metal metallocenter at the active site and undergoes dramatic structural and electronic perturbation in forming this organometallic Ni–CO intermediate. This direct identification of a Ni–carbon bond in the catalytically competent CO-bound form of the In conclusion, a cluster of ACS provides definitive experimental structural evidence supporting the proposed organometallic mechanism of anaerobic acetyl-CoA synthesis.« less

X-ray Absorption Spectroscopy Reveals an Organometallic Ni–C Bond in the CO-Treated Form of Acetyl-CoA Synthase

DOE PAGES

Can, Mehmet; Giles, Logan J.; Ragsdale, Stephen W.; ...

2017-02-10

Acetyl-CoA synthase (ACS) is a key enzyme in the Wood–Ljungdahl pathway of anaerobic CO 2 fixation, which has long been proposed to operate by a novel mechanism involving a series of protein-bound organometallic (Ni–CO, methyl–Ni, and acetyl–Ni) intermediates. Here we report the first direct structural evidence of the proposed metal–carbon bond. We describe the preparation of the highly active metal-replete enzyme and near-quantitative generation of the kinetically competent carbonylated intermediate. This advance has allowed a combination of Ni and Fe K-edge X-ray absorption spectroscopy and extended X-ray absorption fine structure experiments along with density functional theory calculations. The data revealmore » that CO binds to the proximal Ni of the six-metal metallocenter at the active site and undergoes dramatic structural and electronic perturbation in forming this organometallic Ni–CO intermediate. This direct identification of a Ni–carbon bond in the catalytically competent CO-bound form of the In conclusion, a cluster of ACS provides definitive experimental structural evidence supporting the proposed organometallic mechanism of anaerobic acetyl-CoA synthesis.« less

Advance Directives in Hospice Healthcare Providers: A Clinical Challenge.

PubMed

Luck, George R; Eggenberger, Terry; Newman, David; Cortizo, Jacqueline; Blankenship, Derek C; Hennekens, Charles H

2017-11-01

On a daily basis, healthcare providers, especially those dealing with terminally ill patients, such as hospice workers, witness how advance directives help ensure the wishes of patients. They also witness the deleterious consequences when patients fail to document the care they desire at their end of life. To the best of our knowledge there are no data concerning the prevalence of advance directives among hospice healthcare providers. We therefore explored the prevalence and factors influencing completion rates in a survey of hospice healthcare providers. Surveys that included 32 items to explore completion rates, as well as barriers, knowledge, and demographics, were e-mailed to 2097 healthcare providers, including employees and volunteers, at a nonprofit hospice. Of 890 respondents, 44% reported having completed an advance directive. Ethnicity, age, relationship status, and perceived knowledge were all significant factors influencing the completion rates, whereas years of experience or working directly with patients had no effect. Procrastination, fear of the subject, and costs were common reasons reported as barriers. Upon completion of the survey, 43% said they will now complete an advance directive, and 45% will talk to patients and families about their wishes. The majority of hospice healthcare providers have not completed an advance directive. These results are very similar to those for other healthcare providers treating patients with terminal diseases, specifically oncologists. Because, at completion, 43% said that they would now complete an advance directive, such a survey of healthcare providers may help increase completion rates. Copyright © 2017 Elsevier Inc. All rights reserved.

Biaxial experiments supporting the development of constitutive theories for advanced high-temperature materials

NASA Technical Reports Server (NTRS)

Ellis, J. R.

1988-01-01

Complex states of stress and strain are introduced into components during service in engineering applications. It follows that analysis of such components requires material descriptions, or constitutive theories, which reflect the tensorial nature of stress and strain. For applications involving stress levels above yield, the situation is more complex in that material response is both nonlinear and history dependent. This has led to the development of viscoplastic constitutive theories which introduce time by expressing the flow and evolutionary equation in the form of time derivatives. Models were developed here which can be used to analyze high temperature components manufactured from advanced composite materials. In parallel with these studies, effort was directed at developing multiaxial testing techniques to verify the various theories. Recent progress in the development of constitutive theories from both the theoretical and experimental viewpoints are outlined. One important aspect is that material descriptions for advanced composite materials which can be implemented in general purpose finite element codes and used for practical design are verified.

Recent advances in visible-light-responsive photocatalysts for hydrogen production and solar energy conversion--from semiconducting TiO2 to MOF/PCP photocatalysts.

PubMed

Horiuchi, Yu; Toyao, Takashi; Takeuchi, Masato; Matsuoka, Masaya; Anpo, Masakazu

2013-08-28

The present perspective describes recent advances in visible-light-responsive photocatalysts intended to develop novel and efficient solar energy conversion technologies, including water splitting and photofuel cells. Water splitting is recognized as one of the most promising techniques to convert solar energy as a clean and abundant energy resource into chemical energy in the form of hydrogen. In recent years, increasing concern is directed to not only the development of new photocatalytic materials but also the importance of technologies to produce hydrogen and oxygen separately. Photofuel cells can convert solar energy into electrical energy by decomposing bio-related compounds and livestock waste as fuels. The advances of photocatalysts enabling these solar energy conversion technologies have been going on since the discovery of semiconducting titanium dioxide materials and have extended to organic-inorganic hybrid materials, such as metal-organic frameworks and porous coordination polymers (MOF/PCP).

Verbal Auditory Cueing of Improvisational Dance: A Proposed Method for Training Agency in Parkinson’s Disease

PubMed Central

Batson, Glenna; Hugenschmidt, Christina E.; Soriano, Christina T.

2016-01-01

Dance is a non-pharmacological intervention that helps maintain functional independence and quality of life in people with Parkinson’s disease (PPD). Results from controlled studies on group-delivered dance for people with mild-to-moderate stage Parkinson’s have shown statistically and clinically significant improvements in gait, balance, and psychosocial factors. Tested interventions include non-partnered dance forms (ballet and modern dance) and partnered (tango). In all of these dance forms, specific movement patterns initially are learned through repetition and performed in time-to-music. Once the basic steps are mastered, students may be encouraged to improvise on the learned steps as they perform them in rhythm with the music. Here, we summarize a method of teaching improvisational dance that advances previous reported benefits of dance for people with Parkinson’s disease (PD). The method relies primarily on improvisational verbal auditory cueing with less emphasis on directed movement instruction. This method builds on the idea that daily living requires flexible, adaptive responses to real-life challenges. In PD, movement disorders not only limit mobility but also impair spontaneity of thought and action. Dance improvisation demands open and immediate interpretation of verbally delivered movement cues, potentially fostering the formation of spontaneous movement strategies. Here, we present an introduction to a proposed method, detailing its methodological specifics, and pointing to future directions. The viewpoint advances an embodied cognitive approach that has eco-validity in helping PPD meet the changing demands of daily living. PMID:26925029

Paramedics experiences and expectations concerning advance directives: a prospective, questionnaire-based, bi-centre study.

PubMed

Taghavi, Mahmoud; Simon, Alfred; Kappus, Stefan; Meyer, Nicole; Lassen, Christoph L; Klier, Tobias; Ruppert, David B; Graf, Bernhard M; Hanekop, Gerd G; Wiese, Christoph H R

2012-10-01

Advance directives and palliative crisis cards are means by which palliative care patients can exert their autonomy in end-of-life decisions. To examine paramedics' attitudes towards advance directives and end-of-life care. Questionnaire-based investigation using a self-administered survey instrument. Paramedics of two cities (Hamburg and Goettingen, Germany) were included. Participants were questioned as to (1) their attitudes about advance directives, (2) their clinical experiences in connection with end-of-life situations (e.g. resuscitation), (3) their suggestions in regard to advance directives, 'Do not attempt resuscitation' orders and palliative crisis cards. Questionnaires were returned by 728 paramedics (response rate: 81%). The majority of paramedics (71%) had dealt with advance directives and end-of-life decisions in emergency situations. Most participants (84%) found that cardiopulmonary resuscitation in end-of-life patients is not useful and 75% stated that they would withhold cardiopulmonary resuscitation in the case of legal possibility. Participants also mentioned that more extensive discussion of legal aspects concerning advance directives should be included in paramedic training curricula. They suggested that palliative crisis cards should be integrated into end-of-life care. Decision making in prehospital end-of-life care is a challenge for all paramedics. The present investigation demonstrates that a dialogue bridging emergency medical and palliative care issues is necessary. The paramedics indicated that improved guidelines on end-of-life decisions and the termination of cardiopulmonary resuscitation in palliative care patients may be essential. Participants do not feel adequately trained in end-of-life care and the content of advance directives. Other recent studies have also demonstrated that there is a need for training curricula in end-of-life care for paramedics.

Advance directives in intensive care: Health professional competences.

PubMed

Velasco-Sanz, T R; Rayón-Valpuesta, E

2016-04-01

To identify knowledge, skills and attitudes among physicians and nurses of adults' intensive care units (ICUs), referred to advance directives or living wills. A cross-sectional descriptive study was carried out. Nine hospitals in the Community of Madrid (Spain). Physicians and nurses of adults' intensive care. A qualitative Likert-type scale and multiple response survey were made. Knowledge, skills and attitudes about the advance directives. A descriptive statistical analysis based on percentages was made, with application of the chi-squared test for comparisons, accepting p < 0.05 as representing statistical significance. A total of 331 surveys were collected (51%). It was seen that 90.3% did not know all the measures envisaged by the advance directives. In turn, 50.2% claimed that the living wills are not respected, and 82.8% believed advance directives to be a useful tool for health professionals in the decision making process. A total of 85.3% the physicians stated that they would respect a living will, in cases of emergencies, compared to 66.2% of the nursing staff (p = 0.007). Lastly, only 19.1% of the physicians and 2.3% of the nursing staff knew whether their patients had advance directives (p < 0.001). Although health professionals displayed poor knowledge of advance directives, they had a favorable attitude toward their usefulness. However, most did not know whether their patients had a living will, and some professionals even failed to respect such instructions despite knowledge of the existence of advance directives. Improvements in health professional education in this field are needed. Copyright © 2015 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

Doppler-guided retrograde catheterization system

NASA Astrophysics Data System (ADS)

Frazin, Leon J.; Vonesh, Michael J.; Chandran, Krishnan B.; Khasho, Fouad; Lanza, George M.; Talano, James V.; McPherson, David D.

1991-05-01

The purpose of this study was to investigate a Doppler guided catheterization system as an adjunctive or alternative methodology to overcome the disadvantages of left heart catheterization and angiography. These disadvantages include the biological effects of radiation and the toxic and volume effects of iodine contrast. Doppler retrograde guidance uses a 20 MHz circular pulsed Doppler crystal incorporated into the tip of a triple lumen multipurpose catheter and is advanced retrogradely using the directional flow information provided by the Doppler waveform. The velocity detection limits are either 1 m/second or 4 m/second depending upon the instrumentation. In a physiologic flow model of the human aortic arch, multiple data points revealed a positive wave form when flow was traveling toward the catheter tip indicating proper alignment for retrograde advancement. There was a negative wave form when flow was traveling away from the catheter tip if the catheter was in a branch or bent upon itself indicating improper catheter tip position for retrograde advancement. In a series of six dogs, the catheter was able to be accurately advanced from the femoral artery to the left ventricular chamber under Doppler signal guidance without the use of x-ray. The potential applications of a Doppler guided retrograde catheterization system include decreasing time requirements and allowing safer catheter guidance in patients with atherosclerotic vascular disease and suspected aortic dissection. The Doppler system may allow left ventricular pressure monitoring in the intensive care unit without the need for x-ray and it may allow left sided contrast echocardiography. With pulse velocity detection limits of 4 m/second, this system may allow catheter direction and passage into the aortic root and left ventricle in patients with aortic stenosis. A modification of the Doppler catheter may include transponder technology which would allow precise catheter tip localization once the catheter tip is placed in the aortic root. Such technology may conceivably assist in allowing selective coronary catheterization. These studies have demonstrated that Doppler guided retrograde catheterization provides an accurate method to catheterization the aortic root and left ventricular chamber without x-ray. In humans, it may prove useful in a variety of settings including the development of invasive ultrasonic diagnostic and therapeutic technology.

Advance directives: the consecration of autonomy and dignity of the human being.

PubMed

Chaves, Marianna

2013-12-01

Advance directives emerge in the doctor-patient relationship as a way to ensure that the autonomy of the patient is observed, prior to a potential state of incapacity. Thus, autonomy can be exercised ensuring patient's dignity and self-determination. Advance directives yet have the power to drive the medical practitioner and his staff so that it is given the treatment and care previously chosen by the patient. The main purpose of this paper is to show the lack of legislation on the matter in Brazil versus the recognition of Advance Directives by the Brazilian Federal Council of Medicine. Can a mere resolution of the Council transform directives into enforceable wishes? This is an answer we intend to offer throughout the text.

Differences in presenting advance directives in the chart, in the minimum data set, and through the staff's perceptions.

PubMed

Cohen-Mansfield, Jiska; Libin, Alexander; Lipson, Steven

2003-06-01

Decisions concerning end-of-life care depend on information contained in advance directives that are documented in residents' charts in the nursing home. The availability of that information depends on the quality of the chart and on the location of the information in the chart. No research was found that compared directives by the manner in which they are collected and summarized in the chart. The goal of the proposed study was to clarify how advance directives are summarized in the patient's record and to clarify how physicians perceive the same advance directives and formal orders. The study involved 122 elderly persons who reside in one large (587 beds) nursing home. The authors collected data regarding the advance directives from three sources-Minimum Data Set (MDS), the front cover of the resident's chart, and from inside the chart. The rates of documented advance directives found in this study are higher than those reported in the literature. Agreement rates between sources varied as a function of which sources were compared, as well as on the basis of which directive was examined. More specifically, the authors found higher rates of agreement between the information inside the chart and on the cover of the chart than between the MDS and the other two sources. The reasons for discrepancies may lie in the different functions and procedures pertaining to these source documents.

Particle-bearing currents in uniform density and two-layer fluids

NASA Astrophysics Data System (ADS)

Sutherland, Bruce R.; Gingras, Murray K.; Knudson, Calla; Steverango, Luke; Surma, Christopher

2018-02-01

Lock-release gravity current experiments are performed to examine the evolution of a particle bearing flow that propagates either in a uniform-density fluid or in a two-layer fluid. In all cases, the current is composed of fresh water plus micrometer-scale particles, the ambient fluid is saline, and the current advances initially either over the surface as a hypopycnal current or at the interface of the two-layer fluid as a mesopycnal current. In most cases the tank is tilted so that the ambient fluid becomes deeper with distance from the lock. For hypopycnal currents advancing in a uniform density fluid, the current typically slows as particles rain out of the current. While the loss of particles alone from the current should increase the current's buoyancy and speed, in practice the current's speed decreases because the particles carry with them interstitial fluid from the current. Meanwhile, rather than settling on the sloping bottom of the tank, the particles form a hyperpycnal (turbidity) current that advances until enough particles rain out that the relatively less dense interstitial fluid returns to the surface, carrying some particles back upward. When a hypopycnal current runs over the surface of a two-layer fluid, the particles that rain out temporarily halt their descent as they reach the interface, eventually passing through it and again forming a hyperpycnal current. Dramatically, a mesopycnal current in a two-layer fluid first advances along the interface and then reverses direction as particles rain out below and fresh interstitial fluid rises above.

Importance of the advance directive and the beginning of the dying process from the point of view of German doctors and judges dealing with guardianship matters: results of an empirical survey.

PubMed

van Oorschot, B; Simon, A

2006-11-01

To analyse and compare the surveys on German doctors and judges on end of life decision making regarding their attitudes on the advance directive and on the dying process. The respondents were to indicate their agreement or disagreement to eight statements on the advance directive and to specify their personal view on the beginning of the dying process. 727 doctors (anaesthetists or intensive-care physicians, internal specialists and general practitioners) in three federal states and 469 judges dealing with guardianship matters all over Germany. Comparisons of means, analyses of variance, pivot tables (chi(2) test) and factor analyses (varimax with Kaiser normalisation). Three attitude groups on advance directive were disclosed by the analysis: the decision model, which emphasises the binding character of a situational advance directive; the deliberation model, which puts more emphasis on the communicative aspect; and the delegation model, which regards the advance directive as a legal instrument. The answers regarding the beginning of the dying process were broadly distributed, but no marked difference was observed between the responding professions. The dying process was assumed by most participants to begin with a life expectancy of only a few days. A high degree of valuation for advance directive was seen in both German doctors and judges; most agreed to the binding character of the situational directive. Regarding the different individual concepts of the dying process, a cross-professional discourse on the contents of this term seems to be overdue.

Application of effect-directed analysis to identify mutagenic nitrogenous disinfection by-products of advanced oxidation drinking water treatment.

PubMed

Vughs, D; Baken, K A; Kolkman, A; Martijn, A J; de Voogt, P

2018-02-01

Advanced oxidation processes are important barriers for organic micropollutants in (drinking) water treatment. It is however known that medium pressure UV/H 2 O 2 treatment may lead to mutagenicity in the Ames test, which is no longer present after granulated activated carbon (GAC) filtration. Many nitrogen-containing disinfection by-products (N-DBPs) result from the reaction of photolysis products of nitrate with (photolysis products of) natural organic material (NOM) during medium pressure UV treatment of water. Identification of the N-DBPs and the application of effect-directed analysis to combine chemical screening results with biological activity would provide more insight into the relation of specific N-DBPs with the observed mutagenicity and was the subject of this study. To this end, fractions of medium pressure UV-treated and untreated water extracts were prepared using preparative HPLC and tested using the Ames fluctuation test. In addition, high-resolution mass spectrometry was performed on all fractions to assess the presence of N-DBPs. Based on toxicity data and read across analysis, we could identify five N-DBPs that are potentially genotoxic and were present in relatively high concentrations in the fractions in which mutagenicity was observed. The results of this study offer opportunities to further evaluate the identity and potential health concern of N-DBPs formed during advanced oxidation UV drinking water treatment.

19 CFR 4.7 - Inward foreign manifest; production on demand; contents and form; advance filing of cargo...

Code of Federal Regulations, 2014 CFR

2014-04-01

... as homogeneous cargo that is stowed loose in the hold and is not enclosed in any container such as a...; contents and form; advance filing of cargo declaration. 4.7 Section 4.7 Customs Duties U.S. CUSTOMS AND... and form; advance filing of cargo declaration. (a) The master of every vessel arriving in the United...

19 CFR 4.7 - Inward foreign manifest; production on demand; contents and form; advance filing of cargo...

Code of Federal Regulations, 2012 CFR

2012-04-01

... enclosed in any container such as a box, bale, bag, cask, or the like. Such cargo is also described as bulk...; contents and form; advance filing of cargo declaration. 4.7 Section 4.7 Customs Duties U.S. CUSTOMS AND... and form; advance filing of cargo declaration. (a) The master of every vessel arriving in the United...

19 CFR 4.7 - Inward foreign manifest; production on demand; contents and form; advance filing of cargo...

Code of Federal Regulations, 2013 CFR

2013-04-01

... as homogeneous cargo that is stowed loose in the hold and is not enclosed in any container such as a...; contents and form; advance filing of cargo declaration. 4.7 Section 4.7 Customs Duties U.S. CUSTOMS AND... and form; advance filing of cargo declaration. (a) The master of every vessel arriving in the United...

Advance care planning for adolescent patients with life-threatening neurological conditions: a survey of Japanese paediatric neurologists.

PubMed

Yotani, Nobuyuki; Kizawa, Yoshiyuki; Shintaku, Haruo

2017-01-01

To evaluate current attitudes and barriers to advance care planning for adolescent patients with life-threatening conditions among paediatric neurologists. Cross-sectional study. A self-reported questionnaire was administered to assess the practice of advance care planning, advance directives and barriers to advance care planning for adolescent patients with life-threatening conditions. All board-certified paediatric neurologists in Japan were surveyed and those who had experience in taking care of adolescent patients with decision-making capacity were analysed. We compared the results with those of paediatric haematologists reported previously. In total, 186 paediatric neurologists were analysed. If the patient's prognosis was <3 months, only about 30% of paediatric neurologists reported having discussions with patients, such as 'do not attempt resuscitation' orders (28%) and ventilator use (32%), whereas more than 70% did discuss these topics with patients' families. About half of the paediatric neurologists did not discuss advance directives at the end of life with their patients, whereas over 75% did discuss advance directives with patients' families. Compared with paediatric haematologists, paediatric neurologists had more end-of-life discussions with patients, such as where treatment and care will take place, do not attempt resuscitation orders, and the use of a ventilator, if the patient's prognosis was >1 year. About half or less of the paediatric neurologists discussed advance care planning and advance directives with their adolescent patients who had life-threatening conditions, even if the patient's prognosis was <3 months. They tended to discuss advance care planning and advance directives more with families than with patients themselves.

Free-form illumination optics

NASA Astrophysics Data System (ADS)

Mohedano, Rubén; Chaves, Julio; Hernández, Maikel

2016-04-01

In many illumination problems, the beam pattern needed and/or some geometrical constraints lead to very asymmetric design conditions. These asymmetries have been solved in the past by means of arrangements of rotationally symmetric or linear lamps aimed in different directions whose patterns overlap to provide the asymmetric prescriptions or by splitting one single lamp into several sections, each one providing a part of the pattern. The development of new design methods yielding smooth continuous free-form optical surfaces to solve these challenging design problems, combined with the proper CAD modeling tools plus the development of multiple axes diamond turn machines, give birth to a new generation of optics. These are able to offer the performance and other advanced features, such as efficiency, compactness, or aesthetical advantages, and can be manufactured at low cost by injection molding. This paper presents two examples of devices with free-form optical surfaces, a camera flash, and a car headlamp.

Joining of Silicon Carbide: Diffusion Bond Optimization and Characterization

NASA Technical Reports Server (NTRS)

Halbig, Michael C.; Singh, Mrityunjay

2008-01-01

Joining and integration methods are critically needed as enabling technologies for the full utilization of advanced ceramic components in aerospace and aeronautics applications. One such application is a lean direct injector for a turbine engine to achieve low NOx emissions. In the application, several SiC substrates with different hole patterns to form fuel and combustion air channels are bonded to form the injector. Diffusion bonding is a joining approach that offers uniform bonds with high temperature capability, chemical stability, and high strength. Diffusion bonding was investigated with the aid of titanium foils and coatings as the interlayer between SiC substrates to aid bonding. The influence of such variables as interlayer type, interlayer thickness, substrate finish, and processing time were investigated. Optical microscopy, scanning electron microscopy, and electron microprobe analysis were used to characterize the bonds and to identify the reaction formed phases.

Advance Care Planning in an Accountable Care Organization Is Associated with Increased Advanced Directive Documentation and Decreased Costs

PubMed Central

Kim, Minchul; Franciskovich, Chris M.; Weinberg, Jason E.; Svendsen, Jessica D.; Fehr, Linda S.; Funk, Amy; Sawicki, Robert; Asche, Carl V.

2018-01-01

Abstract Background: Advance care planning (ACP) documents patient wishes and increases awareness of palliative care options. Objective: To study the association of outpatient ACP with advanced directive documentation, utilization, and costs of care. Design: This was a case–control study of cases with ACP who died matched 1:1 with controls. We used 12 months of data pre-ACP/prematch and predeath. We compared rates of documentation with logit model regression and conducted a difference-in-difference analysis using generalized linear models for utilization and costs. Setting/subjects: Medicare beneficiaries attributed to a large rural-suburban-small metro multisite accountable care organization from January 2013 to April 2016, with cross reference to ACP facilitator logs to find cases. Measurements: The presence of advance directive forms was verified by chart review. Cost analysis included all utilization and costs billed to Medicare. Results: We matched 325 cases and 325 controls (51.1% female and 48.9% male, mean age 81). 320/325 (98.5%) ACP versus 243/325 (74.8%) of controls had a Healthcare Power of Attorney (odds ratio [OR] 21.6, 95% CI 8.6–54.1) and 172/325(52.9%) ACP versus 145/325 (44.6%) controls had Practitioner Orders for Life Sustaining Treatment (OR 1.40, 95% CI 1.02–1.90) post-ACP/postmatch. Adjusted results showed ACP cases had fewer inpatient admissions (−0.37 admissions, 95% CI −0.66 to −0.08), and inpatient days (−3.66 days, 95% CI −6.23 to −1.09), with no differences in hospice, hospice days, skilled nursing facility use, home health use, 30-day readmissions, or emergency department visits. Adjusted costs were $9,500 lower in the ACP group (95% CI −$16,207 to −$2,793). Conclusions: ACP increases documentation and was associated with a reduction in overall costs driven primarily by a reduction in inpatient utilization. Our data set was limited by small numbers of minorities and cancer patients. PMID:29206564

A 17-Year-Old Girl With Acute Onset of Hemiparesis.

PubMed

Morrissey, Michael; Ciorciari, Anthony J; Cunningham, Sandra J

2016-06-01

The presentation of acute-onset hemiparesis in a teenager can be challenging and offers a wide differential diagnosis. We discuss the approach to the patient (which should begin with thorough history taking and physical examination) and advanced imaging as directed by the patient's signs and symptoms. We report the case of an otherwise well 17-year-old girl who presented to the pediatric emergency department with a 2-day history of left-sided weakness and difficulty ambulating. Her eventual diagnosis of Balo concentric sclerosis, a rare form of multiple sclerosis, is discussed.

Anesthesiologists' familiarity with the ASA and ACS guidelines on Advance Directives in the perioperative setting.

PubMed

Nurok, Michael; Green, Douglas S T; Chisholm, Mary F; Fins, Joseph J; Liguori, Gregory A

2014-05-01

To assess anesthesiologists' familiarity with the American Society of Anesthesiologists (ASA) and American College of Surgeons (ACS) guidelines on Advance Directives in the perioperative setting. Single-center, 4-question anonymous survey. Urban academic medical center. Up to 34 subjects responded to each question. Familiarity with the ASA and ACS guidelines on Advance Directives in the perioperative setting ranged from 45% to 100%. There was inadequate familiarity with components of the ASA and ACS guidelines on advance directives in the perioperative setting. Larger studies are required to assess anesthesiologists' familiarity with national society guidelines that directly affect patient care. Future work should investigate best practices for guideline implementation, and consequences of poor adherence to national guidelines. Copyright © 2014 Elsevier Inc. All rights reserved.

Advanced energy system program

NASA Astrophysics Data System (ADS)

Trester, K.

1987-06-01

The ogjectives are to design, develop, and demonstrate a natural-gas-fueled, highly recuperated, 50 kw Brayton-cycle cogeneration system for commercial, institutional, and multifamily residential applications. Recent marketing studies have shown that the Advanced Energy System (AES), with its many cost-effective features, has the potential to offer significant reductions in annual electrical and thermal energy costs to the consumer. Specific advantates of the system that result in low cost ownership are high electrical efficiency (34 percent, LHV), low maintenance, high reliability and long life (20 years). Significant technical features include: an integral turbogenerator with shaft-speed permanent magnet generator; a rotating assembly supported by compliant foil air bearings; a formed-tubesheet plate/fin recuperator with 91 percent effectiveness; and a bi-directional power conditioner to ultilize the generator for system startup. The planned introduction of catalytic combustion will further enhance the economic and ecological attractiveness.

Biochemical separations by continuous-bed chromatography.

PubMed

Tisch, T L; Frost, R; Liao, J L; Lam, W K; Remy, A; Scheinpflug, E; Siebert, C; Song, H; Stapleton, A

1998-08-07

Innovations in column-packing media for biomolecule purification have progressed from large spherical, porous polysaccharide beads to advanced polymeric supports. Continuous-bed technology is a radical new technology for chromatography based on the polymerization of advanced monomers and ionomers directly in the chromatographic column. The polymer chains form aggregates which coalesce into a dense, homogeneous network of interconnected nodules consisting of microparticles with an average diameter of 3000 A. The voids or channels between the nodules are large enough to permit a high hydrodynamic flow. Due to the high cross-linking of the polymer matrix, the surface of each nodule is nonporous yet the polymeric microparticles provide a very large surface area for high binding capacity. This paper will demonstrate the properties and advantages of using a continuous bed support for high resolution biomolecule separations at high flow-rates without sacrificing capacity.

78 FR 32533 - Proposed Collection of Information: Direct Deposit, Go Direct, and Direct Express Sign-Up Forms

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-30

... Deposit, Go Direct, and Direct Express Sign-Up Forms AGENCY: Bureau of the Fiscal Service, Fiscal Service... ``Direct Deposit Sign-Up Form'', Form 1200 ``Go Direct Sign-Up Form for Direct Deposit of Federal Benefit... information described below: Title: Direct Deposit Sign-Up Form, and Go Direct Sign-Up Form, and Direct...

"It's like playing with your destiny": Bosnian immigrants' views of advance directives and end-of-life decision-making.

PubMed

Searight, H Russell; Gafford, Jennifer

2005-07-01

Patient autonomy is a primary value in US health care. It is assumed that patients want to be fully and directly informed about serious health conditions and want to engage in advance planning about medical care at the end-of-life. Written advance directives and proxy decision-makers are vehicles to promote autonomy when patients are no longer able to represent their wishes. Cross-cultural studies have raised questions about the universal acceptance of these health care values among all ethnicities. In the current investigation, Bosnian immigrants were interviewed about their views of physician-patient communication, advance directives, and locus of decision-making in serious illness. Many of the respondents indicated that they did not want to be directly informed of a serious illness. There was an expressed preference for physician- or family-based health care decisions. Advance directives and formally appointed proxies were typically seen as unnecessary and inconsistent with many respondents' personal values. The findings suggest that the value of individual autonomy and control over the health care decisions may not be applicable to cultures with a collectivist orientation.

41 CFR 302-10.301 - May I receive an advance of funds when payment is made directly to the carrier by my agency?

Code of Federal Regulations, 2010 CFR

2010-07-01

... PRIMARY RESIDENCE Advance of Funds § 302-10.301 May I receive an advance of funds when payment is made directly to the carrier by my agency? No, your agency will not authorize you an advance of funds when it... 41 Public Contracts and Property Management 4 2010-07-01 2010-07-01 false May I receive an advance...

The Bridging Advanced Developments for Exceptional Rehabilitation (BADER) Consortium: Reaching in Partnership for Optimal Orthopaedic Rehabilitation Outcomes

PubMed Central

Stanhope, Steven J.; Wilken, Jason M.; Pruziner, Alison L.; Dearth, Christopher L.; Wyatt, Marilynn; Ziemke, CAPT Gregg W.; Strickland, Rachel; Milbourne, Suzanne A.; Kaufman, Kenton R.

2017-01-01

The Bridging Advanced Developments for Exceptional Rehabilitation (BADER) Consortium began in September 2011 as a cooperative agreement with the Department of Defense (DoD) Congressionally Directed Medical Research Programs Peer Reviewed Orthopaedic Research Program. A partnership was formed with DoD Military Treatment Facilities (MTFs), U.S. Department of Veterans Affairs (VA) Centers, the National Institutes of Health (NIH), academia, and industry to rapidly conduct innovative, high-impact, and sustainable clinically relevant research. The BADER Consortium has a unique research capacity-building focus that creates infrastructures and strategically connects and supports research teams to conduct multiteam research initiatives primarily led by MTF and VA investigators. BADER relies on strong partnerships with these agencies to strengthen and support orthopaedic rehabilitation research. Its focus is on the rapid forming and execution of projects focused on obtaining optimal functional outcomes for patients with limb loss and limb injuries. The Consortium is based on an NIH research capacity-building model that comprises essential research support components that are anchored by a set of BADER-funded and initiative-launching studies. Through a partnership with the DoD/VA Extremity Trauma and Amputation Center of Excellence, the BADER Consortium’s research initiative-launching program has directly supported the identification and establishment of eight BADER-funded clinical studies. BADER’s Clinical Research Core (CRC) staff, who are embedded within each of the MTFs, have supported an additional 37 non-BADER Consortium-funded projects. Additional key research support infrastructures that expedite the process for conducting multisite clinical trials include an omnibus Cooperative Research and Development Agreement and the NIH Clinical Trials Database. A 2015 Defense Health Board report highlighted the Consortium’s vital role, stating the research capabilities of the DoD Advanced Rehabilitation Centers are significantly enhanced and facilitated by the BADER Consortium. PMID:27849456

The Bridging Advanced Developments for Exceptional Rehabilitation (BADER) Consortium: Reaching in Partnership for Optimal Orthopaedic Rehabilitation Outcomes.

PubMed

Stanhope, Steven J; Wilken, Jason M; Pruziner, Alison L; Dearth, Christopher L; Wyatt, Marilynn; Ziemke, Gregg W; Strickland, Rachel; Milbourne, Suzanne A; Kaufman, Kenton R

2016-11-01

The Bridging Advanced Developments for Exceptional Rehabilitation (BADER) Consortium began in September 2011 as a cooperative agreement with the Department of Defense (DoD) Congressionally Directed Medical Research Programs Peer Reviewed Orthopaedic Research Program. A partnership was formed with DoD Military Treatment Facilities (MTFs), U.S. Department of Veterans Affairs (VA) Centers, the National Institutes of Health (NIH), academia, and industry to rapidly conduct innovative, high-impact, and sustainable clinically relevant research. The BADER Consortium has a unique research capacity-building focus that creates infrastructures and strategically connects and supports research teams to conduct multiteam research initiatives primarily led by MTF and VA investigators.BADER relies on strong partnerships with these agencies to strengthen and support orthopaedic rehabilitation research. Its focus is on the rapid forming and execution of projects focused on obtaining optimal functional outcomes for patients with limb loss and limb injuries. The Consortium is based on an NIH research capacity-building model that comprises essential research support components that are anchored by a set of BADER-funded and initiative-launching studies. Through a partnership with the DoD/VA Extremity Trauma and Amputation Center of Excellence, the BADER Consortium's research initiative-launching program has directly supported the identification and establishment of eight BADER-funded clinical studies. BADER's Clinical Research Core (CRC) staff, who are embedded within each of the MTFs, have supported an additional 37 non-BADER Consortium-funded projects. Additional key research support infrastructures that expedite the process for conducting multisite clinical trials include an omnibus Cooperative Research and Development Agreement and the NIH Clinical Trials Database. A 2015 Defense Health Board report highlighted the Consortium's vital role, stating the research capabilities of the DoD Advanced Rehabilitation Centers are significantly enhanced and facilitated by the BADER Consortium. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

Autonomy and the Moral Authority of Advance Directives.

PubMed

Vogelstein, Eric

2016-10-01

Although advance directives are widely believed to be a key way to safeguard the autonomy of incompetent medical patients, significant questions exist about their moral authority. The main philosophical concern involves cases in which an incompetent patient no longer possesses the desires on which her advance directive was based (e.g., in cases of severe dementia). The question is, does that entail that prior expressions of medical choices are no longer morally binding? I believe that the answer is "yes." I argue that a patient's autonomy is not respected by honoring the desires she used to have but no longer does. I also consider and reject the view that honoring an advance directive that reflects the patient's previous values must be in that patient's best interests. If that is correct, then advance directives in the kind of case at issue are not morally binding. © The Author 2016. Published by Oxford University Press, on behalf of the Journal of Medicine and Philosophy Inc. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Cost savings at the end of life. What do the data show?

PubMed

Emanuel, E J

1996-06-26

Medical care at the end of life consumes 10% to 12% of the total health care budget and 27% of the Medicare budget. Many people claim that increased use of hospice and advance directives and lower use of high-technology interventions for terminally ill patients will produce significant cost savings. However, the studies on cost savings from hospice and advance directives are not definitive. The 3 randomized trials show no savings from these interventions, but either they are too small for confidence in their negative results or their intervention and cost accounting are flawed. The nonrandomized trials of hospice and advance directives show a wide range of savings, from 68% to none. Five methodological issues obscure the assessment of these studies: (1) selection bias in those patients who use hospice and advance directives, (2) the different time frames of assessing the costs, (3) the limited types of medical costs evaluated, (4) the variability of reporting the savings, and (5) the lack of generalizability of the findings to other patient populations. A more definitive study that assessed patients' end-of-life care preferences, use of hospice and advance directives, and direct and indirect costs would be desirable. In the absence of such a study, the existing data suggest that hospice and advance directives can save between 25% and 40% of health care costs during the last month of life, with savings decreasing to 10% to 17% over the last 6 months of life and decreasing further to 0% to 10% over the last 12 months of life. These savings are less than most people anticipate. Nevertheless, they do indicate that hospice and advance directives should be encouraged because they certainly do not cost more and they provide a means for patients to exercise their autonomy over end-of-life decisions.

Advanced Glycation End Products: Association with the Pathogenesis of Diseases and the Current Therapeutic Advances.

PubMed

Ajith, Thekkuttuparambil A; Vinodkumar, Puzhikunathu

2016-01-01

Advanced glycation end products (AGE) such as N-ε-carboxy-ethyl-lysine (CEL), N-ε-carboxy-methyl-lysine (CML), imidazolone, methyl-glyoxal-lysine dimer (MOLD), glyoxal-lysine dimer (GOLD), pyrraline and pentosidine have been imparted in the development and worsening of complications of diabetes. They are also involved in atherosclerosis, normal aging process, arthritis, cancer and progression of age-related neurodegenerative diseases like Alzheimer`s disease. Endogenously, they are formed by nonenzymatic glycation by aldoses/ketoses to form intermediate precursor that were slowly converted into AGE. A positive correlation was observed with the level of AGEs formation and progression of the diseases. Exogenously, they formed in foods when they were cooked at very high temperature. AGEs can interact with the cell surface receptors of AGE (RAGE) to release cytokines, free radicals as well as directly modify the extracellular matrix and action of hormones. Hence, the mechanism of AGE association with pathogenesis of diseases can be ascribed mainly to the generated cytokines and free radicals. Second type of receptors such as AGE receptor-1, 2 and 3 were more specific and involved in their detoxification and clearance. Therapeutic agents were used to inhibit AGEs formation, traps the reactive carbonyl intermediate precursors, interfering with Amadori`s products, cross-link breaker and low molecular weight inhibitors of RAGE had been described as well. Despite the several therapeutic agents described so far, none of them have proven to be recommended for clinical use. Furthermore, no methods or standard units were accepted universally to measure AGEs are existing. This review discusses AGEs formation, association with diseases and therapeutic agents to alleviate them.

Advance Directives for End-of-Life Care and the Role of Health Education Specialists: Applying the Theory of Reasoned Action

ERIC Educational Resources Information Center

Tremethick, Mary Jane; Johnson, Maureen K.; Carter, Mary R.

2011-01-01

Quality end-of-life care is subjective and based on individual values and beliefs. An advance directive provides a legal means of communicating these values and beliefs, as well as preferences in regards to end-of-life care when an individual is no longer able to make his or her desires known. In many nations, advance directives are underused…

Development of a direct three-dimensional biomicrofabrication concept based on electrospraying a custom made siloxane sol.

PubMed

Sullivan, Alice C; Jayasinghe, Suwan N

2007-07-19

We demonstrate here the discovery of a unique and direct three-dimensional biomicrofabrication concept possessing the ability to revolutionize the jet-based fabrication arena. Previous work carried out on similar jet-based approaches have been successful in fabricating only vertical wallpillar-structures by the controlled deposition of stacked droplets. However, these advanced jet-techniques have not been able to directly fabricate self-supporting archeslinks (without molds or reaction methods) between adjacent structures (walls or pillars). Our work reported here gives birth to a unique type of jet determined by high intensity electric fields, which is derived from a specially formulated siloxane sol. The sol studied here has been chosen for its attractive properties (such as an excellent cross-linking nature as well as the ability to polymerize via polycondensation on deposition to its biocompatability), which promotes direct forming of biostructures with nanometer (<50 nm) sized droplets in three dimensions. We foresee that this direct three-dimensional biomicrofabrication jet technique coupled with a variety of formulated sols having focused and enhanced functionality will be explored throughout the physical and life sciences.

Trust in direct leaders and top leaders: A trickle-up model.

PubMed

Fulmer, C Ashley; Ostroff, Cheri

2017-04-01

Low levels of employee trust in top leaders pose challenges to organizations with respect to retention, performance, and profits. This research examines how trust in top leaders can be fostered through the relationships individuals have with their direct leaders. We propose a trickle-up model whereby trust in direct leaders exerts an upward influence on trust in top leaders. Drawing on the group value model, we predict that direct leaders' procedural justice serves as the key mechanism in facilitating the trickle-up process. Further, this process should be particularly strong for employees high on vertical collectivism, and the trickled-up trust in top leaders should exert a stronger impact on employees' overall performance in the organization than trust in direct leaders. Multiphase and multisource data from 336 individuals support these hypotheses. The findings advance our understanding of trust and leadership by highlighting that trust in leaders at different levels does not form independently and that trust in leaders trickles up across hierarchical levels. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

End-of-life care in the 21st century: advance directives in universal rights discourse.

PubMed

Besirević, Violeta

2010-03-01

This article explores universal normative bases that could help to shape a workable legal construct that would facilitate a global use of advance directives. Although I believe that advance directives are of universal character, my primary aim in approaching this issue is to remain realistic. I will make three claims. First, I will argue that the principles of autonomy, dignity and informed consent, embodied in the Oviedo Convention and the UNESCO Declaration on Bioethics and Human Rights, could arguably be regarded as universal bases for the global use of advance directives. Second, I will demonstrate that, despite the apparent consensus of ethical authorities in support of their global use, it is unlikely, for the time being, that such consensus could lead to unqualified legal recognition of advance directives, because of different understandings of the nature of the international rules, meanings of autonomy and dignity which are context-specific and culture-specific, and existing imperfections that make advance directives either unworkable or hardly applicable in practice. The third claim suggests that the fact that the concept of the advance directive is not universally shared does not mean that it should not become so, but never as the only option in managing incompetent patients. A way to proceed is to prioritize work on developing higher standards in managing incompetent patients and on progressing towards the realization of universal human rights in the sphere of bioethics, by advocating a universal, legally binding international convention that would outlaw human rights violations in end-of-life decision-making.

Racial and Ethnic Differences in Advance Directive Possession: Role of Demographic Factors, Religious Affiliation, and Personal Health Values in a National Survey of Older Adults

PubMed Central

Neuhaus, John M.; Chiong, Winston

2016-01-01

Abstract Background: Black and Hispanic older Americans are less likely than white older Americans to possess advance directives. Understanding the reasons for this racial and ethnic difference is necessary to identify targets for future interventions to improve advance care planning in these populations. Methods: The aim of the study was to evaluate whether racial and ethnic differences in advance directive possession are explained by other demographic factors, religious characteristics, and personal health values. A general population survey was conducted in a nationally representative sample using a web-enabled survey panel of American adults aged 50 and older (n = 2154). Results: In a sample of older Americans, white participants are significantly more likely to possess advance directives (44.0%) than black older Americans (24.0%, p < 0.001) and Hispanic older Americans (29.0%, p = 0.006). Gender, age, retired or disabled employment status, educational attainment, religious affiliation, Internet access, preferences for physician-centered decision making, and desiring longevity regardless of functional status were independent predictors of advance directive possession. In fully adjusted multivariable models with all predictors included, black older Americans remained significantly less likely than white older Americans to have an advance directive (odds ratio [OR] = 0.42, 95% confidence interval [CI] = 0.24–0.75), whereas the effect of Hispanic ethnicity was no longer statistically significant (OR = 0.65, 95% CI = 0.39–1.1). Conclusion: In a nationally representative sample, black race is an independent predictor for advance directive possession. This association remains even after adjustment for other demographic variables, religious characteristics, and personal health values. These findings support targeted efforts to mitigate racial disparities in access to advance care planning. PMID:26840850

Willingness to complete advance directives among low-income older adults living in the USA.

PubMed

Ko, Eunjeong; Lee, Jaehoon; Hong, Youngjoon

2016-11-01

This study explored low-income older adults' willingness to (i) complete advance directives, legal documents, whereby an individual designates decision-makers in the event that they cannot make their own decisions about end-of-life treatment preferences, and (ii) the role of social support and other predictors that impact their willingness. This study was conducted as part of a larger study exploring behaviours of advance care planning among low-income older adults. Out of a total of 255 participants from the original study, this study included 204 participants who did not complete an advance directive for data analysis. A cross-sectional study using probability random sampling stratified by ethnicity was used. Older adults residing in two supportive housing facilities or who were members of a senior centre in San Diego, California, USA, were interviewed in person between December 2010 and April 2011. Hierarchical logistic regression analysis revealed that the majority of participants (72.1%) were willing to complete advance directives and the factors significantly predicting willingness to complete included self-rated health, attitudes towards advance decision-making and social support. Participants with a poorer health status (OR = 1.43, 95% CI = 1.07-1.90) were more willing to complete advance directives. Conversely, participants with higher positive attitudes (OR = 1.18, 95% CI = 1.00-1.39) and greater social support (OR = 1.07, 95% CI = 1.00-1.15) were also more willing to complete advance directives. The findings suggest the importance of ongoing support from healthcare professionals in end-of-life care planning. Healthcare professionals can be a source of support assisting older adults in planning end-of-life care. Initiating ongoing communication regarding personal value and preference for end-of-life care, providing relevant information and evaluating willingness to complete as well as assisting in the actual completion of advance directives will be necessary. © 2015 John Wiley & Sons Ltd.

Advance care planning and proxy decision making for patients with advanced Parkinson disease.

PubMed

Kwak, Jung; Wallendal, Maggie S; Fritsch, Thomas; Leo, Gary; Hyde, Trevor

2014-03-01

To examine advance care planning practices and proxy decision making by family healthcare proxies for patients with advanced Parkinson disease (PD). Sixty-four spouses and adult children, self-designated as a/the healthcare proxy for advanced patients with PD, participated in a cross-sectional survey study. Sixty patients with PD (95%) had completed a living will, but only 38% had shared the document with a physician. Among three life-support treatments--cardiopulmonary resuscitation (CPR), ventilator, and feeding tube--47% of patients opted for CPR, 16% for ventilator, and 20% for feeding tube. Forty-two percent of proxies did not know patients' preferences for one or more of the three life-support treatments. Only 28% of proxies reported that patients wanted hospice. Patients who shared advance directives with a physician were significantly less likely to choose CPR and a feeding tube and they were more likely to choose hospice. In a hypothetical end-of-life (EOL) scenario, the majority of proxies chose comfort care as the EOL goal of care (53%) and pain and symptom management only as the course of treatment option (72%); these proxy choices for patients, however, were not associated with patients' preferences for life support. Patients' proxies preferred a form of shared decision making with other family members and physicians. Advance care planning is effective when patients, families, and healthcare professionals together consider future needs for EOL care decisions. Further efforts are needed by healthcare professionals to provide evidence-based education about care options and facilitate advanced discussion and shared decision making by the patient and families.

Next-Generation Connexin and Pannexin Cell Biology.

PubMed

Esseltine, Jessica L; Laird, Dale W

2016-12-01

Connexins and pannexins are two families of large-pore channel forming proteins that are capable of passing small signaling molecules. While connexins serve the seminal task of direct gap junctional intercellular communication, pannexins are far less understood but function primarily as single membrane channels in autocrine and paracrine signaling. Advancements in connexin and pannexin biology in recent years has revealed that in addition to well-described classical functions at the plasma membrane, exciting new evidence suggests that connexins and pannexins participate in alternative pathways involving multiple intracellular compartments. Here we briefly highlight classical functions of connexins and pannexins but focus our attention mostly on the transformative findings that suggest that these channel-forming proteins may serve roles far beyond our current understandings. Copyright © 2016 Elsevier Ltd. All rights reserved.

Laser Scanning Holographic Lithography for Flexible 3D Fabrication of Multi-Scale Integrated Nano-structures and Optical Biosensors

PubMed Central

Yuan, Liang (Leon); Herman, Peter R.

2016-01-01

Three-dimensional (3D) periodic nanostructures underpin a promising research direction on the frontiers of nanoscience and technology to generate advanced materials for exploiting novel photonic crystal (PC) and nanofluidic functionalities. However, formation of uniform and defect-free 3D periodic structures over large areas that can further integrate into multifunctional devices has remained a major challenge. Here, we introduce a laser scanning holographic method for 3D exposure in thick photoresist that combines the unique advantages of large area 3D holographic interference lithography (HIL) with the flexible patterning of laser direct writing to form both micro- and nano-structures in a single exposure step. Phase mask interference patterns accumulated over multiple overlapping scans are shown to stitch seamlessly and form uniform 3D nanostructure with beam size scaled to small 200 μm diameter. In this way, laser scanning is presented as a facile means to embed 3D PC structure within microfluidic channels for integration into an optofluidic lab-on-chip, demonstrating a new laser HIL writing approach for creating multi-scale integrated microsystems. PMID:26922872

What's in the input? Frequent frames in child-directed speech offer distributional cues to grammatical categories in Spanish and English

PubMed Central

Weisleder, Adriana; Waxman, Sandra R.

2010-01-01

Recent analyses have revealed that child-directed speech contains distributional regularities that could, in principle, support young children's discovery of distinct grammatical categories (noun, verb, adjective). In particular, a distributional unit known as the frequent frame appears to be especially informative (Mintz, 2003). However, analyses have focused almost exclusively on the distributional information available in English. Because languages differ considerably in how the grammatical forms are marked within utterances, the scarcity of cross-linguistic evidence represents an unfortunate gap. We therefore advance the developmental evidence by analyzing the distributional information available in frequent frames across two languages (Spanish and English), across sentence positions (phrase medial and phrase final), and across grammatical forms (noun, verb, adjective). We selected six parent-child corpora from the CHILDES database (3 English; 3 Spanish), and analyzed the input when children were 2;6 years or younger. In each language, frequent frames did indeed offer systematic cues to grammatical category assignment. We also identify differences in the accuracy of these frames across languages, sentences positions, and grammatical classes. PMID:19698207

What's in the input? Frequent frames in child-directed speech offer distributional cues to grammatical categories in Spanish and English.

PubMed

Weisleder, Adriana; Waxman, Sandra R

2010-11-01

Recent analyses have revealed that child-directed speech contains distributional regularities that could, in principle, support young children's discovery of distinct grammatical categories (noun, verb, adjective). In particular, a distributional unit known as the frequent frame appears to be especially informative (Mintz, 2003). However, analyses have focused almost exclusively on the distributional information available in English. Because languages differ considerably in how the grammatical forms are marked within utterances, the scarcity of cross-linguistic evidence represents an unfortunate gap. We therefore advance the developmental evidence by analyzing the distributional information available in frequent frames across two languages (Spanish and English), across sentence positions (phrase medial and phrase final), and across grammatical forms (noun, verb, adjective). We selected six parent-child corpora from the CHILDES database (three English; three Spanish), and analyzed the input when children were aged 2 ; 6 or younger. In each language, frequent frames did indeed offer systematic cues to grammatical category assignment. We also identify differences in the accuracy of these frames across languages, sentences positions and grammatical classes.

Sister kinetochores are mechanically fused during meiosis I in yeast.

PubMed

Sarangapani, Krishna K; Duro, Eris; Deng, Yi; Alves, Flavia de Lima; Ye, Qiaozhen; Opoku, Kwaku N; Ceto, Steven; Rappsilber, Juri; Corbett, Kevin D; Biggins, Sue; Marston, Adèle L; Asbury, Charles L

2014-10-10

Production of healthy gametes requires a reductional meiosis I division in which replicated sister chromatids comigrate, rather than separate as in mitosis or meiosis II. Fusion of sister kinetochores during meiosis I may underlie sister chromatid comigration in diverse organisms, but direct evidence for such fusion has been lacking. We used laser trapping and quantitative fluorescence microscopy to study native kinetochore particles isolated from yeast. Meiosis I kinetochores formed stronger attachments and carried more microtubule-binding elements than kinetochores isolated from cells in mitosis or meiosis II. The meiosis I-specific monopolin complex was both necessary and sufficient to drive these modifications. Thus, kinetochore fusion directs sister chromatid comigration, a conserved feature of meiosis that is fundamental to Mendelian inheritance. Copyright © 2014, American Association for the Advancement of Science.

Advance Directives in Some Western European Countries: A Legal and Ethical Comparison between Spain, France, England, and Germany.

PubMed

Veshi, Denard; Neitzke, Gerald

2015-09-01

We have studied national laws on advance directives in various Western European countries: Romance-speaking countries (Italy, France, Portugal, and Spain), English-speaking countries (Ireland and the United Kingdom), and German-speaking countries (Austria, Germany, and Switzerland). We distinguish two potentially complementary types of advance medical declaration: the 'living will' and the nomination of a legal proxy. After examining the similarities and differences between countries, we analyse in detail the legislation of four countries (Spain, France, England, and Germany), since the other countries in this survey have similar legal principles and/or a similar political approach. In conclusion, we note that in all the countries examined, advance directives have been seen as an instrument to enable the patient's right to self-determination. Notwithstanding, in Romance-speaking countries, the involvement of physicians in the end-of-life process and risks arising from the execution of advance directives were also considered.

[Debate over the patient's right to self-determination in Germany].

PubMed

Simon, Alfred

2008-01-01

In Germany, advanced directives ought to be regulated by law. Yet, with respect to how such a law should be set up, opinions are drifting far apart: Referring to the patient's right to self-determination, one group claims the bindingness of advanced directives. Others, by referring to physician's fiduciary duty and the state's duty to protect life, seek a limitation of bindingness of advanced directives to situations of unfavourable prognosis.

Challenges to implementation of advance directives of will in hospital practice.

PubMed

Cogo, Silvana Bastos; Lunardi, Valéria Lerch; Quintana, Alberto Manuel; Girardon-Perlini, Nara Marilene Oliveira; Silveira, Rosemary Silva da

2016-01-01

to understand the difficulties and limitations in the implementation of advance directives of will in the hospital context. qualitative, exploratory and descriptive study conducted by means of semi-structured interviews with nurses, resident physicians and family caregivers. The data were analyzed by using discursive textual analysis based on the framework of bioethics principles. the following categories emerged: Terminality as an expression of loss and cure as an option for care; concerns about legal implications; advance directives of will demand patient autonomy and proper communication. limitations and difficulties in practice of advance directives of will from the perspective of the participants show, apart from countless conflicts and dilemmas regarding end-of life matters, that impending death experiences obstruct patients' wishes.

Advancing drug delivery systems for the treatment of multiple sclerosis.

PubMed

Tabansky, Inna; Messina, Mark D; Bangeranye, Catherine; Goldstein, Jeffrey; Blitz-Shabbir, Karen M; Machado, Suly; Jeganathan, Venkatesh; Wright, Paul; Najjar, Souhel; Cao, Yonghao; Sands, Warren; Keskin, Derin B; Stern, Joel N H

2015-12-01

Multiple sclerosis (MS) is a chronic inflammatory autoimmune disease of the central nervous system. It is characterized by demyelination of neurons and loss of neuronal axons and oligodendrocytes. In MS, auto-reactive T cells and B cells cross the blood-brain barrier (BBB), causing perivenous demyelinating lesions that form multiple discrete inflammatory demyelinated plaques located primarily in the white matter. In chronic MS, cortical demyelination and progressive axonal transections develop. Treatment for MS can be stratified into disease-modifying therapies (DMTs) and symptomatic therapy. DMTs aim to decrease circulating immune cells or to prevent these cells from crossing the BBB and reduce the inflammatory response. There are currently 10 DMTs approved for the relapsing forms of MS; these vary with regard to their efficacy, route and frequency of administration, adverse effects, and toxicity profile. Better drug delivery systems are being developed in order to decrease adverse effects, increase drug efficacy, and increase patient compliance through the direct targeting of pathologic cells. Here, we address the uses and benefits of advanced drug delivery systems, including nanoparticles, microparticles, fusion antibodies, and liposomal formulations. By altering the properties of therapeutic particles and enhancing targeting, breakthrough drug delivery technologies potentially applicable to multiple disease treatments may rapidly emerge.

The chemistry of planet-forming regions is not interstellar.

PubMed

Pontoppidan, Klaus M; Blevins, Sandra M

2014-01-01

Advances in infrared and submillimeter technology have allowed for detailed observations of the molecular content of the planet-forming regions of protoplanetary disks. In particular, disks around solar-type stars now have growing molecular inventories that can be directly compared with both prestellar chemistry and that inferred for the early solar nebula. The data directly address the old question of whether the chemistry of planet-forming matter is similar or different and unique relative to the chemistry of dense clouds and protostellar envelopes. The answer to this question may have profound consequences for the structure and composition of planetary systems. The practical challenge is that observations of emission lines from disks do not easily translate into chemical concentrations. Here, we present a two-dimensional radiative transfer model of RNO 90, a classical protoplanetary disk around a solar-mass star, and retrieve the concentrations of dominant molecular carriers of carbon, oxygen and nitrogen in the terrestrial region around 1 AU. We compare our results to the chemical inventory of dense clouds and protostellar envelopes, and argue that inner disk chemistry is, as expected, fundamentally different from prestellar chemistry. We find that the clearest discriminant may be the concentration of CO2, which is extremely low in disks, but one of the most abundant constituents of dense clouds and protostellar envelopes.

Beyond promiscuity: mate-choice commitments in social breeding

PubMed Central

Boomsma, Jacobus J.

2013-01-01

Obligate eusociality with distinct caste phenotypes has evolved from strictly monogamous sub-social ancestors in ants, some bees, some wasps and some termites. This implies that no lineage reached the most advanced form of social breeding, unless helpers at the nest gained indirect fitness values via siblings that were identical to direct fitness via offspring. The complete lack of re-mating promiscuity equalizes sex-specific variances in reproductive success. Later, evolutionary developments towards multiple queen-mating retained lifetime commitment between sexual partners, but reduced male variance in reproductive success relative to female's, similar to the most advanced vertebrate cooperative breeders. Here, I (i) discuss some of the unique and highly peculiar mating system adaptations of eusocial insects; (ii) address ambiguities that remained after earlier reviews and extend the monogamy logic to the evolution of soldier castes; (iii) evaluate the evidence for indirect fitness benefits driving the dynamics of (in)vertebrate cooperative breeding, while emphasizing the fundamental differences between obligate eusociality and cooperative breeding; (iv) infer that lifetime commitment is a major driver towards higher levels of organization in bodies, colonies and mutualisms. I argue that evolutionary informative definitions of social systems that separate direct and indirect fitness benefits facilitate transparency when testing inclusive fitness theory. PMID:23339241

Tanning and teens: Is indoor exposure the tip of the iceberg?

PubMed Central

Hay, Jennifer L.; Riley, Kristen E.; Geller, Alan C.

2017-01-01

Due to recent state regulations and the reduced availability of free-standing tanning salons, indoor tanning prevalence is beginning to decline. This may lead to unintended consequences – increases in outdoor intentional tanning. We advance a series of research directions to track and intervene to address all forms of intentional tanning. First, we advocate for enforcement of indoor tanning regulation and encourage collection of data on tanning salon compliance and alternative indoor tanning strategies. Second, we suggest questions about outdoor and indoor tanning should be included in national surveys. Third, we need to understand the potentially complex patterns of indoor and outdoor tanning that may exist among those who tan. Fourth, research examining changing motivations for intentional tanning is needed. Finally, indoor tanning intervention studies should include outdoor tanning as an outcome to examine the effect of interventions on these related risk behaviors. These advances will ensure the development of novel interventions to address intentional tanning through multiple routes, and to avoid any unintended negative consequence of indoor tanning regulation. The promising downward direction of indoor tanning use in the United States should now lead the public health field to sharpen its focus on outdoor tanning. PMID:28765337

Family structure, experiences with end-of-life decision making, and who asked about advance directives impacts advance directive completion rates.

PubMed

Van Scoy, Lauren J; Howrylak, Judie; Nguyen, Anhthu; Chen, Melodie; Sherman, Michael

2014-10-01

Advance directives are an important but underutilized resource. Reasons for this underutilization need to be determined. We investigated factors associated with completion of advance directives among inpatients. We conducted prospective, structured interviews on family structure, health care, disease, and end-of-life experiences. We compared those with completed advance directives and those without. We interviewed 130 inpatients in an urban university hospital. We used bivariate analysis and logistic regression to identify characteristics of patients with living wills and health care proxies versus patients without them. Twenty-one percent of patients had a living will and 35% had a health care proxy. Patients with completed living wills were older (p≤0.0046), had more comorbidities (p=0.018), were widowed (p=0.02), and were more often admitted with chronic disease (p=0.009) compared to those without living wills. Patients with health care proxies were older (p<0.001), had religious affiliations (p=0.04), more children (p=0.03), and more often widowed (p≤0.001) than those without health care proxies. Patients were 10.8 times (95% confidence interval [CI] 4.59-25.3), 46.5 times (95% CI 15.1-139.4), and 68.6 times (95% CI 13.0-361.3) more likely to complete a living will when asked by medical staff, legal staff, or family and friends, respectively, than those not asked. Patients with health care proxies were 1.68 times (95% CI 0.81-3.47), 4.34 times (95% CI 1.50-12.6), and 18.0 times (95% CI 2.03-158.8) more likely to have been asked by the same groups. Patients with experience in end-of-life decision-making were 2.54 times more likely to possess a living will (95%CI 1.01-6.42) and 3.53 times more likely to possess a health care proxy (95% CI 1.51-8.25) than those without experiences. Having been asked about advance directives by medical staff, legal staff, or family and friends increases the likelihood that patients will possess an advance directive. Those with prior experience with end-of-life decision-making are more likely to possess an advance directive. Family structure and health care utilization also impacts possession of advance directives.

Widening of Laths in Bainite

NASA Astrophysics Data System (ADS)

Yin, Jiaqing; Hillert, Mats; Borgenstam, Annika

2017-11-01

Units of bainite in Fe-C alloys from the upper temperature range inherit their shape from Widmanstätten plates of ferrite, which are lathlike. The thickness increases by long-range diffusion of carbon and the length by short-range diffusion of carbon from the advancing edge of the tip. Both have been studied extensively and are fairly well understood. Widening growth seems to have been much neglected, but a study of some aspects of widening is now presented. The present report is the last one in a series of four morphological studies of bainite, isothermally formed in Fe-C alloys with 0.3 or 0.7 mass pct carbon, mainly in the upper temperature range. It contains a number of morphological observations made on cross sections of packets of bainite, and it elucidated a number of interesting questions about bainite and resulted in some proposals. The ferrite plates in a packet are nucleated as a group on a grain boundary, not each one separately on the side of a prior plate. Lengthening occurs by advancement of a short edge that is formed in close contact to the grain boundary. Widening of laths does not start spontaneously. It is initiated by a modification of the structure of the long edge of the lath. When it then moves, the lattice of the new ferrite is rotated relative to the ferrite formed by lengthening and the habit plane is different. In a section through the length direction, it is difficult to recognize what part of ferrite has formed by widening growth. Furthermore, it is proposed that the individual plates in a microstructure, previously used to illustrate subunits formed by repeated nucleation, were nucleated on a hidden grain boundary.

Numerical and experimental investigation of strip deformation in cage roll forming process for pipes with low ratio of thickness/diameter

NASA Astrophysics Data System (ADS)

Kasaei, M. M.; Naeini, H. Moslemi; Tehrani, M. Salmani; Tafti, R. Azizi

2011-01-01

Cage roll forming is one of the advanced methods of cold roll forming process which is used widely for producing ERW pipes. In addition to decreasing the production cost and time, using cage roll forming provides smooth deformation on the strip. Few studies can be found about cage roll forming because of its complexity, and the available knowledge is experience-based more than science-based. In this paper, deformation of pipes with low ratio of thickness/diameter is investigated by 3D finite element simulation in Marc-Mentat software. Edge buckling defect in cage roll forming of low ratio of thickness/diameter pipes is very important. Due to direct influence of longitudinal strain on the edge buckling phenomenon, longitudinal strains at the edge and center line of the strip are investigated and high risk stands are introduced. The deformed strip is predicted using the simulation results and effects of each cage forming stage on the deformed strip profile are specified. In order to verify the simulation results, strip width and opening distance of the two edges in different forming stages are obtained from the simulations and compared with the experimental data which were measured from the production line. A good agreement between the experimental and simulated results is observed.

Advance directives: the clinical nurse specialist as a change agent.

PubMed

Meehan, Karen Anne

2009-01-01

The purpose of this article is to describe the impact the clinical nurse specialist (CNS) has on the advance directive process within the cardiac surgery patient population. As a change agent, the CNS needs to be able to increase the number of advance directives obtained and increase the provision of dignified, self-directed, quality patient care. With requirements from The Joint Commission and the Patient Self-determination Act, the change in process must take place to ensure that healthcare professionals are doing all they can do to carry out a patient's wishes. The 6-Source Influencer Model is applied to a case study to illustrate the role of the CNS as a change agent. Following this model, the CNS can facilitate lasting institutional change in the advance directive process. Based on the example, it is possible that a CNS can act as a change agent for other patient populations within the healthcare setting.

Advance directives in the UK: legal, ethical, and practical considerations for doctors.

PubMed

Kessel, A S; Meran, J

1998-05-01

In the United Kingdom (UK), advance directives have recently received considerable attention from professional and voluntary organizations as well as medical journals and the media. However, despite such exposure, many doctors remain uncertain of the importance or relevance of advance directives with regard to their own clinical practice. This paper addresses these uncertainties by first explaining what advance directives are and then describing the current legal status of such directives in the UK. Examination of the cases underpinning this status reveals several key elements: competence, information, anticipation, applicability, and freedom from duress. Each is discussed. Although this paper focuses on legal issues, it is important that medical law does not dominate medical ethics. Accordingly, the paper also discusses some important philosophical and sociological considerations that have remained largely unexplored in the medical press. Finally, the paper deals with practical matters, including how the general practitioner might be involved.

Advance directives and life-sustaining treatment: attitudes of Hong Kong Chinese elders with chronic disease.

PubMed

Ting, Fion H; Mok, Esther

2011-04-01

To examine the attitudes of Hong Kong Chinese elders with chronic disease with regard to advance directives and life-sustaining treatment. Cross-sectional questionnaire survey. Medical unit of a regional teaching hospital in Hong Kong. In-patients aged 60 years or above with chronic disease. Demographic profiles and attitudes towards advance directives and life-sustaining treatment. A total of 219 elderly patients completed the questionnaire. Their mean age was 73 (standard deviation, 8) years; 133 (61%) were female. The majority had neither heard about advance directives (81%), nor discussed the issue with others (73%) before participating in this study. After they were informed of the concept of advance directives, about half (49%) said they would consider using it if it is legislated in Hong Kong. The respondents generally supported the withholding or withdrawing of life-sustaining treatment in medically futile situations. In all, 55% of them believed that the patient alone should make the decision on withholding or withdrawing life-sustaining treatment, if competent to do so. If the patient became not competent, 44% believed that the individual's family alone should make such a decision. The fact that most of the respondents had never heard about advance directives or discussed the concept with others points to a lack of knowledge and to the necessity to step up public education about such issues.

Comparison of patients' and health care professionals' attitudes towards advance directives.

PubMed Central

Blondeau, D; Valois, P; Keyserlingk, E W; Hébert, M; Lavoie, M

1998-01-01

OBJECTIVES: This study was designed to identify and compare the attitudes of patients and health care professionals towards advance directives. Advance directives promote recognition of the patient's autonomy, letting the individual exercise a certain measure of control over life-sustaining care and treatment in the eventuality of becoming incompetent. DESIGN: Attitudes to advance directives were evaluated using a 44-item self-reported questionnaire. It yields an overall score as well as five factor scores: autonomy, beneficence, justice, external norms, and the affective dimension. SETTING: Health care institutions in the province of Québec, Canada. Survey sample: The sampling consisted of 921 subjects: 123 patients, 167 physicians, 340 nurses and 291 administrators of health care institutions. RESULTS: Although the general attitude of each population was favourable to the expression of autonomy, multivariate analysis of variance (MANOVA) indicated that physicians attached less importance to this subscale than did other populations (p < .001). Above all, they favoured legal external norms and beneficence. Physicians and administrators also attached less importance to the affective dimension than did patients and nurses. Specifically, physicians' attitudes towards advance directives were shown to be less positive than patients' attitudes. CONCLUSION: More attention should be given to the importance of adequately informing patients about advance directives because they may not represent an adequate means for patients to assert their autonomy. PMID:9800589

Public Opinion Regarding Financial Incentives to Engage in Advance Care Planning and Complete Advance Directives.

PubMed

Auriemma, Catherine L; Chen, Lucy; Olorunnisola, Michael; Delman, Aaron; Nguyen, Christina A; Cooney, Elizabeth; Gabler, Nicole B; Halpern, Scott D

2017-09-01

The Centers for Medicare & Medicaid Services (CMS) recently instituted physician reimbursements for advance care planning (ACP) discussions with patients. To measure public support for similar programs. Cross-sectional online and in-person surveys. English-speaking adults recruited at public parks in Philadelphia, Pennsylvania, from July to August 2013 and online through survey sampling international Web-based recruitment platform in July 2015. Participants indicated support for 6 programs designed to increase advance directive (AD) completion or ACP discussion using 5-point Likert scales. Participants also indicated how much money (US$0-US$1000) was appropriate to incentivize such behaviors, compared to smoking cessation or colonoscopy screening. We recruited 883 participants: 503 online and 380 in-person. The status quo of no systematic approach to motivate AD completion was supported by 67.0% of participants (63.9%-70.1%). The most popular programs were paying patients to complete ADs (58.0%; 54.5%-61.2%) and requiring patients to complete ADs or declination forms for health insurance (54.1%; 50.8%-57.4%). Participants more commonly supported paying patients to complete ADs than paying physicians whose patients complete ADs (22.6%; 19.8%-25.4%) or paying physicians who document ACP discussions (19.1%; 16.5%-21.7%; both P < .001). Participants supported smaller payments for AD completion and ACP than for obtaining screening colonoscopies or stopping smoking. Americans view payments for AD completion or ACP more skeptically than for other health behaviors and prefer that such payments go to patients rather than physicians. The current CMS policy of reimbursing physicians for ACP conversations with patients was the least preferred of the programs evaluated.

MO-A-BRD-02: Physics Perspective

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

Kappadath, S.

2015-06-15

Yttrium-90 (Y90) microsphere therapy, a form of radiation therapy, is an increasingly popular option for care of patients with liver metastases or unresectable hepatocellular carcinoma. The therapy directly delivers Y90 microspheres via the hepatic artery to disease sites. Following delivery, a vast majority of microspheres preferentially lodge in the capillary vessels due to their embolic size and targeted trans-arterial delivery – depositing up to 90% of its energy in the first 5 mm of tissue. There have been a number of advances in tomographic imaging within both interventional radiology and nuclear medicine that has advanced therapy planning techniques. Quantitative imagingmore » of Y90 microsphere distribution post-therapy has also seen innovations that have led to improvements in tumor dosimetry and characterization of tumor response. A review of current trends and recent innovation in Y90 microsphere therapies will be presented. Learning Objectives: To present the imaging requirements for Y90 microsphere therapy planning To explain the standard dosimetry models used in Y90 microsphere therapy planning To report on advances in imaging for therapy planning and posttherapy assessment of tumor dosimetry and response.« less

MO-A-BRD-01: Clinical Perspective

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

Mahvash, A.

2015-06-15

Yttrium-90 (Y90) microsphere therapy, a form of radiation therapy, is an increasingly popular option for care of patients with liver metastases or unresectable hepatocellular carcinoma. The therapy directly delivers Y90 microspheres via the hepatic artery to disease sites. Following delivery, a vast majority of microspheres preferentially lodge in the capillary vessels due to their embolic size and targeted trans-arterial delivery – depositing up to 90% of its energy in the first 5 mm of tissue. There have been a number of advances in tomographic imaging within both interventional radiology and nuclear medicine that has advanced therapy planning techniques. Quantitative imagingmore » of Y90 microsphere distribution post-therapy has also seen innovations that have led to improvements in tumor dosimetry and characterization of tumor response. A review of current trends and recent innovation in Y90 microsphere therapies will be presented. Learning Objectives: To present the imaging requirements for Y90 microsphere therapy planning To explain the standard dosimetry models used in Y90 microsphere therapy planning To report on advances in imaging for therapy planning and posttherapy assessment of tumor dosimetry and response.« less

Advances in immunotherapy for non-small cell lung cancer.

PubMed

Reckamp, Karen L

2015-12-01

In most patients, lung cancer presents as advanced disease with metastases to lymph nodes and/or distant organs, and survival is poor. Lung cancer is also a highly immune-suppressing malignancy with numerous methods to evade antitumor immune responses, including deficiencies in antigen processing and presentation, release of immunomodulatory cytokines, and inhibition of T-cell activation. Advances in understanding the complex interactions of the immune system and cancer have led to novel therapies that promote T-cell activation at the tumor site, resulting in prolonged clinical benefit. Immune checkpoint inhibitors, specifically programmed death receptor 1 pathway antibodies, have demonstrated impressively durable responses and improved survival in patients with non-small cell lung cancer. This article will review the recent progress made in immunotherapy for lung cancer with data from trials evaluating programmed death receptor 1 and cytotoxic T-lymphocyte-associated protein 4 monoclonal antibodies in addition to cancer vaccines. The review will focus on studies that have been published and the latest randomized trials exploring immune therapy in lung cancer. These results form the framework for a new direction in the treatment of lung cancer toward immunotherapy.

Nurses' knowledge of advance directives and perceived confidence in end-of-life care: a cross-sectional study in five countries.

PubMed

Coffey, Alice; McCarthy, Geraldine; Weathers, Elizabeth; Friedman, M Isabel; Gallo, Katherine; Ehrenfeld, Mally; Chan, Sophia; Li, William H C; Poletti, Piera; Zanotti, Renzo; Molloy, D William; McGlade, Ciara; Fitzpatrick, Joyce J; Itzhaki, Michal

2016-06-01

Nurses' knowledge regarding advance directives may affect their administration and completion in end-of-life care. Confidence among nurses is a barrier to the provision of quality end-of-life care. This study investigated nurses' knowledge of advance directives and perceived confidence in end-of-life care, in Hong Kong, Ireland, Israel, Italy and the USA using a cross-sectional descriptive design (n = 1089). In all countries, older nurses and those who had more professional experience felt more confident managing patients' symptoms at end-of-life and more comfortable stopping preventive medications at end-of-life. Nurses in the USA reported that they have more knowledge and experience of advance directives compared with other countries. In addition, they reported the highest levels of confidence and comfort in dealing with end-of-life care. Although legislation for advance directives does not yet exist in Ireland, nurses reported high levels of confidence in end-of-life care. © 2016 The Authors International Journal of Nursing Practice Published by Wiley Publishing Asia Pty Ltd.

Are treelines advancing? A global meta-analysis of treeline response to climate warming.

PubMed

Harsch, Melanie A; Hulme, Philip E; McGlone, Matt S; Duncan, Richard P

2009-10-01

Treelines are temperature sensitive transition zones that are expected to respond to climate warming by advancing beyond their current position. Response to climate warming over the last century, however, has been mixed, with some treelines showing evidence of recruitment at higher altitudes and/or latitudes (advance) whereas others reveal no marked change in the upper limit of tree establishment. To explore this variation, we analysed a global dataset of 166 sites for which treeline dynamics had been recorded since 1900 AD. Advance was recorded at 52% of sites with only 1% reporting treeline recession. Treelines that experienced strong winter warming were more likely to have advanced, and treelines with a diffuse form were more likely to have advanced than those with an abrupt or krummholz form. Diffuse treelines may be more responsive to warming because they are more strongly growth limited, whereas other treeline forms may be subject to additional constraints.

Advance care planning in Australia: what does the law say?

PubMed

Carter, Rachel Z; Detering, Karen M; Silvester, William; Sutton, Elizabeth

2016-09-01

Advance care planning (ACP) assists people to plan for their future health and personal care. ACP encourages a person to legally appoint a substitute decision maker (SDM) and to document any specific wishes regarding their future health care in an advance care directive (ACD). Formal documentation of wishes increases the chances that a person's wishes will be known and followed. However, one of the biggest impediments for doctors following the person's wishes is uncertainty surrounding the law, which is complicated and varies between the states and territories of Australia. SDM legislation varies regarding who can be appointed, how they are appointed, the powers that an SDM can be given and the decision-making principles that the SDM needs to follow. In circumstances where an SDM has not been appointed, the hierarchy for determining the default SDM for a person also varies between states. Although many states have legislated ACD forms allowing for documentation of a person's health care wishes, these forms allow for different things to be documented and have different requirements to be valid. The Australian population is mobile, with patients frequently moving between states. The status of ACP documentation created in a state other than the state in which a patient requires treatment also varies, with some states recognising interstate ACDs whereas others do not. This article outlines the legal status of ACDs, within Australian jurisdictions, including the legal validity of interstate ACDs, and argues that uniform laws and documents would assist with awareness and understanding of, and compliance with, ACDs.

The body electric 2.0: recent advances in developmental bioelectricity for regenerative and synthetic bioengineering.

PubMed

Mathews, Juanita; Levin, Michael

2018-04-20

Breakthroughs in biomedicine and synthetic bioengineering require predictive, rational control over anatomical structure and function. Recent successes in manipulating cellular and molecular hardware have not been matched by progress in understanding the patterning software implemented during embryogenesis and regeneration. A fundamental capability gap is driving desired changes in growth and form to address birth defects and traumatic injury. Here we review new tools, results, and conceptual advances in an exciting emerging field: endogenous non-neural bioelectric signaling, which enables cellular collectives to make global decisions and implement large-scale pattern homeostasis. Spatially distributed electric circuits regulate gene expression, organ morphogenesis, and body-wide axial patterning. Developmental bioelectricity facilitates the interface to organ-level modular control points that direct patterning in vivo. Cracking the bioelectric code will enable transformative progress in bioengineering and regenerative medicine. Copyright © 2018 Elsevier Ltd. All rights reserved.

Ultrasound and other imaging technologies in the intensive care unit.

PubMed

Lee, S Y; Frankel, H L

2000-06-01

As technology advances, more imaging and procedures are performed at the bedside on critically ill patients in ICUs, thereby eliminating the risks of transporting patients. These imaging techniques can serve as diagnostic and therapeutic tools in treating the acute and chronic consequences of injured, critically ill patients. One area of growth is ultrasonography. Critical care applications of ultrasonography are expanding, and the learning curve of surgeons and intensivists performing some of these studies is improving. Ultrasonography can supplement physical examination and provide useful "real-time" information on nearly every body cavity. Other imaging technology is also available in a portable form, enabling imaging directly at the bedside. Images are now becoming readily and easily available with the advancement of teleradiology. Some of the imaging modalities are still in development, and their clinical effectiveness is being studied. In the future, more uses of these various imaging technologies may become evident and cost-effective.

Vibrio parahaemolyticus: a review on the pathogenesis, prevalence, and advance molecular identification techniques

PubMed Central

Letchumanan, Vengadesh; Chan, Kok-Gan; Lee, Learn-Han

2014-01-01

Vibrio parahaemolyticus is a Gram-negative halophilic bacterium that is found in estuarine, marine and coastal environments. V. parahaemolyticus is the leading causal agent of human acute gastroenteritis following the consumption of raw, undercooked, or mishandled marine products. In rare cases, V. parahaemolyticus causes wound infection, ear infection or septicaemia in individuals with pre-existing medical conditions. V. parahaemolyticus has two hemolysins virulence factors that are thermostable direct hemolysin (tdh)-a pore-forming protein that contributes to the invasiveness of the bacterium in humans, and TDH-related hemolysin (trh), which plays a similar role as tdh in the disease pathogenesis. In addition, the bacterium is also encodes for adhesions and type III secretion systems (T3SS1 and T3SS2) to ensure its survival in the environment. This review aims at discussing the V. parahaemolyticus growth and characteristics, pathogenesis, prevalence and advances in molecular identification techniques. PMID:25566219

Materials and structure synergistic with in-space materials utilization. [as means of reducing costs of space missions, colonization, and settlements

NASA Technical Reports Server (NTRS)

Ramohalli, Kumar; Shadman, Farhang; Sridhar, K. R.

1992-01-01

The significant advances made recently toward actual hardware realizations of various concepts for the application of in-space materials utilization (ISMU) are demonstrated. The overall plan for taking innovative concepts through technical feasibility, small-scale tests, scale-up, computer modeling, and larger-scale execution is outlined. Two specific fields of endeavor are surveyed: one has direct applications to construction on the moon, while the other has more basic implications, in addition to the practical aspects of lunar colonies. Several fundamental scientific advances made in the characterization of the physical and chemical processes that need to be elucidated for any intelligent application of the ISMU concepts in future space missions are described. A rigorous quantitative technique for the unambiguous evaluation of various components and component technology that form any space (or terrestrial mission) is also described.

Current pathophysiological concepts and management of pulmonary hypertension.

PubMed

Lourenço, André P; Fontoura, Dulce; Henriques-Coelho, Tiago; Leite-Moreira, Adelino F

2012-03-22

Pulmonary hypertension (PH), increasingly recognized as a major health burden, remains underdiagnosed due mainly to the unspecific symptoms. Pulmonary arterial hypertension (PAH) has been extensively investigated. Pathophysiological knowledge derives mostly from experimental models. Paradoxically, common non-PAH PH forms remain largely unexplored. Drugs targeting lung vascular tonus became available during the last two decades, notwithstanding the disease progresses in many patients. The aim of this review is to summarize recent advances in epidemiology, pathophysiology and management with particular focus on associated myocardial and systemic compromise and experimental therapeutic possibilities. PAH, currently viewed as a panvasculopathy, is due to a crosstalk between endothelial and smooth muscle cells, inflammatory activation and altered subcellular pathways. Cardiac cachexia and right ventricular compromise are fundamental determinants of PH prognosis. Combined vasodilator therapy is already mainstay for refractory cases, but drugs directed at these new pathophysiological pathways may constitute a significant advance. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

US long distance fiber optic networks: Technology, evolution and advanced concepts. Volume 2: Fiber optic technology and long distance networks

NASA Astrophysics Data System (ADS)

1986-10-01

The study projects until 2000 the evolution of long distance fiber optic networks in the U.S. Volume 1 is the Executive Summary. Volume 2 focuses on fiber optic components and systems that are directly related to the operation of long-haul networks. Optimistic, pessimistic and most likely scenarios of technology development are presented. The activities of national and regional companies implementing fiber long haul networks are also highlighted, along with an analysis of the market and regulatory forces affecting network evolution. Volume 3 presents advanced fiber optic network concept definitions. Inter-LATA traffic is quantified and forms the basis for the construction of 11-, 15-, 17-, and 23-node networks. Using the technology projections from Volume 2, a financial model identifies cost drivers and determines circuit mile costs between any two LATAs. A comparison of fiber optics with alternative transmission concludes the report.

Development Status of the Advanced Life Support On-Line Project Information System

NASA Technical Reports Server (NTRS)

Levri, Julie A.; Hogan, John A.; Cavazzoni, Jim; Brodbeck, Christina; Morrow, Rich; Ho, Michael; Kaehms, Bob; Whitaker, Dawn R.

2005-01-01

The Advanced Life Support Program has recently accelerated an effort to develop an On-line Project Information System (OPIS) for research project and technology development data centralization and sharing. The core functionality of OPIS will launch in October of 2005. This paper presents the current OPIS development status. OPIS core functionality involves a Web-based annual solicitation of project and technology data directly from ALS Principal Investigators (PIS) through customized data collection forms. Data provided by PIs will be reviewed by a Technical Task Monitor (TTM) before posting the information to OPIS for ALS Community viewing via the Web. The data will be stored in an object-oriented relational database (created in MySQL(R)) located on a secure server at NASA ARC. Upon launch, OPIS can be utilized by Managers to identify research and technology development gaps and to assess task performance. Analysts can employ OPIS to obtain.

A complete heart block in a young male: a case report and review of literature of cardiac sarcoidosis.

PubMed

Patel, Brijesh; Shah, Mahek; Gelaye, Alehegn; Dusaj, Raman

2017-01-01

Cardiac sarcoidosis is one of the uncommon causes of heart failure. Generally, it presents in the form of varying clinical manifestations ranging from asymptomatic to fatal arrhythmias such as ventricular tachycardia and complete heart block. It is difficult to make a diagnosis strictly based on clinical grounds. However, in the setting of extracardiac sarcoidosis and patients presenting with advanced heart block or ventricular arrhythmia, direct cardiac involvement should be suspected. The definitive diagnosis of cardiac sarcoidosis can be made from endomyocardial biopsy, but it is falling out of favor due to patchy myocardial involvement, considerable procedure-related risks, and advancement in additional imaging modalities. Once cardiac sarcoidosis has been diagnosed, management of the disease remains challenging. Steroids are considered the mainstay of therapy, and implantable cardioverter defibrillator therapy can be considered in a selected group of patients at greater risk for malignant ventricular arrhythmias.

Recent Advances in the Theory and Simulation of Model Colloidal Microphase Formers.

PubMed

Zhuang, Yuan; Charbonneau, Patrick

2016-08-18

This mini-review synthesizes our understanding of the equilibrium behavior of particle-based models with short-range attractive and long-range repulsive (SALR) interactions. These models, which can form stable periodic microphases, aim to reproduce the essence of colloidal suspensions with competing interparticle interactions. Ordered structures, however, have yet to be obtained in experiments. In order to better understand the hurdles to periodic microphase assembly, marked theoretical and simulation advances have been made over the past few years. Here, we present recent progress in the study of microphases in models with SALR interactions using liquid-state theory and density-functional theory as well as numerical simulations. Combining these various approaches provides a description of periodic microphases, and gives insights into the rich phenomenology of the surrounding disordered regime. Ongoing research directions in the thermodynamics of models with SALR interactions are also presented.

Perspectives on the neuroscience of alcohol from the National Institute on Alcohol Abuse and Alcoholism.

PubMed

Reilly, Matthew T; Noronha, Antonio; Warren, Kenneth

2014-01-01

Mounting evidence over the last 40 years clearly indicates that alcoholism (alcohol dependence) is a disorder of the brain. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) has taken significant steps to advance research into the neuroscience of alcohol. The Division of Neuroscience and Behavior (DNB) was formed within NIAAA in 2002 to oversee, fund, and direct all research areas that examine the effects of alcohol on the brain, the genetic underpinnings of alcohol dependence, the neuroadaptations resulting from excessive alcohol consumption, advanced behavioral models of the various stages of the addiction cycle, and preclinical medications development. This research portfolio has produced important discoveries in the etiology, treatment, and prevention of alcohol abuse and dependence. Several of these salient discoveries are highlighted and future areas of neuroscience research on alcohol are presented. © 2014 Elsevier B.V. All rights reserved.

US long distance fiber optic networks: Technology, evolution and advanced concepts. Volume 2: Fiber optic technology and long distance networks

NASA Technical Reports Server (NTRS)

1986-01-01

The study projects until 2000 the evolution of long distance fiber optic networks in the U.S. Volume 1 is the Executive Summary. Volume 2 focuses on fiber optic components and systems that are directly related to the operation of long-haul networks. Optimistic, pessimistic and most likely scenarios of technology development are presented. The activities of national and regional companies implementing fiber long haul networks are also highlighted, along with an analysis of the market and regulatory forces affecting network evolution. Volume 3 presents advanced fiber optic network concept definitions. Inter-LATA traffic is quantified and forms the basis for the construction of 11-, 15-, 17-, and 23-node networks. Using the technology projections from Volume 2, a financial model identifies cost drivers and determines circuit mile costs between any two LATAs. A comparison of fiber optics with alternative transmission concludes the report.

To what extent are the wishes of a signatory reflected in their advance directive: a qualitative analysis

PubMed Central

2014-01-01

Background Advance directives (ADs) are assumed to reflect the patients’ preferences, even if these are not clearly expressed. Research into whether this assumption is correct has been lacking. This study explores to what extent ADs reflect the true wishes of the signatories. Methods Semi-structured interviews (INT), pretest. Transcribed INT and the contents of ADs were inductively categorised (Mayring) and triangulated. Software: MAXQDA 2007. Participants: Patients receiving palliative care (PPC), healthy (H) and chronically ill (CI) individuals with an AD completed ≥3 months prior to recruitment. Results Between 08/2008 and 07/2009, 53 individuals (20 H, 17 CI, 16 PPC) were interviewed (mean age 63.2 years (55–70 years)), 34% male). Most important (in)consistencies between preferences as expressed in INT compared to ADs included preconditions for termination/rejection of life-sustaining measures, refusal of/demand for medical interventions and the nomination of proxies. Standardized AD forms were rarely tailored to the individual. We found a high tendency to use set phrases, such as want to die with dignity or do not want to suffer/vegetate. Likely events in the course of an existing progressive disease were not covered, even in ADs of PPC close to death. Conclusions Only some of the incongruities between verbally expressed preferences and the contents of the AD can be put down to use of standardized forms or lack of medical knowledge. Nevertheless, the non-involvement of a doctor in the process of making an AD must be seen as potentially problematic and seeking medical advice should be promoted by politics and physicians. Standardised forms should encourage amendments and present space for free text entries for all aspects covered. Set phrases need to be defined by the individual to enable them to be translated into a specific course of action. PMID:24981101

Predator functional response and prey survival: Direct and indirect interactions affecting a marked prey population

USGS Publications Warehouse

Miller, David A.; Grand, J.B.; Fondell, T.F.; Anthony, M.

2006-01-01

1. Predation plays an integral role in many community interactions, with the number of predators and the rate at which they consume prey (i.e. their functional response) determining interaction strengths. Owing to the difficulty of directly observing predation events, attempts to determine the functional response of predators in natural systems are limited. Determining the forms that predator functional responses take in complex systems is important in advancing understanding of community interactions. 2. Prey survival has a direct relationship to the functional response of their predators. We employed this relationship to estimate the functional response for bald eagle Haliaeetus leucocepalus predation of Canada goose Branta canadensis nests. We compared models that incorporated eagle abundance, nest abundance and alternative prey presence to determine the form of the functional response that best predicted intra-annual variation in survival of goose nests. 3. Eagle abundance, nest abundance and the availability of alternative prey were all related to predation rates of goose nests by eagles. There was a sigmoidal relationship between predation rate and prey abundance and prey switching occurred when alternative prey was present. In addition, predation by individual eagles increased as eagle abundance increased. 4. A complex set of interactions among the three species examined in this study determined survival rates of goose nests. Results show that eagle predation had both prey- and predator-dependent components with no support for ratio dependence. In addition, indirect interactions resulting from the availability of alternative prey had an important role in mediating the rate at which eagles depredated nests. As a result, much of the within-season variation in nest survival was due to changing availability of alternative prey consumed by eagles. 5. Empirical relationships drawn from ecological theory can be directly integrated into the estimation process to determine the mechanisms responsible for variation in observed survival rates. The relationship between predator functional response and prey survival offers a flexible and robust method to advance our understanding of predator-prey interactions in many complex natural systems where prey populations are marked and regularly visited. ?? 2006 British Ecological Society.

Alterations in Mouse Hypothalamic Adipokine Gene Expression and Leptin Signaling following Chronic Spinal Cord Injury and with Advanced Age

PubMed Central

Bigford, Gregory E.; Bracchi-Ricard, Valerie C.; Nash, Mark S.; Bethea, John R.

2012-01-01

Chronic spinal cord injury (SCI) results in an accelerated trajectory of several cardiovascular disease (CVD) risk factors and related aging characteristics, however the molecular mechanisms that are activated have not been explored. Adipokines and leptin signaling are known to play a critical role in neuro-endocrine regulation of energy metabolism, and are now implicated in central inflammatory processes associated with CVD. Here, we examine hypothalamic adipokine gene expression and leptin signaling in response to chronic spinal cord injury and with advanced age. We demonstrate significant changes in fasting-induced adipose factor (FIAF), resistin (Rstn), long-form leptin receptor (LepRb) and suppressor of cytokine-3 (SOCS3) gene expression following chronic SCI and with advanced age. LepRb and Jak2/stat3 signaling is significantly decreased and the leptin signaling inhibitor SOCS3 is significantly elevated with chronic SCI and advanced age. In addition, we investigate endoplasmic reticulum (ER) stress and activation of the uncoupled protein response (UPR) as a biological hallmark of leptin resistance. We observe the activation of the ER stress/UPR proteins IRE1, PERK, and eIF2alpha, demonstrating leptin resistance in chronic SCI and with advanced age. These findings provide evidence for adipokine-mediated inflammatory responses and leptin resistance as contributing to neuro-endocrine dysfunction and CVD risk following SCI and with advanced age. Understanding the underlying mechanisms contributing to SCI and age related CVD may provide insight that will help direct specific therapeutic interventions. PMID:22815920

Study of Advanced Propulsion Systems for Small Transport Aircraft Technology (STAT) Program

NASA Technical Reports Server (NTRS)

Baerst, C. F.; Heldenbrand, R. W.; Rowse, J. H.

1981-01-01

Definitions of takeoff gross weight, performance, and direct operating cost for both a 30 and 50 passenger airplane were established. The results indicate that a potential direct operating cost benefit, resulting from advanced technologies, of approximately 20 percent would be achieved for the 1990 engines. Of the numerous design features that were evaluated, only maintenance-related items contributed to a significant decrease in direct operating cost. Recommendations are made to continue research and technology programs for advanced component and engine development.

Health Care Providers’ Attitudes and Practices Regarding the use of Advance Directives in a Military Health Care Setting

DTIC Science & Technology

1998-10-02

PROVIDERS’ ATTITUDES AND PRACTICES REGARDING THE USE OF ADVANCE DIRECTIVES IN A MILITARY HEALTH CARE SETTING by Bridget L. Larew, Maj, USAF, NC Thesis...entitled: "HEALTH CARE PROVIDER’S ATTITUDES AND PRACTICES REGARDING THE PURPOSE AND USE OF ADVANCE DIRECTIVES IN A MILITARY HEALTH CARE SETTING" beyond...health care, recognized under State law (whether statutory or as recognized by the courts of the State) and relating to the provision of such care

Surface Science and the Advancement of Direct Olefin Epoxidation A Perspective on the Article, ‘‘Partial Oxidation of Higher Olefins on Ag(111) and Ag(110): Conversion of Styrene to Styrene Oxide, Benzene, and Benzoic Acid’’, by Andreas Klust and Robert J. Madix.

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

Barteau, Mark A.

2006-10-04

The research described in this product was performed in part in the Environmental Molecular Sciences Laboratory, a national scientific user facility sponsored by the Department of Energy's Office of Biological and Environmental Research and located at Pacific Northwest National Laboratory. Few reactions are as conceptually simple or as devilishly difficult as the epoxidation of ethylene to form ethylene oxide:

On a computational model of building thermal dynamic response

NASA Astrophysics Data System (ADS)

Jarošová, Petra; Vala, Jiří

2016-07-01

Development and exploitation of advanced materials, structures and technologies in civil engineering, both for buildings with carefully controlled interior temperature and for common residential houses, together with new European and national directives and technical standards, stimulate the development of rather complex and robust, but sufficiently simple and inexpensive computational tools, supporting their design and optimization of energy consumption. This paper demonstrates the possibility of consideration of such seemingly contradictory requirements, using the simplified non-stationary thermal model of a building, motivated by the analogy with the analysis of electric circuits; certain semi-analytical forms of solutions come from the method of lines.

How can psychiatrists offer psychotherapeutic leadership in the public sector?

PubMed

Cammell, Paul; Amos, Jackie; Baigent, Michael

2016-06-01

This article reviews the forms that psychotherapeutic leadership can take for psychiatrists attempting to optimise outcomes for individuals receiving treatment in the public mental health sector. It explores a range of roles and functions that psychiatrists can take on as psychotherapy leaders, and how these can be applied in clinical, administrative and research contexts. Psychiatrists need to play an increasing role in clinical, administrative and academic settings to advance service provision, resource allocation, training and research directed at psychotherapies in the public health sector. © The Royal Australian and New Zealand College of Psychiatrists 2016.

[Are advance directives useful for doctors and what for?].

PubMed

Fournier, Véronique; Berthiau, Denis; Kempf, Emmanuelle; d'Haussy, Julie

2013-06-01

In France, the law has introduced the possibility to write advance directives since 2005. In this paper, we will present the results of a study designed for checking how much people over 75 years are interested by this new tool. The inquiry consisted in deep qualitative interviews (around 45') to further understand what people included in the study have to say about advance directives, but also about the conditions of ageing and dying. The study sample was composed of 8 over 75 years subgroups, chosen for being illustrative of different health status and/or disabling status. Finally, a last subgroup was also included, called "referent", because composed of people, all members of the "Association pour le droit à mourir dans la dignité" (ADMD), and as such supposed to be pro-advance directives. Interviews content was analysed through qualitative analysis referent methods ("Analyse qualitative en sciences humaines et sociales", Paillé et Muschielli, "Grounded Theory", Glaser). POPULATION OF THE STUDY: One hundred and eighty-six patients were included (106 female, 80 male, mean age 82.7 ans), 167 in the general group and 19 in the "ADMD" group. Ninety percent in the general group said that they never heard about advance directives before the inquiry. After having been informed by us about what advance directives were for, 83% remained not interested they said, some because they felt they were not personally concerned, others expressed that the tool appears to them inefficient - "things never happen the way you planned it", not useful - "doctors will act as they will decide whatever will be written", or even more potentially dangerous - "writing advance directives might lead doctors not to be as much therapeutically aggressive as for other people". Only 28 persons in the general group (17%), together with the 19 of the ADMD group, said they were interested by advance directives. They all were quite similar according to their personal character: they were quite strong and voluntary people, claiming firmly about their autonomy, independently of any sociodemographic profile. Furthermore, the interest for advance directives appears to be completely independent from the health or disabling status. Another important result of the study is that patients generally express themselves as being very confident and trustful in their doctors. They do not fear to be over-treated and having to support any futile treatment. Around 20% of people are very much concerned by advance directives and do really expect that their wishes will be respected. The authors suggest that advance directives should be for them really respected, even if the French law let doctors free at this point to decide what the best interest of the patient actually is and if they should or not respect in this case what the patient wrote as advance directives. Around 30% of other people appear interested to speak with someone of the time they will still live. Their concern is more to express what is important for them in terms of still living and quality of life, than to express very clear advance directives about the way they would like to dye. The last learning of the study is that there is still a lot to do if we want more people precisely express something on the conditions of their dying. Doctors might have a fundamental pedagogic role in that respect: they should better inform patients about the limits of medicine and tell them more about the new complexity of medical decision-making at the end of life due to recent improvements in techniques. Copyright © 2013. Published by Elsevier Masson SAS.

75 FR 12250 - Agency Information Collection Activities: Form I-191, Extension of a Currently Approved...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-15

...: Application for Advance Permission to Return to Unrelinquished Domicile. (3) Agency form number, if any, and... ACTION: 30-Day Notice of Information Collection under Review: Form I- 191, Application for Advance Permission to Return to Unrelinquished Domicile; OMB Control Number 1615-0016. The Department of Homeland...

76 FR 69275 - Agency Information Collection Activities: Form I-192, Extension of a Currently Approved...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-08

...) Title of the Form/Collection: Application for Advance Permission to Enter as Nonimmigrant (Pursuant to... ACTION: 30-Day Notice of Information Collection Under Review: Form I- 192, Application for Advance Permission to Enter as Nonimmigrant (Pursuant to 212(d)(3) of the Immigration and Nationality Act); OMB...

Gender bias against and sexual harassment of AMWA members in Massachusetts.

PubMed

Lenhart, S A; Klein, F; Falcao, P; Phelan, E; Smith, K

1991-01-01

Despite the increasing participation of women in medicine over the past few decades, hindrances to professional advancement for women physicians and medical students persist. The present study sought to assess the prevalence of gender bias and sexual harassment in a sample of women physicians and medical students. Within a one-year period, 54% of respondents encountered some form of sex discrimination. In addition, approximately one-fourth experienced sexual harassment (27%) and/or discrimination related to parenthood (24%). Unwanted sexual attention not viewed as sexual harassment was experienced by more than twice as many respondents (55%). Other forms of discrimination were reported as well: age (22%), sexual preference (20%), and race (7%). Perceptions of the extent of sex discrimination and sexual harassment, of their impact on professional commitment, and of the adequacy of solutions at institutions varied directly with whether or not respondents had experienced some form of employment discrimination within the past 12 months. This study points to the need for clarification of what constitutes sexual harassment and for the creation of safe, effective mechanisms to remedy and prevent all forms of gender bias.

The role of advance directives in end-of-life decisions in Austria: survey of intensive care physicians.

PubMed

Schaden, Eva; Herczeg, Petra; Hacker, Stefan; Schopper, Andrea; Krenn, Claus G

2010-10-21

Currently, intensive care medicine strives to define a generally accepted way of dealing with end-of-life decisions, therapy limitation and therapy discontinuation.In 2006 a new advance directive legislation was enacted in Austria. Patients may now document their personal views regarding extension of treatment. The aim of this survey was to explore Austrian intensive care physicians' experiences with and their acceptance of the new advance directive legislation two years after enactment (2008). Under the aegis of the OEGARI (Austrian Society of Anaesthesiology, Resuscitation and Intensive Care) an anonymised questionnaire was sent to the medical directors of all intensive care units in Austria. The questions focused on the physicians' experiences regarding advance directives and their level of knowledge about the underlying legislation. There were 241 questionnaires sent and 139 were turned, which was a response rate of 58%. About one third of the responders reported having had no experience with advance directives and only 9 directors of intensive care units had dealt with more than 10 advance directives in the previous two years. Life-supporting measures, resuscitation, and mechanical ventilation were the predominantly refused therapies, wishes were mainly expressed concerning pain therapy. A response rate of almost 60% proves the great interest of intensive care professionals in making patient-oriented end-of-life decisions. However, as long as patients do not make use of their right of co-determination, the enactment of the new law can be considered only a first important step forward.

Molecular nitrogen in comet 67P/Churyumov-Gerasimenko indicates a low formation temperature.

PubMed

Rubin, M; Altwegg, K; Balsiger, H; Bar-Nun, A; Berthelier, J-J; Bieler, A; Bochsler, P; Briois, C; Calmonte, U; Combi, M; De Keyser, J; Dhooghe, F; Eberhardt, P; Fiethe, B; Fuselier, S A; Gasc, S; Gombosi, T I; Hansen, K C; Hässig, M; Jäckel, A; Kopp, E; Korth, A; Le Roy, L; Mall, U; Marty, B; Mousis, O; Owen, T; Rème, H; Sémon, T; Tzou, C-Y; Waite, J H; Wurz, P

2015-04-10

Molecular nitrogen (N2) is thought to have been the most abundant form of nitrogen in the protosolar nebula. It is the main N-bearing molecule in the atmospheres of Pluto and Triton and probably the main nitrogen reservoir from which the giant planets formed. Yet in comets, often considered the most primitive bodies in the solar system, N2 has not been detected. Here we report the direct in situ measurement of N2 in the Jupiter family comet 67P/Churyumov-Gerasimenko, made by the Rosetta Orbiter Spectrometer for Ion and Neutral Analysis mass spectrometer aboard the Rosetta spacecraft. A N2/CO ratio of (5.70 ± 0.66) × 10(-3) (2σ standard deviation of the sampled mean) corresponds to depletion by a factor of ~25.4 ± 8.9 as compared to the protosolar value. This depletion suggests that cometary grains formed at low-temperature conditions below ~30 kelvin. Copyright © 2015, American Association for the Advancement of Science.

Tensile strengths of polyamide based 3D printed polymers in liquid nitrogen

NASA Astrophysics Data System (ADS)

Cruz, P.; Shoemake, E. D.; Adam, P.; Leachman, J.

2015-12-01

Advances in additive manufacturing technology have made 3D printing a viable solution for many industries, allowing for the manufacture of designs that could not be made through traditional subtractive methods. Applicability of additive manufacturing in cryogenic applications is hindered, however, by a lack of accurate material properties information. Nylon is available for printing using fused deposition modeling (FDM) and selective laser sintering (SLS). We selected 5 SLS (DuraForm® EX, DuraForm® HST, DuraForm® PA, PA 640-GSL, and PA 840-GSL) and 2 FDM (Nylon 12, ULTEM) nylon variants based on the bulk material properties and printed properties at room temperature. Tensile tests were performed on five samples of each material while immersed in liquid nitrogen at approximately 77 Kelvin. Samples were tested in XY and, where available, Z printing directions to determine influence on material properties. Results show typical SLS and FDM nylon ultimate strength retention at 77 K, when compared to (extruded or molded) nylon ultimate strength.

Triplex technology in studies of DNA damage, DNA repair, and mutagenesis.

PubMed

Mukherjee, Anirban; Vasquez, Karen M

2011-08-01

Triplex-forming oligonucleotides (TFOs) can bind to the major groove of homopurine-homopyrimidine stretches of double-stranded DNA in a sequence-specific manner through Hoogsteen hydrogen bonding to form DNA triplexes. TFOs by themselves or conjugated to reactive molecules can be used to direct sequence-specific DNA damage, which in turn results in the induction of several DNA metabolic activities. Triplex technology is highly utilized as a tool to study gene regulation, molecular mechanisms of DNA repair, recombination, and mutagenesis. In addition, TFO targeting of specific genes has been exploited in the development of therapeutic strategies to modulate DNA structure and function. In this review, we discuss advances made in studies of DNA damage, DNA repair, recombination, and mutagenesis by using triplex technology to target specific DNA sequences. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

[Advance directives in clinical practice : Living will, healthcare power of attorney and care directive].

PubMed

Hack, J; Buecking, B; Lopez, C L; Ruchholtz, S; Kühne, C A

2017-06-01

In clinical practice, situations continuously occur in which medical professionals and family members are confronted with decisions on whether to extend or limit treatment for severely ill patients in end of life treatment decisions. In these situations, advance directives are helpful tools in decision making according to the wishes of the patient; however, not every patient has made an advance directive and in our experience medical staff as well as patients are often not familiar with these documents. The purpose of this article is therefore to explain the currently available documents (e.g. living will, healthcare power of attorney and care directive) and the possible (legal) applications and limitations in the routine clinical practice.

[Advance directives in clinical practice : Living will, healthcare power of attorney and care directive].

PubMed

Hack, J; Buecking, B; Lopez, C L; Ruchholtz, S; Kühne, C A

2017-02-01

In clinical practice, situations continuously occur in which medical professionals and family members are confronted with decisions on whether to extend or limit treatment for severely ill patients in end of life treatment decisions. In these situations, advance directives are helpful tools in decision making according to the wishes of the patient; however, not every patient has made an advance directive and in our experience medical staff as well as patients are often not familiar with these documents. The purpose of this article is therefore to explain the currently available documents (e.g. living will, healthcare power of attorney and care directive) and the possible (legal) applications and limitations in the routine clinical practice.

[Advance directives in clinical practice : Living will, healthcare power of attorney and care directive].

PubMed

Hack, J; Buecking, B; Lopez, C L; Ruchholtz, S; Kühne, C A

2017-12-01

In clinical practice, situations continuously occur in which medical professionals and family members are confronted with decisions on whether to extend or limit treatment for severely ill patients in end of life treatment decisions. In these situations, advance directives are helpful tools in decision making according to the wishes of the patient; however, not every patient has made an advance directive and in our experience medical staff as well as patients are often not familiar with these documents. The purpose of this article is therefore to explain the currently available documents (e.g. living will, healthcare power of attorney and care directive) and the possible (legal) applications and limitations in the routine clinical practice.

[Advance directives in clinical practice : Living will, healthcare power of attorney and care directive].

PubMed

Hack, J; Buecking, B; Lopez, C L; Ruchholtz, S; Kühne, C A

2017-04-01

In clinical practice, situations continuously occur in which medical professionals and family members are confronted with decisions on whether to extend or limit treatment for severely ill patients in end of life treatment decisions. In these situations, advance directives are helpful tools in decision making according to the wishes of the patient; however, not every patient has made an advance directive and in our experience medical staff as well as patients are often not familiar with these documents. The purpose of this article is therefore to explain the currently available documents (e.g. living will, healthcare power of attorney and care directive) and the possible (legal) applications and limitations in the routine clinical practice.

Evolution of natural agents: preservation, advance, and emergence of functional information.

PubMed

Sharov, Alexei A

2016-04-01

Biological evolution is often viewed narrowly as a change of morphology or allele frequency in a sequence of generations. Here I pursue an alternative informational concept of evolution, as preservation, advance, and emergence of functional information in natural agents. Functional information is a network of signs (e.g., memory, transient messengers, and external signs) that are used by agents to preserve and regulate their functions. Functional information is preserved in evolution via complex interplay of copying and construction processes: the digital components are copied, whereas interpreting subagents together with scaffolds, tools, and resources, are constructed. Some of these processes are simple and invariant, whereas others are complex and contextual. Advance of functional information includes improvement and modification of already existing functions. Although the genome information may change passively and randomly, the interpretation is active and guided by the logic of agent behavior and embryonic development. Emergence of new functions is based on the reinterpretation of already existing information, when old tools, resources, and control algorithms are adopted for novel functions. Evolution of functional information progressed from protosemiosis, where signs correspond directly to actions, to eusemiosis, where agents associate signs with objects. Language is the most advanced form of eusemiosis, where the knowledge of objects and models is communicated between agents.

Evolution of natural agents: preservation, advance, and emergence of functional information

PubMed Central

Sharov, Alexei A.

2016-01-01

Biological evolution is often viewed narrowly as a change of morphology or allele frequency in a sequence of generations. Here I pursue an alternative informational concept of evolution, as preservation, advance, and emergence of functional information in natural agents. Functional information is a network of signs (e.g., memory, transient messengers, and external signs) that are used by agents to preserve and regulate their functions. Functional information is preserved in evolution via complex interplay of copying and construction processes: the digital components are copied, whereas interpreting subagents together with scaffolds, tools, and resources, are constructed. Some of these processes are simple and invariant, whereas others are complex and contextual. Advance of functional information includes improvement and modification of already existing functions. Although the genome information may change passively and randomly, the interpretation is active and guided by the logic of agent behavior and embryonic development. Emergence of new functions is based on the reinterpretation of already existing information, when old tools, resources, and control algorithms are adopted for novel functions. Evolution of functional information progressed from protosemiosis, where signs correspond directly to actions, to eusemiosis, where agents associate signs with objects. Language is the most advanced form of eusemiosis, where the knowledge of objects and models is communicated between agents. PMID:27525048

OPTICS. Quantum spin Hall effect of light.

PubMed

Bliokh, Konstantin Y; Smirnova, Daria; Nori, Franco

2015-06-26

Maxwell's equations, formulated 150 years ago, ultimately describe properties of light, from classical electromagnetism to quantum and relativistic aspects. The latter ones result in remarkable geometric and topological phenomena related to the spin-1 massless nature of photons. By analyzing fundamental spin properties of Maxwell waves, we show that free-space light exhibits an intrinsic quantum spin Hall effect—surface modes with strong spin-momentum locking. These modes are evanescent waves that form, for example, surface plasmon-polaritons at vacuum-metal interfaces. Our findings illuminate the unusual transverse spin in evanescent waves and explain recent experiments that have demonstrated the transverse spin-direction locking in the excitation of surface optical modes. This deepens our understanding of Maxwell's theory, reveals analogies with topological insulators for electrons, and offers applications for robust spin-directional optical interfaces. Copyright © 2015, American Association for the Advancement of Science.

Health effects of coal technologies: research needs

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

Not Available

1980-09-01

In this 1977 Environmental Message, President Carter directed the establishment of a joint program to identify the health and environmental problems associated with advanced energy technologies and to review the adequacy of present research programs. In response to the President's directive, representatives of three agencies formed the Federal Interagency Committee on the Health and Environmental Effects of Energy Technologies. This report was prepared by the Health Effects Working Group on Coal Technologies for the Committee. In this report, the major health-related problems associated with conventional coal mining, storage, transportation, and combustion, and with chemical coal cleaning, in situ gasification, fluidizedmore » bed combustion, magnetohydrodynamic combustion, cocombustion of coal-oil mixtures, and cocombustion of coal with municipal solid waste are identified. The report also contains recommended research required to address the identified problems.« less

Direct writing of continuous and discontinuous sub-wavelength periodic surface structures on single-crystalline silicon using femtosecond laser

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

Kuladeep, Rajamudili; Sahoo, Chakradhar; Narayana Rao, Desai, E-mail: dnrsp@uohyd.ernet.in, E-mail: dnr-laserlab@yahoo.com

Laser-induced ripples or uniform arrays of continuous near sub-wavelength or discontinuous deep sub-wavelength structures are formed on single-crystalline silicon (Si) by femtosecond (fs) laser direct writing technique. Laser irradiation was performed on Si wafers at normal incidence in air and by immersing them in dimethyl sulfoxide using linearly polarized Ti:sapphire fs laser pulses of ∼110 fs pulse duration and ∼800 nm wavelength. Morphology studies of laser written surfaces reveal that sub-wavelength features are oriented perpendicular to laser polarization, while their morphology and spatial periodicity depend on the surrounding dielectric medium. The formation mechanism of the sub-wavelength features is explained by interferencemore » of incident laser with surface plasmon polaritons. This work proves the feasibility of fs laser direct writing technique for the fabrication of sub-wavelength features, which could help in fabrication of advanced electro-optic devices.« less

Adaptive array antenna for satellite cellular and direct broadcast communications

NASA Technical Reports Server (NTRS)

Horton, Charles R.; Abend, Kenneth

1993-01-01

Adaptive phased-array antennas provide cost-effective implementation of large, light weight apertures with high directivity and precise beamshape control. Adaptive self-calibration allows for relaxation of all mechanical tolerances across the aperture and electrical component tolerances, providing high performance with a low-cost, lightweight array, even in the presence of large physical distortions. Beam-shape is programmable and adaptable to changes in technical and operational requirements. Adaptive digital beam-forming eliminates uplink contention by allowing a single electronically steerable antenna to service a large number of receivers with beams which adaptively focus on one source while eliminating interference from others. A large, adaptively calibrated and fully programmable aperture can also provide precise beam shape control for power-efficient direct broadcast from space. Advanced adaptive digital beamforming technologies are described for: (1) electronic compensation of aperture distortion, (2) multiple receiver adaptive space-time processing, and (3) downlink beam-shape control. Cost considerations for space-based array applications are also discussed.

Chimeric antigen receptor (CAR)-directed adoptive immunotherapy: a new era in targeted cancer therapy.

PubMed

Chen, Yamei; Liu, Delong

2014-01-01

As a result of the recent advances in molecular immunology, virology, genetics, and cell processing, chimeric antigen receptor (CAR)-directed cancer therapy has finally arrived for clinical application. CAR-directed adoptive immunotherapy represents a novel form of gene therapy, cellular therapy, and immunotherapy, a combination of three in one. Early phase clinical trial was reported in patients with refractory chronic lymphoid leukemia with 17p deletion. Accompanying the cytokine storm and tumor lysis syndrome was the shocking disappearance of the leukemia cells refractory to chemotherapy and monoclonal antibodies. CAR therapy was reproduced in both children and adults with refractory acute lymphoid leukemia. The CAR technology is being explored for solid tumor therapy, such as glioma. Close to 30 clinical trials are underway in the related fields (www.clinicaltrials.gov). Further improvement in gene targeting, cell expansion, delivery constructs (such as using Sleeping Beauty or Piggyback transposons) will undoubtedly enhance clinical utility. It is foreseeable that CAR-engineered T cell therapy will bring targeted cancer therapy into a new era.

Advance Care Planning and the Quality of End-of-Life Care among Older Adults

PubMed Central

Bischoff, Kara E.; Sudore, Rebecca; Miao, Yinghui; Boscardin, W. John; Smith, Alexander K.

2013-01-01

Background Advance care planning is increasingly common, but whether it influences end-of-life quality of care remains controversial. Design Medicare data and survey data from the Health and Retirement Study were combined to determine whether advance care planning was associated with quality metrics. Setting The nationally representative Health and Retirement Study. Participants 4394 decedent subjects (mean age 82.6 years at death, 55% women). Measurements Advance care planning was defined as having an advance directive, durable power of attorney or having discussed preferences for end-of-life care with a next-of-kin. Outcomes included previously reported quality metrics observed during the last month of life (rates of hospital admission, in-hospital death, >14 days in the hospital, intensive care unit admission, >1 emergency department visit, hospice admission, and length of hospice ≤3 days). Results Seventy-six percent of subjects engaged in advance care planning. Ninety-two percent of advance directives stated a preference to prioritize comfort. After adjustment, subjects who engaged in advance care planning were less likely to die in a hospital (adjusted RR 0.87, 95% CI 0.80-0.94), more likely to be enrolled in hospice (aRR 1.68, 1.43-1.97), and less likely to receive hospice for ≤3 days before death (aRR 0.88, 0.85-0.91). Having an advance directive, a durable-power-of-attorney or an advance care planning discussion were each independently associated with a significant increase in hospice use (p<0.01 for all). Conclusion Advance care planning was associated with improved quality of care at the end of life, including less in-hospital death and increased use of hospice. Having an advance directive, assigning a durable power of attorney and conducting advance care planning discussions are all important elements of advance care planning. PMID:23350921

Wake Geometry Effects on Rotor Blade-Vortex Interaction Noise Directivity

NASA Technical Reports Server (NTRS)

Martin, R. M.; Marcolini, Michael A.; Splettstoesser, W. R.; Schultz, K.-J.

1990-01-01

Acoustic measurements from a model rotor wind tunnel test are presented which show that the directionality of rotor blade vortex interaction (BVI) noise is strongly dependent on the rotor advance ratio and disk attitude. A rotor free wake analysis is used to show that the general locus of interactions on the rotor disk is also strongly dependent on advance ratio and disk attitude. A comparison of the changing directionality of the BVI noise with changes in the interaction locations shows that the strongest noise radiation occurs in the direction of motion normal to the blade span at the time of interaction, for both advancing and retreating side BVI. For advancing side interactions, the BVI radiation angle down from the tip-path plane appears relatively insensitive to rotor operating condition and is typically between 40 and 55 deg below the disk. However, the azimuthal radiation direction shows a clear trend with descent speed, moving towards the right of the flight path with increasing descent speed. The movement of the strongest radiation direction is attributed to the movement of the interaction locations on the rotor disk with increasing descent speed.

When previously expressed wishes conflict with best interests.

PubMed

Smith, Alexander K; Lo, Bernard; Sudore, Rebecca

2013-07-08

Rising use of advance directives has made surrogate decision making both easier and harder. In many cases, these directives help guide decision making for patients who have lost decision-making capacity. In some cases, however, directives may conflict with what physicians or surrogates view as what is in the patient's best interest. These conflicts can place substantial emotional and moral burdens on physicians and surrogates, and there is little practical guidance for how to address them. We propose a 5-question framework for untangling the conflict between advance directives and best interests of a patient with a surrogate decision maker: (1) Is the clinical situation an emergency? (2) In view of the patient's values and goals, how likely is it that the benefits of the intervention will outweigh the burdens? (3) How well does the advance directive fit the situation at hand? (4) How much leeway did the patient provide the surrogate for overriding the advance directive? (5) How well does the surrogate represent the patient's best interests? We use 2 clinical cases with contrasting outcomes to demonstrate how this framework can help resolve common dilemmas.

Default Options In Advance Directives Influence How Patients Set Goals For End-Of-Life Care

PubMed Central

Halpern, Scott D.; Loewenstein, George; Volpp, Kevin G.; Cooney, Elizabeth; Vranas, Kelly; Quill, Caroline M.; Mckenzie, Mary S.; Harhay, Michael O.; Gabler, Nicole B.; Silva, Tatiana; Arnold, Robert; Angus, Derek C.; Bryce, Cindy

2015-01-01

Although decisions regarding end-of-life care are personal and important, they may be influenced by the ways in which options are presented. To test this hypothesis, we randomly assigned 132 seriously ill patients to complete one of three types of advance directives. Two types had end-of-life care options already checked—a default choice—but one of these favored comfort-oriented care, and the other, life-extending care. The third type was a standard advance directive with no options checked. We found that most patients preferred comfort-oriented care, but the defaults influenced those choices. For example, 77 percent of patients in the comfort-oriented group retained that choice, while 43 percent of those in the life-extending group rejected the default choice and selected comfort-oriented care instead. Among the standard advance directive group, 61 percent of patients selected comfort-oriented care. Our findings suggest that patients may not hold deep-seated preferences regarding end-of-life care. The findings provide motivation for future research examining whether using default options in advance directives may improve important outcomes, including patients’ receipt of wanted and unwanted services, resource use, survival, and quality of life. PMID:23381535

'Nurses don't deal with these issues': nurses' role in advance care planning for lesbian, gay, bisexual and transgender patients.

PubMed

Carabez, Rebecca; Scott, Megan

2016-12-01

We used a question from the Healthcare Equality Index to explore nurses' knowledge and understanding of medical advance directives, medical power of attorney and other legal documents for lesbian, gay, bisexual and transgender patients. Until the landmark ruling in Obergefell vs. Hodges, lesbian, gay, bisexual and transgender individuals and same-sex couples have had limited relationship rights as only a few states recognised marriages and provided legal protections for same-sex couples. Health care providers' knowledge of and attitudes towards advance care planning plays a significant role in determining whether or not individuals successfully complete advance directives, yet advance care planning for lesbian, gay, bisexual and transgender individuals is poorly understood among both health care providers and same-sex couples. These data were part of a larger research study that explored the current state of lesbian, gay, bisexual and transgender-sensitive nursing practice. Undergraduate nursing students recruited and interviewed nurse key informants (n = 268) about medical advance directives, medical power of attorney and other legal documents for lesbian, gay, bisexual and transgender patients. Nearly 50% of key informants indicated a lack of knowledge of advance directives, over 26% reported the difficulties nurses face regarding advance directives are the same for both lesbian, gay, bisexual and transgender and heterosexual patients, and nearly 25% indicated difficulties including having to decide who has the legal right to make decisions for the patient. The study demonstrated the need for education and training for practising nurses in advance care planning for lesbian, gay, bisexual and transgender patients and same-sex couples. Nurses are in a position to act as educators, advocates and decision makers for their patients. Nurse's lack of understanding of advance care planning may negatively impact the type and quality of care lesbian, gay, bisexual and transgender patients receive. © 2016 John Wiley & Sons Ltd.

Advance care planning in CKD/ESRD: an evolving process.

PubMed

Holley, Jean L

2012-06-01

Advance care planning was historically considered to be simply the completion of a proxy (health care surrogate designation) or instruction (living will) directive that resulted from a conversation between a patient and his or her physician. We now know that advance care planning is a much more comprehensive and dynamic patient-centered process used by patients and families to strengthen relationships, achieve control over medical care, prepare for death, and clarify goals of care. Some advance directives, notably designated health care proxy documents, remain appropriate expressions of advance care planning. Moreover, although physician orders, such as do-not-resuscitate orders and Physician Orders for Life-Sustaining Treatment, may not be strictly defined as advance directives, their completion, when appropriate, is an integral component of advance care planning. The changing health circumstances and illness trajectory characteristic of ESRD mandate that advance care planning discussions adapt to a patient's situation and therefore must be readdressed at appropriate times and intervals. The options of withholding and withdrawing dialysis add ESRD-specific issues to advance care planning in this population and are events each nephrologist will at some time confront. Advance care planning is important throughout the spectrum of ESRD and is a part of nephrology practice that can be rewarding to nephrologists and beneficial to patients and their families.

Development of a direct three-dimensional biomicrofabrication concept based on electrospraying a custom made siloxane sol

PubMed Central

Sullivan, Alice C.; Jayasinghe, Suwan N.

2007-01-01

We demonstrate here the discovery of a unique and direct three-dimensional biomicrofabrication concept possessing the ability to revolutionize the jet-based fabrication arena. Previous work carried out on similar jet-based approaches have been successful in fabricating only vertical wall∕pillar-structures by the controlled deposition of stacked droplets. However, these advanced jet-techniques have not been able to directly fabricate self-supporting arches∕links (without molds or reaction methods) between adjacent structures (walls or pillars). Our work reported here gives birth to a unique type of jet determined by high intensity electric fields, which is derived from a specially formulated siloxane sol. The sol studied here has been chosen for its attractive properties (such as an excellent cross-linking nature as well as the ability to polymerize via polycondensation on deposition to its biocompatability), which promotes direct forming of biostructures with nanometer (<50 nm) sized droplets in three dimensions. We foresee that this direct three-dimensional biomicrofabrication jet technique coupled with a variety of formulated sols having focused and enhanced functionality will be explored throughout the physical and life sciences. PMID:19693359

Blue Horizons IV: Deterrence in the Age of Surprise

DTIC Science & Technology

2014-01-01

technologies. It posits that the result of rapid advances in nanotechnology, biotechnology , directed energy, space, computers and communications...nanotechnology, and biotechnology . Each of these poses the risk of catastrophic attack to the United States, its citizens, and its infrastructure. Deterring...of advanced and potentially dangerous technologies. It posits that the result of rapid advances in nanotechnology, biotechnology , directed energy

Middle-Aged Independent-Living African Americans' Selections for Advance Directives: A Case Study

ERIC Educational Resources Information Center

McDaniel, Brenda J.

2013-01-01

The purpose of this collective embedded qualitative case study was to examine the perspectives of three middle-aged independent-living African Americans who had participated in the process of advance care planning (ACP) and completed at least two advance directives (ADs), a Durable Power of Attorney for Health Care (DPAHC) and a Living Will (LW).…

Advance care planning in 21st century Australia: a systematic review and appraisal of online advance care directive templates against national framework criteria.

PubMed

Luckett, Tim; Bhattarai, Priyanka; Phillips, Jane; Agar, Meera; Currow, David; Krastev, Yordanka; Davidson, Patricia M

2015-11-01

A drive to promote advance care planning at a population level has led to a proliferation of online advance care directive (ACD) templates but little information to guide consumer choice. The current study aimed to appraise the quality of online ACD templates promoted for use in Australia. A systematic review of online Australian ACD templates was conducted in February 2014. ACD templates were identified via Google searches, and quality was independently appraised by two reviewers against criteria from the 2011 report A National Frameworkfor Advance Care Directives. Bias either towards or against future medical treatment was assessed using criteria designed to limit subjectivity. Fourteen online ACD templates were included, all of which were available only in English. Templates developed by Southern Cross University best met the framework criteria. One ACD template was found to be biased against medical treatment--the Dying with Dignity Victoria Advance Healthcare Directive. More research is needed to understand how online resources can optimally elicit and record consumers' individual preferences for future care. Future iterations of the framework should address online availability and provide a simple rating system to inform choice and drive quality improvement.

Gastrointestinal Neuroendocrine Tumors: Pancreatic Endocrine Tumors

PubMed Central

Metz, David C.

2008-01-01

Pancreatic endocrine tumors (PETs) have long fascinated clinicians and investigators despite their relative rarity. Their clinical presentation varies depending upon whether the tumor is functional or not and also according to the specific hormonal syndrome produced. Tumors may be sporadic or inherited but little is known about their molecular pathology, especially the sporadic forms. Chromogranin A appears to be the most useful serum marker for diagnosis, staging and monitoring. Initially, therapy should be directed at the hormonal syndrome as this has the major initial impact on the patient's health. Most PETs are relatively indolent but ultimately malignant, except for insulinomas which are predominantly benign. Surgery is the only modality that offers the possibility of cure although it is generally noncurative in patients with Zollinger-Ellison syndrome or nonfunctional PETs with MEN1. Preoperative staging of disease extent is necessary to determine the likelihood of complete resection though debulking surgery is often felt to be useful in unresectable patients. Once metastatic, biotherapy is usually the first modality employed because it is generally well tolerated. Systemic or regional therapies are generally reserved until symptoms occur or tumor growth is rapid. Recently a number of newer agents, as well as receptor-directed radiotherapy, are being evalulated for patients with advanced disease. This review addresses a number of recent advances regarding the molecular pathology, diagnosis, localization and management of PETs including discussion of peptide receptor radionuclide therapy and other novel antitumor approaches. We conclude with a discussion of future directions and unsettled problems in the field. PMID:18703061

Method of lining a vertical mine shaft with concrete

DOEpatents

Eklund, James D.; Halter, Joseph M.; Rasmussen, Donald E.; Sullivan, Robert G.; Moffat, Robert B.

1981-01-01

The apparatus includes a cylindrical retainer form spaced inwardly of the wall of the shaft by the desired thickness of the liner to be poured and having overlapping edges which seal against concrete flow but permit the form to be contracted to a smaller circumference after the liner has hardened and is self-supporting. A curb ring extends downwardly and outwardly toward the shaft wall from the bottom of the retainer form to define the bottom surface of each poured liner section. An inflatable toroid forms a seal between the curb ring and the shaft wall. A form support gripper ring having gripper shoes laterally extendable under hydraulic power to engage the shaft wall supports the retainer form, curb ring and liner until the newly poured liner section becomes self-supporting. Adjusting hydraulic cylinders permit the curb ring and retainer form to be properly aligned relative to the form support gripper ring. After a liner section is self-supporting, an advancing system advances the retainer form, curb ring and form support gripper ring toward a shaft boring machine above which the liner is being formed. The advancing system also provides correct horizontal alignment of the form support gripper ring.

Protecting me from my Directive: Ensuring Appropriate Safeguards for Advance Directives in Dementia.

PubMed

Auckland, Cressida

2018-02-01

With one in six people over 80 now suffering from dementia, advance directives provide an important means of empowerment. Upholding directives in the context of dementia, however, raises extra challenges, given the potential for the directive to conflict with an assessment of what is in the person's current best interests. Given the profound harm that tying a person with dementia to their previous wishes can do, it is essential that we have sufficient safeguards in place to ensure that we only uphold such directives where we can be sure they are truly autonomous and are intended to apply to the situation at hand-safeguards which are at present, severely lacking. This article will consider various mechanisms by which safeguards can be built into the legal regime to ensure that the original decision is autonomous, including making it mandatory for the person to undergo a consultation with a healthcare professional, which would involve a contemporaneous capacity assessment. Clinicians must also be confident that the directive applies to the situation at hand. Introducing formalities, including a standardised (though not mandatory) proforma, may help to enhance specificity about when the directive is triggered, and to what treatments it relates, to enable clinicians to better assess the directive's applicability. A national registry for advance directives might also be beneficial. It will be argued that health care professionals will have to play a much greater role in the drafting and registering of advance directives, if we are to feel comfortable in upholding them.

Advance directives and medical treatment at the end of life.

PubMed

Kessler, Daniel P; McClellan, Mark B

2004-01-01

To assess the consequences of advance medical directives--which explicitly specify a patient's preferences for one or more specific types of medical treatment in the event of a loss of competence--we analyze the medical care of elderly Medicare beneficiaries who died between 1985 and 1995. We compare the care of patients from states that adopted laws enhancing incentives for compliance with advance directives and laws requiring the appointment of a health care surrogate in the absence of an advance directive to the care of patients from states that did not. We report three key findings. First, laws enhancing incentives for compliance significantly reduce the probability of dying in an acute care hospital. Second, laws requiring the appointment of a surrogate significantly increase the probability of receiving acute care in the last month of life, but decrease the probability of receiving nonacute care. Third, neither type of law leads to any savings in medical expenditures.

Advance directives in psychiatric care: a narrative approach

PubMed Central

Widdershoven, G.; Berghmans, R.

2001-01-01

Advance directives for psychiatric care are the subject of debate in a number of Western societies. By using psychiatric advance directives (or so-called "Ulysses contracts"), it would be possible for mentally ill persons who are competent and with their disease in remission, and who want timely intervention in case of future mental crisis, to give prior authorisation to treatment at a later time when they are incompetent, have become non-compliant, and are refusing care. Thus the devastating consequences of recurrent psychosis could be minimised. Ulysses contracts raise a number of ethical questions. In this article the central issues of concern and debate are discussed from a narrative perspective. Ulysses contracts are viewed as elements of an ongoing narrative in which patient and doctor try to make sense of and get a hold on the recurrent crises inherent in the patient's psychiatric condition. Key Words: Medical ethics • narrative ethics • advance directives • psychiatry PMID:11314165

When lithography meets self-assembly: a review of recent advances in the directed assembly of complex metal nanostructures on planar and textured surfaces

NASA Astrophysics Data System (ADS)

Hughes, Robert A.; Menumerov, Eredzhep; Neretina, Svetlana

2017-07-01

One of the foremost challenges in nanofabrication is the establishment of a processing science that integrates wafer-based materials, techniques, and devices with the extraordinary physicochemical properties accessible when materials are reduced to nanoscale dimensions. Such a merger would allow for exacting controls on nanostructure positioning, promote cooperative phenomenon between adjacent nanostructures and/or substrate materials, and allow for electrical contact to individual or groups of nanostructures. With neither self-assembly nor top-down lithographic processes being able to adequately meet this challenge, advancements have often relied on a hybrid strategy that utilizes lithographically-defined features to direct the assembly of nanostructures into organized patterns. While these so-called directed assembly techniques have proven viable, much of this effort has focused on the assembly of periodic arrays of spherical or near-spherical nanostructures comprised of a single element. Work directed toward the fabrication of more complex nanostructures, while still at a nascent stage, has nevertheless demonstrated the possibility of forming arrays of nanocubes, nanorods, nanoprisms, nanoshells, nanocages, nanoframes, core-shell structures, Janus structures, and various alloys on the substrate surface. In this topical review, we describe the progress made in the directed assembly of periodic arrays of these complex metal nanostructures on planar and textured substrates. The review is divided into three broad strategies reliant on: (i) the deterministic positioning of colloidal structures, (ii) the reorganization of deposited metal films at elevated temperatures, and (iii) liquid-phase chemistry practiced directly on the substrate surface. These strategies collectively utilize a broad range of techniques including capillary assembly, microcontact printing, chemical surface modulation, templated dewetting, nanoimprint lithography, and dip-pen nanolithography and employ a wide scope of chemical processes including redox reactions, alloying, dealloying, phase separation, galvanic replacement, preferential etching, template-mediated reactions, and facet-selective capping agents. Taken together, they highlight the diverse toolset available when fabricating organized surfaces of substrate-supported nanostructures.

Fuel conservative aircraft engine technology

NASA Technical Reports Server (NTRS)

Nored, D. L.

1978-01-01

Technology developments for more fuel-efficiency subsonic transport aircraft are reported. Three major propulsion projects were considered: (1) engine component improvement - directed at current engines; (2) energy efficient engine - directed at new turbofan engines; and (3) advanced turboprops - directed at technology for advanced turboprop-powered aircraft. Each project is reviewed and some of the technologies and recent accomplishments are described.

Recent Advances in High-Performance Direct Methanol Fuel Cells

NASA Technical Reports Server (NTRS)

Narayanan, S. R.; Chun, W.; Valdez, T. I.; Jeffries-Nakamura, B.; Frank, H.; Surumpudi, S.; Halpert, G.; Kosek, J.; Cropley, C.; La Conti, A. B.;

Where There's a Will: The Link Between Estate Planning and Disparities in Advance Care Planning by White and Black Older Adults.

PubMed

Koss, Catheryn S; Baker, Tamara A

2018-03-01

Data from the Health and Retirement Study ( n = 6,946) were used to test whether differences in estate planning accounted for disparities in advance care planning between White and Black older adults. White participants were more likely to have advance directives after controlling for demographic, health, and financial variables. When estate planning was also controlled, the odds of having an advance directive were equal for White and Black participants. In contrast, Whites remained more likely to discuss end-of-life preferences after controlling for demographic, health, financial, and estate planning variables. White participants were almost four times as likely to have wills or trusts. Wealth, income, and home ownership were predictive of estate planning. Financial disparities contributed to lower rates of estate planning which in turn explained in large part why Black older adults were less likely to have advance directives but did not account for race disparities in advance care discussion.

The role of advance directives in end-of-life decisions in Austria: survey of intensive care physicians

PubMed Central

2010-01-01

Background Currently, intensive care medicine strives to define a generally accepted way of dealing with end-of-life decisions, therapy limitation and therapy discontinuation. In 2006 a new advance directive legislation was enacted in Austria. Patients may now document their personal views regarding extension of treatment. The aim of this survey was to explore Austrian intensive care physicians' experiences with and their acceptance of the new advance directive legislation two years after enactment (2008). Methods Under the aegis of the OEGARI (Austrian Society of Anaesthesiology, Resuscitation and Intensive Care) an anonymised questionnaire was sent to the medical directors of all intensive care units in Austria. The questions focused on the physicians' experiences regarding advance directives and their level of knowledge about the underlying legislation. Results There were 241 questionnaires sent and 139 were turned, which was a response rate of 58%. About one third of the responders reported having had no experience with advance directives and only 9 directors of intensive care units had dealt with more than 10 advance directives in the previous two years. Life-supporting measures, resuscitation, and mechanical ventilation were the predominantly refused therapies, wishes were mainly expressed concerning pain therapy. Conclusion A response rate of almost 60% proves the great interest of intensive care professionals in making patient-oriented end-of-life decisions. However, as long as patients do not make use of their right of co-determination, the enactment of the new law can be considered only a first important step forward. PMID:20964852

Aligned fibers direct collective cell migration to engineer closing and nonclosing wound gaps

PubMed Central

Sharma, Puja; Ng, Colin; Jana, Aniket; Padhi, Abinash; Szymanski, Paige; Lee, Jerry S. H.; Behkam, Bahareh; Nain, Amrinder S.

2017-01-01

Cell emergence onto damaged or organized fibrous extracellular matrix (ECM) is a crucial precursor to collective cell migration in wound closure and cancer metastasis, respectively. However, there is a fundamental gap in our quantitative understanding of the role of local ECM size and arrangement in cell emergence–based migration and local gap closure. Here, using ECM-mimicking nanofibers bridging cell monolayers, we describe a method to recapitulate and quantitatively describe these in vivo behaviors over multispatial (single cell to cell sheets) and temporal (minutes to weeks) scales. On fiber arrays with large interfiber spacing, cells emerge (invade) either singularly by breaking cell–cell junctions analogous to release of a stretched rubber band (recoil), or in groups of few cells (chains), whereas on closely spaced fibers, multiple chains emerge collectively. Advancing cells on fibers form cell streams, which support suspended cell sheets (SCS) of various sizes and curvatures. SCS converge to form local gaps that close based on both the gap size and shape. We document that cell stream spacing of 375 µm and larger hinders SCS advancement, thus providing abilities to engineer closing and nonclosing gaps. Altogether we highlight the importance of studying cell-fiber interactions and matrix structural remodeling in fundamental and translational cell biology. PMID:28747440

High-quality multilayer graphene on an insulator formed by diffusion controlled Ni-induced layer exchange

NASA Astrophysics Data System (ADS)

Murata, H.; Saitoh, N.; Yoshizawa, N.; Suemasu, T.; Toko, K.

2017-12-01

The Ni-induced layer-exchange growth of amorphous carbon is a unique method used to fabricate uniform multilayer graphene (MLG) directly on an insulator. To improve the crystal quality of MLG, we prepare AlOx or SiO2 interlayers between amorphous C and Ni layers, which control the extent of diffusion of C atoms into the Ni layer. The growth morphology and Raman spectra observed from MLG formed by layer exchange strongly depend on the material type and thickness of the interlayers; a 1-nm-thick AlOx interlayer is found to be ideal for use in experiments. Transmission electron microscopy and electron energy-loss spectra reveal that the crystal quality of the resulting MLG is much higher than that of a sample without an interlayer. The grain size reaches a few μm, leading to an electrical conductivity of 1290 S/cm. The grain size and the electrical conductivity are the highest among MLG synthesized using a solid-phase reaction including metal-induced crystallization. The direct synthesis of uniform, high-quality MLG on arbitrary substrates will pave the way for advanced electronic devices integrated with carbon materials.

Solution-processed air-stable mesoscopic selenium solar cells

DOE PAGES

Zhu, Menghua; Hao, Feng; Ma, Lin; ...

2016-07-28

Crystalline selenium (c-Se) is a direct band gap semiconductor and has been developed for detector applications for more than 30 years. While most advances have been made using vacuum deposition processes, it remains a challenge to prepare efficient c-Se devices directly from solution. We demonstrate a simple solution process leading to uniform and high-crystallinity selenium films under ambient conditions. A combination of ethylenediamine (EDA) and hydrazine solvents was found to be effective in dissolving selenium powder and forming highly concentrated solutions. These can be used to infiltrate a mesoporous titanium dioxide layer and form a smooth and pinhole-free capping overlayer.more » Efficient light-induced charge injection from the crystalline selenium to TiO 2 was observed using transient absorption spectroscopy. A small amount of EDA addition in the hydrazine solution was found to improve the film coverage significantly, and on the basis of the finding, we are able to achieve up to 3.52% power conversion efficiency solar cells with a fill factor of 57%. Lastly, these results provide a method to control the crystalline selenium film and represent significant progress in developing low-cost selenium-based solar cells.« less

Art on the Nanoscale and Beyond.

PubMed

Yetisen, Ali K; Coskun, Ahmet F; England, Grant; Cho, Sangyeon; Butt, Haider; Hurwitz, Jonty; Kolle, Mathias; Khademhosseini, Ali; Hart, A John; Folch, Albert; Yun, Seok Hyun

2016-03-02

Methods of forming and patterning materials at the nano- and microscales are finding increased use as a medium of artistic expression, and as a vehicle for communicating scientific advances to a broader audience. While sharing many attributes of other art forms, miniaturized art enables the direct engagement of sensory aspects such as sight and touch for materials and structures that are otherwise invisible to the eye. The historical uses of nano-/microscale materials and imaging techniques in arts and sciences are presented. The motivations to create artwork at small scales are discussed, and representations in scientific literature and exhibitions are explored. Examples are presented using semiconductors, microfluidics, and nanomaterials as the artistic media; these utilized techniques including micromachining, focused ion beam milling, two-photon polymerization, and bottom-up nanostructure growth. Finally, the technological factors that limit the implementation of artwork at miniature scales are identified, and potential future directions are discussed. As research marches toward even smaller length scales, innovative and engaging visualizations and artistic endeavors will have growing implications on education, communication, policy making, media activism, and public perception of science and technology. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Editors' Introduction: Abstract Concepts: Structure, Processing, and Modeling.

PubMed

Bolognesi, Marianna; Steen, Gerard

2018-06-22

Our ability to deal with abstract concepts is one of the most intriguing faculties of human cognition. Still, we know little about how such concepts are formed, processed, and represented in mind. For example, because abstract concepts do not designate referents that can be experienced through our body, the role of perceptual experiences in shaping their content remains controversial. Current theories suggest a variety of alternative explanations to the question of "how abstract concepts are represented in the human mind." These views pinpoint specific streams of semantic information that would play a prominent role in shaping the content of abstract concepts, such as situation-based information (e.g., Barsalou & Wiemer-Hastings, ), affective information (Kousta, Vigliocco, Vinson, Andrews, & Del Campo, ), and linguistic information (Louwerse, ). Rarely, these theoretical views are directly compared. In this special issue, current views are presented in their most recent and advanced form, and directly compared and discussed in a debate, which is reported at the end of each article. As a result, new exciting questions and challenges arise. These questions and challenges, reported in this introductory article, can arguably pave the way to new empirical studies and theoretical developments on the nature of abstract concepts. © 2018 Cognitive Science Society, Inc.

Sparse electrocardiogram signals recovery based on solving a row echelon-like form of system.

PubMed

Cai, Pingmei; Wang, Guinan; Yu, Shiwei; Zhang, Hongjuan; Ding, Shuxue; Wu, Zikai

2016-02-01

The study of biology and medicine in a noise environment is an evolving direction in biological data analysis. Among these studies, analysis of electrocardiogram (ECG) signals in a noise environment is a challenging direction in personalized medicine. Due to its periodic characteristic, ECG signal can be roughly regarded as sparse biomedical signals. This study proposes a two-stage recovery algorithm for sparse biomedical signals in time domain. In the first stage, the concentration subspaces are found in advance. Then by exploiting these subspaces, the mixing matrix is estimated accurately. In the second stage, based on the number of active sources at each time point, the time points are divided into different layers. Next, by constructing some transformation matrices, these time points form a row echelon-like system. After that, the sources at each layer can be solved out explicitly by corresponding matrix operations. It is noting that all these operations are conducted under a weak sparse condition that the number of active sources is less than the number of observations. Experimental results show that the proposed method has a better performance for sparse ECG signal recovery problem.

Advanced nuclear thermal propulsion concepts

NASA Technical Reports Server (NTRS)

Howe, Steven D.

1993-01-01

In 1989, a Presidential directive created the Space Exploration Initiative (SEI) which had a goal of placing mankind on Mars in the early 21st century. The SEI was effectively terminated in 1992 with the election of a new administration. Although the initiative did not exist long enough to allow substantial technology development, it did provide a venue, for the first time in 20 years, to comprehensively evaluate advanced propulsion concepts which could enable fast, manned transits to Mars. As part of the SEI based investigations, scientists from NASA, DoE National Laboratories, universities, and industry met regularly and proceeded to examine a variety of innovative ideas. Most of the effort was directed toward developing a solid-core, nuclear thermal rocket and examining a high-power nuclear electric propulsion system. In addition, however, an Innovative Concepts committee was formed and charged with evaluating concepts that offered a much higher performance but were less technologically mature. The committee considered several concepts and eventually recommended that further work be performed in the areas of gas core fission rockets, inertial confinement fusion systems, antimatter based rockets, and gas core fission electric systems. Following the committee's recommendations, some computational modeling work has been performed at Los Alamos in certain of these areas and critical issues have been identified.

Microstructure Evolution and Mechanical Behavior of 2219 Aluminum Alloys Additively Fabricated by the Cold Metal Transfer Process

PubMed Central

Fang, Xuewei; Li, Hui; Li, Chaolong; Lu, Bingheng

2018-01-01

In this research, four different welding arc modes including conventional cold metal transfer (CMT), CMT-Pulse (CMT-P), CMT-Advanced (CMT-ADV), and CMT pulse advanced (CMT-PADV) were used to deposit 2219-Al wire. The effects of different arc modes on porosity, pore size distribution, microstructure evolution, and mechanical properties were thoroughly investigated. The statistical analysis of the porosity and its size distribution indicated that the CMT-PADV process gave the smallest pore area percentage and pore aspect ratio, and had almost no larger pores. The results from optical microscopy, scanning electron microscopy, and fractographic morphology proved that uniform and fine equiaxed grains, evenly distributed Al2Cu second phase particles were formed during the CMT-PADV process. Furthermore, the X-ray diffraction test ascertained that the CMT-PADV sample had the smallest lattice parameter and the highest solute Cu content. Besides, the tensile strength could reach 283 MPa, the data scattering was the smallest, and the strength scattering of the sample in the horizontal direction was the shortest. In addition, the strength properties were nearly isotropic, with only 5 MPa difference in the vertical and horizontal directions. The above mentioned results indicated that the mechanical properties of 2219 aluminum alloy was improved using the CMT-PADV arc mode. PMID:29772708

Modulation of innate immune responses by Yersinia type III secretion system translocators and effectors.

PubMed

Bliska, James B; Wang, Xiaoying; Viboud, Gloria I; Brodsky, Igor E

2013-10-01

The innate immune system of mammals responds to microbial infection through detection of conserved molecular determinants called 'pathogen-associated molecular patterns' (PAMPs). Pathogens use virulence factors to counteract PAMP-directed responses. The innate immune system can in turn recognize signals generated by virulence factors, allowing for a heightened response to dangerous pathogens. Many Gram-negative bacterial pathogens encode type III secretion systems (T3SSs) that translocate effector proteins, subvert PAMP-directed responses and are critical for infection. A plasmid-encoded T3SS in the human-pathogenic Yersinia species translocates seven effectors into infected host cells. Delivery of effectors by the T3SS requires plasma membrane insertion of two translocators, which are thought to form a channel called a translocon. Studies of the Yersinia T3SS have provided key advances in our understanding of how innate immune responses are generated by perturbations in plasma membrane and other signals that result from translocon insertion. Additionally, studies in this system revealed that effectors function to inhibit innateimmune responses resulting from insertion of translocons into plasma membrane. Here, we review these advances with the goal of providing insight into how a T3SS can activate and inhibit innate immune responses, allowing a virulent pathogen to bypass host defences. © 2013 John Wiley & Sons Ltd.

Microstructure Evolution and Mechanical Behavior of 2219 Aluminum Alloys Additively Fabricated by the Cold Metal Transfer Process.

PubMed

Fang, Xuewei; Zhang, Lijuan; Li, Hui; Li, Chaolong; Huang, Ke; Lu, Bingheng

2018-05-16

In this research, four different welding arc modes including conventional cold metal transfer (CMT), CMT-Pulse (CMT-P), CMT-Advanced (CMT-ADV), and CMT pulse advanced (CMT-PADV) were used to deposit 2219-Al wire. The effects of different arc modes on porosity, pore size distribution, microstructure evolution, and mechanical properties were thoroughly investigated. The statistical analysis of the porosity and its size distribution indicated that the CMT-PADV process gave the smallest pore area percentage and pore aspect ratio, and had almost no larger pores. The results from optical microscopy, scanning electron microscopy, and fractographic morphology proved that uniform and fine equiaxed grains, evenly distributed Al₂Cu second phase particles were formed during the CMT-PADV process. Furthermore, the X-ray diffraction test ascertained that the CMT-PADV sample had the smallest lattice parameter and the highest solute Cu content. Besides, the tensile strength could reach 283 MPa, the data scattering was the smallest, and the strength scattering of the sample in the horizontal direction was the shortest. In addition, the strength properties were nearly isotropic, with only 5 MPa difference in the vertical and horizontal directions. The above mentioned results indicated that the mechanical properties of 2219 aluminum alloy was improved using the CMT-PADV arc mode.

Tanning and Teens: Is Indoor Exposure the Tip of the Iceberg?

PubMed

Hay, Jennifer L; Riley, Kristen E; Geller, Alan C

2017-08-01

Because of recent state regulations and the reduced availability of free-standing tanning salons, indoor tanning (IT) prevalence is beginning to decline. This may lead to unintended consequences, such as increases in outdoor intentional tanning. We advance a series of research directions to track and intervene to address all forms of intentional tanning. First, we advocate for enforcement of IT regulation and encourage collection of data on tanning salon compliance and alternative IT strategies. Second, we suggest questions about outdoor and IT should be included in national surveys. Third, we need to understand the potentially complex patterns of indoor and outdoor tanning that may exist among those who tan. Fourth, research examining changing motivations for intentional tanning is needed. Finally, IT intervention studies should include outdoor tanning as an outcome to examine the effect of interventions on these related risk behaviors. These advances will ensure the development of novel interventions to address intentional tanning through multiple routes, and to avoid any unintended negative consequence of IT regulation. The promising downward direction of IT use in the United States should now lead the public health field to sharpen its focus on outdoor tanning. Cancer Epidemiol Biomarkers Prev; 26(8); 1170-4. ©2017 AACR . ©2017 American Association for Cancer Research.

Androgens and estrogens in skeletal sexual dimorphism

PubMed Central

Laurent, Michaël; Antonio, Leen; Sinnesael, Mieke; Dubois, Vanessa; Gielen, Evelien; Classens, Frank; Vanderschueren, Dirk

2014-01-01

Bone is an endocrine tissue expressing androgen and estrogen receptors as well as steroid metabolizing enzymes. The bioactivity of circulating sex steroids is modulated by sex hormone-binding globulin and local conversion in bone tissue, for example, from testosterone (T) to estradiol (E2) by aromatase, or to dihydrotestosterone by 5α-reductase enzymes. Our understanding of the structural basis for gender differences in bone strength has advanced considerably over recent years due to increasing use of (high resolution) peripheral computed tomography. These microarchitectural insights form the basis to understand sex steroid influences on male peak bone mass and turnover in cortical vs trabecular bone. Recent studies using Cre/LoxP technology have further refined our mechanistic insights from global knockout mice into the direct contributions of sex steroids and their respective nuclear receptors in osteoblasts, osteoclasts, osteocytes, and other cells to male osteoporosis. At the same time, these studies have reinforced the notion that androgen and estrogen deficiency have both direct and pleiotropic effects via interaction with, for example, insulin-like growth factor 1, inflammation, oxidative stress, central nervous system control of bone metabolism, adaptation to mechanical loading, etc., This review will summarize recent advances on these issues in the field of sex steroid actions in male bone homeostasis. PMID:24385015

Vorticity dynamics in an intracranial aneurysm

NASA Astrophysics Data System (ADS)

Le, Trung; Borazjani, Iman; Sotiropoulos, Fotis

2008-11-01

Direct Numerical Simulation is carried out to investigate the vortex dynamics of physiologic pulsatile flow in an intracranial aneurysm. The numerical solver is based on the CURVIB (curvilinear grid/immersed boundary method) approach developed by Ge and Sotiropoulos, J. Comp. Physics, 225 (2007) and is applied to simulate the blood flow in a grid with 8 million grid nodes. The aneurysm geometry is extracted from MRI images from common carotid artery (CCA) of a rabbit (courtesy Dr.Kallmes, Mayo Clinic). The simulation reveals the formation of a strong vortex ring at the proximal end during accelerated flow phase. The vortical structure advances toward the aneurysm dome forming a distinct inclined circular ring that connects with the proximal wall via two long streamwise vortical structures. During the reverse flow phase, the back flow results to the formation of another ring at the distal end that advances in the opposite direction toward the proximal end and interacts with the vortical structures that were created during the accelerated phase. The basic vortex formation mechanism is similar to that observed by Webster and Longmire (1998) for pulsed flow through inclined nozzles. The similarities between the two flows will be discussed and the vorticity dynamics of an aneurysm and inclined nozzle flows will be analyzed.This work was supported in part by the University of Minnesota Supercomputing Institute.

Patients' perceptions and experiences of using a mobile phone-based advanced symptom management system (ASyMS) to monitor and manage chemotherapy related toxicity.

PubMed

McCann, L; Maguire, R; Miller, M; Kearney, N

2009-03-01

Chemotherapy forms a core component of treatment for the majority patients with cancer. Recent changes in cancer services mean patients frequently receive such treatment as outpatients and are often required to manage side effects at home without direct support from oncology health professionals. Information technology continues to develop to support patients in the community; this study evaluated the impact of a mobile phone-based advanced symptom management system (ASyMS) on chemotherapy related toxicity in patients with lung, breast or colorectal cancer. One hundred and twelve patients were randomized from seven clinical sites across the UK; 56 patients used the mobile phone to record their symptoms, sending their reports directly to the nurses at their clinical site; 56 control group patients received standard care. Health professionals were alerted about any severe or life-threatening symptoms through the development of a chemotherapy symptom risk model. Patients' perceptions of ASyMS were evaluated pre and post participation. Patients reported many benefits of using ASyMS including improved communication with health professionals, improvements in the management of their symptoms, and feeling reassured their symptoms were being monitored while at home. ASyMS has the potential to positively impact on the management of symptoms in patients receiving chemotherapy treatment.

Multimedia decision support intervention: a promising approach to enhance the intention to complete an advance directive among hospitalized adults.

PubMed

Hickman, Ronald L; Lipson, Amy R; Pinto, Melissa D; Pignatiello, Grant

2014-04-01

We examined the acceptability and initial efficacy of a multimedia decision support (MDS) intervention to improve intention to complete an advanced directive (AD) among hospitalized adults following an episode of critical illness. We used comparative quasi-experimental posttest only design. Forty-nine hospitalized adults, recovering from a critical illness, received either MDS or AD educational brochure. Demographic characteristics and self-report measures of AD knowledge were captured at baseline and used as covariates. Helpfulness of the intervention (acceptability) and the outcome variable, intention to complete an AD decision, were assessed after exposure to the MDS intervention or educational brochure (information-only control condition). The MDS was a more acceptable form of education compared to a brochure. After adjusting for covariates, participants exposed to the MDS intervention were 24.7 times more likely to intend to complete an AD compared to those who were assigned to the information-only control condition. This pilot study establishes the acceptability and initial efficacy of the MDS intervention among individuals with critical illness, who are at high risk for hospital readmission life-sustaining treatment. This study illuminates a teachable moment in which patients are more receptive to interventions to complete an AD. ©2013 The Author(s) ©2013 American Association of Nurse Practitioners.

Flexible fabrication of multi-scale integrated 3D periodic nanostructures with phase mask

NASA Astrophysics Data System (ADS)

Yuan, Liang Leon

Top-down fabrication of artificial nanostructures, especially three-dimensional (3D) periodic nanostructures, that forms uniform and defect-free structures over large area with the advantages of high throughput and rapid processing and in a manner that can further monolithically integrate into multi-scale and multi-functional devices is long-desired but remains a considerable challenge. This thesis study advances diffractive optical element (DOE) based 3D laser holographic nanofabrication of 3D periodic nanostructures and develops new kinds of DOEs for advanced diffracted-beam control during the fabrication. Phase masks, as one particular kind of DOE, are a promising direction for simple and rapid fabrication of 3D periodic nanostructures by means of Fresnel diffraction interference lithography. When incident with a coherent beam of light, a suitable phase mask (e.g. with 2D nano-grating) can create multiple diffraction orders that are inherently phase-locked and overlap to form a 3D light interference pattern in the proximity of the DOE. This light pattern is typically recorded in photosensitive materials including photoresist to develop into 3D photonic crystal nanostructure templates. Two kinds of advanced phase masks were developed that enable delicate phase control of multiple diffraction beams. The first exploits femtosecond laser direct writing inside fused silica to assemble multiple (up to nine) orthogonally crossed (2D) grating layers, spaced on Talbot planes to overcome the inherent weak diffraction efficiency otherwise found in low-contrast volume gratings. A systematic offsetting of orthogonal grating layers to establish phase offsets over 0 to pi/2 range provided precise means for controlling the 3D photonic crystal structure symmetry between body centered tetragonal (BCT) and woodpile-like tetragonal (wTTR). The second phase mask consisted of two-layered nanogratings with small sub-wavelength grating periods and phase offset control. That was designed with isotropic properties attractive for generating a complete photonic band gap (PBG). An isolation layer was used between adjacent polymer layers to offer a reversal coating for sample preparation of scanning electron microscopy (SEM) imaging and top surface planarization. Electron beam lithography has been employed to fabricate a multi-level nano-grating phase mask that produces a diamond-like 3D nanostructure via phase mask lithography, promising for creating photonic crystal (PC) templates that can be inverted with high-index materials and form a complete PBG at telecommunication wavelengths. A laser scanning holographic method for 3D exposure in thick photoresist is introduced that combines the unique advantages of large area 3D holographic interference lithography (HIL) with the flexible patterning of laser direct writing to form both micro- and nano-structures in a single exposure step. Phase mask interference patterns accumulated over multiple overlapping scans are shown to stitch seamlessly and form highly uniform 3D nanostructure with beam size scaled to small 200 microm diameter. Further direct-write holography demonstrates monolithical writing of multi-scale lab-on-a-chip with multiple functionalities including on-chip integrated fluorescence. Various 3D periodic nanostructures are demonstrated over a 15 mmx15 mm area, through full 40 microm photoresist thickness and with uniform structural and optical properties revealed by focused ion beam (FIB) milling, SEM imaging and stopband measures. The lateral and axial periods scale from respective 1500 nm to 570 nm and 9.2 microm to 1.2 microm to offer a Gamma-Z stopband at 1.5 microm. Overall, laser scanning is presented as a facile means to embed 3D PC nanostructure within microfluidic channels for integration into an optofluidic lab-on-chip, demonstrating a new laser HIL writing approach for creating multi-scale integrated microsystems.

Current diagnosis and treatment of benign biliary strictures after living donor liver transplantation

PubMed Central

Chang, Jae Hyuck; Lee, Inseok; Choi, Myung-Gyu; Han, Sok Won

2016-01-01

Despite advances in surgical techniques, benign biliary strictures after living donor liver transplantation (LDLT) remain a significant biliary complication and play an important role in graft and patient survival. Benign biliary strictures after transplantation are classified into anastomotic or non-anastomotic strictures. These two types differ in presentation, outcome, and response to therapy. The leading causes of biliary strictures include impaired blood supply, technical errors during surgery, and biliary anomalies. Because patients usually have non-specific symptoms, a high index of suspicion should be maintained. Magnetic resonance cholangiography has gained widespread acceptance as a reliable noninvasive tool for detecting biliary complications. Endoscopy has played an increasingly prominent role in the diagnosis and treatment of biliary strictures after LDLT. Endoscopic management in LDLT recipients may be more challenging than in deceased donor liver transplantation patients because of the complex nature of the duct-to-duct reconstruction. Repeated aggressive endoscopic treatment with dilation and the placement of multiple plastic stents is considered the first-line treatment for biliary strictures. Percutaneous and surgical treatments are now reserved for patients for whom endoscopic management fails and for those with multiple, inaccessible intrahepatic strictures or Roux-en-Y anastomoses. Recent advances in enteroscopy enable treatment, even in these latter cases. Direct cholangioscopy, another advanced form of endoscopy, allows direct visualization of the inner wall of the biliary tree and is expected to facilitate stenting or stone extraction. Rendezvous techniques can be a good option when the endoscopic approach to the biliary stricture is unfeasible. These developments have resulted in almost all patients being managed by the endoscopic approach. PMID:26819525

The Assisted Decision-Making (Capacity) Act 2015: what it is and why it matters.

PubMed

Kelly, B D

2017-05-01

Ireland's Assisted Decision-Making (Capacity) Act 2015 was signed by President Higgins in December 2015 and scheduled for commencement in 2016. To explore the content and implications of the 2015 Act. Review of the 2015 Act and related literature. The 2015 Act places the "will and preferences" of persons with impaired mental capacity at the heart of decision-making relating to "personal welfare" (including healthcare) and "property and affairs". Capacity is to be "construed functionally" and interventions must be "for the benefit of the relevant person". The Act outlines three levels of decision-making assistance: "decision-making assistant", "co-decision-maker" (joint decision-maker) and "decision-making representative" (substitute decision-maker). There are procedures relating to "enduring power of attorney" and "advance healthcare directives"; in the case of the latter, a "refusal of treatment" can be legally binding, while a "request for a specific treatment" must "be taken into consideration". The 2015 Act is considerably more workable than the 2013 Bill that preceded it. Key challenges include the subtle decision-making required by patients, healthcare staff, Circuit Court judges and the director of the Decision Support Service; implementation of "advance healthcare directives", especially if they do not form part of a broader model of advance care planning (incorporating the flexibility required for unpredictable future circumstances); and the over-arching issue of logistics, as very many healthcare decisions are currently made in situations where the patient's capacity is impaired. A key challenge will lie in balancing the emphasis on autonomy with principles of beneficence, mutuality and care.

Advanced Parkinson's disease effect on goal-directed and habitual processes involved in visuomotor associative learning

PubMed Central

Hadj-Bouziane, Fadila; Benatru, Isabelle; Brovelli, Andrea; Klinger, Hélène; Thobois, Stéphane; Broussolle, Emmanuel; Boussaoud, Driss; Meunier, Martine

2013-01-01

The present behavioral study re-addresses the question of habit learning in Parkinson's disease (PD). Patients were early onset, non-demented, dopa-responsive, candidates for surgical treatment, similar to those we found earlier as suffering greater dopamine depletion in the putamen than in the caudate nucleus. The task was the same conditional associative learning task as that used previously in monkeys and healthy humans to unveil the striatum involvement in habit learning. Sixteen patients and 20 age- and education-matched healthy control subjects learned sets of 3 visuo-motor associations between complex patterns and joystick displacements during two testing sessions separated by a few hours. We distinguished errors preceding vs. following the first correct response to compare patients' performance during the earliest phase of learning dominated by goal-directed actions with that observed later on, when responses start to become habitual. The disease significantly retarded both learning phases, especially in patients under 60 years of age. However, only the late phase deficit was disease severity-dependent and persisted on the second testing session. These findings provide the first corroboration in Parkinson patients of two ideas well-established in the animal literature. The first is the idea that associating visual stimuli to motor acts is a form of habit learning that engages the striatum. It is confirmed here by the global impairment in visuo-motor learning induced by PD. The second idea is that goal-directed behaviors are predominantly caudate-dependent whereas habitual responses are primarily putamen-dependent. At the advanced PD stages tested here, dopamine depletion is greater in the putamen than in the caudate nucleus. Accordingly, the late phase of learning corresponding to the emergence of habitual responses was more vulnerable to the disease than the early phase dominated by goal-directed actions. PMID:23386815

Fractography applied to investigations of cores, outcrops, and fractured reservoirs

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

Kulander, B.

1995-11-01

Fractography focuses investigations on the topography of fracture surfaces. This topography is composed of fractographic features produced by changing stress magnitudes and directions along the advancing crack tip. Fractographic features commonly useful in core and outcrop analysis include the origin, twist hackle, inclusion hackle, and rib marks. These structures develop during brittle failure by Mode I loading at the crack tip and act together to form a hackle plume. Fractographic components throughout the plume record the dynamic history of fracture development. Components show, to the limit of visual scale, the principal stress directions, as well as relative stress magnitudes andmore » propagation velocities, that existed at the advancing fracture front. This information contributes to more meaningful conclusions in fracture investigations. In core studies, fractography aids identification of induced and natural fractures. Induced fractures and fractographic features show distinct geometry with that of the core and reflect the effects of the core boundary, in-situ stresses, drilling stresses, and rock anisotropies. Certain drilling- and coring-induced fractures possess orientations and fractographic features that suggest the direction of minimum in-situ stress and that this direction may change abruptly within the drilled volume of rock. Cored natural fractures generally originated away from the bit and possess fractographic features that bear no geometerical relationship to core parameters. Abrupt changes of natural fracture strike and development of twist hackle suggest locally complex paleostress distributions. A combined knowledge of in-situ stress and natural fracture trends is useful in predicting reservoir permeability. In outcrop, fractographic features, including abutting relationships between joints, more readily depict order of development, intrastratum distribution of fracturing stress, and size for joints in any set.« less

Basaltic lava flows covering active aeolian dunes in the Paraná Basin in southern Brazil: Features and emplacement aspects

NASA Astrophysics Data System (ADS)

Waichel, Breno L.; Scherer, Claiton M. S.; Frank, Heinrich T.

2008-03-01

Burial of active aeolian dunes by lava flows can preserve the morphology of the dunes and generate diverse features related to interaction between unconsolidated sediments and lavas. In the study area, located in southern Brazil, burial of aeolian deposits by Cretaceous basaltic lava flows completely preserved dunes, and generate sand-deformation features, sand diapirs and peperite-like breccia. The preserved dunes are crescentic and linear at the main contact with basalts, and smaller crescentic where interlayered with lavas. The various feature types formed on sediment surfaces by the advance of the flows reflect the emplacement style of the lavas which are compound pahoehoe type. Four feature types can be recognized: (a) type 1 features are related to the advance of sheet flows in dune-interdune areas with slopes > 5°, (b) type 2 is formed where the lava flows advance in lobes and climb the stoss slope of crescentic dunes (slopes 8-12°), (c) type 3 is generated by toes that descend the face of linear dunes (slopes 17-23°) and (d) type 4 occurs when lava lobes descend the stoss slope of crescentic dunes (slopes 10-15°). The direction of the flows, the disposition and morphology of the dunes and the ground slope are the main factors controlling formation of the features. The injection of unconsolidated sand in lava lobes forms diapirs and peperite-like breccias. Sand diapirs occur at the basal portion of lobes where the lava was more solidified. Peperite-like breccias occur in the inner portion where lava was more plastic, favoring the mingling of the components. The generation of both features is related to a mechanical process: the weight of the lava causes the injection of sand into the lava and the warming of the air in the pores of the sand facilitates this process. The lava-sediment interaction features presented here are consistent with previous reports of basalt lavas with unconsolidated arid sediments, and additional new sand-deformation features formed by lava breakouts and sand diapir injections are presented.

Tapping and involving the youth. NGOs can do a lot in advancing adolescent reproductive health.

PubMed

Divinagracia, E R

1998-01-01

This article describes the role of nongovernmental organizations (NGOs) in advancing reproductive health (RH) among adolescents in the Philippines. In the Philippines, NGOs are major actors in community development work. NGOs, such as the Philippine Rural Reconstruction Movement, are teaching people ways to improve their lives and mobilizing them for own community advancement. NGOs are usually the first to initiate new approaches and programs. The new concept of RH puts NGOs in the position to assume a crucial role as change agents. This article describes community organizations, community-based strategies for adolescent RH, IEC, capacity building, vocational training, youth clubs, project management, and reasons for community involvement to advance youth RH. It is stated that community involvement is important because RH is a new and sensitive issue, youth are a large percentage of the local population, and youth need to be educated in sound health attitudes and behavior by the entire community. NGOs are in a position to advance youth RH because of their grassroots work and immersion in the daily concerns of the community. NGOs in the Philippines rely on youth and community-based strategies such as 1) empowering indigenous communities; 2) developing college editors as advocates of RH; 3) forming theater guilds among school and out-of-school youth; and 4) establishing drop-in youth centers. The author identifies about 15 NGOs with experience in the community who are directing efforts to youth RH programs.

Figure-ground assignment to a translating contour: a preference for advancing vs. receding motion.

PubMed

Barenholtz, Elan; Tarr, Michael J

2009-05-28

Past research on figure-ground assignment to contours has largely considered static stimuli. Here we report a simple and extremely robust dynamic cue to figural assignment, based on whether the bounding region of a contour is growing larger within the field of view ("advancing") rather than smaller ("receding"). Subjects viewed a straight or jagged contour dividing two colored regions translating behind a virtual aperture and had to report which color they had seen "moving in front", effectively assigning figure to that side of the contour. Across three experiments, subjects showed a strong preference to assign figure such that the bounded contour was advancing. This was true regardless of the direction of motion of the contour and regardless of the initial/ending size of the bounded regions (i.e., the motion cue served to override the conventional cue to figure-ground of smaller area). In a fourth, control experiment, subjects showed no such bias when it was the aperture, rather than the contour, that moved, demonstrating that the effect depends on contour motion and not simply an increase in area. We discuss a possible explanation for this bias as well as the general implications regarding dynamic factors in form perception.

Recent advances in acute lymphoblastic leukemia in children and adolescents: an expert panel discussion.

PubMed

Asselin, Barbara L; Gaynon, Paul; Whitlock, James A

2013-12-01

Acute lymphoblastic leukemia (ALL) is the most common form of childhood leukemia, representing 75% to 80% of cases of acute leukemia among children. Dramatic improvements in the cure rates and survival outcomes for children with ALL have been seen over the past several decades; currently the 5-year survival rate for childhood ALL is more than 80%. These improvements have come about because of advances in the understanding of the molecular genetics and pathogenesis of the disease, incorporation of risk-adapted therapy, and the advent of new targeted agents. Scientific advances have provided new insights into leukemogenesis, drug resistance, and host pharmacogenomics, identified novel subtypes of leukemia, and suggested potential targets for therapy. At the same time novel monoclonal antibodies, small molecule inhibitors, chemotherapeutics, and cell-based treatment strategies have been developed and investigated. In this article, experts will discuss some of the current challenges and future directions in the treatment of pediatric ALL. The authors will offer expert guidance to practicing oncologists on how to best incorporate newer treatment approaches into the care of children and adolescents with ALL. The most important ongoing clinical trials in the area will also be reviewed.

MO-A-BRD-00: Current Trends in Y90-Microsphere Therapy: Delivery and Dosimetry

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

NONE

2015-06-15

Yttrium-90 (Y90) microsphere therapy, a form of radiation therapy, is an increasingly popular option for care of patients with liver metastases or unresectable hepatocellular carcinoma. The therapy directly delivers Y90 microspheres via the hepatic artery to disease sites. Following delivery, a vast majority of microspheres preferentially lodge in the capillary vessels due to their embolic size and targeted trans-arterial delivery – depositing up to 90% of its energy in the first 5 mm of tissue. There have been a number of advances in tomographic imaging within both interventional radiology and nuclear medicine that has advanced therapy planning techniques. Quantitative imagingmore » of Y90 microsphere distribution post-therapy has also seen innovations that have led to improvements in tumor dosimetry and characterization of tumor response. A review of current trends and recent innovation in Y90 microsphere therapies will be presented. Learning Objectives: To present the imaging requirements for Y90 microsphere therapy planning To explain the standard dosimetry models used in Y90 microsphere therapy planning To report on advances in imaging for therapy planning and posttherapy assessment of tumor dosimetry and response.« less

Advances in Behavioral Laboratory Methods that Inform Tobacco Regulatory Science: A TCORS Working Group Special Issue

PubMed Central

Wright, M. Jerry; Valentine, Gerald

2017-01-01

Objective The 2009 Family Smoking Prevention and Tobacco Control Act (TCA) created unprecented enabling conditions for establishing national regulatory policy that reduces the burden of public health and societal problems associated with tobacco product use. The Center for Tobacco Products (CTP), created by the FDA to implement the TCA, developed a first-of-its-kind FDA/National Institutes of Health (NIH) collaborative program to fund Tobacco Centers of Regulatory Science (TCORS). Methods To assist the TCORS with addressing research priorites, working groups (WGs) comprised of FDA-CTP liasions and TCORS investigators were formed. Under the direction of the Center for Evaluation and Coordination of Trainin and Research (CECTR), the TCORS WGs seek to develop tangible work products in their respective areas of focus. Results The focus of the behavioral pharmacology WG evolved from publishing a narrow paper on behavioral methods in electronic cigarette research to a collection of papers on advances in behavioral laboratory methods that may inform tobacco regulatory science. Conclusion This Special Issue contains articles that address all of the CTP research priorities and demonstrates how advances in behavioral laboratory methods made by TCORS investigators can inform FDA efforst to regulate tobacco products. PMID:29152546

Direct Numerical Simulations of Turbulent Autoigniting Hydrogen Jets

NASA Astrophysics Data System (ADS)

Asaithambi, Rajapandiyan

Autoignition is an important phenomenon and a tool in the design of combustion engines. To study autoignition in a canonical form a direct numerical simulation of a turbulent autoigniting hydrogen jet in vitiated coflow conditions at a jet Reynolds number of 10,000 is performed. A detailed chemical mechanism for hydrogen-air combustion and non-unity Lewis numbers for species transport is used. Realistic inlet conditions are prescribed by obtaining the velocity eld from a fully developed turbulent pipe flow simulation. To perform this simulation a scalable modular density based method for direct numerical simulation (DNS) and large eddy simulation (LES) of compressible reacting flows is developed. The algorithm performs explicit time advancement of transport variables on structured grids. An iterative semi-implicit time advancement is developed for the chemical source terms to alleviate the chemical stiffness of detailed mechanisms. The algorithm is also extended from a Cartesian grid to a cylindrical coordinate system which introduces a singularity at the pole r = 0 where terms with a factor 1/r can be ill-defined. There are several approaches to eliminate this pole singularity and finite volume methods can bypass this issue by not storing or computing data at the pole. All methods however face a very restrictive time step when using a explicit time advancement scheme in the azimuthal direction (theta) where the cell sizes are of the order DelrDeltheta. We use a conservative finite volume based approach to remove the severe time step restriction imposed by the CFL condition by merging cells in the azimuthal direction. In addition, fluxes in the radial direction are computed with an implicit scheme to allow cells to be clustered along the jet's shear layer. This method is validated and used to perform the large scale turbulent reacting simulation. The resulting flame structure is found to be similar to a turbulent diusion flame but stabilized by autoignition at the flame base. Mass-fraction of the hydroperoxyl radical, HO2, peaks in magnitude upstream of the flame's stabilization point indicating autoignition. A flame structure similar to a triple-flame, with a lean premixed flame and a rich premixed flame flanking a thick diffusion flame is identified by the flame index. Radicals formed in the shear layer ahead of ignition and oxygen from the coflow do not get fully consumed by the flame and are transported along the edges of the flame brush into the core of the jet. Ignition delays from a well-stirred reactor model and an autoigniting diffusion flame model are able predict the lift-off height of the turbulent flame. The local entrainment rate was observed to increase with axial distance until the flame stabilization point and then decrease downstream. Data from probes placed along the flame reveals a highly turbulent flow field with variable composition at a given location. In general however, it is observed that the turbulent kinetic energy (TKE) is very high in cold fuel rich mixtures and is lowest in hot fuel lean mixtures. Autoignition occurs at the most-reactive hot and lean mixture fractions where the TKE is the lowest.

Advanced Gradient Heating Facility (AGHF)

NASA Technical Reports Server (NTRS)

1998-01-01

This section of the publication includes papers entitled: (1) Coupled growth in hypermonotectics; (2) Directional solidification of refined Al-4 wt.% Cu alloys; (3) Effects of convection on interface curvature during growth of concentrated ternary compounds; (4) Directional solidification of Al-1.5 wt.% Ni alloys; (5) Interactive response of advancing phase boundaries to particles; (6) INTeractive Response of Advancing Phase boundaries to Particles-INTRAPP; and (7) Particle engulfment and pushing by solidifying interfaces.

Shaping metallic glasses by electromagnetic pulsing

PubMed Central

Kaltenboeck, Georg; Demetriou, Marios D.; Roberts, Scott; Johnson, William L.

2016-01-01

With damage tolerance rivalling advanced engineering alloys and thermoplastic forming capabilities analogous to conventional plastics, metallic glasses are emerging as a modern engineering material. Here, we take advantage of their unique electrical and rheological properties along with the classic Lorentz force concept to demonstrate that electromagnetic coupling of electric current and a magnetic field can thermoplastically shape a metallic glass without conventional heating sources or applied mechanical forces. Specifically, we identify a process window where application of an electric current pulse in the presence of a normally directed magnetic field can ohmically heat a metallic glass to a softened state, while simultaneously inducing a large enough magnetic body force to plastically shape it. The heating and shaping is performed on millisecond timescales, effectively bypassing crystallization producing fully amorphous-shaped parts. This electromagnetic forming approach lays the groundwork for a versatile, time- and energy-efficient manufacturing platform for ultrastrong metals. PMID:26853460

Positive versus negative perfectionism in psychopathology: a comment on Slade and Owens's dual process model.

PubMed

Flett, Gordon L; Hewitt, Paul L

2006-07-01

This article reviews the concepts of positive and negative perfectionism and the dual process model of perfectionism outlined by Slade and Owens (1998). The authors acknowledge that the dual process model represents a conceptual advance in the study of perfectionism and that Slade and Owens should be commended for identifying testable hypotheses and future research directions. However, the authors take issue with the notion that there are two types of perfectionism, with one type of perfectionism representing a "normal" or "healthy" form of perfectionism. They suggest that positive perfectionism is motivated, at least in part, by an avoidance orientation and fear of failure, and recent attempts to define and conceptualize positive perfectionism may have blurred the distinction between perfectionism and conscientiousness. Research findings that question the adaptiveness of positive forms of perfectionism are highlighted, and key issues for future research are identified.

Energy absorption ability of buckyball C720 at low impact speed: a numerical study based on molecular dynamics

PubMed Central

2013-01-01

The dynamic impact response of giant buckyball C720 is investigated by using molecular dynamics simulations. The non-recoverable deformation of C720 makes it an ideal candidate for high-performance energy absorption. Firstly, mechanical behaviors under dynamic impact and low-speed crushing are simulated and modeled, which clarifies the buckling-related energy absorption mechanism. One-dimensional C720 arrays (both vertical and horizontal alignments) are studied at various impact speeds, which show that the energy absorption ability is dominated by the impact energy per buckyball and less sensitive to the number and arrangement direction of buckyballs. Three-dimensional stacking of buckyballs in simple cubic, body-centered cubic, hexagonal, and face-centered cubic forms are investigated. Stacking form with higher occupation density yields higher energy absorption. The present study may shed lights on employing C720 assembly as an advanced energy absorption system against low-speed impacts. PMID:23360618

Snake trajectories in ultraclean graphene p–n junctions

PubMed Central

Rickhaus, Peter; Makk, Péter; Liu, Ming-Hao; Tóvári, Endre; Weiss, Markus; Maurand, Romain; Richter, Klaus; Schönenberger, Christian

2015-01-01

Snake states are trajectories of charge carriers curving back and forth along an interface. There are two types of snake states, formed by either inverting the magnetic field direction or the charge carrier type at an interface. The former has been demonstrated in GaAs–AlGaAs heterostructures, whereas the latter has become conceivable only with the advance of ballistic graphene where a gap-less p–n interface governed by Klein tunnelling can be formed. Such snake states were hidden in previous experiments due to limited sample quality. Here we report on magneto-conductance oscillations due to snake states in a ballistic suspended graphene p–n junction, which occur already at a very small magnetic field of 20 mT. The visibility of 30% is enabled by Klein collimation. Our finding is firmly supported by quantum transport simulations. We demonstrate the high tunability of the device and operate it in different magnetic field regimes. PMID:25732244

Regulation of alveolar macrophage death in acute lung inflammation.

PubMed

Fan, Erica K Y; Fan, Jie

2018-03-27

Acute lung injury (ALI) and its severe form, known as acute respiratory distress syndrome (ARDS), are caused by direct pulmonary insults and indirect systemic inflammatory responses that result from conditions such as sepsis, trauma, and major surgery. The reciprocal influences between pulmonary and systemic inflammation augments the inflammatory process in the lung and promotes the development of ALI. Emerging evidence has revealed that alveolar macrophage (AM) death plays important roles in the progression of lung inflammation through its influence on other immune cell populations in the lung. Cell death and tissue inflammation form a positive feedback cycle, ultimately leading to exaggerated inflammation and development of disease. Pharmacological manipulation of AM death signals may serve as a logical therapeutic strategy for ALI/ARDS. This review will focus on recent advances in the regulation and underlying mechanisms of AM death as well as the influence of AM death on the development of ALI.

Toward an Astrophysical Theory of Chondrites

NASA Technical Reports Server (NTRS)

Shang, Hsien; Shu, Frank H.; Lee, Typhoon

1996-01-01

Sunlike stars are born with disks. Based on our recently developed model to understand how a magnetized new star interacts with its surrounding accretion disk, we advanced an astrophysical theory for the early solar system. The aerodynamic drag of a magnetocentrifugally driven wind out of the inner edge of a shaded disk could expose solid bodies lifted into the heat of direct sunlight, when material is still accreting onto the protosun. Chondrules, calcium-aluminum-rich inclusions (CAI's), and rims could form along the flight for typical self-consistent parameters of the outflow in different stages of star formation. The process gives a natural sorting mechanism that explains the size distribution of CAI's and chondrules, as well as their associated rims. Chondritic bodies then subsequently form by compaction of the processed solids with the ambient nebular dust comprising the matrices after their reentry at great distances from the original launch radius.

Alfred Werner's role in the mid-20th century flourishing of American inorganic chemistry.

PubMed

Labinger, Jay A

2014-01-01

The development of organic and physical chemistry as specialist fields, during the middle and end of the 19th century respectively, left inorganic behind as a decidedly less highly regarded subfield of chemistry. Despite Alfred Werner's groundbreaking studies of coordination chemistry in the early 20th century, that inferior status remained in place - particularly in the US - until the 1950s, when the beginnings of a resurgence that eventually restored its parity with the other subfields can be clearly observed. This paper explores the extent to which Werner's heritage - both direct, in the form of academic descendants, and indirect - contributed to those advances.

Strong motion seismology in Mexico

NASA Astrophysics Data System (ADS)

Singh, S. K.; Ordaz, M.

1993-02-01

Since 1985, digital accelerographs have been installed along a 500 km segment above the Mexican subduction zone, at some inland sites which form an attenuation line between the Guerrero seismic gap and Mexico City, and in the Valley of Mexico. These networks have recorded a few large earthquakes and many moderate and small earthquakes. Analysis of the data has permitted a significant advance in the understanding of source characteristics, wave propagation and attenuation, and site effects. This, in turn, has permitted reliable estimations of ground motions from future earthquakes. This paper presents a brief summary of some important results which are having a direct bearing on current earthquake engineering practice in Mexico.

FTIR Monitoring Of Curing Of Composites

NASA Technical Reports Server (NTRS)

Druy, Mark A.; Stevenson, William A.; Young, Philip R.

1990-01-01

Infrared-sensing optical fiber system developed to monitor principal infrared absorption bands resulting from vibrations of atoms and molecules as chemical bonds form when resin cured. System monitors resin chemistry more directly. Used to obtain Fourier transform infrared (FTIR) spectrum from graphite fiber/polyimide matrix resin prepreg. Embedded fiber optic FTIR sensor used to indicate state of cure of thermosetting composite material. Developed primarily to improve quality of advanced composites, many additional potential applications exist because principal of operation applicable to all organic materials and most inorganic gases. Includes monitoring integrities of composite materials in service, remote sensing of hazardous materials, and examination of processes in industrial reactors and furnaces.

Data Science for Public Policy: Of the people, for the people, by the people 2.0 ?

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

Sukumar, Sreenivas R.; Shankar, Mallikarjun

In this paper, we explore the role of data science in the public policy lifecycle. We posit policy documents (bills, acts, regulations and directives) as forms of social objects and present a methodology to understand interactions between prior context in professional and personal social networks to a given public policy document release. We employ natural language processing tools along with recent advances in semantic reasoning to formulate document-level proximity metrics which we use to predict the relevance (and impact) of the policy artifacts. These metrics serve as a measure of excitation between people and the public policy initiatives.

Direct synthesis of multilayer graphene on an insulator by Ni-induced layer exchange growth of amorphous carbon

NASA Astrophysics Data System (ADS)

Murata, H.; Toko, K.; Saitoh, N.; Yoshizawa, N.; Suemasu, T.

2017-01-01

Multilayer graphene (MLG) growth on arbitrary substrates is desired for incorporating carbon wiring and heat spreaders into electronic devices. We investigated the metal-induced layer exchange growth of a sputtered amorphous C layer using Ni as a catalyst. A MLG layer uniformly formed on a SiO2 substrate at 600 °C by layer exchange between the C and Ni layers. Raman spectroscopy and electron microscopy showed that the resulting MLG layer was highly oriented and contained relatively few defects. The present investigation will pave the way for advanced electronic devices integrated with carbon materials.

Surface emitting ring quantum cascade lasers for chemical sensing

NASA Astrophysics Data System (ADS)

Szedlak, Rolf; Hayden, Jakob; Martín-Mateos, Pedro; Holzbauer, Martin; Harrer, Andreas; Schwarz, Benedikt; Hinkov, Borislav; MacFarland, Donald; Zederbauer, Tobias; Detz, Hermann; Andrews, Aaron Maxwell; Schrenk, Werner; Acedo, Pablo; Lendl, Bernhard; Strasser, Gottfried

2018-01-01

We review recent advances in chemical sensing applications based on surface emitting ring quantum cascade lasers (QCLs). Such lasers can be implemented in monolithically integrated on-chip laser/detector devices forming compact gas sensors, which are based on direct absorption spectroscopy according to the Beer-Lambert law. Furthermore, we present experimental results on radio frequency modulation up to 150 MHz of surface emitting ring QCLs. This technique provides detailed insight into the modulation characteristics of such lasers. The gained knowledge facilitates the utilization of ring QCLs in combination with spectroscopic techniques, such as heterodyne phase-sensitive dispersion spectroscopy for gas detection and analysis.

A time for new north–south relationships in global health

PubMed Central

Kim, Jin Un; Oleribe, Obinna; Njie, Ramou; Taylor-Robinson, Simon D

2017-01-01

The modern concept of globalization in health care and clinical research often carries a positive message for the “Global South” nations of Africa, South America and Southeast Asia. However, bioethical abuse of participants in clinical trials still exists in the Global South. Unethical studies directed by the “Global North”, formed by the medically advanced nations in North America, Western Europe and Japan, have been hugely concerning. The issue between the Global North and South is a well-recognized socioeconomic phenomenon of globalization. Medical exploitation has its roots in the socioeconomic interactions of a postcolonial world, and solutions to reducing exploitation require a deeper understanding of these societal models of globalization. We explore the fundamental causes of imbalance and suggest solutions. Reflecting on the globalization model, there must be an effort to empower the Global South nations to direct and govern their own health care systems efficiently on the basis of equality. PMID:29158688

Alkyne–Aldehyde Reductive C–C Coupling through Ruthenium-Catalyzed Transfer Hydrogenation: Direct Regio- and Stereoselective Carbonyl Vinylation to Form Trisubstituted Allylic Alcohols in the Absence of Premetallated Reagents

PubMed Central

Leung, Joyce C.; Patman, Ryan L.; Sam, Brannon

2011-01-01

Nonsymmetric 1,2-disubstituted alkynes engage in reductive coupling to a variety of aldehydes under the conditions of ruthenium-catalyzed transfer hydrogenation by employing formic acid as the terminal reductant and delivering the products of carbonyl vinylation with good to excellent levels of regioselectivity and with complete control of olefin stereochemistry. As revealed in an assessment of the ruthenium counterion, iodide plays an essential role in directing the regioselectivity of C–C bond formation. Isotopic labeling studies corroborate reversible catalytic propargyl C–H oxidative addition in advance of the C–C coupling, and demonstrate that the C–C coupling products do not experience reversible dehydrogenation by way of enone intermediates. This transfer hydrogenation protocol enables carbonyl vinylation in the absence of stoichiometric metallic reagents. PMID:21953608

High-Resolution Characterization of UMo Alloy Microstructure

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

Devaraj, Arun; Kovarik, Libor; Joshi, Vineet V.

2016-11-30

This report highlights the capabilities and procedure for high-resolution characterization of UMo fuels in PNNL. Uranium-molybdenum (UMo) fuel processing steps, from casting to forming final fuel, directly affect the microstructure of the fuel, which in turn dictates the in-reactor performance of the fuel under irradiation. In order to understand the influence of processing on UMo microstructure, microstructure characterization techniques are necessary. Higher-resolution characterization techniques like transmission electron microscopy (TEM) and atom probe tomography (APT) are needed to interrogate the details of the microstructure. The findings from TEM and APT are also directly beneficial for developing predictive multiscale modeling tools thatmore » can predict the microstructure as a function of process parameters. This report provides background on focused-ion-beam–based TEM and APT sample preparation, TEM and APT analysis procedures, and the unique information achievable through such advanced characterization capabilities for UMo fuels, from a fuel fabrication capability viewpoint.« less

Brain-Computer Symbiosis

PubMed Central

Schalk, Gerwin

2009-01-01

The theoretical groundwork of the 1930’s and 1940’s and the technical advance of computers in the following decades provided the basis for dramatic increases in human efficiency. While computers continue to evolve, and we can still expect increasing benefits from their use, the interface between humans and computers has begun to present a serious impediment to full realization of the potential payoff. This article is about the theoretical and practical possibility that direct communication between the brain and the computer can be used to overcome this impediment by improving or augmenting conventional forms of human communication. It is about the opportunity that the limitations of our body’s input and output capacities can be overcome using direct interaction with the brain, and it discusses the assumptions, possible limitations, and implications of a technology that I anticipate will be a major source of pervasive changes in the coming decades. PMID:18310804

Levitation force of small clearance superconductor-magnet system under non-coaxial condition

NASA Astrophysics Data System (ADS)

Xu, Jimin; Jin, Yingze; Yuan, Xiaoyang; Miao, Xusheng

2017-03-01

A novel superconducting tilting-pad bearing was proposed for the advanced research of reusable liquid hydrogen turbopump in liquid rocket. The bearing is a combination of superconducting magnetic bearing and hydrodynamic fluid-film bearing. Since the viscosity of cryogenic fuel to activate superconducting state and form hydrodynamic fluid-film is very low, bearing clearance will be very small. This study focuses on the investigation of superconducting levitation force in this kind of small clearance superconductor-magnet system. Based on Bean critical state model and three-dimensional finite element method, an analysis method is presented to obtain the levitation force under such situation. Since the complicated operational conditions and structural arrangement for application in liquid rocket, center lines of bulk superconductor and magnet rotor will usually be in non-coaxial state. Superconducting levitation forces in axial direction and radial direction under non-coaxial situation are also analyzed by the presented method.

BiFeO3 Thin Films: A Playground for Exploring Electric-Field Control of Multifunctionalities

NASA Astrophysics Data System (ADS)

Yang, Jan-Chi; He, Qing; Yu, Pu; Chu, Ying-Hao

2015-07-01

A promising approach to the next generation of low-power, functional, and green nanoelectronics relies on advances in the electric-field control of lattice, charge, orbital, and spin degrees of freedom in novel materials. The possibility of electric-field control of these multiple materials functionalities offers interesting options across a range of modern technologies, including information communication, computing processes, data storage, active components, and functional electronics. This article reviews electric-field control and modulation of various degrees of freedom through the medium of multiferroic BiFeO3. Coexisting order parameters and inherent couplings in this materials system form a potent playground, enabling direct and indirect manipulation to obtain intriguing properties and functionalities with an electric stimulus. An in-depth understanding of those electrically controlled phenomena and breakthroughs is highlighted, paving a new route toward multifunctional nanoelectronics. This article concludes with a brief discussion on foreseeable challenges as well as future directions.

Active materials by four-dimension printing

NASA Astrophysics Data System (ADS)

Ge, Qi; Qi, H. Jerry; Dunn, Martin L.

2013-09-01

We advance a paradigm of printed active composite materials realized by directly printing glassy shape memory polymer fibers in an elastomeric matrix. We imbue the active composites with intelligence via a programmed lamina and laminate architecture and a subsequent thermomechanical training process. The initial configuration is created by three-dimension (3D) printing, and then the programmed action of the shape memory fibers creates time dependence of the configuration—the four-dimension (4D) aspect. We design and print laminates in thin plate form that can be thermomechanically programmed to assume complex three-dimensional configurations including bent, coiled, and twisted strips, folded shapes, and complex contoured shapes with nonuniform, spatially varying curvature. The original flat plate shape can be recovered by heating the material again. We also show how the printed active composites can be directly integrated with other printed functionalities to create devices; here we demonstrate this by creating a structure that can assemble itself.

Advance Directives and End-of-Life Care among Nursing Home Residents Receiving Maintenance Dialysis

PubMed Central

Montez-Rath, Maria E.; Hall, Yoshio N.; Katz, Ronit; O’Hare, Ann M.

2017-01-01

Background and objectives Little is known about the relation between the content of advance directives and downstream treatment decisions among patients receiving maintenance dialysis. In this study, we determined the prevalence of advance directives specifying treatment limitations and/or surrogate decision-makers in the last year of life and their association with end-of-life care among nursing home residents. Design, setting, participants, & measurements Using national data from 2006 to 2007, we compared the content of advance directives among 30,716 nursing home residents receiving dialysis to 30,825 nursing home residents with other serious illnesses during the year before death. Among patients receiving dialysis, we linked the content of advance directives to Medicare claims to ascertain site of death and treatment intensity in the last month of life. Results In the last year of life, 36% of nursing home residents receiving dialysis had a treatment-limiting directive, 22% had a surrogate decision-maker, and 13% had both in adjusted analyses. These estimates were 13%–27%, 5%–11%, and 6%–13% lower, respectively, than for decedents with other serious illnesses. For patients receiving dialysis who had both a treatment-limiting directive and surrogate decision-maker, the adjusted frequency of hospitalization, intensive care unit admission, intensive procedures, and inpatient death were lower by 13%, 17%, 13%, and 14%, respectively, and hospice use and dialysis discontinuation were 5% and 7% higher compared with patients receiving dialysis lacking both components. Conclusions Among nursing home residents receiving dialysis, treatment-limiting directives and surrogates were associated with fewer intensive interventions and inpatient deaths, but were in place much less often than for nursing home residents with other serious illnesses. PMID:28057703

[Advance directives in patients with kidney disease or other general medical diagnoses].

PubMed

Driehorst, F; Keller, F

2014-03-01

After the law on living will was released in 2009 in Germany, an increased use of advance directives was observed. Since patients with kidney diseases are facing the potential or real need for expensive and invasive renal replacement therapy, one could speculate that they will either less or even more frequently state an advance directive than patients with other diseases. A structured interviewing was performed of all patients on a nephrology ward where also patients with other general medical conditions are treated. The study was approved by our local ethics committee (protocol # 303/08). All admitted patients were successively included who could give signed consent. The investigation was performed between July 2009 and April 2010 by a single interviewer (FD). Among 505 admitted patients, 211 were included but 11 patients did not consent to the investigation. Of the 200 investigated patients, 121 had a renal diagnosis and 79 other medical diseases. Compared to other European studies, the frequency of advance directives was high (26 %), underlining its clinical relevance. Upon multivariate logistic regression analysis the odds ratio (95 % confidence interval, CI) for the presence of an advance directive was significantly increased only by the age (1.06; CI 1.03-1.09; p = 0.001), but not by the underlying diagnosis (1.47; CI 0.72-2.97; p = 0.287). Significantly more patients did forego resuscitation than did dialysis in their living will (16 vs. 4) while the majority was undecided (36 vs. 47; p = 0.01). Age was found the more impacting variable than the renal diagnosis on the prevalence of advance directives. Patients with a renal diagnosis should be encouraged to make a statement on dialysis in their living will. © Georg Thieme Verlag KG Stuttgart · New York.

Differences in Presenting Advance Directives in the Chart, in the Minimum Data Set, and through the Staffs Perceptions

ERIC Educational Resources Information Center

Cohen-Mansfield, Jiska; Libin, Alexander; Lipson, Steven

2003-01-01

Purpose: Decisions concerning end-of-life care depend on information contained in advance directives that are documented in residents' charts in the nursing home. The availability of that information depends on the quality of the chart and on the location of the information in the chart. No research was found that compared directives by the manner…

What are the consequences of disregarding a "do not resuscitate directive" in the United States?

PubMed

Saitta, Nicole Marie; Hodge, Samuel D

2013-12-01

Does a valid cause of action exist against a health care provider who intentionally disregards a "do-not resuscitate order," prolonging a patient's life? Wrongful prolongation of life has not gained traction in the United States. Although the issue has garnered media attention and has raised awareness of advanced directives, physicians still may disregard a patient's last wishes for fear of legal reprisal or due to lack of communication. This article examines key cases and explains the differences between living wills, advanced directives and proxies. Claims have been advanced under theories of battery, Constitutional violations, breach of contract, infliction of emotional distress, and negligence, but no cause of action has allowed monetary damages. Courts maintain that it is not their place to judge an impaired life as being less valuable than no life. A state-by-state analysis of legislation concerning advanced directives follows along with a discussion of the Patient Self-Determination Act.

Advance directives and mortality rates among nursing home residents in Taiwan: A retrospective, longitudinal study.

PubMed

Tsai, Hsiu-Hsin; Tsai, Yun-Fang; Liu, Chia-Yih

2017-03-01

No data-based evidence is available regarding the best time for nursing home nurses to obtain residents' signatures on advance directives, especially for do-not-resuscitate directives, the most common type of advance directive. This information is needed to enhance the low prevalence of advance directives in Asian countries. The purposes of this study were to understand (1) the timing between nursing home admission and signing a do-not-resuscitate directive, (2) the factors related to having a do-not-resuscitate directive, and (3) the association between having a do-not-resuscitate directive and nursing home residents' mortality in Taiwan. Retrospective, longitudinal design. Six nursing homes in Taiwan. Nursing home residents (N=563). Data were collected by retrospective chart review with 1-year follow-up. Factors related to having a do-not-resuscitate directive were analyzed by multiple logistic regression, while associations between signing a do-not-resuscitate directive (resuscitation preference) and mortality were examined by Cox proportional hazard regression models. The mean interval between nursing home admission and signing a do-not-resuscitate directive was 840.65days (2.30 years), which was longer than the time from admission to first transfer to hospital (742.4days). Having a do-not-resuscitate directive was related to whether the resident had a nasogastric tube (odds=2.57) and the number of transfers to hospital (odds=1.18). Among the 563 residents, 55 (9.77%) had died at the 1-year follow-up. Having a do-not-resuscitate directive was associated with a greater risk of death (unadjusted hazard ratio, 2.03; 95% confidence interval, 1.10-3.98; p=0.02), but this risk did not persist after adjusting for age (hazard ratio, 1.89; 95% confidence interval, 0.99-3.59; p=0.05). Early research recommendations to sign an advance directive, particularly a do-not-resuscitate order, on nursing home admission may not be the best time for Chinese nursing home residents. Our results suggest that the best time to sign a do-not-resuscitate directive is as early as possible and no later than 2 years (742days) after admission if residents had not already done so. Residents on nasogastric tube feeding should be particularly targeted for discussions about do-not-resuscitate directives. Copyright © 2016 Elsevier Ltd. All rights reserved.

Emerging Chitosan-Based Films for Food Packaging Applications.

PubMed

Wang, Hongxia; Qian, Jun; Ding, Fuyuan

2018-01-17

Recent years have witnessed great developments in biobased polymer packaging films for the serious environmental problems caused by the petroleum-based nonbiodegradable packaging materials. Chitosan is one of the most abundant biopolymers after cellulose. Chitosan-based materials have been widely applied in various fields for their biological and physical properties of biocompatibility, biodegradability, antimicrobial ability, and easy film forming ability. Different chitosan-based films have been fabricated and applied in the field of food packaging. Most of the review papers related to chitosan-based films are focusing on antibacterial food packaging films. Along with the advances in the nanotechnology and polymer science, numerous strategies, for instance direct casting, coating, dipping, layer-by-layer assembly, and extrusion, have been employed to prepare chitosan-based films with multiple functionalities. The emerging food packaging applications of chitosan-based films as antibacterial films, barrier films, and sensing films have achieved great developments. This article comprehensively reviews recent advances in the preparation and application of engineered chitosan-based films in food packaging fields.

Thermal Writing 1987

NASA Astrophysics Data System (ADS)

Peckham, Robert F.

1987-04-01

The creating of intelligent marks on a substrate by means of thermal energy has been in use for thousands of years, e.g., branding of livestock and burning images onto wood. During the past 30 years, this type of imaging has been significantly refined. Recent advances allow the creation of color images, 16 shades of gray and letter quality printing on white substrates. Permanent images are now being written with direct thermal processes. The foregoing make thermal writing very attractive for numerous applications. The general technology of how thermal writing is accomplished today, its applications, and why society should use thermal writing are the topics of this paper. To attempt to cover in great technical detail all of the current advancements in thermal writing is beyond our scope here. What is intended is the proposition that THERMAL WRITING is a superior form of creating images on paper substrates for Society's on demand hard copy requirements. First let's look at how thermal writing is being accomplished with today's technologies.

Germline determinants of clinical outcome of cutaneous melanoma

PubMed Central

Vogelsang, Matjaz; Wilson, Melissa; Kirchhoff, Tomas

2016-01-01

Cutaneous melanoma (CM) is the most lethal form of skin cancer. Despite the constant increase of melanoma incidence, which is in part due to incremental advances in early diagnostic modalities, mortality rates have not improved over the last decade and for advanced stages remain steadily high. While conventional prognostic biomarkers currently in use find significant utility for predicting overall general survival probabilities, they are not sensitive enough for a more personalized clinical assessment on an individual level. In recent years, the advent of genomic technologies has brought the promise of identification of germline DNA alterations that may associate with CM outcomes and hence represent novel biomarkers for clinical utilization. This review attempts to summarize the current state of knowledge of germline genetic factors studied for their impact on melanoma clinical outcomes. We also discuss ongoing problems and hurdles in validating such surrogates, and we also project future directions in discovery of more powerful germline genetic factors with clinical utility in melanoma prognostication. PMID:26342156

Predictive models in urology.

PubMed

Cestari, Andrea

2013-01-01

Predictive modeling is emerging as an important knowledge-based technology in healthcare. The interest in the use of predictive modeling reflects advances on different fronts such as the availability of health information from increasingly complex databases and electronic health records, a better understanding of causal or statistical predictors of health, disease processes and multifactorial models of ill-health and developments in nonlinear computer models using artificial intelligence or neural networks. These new computer-based forms of modeling are increasingly able to establish technical credibility in clinical contexts. The current state of knowledge is still quite young in understanding the likely future direction of how this so-called 'machine intelligence' will evolve and therefore how current relatively sophisticated predictive models will evolve in response to improvements in technology, which is advancing along a wide front. Predictive models in urology are gaining progressive popularity not only for academic and scientific purposes but also into the clinical practice with the introduction of several nomograms dealing with the main fields of onco-urology.

PROTEOMIC IDENTIFICATION OF CARBONYLATED PROTEINS AND THEIR OXIDATION SITES

PubMed Central

Madian, Ashraf G.; Regnier, Fred E.

2011-01-01

Excessive oxidative stress leaves a protein carbonylation fingerprint in biological systems. Carbonylation is an irreversible post translational modification (PTM) that often leads to the loss of protein function and can be a component of multiple diseases. Protein carbonyl groups can be generated directly (by amino acids oxidation and the a-amidation pathway) or indirectly by forming adducts with lipid peroxidation products or glycation and advanced glycation end-products. Studies of oxidative stress are complicated by the low concentration of oxidation products and wide array of routes by which proteins are carbonylated. The development of new selection and enrichment techniques coupled with advances in mass spectrometry are allowing identification of hundreds of new carbonylated protein products from a broad range of proteins located at many sites in biological systems. The focus of this review is on the use of proteomics tools and methods to identify oxidized proteins along with specific sites of oxidative damage and the consequences of protein oxidation. PMID:20521848

Self-Assembled Protein Nanofilter for Trapping Polysulfides and Promoting Li+ Transport in Lithium-Sulfur Batteries.

PubMed

Fu, Xuewei; Li, Chunhui; Wang, Yu; Scudiero, Louis; Liu, Jin; Zhong, Wei-Hong

2018-05-17

The diffusion of polysulfides in lithium-sulfur (Li-S) batteries represents a critical issue deteriorating the electrochemical performance. Here, borrowing the concepts from air filtration, we design and fabricate a protein-based nanofilter for effectively trapping polysulfides but facilitating Li + transport. The unique porous structures are formed through a protein-directed self-assembly process, and the surfaces are functionalized by the protein residues. The experiments and molecular simulation results demonstrate that our polysulfide nanofilter can effectively trap the dissolved polysulfides and promote Li + transport in Li-S batteries. When the polysulfide nanofilter is added in a Li-S battery, the electrochemical performance of the battery is significantly improved. Moreover, the contribution of the protein nanofilter to the ion transport is further analyzed by correlating filter properties and battery performance. This study is of universal significance for the understanding, design, and fabrication of advanced battery interlayers that can help realize good management of the ion transport inside advanced energy storage devices.

What factors are associated with having an advance directive among older adults who are new to long term care services?

PubMed

Hirschman, Karen B; Abbott, Katherine M; Hanlon, Alexandra L; Prvu Bettger, Janet; Naylor, Mary D

2012-01-01

To explore differences in having an advance directive among older adults newly transitioned to long term services and support (LTSS) settings (ie, nursing homes [NHs]; assisted living facilities [ALFs]; home and community-based services). Cross sectional survey. LTSS in New York and Pennsylvania. Participants were 470 older adults who recently started receiving LTSS. Included in this analyses, N = 442 (ALF: n = 153; NH: n = 145; home and community-based services: n = 144). Interviews consisted of questions about advance directives (living will and health care power of attorney), significant health changes in the 6 months before the start of long term care support services, Mini-Mental State Examination, and basic demographics. Sixty-one percent (270/442) of older adults receiving LTSS reported having either a living will and/or an health care power of attorney. ALF residents reported having an advance directive more frequently than NH residents and older adults receiving LTSS in their own home (living will: χ(2)[2]= 120.9; P < .001; health care power of attorney: χ(2)[2]= 69.1; P < .001). In multivariate logistic regression models, receiving LTSS at an ALF (OR = 5.01; P < .001), being white (OR = 2.87; P < .001), having more than 12 years of education (OR = 2.50; P < .001), and experiencing a significant health change in past 6 months (OR = 1.97; P = .007) were predictive of having a living will. Receiving LTSS at an ALF (OR = 4.16; P < .001), having more than 12 years of education (OR = 1.74, P = .022), and having had a significant change in health in the last 6 months (OR = 1.61; P = .037) were predictive in having an health care power of attorney in this population of LTSS recipients. These data provide insight into advance directives and older adults new to LTSS. Future research is needed to better understand the barriers to completing advance directives before and during enrollment in LTSS as well as to assess advance directive completion changes over time for this population of older adults. Copyright © 2012 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

Theoretical discrepancy between cage size and efficient tibial tuberosity advancement in dogs treated for cranial cruciate ligament rupture.

PubMed

Etchepareborde, S; Mills, J; Busoni, V; Brunel, L; Balligand, M

2011-01-01

To calculate the difference between the desired tibial tuberosity advancement (TTA) along the tibial plateau axis and the advancement truly achieved in that direction when cage size has been determined using the method of Montavon and colleagues. To measure the effect of this difference on the final patellar tendon-tibial plateau angle (PTA) in relation to the ideal 90°. Trigonometry was used to calculate the theoretical actual advancement of the tibial tuberosity in a direction parallel to the tibial plateau that would be achieved by the placement of a cage at the level of the tibial tuberosity in the osteotomy plane of the tibial crest. The same principle was used to calculate the size of the cage that would have been required to achieve the desired advancement. The effect of the difference between the desired advancement and the actual advancement achieved on the final PTA was calculated. For a given desired advancement, the greater the tibial plateau angle (TPA), the greater the difference between the desired advancement and the actual advancement achieved. The maximum discrepancy calculated was 5.8 mm for a 12 mm advancement in a case of extreme TPA (59°). When the TPA was less than 31°, the PTA was in the range of 90° to 95°. A discrepancy does exist between the desired tibial tuberosity advancement and the actual advancement in a direction parallel to the TPA, when the tibial tuberosity is not translated proximally. Although this has an influence on the final PTA, further studies are warranted to evaluate whether this is clinically significant.

Laser direct writing of combinatorial libraries of idealized cellular constructs: Biomedical applications

NASA Astrophysics Data System (ADS)

Schiele, Nathan R.; Koppes, Ryan A.; Corr, David T.; Ellison, Karen S.; Thompson, Deanna M.; Ligon, Lee A.; Lippert, Thomas K. M.; Chrisey, Douglas B.

2009-03-01

The ability to control cell placement and to produce idealized cellular constructs is essential for understanding and controlling intercellular processes and ultimately for producing engineered tissue replacements. We have utilized a novel intra-cavity variable aperture excimer laser operated at 193 nm to reproducibly direct write mammalian cells with micrometer resolution to form a combinatorial array of idealized cellular constructs. We deposited patterns of human dermal fibroblasts, mouse myoblasts, rat neural stem cells, human breast cancer cells, and bovine pulmonary artery endothelial cells to study aspects of collagen network formation, breast cancer progression, and neural stem cell proliferation, respectively. Mammalian cells were deposited by matrix assisted pulsed laser evaporation direct write from ribbons comprised of a UV transparent quartz coated with either a thin layer of extracellular matrix or triazene as a dynamic release layer using CAD/CAM control. We demonstrate that through optical imaging and incorporation of a machine vision algorithm, specific cells on the ribbon can be laser deposited in spatial coherence with respect to geometrical arrays and existing cells on the receiving substrate. Having the ability to direct write cells into idealized cellular constructs can help to answer many biomedical questions and advance tissue engineering and cancer research.

42 CFR 430.12 - Submittal of State plans and plan amendments.

Code of Federal Regulations, 2010 CFR

2010-10-01

... periodic reports on the Medicaid program, excluding periodic statistical, budget and fiscal reports. (iii... the Medicaid program. For changes related to advance directive requirements, amendments must be... concerning advance directives. (2) Prompt submittal of amendments is necessary— (i) So that CMS can determine...

Advance Directives - Multiple Languages

MedlinePlus

... List of All Topics All Advance Directives - Multiple Languages To use the sharing features on this page, please enable JavaScript. Arabic (العربية) ... Bethesda, MD 20894 U.S. Department of Health and Human Services National Institutes of Health Page last updated on 7 December 2017

42 CFR 422.128 - Information on advance directives.

Code of Federal Regulations, 2010 CFR

2010-10-01

.... (ii) The MA organization's written policies respecting the implementation of those rights, including a... 42 Public Health 3 2010-10-01 2010-10-01 false Information on advance directives. 422.128 Section 422.128 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN...

US hospital-based direct access with radiology referral: an administrative case report.

PubMed

Keil, Aaron; Brown, Suzanne Robben

2015-01-01

Legislative gains in the US allow physical therapists to function in expanded scopes of practice including direct access and referral to specialists. The combination of direct access with privileges to order imaging studies directly offers a desirable practice status for many physical therapists, especially in musculoskeletal focused settings. Although direct access is legal in all US jurisdictions, institutional-based physical therapy settings have not embraced these practices. Barriers cited to implementing direct access with advanced practice are concerns over medical and administrative opposition, institutional policies, provider qualifications and reimbursement. This administrative case report describes the process taken to allow therapists to see patients without a referral and to order diagnostic imaging studies at an academic medical center. Nine-month implementation results show 66 patients seen via direct access with 15% referred for imaging studies. Claims submitted to 20 different insurance providers were reimbursed at 100%. While institutional regulations and reimbursement are reported as barriers to direct access, this report highlights the process one academic medical center used to implement direct access and advanced practice radiology referral by updating policies and procedures, identifying advanced competencies and communicating with necessary stakeholder groups. Favorable reimbursement for services is documented.

Advance directives in english and French law: different concepts, different values, different societies.

PubMed

Horn, Ruth Judith

2014-03-01

In Western societies advance directives are widely recognised as important means to extend patient self-determination under circumstances of incapacity. Following other countries, England and France have adopted legislation aiming to clarify the legal status of advance directives. In this paper, I will explore similarities and differences in both sets of legislation, the arguments employed in the respective debates and the socio-political structures on which these differences are based. The comparison highlights how different legislations express different concepts emphasising different values accorded to the duty to respect autonomy and to protect life, and how these differences are informed by different socio-political contexts. Furthermore each country associates different ethical concerns with ADs which raise doubts about whether these directives are a theoretical idea which is hardly applicable in practice.

Zirconia-magnesia inert matrix fuel and waste form: Synthesis, characterization and chemical performance in an advanced fuel cycle

NASA Astrophysics Data System (ADS)

Holliday, Kiel Steven

There is a significant buildup in plutonium stockpiles throughout the world, because of spent nuclear fuel and the dismantling of weapons. The radiotoxicity of this material and proliferation risk has led to a desire for destroying excess plutonium. To do this effectively, it must be fissioned in a reactor as part of a uranium free fuel to eliminate the generation of more plutonium. This requires an inert matrix to volumetrically dilute the fissile plutonium. Zirconia-magnesia dual phase ceramic has been demonstrated to be a favorable material for this task. It is neutron transparent, zirconia is chemically robust, magnesia has good thermal conductivity and the ceramic has been calculated to conform to current economic and safety standards. This dissertation contributes to the knowledge of zirconia-magnesia as an inert matrix fuel to establish behavior of the material containing a fissile component. First, the zirconia-magnesia inert matrix is synthesized in a dual phase ceramic containing a fissile component and a burnable poison. The chemical constitution of the ceramic is then determined. Next, the material performance is assessed under conditions relevant to an advanced fuel cycle. Reactor conditions were assessed with high temperature, high pressure water. Various acid solutions were used in an effort to dissolve the material for reprocessing. The ceramic was also tested as a waste form under environmental conditions, should it go directly to a repository as a spent fuel. The applicability of zirconia-magnesia as an inert matrix fuel and waste form was tested and found to be a promising material for such applications.

Advanced 3D Ni(OH)2/CNT Gel Composite Electrodes for Supercapacitors

NASA Astrophysics Data System (ADS)

Cheng, Hanlin; Duong, Hai Minh

2015-03-01

In order to enhance the performance of supercapacitors, advanced 3D Porous CNT/Ni(OH)2 gel composite electrodes are developed in this work. Compared with previously reported graphene gel supercapacitors, our electrodes using 1D CNTs have smaller diffusion resistance due to a shorter ion transport path. The developed 3D xerogel composite electrodes demonstrate the success of a careful engineered guest/host materials interface. Initially, the CNT gels are coated on the nickel foam to form a 3D scaffold, which serves as a microscopic electrical conductive network. Then Ni(OH)2 are incorporated using a traditional electrodeposition method. In this work, two types of the 3D CNT-coated nickel foams are investigated. The gels can be used directly as hydrogels or dried in air to form xerogels. Both hydrogels and xerogels present 3D tangled CNT networks. It shows that the hydrogel composite electrodes with unbundled CNTs, though presenting high capacitances of 1400 F/g at low discharge rate, possess lower capacitances at higher discharge rate and a poor cycling performance of less than 23% retention. In contrast, the xerogel composite electrodes can overcome these limitations in terms of a satisfied discharge performance of 1200 F/g and a good cycling retention more than 85% due to a stronger Ni(OH)2/CNT interface. The CNT bundles in the xerogel electrodes formed during the drying process can give a flat surface with small curvature, which facilitate the Ni(OH)2 nucleation and growth. Thanks for the support from the A star R-265-000-424-305.

Inducing jet-lag in older people: directional asymmetry

NASA Technical Reports Server (NTRS)

Monk, T. H.; Buysse, D. J.; Carrier, J.; Kupfer, D. J.

2000-01-01

Twenty healthy elderly subjects (12 female, 8 male; mean age 81 years, range 67-87 years) each experienced a 15-day time isolation protocol in which they lived individually in a special laboratory apartment in which sleep and circadian rhythm measures could be taken. There were two experiments: one (6 females, 4 males) involved a 6-h phase advance of the sleep/wake cycle, and the other (6 females, 4 males) a 6-h phase delay. Each started with 5 baseline days, immediately followed by the phase shift. The subject was then held to the phase shifted routine for the remainder of the study. Rectal temperatures were recorded minute-by-minute throughout the entire experiment and each night of sleep was recorded using polysomnography. A directional asymmetry in phase-shift effects was apparent, with significantly more sleep disruption and circadian rhythm amplitude disruption after the phase advance than after the phase delay. Sleep disruption was reflected in reduced time spent asleep, and in changed REM latency, which increased in the phase advance direction but decreased in the phase delay direction. Although the phase advance led to a significant increase in wakefulness in the first half of the night, the phase delay did not lead to an equivalent increase in wakefulness during the second half of the night. Examination of both raw and 'demasked' circadian rectal temperature rhythms confirmed that phase adjustment was slow in both directions, but was less slow (and more monotonic) after the phase delay than after the phase advance. Subjective alertness suffered more disruption after the phase advance than after the phase delay.

Development of Efficient Chemistry to Generate Site-Specific Disulfide-Linked Protein- and Peptide-Payload Conjugates: Application to THIOMAB Antibody-Drug Conjugates.

PubMed

Sadowsky, Jack D; Pillow, Thomas H; Chen, Jinhua; Fan, Fang; He, Changrong; Wang, Yanli; Yan, Gang; Yao, Hui; Xu, Zijin; Martin, Shanique; Zhang, Donglu; Chu, Phillip; Dela Cruz-Chuh, Josefa; O'Donohue, Aimee; Li, Guangmin; Del Rosario, Geoffrey; He, Jintang; Liu, Luna; Ng, Carl; Su, Dian; Lewis Phillips, Gail D; Kozak, Katherine R; Yu, Shang-Fan; Xu, Keyang; Leipold, Douglas; Wai, John

2017-08-16

Conjugation of small molecule payloads to cysteine residues on proteins via a disulfide bond represents an attractive strategy to generate redox-sensitive bioconjugates, which have value as potential diagnostic reagents or therapeutics. Advancement of such "direct-disulfide" bioconjugates to the clinic necessitates chemical methods to form disulfide connections efficiently, without byproducts. The disulfide connection must also be resistant to premature cleavage by thiols prior to arrival at the targeted tissue. We show here that commonly employed methods to generate direct disulfide-linked bioconjugates are inadequate for addressing these challenges. We describe our efforts to optimize direct-disulfide conjugation chemistry, focusing on the generation of conjugates between cytotoxic payloads and cysteine-engineered antibodies (i.e., THIOMAB antibody-drug conjugates, or TDCs). This work culminates in the development of novel, high-yielding conjugation chemistry for creating direct payload disulfide connections to any of several Cys mutation sites in THIOMAB antibodies or to Cys sites in other biomolecules (e.g., human serum albumin and cell-penetrating peptides). We conclude by demonstrating that hindered direct disulfide TDCs with two methyl groups adjacent to the disulfide, which have heretofore not been described for any bioconjugate, are more stable and more efficacious in mouse tumor xenograft studies than less hindered analogs.

The impact of biotechnological advances on the future of US bioenergy

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

Davison, Brian H.; Brandt, Craig C.; Guss, Adam M.

Modern biotechnology has the potential to substantially advance the feasibility, structure, and efficiency of future biofuel supply chains. Advances might be direct or indirect. A direct advance would be improving the efficiency of biochemical conversion processes and feedstock production. Direct advances in processing may involve developing improved enzymes and bacteria to convert lignocellulosic feedstocks to ethanol. Progress in feedstock production could include enhancing crop yields via genetic modification or the selection of specific natural variants and breeds. Other direct results of biotechnology might increase the production of fungible biofuels and bioproducts, which would impact the supply chain. Indirect advances mightmore » include modifications to dedicated bioenergy crops that enable them to grow on marginal lands rather than land needed for food production. This study assesses the feasibility and advantages of near-future (10-year) biotechnological developments for a US biomass-based supply chain for bioenergy production. We assume a simplified supply chain of feedstock, logistics and land use, conversion, and products and utilization. The primary focus is how likely developments in feedstock production and conversion technologies will impact bioenergy and biofuels in the USA; a secondary focus is other innovative uses of biotechnologies in the energy arenas. The assessment addresses near-term biofuels based on starch, sugar, and cellulosic feedstocks and considers some longer-term options, such as oil-crop and algal technologies.« less

The impact of biotechnological advances on the future of US bioenergy

DOE PAGES

Davison, Brian H.; Brandt, Craig C.; Guss, Adam M.; ...

2015-05-14

Modern biotechnology has the potential to substantially advance the feasibility, structure, and efficiency of future biofuel supply chains. Advances might be direct or indirect. A direct advance would be improving the efficiency of biochemical conversion processes and feedstock production. Direct advances in processing may involve developing improved enzymes and bacteria to convert lignocellulosic feedstocks to ethanol. Progress in feedstock production could include enhancing crop yields via genetic modification or the selection of specific natural variants and breeds. Other direct results of biotechnology might increase the production of fungible biofuels and bioproducts, which would impact the supply chain. Indirect advances mightmore » include modifications to dedicated bioenergy crops that enable them to grow on marginal lands rather than land needed for food production. This study assesses the feasibility and advantages of near-future (10-year) biotechnological developments for a US biomass-based supply chain for bioenergy production. We assume a simplified supply chain of feedstock, logistics and land use, conversion, and products and utilization. The primary focus is how likely developments in feedstock production and conversion technologies will impact bioenergy and biofuels in the USA; a secondary focus is other innovative uses of biotechnologies in the energy arenas. The assessment addresses near-term biofuels based on starch, sugar, and cellulosic feedstocks and considers some longer-term options, such as oil-crop and algal technologies.« less

Final Technical Report: Electrohydrodynamic Tip Streaming

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

Basaran, Osman

2016-01-06

When subjected to strong electric fields, liquid drops and films form conical tips and emit thin jets from their tips. Such electrodydrodynamic (EDH) tip streaming or cone-jetting phenomena, which are sometimes referred to as electrospraying, occur widely in nature, e.g., in ejection of streams of small charged drops from pointed tips of raindrops in thunderclouds, and technology, e.g., in electrospray mass spectrometry or electric field-driven solvent extraction. More recently, EHD cone-jetting has emerged as a powerful technique for direct printing of solar cells, micro- and nano- particle production, and microencapsulation for controlled release. In many of the aforementioned situations, ofmore » equal importance to the processes by which one drop disintegrates to form several drops are those by which (a) two drops come together and coalesce and (b) two drops are coupled to form a double droplet system (DDS) or a capillary switch (CS). the main objective of this research program is to advance through simulation, theory, and experiment the breakup, coalescence, and oscillatory dynamics of single and pairs of charged as well as uncharged drops.« less

Geologic Evolution of North America: Geologic features suggest that the continent has grown and differentiated through geologic time.

PubMed

Engel, A E

1963-04-12

The oldest decipherable rock complexes within continents (more than 2.5 billion years old) are largely basaltic volcanics and graywacke. Recent and modern analogs are the island arcs formed along and adjacent to the unstable interface of continental and oceanic crusts. The major interfacial reactions (orogenies) incorporate pre-existing sial, oceanic crust, and mantle into crust of a more continental type. Incipient stages of continental evolution, more than 3 billion years ago, remain obscure. They may involve either a cataclysmic granite-forming event or a succession of volcanic-sedimentary and granite-forming cycles. Intermediate and recent stages of continental evolution, as indicated by data for North America, involve accretion of numerous crustal interfaces with fragments of adjacent continental crust and their partial melting, reinjection, elevation, unroofing, and stabilization. Areas of relict provinces defined by ages of granites suggest that continental growth is approximately linear. But the advanced differentiation found in many provinces and the known overlaps permit wide deviation from linearity in the direction of a more explosive early or intermediate growth.

Advanced Platform Systems Technology study. Volume 3: Supporting data

NASA Technical Reports Server (NTRS)

1983-01-01

The overall study effort proceeded from the identification of 106 technology topics to the selection of 5 for detail trade studies. The technical issues and options were evaluated through the trade process. Finally, individual consideration was given to costs and benefits for the technologies identified for advancement. Eight priority technology items were identified for advancement. Supporting data generated during the trade selection and trade study process were presented. Space platform requirements, trade study and cost benefits analysis, and technology advancement planning are advanced. The structured approach used took advantage of a number of forms developed to ensure that a consistent approach was employed by each of the diverse specialists that participated. These forms were an intrinsic part of the study protocol.

Health Care Professionals' Death Attitudes, Experiences, and Advance Directive Communication Behavior

ERIC Educational Resources Information Center

Black, Kathy

2007-01-01

The study surveyed 135 health care professionals (74 nurses, 32 physicians, and 29 social workers) to examine their personal death attitudes and experiences in relation to their reported advance directive communication practice behavior. Negative correlations were found between collaborating with other health care professionals regarding the…

Comparison of advanced thermal and electrical storage for parabolic dish solar thermal power systems

NASA Astrophysics Data System (ADS)

Fujita, T.; Birur, G. C.; Schredder, J. M.; Bowyer, J. M.; Awaya, H. I.

Parabolic dish solar concentrator cluster concepts are explored, with attention given to thermal storage systems coupled to Stirling and Brayton cycle power conversion devices. Sensible heat storage involving molten salt (NaOH), liquid sodium, and solid cordierite bricks are considered for 1500 F thermal storage systems. Latent heat storage with NaF-MgF2 phase change materials are explored in terms of passive, active, and direct contact designs. Comparisons are made of the effectiveness of thermal storage relative to redox, Na-S, Zn-Cl, and Zn-Br battery storage systems. Molten lead trickling down through a phase change eutectic, the NaF-MgF2, formed the direct contact system. Heat transport in all systems is effected through Inconel pipes. Using a cost goal of 120-150 mills/kWh as the controlling parameter, sensible heat systems with molten salts transport with either Stirling or Brayton engines, or latent heat systems with Stirling engines, and latent heat-Brayton engine with direct contact were favored in the analyses. Battery storage systems, however, offered the most flexibility of applications.

Comparison of advanced thermal and electrical storage for parabolic dish solar thermal power systems

NASA Technical Reports Server (NTRS)

Fujita, T.; Birur, G. C.; Schredder, J. M.; Bowyer, J. M.; Awaya, H. I.

1982-01-01

Parabolic dish solar concentrator cluster concepts are explored, with attention given to thermal storage systems coupled to Stirling and Brayton cycle power conversion devices. Sensible heat storage involving molten salt (NaOH), liquid sodium, and solid cordierite bricks are considered for 1500 F thermal storage systems. Latent heat storage with NaF-MgF2 phase change materials are explored in terms of passive, active, and direct contact designs. Comparisons are made of the effectiveness of thermal storage relative to redox, Na-S, Zn-Cl, and Zn-Br battery storage systems. Molten lead trickling down through a phase change eutectic, the NaF-MgF2, formed the direct contact system. Heat transport in all systems is effected through Inconel pipes. Using a cost goal of 120-150 mills/kWh as the controlling parameter, sensible heat systems with molten salts transport with either Stirling or Brayton engines, or latent heat systems with Stirling engines, and latent heat-Brayton engine with direct contact were favored in the analyses. Battery storage systems, however, offered the most flexibility of applications.

Prevalence of advanced adenomas in small and diminutive colon polyps using direct measurement of size.

PubMed

Tsai, Franklin C; Strum, Williamson B

2011-08-01

Most studies reporting polyp size use visual estimates. Determining the prevalence of advanced histology based on direct measurement of polyp size may help guide the management of polyps found at optical colonoscopy (OC) and CT colonography (CTC). We designed a large, prospective study to assess the prevalence of advanced adenomas based on direct measurement of polyp size by a certified pathologists' assistant as reported in the pathology report. Patients between 40 and 89 years of age who presented for screening colonoscopy were included in our study. Advanced adenomas were defined as ≥10 mm or ≥25% villous features, high grade dysplasia or cancer. Polyps were divided by size into three groups: diminutive (≤5 mm), small (6-9 mm) and large (≥10 mm). If more than one adenoma was present, the most advanced was used for analysis. We evaluated 6,905 consecutive patients referred for colonoscopy between January 2005 and December 2006. Of the 4,967 who met the inclusion criteria, the mean age was 58.8 and consisted of 59% women. Overall, 930 (18.7%) had an adenoma; 248 (5%) were advanced adenomas including 8 (0.16%) cancers. Of 89 polyps≥10 mm, 76 (85%) had advanced histology; of 247 polyps 6-9 mm, 67 (27%) were advanced; of 1,025 polyps ≤5 mm, 105 (10%) were advanced. Thus, 172 of 248 (69%) patients with advanced adenomas had small or diminutive adenomas. Our data indicate the majority (69%) of advanced adenomas are <10 mm. Even among polyps≤5 mm, there was an appreciable prevalence of advanced adenomas (10%). These findings may help guide the management of sub-centimeter colon polyps found by OC or CTC.

Application of an efficient hybrid scheme for aeroelastic analysis of advanced propellers

NASA Technical Reports Server (NTRS)

Srivastava, R.; Sankar, N. L.; Reddy, T. S. R.; Huff, D. L.

1989-01-01

An efficient 3-D hybrid scheme is applied for solving Euler equations to analyze advanced propellers. The scheme treats the spanwise direction semi-explicitly and the other two directions implicitly, without affecting the accuracy, as compared to a fully implicit scheme. This leads to a reduction in computer time and memory requirement. The calculated power coefficients for two advanced propellers, SR3 and SR7L, and various advanced ratios showed good correlation with experiment. Spanwise distribution of elemental power coefficient and steady pressure coefficient differences also showed good agreement with experiment. A study of the effect of structural flexibility on the performance of the advanced propellers showed that structural deformation due to centrifugal and aero loading should be included for better correlation.

75 FR 11836 - Bioenergy Program for Advanced Biofuels

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-12

... (NOCP); additional payment for advanced biofuel produced from October 1, 2008 through September 30, 2009. SUMMARY: RBS is announcing additional payments to advanced biofuel producers determined eligible in Fiscal... biofuel produced in FY 2009, the request must include: Form RD 9005-3, ``Advanced Biofuel Program Payment...

Photodynamic Therapy in Patients with Advanced Hilar Cholangiocarcinoma: Percutaneous Cholangioscopic Versus Peroral Transpapillary Approach.

PubMed

Lee, Tae Yoon; Cheon, Young Koog; Shim, Chan Sup

2016-04-01

This study aimed to compare the clinical outcomes of patients with advanced hilar cholangiocarcinoma (CC) who underwent photodynamic therapy (PDT) with either percutaneous transhepatic cholangioscopy (PTCS) or endoscopic retrograde cholangiopancreatography (ERCP). PDT has been proposed as a promising therapy for treatment of unresectable hilar CC that is resistant to conventional standard treatment. However, few studies have compared the delivery methods of PDT in unresectable hilar CC patients. Thirty-seven adult patients with advanced hilar CC were included in this study. Twenty-four patients treated with PTCS-directed PDT and 13 patients treated with ERCP-directed PDT were analyzed retrospectively. The PTCS- and ERCP-directed PDT groups were comparable with respect to age, gender, health status, pretreatment bilirubin levels, Bismuth type, and hilar CC stage. The length of hospital stay differed significantly (p < 0.001) between the two groups, with a median hospital stay of 37 days (range, 13-77 days) in the ERCP-directed PDT group versus 63 days (range, 23-125 days) in the PTCS-directed group. PTCS-directed PDT patients demonstrated an overall survival similar to that of ERCP-directed PDT patients, with a median survival of 11.6 versus 9.5 months, respectively (p = 0.96). Only lower pre-PDT bilirubin levels (p = 0.002) were a significant predictor of improved survival in all patients who underwent PDT, as determined by multivariate analysis. Median metal stent patency was similar between the groups [PTCS-directed PDT group (n = 8), 6.2 months; ERCP-directed PDT group (n = 7), 7.2 months; p = 0.642]. Survival after PTCS- or ERCP-directed PDT was not statistically different in patients with advanced hilar CC. Lower pre-PDT bilirubin levels were associated with longer survival in all patients.

Large-scale evolution of the central-east Greenland margin: New insights to the North Atlantic glaciation history

NASA Astrophysics Data System (ADS)

Pérez, Lara F.; Nielsen, Tove; Knutz, Paul C.; Kuijpers, Antoon; Damm, Volkmar

2018-04-01

The continental shelf of central-east Greenland is shaped by several glacially carved transverse troughs that form the oceanward extension of the major fjord systems. The evolution of these troughs through time, and their relation with the large-scale glaciation of the Northern Hemisphere, is poorly understood. In this study seismostratigraphic analyses have been carried out to determine the morphological and structural development of this important sector of the East Greenland glaciated margin. The age of major stratigraphic discontinuities has been constrained by a direct tie to ODP site 987 drilled in the Greenland Sea basin plain off Scoresby Sund fan system. The areal distribution and internal facies of the identified seismic units reveal the large-scale depositional pattern formed by ice-streams draining a major part of the central-east Greenland ice sheet. Initial sedimentation along the margin was, however, mainly controlled by tectonic processes related to the margin construction, continental uplift, and fluvial processes. From late Miocene to present, progradational and erosional patterns point to repeated glacial advances across the shelf. The evolution of depo-centres suggests that ice sheet advances over the continental shelf have occurred since late Miocene, about 2 Myr earlier than previously assumed. This cross-shelf glaciation is more pronounced during late Miocene and early Pliocene along Blosseville Kyst and around the Pliocene/Pleistocene boundary off Scoresby Sund; indicating a northward migration of the glacial advance. The two main periods of glaciation were separated by a major retreat of the ice sheet to an inland position during middle Pliocene. Mounded-wavy deposits interpreted as current-related deposits suggest the presence of changing along-slope current dynamics in concert with the development of the modern North Atlantic oceanographic pattern.

Advances in Planetary Geology

NASA Technical Reports Server (NTRS)

Woronow, A. (Editor)

1982-01-01

Advances in Planetary Geology is a new series intended to serve the planetary geology community with a form for quick and thorough communications. There are no set lists of acceptable topics or formats, and submitted manuscripts will not undergo a formal review. All submissions should be in a camera ready form, preferably spaced, and submitted to the editor.

76 FR 50239 - Agency Information Collection Activities: Extension of a Currently Approved Information...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-12

...-Day Notice of Information Collection Under Review: Form I- 192, Application for Advance Permission to...: Extension of a currently approved information collection. (2) Title of the Form/Collection: Application for Advance Permission to enter as Nonimmigrant (Pursuant to 212(d)(3) of the Immigration and Nationality Act...

Opinions about euthanasia and advanced dementia: a qualitative study among Dutch physicians and members of the general public.

PubMed

Kouwenhoven, Pauline S C; Raijmakers, Natasja J H; van Delden, Johannes J M; Rietjens, Judith A C; van Tol, Donald G; van de Vathorst, Suzanne; de Graeff, Nienke; Weyers, Heleen A M; van der Heide, Agnes; van Thiel, Ghislaine J M W

2015-01-28

The Dutch law states that a physician may perform euthanasia according to a written advance euthanasia directive (AED) when a patient is incompetent as long as all legal criteria of due care are met. This may also hold for patients with advanced dementia. We investigated the differing opinions of physicians and members of the general public on the acceptability of euthanasia in patients with advanced dementia. In this qualitative study, 16 medical specialists, 19 general practitioners, 16 elderly physicians and 16 members of the general public were interviewed and asked for their opinions about a vignette on euthanasia based on an AED in a patient with advanced dementia. Members of the general public perceived advanced dementia as a debilitating and degrading disease. Physicians emphasized the need for direct communication with the patient when making decisions about euthanasia. Respondent from both groups acknowledged difficulties in the assessment of patients' autonomous wishes and the unbearableness of their suffering. Legally, an AED may replace direct communication with patients about their request for euthanasia. In practice, physicians are reluctant to forego adequate verbal communication with the patient because they wish to verify the voluntariness of patients' request and the unbearableness of suffering. For this reason, the applicability of AEDs in advanced dementia seems limited.

Dry Age-Related Macular Degeneration Pharmacology

PubMed Central

Wright, Charles B.

2017-01-01

Age-related macular degeneration (AMD), the most common form of irreversible blindness in the industrially developed world, can present years before a patient begins to lose vision. For most of these patients, AMD never progresses past its early stages to the advanced forms that are principally responsible for the vast majority of vision loss. Advanced AMD can manifest as either an advanced avascular form known as geographic atrophy (GA) marked by regional retinal pigment epithelium (RPE) cell death or as an advanced form known as neovascular AMD marked by the intrusion of fragile new blood vessels into the normally avascular retina. Physicians have several therapeutic interventions available to combat neovascular AMD, but GA has no approved effective therapies as of yet. In this chapter, we will discuss the current strategies for limiting dry AMD in patients. We will also discuss previous attempts at pharmacological intervention that were tested in a clinical setting and consider reasons why these putative therapeutics did not perform successfully in large-scale trials. Despite the number of unsuccessful past trials, new pharmacological interventions may succeed. These future therapies may aid millions of AMD patients worldwide. PMID:27900609

An update: improvements in imaging perfluorocarbon-mounted plant leaves with implications for studies of plant pathology, physiology, development and cell biology

PubMed Central

Littlejohn, George R.; Mansfield, Jessica C.; Christmas, Jacqueline T.; Witterick, Eleanor; Fricker, Mark D.; Grant, Murray R.; Smirnoff, Nicholas; Everson, Richard M.; Moger, Julian; Love, John

2014-01-01

Plant leaves are optically complex, which makes them difficult to image by light microscopy. Careful sample preparation is therefore required to enable researchers to maximize the information gained from advances in fluorescent protein labeling, cell dyes and innovations in microscope technologies and techniques. We have previously shown that mounting leaves in the non-toxic, non-fluorescent perfluorocarbon (PFC), perfluorodecalin (PFD) enhances the optical properties of the leaf with minimal impact on physiology. Here, we assess the use of the PFCs, PFD, and perfluoroperhydrophenanthrene (PP11) for in vivo plant leaf imaging using four advanced modes of microscopy: laser scanning confocal microscopy (LSCM), two-photon fluorescence microscopy, second harmonic generation microscopy, and stimulated Raman scattering (SRS) microscopy. For every mode of imaging tested, we observed an improved signal when leaves were mounted in PFD or in PP11, compared to mounting the samples in water. Using an image analysis technique based on autocorrelation to quantitatively assess LSCM image deterioration with depth, we show that PP11 outperformed PFD as a mounting medium by enabling the acquisition of clearer images deeper into the tissue. In addition, we show that SRS microscopy can be used to image PFCs directly in the mesophyll and thereby easily delimit the “negative space” within a leaf, which may have important implications for studies of leaf development. Direct comparison of on and off resonance SRS micrographs show that PFCs do not to form intracellular aggregates in live plants. We conclude that the application of PFCs as mounting media substantially increases advanced microscopy image quality of living mesophyll and leaf vascular bundle cells. PMID:24795734

Direct 3D bioprinting of perfusable vascular constructs using a blend bioink.

PubMed

Jia, Weitao; Gungor-Ozkerim, P Selcan; Zhang, Yu Shrike; Yue, Kan; Zhu, Kai; Liu, Wanjun; Pi, Qingment; Byambaa, Batzaya; Dokmeci, Mehmet Remzi; Shin, Su Ryon; Khademhosseini, Ali

2016-11-01

Despite the significant technological advancement in tissue engineering, challenges still exist towards the development of complex and fully functional tissue constructs that mimic their natural counterparts. To address these challenges, bioprinting has emerged as an enabling technology to create highly organized three-dimensional (3D) vascular networks within engineered tissue constructs to promote the transport of oxygen, nutrients, and waste products, which can hardly be realized using conventional microfabrication techniques. Here, we report the development of a versatile 3D bioprinting strategy that employs biomimetic biomaterials and an advanced extrusion system to deposit perfusable vascular structures with highly ordered arrangements in a single-step process. In particular, a specially designed cell-responsive bioink consisting of gelatin methacryloyl (GelMA), sodium alginate, and 4-arm poly(ethylene glycol)-tetra-acrylate (PEGTA) was used in combination with a multilayered coaxial extrusion system to achieve direct 3D bioprinting. This blend bioink could be first ionically crosslinked by calcium ions followed by covalent photocrosslinking of GelMA and PEGTA to form stable constructs. The rheological properties of the bioink and the mechanical strengths of the resulting constructs were tuned by the introduction of PEGTA, which facilitated the precise deposition of complex multilayered 3D perfusable hollow tubes. This blend bioink also displayed favorable biological characteristics that supported the spreading and proliferation of encapsulated endothelial and stem cells in the bioprinted constructs, leading to the formation of biologically relevant, highly organized, perfusable vessels. These characteristics make this novel 3D bioprinting technique superior to conventional microfabrication or sacrificial templating approaches for fabrication of the perfusable vasculature. We envision that our advanced bioprinting technology and bioink formulation may also have significant potentials in engineering large-scale vascularized tissue constructs towards applications in organ transplantation and repair. Copyright © 2016 Elsevier Ltd. All rights reserved.

[Ethical issues in the practice of advance directives, living wills, and self-determination in end of life care].

PubMed

Fang, Hui-Feng; Jhing, Huei-Yu; Lin, Chia-Chin

2009-02-01

The Hospice-Palliative Care Act, enacted in Taiwan in 2000, was designed to respect the end of life medical wishes of patients with incurable illnesses, safeguard the rights of these patients, and provide clinical guidelines for healthcare workers responsible to provide end of life care. Self-determination is a core element of human dignity. Advance directive documents include a living will, and durable power of attorney for healthcare. This article reviews current issues and ethical dilemmas with regard to advance directives. Patients, family members, and clinicians may require better education on the Hospice-Palliative Care Act in order to respect more appropriately patient end of life medical care wishes.

Tip-path-plane angle effects on rotor blade-vortex interaction noise levels and directivity

NASA Technical Reports Server (NTRS)

Burley, Casey L.; Martin, Ruth M.

1988-01-01

Acoustic data of a scale model BO-105 main rotor acquired in a large aeroacoustic wind tunnel are presented to investigate the parametric effects of rotor operating conditions on blade-vortex interaction (BVI) impulsive noise. Contours of a BVI noise metric are employed to quantify the effects of rotor advance ratio and tip-path-plane angle on BVI noise directivity and amplitude. Acoustic time history data are presented to illustrate the variations in impulsive characteristics. The directionality, noise levels and impulsive content of both advancing and retreating side BVI are shown to vary significantly with tip-path-plane angle and advance ratio over the range of low and moderate flight speeds considered.

Advances in Mechanical Architectures of Large Precision Space Apertures

NASA Astrophysics Data System (ADS)

Datashvili, Leri; Maghaldadze, Nikoloz; Endler, Stephan; Pauw, Julian; He, Peng; Baier, Horst; Ihle, Alexander; Santiago Prowlad, Julian

2014-06-01

Recent advances in development of mechanical architectures of large deployable reflectors (LDRs) through the projects of the European Space Agency are addressed in this paper. Two different directions of LDR architectures are being investigated and developed at LSS and LLB. These are LDRs with knitted metal mesh and with flexible shell-membrane reflecting surfaces. The first direction is matured and required advancing of the novel architecture of the supporting structure that provides deployment and final shape accuracy of the metal mesh is underway. The second direction is rather new and its current development stage is focused on investigations of dimensional stability of the flexible shell-membrane reflecting surface. In both directions 5 m diameter functional models will be built to demonstrate achieved performances, which shall prepare the basis for further improvement of their technology readiness levels.

Precompetitive cooperative research: the culture of the '90s

NASA Astrophysics Data System (ADS)

Holton, William C.

1991-03-01

In the current worldwide technology environment, it is essential for the U.S. microelectronics industry. and especially for the integrated circuit portion of that industry, that precompeutive cooperative research alliances be formed and funded at a level that emables them to be effective in rapidly advancing technology. It is important to realize that technology advances with or without our direct participation. If we do not aggressively participate we are quickly left behind. Increasing complexity and miniaturization have been the themes in semiconductor technology. Many are aware that what began in the early 60's with a few masking steps and minimum dimensions measured in mils. has now evolved to a level of sophistication requiring a 100 MW workstation for IC design and the investment of nearly S400 million dollars in fab cost to produce today's microchips. The leading nations of the world have come to realize that their future well-being is closely tied to their ability to compete in this hi-tech environment. Industry coalitions have been formed to exploit the early ramifications of emeging technologies. Improvements in overseas manufacturing have been made and continue unabated with new producLs, new processes, and new services being introduced at an increasing rate. Many foreign governments are now actively involved in formulating and conducting industrial and technology policies to aid their hi-tech industry. To meet these challenges, U.S. firms, with U. S. government cooperation, must respond.

Dopant-Free and Carrier-Selective Heterocontacts for Silicon Solar Cells: Recent Advances and Perspectives.

PubMed

Gao, Pingqi; Yang, Zhenhai; He, Jian; Yu, Jing; Liu, Peipei; Zhu, Juye; Ge, Ziyi; Ye, Jichun

2018-03-01

By combining the most successful heterojunctions (HJ) with interdigitated back contacts, crystalline silicon (c-Si) solar cells (SCs) have recently demonstrated a record efficiency of 26.6%. However, such SCs still introduce optical/electrical losses and technological issues due to parasitic absorption/Auger recombination inherent to the doped films and the complex process of integrating discrete p + - and n + -HJ contacts. These issues have motivated the search for alternative new functional materials and simplified deposition technologies, whereby carrier-selective contacts (CSCs) can be formed directly with c-Si substrates, and thereafter form IBC cells, via a dopant-free method. Screening and modifying CSC materials in a wider context is beneficial for building dopant-free HJ contacts with better performance, shedding new light on the relatively mature Si photovoltaic field. In this review, a significant number of achievements in two representative dopant-free hole-selective CSCs, i.e . , poly(3,4-ethylene dioxythiophene):poly(styrenesulfonate)/Si and transition metal oxides/Si, have been systemically presented and surveyed. The focus herein is on the latest advances in hole-selective materials modification, interfacial passivation, contact resistivity, light-trapping structure and device architecture design, etc. By analyzing the structure-property relationships of hole-selective materials and assessing their electrical transport properties, promising functional materials as well as important design concepts for such CSCs toward high-performance SCs have been highlighted.

Dopant‐Free and Carrier‐Selective Heterocontacts for Silicon Solar Cells: Recent Advances and Perspectives

PubMed Central

Yang, Zhenhai; He, Jian; Yu, Jing; Liu, Peipei; Zhu, Juye; Ge, Ziyi; Ye, Jichun

2017-01-01

Abstract By combining the most successful heterojunctions (HJ) with interdigitated back contacts, crystalline silicon (c‐Si) solar cells (SCs) have recently demonstrated a record efficiency of 26.6%. However, such SCs still introduce optical/electrical losses and technological issues due to parasitic absorption/Auger recombination inherent to the doped films and the complex process of integrating discrete p+‐ and n+‐HJ contacts. These issues have motivated the search for alternative new functional materials and simplified deposition technologies, whereby carrier‐selective contacts (CSCs) can be formed directly with c‐Si substrates, and thereafter form IBC cells, via a dopant‐free method. Screening and modifying CSC materials in a wider context is beneficial for building dopant‐free HJ contacts with better performance, shedding new light on the relatively mature Si photovoltaic field. In this review, a significant number of achievements in two representative dopant‐free hole‐selective CSCs, i.e., poly(3,4‐ethylene dioxythiophene):poly(styrenesulfonate)/Si and transition metal oxides/Si, have been systemically presented and surveyed. The focus herein is on the latest advances in hole‐selective materials modification, interfacial passivation, contact resistivity, light‐trapping structure and device architecture design, etc. By analyzing the structure–property relationships of hole‐selective materials and assessing their electrical transport properties, promising functional materials as well as important design concepts for such CSCs toward high‐performance SCs have been highlighted. PMID:29593956

Advanced stitching technology

NASA Technical Reports Server (NTRS)

Scardino, Frank L.

1992-01-01

In the design of textile composites, the selection of materials and constructional techniques must be matched with product performance, productivity, and cost requirements. Constructional techniques vary. A classification of various textile composite systems is given. In general, the chopped fiber system is not suitable for structural composite applications because of fiber discontinuity, uncontrolled fiber orientation and a lack of fiber integration or entanglement. Linear filament yarn systems are acceptable for structural components which are exposed to simple tension in their applications. To qualify for more general use as structural components, filament yarn systems must be multi-directionally positioned. With the most sophisticated filament winding and laying techniques, however, the Type 2 systems have limited potential for general load-bearing applications because of a lack of filament integration or entanglement, which means vulnerability to splitting and delamination among filament layers. The laminar systems (Type 3) represented by a variety of simple fabrics (woven, knitted, braided and nonwoven) are especially suitable for load-bearing panels in flat form and for beams in a roled up to wound form. The totally integrated, advanced fabric system (Type 4) are thought to be the most reliable for general load-bearing applications because of fiber continuity and because of controlled multiaxial fiber orientation and entanglement. Consequently, the risk of splitting and delamination is minimized and practically omitted. Type 4 systems can be woven, knitted, braided or stitched through with very special equipment. Multiaxial fabric technologies are discussed.

Advance Health Care Directives and “Public Guardian”: The Italian Supreme Court Requests the Status of Current and Not Future Inability

PubMed Central

Busardò, Francesco Paolo; Bello, Stefania; Gulino, Matteo; Zaami, Simona; Frati, Paola

2014-01-01

Advance health care decisions animate an intense debate in several European countries, which started more than 20 years ago in the USA and led to the adoption of different rules, based on the diverse legal, sociocultural and philosophical traditions of each society. In Italy, the controversial issue of advance directives and end of life's rights, in the absence of a clear and comprehensive legislation, has been over time a subject of interest of the Supreme Court. Since 2004 a law introduced the “Public Guardian,” aiming to provide an instrument of assistance to the person lacking in autonomy because of an illness or incapacity. Recently, this critical issue has once again been brought to the interest of the Supreme Court, which passed a judgment trying to clarify the legislative application of the appointment of the Guardian in the field of advance directives. PMID:24729977

An Evaluation of the Accuracy of the Subtraction Method Used for Determining Platelet Counts in Advanced Platelet-Rich Fibrin and Concentrated Growth Factor Preparations

PubMed Central

Watanabe, Taisuke; Isobe, Kazushige; Suzuki, Taiji; Kawabata, Hideo; Nakamura, Masayuki; Tsukioka, Tsuneyuki; Okudera, Toshimitsu; Okudera, Hajime; Uematsu, Kohya; Okuda, Kazuhiro; Nakata, Koh; Kawase, Tomoyuki

2017-01-01

Platelet concentrates should be quality-assured of purity and identity prior to clinical use. Unlike for the liquid form of platelet-rich plasma, platelet counts cannot be directly determined in solid fibrin clots and are instead calculated by subtracting the counts in other liquid or semi-clotted fractions from those in whole blood samples. Having long suspected the validity of this method, we herein examined the possible loss of platelets in the preparation process. Blood samples collected from healthy male donors were immediately centrifuged for advanced platelet-rich fibrin (A-PRF) and concentrated growth factors (CGF) according to recommended centrifugal protocols. Blood cells in liquid and semi-clotted fractions were directly counted. Platelets aggregated on clot surfaces were observed by scanning electron microscopy. A higher centrifugal force increased the numbers of platelets and platelet aggregates in the liquid red blood cell fraction and the semi-clotted red thrombus in the presence and absence of the anticoagulant, respectively. Nevertheless, the calculated platelet counts in A-PRF/CGF preparations were much higher than expected, rendering the currently accepted subtraction method inaccurate for determining platelet counts in fibrin clots. To ensure the quality of solid types of platelet concentrates chairside in a timely manner, a simple and accurate platelet-counting method should be developed immediately. PMID:29563413

The RPG gene of Medicago truncatula controls Rhizobium-directed polar growth during infection

PubMed Central

Arrighi, Jean-François; Godfroy, Olivier; de Billy, Françoise; Saurat, Olivier; Jauneau, Alain; Gough, Clare

2008-01-01

Rhizobia can infect roots of host legume plants and induce new organs called nodules, in which they fix atmospheric nitrogen. Infection generally starts with root hair curling, then proceeds inside newly formed, intracellular tubular structures called infection threads. A successful symbiotic interaction relies on infection threads advancing rapidly at their tips by polar growth through successive cell layers of the root toward developing nodule primordia. To identify a plant component that controls this tip growth process, we characterized a symbiotic mutant of Medicago truncatula, called rpg for rhizobium-directed polar growth. In this mutant, nitrogen-fixing nodules were rarely formed due to abnormally thick and slowly progressing infection threads. Root hair curling was also abnormal, indicating that the RPG gene fulfils an essential function in the process whereby rhizobia manage to dominate the process of induced tip growth for root hair infection. Map-based cloning of RPG revealed a member of a previously unknown plant-specific gene family encoding putative long coiled-coil proteins we have called RRPs (RPG-related proteins) and characterized by an “RRP domain” specific to this family. RPG expression was strongly associated with rhizobial infection, and the RPG protein showed a nuclear localization, indicating that this symbiotic gene constitutes an important component of symbiotic signaling. PMID:18621693

The RPG gene of Medicago truncatula controls Rhizobium-directed polar growth during infection.

PubMed

Arrighi, Jean-François; Godfroy, Olivier; de Billy, Françoise; Saurat, Olivier; Jauneau, Alain; Gough, Clare

2008-07-15

Rhizobia can infect roots of host legume plants and induce new organs called nodules, in which they fix atmospheric nitrogen. Infection generally starts with root hair curling, then proceeds inside newly formed, intracellular tubular structures called infection threads. A successful symbiotic interaction relies on infection threads advancing rapidly at their tips by polar growth through successive cell layers of the root toward developing nodule primordia. To identify a plant component that controls this tip growth process, we characterized a symbiotic mutant of Medicago truncatula, called rpg for rhizobium-directed polar growth. In this mutant, nitrogen-fixing nodules were rarely formed due to abnormally thick and slowly progressing infection threads. Root hair curling was also abnormal, indicating that the RPG gene fulfils an essential function in the process whereby rhizobia manage to dominate the process of induced tip growth for root hair infection. Map-based cloning of RPG revealed a member of a previously unknown plant-specific gene family encoding putative long coiled-coil proteins we have called RRPs (RPG-related proteins) and characterized by an "RRP domain" specific to this family. RPG expression was strongly associated with rhizobial infection, and the RPG protein showed a nuclear localization, indicating that this symbiotic gene constitutes an important component of symbiotic signaling.

The Greenland Sea Odden: Intra- and inter-annual variability

USGS Publications Warehouse

Russell, C.A.; Fischer, K.W.; Shuchman, R.A.; Josberger, E.G.

1997-01-01

The "Odden" is a large sea ice feature that forms in the East Greenland Sea which generally forms at the beginning of the winter season and can cover 300,000 km2. Throughout the winter, the outer edge of the Odden may advance and retreat by several hundred kilometers on time scales of a few days to weeks. Satellite passive microwave observations from 1978 through 1995 provide a continuous record of the spatial and temporal variations of this extremely dynamic phenomenon. The 17 year record shows both strong inter- and intra-annual variations in Odden extent and temporal behavior. An analysis of the satellite passive microwave derived ice area and extent time series along with meteorological data from the Arctic Drifting Buoy Network determined the meteorological forcing required for Odden growth, maintenance and decay. The key meteorological parameters which cause the rapid ice formation and decay associated with the Odden are, in order of importance, air temperature, wind speed, and wind direction. Atmospheric pressure was found not to play a significant role in the Odden events. Air temperature and wind direction are the dominant variables with temperatures below -9.5??C and winds from the west required to trigger significant Odden ice formation events. ??2004 Copyright SPIE - The International Society for Optical Engineering.

The interaction of reaction-bonded silicon carbide and inconel 600 with a nickel-based brazing alloy

NASA Astrophysics Data System (ADS)

McDermid, J. R.; Pugh, M. D.; Drew, R. A. L.

1989-09-01

The objective of the present research was to join reaction-bonded silicon carbide (RBSC) to INCONEL 600 (a nickel-based superalloy) for use in advanced heat engine applications using either direct brazing or composite interlayer joining. Direct brazing experiments employed American Welding Society (AWS) BNi-5, a commercial nickel-based brazing alloy, as a filler material; composite interlayers consisted of intimate mixtures of α-SiC and BNi-5 powders. Both methods resulted in the liquid filler metal forming a Ni-Si liquid with the free Si in the RBSC, which, in turn, reacted vigorously with the SiC component of the RBSC to form low melting point constituents in both starting materials and Cr carbides at the metal-ceramic interface. Using solution thermodynamics, it was shown that a Ni-Si liquid of greater than 60 at. pct Ni will decompose a-SiC at the experimental brazing temperature of 1200 ‡C; these calculations are consistent with the experimentally observed composition profiles and reaction morphology within the ceramic. It was concluded that the joining of RBSC to INCONEL 600 using a nickel-based brazing alloy is not feasible due to the inevitability of the filler metal reacting with the ceramic, degrading the high-temperature properties of the base materials.

Completion of Advance Directives: Do Social Work Preadmission Interviews Make a Difference?

ERIC Educational Resources Information Center

Johnson, Yvonne M.; Stadel, Vivian L.

2007-01-01

Objectives: This study tests the efficacy of a preadmission, educational interview on advance directives, in this case, health care proxies (HCPs) offered to elective, orthopedic patients. Method: Using a quasi-experimental design, participants (n = 54) are assigned to either treatment group (who received the educational interview, conducted by a…

Patient safety: honoring advanced directives.

PubMed

Tice, Martha A

2007-02-01

Healthcare providers typically think of patient safety in the context of preventing iatrogenic injury. Prevention of falls and medication or treatment errors is the typical focus of adverse event analyses. If healthcare providers are committed to honoring the wishes of patients, then perhaps failures to honor advanced directives should be viewed as reportable medical errors.

A Comparison of State Advance Directive Documents

ERIC Educational Resources Information Center

Gunter-Hunt, Gail; Mahoney, Jane E.; Sieger, Carol E.

2002-01-01

Purpose: Advance directive (AD) documents are based on state-specific statutes and vary in terms of content. These differences can create confusion and inconsistencies resulting in a possible failure to honor the health care wishes of people who execute health care documents for one state and receive health care in another state. The purpose of…

Protecting prisoners' autonomy with advance directives: ethical dilemmas and policy issues.

PubMed

Andorno, Roberto; Shaw, David M; Elger, Bernice

2015-02-01

Over the last decade, several European countries and the Council of Europe itself have strongly supported the use of advance directives as a means of protecting patients' autonomy, and adopted specific norms to regulate this matter. However, it remains unclear under which conditions those regulations should apply to people who are placed in correctional settings. The issue is becoming more significant due to the increasing numbers of inmates of old age or at risk of suffering from mental disorders, all of whom might benefit from using advance directives. At the same time, the closed nature of prisons and the disparate power relationships that characterise them mean that great caution must be exercised to prevent care being withdrawn or withheld from inmates who actually want to receive it. This paper explores the issue of prisoners' advance directives in the European context, starting with the position enshrined in international and European law that prisoners retain all their human rights, except the right to liberty, and are therefore entitled to self-determination regarding health care decisions.

Health literacy: a study of internet-based information on advance directives.

PubMed

Stuart, Peter

2017-11-28

The aim of this study was to evaluate the quality and value of web-based information on advance directives. Internet-based information on advance directives was selected because, if it is inaccurate or difficult to understand, patients risk making decisions about their care that may not be followed in practice. Two validated health information evaluation tools, the Suitability Assessment of Materials and DISCERN, and a focus group were used to assess credibility, user orientation and effectiveness. Only one of the 34 internet-based information items on advance directives reviewed fulfilled the study criteria and 30% of the sites were classed as unreadable. In terms of learning and informing, 79% of the sites were considered unsuitable. Using health literacy tools to evaluate internet-based health information highlights that often it is not at a functional literacy level and neither informs nor empowers users to make independent and valid healthcare decisions. ©2017 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

[Experience assisting an AIDS-infected homosexual patient and his same-sex partner make a do-not-resuscitate decision].

PubMed

Wang, Shu-Jang; Lai, Pei-Yu; Liou, Siao-Ying; Ko, Wen-Chien; Ko, Nai-Ying

2012-10-01

Family members play an important role in the process of writing advance directives. Homosexual men infected with HIV often wish to authorize their intimate same-sex partner or friends rather than immediate family members to make medical decisions on their behalf. Although same-sex marriage is currently illegal in Taiwan, HIV infected homosexual patients are able to write advance directives appointing their same-sex partner to be their surrogate decision maker for end-of-life medical decisions. This case report describes an experience assisting a homosexual patient with HIV to write his advance directives. The nurse assisted the patient and his partner to make a self-determined decision not to resuscitate. Family conferences held to discuss the patient's decisions regarding resuscitation helped legitimize his partner's primary role in making end-of-life healthcare decisions on his behalf. As an advocate for patient rights, nurses should understand the law as it relates to homosexuality and end-of-life decision making, inform patients on the durable power of autonomy, and help execute their advance directives.

Crowdfunding the Azolla fern genome project: a grassroots approach.

PubMed

Li, Fay-Wei; Pryer, Kathleen M

2014-01-01

Much of science progresses within the tight boundaries of what is often seen as a "black box". Though familiar to funding agencies, researchers and the academic journals they publish in, it is an entity that outsiders rarely get to peek into. Crowdfunding is a novel means that allows the public to participate in, as well as to support and witness advancements in science. Here we describe our recent crowdfunding efforts to sequence the Azolla genome, a little fern with massive green potential. Crowdfunding is a worthy platform not only for obtaining seed money for exploratory research, but also for engaging directly with the general public as a rewarding form of outreach.

Crowdfunding the Azolla fern genome project: a grassroots approach

PubMed Central

2014-01-01

Much of science progresses within the tight boundaries of what is often seen as a “black box”. Though familiar to funding agencies, researchers and the academic journals they publish in, it is an entity that outsiders rarely get to peek into. Crowdfunding is a novel means that allows the public to participate in, as well as to support and witness advancements in science. Here we describe our recent crowdfunding efforts to sequence the Azolla genome, a little fern with massive green potential. Crowdfunding is a worthy platform not only for obtaining seed money for exploratory research, but also for engaging directly with the general public as a rewarding form of outreach. PMID:25276348

Parametric Study of Reactive Melt Infiltration

NASA Technical Reports Server (NTRS)

Nelson, Emily S.; Colella, Phillip

2000-01-01

Reactive melt infiltration is viewed as a promising means of achieving near-net shape manufacturing with quick processing time and at low cost. Since the reactants and products are, in general, of varying density, overall conservation of mass dictates that there is a force related to chemical conversion which can directly influence infiltration behavior. In effect, the driving pressure forces may compete with the forces from chemical conversion, affecting the advancement of the front. We have developed a two-dimensional numerical code to examine these effects, using reaction-formed silicon carbide as a model system for this process. We have examined a range of initial porosities, pore radii, and reaction rates in order to investigate their effects on infiltration dynamics.

Engineering Approaches to Illuminating Brain Structure and Dynamics

PubMed Central

Deisseroth, Karl; Schnitzer, Mark J.

2017-01-01

Historical milestones in neuroscience have come in diverse forms, ranging from the resolution of specific biological mysteries via creative experimentation to broad technological advances allowing neuroscientists to ask new kinds of questions. The continuous development of tools is driven with a special necessity by the complexity, fragility, and inaccessibility of intact nervous systems, such that inventive technique development and application drawing upon engineering and the applied sciences has long been essential to neuroscience. Here we highlight recent technological directions in neuroscience spurred by progress in optical, electrical, mechanical, chemical, and biological engineering. These research areas are poised for rapid growth and will likely be central to the practice of neuroscience well into the future. PMID:24183010

Calcium signaling in immune cells

PubMed Central

Vig, Monika; Kinet, Jean-Pierre

2010-01-01

Calcium acts as a second messenger in many cell types, including lymphocytes. Resting lymphocytes maintain a low concentration of Ca2+. However, engagement of antigen receptors induces calcium influx from the extracellular space by several routes. A chief mechanism of Ca2+ entry in lymphocytes is through store-operated calcium (SOC) channels. The identification of two important molecular components of SOC channels, CRACM1 (the pore-forming subunit) and STIM1 (the sensor of stored calcium), has allowed genetic and molecular manipulation of the SOC entry pathway. In this review, we highlight advances in the understanding of Ca2+ signaling in lymphocytes with special emphasis on SOC entry. We also discuss outstanding questions and probable future directions of the field. PMID:19088738

Protoplanetary disk observations in the ALMA era

NASA Astrophysics Data System (ADS)

Salyk, Colette

2018-06-01

In this talk, I’ll discuss how ALMA is advancing our understanding of protoplanetary disks with its unprecedented sensitivity and spatial resolution. In particular, I’ll focus on how ALMA is providing our first detailed view of gas-phase chemistry in giant planet forming regions, allowing us to test our ideas about how planets develop their diverse characteristics. Interpretation of these spectroscopic datasets requires sophisticated modeling tools and accurate laboratory data, as protoplanetary disks are ever-evolving environments that span a large range in density, temperature, and radiation field. I’ll discuss some recent results that highlight the important interplay between modeling and data analysis/interpretation, and suggest research directions that ALMA is likely to pursue going forward.

Large Eddy Simulations and Turbulence Modeling for Film Cooling

NASA Technical Reports Server (NTRS)

Acharya, Sumanta

1999-01-01

The objective of the research is to perform Direct Numerical Simulations (DNS) and Large Eddy Simulations (LES) for film cooling process, and to evaluate and improve advanced forms of the two equation turbulence models for turbine blade surface flow analysis. The DNS/LES were used to resolve the large eddies within the flow field near the coolant jet location. The work involved code development and applications of the codes developed to the film cooling problems. Five different codes were developed and utilized to perform this research. This report presented a summary of the development of the codes and their applications to analyze the turbulence properties at locations near coolant injection holes.

Application of BIM technology in green scientific research office building

NASA Astrophysics Data System (ADS)

Ni, Xin; Sun, Jianhua; Wang, Bo

2017-05-01

BIM technology as a kind of information technology, has been along with the advancement of building industrialization application in domestic building industry gradually. Based on reasonable construction BIM model, using BIM technology platform, through collaborative design tools can effectively improve the design efficiency and design quality. Vanda northwest engineering design and research institute co., LTD., the scientific research office building project in combination with the practical situation of engineering using BIM technology, formed in the BIM model combined with related information according to the energy energy model (BEM) and the application of BIM technology in construction management stage made exploration, and the direct experience and the achievements gained by the architectural design part made a summary.

A ground-based experimental test program to duplicate and study the spacecraft glow phenomenon

NASA Technical Reports Server (NTRS)

Langer, W. D.; Cohen, S. A.; Manos, D. M.; Mcneill, D. H.; Motley, R. W.; Ono, M.; Paul, S.

1985-01-01

The use of a plasma device, the Advanced Concepts Torus-I, for producing atoms and molecules to study spacecraft glow mechanisms is discussed. A biased metal plate, located in the plasma edge, is used to accelerate and neutralize plasma ions, thus generating a neutral beam with a flux approx. 5 x 10 to the 14th power/sq cm/sec at the end of a drift tube. Our initial experiments are to produce a 10 eV molecular and atomic nitrogen beam directed onto material targets. Photon emission in the spectral range 2000 to 9000 A from excited species formed on the target surface will be investigated.

Genetic control of inflorescence architecture in legumes

PubMed Central

Benlloch, Reyes; Berbel, Ana; Ali, Latifeh; Gohari, Gholamreza; Millán, Teresa; Madueño, Francisco

2015-01-01

The architecture of the inflorescence, the shoot system that bears the flowers, is a main component of the huge diversity of forms found in flowering plants. Inflorescence architecture has also a strong impact on the production of fruits and seeds, and on crop management, two highly relevant agronomical traits. Elucidating the genetic networks that control inflorescence development, and how they vary between different species, is essential to understanding the evolution of plant form and to being able to breed key architectural traits in crop species. Inflorescence architecture depends on the identity and activity of the meristems in the inflorescence apex, which determines when flowers are formed, how many are produced and their relative position in the inflorescence axis. Arabidopsis thaliana, where the genetic control of inflorescence development is best known, has a simple inflorescence, where the primary inflorescence meristem directly produces the flowers, which are thus borne in the main inflorescence axis. In contrast, legumes represent a more complex inflorescence type, the compound inflorescence, where flowers are not directly borne in the main inflorescence axis but, instead, they are formed by secondary or higher order inflorescence meristems. Studies in model legumes such as pea (Pisum sativum) or Medicago truncatula have led to a rather good knowledge of the genetic control of the development of the legume compound inflorescence. In addition, the increasing availability of genetic and genomic tools for legumes is allowing to rapidly extending this knowledge to other grain legume crops. This review aims to describe the current knowledge of the genetic network controlling inflorescence development in legumes. It also discusses how the combination of this knowledge with the use of emerging genomic tools and resources may allow rapid advances in the breeding of grain legume crops. PMID:26257753

Advanced Foreign Language Learning: A Challenge to College Programs. Issues in Language Program Direction.

ERIC Educational Resources Information Center

Byrnes, Heidi, Ed.; Maxim, Hiram H., Ed.

This book includes the following chapters: "Literacy and Advanced Foreign Language Learning: Rethinking he Curriculum" (Richard G. Kern); "A Template for Advanced Learner Tasks: Staging Genre Reading and Cultural Literacy Through the Precis" (Janet Swaffar); "Fostering Advanced L2 Literacy: A Genre-Based, Cognitive…

Apparatus for leaching core material from clad nuclear fuel pin segments

DOEpatents

Yarbro, Orlan O.

1980-01-01

This invention relates to improved apparatus for counter-currently contacting liquids and solids to dissolve, or leach, a selected component of the solids while minimizing back-mixing of the liquid phase. The apparatus includes an elongated drum which is rotatable about its longitudinal axis in either direction and is partitioned radially into a solids-inlet/liquid-outlet compartment at one end, a solids-outlet/liquid-inlet compartment at its other end, and leaching compartments therebetween. The drum is designed to operate with its acid-inlet end elevated and with the longitudinal axis of the drum at an angle in the range of from about 3.degree. to 14.degree. to the horizontal. Each leaching compartment contains a chute assembly for advancing solids into the next compartment in the direction of solids flow when the drum is rotated in a selected direction. The chute assembly includes a solids-transfer baffle and a chute in the form of a slotted, skewed, conical frustum portion. When the drum is rotated in the direction opposite to that effecting solids transfer, the solids-transfer baffles continually separate and re-mix the solids and liquids in their respective compartments. The partitions defining the leaching compartments are formed with corresponding outer, annular, imperforate regions, each region extending inwardly from the partition rim to an annular array of perforations concentric with the rim. In each leaching compartment, the spacing between the rim and the perforations determines the depth of liquid at the liquid-outlet end of the compartment. The liquid input to the drum assembly flows continuously through the compartments, preventing back-mixing due to density differences, whereas backflow due to waves generated by the solids-transfer baffles is virtually eliminated because of the tilted orientation of the drum assembly.

Compact Assumption Applied to the Monopole Term of Farassat's Formulations

NASA Technical Reports Server (NTRS)

Lopes, Leonard V.

2015-01-01

Farassat's formulations provide an acoustic prediction at an observer location provided a source surface, including motion and flow conditions. This paper presents compact forms for the monopole term of several of Farassat's formulations. When the physical surface is elongated, such as the case of a high aspect ratio rotorcraft blade, compact forms can be derived which are shown to be a function of the blade cross sectional area by reducing the computation from a surface integral to a line integral. The compact forms of all formulations are applied to two example cases: a short span wing with constant airfoil cross section moving at three forward flight Mach numbers and a rotor at two advance ratios. Acoustic pressure time histories and power spectral densities of monopole noise predicted from the compact forms of all the formulations at several observer positions are shown to compare very closely to the predictions from their non-compact counterparts. A study on the influence of rotorcraft blade shape on the high frequency portion of the power spectral density shows that there is a direct correlation between the aspect ratio of the airfoil and the error incurred by using the compact form. Finally, a prediction of pressure gradient from the non-compact and compact forms of the thickness term of Formulation G1A shows that using the compact forms results in a 99.6% improvement in computation time, which will be critical when noise is incorporated into a design environment.

Responses of hardwood advace regeneration to seasonal prescribed fires in oak-dominated shelterwood stands

Treesearch

Patrick H. Brose; David H. Van Lear

1998-01-01

Effects of seasonal prescribed fires of varying intensities on density, mortality, stem form, height, and height growth of hardwood advance regeneration were investigated. Three mixed-hardwood stands on productive upland sites were cut using a shelterwood technique, each forming a block of spring burn, summer burn, winter burn, and control treatments. Advance...

17 CFR 249.819 - Form 19b-4, for electronic filings with respect to proposed rule changes, advance notices and...

Code of Federal Regulations, 2013 CFR

2013-04-01

... self-regulatory organizations. 249.819 Section 249.819 Commodity and Securities Exchanges SECURITIES... changes, advance notices and security-based swap submissions by all self-regulatory organizations. This form shall be used by all self-regulatory organizations, as defined in Section 3(a)(26) of the...

17 CFR 249.819 - Form 19b-4, for electronic filings with respect to proposed rule changes, advance notices and...

Code of Federal Regulations, 2014 CFR

2014-04-01

... self-regulatory organizations. 249.819 Section 249.819 Commodity and Securities Exchanges SECURITIES... changes, advance notices and security-based swap submissions by all self-regulatory organizations. This form shall be used by all self-regulatory organizations, as defined in Section 3(a)(26) of the...

Integrated Evaluation Concept to Assess the Efficacy of Advanced Wastewater Treatment Processes for the Elimination of Micropollutants and Pathogens.

PubMed

Ternes, Thomas A; Prasse, Carsten; Eversloh, Christian Lütke; Knopp, Gregor; Cornel, Peter; Schulte-Oehlmann, Ulrike; Schwartz, Thomas; Alexander, Johannes; Seitz, Wolfram; Coors, Anja; Oehlmann, Jörg

2017-01-03

A multidisciplinary concept has been developed to compare advanced wastewater treatment processes for their efficacy of eliminating micropollutants and pathogens. The concept is based on (i) the removal/formation of selected indicator substances and their transformation products (TPs), (ii) the assessment of ecotoxicity via in vitro tests, and (iii) the removal of pathogens and antibiotic resistant bacteria. It includes substances passing biological wastewater treatment plants regulated or proposed to be regulated in the European Water Framework Directive, TPs formed in biological processes or during ozonation, agonistic/antagonistic endocrine activities, mutagenic/genotoxic activities, cytotoxic activities, further activities like neurotoxicity as well as antibiotics resistance genes, and taxonomic gene markers for pathogens. At a pilot plant, ozonation of conventionally treated wastewater resulted in the removal of micropollutants and pathogens and the reduction of estrogenic effects, whereas the in vitro mutagenicity increased. Subsequent post-treatment of the ozonated water by granular activated carbon (GAC) significantly reduced the mutagenic effects as well as the concentrations of remaining micropollutants, whereas this was not the case for biofiltration. The results demonstrate the suitability of the evaluation concept to assess processes of advanced wastewater treatment including ozonation and GAC by considering chemical, ecotoxicological, and microbiological parameters.

System Engineering and Integration of Controls for Advanced Life Support

NASA Technical Reports Server (NTRS)

Overland, David; Hoo, Karlene; Ciskowski, Marvin

2006-01-01

The Advanced Integration Matrix (AIM) project at the Johnson Space Center (JSC) was chartered to study and solve systems-level integration issues for exploration missions. One of the first issues identified was an inability to conduct trade studies on control system architectures due to the absence of mature evaluation criteria. Such architectures are necessary to enable integration of regenerative life support systems. A team was formed to address issues concerning software and hardware architectures and system controls.. The team has investigated what is required to integrate controls for the types of non-linear dynamic systems encountered in advanced life support. To this end, a water processing bioreactor testbed is being developed which will enable prototyping and testing of integration strategies and technologies. Although systems such as the water bioreactors exhibit the complexities of interactions between control schemes most vividly, it is apparent that this behavior and its attendant risks will manifest itself among any set of interdependent autonomous control systems. A methodology for developing integration requirements for interdependent and autonomous systems is a goal of this team and this testbed. This paper is a high-level summary of the current status of the investigation, the issues encountered, some tentative conclusions, and the direction expected for further research.

Biogenicity and Syngeneity of Organic Matter in Ancient Sedimentary Rocks: Recent Advances in the Search for Evidence of Past Life

NASA Astrophysics Data System (ADS)

Oehler, Dorothy Z.; Cady, Sherry L.

2014-08-01

The past decade has seen an explosion of new technologies for assessment of biogenicity and syngeneity of carbonaceous material within sedimentary rocks. Advances have been made in techniques for analysis of in situ organic matter as well as for extracted bulk samples of soluble and insoluble (kerogen) organic fractions. The in situ techniques allow analysis of micrometer-to-sub-micrometer-scale organic residues within their host rocks and include Raman and fluorescence spectroscopy/imagery, confocal laser scanning microscopy, and forms of secondary ion/laser-based mass spectrometry, analytical transmission electron microscopy, and X-ray absorption microscopy/spectroscopy. Analyses can be made for chemical, molecular, and isotopic composition coupled with assessment of spatial relationships to surrounding minerals, veins, and fractures. The bulk analyses include improved methods for minimizing contamination and recognizing syngenetic constituents of soluble organic fractions as well as enhanced spectroscopic and pyrolytic techniques for unlocking syngenetic molecular signatures in kerogen. Together, these technologies provide vital tools for the study of some of the oldest and problematic carbonaceous residues and for advancing our understanding of the earliest stages of biological evolution on Earth and the search for evidence of life beyond Earth. We discuss each of these new technologies, emphasizing their advantages and disadvantages, applications, and likely future directions.

R and D limited partnerships (possible applications in advanced communications satellite technology experiment program)

NASA Technical Reports Server (NTRS)

1985-01-01

Typical R&D limited partnership arrangements, advantages and disadvantages of R&D limited partnership (RDLPs) and antitrust and tax implications are described. A number of typical forms of RDLPs are described that may be applicable for use in stimulating R&D and experimental programs using the advanced communications technology satellite. The ultimate goal is to increase the rate of market penetration of goods and/or services based upon advanced satellite communications technology. The conditions necessary for these RDLP forms to be advantageous are outlined.

Development of the High-Order Decoupled Direct Method in Three Dimensions for Particulate Matter: Enabling Advanced Sensitivity Analysis in Air Quality Models

EPA Science Inventory

The high-order decoupled direct method in three dimensions for particular matter (HDDM-3D/PM) has been implemented in the Community Multiscale Air Quality (CMAQ) model to enable advanced sensitivity analysis. The major effort of this work is to develop high-order DDM sensitivity...

22 CFR 72.30 - Provisions in a will or advanced directive regarding disposition of remains.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Provisions in a will or advanced directive regarding disposition of remains. 72.30 Section 72.30 Foreign Relations DEPARTMENT OF STATE PROTECTION AND WELFARE OF AMERICANS, THEIR PROPERTY AND ESTATES DEATHS AND ESTATES Real Property Overseas Belonging to A...

Factors Affecting Long-Term-Care Residents' Decision-Making Processes as They Formulate Advance Directives

ERIC Educational Resources Information Center

Lambert, Heather C.; McColl, Mary Ann; Gilbert, Julie; Wong, Jiahui; Murray, Gale; Shortt, Samuel E. D.

2005-01-01

Purpose: The purpose of this study was to describe factors contributing to the decision-making processes of elderly persons as they formulate advance directives in long-term care. Design and Methods: This study was qualitative, based on grounded theory. Recruitment was purposive and continued until saturation was reached. Nine residents of a…

Palliative Care Processes Embedded in the ICU Workflow May Reserve Palliative Care Teams for Refractory Cases.

PubMed

Mun, Eluned; Umbarger, Lillian; Ceria-Ulep, Clementina; Nakatsuka, Craig

2018-01-01

Palliative Care Teams have been shown to be instrumental in the early identification of multiple aspects of advanced care planning. Despite an increased number of services to meet the rising consultation demand, it is conceivable that the numbers of palliative care consultations generated from an ICU alone could become overwhelming for an existing palliative care team. Improve end-of-life care in the ICU by incorporating basic palliative care processes into the daily routine ICU workflow, thereby reserving the palliative care team for refractory situations. A structured, palliative care, quality-improvement program was implemented and evaluated in the ICU at Kaiser Permanente Medical Center in Hawaii. This included selecting trigger criteria, a care model, forming guidelines, and developing evaluation criteria. These included the early identification of the multiple features of advanced care planning, numbers of proactive ICU and palliative care family meetings, and changes in code status and treatment upon completion of either meeting. Early identification of Goals-of-Care, advance directives, and code status by the ICU staff led to a proactive ICU family meeting with resultant increases in changes in code status and treatment. The numbers of palliative care consultations also rose, but not significantly. Palliative care processes could be incorporated into a daily ICU workflow allowing for integration of aspects of advanced care planning to be identified in a systematic and proactive manner. This reserved the palliative care team for situations when palliative care efforts performed by the ICU staff were ineffective.

1996 Laboratory directed research and development annual report

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

Meyers, C.E.; Harvey, C.L.; Lopez-Andreas, L.M.

This report summarizes progress from the Laboratory Directed Research and Development (LDRD) program during fiscal year 1996. In addition to a programmatic and financial overview, the report includes progress reports from 259 individual R&D projects in seventeen categories. The general areas of research include: engineered processes and materials; computational and information sciences; microelectronics and photonics; engineering sciences; pulsed power; advanced manufacturing technologies; biomedical engineering; energy and environmental science and technology; advanced information technologies; counterproliferation; advanced transportation; national security technology; electronics technologies; idea exploration and exploitation; production; and science at the interfaces - engineering with atoms.

End-of-life, euthanasia, and assisted suicide: An update on the situation in France.

PubMed

Aubry, R

2016-12-01

On February 2, 2016, the French parliament adopted legislation creating new rights for the terminally ill. The text modifies and reinforces the rights of patients to end-of-life care and strengthens the status of surrogate decision makers. Under the new regulations, advance directives become legally binding though not unenforceable. Two types of advance directives are distinguished depending on whether the person is suffering or not from a serious illness when drafting them. The attending physician must abide by the patient's advance directives except in three situations: there is a life-threatening emergency; the directives are manifestly inappropriate; the directives are not compatible with the patient's medical condition. There is no time limit on the validity of advance directives. They are to be written in concordance with a model elaborated by the French superior health authority. This model takes into account the person's knowledge (or not) of having a serious illness when drafting his/her advance directives. In all likelihood, physicians will be called upon to help patients elaborate their advance directives. The law also has a provision for a national registry - potentially the shared medical file - to be designed as a reference source to facilitate storage, accessibility and safety of advance directives. The law introduces the right to continuous deep sedation until death in three specific situations: (i) at the patient's request when the short-term prognosis is death and continuous deep sedation is the only alternative for relieving the patient's suffering or one or more otherwise uncontrollable symptoms; (ii) at the patient's request when the patient chooses to withdraw artificial life-sustaining treatment and such withdrawal would be rapidly life-shortening and susceptible to cause unbearable suffering; (iii) when the patient is unable to express his/her wishes and the collegiate medical decision is to withdraw aggressive futile life-sustaining treatment; continuous deep sedation is mandatory when the patient presents signs of suffering or when the patient's suffering cannot be evaluated due to the patient's cerebral or cognitive state. The law stipulates prior control of such practices, implying the development of a new type of collegiate procedure for medical decision-making. Satisfactory application of this new law will depend greatly on the implementing decrees. It will also depend on the implementation of a genuine policy for the development of palliative care. Professional guidelines will be needed. Several issues relevant to the field of neurology remain unresolved or are introduced by the new regulations. Further in-depth reflection and research are need. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

77 FR 470 - Specialty Crop Block Grant Program-Farm Bill Request for Extension and Revision of a Currently...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-05

... number 0348-0044) is required to show each project's budget breakdown. (c) Form SF-424B, ``Assurances-Non... Total Annual Burden on Respondents: 112 hours. (b) Form SF-270, ``Request for Advance and Reimbursement'' (approved under OMB collection number 0348-0004) is required whenever the grantees request an advance or...

Fatigue and Creep-Fatigue Deformation of an Ultra-Fine Precipitate Strengthened Advanced Austenitic Alloy

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

M.C. Carroll; L.J. Carroll

An advanced austenitic alloy, HT-UPS (high-temperature ultrafine-precipitation-strengthened), has been identified as an ideal candidate material for the structural components of fast reactors and energy-conversion systems. HT-UPS alloys demonstrate improved creep resistance relative to 316 stainless steel (SS) through additions of Ti and Nb, which precipitate to form a widespread dispersion of stable nanoscale metallic carbide (MC) particles in the austenitic matrix. The low-cycle fatigue and creep-fatigue behavior of an HT-UPS alloy have been investigated at 650 °C and a 1.0% total strain, with an R-ratio of -1 and hold times at peak tensile strain as long as 150 min. Themore » cyclic deformation response of HT-UPS is directly compared to that of standard 316 SS. The measured values for total cycles to failure are similar, despite differences in peak stress profiles and in qualitative observations of the deformed microstructures. Crack propagation is primarily transgranular in fatigue and creep-fatigue of both alloys at the investigated conditions. Internal grain boundary damage in the form of fine cracks resulting from the tensile hold is present for hold times of 60 min and longer, and substantially more internal cracks are quantifiable in 316 SS than in HT-UPS. The dislocation substructures observed in the deformed material differ significantly; an equiaxed cellular structure is observed in 316 SS, whereas in HT-UPS the microstructure takes the form of widespread and relatively homogenous tangles of dislocations pinned by the nanoscale MC precipitates. The significant effect of the fine distribution of precipitates on observed fatigue and creep-fatigue response is described in three distinct behavioral regions as it evolves with continued cycling.« less

The Intersection of Emotional and Sociocognitive Competencies with Civic Engagement in Middle Childhood and Adolescence.

PubMed

Metzger, Aaron; Alvis, Lauren M; Oosterhoff, Benjamin; Babskie, Elizabeth; Syvertsen, Amy; Wray-Lake, Laura

2018-03-23

Civic developmental theory anticipates connections between normative developmental competencies and civic engagement, but little previous research has directly studied such links. The current study sought to contribute to civic development theory by examining associations between emotional and sociocognitive competencies (empathy, emotion regulation, prosocial moral reasoning, future-orientation) and civic engagement (volunteering, informal helping, political behaviors and beliefs, environmental behaviors, social responsibility values, civic skills). Data came from a geographically and racially diverse sample of 2467 youth (M age  = 13.4, Range: 8-20 years, 56% female). The results indicated that empathy and future-orientation significantly predicted nearly all forms of civic engagement, whereas emotion regulation and prosocial moral reasoning were uniquely associated with specific forms of civic engagement. Exploratory multi-group models indicated that empathy and emotion regulation were more strongly associated with civic engagement among younger youth and prosocial moral reasoning and future-orientation were more strongly related to civic engagement among older youth. The findings help to advance developmental theory of youth civic engagement.

How can transcranial magnetic stimulation be used to causally manipulate memory representations in the human brain?

PubMed

Widhalm, Morgan L; Rose, Nathan S

2018-06-27

We present a focused review on the utility of transcranial magnetic stimulation (TMS) for modulating memory, with a particular focus on multimodal approaches in which TMS is paired with neuroimaging methods (electroencephalography and magnetic resonance imaging (MRI)) to manipulate and measure working memory processes. We contrast the utility of TMS for manipulating memory with other forms of noninvasive brain stimulation, as well as different forms of TMS including single-pulse, paired-pulse and repetitive TMS protocols. We discuss the potential for TMS to address fundamental cognitive neuroscience questions about the nature of memory processes and representations, while acknowledging the considerable variability of behavioral and neural outcomes in TMS studies. Also discussed are the limitations of this technology, current advancements that have helped to defray the impact of these limitations, and suggestions for future directions in research and methodology. This article is categorized under: Neuroscience > Clinical Neuroscience Neuroscience > Cognition Psychology > Memory. © 2018 Wiley Periodicals, Inc.

Highly Microporous Nitrogen-doped Carbon Synthesized from Azine-linked Covalent Organic Framework and its Supercapacitor Function.

PubMed

Kim, Gayoung; Yang, Jun; Nakashima, Naotoshi; Shiraki, Tomohiro

2017-12-11

Porous carbons with nitrogen-doped (N-doped) structures are promising materials for advanced energy conversion and storage applications, including supercapacitors and fuel cell catalysts. In this study, microporous N-doped carbon was successfully fabricated through carbonization of covalent organic frameworks (COFs) with an azine-linked two-dimensional molecular network (ACOF1). In the carbonized ACOF1, micropores with diameters smaller than 1 nm are selectively formed, and a high specific surface area (1596 cm 2  g -1 ) is achieved. In addition, the highly porous structure with N-doped sites results in enhancement of the electrochemical capacitance. Detailed investigation for the micropore-forming process reveals that the formation of nitrogen gas during the thermal degradation of the azine bond contributes to the microporous structure formation. Therefore, the present direct carbonization approach using COFs allows the fabrication of microporous heteroatom-doped carbons, based on molecularly designed COFs, toward future electrochemical and energy applications. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

Team science of nursing, engineering, statistics, and practitioner in the development of a robotic reflexology device.

PubMed

Wyatt, Gwen; Sikorskii, Alla; Bush, Tamara Reid; Mukherjee, Ranjan

2010-01-01

The purpose of this article is to share the lessons learned in forming an interdisciplinary team that implements a team science approach to integrative medicine (IM) research. The disciplines of nursing, statistics, and engineering, along with consultants and a reflexology practitioner, formed this university-based team to conceptualize and develop a prototype robotic device for reflexology for breast cancer patients. The nurse investigator contributed the intervention background and access to the population; the statistician guided the team thinking on factors that needed to be controlled for; the engineers provided the expertise in device design and development; consultants facilitated the team's thinking in new directions; and the reflexology practitioner prescribed the protocol. We discuss the contributions and achievements of each discipline, as well as the challenges, and share the team experiences with the intent to help guide the formation of new IM teams that promote a conducive atmosphere for carrying out cutting-edge IM research and advancing the science.

Panoramic projection avionics displays

NASA Astrophysics Data System (ADS)

Kalmanash, Michael H.

2003-09-01

Avionics projection displays are entering production in advanced tactical aircraft. Early adopters of this technology in the avionics community used projection displays to replace or upgrade earlier units incorporating direct-view CRT or AMLCD devices. Typical motivation for these upgrades were the alleviation of performance, cost and display device availability concerns. In these systems, the upgraded (projection) displays were one-for-one form / fit replacements for the earlier units. As projection technology has matured, this situation has begun to evolve. The Lockheed-Martin F-35 is the first program in which the cockpit has been specifically designed to take advantage of one of the more unique capabilities of rear projection display technology, namely the ability to replace multiple small screens with a single large conformal viewing surface in the form of a panoramic display. Other programs are expected to follow, since the panoramic formats enable increased mission effectiveness, reduced cost and greater information transfer to the pilot. Some of the advantages and technical challenges associated with panoramic projection displays for avionics applications are described below.

JAX Colony Management System (JCMS): an extensible colony and phenotype data management system.

PubMed

Donnelly, Chuck J; McFarland, Mike; Ames, Abigail; Sundberg, Beth; Springer, Dave; Blauth, Peter; Bult, Carol J

2010-04-01

The Jackson Laboratory Colony Management System (JCMS) is a software application for managing data and information related to research mouse colonies, associated biospecimens, and experimental protocols. JCMS runs directly on computers that run one of the PC Windows operating systems, but can be accessed via web browser interfaces from any computer running a Windows, Macintosh, or Linux operating system. JCMS can be configured for a single user or multiple users in small- to medium-size work groups. The target audience for JCMS includes laboratory technicians, animal colony managers, and principal investigators. The application provides operational support for colony management and experimental workflows, sample and data tracking through transaction-based data entry forms, and date-driven work reports. Flexible query forms allow researchers to retrieve database records based on user-defined criteria. Recent advances in handheld computers with integrated barcode readers, middleware technologies, web browsers, and wireless networks add to the utility of JCMS by allowing real-time access to the database from any networked computer.

Surface Modifications of Materials by Electrochemical Methods to Improve the Properties for Industrial and Medical Applications

NASA Astrophysics Data System (ADS)

Benea, Lidia

2018-06-01

There are two applied electrochemical methods in our group in order to obtain advanced functional surfaces on materials: (i) direct electrochemical synthesis by electro-codeposition process and (ii) anodization of materials to form nanoporous oxide layers followed by electrodeposition of hydroxyapatite or other bioactive molecules and compounds into porous film. Electrodeposition is a process of low energy consumption, and therefore very convenient for the surface modification of various types of materials. Electrodeposition is a powerful method compared with other methods, which led her to be adopted and spread rapidly in nanotechnology to obtain nanostructured layers and films. Nanoporous thin oxide layers on titanum alloys as support for hydroxyapatite or other biomolecules electrodeposition in view of biomedical applications could be obtained by electrochemical methods. For surface modification of titanium or titanium alloys to improve the biocompatibility or osseointegration, the two steps must be fulfilled; the first is controlled growth of oxide layer followed by second being biomolecule electrodeposition into nanoporous formed titanium oxide layer.

Complementation of mitochondrial electron transport chain by manipulation of the NAD+/NADH ratio.

PubMed

Titov, Denis V; Cracan, Valentin; Goodman, Russell P; Peng, Jun; Grabarek, Zenon; Mootha, Vamsi K

2016-04-08

A decline in electron transport chain (ETC) activity is associated with many human diseases. Although diminished mitochondrial adenosine triphosphate production is recognized as a source of pathology, the contribution of the associated reduction in the ratio of the amount of oxidized nicotinamide adenine dinucleotide (NAD(+)) to that of its reduced form (NADH) is less clear. We used a water-forming NADH oxidase from Lactobacillus brevis (LbNOX) as a genetic tool for inducing a compartment-specific increase of the NAD(+)/NADH ratio in human cells. We used LbNOX to demonstrate the dependence of key metabolic fluxes, gluconeogenesis, and signaling on the cytosolic or mitochondrial NAD(+)/NADH ratios. Expression of LbNOX in the cytosol or mitochondria ameliorated proliferative and metabolic defects caused by an impaired ETC. The results underscore the role of reductive stress in mitochondrial pathogenesis and demonstrate the utility of targeted LbNOX for direct, compartment-specific manipulation of redox state. Copyright © 2016, American Association for the Advancement of Science.

Glasslike Membrane Protein Diffusion in a Crowded Membrane.

PubMed

Munguira, Ignacio; Casuso, Ignacio; Takahashi, Hirohide; Rico, Felix; Miyagi, Atsushi; Chami, Mohamed; Scheuring, Simon

2016-02-23

Many functions of the plasma membrane depend critically on its structure and dynamics. Observation of anomalous diffusion in vivo and in vitro using fluorescence microscopy and single particle tracking has advanced our concept of the membrane from a homogeneous fluid bilayer with freely diffusing proteins to a highly organized crowded and clustered mosaic of lipids and proteins. Unfortunately, anomalous diffusion could not be related to local molecular details given the lack of direct and unlabeled molecular observation capabilities. Here, we use high-speed atomic force microscopy and a novel analysis methodology to analyze the pore forming protein lysenin in a highly crowded environment and document coexistence of several diffusion regimes within one membrane. We show the formation of local glassy phases, where proteins are trapped in neighbor-formed cages for time scales up to 10 s, which had not been previously experimentally reported for biological membranes. Furthermore, around solid-like patches and immobile molecules a slower glass phase is detected leading to protein trapping and creating a perimeter of decreased membrane diffusion.

Left-handed Z-DNA: structure and function

NASA Technical Reports Server (NTRS)

Herbert, A.; Rich, A.

1999-01-01

Z-DNA is a high energy conformer of B-DNA that forms in vivo during transcription as a result of torsional strain generated by a moving polymerase. An understanding of the biological role of Z-DNA has advanced with the discovery that the RNA editing enzyme double-stranded RNA adenosine deaminase type I (ADAR1) has motifs specific for the Z-DNA conformation. Editing by ADAR1 requires a double-stranded RNA substrate. In the cases known, the substrate is formed by folding an intron back onto the exon that is targeted for modification. The use of introns to direct processing of exons requires that editing occurs before splicing. Recognition of Z-DNA by ADAR1 may allow editing of nascent transcripts to be initiated immediately after transcription, ensuring that editing and splicing are performed in the correct sequence. Structural characterization of the Z-DNA binding domain indicates that it belongs to the winged helix-turn-helix class of proteins and is similar to the globular domain of histone-H5.

Cell electrospinning: a novel tool for functionalising fibres, scaffolds and membranes with living cells and other advanced materials for regenerative biology and medicine.

PubMed

Jayasinghe, Suwan N

2013-04-21

Recent years have seen interest in approaches for directly generating fibers and scaffolds following a rising trend for their exploration in the health sciences. In this review the author wishes to briefly highlight the many approaches explored to date for generating such structures, while underlining their advantages and disadvantages, and their contribution in particular to the biomedical sciences. Such structures have been demonstrated as having implications in both the laboratory and the clinic, as they mimic the native extra cellular matrix. Interestingly the only materials investigated until very recently for generating fibrous architectures employed either natural or synthetic polymers with or without the addition of functional molecule(s). Arguably although such constructs have been demonstrated to have many applications, they lack the one unit most important for carrying out the ability to directly reconstruct a three-dimensional functional tissue, namely living cells. Therefore recent findings have demonstrated the ability to directly form cell-laden fibers and scaffolds in useful quantities from which functional three-dimensional living tissues can be conceived. These recent developments have far-reaching ramifications to many areas of research and development, a few of which range from tissue engineering and regenerative medicine, a novel approach to analyzing cell behavior and function in real time in three-dimensions, to the advanced controlled and targeted delivery of experimental and/or medical cells and/or genes for localized treatment. At present these developments have passed all in vitro and in vivo mouse model based challenge trials and are now spearheading their journey towards initiating human clinical trials.

Planning for Advanced Cancer

Cancer.gov

Find out what issues need to be addressed when dealing with an advanced or metastatic cancer diagnosis. Completing advance directives, looking at health insurance, organizing records and documents, and looking at the meanings in your life are some of the things to think about.

DETECTION OF WHITE DWARF COMPANIONS TO BLUE STRAGGLERS IN THE OPEN CLUSTER NGC 188: DIRECT EVIDENCE FOR RECENT MASS TRANSFER

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

Gosnell, Natalie M.; Mathieu, Robert D.; Geller, Aaron M.

2014-03-01

Several possible formation pathways for blue straggler stars have been developed recently, but no one pathway has yet been observationally confirmed for a specific blue straggler. Here we report the first findings from a Hubble Space Telescope Advanced Camera for Surveys/Solar Blind Channel far-UV photometric program to search for white dwarf companions to blue straggler stars. We find three hot and young white dwarf companions to blue straggler stars in the 7 Gyr open cluster NGC 188, indicating that mass transfer in these systems ended less than 300 Myr ago. These companions are direct and secure observational evidence that these blue straggler starsmore » were formed through mass transfer in binary stars. Their existence in a well-studied cluster environment allows for observational constraints of both the current binary system and the progenitor binary system, mapping the entire mass transfer history.« less

A compact model and direct parameters extraction techniques For amorphous gallium-indium-zinc-oxide thin film transistors

NASA Astrophysics Data System (ADS)

Moldovan, Oana; Castro-Carranza, Alejandra; Cerdeira, Antonio; Estrada, Magali; Barquinha, Pedro; Martins, Rodrigo; Fortunato, Elvira; Miljakovic, Slobodan; Iñiguez, Benjamin

2016-12-01

An advanced compact and analytical drain current model for the amorphous gallium indium zinc oxide (GIZO) thin film transistors (TFTs) is proposed. Its output saturation behavior is improved by introducing a new asymptotic function. All model parameters were extracted using an adapted version of the Universal Method and Extraction Procedure (UMEM) applied for the first time for GIZO devices in a simple and direct form. We demonstrate the correct behavior of the model for negative VDS, a necessity for a complete compact model. In this way we prove the symmetry of source and drain electrodes and extend the range of applications to both signs of VDS. The model, in Verilog-A code, is implemented in Electronic Design Automation (EDA) tools, such as Smart Spice, and compared with measurements of TFTs. It describes accurately the experimental characteristics in the whole range of GIZO TFTs operation, making the model suitable for the design of circuits using these types of devices.

A numerical model for predicting crack path and modes of damage in unidirectional metal matrix composites

NASA Technical Reports Server (NTRS)

Bakuckas, J. G.; Tan, T. M.; Lau, A. C. W.; Awerbuch, J.

1993-01-01

A finite element-based numerical technique has been developed to simulate damage growth in unidirectional composites. This technique incorporates elastic-plastic analysis, micromechanics analysis, failure criteria, and a node splitting and node force relaxation algorithm to create crack surfaces. Any combination of fiber and matrix properties can be used. One of the salient features of this technique is that damage growth can be simulated without pre-specifying a crack path. In addition, multiple damage mechanisms in the forms of matrix cracking, fiber breakage, fiber-matrix debonding and plastic deformation are capable of occurring simultaneously. The prevailing failure mechanism and the damage (crack) growth direction are dictated by the instantaneous near-tip stress and strain fields. Once the failure mechanism and crack direction are determined, the crack is advanced via the node splitting and node force relaxation algorithm. Simulations of the damage growth process in center-slit boron/aluminum and silicon carbide/titanium unidirectional specimens were performed. The simulation results agreed quite well with the experimental observations.

The basic physics of the binary black hole merger GW150914

NASA Astrophysics Data System (ADS)

Abbott, B. P.; Abbott, R.; Abbott, T. D.; Abernathy, M. R.; Acernese, F.; Ackley, K.; Adams, C.; Adams, T.; Addesso, P.; Adhikari, R. X.; Adya, V. B.; Affeldt, C.; Agathos, M.; Agatsuma, K.; Aggarwal, N.; Aguiar, O. D.; Aiello, L.; Ain, A.; Ajith, P.; Allen, B.; Allocca, A.; Altin, P. A.; Anderson, S. B.; Anderson, W. G.; Arai, K.; Araya, M. C.; Arceneaux, C. C.; Areeda, J. S.; Arnaud, N.; Arun, K. G.; Ascenzi, S.; Ashton, G.; Ast, M.; Aston, S. M.; Astone, P.; Aufmuth, P.; Aulbert, C.; Babak, S.; Bacon, P.; Bader, M. K. M.; Baldaccini, F.; Ballardin, G.; Ballmer, S. W.; Barayoga, J. C.; Barclay, S. E.; Barish, B. C.; Barker, D.; Barone, F.; Barr, B.; Barsotti, L.; Barsuglia, M.; Barta, D.; Bartlett, J.; Bartos, I.; Bassiri, R.; Basti, A.; Batch, J. C.; Baune, C.; Bavigadda, V.; Bazzan, M.; Bejger, M.; Bell, A. S.; Bergmann, G.; Berry, C. P. L.; Bersanetti, D.; Bertolini, A.; Betzwieser, J.; Bhagwat, S.; Bhandare, R.; Bilenko, I. A.; Billingsley, G.; Birch, J.; Birney, R.; Birnholtz, O.; Biscans, S.; Bisht, A.; Bitossi, M.; Biwer, C.; Bizouard, M. A.; Blackburn, J. K.; Blair, C. D.; Blair, D. G.; Blair, R. M.; Bloemen, S.; Bock, O.; Boer, M.; Bogaert, G.; Bogan, C.; Bohe, A.; Bond, C.; Bondu, F.; Bonnand, R.; Boom, B. A.; Bork, R.; Boschi, V.; Bose, S.; Bouffanais, Y.; Bozzi, A.; Bradaschia, C.; Braginsky, V. B.; Branchesi, M.; Brau, J. E.; Briant, T.; Brillet, A.; Brinkmann, M.; Brisson, V.; Brockill, P.; Broida, J. E.; Brooks, A. F.; Brown, D. A.; Brown, D. D.; Brown, N. M.; Brunett, S.; Buchanan, C. C.; Buikema, A.; Bulik, T.; Bulten, H. J.; Buonanno, A.; Buskulic, D.; Buy, C.; Byer, R. L.; Cabero, M.; Cadonati, L.; Cagnoli, G.; Cahillane, C.; Bustillo, J. Calderón; Callister, T.; Calloni, E.; Camp, J. B.; Cannon, K. C.; Cao, J.; Capano, C. D.; Capocasa, E.; Carbognani, F.; Caride, S.; Casanueva Diaz, J.; Casentini, C.; Caudill, S.; Cavaglià, M.; Cavalier, F.; Cavalieri, R.; Cella, G.; Cepeda, C. B.; Cerboni Baiardi, L.; Cerretani, G.; Cesarini, E.; Chamberlin, S. J.; Chan, M.; Chao, S.; Charlton, P.; Chassande-Mottin, E.; Chen, H. Y.; Chen, Y.; Cheng, C.; Chincarini, A.; Chiummo, A.; Cho, H. S.; Cho, M.; Chow, J. H.; Christensen, N.; Chu, Q.; Chua, S.; Chung, S.; Ciani, G.; Clara, F.; Clark, J. A.; Cleva, F.; Coccia, E.; Cohadon, P.-F.; Colla, A.; Collette, C. G.; Cominsky, L.; Constancio, M., Jr.; Conte, A.; Conti, L.; Cook, D.; Corbitt, T. R.; Corsi, A.; Cortese, S.; Costa, C. A.; Coughlin, M. W.; Coughlin, S. B.; Coulon, J.-P.; Countryman, S. T.; Couvares, P.; Cowan, E. E.; Coward, D. M.; Cowart, M. J.; Coyne, D. C.; Coyne, R.; Craig, K.; Creighton, J. D. E.; Cripe, J.; Crowder, S. G.; Cumming, A.; Cunningham, L.; Cuoco, E.; Dal Canton, T.; Danilishin, S. L.; D'Antonio, S.; Danzmann, K.; Darman, N. S.; Dasgupta, A.; Da Silva Costa, C. F.; Dattilo, V.; Dave, I.; Davier, M.; Davies, G. S.; Daw, E. J.; Day, R.; De, S.; DeBra, D.; Debreczeni, G.; Degallaix, J.; De Laurentis, M.; Deléglise, S.; Del Pozzo, W.; Denker, T.; Dent, T.; Dergachev, V.; De Rosa, R.; DeRosa, R. T.; DeSalvo, R.; Devine, R. C.; Dhurandhar, S.; Díaz, M. C.; Fiore, L. Di; Giovanni, M. Di; Girolamo, T. Di; Lieto, A. Di; Pace, S. Di; Palma, I. Di; Virgilio, A. Di; Dolique, V.; Donovan, F.; Dooley, K. L.; Doravari, S.; Douglas, R.; Downes, T. P.; Drago, M.; Drever, R. W. P.; Driggers, J. C.; Ducrot, M.; Dwyer, S. E.; Edo, T. B.; Edwards, M. C.; Effler, A.; Eggenstein, H.-B.; Ehrens, P.; Eichholz, J.; Eikenberry, S. S.; Engels, W.; Essick, R. C.; Etzel, T.; Evans, M.; Evans, T. M.; Everett, R.; Factourovich, M.; Fafone, V.; Fair, H.; Fairhurst, S.; Fan, X.; Fang, Q.; Farinon, S.; Farr, B.; Farr, W. M.; Favata, M.; Fays, M.; Fehrmann, H.; Fejer, M. M.; Fenyvesi, E.; Ferrante, I.; Ferreira, E. C.; Ferrini, F.; Fidecaro, F.; Fiori, I.; Fiorucci, D.; Fisher, R. P.; Flaminio, R.; Fletcher, M.; Fournier, J.-D.; Frasca, S.; Frasconi, F.; Frei, Z.; Freise, A.; Frey, R.; Frey, V.; Fritschel, P.; Frolov, V. V.; Fulda, P.; Fyffe, M.; Gabbard, H. A. G.; Gair, J. R.; Gammaitoni, L.; Gaonkar, S. G.; Garufi, F.; Gaur, G.; Gehrels, N.; Gemme, G.; Geng, P.; Genin, E.; Gennai, A.; George, J.; Gergely, L.; Germain, V.; Ghosh, Abhirup; Ghosh, Archisman; Ghosh, S.; Giaime, J. A.; Giardina, K. D.; Giazotto, A.; Gill, K.; Glaefke, A.; Goetz, E.; Goetz, R.; Gondan, L.; González, G.; Gonzalez Castro, J. M.; Gopakumar, A.; Gordon, N. A.; Gorodetsky, M. L.; Gossan, S. E.; Gosselin, M.; Gouaty, R.; Grado, A.; Graef, C.; Graff, P. B.; Granata, M.; Grant, A.; Gras, S.; Gray, C.; Greco, G.; Green, A. C.; Groot, P.; Grote, H.; Grunewald, S.; Guidi, G. M.; Guo, X.; Gupta, A.; Gupta, M. K.; Gushwa, K. E.; Gustafson, E. K.; Gustafson, R.; Hacker, J. J.; Hall, B. R.; Hall, E. D.; Hammond, G.; Haney, M.; Hanke, M. M.; Hanks, J.; Hanna, C.; Hannam, M. D.; Hanson, J.; Hardwick, T.; Harms, J.; Harry, G. M.; Harry, I. W.; Hart, M. J.; Hartman, M. T.; Haster, C.-J.; Haughian, K.; Heidmann, A.; Heintze, M. C.; Heitmann, H.; Hello, P.; Hemming, G.; Hendry, M.; Heng, I. S.; Hennig, J.; Henry, J.; Heptonstall, A. W.; Heurs, M.; Hild, S.; Hoak, D.; Hofman, D.; Holt, K.; Holz, D. E.; Hopkins, P.; Hough, J.; Houston, E. A.; Howell, E. J.; Hu, Y. M.; Huang, S.; Huerta, E. A.; Huet, D.; Hughey, B.; Husa, S.; Huttner, S. H.; Huynh-Dinh, T.; Indik, N.; Ingram, D. R.; Inta, R.; Isa, H. N.; Isac, J.-M.; Isi, M.; Isogai, T.; Iyer, B. R.; Izumi, K.; Jacqmin, T.; Jang, H.; Jani, K.; Jaranowski, P.; Jawahar, S.; Jian, L.; Jiménez-Forteza, F.; Johnson, W. W.; Jones, D. I.; Jones, R.; Jonker, R. J. G.; Ju, L.; K, Haris; Kalaghatgi, C. V.; Kalogera, V.; Kandhasamy, S.; Kang, G.; Kanner, J. B.; Kapadia, S. J.; Karki, S.; Karvinen, K. S.; Kasprzack, M.; Katsavounidis, E.; Katzman, W.; Kaufer, S.; Kaur, T.; Kawabe, K.; Kéfélian, F.; Kehl, M. S.; Keitel, D.; Kelley, D. B.; Kells, W.; Kennedy, R.; Key, J. S.; Khalili, F. Y.; Khan, I.; Khan, S.; Khan, Z.; Khazanov, E. A.; Kijbunchoo, N.; Kim, Chi-Woong; Kim, Chunglee; Kim, J.; Kim, K.; Kim, N.; Kim, W.; Kim, Y.-M.; Kimbrell, S. J.; King, E. J.; King, P. J.; Kissel, J. S.; Klein, B.; Kleybolte, L.; Klimenko, S.; Koehlenbeck, S. M.; Koley, S.; Kondrashov, V.; Kontos, A.; Korobko, M.; Korth, W. Z.; Kowalska, I.; Kozak, D. B.; Kringel, V.; Krishnan, B.; Królak, A.; Krueger, C.; Kuehn, G.; Kumar, P.; Kumar, R.; Kuo, L.; Kutynia, A.; Lackey, B. D.; Landry, M.; Lange, J.; Lantz, B.; Lasky, P. D.; Laxen, M.; Lazzarini, A.; Lazzaro, C.; Leaci, P.; Leavey, S.; Lebigot, E. O.; Lee, C. H.; Lee, H. K.; Lee, H. M.; Lee, K.; Lenon, A.; Leonardi, M.; Leong, J. R.; Leroy, N.; Letendre, N.; Levin, Y.; Lewis, J. B.; Li, T. G. F.; Libson, A.; Littenberg, T. B.; Lockerbie, N. A.; Lombardi, A. L.; London, L. T.; Lord, J. E.; Lorenzini, M.; Loriette, V.; Lormand, M.; Losurdo, G.; Lough, J. D.; Lück, H.; Lundgren, A. P.; Lynch, R.; Ma, Y.; Machenschalk, B.; MacInnis, M.; Macleod, D. M.; Magaña-Sandoval, F.; Zertuche, L. Magaña; Magee, R. M.; Majorana, E.; Maksimovic, I.; Malvezzi, V.; Man, N.; Mandic, V.; Mangano, V.; Mansell, G. L.; Manske, M.; Mantovani, M.; Marchesoni, F.; Marion, F.; Márka, S.; Márka, Z.; Markosyan, A. S.; Maros, E.; Martelli, F.; Martellini, L.; Martin, I. W.; Martynov, D. V.; Marx, J. N.; Mason, K.; Masserot, A.; Massinger, T. J.; Masso-Reid, M.; Mastrogiovanni, S.; Matichard, F.; Matone, L.; Mavalvala, N.; Mazumder, N.; McCarthy, R.; McClelland, D. E.; McCormick, S.; McGuire, S. C.; McIntyre, G.; McIver, J.; McManus, D. J.; McRae, T.; Meacher, D.; Meadors, G. D.; Meidam, J.; Melatos, A.; Mendell, G.; Mercer, R. A.; Merilh, E. L.; Merzougui, M.; Meshkov, S.; Messenger, C.; Messick, C.; Metzdorff, R.; Meyers, P. M.; Mezzani, F.; Miao, H.; Michel, C.; Middleton, H.; Mikhailov, E. E.; Milano, L.; Miller, A. L.; Miller, A.; Miller, B. B.; Miller, J.; Millhouse, M.; Minenkov, Y.; Ming, J.; Mirshekari, S.; Mishra, C.; Mitra, S.; Mitrofanov, V. P.; Mitselmakher, G.; Mittleman, R.; Moggi, A.; Mohan, M.; Mohapatra, S. R. P.; Montani, M.; Moore, B. C.; Moore, C. J.; Moraru, D.; Moreno, G.; Morriss, S. R.; Mossavi, K.; Mours, B.; Mow-Lowry, C. M.; Mueller, G.; Muir, A. W.; Mukherjee, Arunava; Mukherjee, D.; Mukherjee, S.; Mukund, N.; Mullavey, A.; Munch, J.; Murphy, D. J.; Murray, P. G.; Mytidis, A.; Nardecchia, I.; Naticchioni, L.; Nayak, R. K.; Nedkova, K.; Nelemans, G.; Nelson, T. J. N.; Neri, M.; Neunzert, A.; Newton, G.; Nguyen, T. T.; Nielsen, A. B.; Nissanke, S.; Nitz, A.; Nocera, F.; Nolting, D.; Normandin, M. E. N.; Nuttall, L. K.; Oberling, J.; Ochsner, E.; O'Dell, J.; Oelker, E.; Ogin, G. H.; Oh, J. J.; Oh, S. H.; Ohme, F.; Oliver, M.; Oppermann, P.; Oram, Richard J.; O'Reilly, B.; O'Shaughnessy, R.; Ottaway, D. J.; Overmier, H.; Owen, B. J.; Pai, A.; Pai, S. A.; Palamos, J. R.; Palashov, O.; Palomba, C.; Pal-Singh, A.; Pan, H.; Pankow, C.; Pannarale, F.; Pant, B. C.; Paoletti, F.; Paoli, A.; Papa, M. A.; Paris, H. R.; Parker, W.; Pascucci, D.; Pasqualetti, A.; Passaquieti, R.; Passuello, D.; Patricelli, B.; Patrick, Z.; Pearlstone, B. L.; Pedraza, M.; Pedurand, R.; Pekowsky, L.; Pele, A.; Penn, S.; Perreca, A.; Perri, L. M.; Phelps, M.; Piccinni, O. J.; Pichot, M.; Piergiovanni, F.; Pierro, V.; Pillant, G.; Pinard, L.; Pinto, I. M.; Pitkin, M.; Poe, M.; Poggiani, R.; Popolizio, P.; Post, A.; Powell, J.; Prasad, J.; Pratt, J.; Predoi, V.; Prestegard, T.; Price, L. R.; Prijatelj, M.; Principe, M.; Privitera, S.; Prix, R.; Prodi, G. A.; Prokhorov, L.; Puncken, O.; Punturo, M.; Puppo, P.; Pürrer, M.; Qi, H.; Qin, J.; Qiu, S.; Quetschke, V.; Quintero, E. A.; Quitzow-James, R.; Raab, F. J.; Rabeling, D. S.; Radkins, H.; Raffai, P.; Raja, S.; Rajan, C.; Rakhmanov, M.; Rapagnani, P.; Raymond, V.; Razzano, M.; Re, V.; Read, J.; Reed, C. M.; Regimbau, T.; Rei, L.; Reid, S.; Rew, H.; Reyes, S. D.; Ricci, F.; Riles, K.; Rizzo, M.; Robertson, N. A.; Robie, R.; Robinet, F.; Rocchi, A.; Rolland, L.; Rollins, J. G.; Roma, V. J.; Romano, J. D.; Romano, R.; Romanov, G.; Romie, J. H.; Rosińska, D.; Rowan, S.; Rüdiger, A.; Ruggi, P.; Ryan, K.; Sachdev, S.; Sadecki, T.; Sadeghian, L.; Sakellariadou, M.; Salconi, L.; Saleem, M.; Salemi, F.; Samajdar, A.; Sammut, L.; Sanchez, E. J.; Sandberg, V.; Sandeen, B.; Sanders, J. R.; Sassolas, B.; Saulson, P. R.; Sauter, O. E. S.; Savage, R. L.; Sawadsky, A.; Schale, P.; Schilling, R.; Schmidt, J.; Schmidt, P.; Schnabel, R.; Schofield, R. M. S.; Schönbeck, A.; Schreiber, E.; Schuette, D.; Schutz, B. F.; Scott, J.; Scott, S. M.; Sellers, D.; Sengupta, A. S.; Sentenac, D.; Sequino, V.; Sergeev, A.; Setyawati, Y.; Shaddock, D. A.; Shaffer, T.; Shahriar, M. S.; Shaltev, M.; Shapiro, B.; Shawhan, P.; Sheperd, A.; Shoemaker, D. H.; Shoemaker, D. M.; Siellez, K.; Siemens, X.; Sieniawska, M.; Sigg, D.; Silva, A. D.; Singer, A.; Singer, L. P.; Singh, A.; Singh, R.; Singhal, A.; Sintes, A. M.; Slagmolen, B. J. J.; Smith, J. R.; Smith, N. D.; Smith, R. J. E.; Son, E. J.; Sorazu, B.; Sorrentino, F.; Souradeep, T.; Srivastava, A. K.; Staley, A.; Steinke, M.; Steinlechner, J.; Steinlechner, S.; Steinmeyer, D.; Stephens, B. C.; Stone, R.; Strain, K. A.; Straniero, N.; Stratta, G.; Strauss, N. A.; Strigin, S.; Sturani, R.; Stuver, A. L.; Summerscales, T. Z.; Sun, L.; Sunil, S.; Sutton, P. J.; Swinkels, B. L.; Szczepańczyk, M. J.; Tacca, M.; Talukder, D.; Tanner, D. B.; Tápai, M.; Tarabrin, S. P.; Taracchini, A.; Taylor, R.; Theeg, T.; Thirugnanasambandam, M. P.; Thomas, E. G.; Thomas, M.; Thomas, P.; Thorne, K. A.; Thorne, K. S.; Thrane, E.; Tiwari, S.; Tiwari, V.; Tokmakov, K. V.; Toland, K.; Tomlinson, C.; Tonelli, M.; Tornasi, Z.; Torres, C. V.; Torrie, C. I.; Töyrä, D.; Travasso, F.; Traylor, G.; Trifirò, D.; Tringali, M. C.; Trozzo, L.; Tse, M.; Turconi, M.; Tuyenbayev, D.; Ugolini, D.; Unnikrishnan, C. S.; Urban, A. L.; Usman, S. A.; Vahlbruch, H.; Vajente, G.; Valdes, G.; van Bakel, N.; van Beuzekom, M.; van den Brand, J. F. J.; Van Den Broeck, C.; Vander-Hyde, D. C.; van der Schaaf, L.; van Heijningen, J. V.; van Veggel, A. A.; Vardaro, M.; Vass, S.; Vasúth, M.; Vaulin, R.; Vecchio, A.; Vedovato, G.; Veitch, J.; Veitch, P. J.; Venkateswara, K.; Verkindt, D.; Vetrano, F.; Viceré, A.; Vinciguerra, S.; Vine, D. J.; Vinet, J.-Y.; Vitale, S.; Vo, T.; Vocca, H.; Vorvick, C.; Voss, D. V.; Vousden, W. D.; Vyatchanin, S. P.; Wade, A. R.; Wade, L. E.; Wade, M.; Walker, M.; Wallace, L.; Walsh, S.; Wang, G.; Wang, H.; Wang, M.; Wang, X.; Wang, Y.; Ward, R. L.; Warner, J.; Was, M.; Weaver, B.; Wei, L.-W.; Weinert, M.; Weinstein, A. J.; Weiss, R.; Wen, L.; Weßels, P.; Westphal, T.; Wette, K.; Whelan, J. T.; Whiting, B. F.; Williams, R. D.; Williamson, A. R.; Willis, J. L.; Willke, B.; Wimmer, M. H.; Winkler, W.; Wipf, C. C.; Wiseman, A. G.; Wittel, H.; Woan, G.; Woehler, J.; Worden, J.; Wright, J. L.; Wu, D. S.; Wu, G.; Yablon, J.; Yam, W.; Yamamoto, H.; Yancey, C. C.; Yu, H.; Yvert, M.; Zadrożny, A.; Zangrando, L.; Zanolin, M.; Zendri, J.-P.; Zevin, M.; Zhang, L.; Zhang, M.; Zhang, Y.; Zhao, C.; Zhou, M.; Zhou, Z.; Zhu, X. J.; Zucker, M. E.; Zuraw, S. E.; Zweizig, J.

2017-01-01

The first direct gravitational-wave detection was made by the Advanced Laser Interferometer Gravitational Wave Observatory on September 14, 2015. The GW150914 signal was strong enough to be apparent, without using any waveform model, in the filtered detector strain data. Here, features of the signal visible in the data are analyzed using concepts from Newtonian physics and general relativity, accessible to anyone with a general physics background. The simple analysis presented here is consistent with the fully general-relativistic analyses published elsewhere,in showing that the signal was produced by the inspiral and subsequent merger of two black holes. The black holes were each of approximately 35 Msun, still orbited each other as close as ~350 km apart, and subsequently merged to form a single black hole. Similar reasoning, directly from the data, is used to roughly estimate how far these black holes were from the Earth, and the energy that they radiated in gravitational waves.

How Large Scales Flows May Influence Solar Activity

NASA Technical Reports Server (NTRS)

Hathaway, D. H.

2004-01-01

Large scale flows within the solar convection zone are the primary drivers of the Sun's magnetic activity cycle and play important roles in shaping the Sun's magnetic field. Differential rotation amplifies the magnetic field through its shearing action and converts poloidal field into toroidal field. Poleward meridional flow near the surface carries magnetic flux that reverses the magnetic poles at about the time of solar maximum. The deeper, equatorward meridional flow can carry magnetic flux back toward the lower latitudes where it erupts through the surface to form tilted active regions that convert toroidal fields into oppositely directed poloidal fields. These axisymmetric flows are themselves driven by large scale convective motions. The effects of the Sun's rotation on convection produce velocity correlations that can maintain both the differential rotation and the meridional circulation. These convective motions can also influence solar activity directly by shaping the magnetic field pattern. While considerable theoretical advances have been made toward understanding these large scale flows, outstanding problems in matching theory to observations still remain.

Scattering forms and the positive geometry of kinematics, color and the worldsheet

NASA Astrophysics Data System (ADS)

Arkani-Hamed, Nima; Bai, Yuntao; He, Song; Yan, Gongwang

2018-05-01

The search for a theory of the S-Matrix over the past five decades has revealed surprising geometric structures underlying scattering amplitudes ranging from the string worldsheet to the amplituhedron, but these are all geometries in auxiliary spaces as opposed to the kinematical space where amplitudes actually live. Motivated by recent advances providing a reformulation of the amplituhedron and planar N = 4 SYM amplitudes directly in kinematic space, we propose a novel geometric understanding of amplitudes in more general theories. The key idea is to think of amplitudes not as functions, but rather as differential forms on kinematic space. We explore the resulting picture for a wide range of massless theories in general spacetime dimensions. For the bi-adjoint ϕ 3 scalar theory, we establish a direct connection between its "scattering form" and a classic polytope — the associahedron — known to mathematicians since the 1960's. We find an associahedron living naturally in kinematic space, and the tree level amplitude is simply the "canonical form" associated with this "positive geometry". Fundamental physical properties such as locality and unitarity, as well as novel "soft" limits, are fully determined by the combinatorial geometry of this polytope. Furthermore, the moduli space for the open string worldsheet has also long been recognized as an associahedron. We show that the scattering equations act as a diffeomorphism between the interior of this old "worldsheet associahedron" and the new "kinematic associahedron", providing a geometric interpretation and simple conceptual derivation of the bi-adjoint CHY formula. We also find "scattering forms" on kinematic space for Yang-Mills theory and the Non-linear Sigma Model, which are dual to the fully color-dressed amplitudes despite having no explicit color factors. This is possible due to a remarkable fact—"Color is Kinematics"— whereby kinematic wedge products in the scattering forms satisfy the same Jacobi relations as color factors. Finally, all our scattering forms are well-defined on the projectivized kinematic space, a property which can be seen to provide a geometric origin for color-kinematics duality.

13 CFR 120.1860 - How will the SISMBD Loan be disbursed?

Code of Federal Regulations, 2010 CFR

2010-01-01

... other Collateral required by SBA and verification of the required first lien position. SBA will advance... less. Thus, if the loan is purchased at a discount to the principal balance, SBA will not advance more... SISMBD requests an advance under its SISMBD Loan, it will submit a written Loan Advance Request Form to...

Searching for the stochastic gravitational-wave background in Advanced LIGO's first observing run

NASA Astrophysics Data System (ADS)

Meyers, Patrick

2017-01-01

One of the most exciting prospects of gravitational-wave astrophysics and cosmology is the measurement of the stochastic gravitational-wave background. In this talk, we discuss the most recent searches for a stochastic background with Advanced LIGO--the first performed with advanced interferometric detectors. We search for an isotropic as well as an anisotropic background, and perform a directed search for persistent gravitational waves in three promising directions. Additionally, with the accumulation of more Advanced LIGO data and the anticipated addition of Advanced Virgo to the network in 2017, we can also start to consider what the recent gravitational-wave detections--GW150914 and GW151226--tell us about when we can expect a detection of the stochastic background from binary black hole coalescences. For the LIGO Scientific Collaboration and the Virgo Collaboration.

Transformation of localized necking of strain space into stress space for advanced high strength steel sheet

NASA Astrophysics Data System (ADS)

Nakwattanaset, Aeksuwat; Suranuntchai, Surasak

2018-03-01

Normally, Forming Limit Curves (FLCs) can’t explain for shear fracture better than Damage Curve, this article aims to show the experimental of Forming Limit Curve (FLC) for Advanced High Strength Steel (AHSS) sheets grade JAC780Y with the Nakazima forming test and tensile tests of different sample geometries. From these results, the Forming Limit Curve (strain space) was transformed to damage curve (stress space) between plastic strain and stress triaxiality. Therefore, Stress space transformed using by Hill-48 and von-Mises yield function. This article shows that two of these yield criterions can use in the transformation.

After Nerve Injury, Lineage Tracing Shows That Myelin and Remak Schwann Cells Elongate Extensively and Branch to Form Repair Schwann Cells, Which Shorten Radically on Remyelination

PubMed Central

van der Lans, Milou; Benito, Cristina; Wagstaff, Laura J.

2017-01-01

There is consensus that, distal to peripheral nerve injury, myelin and Remak cells reorganize to form cellular columns, Bungner's bands, which are indispensable for regeneration. However, knowledge of the structure of these regeneration tracks has not advanced for decades and the structure of the cells that form them, denervated or repair Schwann cells, remains obscure. Furthermore, the origin of these cells from myelin and Remak cells and their ability to give rise to myelin cells after regeneration has not been demonstrated directly, although these conversions are believed to be central to nerve repair. Using genetic lineage-tracing and scanning-block face electron microscopy, we show that injury of sciatic nerves from mice of either sex triggers extensive and unexpected Schwann cell elongation and branching to form long, parallel processes. Repair cells are 2- to 3-fold longer than myelin and Remak cells and 7- to 10-fold longer than immature Schwann cells. Remarkably, when repair cells transit back to myelinating cells, they shorten ∼7-fold to generate the typically short internodes of regenerated nerves. The present experiments define novel morphological transitions in injured nerves and show that repair Schwann cells have a cell-type-specific structure that differentiates them from other cells in the Schwann cell lineage. They also provide the first direct evidence using genetic lineage tracing for two basic assumptions in Schwann cell biology: that myelin and Remak cells generate the elongated cells that build Bungner bands in injured nerves and that such cells can transform to myelin cells after regeneration. SIGNIFICANCE STATEMENT After injury to peripheral nerves, the myelin and Remak Schwann cells distal to the injury site reorganize and modify their properties to form cells that support the survival of injured neurons, promote axon growth, remove myelin-associated growth inhibitors, and guide regenerating axons to their targets. We show that the generation of these repair-supportive Schwann cells involves an extensive cellular elongation and branching, often to form long, parallel processes. This generates a distinctive repair cell morphology that is favorable for the formation of the regeneration tracks that are essential for nerve repair. Remyelination, conversely, involves a striking cell shortening to form the typical short myelin cells of regenerated nerves. We also provide evidence for direct lineage relationships between: (1) repair cells and myelin and Remak cells of uninjured nerves and (2) remyelinating cells in regenerated nerves. PMID:28904214

After Nerve Injury, Lineage Tracing Shows That Myelin and Remak Schwann Cells Elongate Extensively and Branch to Form Repair Schwann Cells, Which Shorten Radically on Remyelination.

PubMed

Gomez-Sanchez, Jose A; Pilch, Kjara S; van der Lans, Milou; Fazal, Shaline V; Benito, Cristina; Wagstaff, Laura J; Mirsky, Rhona; Jessen, Kristjan R

2017-09-13

There is consensus that, distal to peripheral nerve injury, myelin and Remak cells reorganize to form cellular columns, Bungner's bands, which are indispensable for regeneration. However, knowledge of the structure of these regeneration tracks has not advanced for decades and the structure of the cells that form them, denervated or repair Schwann cells, remains obscure. Furthermore, the origin of these cells from myelin and Remak cells and their ability to give rise to myelin cells after regeneration has not been demonstrated directly, although these conversions are believed to be central to nerve repair. Using genetic lineage-tracing and scanning-block face electron microscopy, we show that injury of sciatic nerves from mice of either sex triggers extensive and unexpected Schwann cell elongation and branching to form long, parallel processes. Repair cells are 2- to 3-fold longer than myelin and Remak cells and 7- to 10-fold longer than immature Schwann cells. Remarkably, when repair cells transit back to myelinating cells, they shorten ∼7-fold to generate the typically short internodes of regenerated nerves. The present experiments define novel morphological transitions in injured nerves and show that repair Schwann cells have a cell-type-specific structure that differentiates them from other cells in the Schwann cell lineage. They also provide the first direct evidence using genetic lineage tracing for two basic assumptions in Schwann cell biology: that myelin and Remak cells generate the elongated cells that build Bungner bands in injured nerves and that such cells can transform to myelin cells after regeneration. SIGNIFICANCE STATEMENT After injury to peripheral nerves, the myelin and Remak Schwann cells distal to the injury site reorganize and modify their properties to form cells that support the survival of injured neurons, promote axon growth, remove myelin-associated growth inhibitors, and guide regenerating axons to their targets. We show that the generation of these repair-supportive Schwann cells involves an extensive cellular elongation and branching, often to form long, parallel processes. This generates a distinctive repair cell morphology that is favorable for the formation of the regeneration tracks that are essential for nerve repair. Remyelination, conversely, involves a striking cell shortening to form the typical short myelin cells of regenerated nerves. We also provide evidence for direct lineage relationships between: (1) repair cells and myelin and Remak cells of uninjured nerves and (2) remyelinating cells in regenerated nerves. Copyright © 2017 Gomez-Sanchez et al.

Professional ethics in extreme circumstances: responsibilities of attending physicians and healthcare providers in hunger strikes.

PubMed

Irmak, Nurbay

2015-08-01

Hunger strikes potentially present a serious challenge for attending physicians. Though rare, in certain cases, a conflict can occur between the obligations of beneficence and autonomy. On the one hand, physicians have a duty to preserve life, which entails intervening in a hunger strike before the hunger striker loses his life. On the other hand, physicians' duty to respect autonomy implies that attending physicians have to respect hunger strikers' decisions to refuse nutrition. International medical guidelines state that physicians should follow the strikers' unpressured advance directives. When physicians encounter an unconscious striker, in the absence of reliable advance directives, the guidelines advise physicians to make a decision on the basis of the patient's values, previously expressed wishes, and best interests. I argue that if there are no advance directives and the striker has already lost his competence, the physician has the responsibility to resuscitate the striker. Once the striker regains his decision-making capacity, he should be asked about his decision. If he is determined to continue fasting and refuses treatment, the physician has a moral obligation to respect this decisions and follow his advance directives.

Patients' understanding and use of advance directives.

PubMed Central

Jacobson, J A; White, B E; Battin, M P; Francis, L P; Green, D J; Kasworm, E S

1994-01-01

The Patient Self-Determination Act was implemented in December 1991. Before and after its implementation, we used a structured interview of 302 randomly selected patients to determine their awareness, understanding, and use of advance directives. Implementation of the Act did not have a major effect on these. Although more than 90% of patients were aware of the living will, only about a third selected the correct definition or the correct circumstances in which it applied, and less than 20% of patients had completed one. About a third of patients were aware of a Durable Power of Attorney for Health Care and chose the correct definition, and about half identified the correct circumstances in which it applies; less than 10% had completed such a document. Surprisingly, patients who said they had completed advance directives did not demonstrate better understanding of these documents. Our results indicate that many patients, including some who have completed advance directives, do not fully understand them. It may be unwise to regard these documents as carefully considered, compelling statements of patients' preferences. Appropriate responses to our findings include increased public education, revising state statutes to bring them into congruence with public perception, and expanding the dialogue between physicians and patients. PMID:8191755

The Cordón Caulle rhyolite lava flow: an exceptional case study

NASA Astrophysics Data System (ADS)

Magnall, N.; James, M. R.; Tuffen, H.; Schipper, C. I.; Castro, J. M.; Vye-Brown, C.; Davies, A. G.; Farquharson, J.

2017-12-01

Rhyolites comprise the most silica-rich lavas, and rhyolitic lava flows can reach tens of kilometres in length. Interpretations of ancient and historic rhyolite lava flows suggest protracted emplacement due to relatively slow cooling of these massive bodies and have identified late stage events such as the formation of pumice diapirs. However, our understanding of emplacement processes has long remained limited by the lack of observations from an active flow. The 2011-2012 eruption of Puyehue-Cordón Caulle in southern Chile resulted in the first scientifically observed emplacement of an extensive (0.4 km3, 5 km long), crystal-poor rhyolite lava flow and has provided an unparalleled opportunity to further our understanding of flow dynamics. Here, we summarise our work on this lava flow, which has combined satellite and field observations, microstructural characterisation of samples, and numerical modelling. Early observations showed that advance of the 40 m thick flow stalled after 150 days of eruption, due to interactions with topographic barriers and the formation of a retarding surface crust. Following this, numerous breakouts formed from the flow fronts and margins, attaining lengths of ≤2 km. Microstructural characterisation supports the model that the breakouts formed due to continued lava supply to the stalled portions of the flow front along preferential thermal pathways, coupled with late-stage vesiculation of the flow core. This led to pressure increase, inflation, and eventual rupturing of the surface crust. These breakouts have been classified into four morphological types (domed, petaloid, rubbly, and cleft split) that reflect processes of advance and inflation. Some breakouts continued to advance and form after the eruption ended, with numerical modelling and direct observations suggesting mobility of the lava years after the eruption ended. Unlike other rhyolite flows, pumice diapirs were not observed at Cordón Caulle, instead late stage volatile exsolution (with associated vapour-phase cristobalite formation), core vesiculation, and resultant inflation contributed to breakout formation. Insights gained from Cordón Caulle aid in the interpretation of ancient silicic lavas and help anticipate the hazards posed by future, potentially lengthy, eruptions of rhyolitic lava.

The sedimentary evolution of the Celtic Sea during Marine Isotope Stages 1 and 2

NASA Astrophysics Data System (ADS)

Lockhart, Edward; Scourse, James; Van Landeghem, Katrien; Praeg, Daniel; Mellett, Claire; Huws, Dei; Saher, Margot; Benetti, Sara

2017-04-01

During the Last Glacial Maximum (LGM), the Celtic Sea was partially glaciated by the Irish Sea Ice Stream and is considered to have subsequently experienced a high-energy post-glacial transgression. The combination of these events resulted in the deposition, reworking and erosion of a wide range of sediment types to produce the upper stratigraphy of the shelf, including the world's largest submarine elongated ridges. These geomorphic features dominate the shelf and have been previously interpreted to have formed as a result of the tidal reworking of shelf deposits during transgression, despite not having been directly dated. Shelf-wide high-resolution geophysical data, and vibrocores, collected as part of the BRITICE-CHRONO Project, provide new information on relationships between seismic and shallow sedimentary units. A regionally extensive near-surface reflector, cored in several locations, correlates to a gravel/shell layer with an erosive base, unconformably overlying fine-grained LGM glacial sediments with undrained shear strengths in excess of 120 kPa, and in places exhibiting visibly deformed laminations. Geotechnical tests suggest these sediments to be over-consolidated, and we propose that these properties and the observed deformation can only be explained by subglacial reworking under a re-advancing Irish Sea Ice Stream, a scenario never before evidenced in reconstructions of Celtic Sea glaciation. Previous reconstructions propose a single advance-retreat cycle; therefore, a re-advance during a time of inferred retreat would represent a significant change in glacial dynamics. Seismic reflection profiles show that the regionally continuous gravel/shell layer appears to form an undulating palaeo-topography, possibly influenced by the geotechnical properties of the deposits below, on which the large surface ridges are formed. The presence of a regionally continuous reflection surface truncating LGM glacial sediments would suggest a significant erosion event after glacial deposition occurred, possibly representing transgression. This suggests that the large surface ridges may be of post-glacial tidal origin, but with significant sediment supply and morphological control influenced by the glaciation of the Celtic Sea.

Violence to Others, Violent Self-Victimization, and Violent Victimization by Others Among Persons With a Mental Illness.

PubMed

Monahan, John; Vesselinov, Roumen; Robbins, Pamela Clark; Appelbaum, Paul S

2017-05-01

This research examined the frequency of and characteristics associated with three forms of violence among persons with mental illness-violence directed at others, self-directed violence, and violence directed at them by others. Previously unreported data from a follow-up sample of 951 patients from the MacArthur Violence Risk Assessment Study were analyzed to characterize involvement in violence directed at others, self-directed violence, and violence directed at them by others. Most patients (58%) experienced at least one form of violence, 28% experienced at least two forms, and 7% experienced all three forms. Several diagnostic, social, and historical variables distinguished the groups. Given the substantial overlap among the three forms of violence, clinicians should routinely screen patients who report one form for the occurrence of the other two. Co-occurrence of several forms of violence may require a package of interventions with components geared to each.

Space water electrolysis: Space Station through advance missions

NASA Technical Reports Server (NTRS)

Davenport, Ronald J.; Schubert, Franz H.; Grigger, David J.

1991-01-01

Static Feed Electrolyzer (SFE) technology can satisfy the need for oxygen (O2) and Hydrogen (H2) in the Space Station Freedom and future advanced missions. The efficiency with which the SFE technology can be used to generate O2 and H2 is one of its major advantages. In fact, the SFE is baselined for the Oxygen Generation Assembly within the Space Station Freedom's Environmental Control and Life Support System (ECLSS). In the conventional SFE process an alkaline electrolyte is contained within the matrix and is sandwiched between two porous electrodes. The electrodes and matrix make up a unitized cell core. The electrolyte provides the necessary path for the transport of water and ions between the electrodes, and forms a barrier to the diffusion of O2 and H2. A hydrophobic, microporous membrane permits water vapor to diffuse from the feed water to the cell core. This membrane separates the liquid feed water from the product H2, and, therefore, avoids direct contact of the electrodes by the feed water. The feed water is also circulated through an external heat exchanger to control the temperature of the cell.

Mobile, Social, and Wearable Computing and the Evolution of Psychological Practice.

PubMed

Morris, Margaret E; Aguilera, Adrian

2012-12-01

Psychological assessment and intervention are extending from the clinic into daily life. Multiple forces are at play: Advances in mobile technology, constrained clinical care, and consumer demand for contextualized, nonstigmatizing, and low-cost alternatives are beginning to change the face of psychological assessment and interventions. Mobile, social, and wearable technologies are now enabling individuals to measure themselves and to integrate myriad forms of help and entertainment. The massive data sets generated by self-tracking of mood and passive sensing of voice, activity, and physiology may eventually reorganize taxonomies of mental health concerns. Compelling mobile therapies will also emerge, involving contextually appropriate, entertaining, and dynamic feedback to provide help in the context of daily life. The efficacy of such applications will be tested through citizen science as well as clinical trials. This article reviews technical advances that can be applied to enhance assessment and intervention and dramatically increase access to psychotherapy. It is recommended that, in addition to exploring clinically oriented products, practitioners should support patients' use of direct-to-consumer applications in ways that align with therapeutic objectives.

Study for requirement of advanced long life small modular fast reactor

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

Tak, Taewoo, E-mail: ttwispy@unist.ac.kr; Choe, Jiwon, E-mail: chi91023@unist.ac.kr; Jeong, Yongjin, E-mail: yjjeong09@unist.ac.kr

2016-01-22

To develop an advanced long-life SMR core concept, the feasibility of the long-life breed-and-burn core concept has been assessed and the preliminary selection on the reactor design requirement such as fuel form, coolant material has been performed. With the simplified cigar-type geometry of 8m-tall CANDLE reactor concept, it has demonstrated the strengths of breed-and-burn strategy. There is a saturation region in the graph for the multiplication factors, which means that a steady breeding is being proceeded along the axial direction. The propagation behavior of the CANDLE core can be also confirmed through the evolution of the axial power profile. Coolantmore » material is expected to have low melting point, density, viscosity and absorption cross section and a high boiling point, specific heat, and thermal conductivity. In this respect, sodium is preferable material for a coolant of this nuclear power plant system. The metallic fuel has harder spectrum compared to the oxide and carbide fuel, which is favorable to increase the breeding and extend the cycle length.« less

Mobile, Social, and Wearable Computing and the Evolution of Psychological Practice

PubMed Central

Morris, Margaret E.; Aguilera, Adrian

2014-01-01

Psychological assessment and intervention are extending from the clinic into daily life. Multiple forces are at play: Advances in mobile technology, constrained clinical care, and consumer demand for contextualized, nonstigmatizing, and low-cost alternatives are beginning to change the face of psychological assessment and interventions. Mobile, social, and wearable technologies are now enabling individuals to measure themselves and to integrate myriad forms of help and entertainment. The massive data sets generated by self-tracking of mood and passive sensing of voice, activity, and physiology may eventually reorganize taxonomies of mental health concerns. Compelling mobile therapies will also emerge, involving contextually appropriate, entertaining, and dynamic feedback to provide help in the context of daily life. The efficacy of such applications will be tested through citizen science as well as clinical trials. This article reviews technical advances that can be applied to enhance assessment and intervention and dramatically increase access to psychotherapy. It is recommended that, in addition to exploring clinically oriented products, practitioners should support patients’ use of direct-to-consumer applications in ways that align with therapeutic objectives. PMID:25587207

Study for requirement of advanced long life small modular fast reactor

NASA Astrophysics Data System (ADS)

Tak, Taewoo; Choe, Jiwon; Jeong, Yongjin; Lee, Deokjung; Kim, T. K.

2016-01-01

To develop an advanced long-life SMR core concept, the feasibility of the long-life breed-and-burn core concept has been assessed and the preliminary selection on the reactor design requirement such as fuel form, coolant material has been performed. With the simplified cigar-type geometry of 8m-tall CANDLE reactor concept, it has demonstrated the strengths of breed-and-burn strategy. There is a saturation region in the graph for the multiplication factors, which means that a steady breeding is being proceeded along the axial direction. The propagation behavior of the CANDLE core can be also confirmed through the evolution of the axial power profile. Coolant material is expected to have low melting point, density, viscosity and absorption cross section and a high boiling point, specific heat, and thermal conductivity. In this respect, sodium is preferable material for a coolant of this nuclear power plant system. The metallic fuel has harder spectrum compared to the oxide and carbide fuel, which is favorable to increase the breeding and extend the cycle length.

Electrocoagulation for the treatment of textile industry effluent--a review.

PubMed

Khandegar, V; Saroha, Anil K

2013-10-15

Various techniques such as physical, chemical, biological, advanced oxidation and electrochemical are used for the treatment of industrial effluent. The commonly used conventional biological treatment processes are time consuming, need large operational area and are not effective for effluent containing toxic elements. Advanced oxidation techniques result in high treatment cost and are generally used to obtain high purity grade water. The chemical coagulation technique is slow and generates large amount of sludge. Electrocoagulation has recently attracted attention as a potential technique for treating industrial effluent due to its versatility and environmental compatibility. This technique uses direct current source between metal electrodes immersed in the effluent, which causes the dissolution of electrode plates into the effluent. The metal ions, at an appropriate pH, can form wide range of coagulated species and metal hydroxides that destabilize and aggregate particles or precipitate and adsorb the dissolved contaminants. Therefore, the objective of the present manuscript is to review the potential of electrocoagulation for the treatment of industrial effluents, mainly removal of dyes from textile effluent. © 2013 Elsevier Ltd. All rights reserved.

[Thermometric diagnostics of chronic ulcerous pulpitis].

PubMed

Zvetkova, P; Mostrova, I

1989-01-01

Thermometric measurements were performed of 408 teeth of the upper and lower jaw with clinically confirmed initial and advanced stage of chronic ulcerous pulpitis in 398 subjects, aged from 18 to 30. Temperature elevation within the range from 1.4 to 3.2 degrees C was established in the initial form of chronic pulpitis and from 1 to 2.5 degrees C in advanced form of chronic pulpitis as compared with the norm. Significant difference in the temperature deviations exists in both forms of chronic pulpitis between the teeth of the upper and lower jaw.

Pleistocene environments and glacial history of the northern North Sea

NASA Astrophysics Data System (ADS)

Reinardy, Benedict; Hjelstuen, Berit; Petter Sejrup, Hans; Augedal, Hans; Jørstad, Arild

2017-04-01

Based on new geochronological and lithological data combined with analyses of 3D seismic data, the Pliocene-Pleistocene development of the central northern North Sea has been investigated. At the start of the Plio-Pleistocene Transition the study area was dominated by a deltaic, shallow marine or tidal depositional environment with sediments mainly sourced from the west with a local provenance. Directly above the base Quaternary a 60 m thick layer of mud-rich sediments of glacimarine origin were deposited at a rate of 12 cm/ka between 2-1.5 Ma and up to 80 cm/ka between 1.5 - 1.2 Ma possibly reflecting glacial ice advancing to the Norwegian coastline. The high rate of deposition in the Early Pleistocene occurred immediately before the initiation of the Norwegian Channel Ice Stream at 1.1 Ma. Following this, a large part of the sediment input from Fennoscandia seems to have been directed away from the study area to the shelf break. At the start of the Mid Pleistocene Transition (MPT), subaerial conditions allowed the formation of a >50 km long fluvial channel across the study area draining water from the east to the south west. The earliest evidence of grounded ice in the investigated area comes from mega scale glacial lineations formed during the MPT, at or just after 1.2 Ma. Following this, a regional unconformity was formed by one or more grounded ice advances across the study area possibly during or directly after the MPT and likely marks the boundary between the Early and Mid Pleistocene glacimarine sediments. The Mid to Late Pleistocene stratigraphy is dominated by glacimarine sediments and tills and is associated with multiple generations of tunnel valleys observed within the seismic data. A high shear strength till containing chalk clasts transported from the west and/or south of the study area was likely deposited during MIS6 and may have been more conducive to tunnel valley formation in comparison to lower shear strength tills deposited by later ice advances. A thick till unit overlain by a sand layer in the study area was deposited by grounded ice during the Last Glacial Maximum and subsequent drainage of an ice dammed lake in the southern North Sea during the last deglaciation (MIS2) of the study area. This study shows that much of the Quaternary age sediments within the northern North Sea were deposited relatively rapidly during short periods of time probably leaving significant hiatuses within the stratigraphic record. This finding has implications for previous studies that use a chronological framework assuming a relatively continuous sedimentation rate and record for the Early Pleistocene within the North Sea.

Application of advanced technologies to small, short-haul transport aircraft

NASA Technical Reports Server (NTRS)

Coussens, T. G.; Tullis, R. H.

1980-01-01

The performance and economic benefits available by incorporation of advanced technologies into the small, short haul air transport were assessed. Low cost structure and advanced composite material, advanced turboprop engines and new propellers, advanced high lift systems and active controls; and alternate aircraft configurations with aft mounted engines were investigated. Improvements in fuel consumed and aircraft economics (acquisition cost and direct operating cost) are available by incorporating selected advanced technologies into the small, short haul aircraft.

Extending the surrogacy analogy: applying the advance directive model to biobanks.

PubMed

Solomon, Stephanie; Mongoven, Ann

2015-01-01

Biobank donors and biobank governance face a conceptual challenge akin to clinical patients and their designated surrogate decision-makers, the necessity of making decisions and policies now that must be implemented under future unknown circumstances. We propose that biobanks take advantage of this parallel to learn lessons from the historical trajectory of advance directives and develop models analogous to current 'best practice' advance directives such as Values Histories and TheFive Wishes. We suggest how such models could improve biobanks' engagement both with communities and with individual donors by being more honest about the limits of current disclosure and eliciting information to ensure the protection of donor interests more robustly through time than current 'informed consent' processes in biobanking. © 2014 S. Karger AG, Basel.

The importance of living wills and advance directives.

PubMed

Alfonso, Heather

2009-10-01

Living wills and advance directives are important components of patients' medical records, which all too often do not indicate the appropriate palliative care measures the patient desires. A review of the current literature indicates that approximately 85% to 95% of the population does not have adequate advance directives or palliative care measures written in their medical record. Furthermore, these orders may not follow the patient when he or she is transferred to other facilities for intermittent care. Unwanted tracheal intubations can be both costly to the facility and distressing to the patient and family members. By instituting a change in policy, organizations can ensure that patients' wishes for end-of-life care are met appropriately. In addition, nurses should advocate for a centralized database at the political level. Copyright 2009, SLACK Incorporated.

Advanced Airspace Concept

NASA Technical Reports Server (NTRS)

Erzberger, Heinz

2002-01-01

A general overview of the Advanced Airspace Concept (AAC) is presented. The topics include: 1) Limitations of the existing system; 2) The Advanced Airspace Concept; 3) Candidate architecture for the AAC; 4) Separation assurance and conflict avoidance system (TSAFE); and 5) Ground-Air Interactions. This paper is in viewgraph form.

Early risk pathways to physical versus relational peer aggression: The interplay of externalizing behavior and corporal punishment varies by child sex.

PubMed

Zulauf, Courtney A; Sokolovsky, Alexander W; Grabell, Adam S; Olson, Sheryl L

2018-03-01

Children who aggress against their peers may use physical or relational forms, yet little research has looked at early childhood risk factors and characteristics that uniquely predict high levels of relational versus physical aggression in preadolescence. Accordingly, the main aim of our study was to link early corporal punishment and externalizing behavior to children's physical and relational peer aggression during preadolescence and to examine how these pathways differed by sex. Participants were 193, 3-year-old boys (39%) and girls who were reassessed following the transition to kindergarten (5.5 years) and preadolescence (10.5 years). A series of autoregressive, cross-lagged path analyses were conducted to examine the relationships between child externalizing problems and corporal punishment at ages 3 and 5.5 years, and their association with physical and relational aggression at age 10.5. Multiple group analysis was used to determine whether pathways differed by sex. Three developmental pathways were identified: (i) direct associations between stable childhood externalizing problems and later physical aggression; (ii) a direct pathway from early corporal punishment to preadolescent relational and physical peer aggression; and (iii) an indirect pathway from early corporal punishment to later physical aggression via continuing externalizing problems in middle childhood. Child sex moderated the nature of these pathways, as well as the direction of association between risk and outcome variables. These data advance our understanding of the etiology of distinct forms of peer aggression and highlight the potential for more efficacious prevention and intervention efforts in the early childhood years. © 2018 Wiley Periodicals, Inc.

Directed evolution: tailoring biocatalysts for industrial applications.

PubMed

Kumar, Ashwani; Singh, Suren

2013-12-01

Current challenges and promises of white biotechnology encourage protein engineers to use a directed evolution approach to generate novel and useful biocatalysts for various sets of applications. Different methods of enzyme engineering have been used in the past in an attempt to produce enzymes with improved functions and properties. Recent advancement in the field of random mutagenesis, screening, selection and computational design increased the versatility and the rapid development of enzymes under strong selection pressure with directed evolution experiments. Techniques of directed evolution improve enzymes fitness without understanding them in great detail and clearly demonstrate its future role in adapting enzymes for use in industry. Despite significant advances to date regarding biocatalyst improvement, there still remains a need to improve mutagenesis strategies and development of easy screening and selection tools without significant human intervention. This review covers fundamental and major development of directed evolution techniques, and highlights the advances in mutagenesis, screening and selection methods with examples of enzymes developed by using these approaches. Several commonly used methods for creating molecular diversity with their advantages and disadvantages including some recently used strategies are also discussed.

Microgravity

NASA Image and Video Library

1997-11-15

The Isothermal Dendritic Growth Experiment (IDGE), flown on three Space Shuttle missions, is yielding new insights into virtually all industrially relevant metal and alloy forming operations. IDGE used transparent organic liquids that form dendrites (treelike structures) similar to those inside metal alloys. Comparing Earth-based and space-based dendrite growth velocity, tip size and shape provides a better understanding of the fundamentals of dentritic growth, including gravity's effects. Shalowgraphic images of pivalic acid (PVA) dendrites forming from the melt show the subtle but distinct effects of gravity-driven heat convection on dentritic growth. In orbit, the dendrite grows as its latent heat is liberated by heat conduction. This yields a blunt dendrite tip. On Earth, heat is carried away by both conduction and gravity-driven convection. This yields a sharper dendrite tip. In addition, under terrestrial conditions, the sidebranches growing in the direction of gravity are augmented as gravity helps carry heat out of the way of the growing sidebranches as opposed to microgravity conditions where no augmentation takes place. IDGE was developed by Rensselaer Polytechnic Institute and NASA/Glenn Research Center. Advanced follow-on experiments are being developed for flight on the International Space Station. Photo Credit: NASA/Glenn Research Center

Reliability-Based Stability Analysis of Rock Slopes Using Numerical Analysis and Response Surface Method

NASA Astrophysics Data System (ADS)

Dadashzadeh, N.; Duzgun, H. S. B.; Yesiloglu-Gultekin, N.

2017-08-01

While advanced numerical techniques in slope stability analysis are successfully used in deterministic studies, they have so far found limited use in probabilistic analyses due to their high computation cost. The first-order reliability method (FORM) is one of the most efficient probabilistic techniques to perform probabilistic stability analysis by considering the associated uncertainties in the analysis parameters. However, it is not possible to directly use FORM in numerical slope stability evaluations as it requires definition of a limit state performance function. In this study, an integrated methodology for probabilistic numerical modeling of rock slope stability is proposed. The methodology is based on response surface method, where FORM is used to develop an explicit performance function from the results of numerical simulations. The implementation of the proposed methodology is performed by considering a large potential rock wedge in Sumela Monastery, Turkey. The accuracy of the developed performance function to truly represent the limit state surface is evaluated by monitoring the slope behavior. The calculated probability of failure is compared with Monte Carlo simulation (MCS) method. The proposed methodology is found to be 72% more efficient than MCS, while the accuracy is decreased with an error of 24%.

Extracellular vesicles and intercellular communication within the nervous system

PubMed Central

Fitzpatrick, Zachary; Maguire, Casey A.; Breakefield, Xandra O.

2016-01-01

Extracellular vesicles (EVs, including exosomes) are implicated in many aspects of nervous system development and function, including regulation of synaptic communication, synaptic strength, and nerve regeneration. They mediate the transfer of packets of information in the form of nonsecreted proteins and DNA/RNA protected within a membrane compartment. EVs are essential for the packaging and transport of many cell-fate proteins during development as well as many neurotoxic misfolded proteins during pathogenesis. This form of communication provides another dimension of cellular crosstalk, with the ability to assemble a “kit” of directional instructions made up of different molecular entities and address it to specific recipient cells. This multidimensional form of communication has special significance in the nervous system. How EVs help to orchestrate the wiring of the brain while allowing for plasticity associated with learning and memory and contribute to regeneration and degeneration are all under investigation. Because they carry specific disease-related RNAs and proteins, practical applications of EVs include potential uses as biomarkers and therapeutics. This Review describes our current understanding of EVs and serves as a springboard for future advances, which may reveal new important mechanisms by which EVs in coordinate brain and body function and dysfunction. PMID:27035811

Recent Advances in Delivery Systems and Therapeutics of Cinnarizine: A Poorly Water Soluble Drug with Absorption Window in Stomach

PubMed Central

Pathak, Kamla

2014-01-01

Low solubility causing low dissolution in gastrointestinal tract is the major problem for drugs meant for systemic action after oral administration, like cinnarizine. Pharmaceutical products of cinnarizine are commercialized globally as immediate release preparations presenting low absorption with low and erratic bioavailability. Approaches to enhance bioavailability are widely cited in the literature. An attempt has been made to review the bioavailability complications and clinical therapeutics of poorly water soluble drug: cinnarizine. The interest of writing this paper is to summarize the pharmacokinetic limitations of drug with special focus on strategies to improvise bioavailability along with effectiveness of novel dosage forms to circumvent the obstacle. The paper provides insight to the approaches to overcome low and erratic bioavailability of cinnarizine by cyclodextrin complexes and novel dosage forms: self-nanoemulsifying systems and buoyant microparticulates. Nanoformulations need to systematically explored in future, for their new clinical role in prophylaxis of migraine attacks in children. Clinical reports have affirmed the role of cinnarizine in migraine prophylaxis. Research needs to be dedicated to develop dosage forms for efficacious bioavailability and drug directly to brain. PMID:25478230

Explicit B-spline regularization in diffeomorphic image registration

PubMed Central

Tustison, Nicholas J.; Avants, Brian B.

2013-01-01

Diffeomorphic mappings are central to image registration due largely to their topological properties and success in providing biologically plausible solutions to deformation and morphological estimation problems. Popular diffeomorphic image registration algorithms include those characterized by time-varying and constant velocity fields, and symmetrical considerations. Prior information in the form of regularization is used to enforce transform plausibility taking the form of physics-based constraints or through some approximation thereof, e.g., Gaussian smoothing of the vector fields [a la Thirion's Demons (Thirion, 1998)]. In the context of the original Demons' framework, the so-called directly manipulated free-form deformation (DMFFD) (Tustison et al., 2009) can be viewed as a smoothing alternative in which explicit regularization is achieved through fast B-spline approximation. This characterization can be used to provide B-spline “flavored” diffeomorphic image registration solutions with several advantages. Implementation is open source and available through the Insight Toolkit and our Advanced Normalization Tools (ANTs) repository. A thorough comparative evaluation with the well-known SyN algorithm (Avants et al., 2008), implemented within the same framework, and its B-spline analog is performed using open labeled brain data and open source evaluation tools. PMID:24409140

Three-dimensional printing of Hela cells for cervical tumor model in vitro.

PubMed

Zhao, Yu; Yao, Rui; Ouyang, Liliang; Ding, Hongxu; Zhang, Ting; Zhang, Kaitai; Cheng, Shujun; Sun, Wei

2014-09-01

Advances in three-dimensional (3D) printing have enabled the direct assembly of cells and extracellular matrix materials to form in vitro cellular models for 3D biology, the study of disease pathogenesis and new drug discovery. In this study, we report a method of 3D printing for Hela cells and gelatin/alginate/fibrinogen hydrogels to construct in vitro cervical tumor models. Cell proliferation, matrix metalloproteinase (MMP) protein expression and chemoresistance were measured in the printed 3D cervical tumor models and compared with conventional 2D planar culture models. Over 90% cell viability was observed using the defined printing process. Comparisons of 3D and 2D results revealed that Hela cells showed a higher proliferation rate in the printed 3D environment and tended to form cellular spheroids, but formed monolayer cell sheets in 2D culture. Hela cells in 3D printed models also showed higher MMP protein expression and higher chemoresistance than those in 2D culture. These new biological characteristics from the printed 3D tumor models in vitro as well as the novel 3D cell printing technology may help the evolution of 3D cancer study.

Production and Physiological Effects of Hydrogen Sulfide

PubMed Central

2014-01-01

Abstract Significance: Hydrogen sulfide (H2S) has been recognized as a physiological mediator with a variety of functions. It regulates synaptic transmission, vascular tone, inflammation, transcription, and angiogenesis; protects cells from oxidative stress and ischemia-reperfusion injury; and promotes healing of ulcers. Recent Advances: In addition to cystathionine β-synthase and cystathionine γ-lyase, 3-mercaptopyruvate sulfurtransferase along with cysteine aminotransferase was recently demonstrated to produce H2S. Even in bacteria, H2S produced by these enzymes functions as a defense against antibiotics, suggesting that the cytoprotective effect of H2S is a universal defense mechanism in organisms from bacteria to mammals. Critical Issues: The functional form of H2S—undissociated H2S gas, dissociated HS ion, or some other form of sulfur—has not been identified. Future Directions: The regulation of H2S production by three enzymes may lead to the identification of the physiological signals that are required to release H2S. The identification of the physiological functions of other forms of sulfur may also help understand the biological significance of H2S. Antioxid. Redox Signal. 20, 783–793. PMID:23581969

The advance care planning PREPARE study among older Veterans with serious and chronic illness: study protocol for a randomized controlled trial.

PubMed

Sudore, Rebecca; Le, Gem M; McMahan, Ryan; McMahon, Ryan; Feuz, Mariko; Katen, Mary; Barnes, Deborah E

2015-12-12

Advance care planning (ACP) is a process whereby patients prepare for medical decision-making. The traditional objective of ACP has focused on the completion of advance directives. We have developed a new paradigm of ACP focused on preparing patients and their loved ones for communication and informed medical decision-making. To operationalize this new paradigm of ACP, we created an interactive, patient-centered website called PREPARE ( www.prepareforyourcare.org ) designed for diverse older adults. This randomized controlled trial with blinded outcome assessment is designed to determine the efficacy of PREPARE to engage older Veterans in the ACP process. Veterans who are ≥ 60 years of age, have ≥ two medical conditions, and have seen a primary care physician ≥ two times in the last year are being randomized to one of two study arms. The PREPARE study arm reviews the PREPARE website and an easy-to-read advance directive. The control arm only reviews the advance directive. The primary outcome is documentation of an advance directive and ACP discussions. Other clinically important outcomes using validated surveys include ACP behavior change process measures (knowledge, contemplation, self-efficacy, and readiness) and a full range of ACP action measures (identifying a surrogate, identifying values and goals, choosing leeway or flexibility for the surrogate, communicating with clinicians and surrogates, and documenting one's wishes). We will also assess satisfaction with decision-making and Veteran activation within primary care visits by direct audio recording. To examine the outcomes at 1 week, 3 months, and 6 months between the two study arms, we will use mixed effects linear, Poisson, or negative binomial regression and mixed effects logistic regression. This study will determine whether PREPARE increases advance directive completion rates and engagement with the ACP process. If PREPARE is efficacious, it could prove to be an easy and effective intervention to help older adults engage in the ACP process within or outside of the medical environment. PREPARE may also help older adults communicate their medical wishes and goals to their loved ones and clinicians, improve medical decision-making, and ensure their wishes are honored over the life course. ClinicalTrials.gov NCT01550731 . Registered on 8 December 2011.

75 FR 9633 - Reports, Forms and Record Keeping Requirements; Agency Information Collection Activity Under OMB...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-03

... Administration Title: Part 585--Advanced Air Bag Phase-In Reporting Requirements. OMB Number: 2127-0599. Type of... requirements of this FMVSS related to the implementation of advanced air bags. Phase 1 of the advanced air bag... advanced air bag phase-in begins September 1, 2007 with 100 percent compliance by September 1, 2009. Phase...

Marginal Fisher analysis and its variants for human gait recognition and content- based image retrieval.

PubMed

Xu, Dong; Yan, Shuicheng; Tao, Dacheng; Lin, Stephen; Zhang, Hong-Jiang

2007-11-01

Dimensionality reduction algorithms, which aim to select a small set of efficient and discriminant features, have attracted great attention for human gait recognition and content-based image retrieval (CBIR). In this paper, we present extensions of our recently proposed marginal Fisher analysis (MFA) to address these problems. For human gait recognition, we first present a direct application of MFA, then inspired by recent advances in matrix and tensor-based dimensionality reduction algorithms, we present matrix-based MFA for directly handling 2-D input in the form of gray-level averaged images. For CBIR, we deal with the relevance feedback problem by extending MFA to marginal biased analysis, in which within-class compactness is characterized only by the distances between each positive sample and its neighboring positive samples. In addition, we present a new technique to acquire a direct optimal solution for MFA without resorting to objective function modification as done in many previous algorithms. We conduct comprehensive experiments on the USF HumanID gait database and the Corel image retrieval database. Experimental results demonstrate that MFA and its extensions outperform related algorithms in both applications.

Machine vision and the OMV

NASA Technical Reports Server (NTRS)

Mcanulty, M. A.

1986-01-01

The orbital Maneuvering Vehicle (OMV) is intended to close with orbiting targets for relocation or servicing. It will be controlled via video signals and thruster activation based upon Earth or space station directives. A human operator is squarely in the middle of the control loop for close work. Without directly addressing future, more autonomous versions of a remote servicer, several techniques that will doubtless be important in a future increase of autonomy also have some direct application to the current situation, particularly in the area of image enhancement and predictive analysis. Several techniques are presentet, and some few have been implemented, which support a machine vision capability proposed to be adequate for detection, recognition, and tracking. Once feasibly implemented, they must then be further modified to operate together in real time. This may be achieved by two courses, the use of an array processor and some initial steps toward data reduction. The methodology or adapting to a vector architecture is discussed in preliminary form, and a highly tentative rationale for data reduction at the front end is also discussed. As a by-product, a working implementation of the most advanced graphic display technique, ray-casting, is described.

The FOXSI solar sounding rocket campaigns

NASA Astrophysics Data System (ADS)

Glesener, Lindsay; Krucker, Säm.; Christe, Steven; Ishikawa, Shin-nosuke; Buitrago-Casas, Juan Camilo; Ramsey, Brian; Gubarev, Mikhail; Takahashi, Tadayuki; Watanabe, Shin; Takeda, Shin'ichiro; Courtade, Sasha; Turin, Paul; McBride, Stephen; Shourt, Van; Hoberman, Jane; Foster, Natalie; Vievering, Juliana

2016-07-01

The Focusing Optics X-ray Solar Imager (FOXSI) is, in its initial form, a sounding rocket experiment designed to apply the technique of focusing hard X-ray (HXR) optics to the study of fundamental questions about the high-energy Sun. Solar HXRs arise via bremsstrahlung from energetic electrons and hot plasma produced in solar flares and thus are one of the most direct diagnostics of are-accelerated electrons and the impulsive heating of the solar corona. Previous missions have always been limited in sensitivity and dynamic range by the use of indirect (Fourier) imaging due to the lack of availability of direct focusing optics, but technological advances now make direct focusing accessible in the HXR regime (as evidenced by the NuSTAR spacecraft and several suborbital missions). The FOXSI rocket experiment develops and optimizes HXR focusing telescopes for the unique scientific requirements of the Sun. To date, FOXSI has completed two successful flights on 2012 November 02 and 2014 December 11 and is funded for a third flight. This paper gives a brief overview of the experiment, which is sensitive to solar HXRs in the 4-20 keV range, describes its first two flights, and gives a preview of plans for FOXSI-3.

The FOXSI Solar Sounding Rocket Campaigns

NASA Technical Reports Server (NTRS)

Glesener, Lindsay; Krucker, Sam; Christe, Steven; Ishikawa, Shin-Nosuke; Buitrago-Casas, Juan Camilo; Ramsey, Brian; Gubarev, Mikhail; Takahashi, Tadayuki; Watanabe, Shin; Takeda, Shin'ichiro;

Molecular engineering of industrial enzymes: recent advances and future prospects.

PubMed

Yang, Haiquan; Li, Jianghua; Shin, Hyun-Dong; Du, Guocheng; Liu, Long; Chen, Jian

2014-01-01

Many enzymes are efficiently produced by microbes. However, the use of natural enzymes as biocatalysts has limitations such as low catalytic efficiency, low activity, and low stability, especially under industrial conditions. Many protein engineering technologies have been developed to modify natural enzymes and eliminate these limitations. Commonly used protein engineering strategies include directed evolution, site-directed mutagenesis, truncation, and terminal fusion. This review summarizes recent advances in the molecular engineering of industrial enzymes and discusses future prospects in this field. We expect this review to increase interest in and advance the molecular engineering of industrial enzymes.

Concept for a Satellite-Based Advanced Air Traffic Management System : Volume 1. Summary.

DOT National Transportation Integrated Search

1974-02-01

The report contains the results of studies and analyses directed toward the definition of a Satellite-Based Advanced Air Traffic Management System (SAATMS). This system is an advanced, integrated air traffic control system which is based on the use o...

Engineering visualization utilizing advanced animation

NASA Technical Reports Server (NTRS)

Sabionski, Gunter R.; Robinson, Thomas L., Jr.

1989-01-01

Engineering visualization is the use of computer graphics to depict engineering analysis and simulation in visual form from project planning through documentation. Graphics displays let engineers see data represented dynamically which permits the quick evaluation of results. The current state of graphics hardware and software generally allows the creation of two types of 3D graphics. The use of animated video as an engineering visualization tool is presented. The engineering, animation, and videography aspects of animated video production are each discussed. Specific issues include the integration of staffing expertise, hardware, software, and the various production processes. A detailed explanation of the animation process reveals the capabilities of this unique engineering visualization method. Automation of animation and video production processes are covered and future directions are proposed.

Recently Investigated Natural Gums and Mucilages as Pharmaceutical Excipients: An Overview

PubMed Central

Choudhary, Pritam Dinesh; Pawar, Harshal Ashok

2014-01-01

Due to advances in drug delivery technology, currently, excipients are included in novel dosage forms to fulfil specific functions and in some cases they directly or indirectly influence the extent and/or rate of drug release and drug absorption. Recent trends towards use of plant based and natural products demand the replacement of synthetic additives with natural ones. Today, the whole world is increasingly interested in natural drugs and excipients. These natural materials have many advantages over synthetic ones as they are chemically inert, nontoxic, less expensive, biodegradable, and widely available. This review discusses majority of the plant-derived polymeric compounds (gums and mucilage's), their sources, chemical constituents, uses, and some recent investigations as excipients in novel drug delivery systems. PMID:26556189

A modified estimation distribution algorithm based on extreme elitism.

PubMed

Gao, Shujun; de Silva, Clarence W

2016-12-01

An existing estimation distribution algorithm (EDA) with univariate marginal Gaussian model was improved by designing and incorporating an extreme elitism selection method. This selection method highlighted the effect of a few top best solutions in the evolution and advanced EDA to form a primary evolution direction and obtain a fast convergence rate. Simultaneously, this selection can also keep the population diversity to make EDA avoid premature convergence. Then the modified EDA was tested by means of benchmark low-dimensional and high-dimensional optimization problems to illustrate the gains in using this extreme elitism selection. Besides, no-free-lunch theorem was implemented in the analysis of the effect of this new selection on EDAs. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Heat Conduction in Ceramic Coatings: Relationship Between Microstructure and Effective Thermal Conductivity

NASA Technical Reports Server (NTRS)

Kachanov, Mark

1998-01-01

Analysis of the effective thermal conductivity of ceramic coatings and its relation to the microstructure continued. Results (obtained in Task 1) for the three-dimensional problem of heat conduction in a solid containing an inclusion (or, in particular, cavity - thermal insulator) of the ellipsoidal shape, were further advanced in the following two directions: (1) closed form expressions of H tensor have been derived for special cases of ellipsoidal cavity geometry: spheroid, crack-like spheroidal cavity and needle shaped spheroidal cavity; (2) these results for one cavity have been incorporated to construct heat energy potential for a solid with many spheroidal cavities (in the approximation of non-interacting defects). This problem constitutes a basic building block for further analyses.