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Sample records for advance directive law

  1. The Texas Advanced Directive Law: Unfinished Business.

    PubMed

    Kapottos, Michael; Youngner, Stuart

    2015-01-01

    The Texas Advance Directive Act allows physicians and hospitals to overrule patient or family requests for futile care. Purposefully not defining futility, the law leaves its determination in specific cases to an institutional process. While the law has received several criticisms, it does seem to work constructively in the cases that come to the review process. We introduce a new criticism: While the law has been justified by an appeal to professional values such as avoiding harm to patients, avoiding the provision of unseemly care, and good stewardship of medical resources, it is applied incompletely. It allows physicians and institutional committees to refuse "futile" treatments desired by patients and families while at the same time providing no way of regulating physicians who recommend or even push "futile" treatments in similar cases. In this sense, the TADA is incomplete on its own terms. PMID:26225515

  2. Lost in Translation: The Unintended Consequences of Advance Directive Law on Clinical Care

    PubMed Central

    Castillo, Lesley S.; Williams, Brie A.; Hooper, Sarah M.; Sabatino, Charles P.; Weithorn, Lois A.; Sudore, Rebecca L.

    2011-01-01

    Background Advance directive law may compromise the clinical effectiveness of advance directives. Purpose To identify unintended legal consequences of advance directive law that may prevent patients from communicating end-of-life preferences. Data Sources Advance directive legal statutes for all 50 U.S. states and the District of Columbia and English-language searches of LexisNexis, Westlaw, and MEDLINE from 1966 to August 2010. Study Selection Two independent reviewers selected 51 advance directive statutes and 20 articles. Three independent legal reviewers selected 105 legal proceedings. Data Extraction Two reviewers independently assessed data sources and used critical content analysis to determine legal barriers to the clinical effectiveness of advance directives. Disagreements were resolved by consensus. Data Synthesis Legal and content-related barriers included poor readability (that is, laws in all states were written above a 12th-grade reading level), health care agent or surrogate restrictions (for example, 40 states did not include same-sex or domestic partners as default surrogates), and execution requirements needed to make forms legally valid (for example, 35 states did not allow oral advance directives, and 48 states required witness signatures, a notary public, or both). Vulnerable populations most likely to be affected by these barriers included patients with limited literacy, limited English proficiency, or both who cannot read or execute advance directives; same-sex or domestic partners who may be without legally valid and trusted surrogates; and unbefriended, institutionalized, or homeless patients who may be without witnesses and suitable surrogates. Limitation Only appellate-level legal cases were available, which may have excluded relevant cases. Conclusion Unintended negative consequences of advance directive legal restrictions may prevent all patients, and particularly vulnerable patients, from making and communicating their end

  3. Advance directives

    PubMed Central

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

    2015-01-01

    Abstract Objective 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. Design A self-administered patient questionnaire. Setting A busy urban family medicine teaching clinic in Hamilton, Ont. Participants A convenience sample of adult patients attending the clinic over the course of a typical business week. Main outcome measures The prevalence of advance directives in the patient population was determined, and the patients’ expectations regarding the role of their family doctors were elucidated. Results 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). Conclusion 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. PMID:25873704

  4. Religious advance directives: the convergence of law, religion, medicine, and public health.

    PubMed Central

    Grodin, M A

    1993-01-01

    Because of the deep interpersonal significance of decisions made at the end of life, it is not surprising that religion has played an important role in patient and family decision making. Specific religious concerns about death and dying have led to religious advance directives. Advance directives offer a case study of models of interaction between religious communities and secular institutions. This paper examines why such directives have been created and how they may affect health care decisions. An analysis of their strengths and weaknesses concludes that specific religious instructions are unnecessary in written directives and may undermine both the religious and health care goals of patients. PMID:8498633

  5. A direct advance on advance directives.

    PubMed

    Shaw, David

    2012-06-01

    Advance directives (ADs), which are also sometimes referred to as 'living wills', are statements made by a person that indicate what treatment she should not be given in the event that she is not competent to consent or refuse at the future moment in question. As such, ADs provide a way for patients to make decisions in advance about what treatments they do not want to receive, without doctors having to find proxy decision-makers or having recourse to the doctrine of necessity. While patients can request particular treatments in an AD, only refusals are binding. This paper will examine whether ADs safeguard the autonomy and best interests of the incompetent patient, and whether legislating for the use of ADs is justified, using the specific context of the legal situation in the United Kingdom to illustrate the debate. The issue of whether the law should permit ADs is itself dependent on the issue of whether ADs are ethically justified; thus we must answer a normative question in order to answer the legislative one. It emerges that ADs suffer from two major problems, one related to autonomy and one to consent. First, ADs' emphasis on precedent autonomy effectively sentences some people who want to live to death. Second, many ADs might not meet the standard criteria for informed refusal of treatment, because they fail on the crucial criterion of sufficient information. Ultimately, it transpires that ADs are typically only appropriate for patients who temporarily lose physical or mental capacity. PMID:21133977

  6. Descendants and advance directives.

    PubMed

    Buford, Christopher

    2014-01-01

    Some of the concerns that have been raised in connection to the use of advance directives are of the epistemic variety. Such concerns highlight the possibility that adhering to an advance directive may conflict with what the author of the directive actually wants (or would want) at the time of treatment. However, at least one objection to the employment of advance directives is metaphysical in nature. The objection to be discussed here, first formulated by Rebecca Dresser and labeled by Allen Buchanan as the slavery argument and David DeGrazia the someone else problem, aims to undermine the legitimacy of certain uses of advance directives by concluding that such uses rest upon an incorrect assumption about the identity over time of those ostensibly governed by the directives. There have been numerous attempts to respond to this objection. This paper aims to assess two strategies that have been pursued to cope with the problem. PMID:25743056

  7. Advance Directives and Do Not Resuscitate Orders

    MedlinePlus

    ... a form. Call a lawyer. Use a computer software package for legal documents. Advance directives and living ... you write by yourself or with a computer software package should follow your state laws. You may ...

  8. [Advance medical directives].

    PubMed

    Sonnenblick, Moshe

    2002-02-01

    A patient's rights to autonomy and to participate in the decision making process is a fundamental ethical principle. However, for the non-competent patient, participation in decision-making is more problematic. A survey carried out in Israel found that less than half of the offspring of terminally ill elderly patients knew the request of their parents regarding life-supporting measures. A solution to this problem is the use of medical advance directives (MADs). In the U.S.A (in 1991) it was required by a federal law to inform every hospitalized patient of his right to use MADs. The experience from the use of MADs in the USA during the last 10 years show that: 1) Most lay persons as well as medical staff support the use of MADs 2) The rate of the use of MADs is about 20%, and among long term care hospitalized patients it is even higher. 3) Sex, age, level of education, morbidity and income were found to be significant factors. 4) Education on the use of the MADs raised the rate of use. 5) Most of the patients who had MADs did not discuss the issue of life supporting treatment with their physicians. 6) Patients who had MADs received less aggressive treatment with reduced medical cost. 7) There is a preference to write generic MADs. Arguments supporting the use of MADs state that they: extend patient autonomy; relieve patient anxiety regarding unwanted treatment; relieve physicians' anxiety concerning legal liability; reduce interfamily conflicts, and they also lower health care costs. Arguments opposing the use claim that they: violate sanctity of life; promote an adversarial physician-patient relationship; may lead to euthanasia; fail to express the patient's current wishes and may even counteract physicians' values. On the basis of experience in the USA and the positive attitude regarding MADs, it appears that MADs can also be applicable in Israel. PMID:11905092

  9. How neuroscience might advance the law.

    PubMed Central

    O'Hara, Erin Ann

    2004-01-01

    This essay discusses the strengths and limitations of the new, growing field of law and biology and suggests that advancements in neuroscience can help to bolster that field. It also briefly discusses some ways that neuroscience can help to improve the workings of law more generally. PMID:15590609

  10. Psychiatric Advance Directives: Getting Started

    MedlinePlus

    ... Getting Started State by State Info FAQs Educational Webcasts Links Current Research In the News Legal Issues ... How to write a Psychiatric Advance Directive?" View webcast (15:04) What are Psychiatric Advance Directives? View ...

  11. Advance directives in family practice.

    PubMed Central

    Kohut, N.; Singer, P. A.

    1993-01-01

    Family physicians can play an important role in helping patients and their families to discuss life-sustaining treatments and to complete advance directives. This article reviews the legal status of, and empirical studies on, advance directives and addresses some important clinical questions about their use relevant to family practice. PMID:8499789

  12. 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

  13. Dementia, death and advance directives.

    PubMed

    Wolff, Jonathan

    2012-10-01

    This article considers the ethics of advance directives, especially in relation to conditions such as dementia. For some choices, such as over whether one's life should end at home or in a hospice, advance directives can be very enlightened and helpful. For others, such as those to end the life of an autonomous subject, against their will, have no moral appeal and would rightly be ignored. In a wide range of intermediate cases, given our typical lack of insight into how changes in our health condition will affect us in other ways, we should be very cautious indeed in promoting the use of advance directives in end-of-life decisions, at least where a reasonable quality of life remains. There may be some reasons for giving priority to the earlier autonomous self over a later, contented but non-autonomous self, but these reasons seem far from compelling. PMID:23079306

  14. CASTLE: an advanced technology partnership serving law enforcement

    NASA Astrophysics Data System (ADS)

    McCoig, Thomas M.

    1997-01-01

    The Center for Applied Science and Technology for Law Enforcement (CASTLE) is supported by the National Institute of Justice Office of Science and Technology and is establishing partnerships with the National Law Enforcement Corrections and Technology Center in Charleston, South Carolina. Additionally, CASTLE is working with the American Society of Crime Lab Directors (ASCLD) to direct effective interface with and support of state and local crime laboratories. Extremely sophisticated, often one-of-a-kind, equipment and very-capable scientific expertise are resident at U.S. federal government laboratories and, until recently, have not been applied often to law enforcement problems, particularly at the state and local level. While there have been a number of research and development programs at national laboratories sponsored by agencies such as the National Institute of Justice, most of these have been focused on long-term objectives to meet broad national needs. In discussions with local law enforcement personnel, it is apparent that there are much more immediate technology needs, which are not being addressed by nationwide programs, in fundamental areas including video and audio surveillance, trace and physical evidence sampling, and forensic laboratory analysis. In a pilot program, Oak Ridge National Laboratory (ORNL), a significant component of the nation's science and technology resources located in Tennessee, recently made a commitment to support law enforcement where possible with advanced technology. ORNL formed the Center for Applied Science and Technology for Law Enforcement (CASTLE), a partnership of scientific, university, private sector, and law enforcement personnel. The goal of the CASTLE program is to apply technology at the grassroots working level to both solve crimes, to improve safety to law enforcement personnel, and to improve the overall quality of law enforcement services within the United States.

  15. Death, taxes and advance directives.

    PubMed

    Wood, N M; D'Amore, J D; Jones, S L; Sittig, D F; Ness, R B

    2014-01-01

    Suboptimal care at the end-of-life can be due to lack of access or knowledge of patient wishes. Ambiguity is often the result of non-standardized formats. Borrowing digital technology from other industries and using existing health information infrastructure can greatly improve the completion, storage, and distribution of advance directives. We believe several simple, low-cost adaptations to regional and federal programs can raise the standard of end-of-life care. PMID:25024771

  16. [Written advance directives in dementia: useful and relevant].

    PubMed

    Widdershoven, Guy A M; Nieuwenhuijzen Kruseman, Arie C; van Wijmen, Frans C B

    2014-01-01

    According to the Dutch euthanasia law, the current wishes of the patient can be replaced by an advance directive if the patient is unable to give consent. However, Dutch physicians say they have difficulty responding to advance directives in people with dementia. A crucial issue is how to establish whether the patient actually suffers in a specific situation. We argue that the patient's wishes, views and decisions should be discussed in a timely manner, and laid down both in patient directives and in the doctor's files. We also ask for regular discussion, updating and reaffirmation of the advance directive so that the patient can trust the doctor knowing the patient's wishes and what constitutes unbearable suffering for that patient. Through frequent discussion and reaffirmation, the advance directive can play the role intended by the law on euthanasia. PMID:25424631

  17. The Evolution of Health Care Advance Planning Law and Policy

    PubMed Central

    Sabatino, Charles P

    2010-01-01

    Context: The legal tools of health care advance planning have substantially changed since their emergence in the mid-1970s. Thirty years of policy development, primarily at the state legislative level addressing surrogate decision making and advance directives, have resulted in a disjointed policy landscape, yet with important points of convergence evolving over time. An understanding of the evolution of advance care planning policy has important implications for policy at both the state and federal levels. Methods: This article is a longitudinal statutory and literature review of health care advance planning from its origins to the present. Findings: While considerable variability across the states still remains, changes in law and policy over time suggest a gradual paradigm shift from what is described as a “legal transactional approach” to a “communications approach,” the most recent extension of which is the emergence of Physician Orders for Life-Sustaining Treatment, or POLST. The communications approach helps translate patients’ goals into visible and portable medical orders. Conclusions: States are likely to continue gradually moving away from a legal transactional mode of advance planning toward a communications model, albeit with challenges to authentic and reliable communication that accurately translates patients’ wishes into the care they receive. In the meantime, the states and their health care institutions will continue to serve as the primary laboratory for advance care planning policy and practice. PMID:20579283

  18. Advance directives as an instrument in an ageing Europe.

    PubMed

    Goffin, Tom

    2012-04-01

    Advance directives are written or oral statements that are intended to govern healthcare decision-making for their authors, for both positive and negative decisions, should they lose decisional capacity in the future. In a Europe which is facing an ageing population, advance directives play an increasing role to (help) formulate the wishes from elderly patient once they start losing the capacity to decide independently. Advance directives should not only be used as a formulation of the patients' previously made decision, but can also be used as guidelines to better understand the previous expressed wishes of the patient. If the advance directive is formulated in too vague form, the healthcare proxy and/or the healthcare trustee can help the physician interpret the directive. This broader approach towards advance directives is reflected in the case-law of the European Court of Human Rights, as well as on the European legislative level. PMID:22558655

  19. Advance directives: principles, problems, and solutions for physicians.

    PubMed

    Hoffman, B F; Humniski, A

    1997-04-01

    Given the passage of recent legislation, the appearance of common-law reports in Canada and the United States, and the practical problems of implementation of advance directives in health care, physicians should understand the principles and issues involved. In this article, the advantages, disadvantages, and practical solutions to the problems are explored. Family physicians, geriatricians, neurologists, and psychiatrists are most likely to be consulted about advance directives in health care. PMID:12382657

  20. Natural resources policy and law: Trends and directions

    SciTech Connect

    MacDonnell, L.J.; Bates, S.F.

    1993-11-01

    The book explores past, present, and future directions in natural resource environmental law and policy, with a special emphasis on new laws and important legal cases of the past decade and their implications for the future. Its ten chapters, each written by a leading expert in the field, consider both specific concerns and broad themes, including topics such as history and evolution of natural resources law and policy, laws governing mining and minerals, oil and gas, and public lands, and relationship between environmentalism and environmental law, and future directions of the field.

  1. Advanced nursing practice and Newton's three laws of motion.

    PubMed

    Sturgeon, David

    This article considers the reasons for the development of advanced practice roles among nurses and other healthcare professions. It explores the implications of financial constraints, consumer preferences and the development of new healthcare services on the reorganization of professional boundaries. It makes use of Sir Isaac Newton's three laws of motion to demonstrate how professional development in nursing has taken place in response to a number of external influences and demands. It also considers the significance of skill mix for the nursing profession, in particular the development and likely expansion of the physician assistant role. The application of different professionals and grades within a healthcare team or organization is central to the Government's Agenda for Change proposals and nurses have successfully adopted a number of roles traditionally performed by doctors. Nurses have demonstrated that they are capable of providing high quality care and contributing directly to positive patient outcome. Advanced nursing roles should not only reflect the changing nature of healthcare work, they should also be actively engaged in reconstructing healthcare boundaries. PMID:18773586

  2. Psychiatric advance directives: potential challenges in India.

    PubMed

    Sarin, Alok; Murthy, Pratima; Chatterjee, Sudipto

    2012-01-01

    The advance directive is a statement of an individual's preference for future treatment. The concept initially evolved in the context of end-of-life treatment decision making. Subsequently, in some countries, advance directives have been promoted in the care and treatment of people with serious mental disorders. They have recently been endorsed by the United Nations Convention for the Rights of Persons with Disability. In India, the legal framework related to the care of persons with mental illness is currently being reappraised, and significant changes are being contemplated. Thus, this is an appropriate time to review the existing evidence on psychiatric advance directives and examine the potential challenges involved in making them legally binding. A wide spectrum of mental health 'advance statements' have been developed and implemented in some high-resource countries. Of special interest to mental health contexts is the complex Ulysses contract to accommodate situations where the advance directive can be overridden during phases of acute illness or relapse. There have been mixed experiences with advance directives in the last couple of decades and there is scant evidence to suggest that they are effective in improving actual care. There has been almost no discourse in India on the issue of mental health advance directives. Yet this feature is being considered for implementation in the revised legal framework for the care of persons with mental illness. There are significant barriers to the feasibility and acceptability of legally mandated advance directives. There are logistical barriers to operationalising them in a manner that guarantees quality assurance of the process, and minimises the possibility of misuse. Thus, while the advance directive is a highly desirable clinical tool for collaborative decision making between the person with mental illness and the treatment provider, at this time, more needs to be done before legal enforcement is considered in

  3. Advance Directives - Multiple Languages: MedlinePlus

    MedlinePlus

    ... Supplements Videos & Tools You Are Here: Home → Multiple Languages → All Health Topics → Advance Directives URL of this page: https://medlineplus.gov/languages/advancedirectives.html Other topics A-Z A B ...

  4. Advance Directives - Multiple Languages: MedlinePlus

    MedlinePlus

    ... Supplements Videos & Tools You Are Here: Home → Multiple Languages → All Health Topics → Advance Directives URL of this page: https://www.nlm.nih.gov/medlineplus/languages/advancedirectives.html Other topics A-Z A B ...

  5. Advance directives: the New Zealand context.

    PubMed

    Wareham, Pauline; McCallin, Antoinette; Diesfeld, Kate

    2005-07-01

    Advance directives convey consumers' wishes about accepting or refusing future treatment if they become incompetent. They are designed to communicate a competent consumer's perspective regarding the preferred treatment, should the consumer later become incompetent. There are associated ethical issues for health practitioners and this article considers the features that are relevant to nurses. In New Zealand, consumers have a legal right to use an advance directive that is not limited to life-prolonging care and includes general health procedures. Concerns may arise regarding a consumer's competence and the document's validity. Nurses need to understand their legal and professional obligations to comply with an advance directive. What role does a nurse play and what questions arise for a nurse when advance directives are discussed with consumers? This article considers the cultural dimensions, legal boundaries, consumers' and providers' perspectives, and the medical and nursing positions in New Zealand. PMID:16045243

  6. Advance directives education: a critical need.

    PubMed

    Kroning, Maureen

    2014-01-01

    Despite increasing age, most older Americans do not have Advance Health Care Directives (AHCDs) while healthcare providers report limited knowledge for teaching about AHCDs. This article offers a history of AHCDs, explores one method for assessing AHCD knowledge using the Knowledge-Attitudinal-Experimental Survey on Advance Directives (KAESAD), and utilizes adult learning theory to develop an AHCD educational in-service for nurses. AHCD information and resources are provided. PMID:25296485

  7. Advance Directives and Operating: Room for Improvement?

    PubMed

    Hadler, Rachel A; Neuman, Mark D; Raper, Steven; Fleisher, Lee A

    2016-04-01

    Anesthesiologists and surgeons are frequently called on to perform procedures on critically ill patients with advanced directives. We assessed the attitudes of attending and resident surgeons and anesthesiologists at our institution regarding their understanding of and practice around the application of consenting critically ill patients with advance directives in the operating room. To do so, we deployed a survey after interdepartmental grand rounds, featuring a panel discussion of ethically complex cases featuring end-of-life issues. PMID:26599738

  8. [Effective laws for tobacco control: EU directives and Italian legislation].

    PubMed

    Charrier, Lorena; Piccinelli, Cristiano; Coppo, Alessandro; Di Stefano, Francesca; D'Elia, Paolo; Molinar, Roberta; Senore, Carlo; Giordano, Livia; Segnan, Nereo

    2006-01-01

    Effective tobacco control policies include law issuing: bans/restrictions on smoking in public areas and workplaces, increasing of taxes on tobacco products, bans on advertising of tobacco products, warning labels on cigarette boxes. For some of these policies the European Union (EU) has introduced specific directives that EU member states have to put into law. This paper briefly presents literature data, EU directives and the laws consequently issued in Italy. The importance of standardizing European legislation, especially for those policies that are not enforced by EU directives is also discussed. In Italy and in some other European countries smoking is forbidden in public and work-places, despite no EU directive. The positive impact of this ban in these countries suggests that it should be considered a priority in the European policies against tobacco in order to reduce the gap between literature recommendations and actions. PMID:17333695

  9. A survey of stakeholder knowledge, experience, and opinions of advance directives for mental health in Virginia.

    PubMed

    Wilder, Christine M; Swanson, Jeffrey W; Bonnie, Richard J; Wanchek, Tanya; McLaughlin, Laura; Richardson, Jeanita

    2013-05-01

    An innovative Virginia health care law enables competent adults with serious mental illness to plan for treatment during incapacitating crises using an integrated advance directive with no legal distinction between psychiatric or other causes of decisional incapacity. This article reports results of a survey of 460 individuals in five stakeholder groups during the initial period of the law's implementation. All respondents held favorable views of advance directives for mental health care. Identified barriers to completing and using advance directives varied by group. We conclude that relevant stakeholders support implementation of advance directives for mental health, but level of baseline knowledge and perception of barriers vary. A multi-pronged approach will be needed to achieve successful implementation of advance directives for mental health. PMID:22240937

  10. Advances in the directed evolution of proteins

    PubMed Central

    Lane, Michael D.; Seelig, Burckhard

    2014-01-01

    Natural evolution has produced a great diversity of proteins that can be harnessed for numerous applications in biotechnology and pharmaceutical science. Commonly, specific applications require proteins to be tailored by protein engineering. Directed evolution is a type of protein engineering that yields proteins with the desired properties under well-defined conditions and in a practical time frame. While directed evolution has been employed for decades, recent creative developments enable the generation of proteins with previously inaccessible properties. Novel selection strategies, faster techniques, the inclusion of unnatural amino acids or modifications, and the symbiosis of rational design approaches and directed evolution continue to advance protein engineering. PMID:25309990

  11. 24 CFR 1720.150 - Failure to comply with administrative law judge's directions.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... administrative law judge's directions. 1720.150 Section 1720.150 Housing and Urban Development Regulations... Failure to comply with administrative law judge's directions. Any party who refuses or fails to comply with a lawfully issued order or direction of an administrative law judge may be considered to be...

  12. 24 CFR 1720.150 - Failure to comply with administrative law judge's directions.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... administrative law judge's directions. 1720.150 Section 1720.150 Housing and Urban Development Regulations... Failure to comply with administrative law judge's directions. Any party who refuses or fails to comply with a lawfully issued order or direction of an administrative law judge may be considered to be...

  13. Advanced Directives and Advanced Care Planning for Healthcare Professionals.

    PubMed

    Booth, Adam T; Lehna, Carlee

    2016-01-01

    The purposes of this study were to assess healthcare professionals' need for information on advanced directives and to implement and evaluate an educational plan for change in knowledge and behaviors related to advanced directives. End-of-life (EOL) care is an important topic for patients to discuss with their families and healthcare professionals (HP). Needs assessment data were collected from healthcare providers at an urban trauma intensive care unit (ICU) in Louisville, Kentucky on concepts related to end-of-life. Next, healthcare professionals participated in an educational intervention focused on: knowledge about advanced directives; communication techniques for healthcare professionals to use with patients and their families; awareness of the patient's level of illness in advanced care planning; and specifics about living wills in Kentucky and how to complete one. Pre- and post-test data were collected to evaluate change in knowledge, capability an average of 8.7 years (SD = 9.1; range = 1.9-35 years) in healthcare and worked an average of 8.4 years (SD = 9.3; range = 4 months to 35 years) in their respective ICUs. Eighty-seven percent did not have an AD in place even though their perceived knowledge about AD remained moderate throughout pre- and post-test scores (3.3 to 3.8 on a 5 point scale, respectively). Total post-test scores revealed a 2% improvement in correct responses. These findings point to the need for education of healthcare providers in the ICU to increase early AD and ACP discussions with patients and their families. PMID:27183766

  14. Advanced Automated Directional Solidification Furnace (AADSF)

    NASA Technical Reports Server (NTRS)

    1983-01-01

    The Advanced Automated Directional Solidification Furnace (AADSF) with the Experimental Apparatus Container (EAC) attached flew during the USMP-2 mission. This assembly consists of a furnace module, a muffle tube assembly and a translation mechanism which are enclosed in the EAC. During USMP-2, the AADSF was used to study the growth of mercury cadmium telluride crystals in microgravity by directional solidification, a process commonly used on earth to process metals and grow crystals. The furnace is tubular and has three independently controlled temperature zone . The sample travels from the hot zone of the furnace (1600 degrees F) where the material solidifies as it cools. The solidification region, known as the solid/liquid interface, moves from one end of the sample to the other at a controlled rate, thus the term directional solidification.

  15. Law of genome evolution direction: Coding information quantity grows

    NASA Astrophysics Data System (ADS)

    Luo, Liao-Fu

    2009-06-01

    The problem of the directionality of genome evolution is studied. Based on the analysis of C-value paradox and the evolution of genome size, we propose that the function-coding information quantity of a genome always grows in the course of evolution through sequence duplication, expansion of code, and gene transfer from outside. The function-coding information quantity of a genome consists of two parts, p-coding information quantity that encodes functional protein and n-coding information quantity that encodes other functional elements. The evidences on the law of the evolutionary directionality are indicated. The needs of function are the motive force for the expansion of coding information quantity, and the information quantity expansion is the way to make functional innovation and extension for a species. Therefore, the increase of coding information quantity of a genome is a measure of the acquired new function, and it determines the directionality of genome evolution.

  16. [Euthanasia in advanced dementia: directive is useful].

    PubMed

    Wijsbek, Henri

    2013-01-01

    The Dutch Euthanasia Act states that an advance directive can replace an actual request for euthanasia in cases in which a patient has become unable to make autonomous decisions. In Euthanasia and the Severely Demented, I agree with Keizer that the severely demented can suffer unbearably, but contrary to Keizer I do not believe that it is impossible to state in advance the conditions under which one would not wish to go on living any longer. Consequently, euthanasia can be permissible even in patients with late-stage dementia, provided that the other due-care criteria are met. Permissibility by itself, however, will not settle disputes about borderline cases. Due to the erratic course of the disease, the right moment for euthanasia may very well be impossible to determine. PMID:23777971

  17. Geysers advanced direct contact condenser results

    SciTech Connect

    Henderson, J.; Bahning, T.

    1997-12-31

    The world`s first geothermal application of the Advanced Direct Contact Condenser (ADCC) technology developed by the National Renewable Energy Laboratory (NREL) is now operational at The Geysers Power Plant Unit 11. This major research effort was supported through the combined efforts of NREL, The Department of Energy (DOE), and Pacific Gas and Electric (PG&E). The project was the first geothermal adaptation of an advanced condenser design originally demonstrated at the Ocean Thermal Energy Conversion (OTEC) plant in Kona, Hawaii. PG&E expects this technology to improve power plant performance and to help extend the life of the steam field by using steam more efficiently. Successful application of this technology at The Geysers will provide a basis for NREL to continue to develop this technology for other geothermal and fossil power plant systems.

  18. 22 CFR 72.30 - Provisions in a will or advanced directive regarding disposition of remains.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... regarding disposition of remains. 72.30 Section 72.30 Foreign Relations DEPARTMENT OF STATE PROTECTION AND... disposition of remains. United States state law regarding advance directives, deaths and estates include... accept such directions, particularly if the surviving spouse/next-of-kin disagree with the wishes of...

  19. 22 CFR 72.30 - Provisions in a will or advanced directive regarding disposition of remains.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... regarding disposition of remains. 72.30 Section 72.30 Foreign Relations DEPARTMENT OF STATE PROTECTION AND... disposition of remains. United States state law regarding advance directives, deaths and estates include... accept such directions, particularly if the surviving spouse/next-of-kin disagree with the wishes of...

  20. Sexuality in advanced age in Jewish thought and law.

    PubMed

    David, Benjamin E; Weitzman, Gideon A

    2015-01-01

    Judaism has a positive attitude to sexual relations within a marriage, and views such sexual relations as important not only for procreation but also as part of the framework of marriage. This is true for any age group, and sexuality is seen as an essential element of marriage for couples of advanced age. In this article, the authors present the views of Jewish law and thought regarding sexuality among older couples. The authors illustrate this using 3 case studies of couples who sought guidance in the area of sexuality. In addition, this area of counseling benefits greatly from an ongoing relationship and dialogue between expert rabbis in the field and therapists treating older Orthodox Jewish patients for sexual dysfunction. The triad relationship of couple, therapist, and rabbi enhances the ability to treat and assist such couples to seek treatment and overcome their difficulties. PMID:24313599

  1. An ultrathin directional carpet cloak based on generalized Snell's law

    NASA Astrophysics Data System (ADS)

    Zhang, Jing; Lei Mei, Zhong; Ru Zhang, Wan; Yang, Fan; Jun Cui, Tie

    2013-10-01

    Based on generalized Snell's law, we propose an ultrathin directional carpet cloak operating in the reflection geometry. The cloak is constructed by two identical ultrathin metal-backed dielectric slabs with metallic "H" patterns on the other sides to form a triangular region. When put on an infinite ground plane and illuminated by electromagnetic waves from overhead, it can manipulate the reflected wavefronts to mimic the infinite ground plane. We fabricate a microwave sample and perform near-field scanning experiments to verify the cloaking effect. The measurement results are in good agreement with full-wave simulations and theoretical analysis.

  2. [Advance directives, a tool to humanize care].

    PubMed

    Olmari-Ebbing, M; Zumbach, C N; Forest, M I; Rapin, C H

    2000-07-01

    The relationship between the patient and a medical care giver is complex specially as it implies to the human, juridical and practical points of view. It depends on legal and deontological considerations, but also on professional habits. Today, we are confronted to a fundamental modification of this relationship. Professional guidelines exist, but are rarely applied and rarely taught in universities. However, patients are eager to move from a paternalistic relationship to a true partnership, more harmonious and more respectful of individual values ("value based medicine"). Advance directives give us an opportunity to improve our practices and to provide care consistent with the needs and wishes of each patient. PMID:10967645

  3. Geysers advanced direct contact condenser research

    SciTech Connect

    Henderson, J.; Bahning, T.; Bharathan, D.

    1997-12-31

    The first geothermal application of the Advanced Direct Contact Condenser (ADCC) technology developed by the National Renewable Energy Laboratory (NREL) is now operational and is being tested at The Geysers Power Plant Unit 11. This major research effort is being supported through the combined efforts of NREL, The Department of Energy (DOE), and Pacific Gas and Electric (PG&E). NREL and PG&E have entered into a Cooperative Research And Development Agreement (CRADA) for a project to improve the direct-contact condenser performance at The Geysers Power Plant. This project is the first geothermal adaptation of an advanced condenser design developed for the Ocean Thermal Energy Conversion (OTEC) systems. PG&E expects this technology to improve power plant performance and to help extend the life of the steam field by using steam more efficiently. In accordance with the CRADA, no money is transferred between the contracting parties. In this case the Department of Energy is funding NREL for their efforts in this project and PG&E is contributing funds in kind. Successful application of this technology at The Geysers will provide a basis for NREL to continue to develop this technology for other geothermal and fossil power plant systems.

  4. Direct Cardiac Reprogramming: Advances in Cardiac Regeneration

    PubMed Central

    Chen, Olivia; Qian, Li

    2015-01-01

    Heart disease is one of the lead causes of death worldwide. Many forms of heart disease, including myocardial infarction and pressure-loading cardiomyopathies, result in irreversible cardiomyocyte death. Activated fibroblasts respond to cardiac injury by forming scar tissue, but ultimately this response fails to restore cardiac function. Unfortunately, the human heart has little regenerative ability and long-term outcomes following acute coronary events often include chronic and end-stage heart failure. Building upon years of research aimed at restoring functional cardiomyocytes, recent advances have been made in the direct reprogramming of fibroblasts toward a cardiomyocyte cell fate both in vitro and in vivo. Several experiments show functional improvements in mouse models of myocardial infarction following in situ generation of cardiomyocyte-like cells from endogenous fibroblasts. Though many of these studies are in an early stage, this nascent technology holds promise for future applications in regenerative medicine. In this review, we discuss the history, progress, methods, challenges, and future directions of direct cardiac reprogramming. PMID:26176012

  5. Advance directive decision making among medical inpatients.

    PubMed

    Rein, A J; Harshman, D L; Frick, T; Phillips, J M; Lewis, S; Nolan, M T

    1996-01-01

    Per the Patient Self-Determination Act of 1991, hospitals are required to ascertain whether patients have an advance directive (AD). At this point, factors prompting patients to issue ADs have not been studied. The purpose of this study was to describe patients' understanding of ADs as well as the process patients used to arrive at their decisions to implement an AD. A stratified random sample of 26 patients from two intensive care units, one general medical unit, one general cardiac unit, and one acquired immunodeficiency unit were selected for participation. Patients were asked a series of open-ended questions to determine their knowledge and understanding of ADs. The constant comparative method was used to review the transcripts. It was found that only 31 per cent of patients had issued an AD, and 20% had learned of ADs for the first time during their hospitalization. Response analysis showed four phases of AD decision making: evaluation of illness, establishment of priorities, consideration of implications of the directives, and selection or rejection of directives. In conclusion, patients continue to have limited understanding of ADs and their implications. Continued investigation will elucidate the best strategies to educate patients about this topic. PMID:8583031

  6. Dietary biomarkers: advances, limitations and future directions.

    PubMed

    Hedrick, Valisa E; Dietrich, Andrea M; Estabrooks, Paul A; Savla, Jyoti; Serrano, Elena; Davy, Brenda M

    2012-01-01

    The subjective nature of self-reported dietary intake assessment methods presents numerous challenges to obtaining accurate dietary intake and nutritional status. This limitation can be overcome by the use of dietary biomarkers, which are able to objectively assess dietary consumption (or exposure) without the bias of self-reported dietary intake errors. The need for dietary biomarkers was addressed by the Institute of Medicine, who recognized the lack of nutritional biomarkers as a knowledge gap requiring future research. The purpose of this article is to review existing literature on currently available dietary biomarkers, including novel biomarkers of specific foods and dietary components, and assess the validity, reliability and sensitivity of the markers. This review revealed several biomarkers in need of additional validation research; research is also needed to produce sensitive, specific, cost-effective and noninvasive dietary biomarkers. The emerging field of metabolomics may help to advance the development of food/nutrient biomarkers, yet advances in food metabolome databases are needed. The availability of biomarkers that estimate intake of specific foods and dietary components could greatly enhance nutritional research targeting compliance to national recommendations as well as direct associations with disease outcomes. More research is necessary to refine existing biomarkers by accounting for confounding factors, to establish new indicators of specific food intake, and to develop techniques that are cost-effective, noninvasive, rapid and accurate measures of nutritional status. PMID:23237668

  7. The Advanced Automated Directional Solidification Furnace

    NASA Technical Reports Server (NTRS)

    Gillies, D. C.; Reeves, F. A.; Jeter, L. B.; Sledd, J. D.; Cole, J. M.; Lehoczky, S. L.

    1996-01-01

    The Advanced Automated Directional Solidification Furnace (AADSF) is a five zone tubular furnace designed for Bridgman-Stockbarger, other techniques of crystal growth involving multiple temperature zones such as vapor transport experiments and other materials science experiments. The five zones are primarily designed to produce uniform hot and cold temperature regions separated by an adiabatic region constructed of a heat extraction plate and an insert to reduce radiation from the hot to the cold zone. The hot and cold zone temperatures are designed to reach 1600 C and 1100 C, respectively. AADSF operates on a Multi-Purpose Experiment Support Structure (MPESS) within the cargo bay of the Space Shuttle on the United States Microgravity Payload (USMP) missions. Two successful flights, both employing the directional solidification or Bridgman Stockbarger technique for crystal growth have been made, and crystals of HgCdTe and PbSnTe grown in microgravity have been produced on USMP-2 and USMP-3, respectively. The addition of a Sample Exchange Mechanism (SEM) will enable three different samples to be processed on future flights including the USMP-4 mission.

  8. Sex Segregation and the Ambivalent Directions of Sex Discrimination Law.

    ERIC Educational Resources Information Center

    Powers, Kathryn L.

    1979-01-01

    Recognition that the goal of equal social participation of women and men is the underlying purpose of sex discrimination law provides means for extending that law to the discriminatory bases of legal policies that support occupational segregation and inequitable treatment of women. Available from Wisconsin Law Review, University of Wisconsin Law…

  9. Tools for advance directives. American Health Information Management Association.

    PubMed

    Schraffenberger, L A

    1992-02-01

    This issue of the Journal of AHIMA contains a Position Statement on advance directives. Here we have included several "tools" or helpful documents to support your organization's ongoing education regarding advance directives. First, we offer a "Sample Policy and Procedure" addressing the administrative process of advance directives. This sample policy was adapted from a policy shared by Jean Clark, RRA, operations director with Roper Hospital in Charleston, SC, and a director on the AHIMA Board of Directors. Do not automatically accept this policy and procedure for your organization. Instead, the health information management professional could use this sample to write your organization's own, specific policy and procedures that are consistent with your state's law and legal counsel's advice. The second article, "Advance Directives and the New Joint Commission Requirements," compares 1992 Joint Commission standards for Patient Rights and The Patient Self-Determination Act requirements. Selected sections from the Joint Commission chapter on Patient Rights are highlighted and comments added that contrast it with the act. "Common Questions and Answers Related to Advance Directives" is the third tool we offer. These questions and answers may be used for a patient education brochure or staff inservice education program outline. Again, information specific to your own state needs to be added. The fourth tool we offer is miniature "Sample Slides" or overhead transparency copy that can be enlarged and used for a presentation on the basics of advance directives for a community group for staff education. We thank Dee McLane, RRA, director, Medical Information Services at Self Memorial Hospital in Greenwood, SC, who developed these slides for presentations conducted at her hospital. We also thank Jeri Whitworth, RRA, who produced the graphics on these slides. Whitworth is a first year director on the AHIMA Board of Directors this year. Again you can use as is or consider

  10. Beyond competence: advance directives in dementia research.

    PubMed

    Jongsma, Karin Rolanda; van de Vathorst, Suzanne

    2015-01-01

    Dementia is highly prevalent and incurable. The participation of dementia patients in clinical research is indispensable if we want to find an effective treatment for dementia. However, one of the primary challenges in dementia research is the patients' gradual loss of the capacity to consent. Patients with dementia are characterized by the fact that, at an earlier stage of their life, they were able to give their consent to participation in research. Therefore, the phase when patients are still competent to decide offers a valuable opportunity to authorize research, by using an advance research directive (ARD). Yet, the use of ARDs as an authorization for research participation remains controversial. In this paper we discuss the role of autonomous decision-making and the protection of incompetent research subjects. We will show why ARDs are a morally defensible basis for the inclusion of this population in biomedical research and that the use of ARDs is compatible with the protection of incompetent research subjects. PMID:26458366

  11. Genetic Psychophysiology: advances, problems, and future directions

    PubMed Central

    Anokhin, Andrey P.

    2014-01-01

    This paper presents an overview of historical advances and the current state of genetic psychophysiology, a rapidly developing interdisciplinary research linking genetics, brain, and human behavior, discusses methodological problems, and outlines future directions of research. The main goals of genetic psychophysiology are to elucidate the neural pathways and mechanisms mediating genetic influences on cognition and emotion, identify intermediate brain-based phenotypes for psychopathology, and provide a functional characterization of genes being discovered by large association studies of behavioral phenotypes. Since the initiation of this neurogenetic approach to human individual differences in the 1970s, numerous twin and family studies have provided strong evidence for heritability of diverse aspects of brain function including resting-state brain oscillations, functional connectivity, and event-related neural activity in a variety of cognitive and emotion processing tasks, as well as peripheral psychophysiological responses. These data indicate large differences in the presence and strength of genetic influences across measures and domains, permitting the selection of heritable characteristics for gene finding studies. More recently, candidate gene association studies began to implicate specific genetic variants in different aspects of neurocognition. However, great caution is needed in pursuing this line of research due to its demonstrated proneness to generate false-positive findings. Recent developments in methods for physiological signal analysis, hemodynamic imaging, and genomic technologies offer new exciting opportunities for the investigation of the interplay between genetic and environmental factors in the development of individual differences in behavior, both normal and abnormal. PMID:24739435

  12. Advance directives, dementia, and physician-assisted death.

    PubMed

    Menzel, Paul T; Steinbock, Bonnie

    2013-01-01

    Physician-assisted suicide laws in Oregon and Washington require the person's current competency and a prognosis of terminal illness. In The Netherlands voluntariness and unbearable suffering are required for euthanasia. Many people are more concerned about the loss of autonomy and independence in years of severe dementia than about pain and suffering in their last months. To address this concern, people could write advance directives for physician-assisted death in dementia. Should such directives be implemented even though, at the time, the person is no longer competent and would not be either terminally ill or suffering unbearably? We argue that in many cases they should be, and that a sliding scale which considers both autonomy and the capacity for enjoyment provides the best justification for determining when: when written by a previously well-informed and competent person, such a directive gains in authority as the later person's capacities to generate new critical interests and to enjoy life decrease. Such an extension of legalized death assistance is grounded in the same central value of voluntariness that undergirds the current more limited legalization. PMID:23802899

  13. 42 CFR 422.128 - Information on advance directives.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Information on advance directives. 422.128 Section....128 Information on advance directives. (a) Each MA organization must maintain written policies and... or otherwise discriminate against an individual based on whether or not the individual has...

  14. Direct therapeutic intervention for advanced pancreatic cancer

    PubMed Central

    Takakura, Kazuki; Koido, Shigeo

    2015-01-01

    Currently, chemotherapy is an accredited, standard treatment for unresectable, advanced pancreatic cancer (PC). However, it has been still showed treatment-resistance and followed dismal prognosis in many cases. Therefore, some sort of new, additional treatments are needed for the better therapeutic results for advanced PC. According to the previous reports, it is obvious that interventional endoscopic ultrasonography (EUS) is a well-established, helpful and low-risky procedure in general. As the additional treatments of the conventional therapy for advanced PC, many therapeutic strategies, such as immunotherapies, molecular biological therapies, physiochemical therapies, radioactive therapies, using siRNA, using autophagy have been developing in recent years. Moreover, the efficacy of the other potential therapeutic targets for PC using EUS-fine needle injection, for example, intra-tumoral chemotherapeutic agents (paclitaxel, irinotecan), several ablative energies (radiofrequency ablation and cryothermal treatment, neodymium-doped yttrium aluminum garnet laser, high-intensity focused ultrasound), etc., has already been showed in animal models. Delivering these promising treatments reliably inside tumor, interventional EUS may probably be indispensable existence for the treatment of locally advanced PC in near future. PMID:26677434

  15. Direct therapeutic intervention for advanced pancreatic cancer.

    PubMed

    Takakura, Kazuki; Koido, Shigeo

    2015-12-10

    Currently, chemotherapy is an accredited, standard treatment for unresectable, advanced pancreatic cancer (PC). However, it has been still showed treatment-resistance and followed dismal prognosis in many cases. Therefore, some sort of new, additional treatments are needed for the better therapeutic results for advanced PC. According to the previous reports, it is obvious that interventional endoscopic ultrasonography (EUS) is a well-established, helpful and low-risky procedure in general. As the additional treatments of the conventional therapy for advanced PC, many therapeutic strategies, such as immunotherapies, molecular biological therapies, physiochemical therapies, radioactive therapies, using siRNA, using autophagy have been developing in recent years. Moreover, the efficacy of the other potential therapeutic targets for PC using EUS-fine needle injection, for example, intra-tumoral chemotherapeutic agents (paclitaxel, irinotecan), several ablative energies (radiofrequency ablation and cryothermal treatment, neodymium-doped yttrium aluminum garnet laser, high-intensity focused ultrasound), etc., has already been showed in animal models. Delivering these promising treatments reliably inside tumor, interventional EUS may probably be indispensable existence for the treatment of locally advanced PC in near future. PMID:26677434

  16. 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. PMID:22190599

  17. Environmental Policy. Law, and Administration: A Guide to Advanced Study.

    ERIC Educational Resources Information Center

    Caldwell, Lynton K.; Siddiqi, Toufiq A.

    This guide is intended to assist the organization of studies dealing with the behavior of human societies and their institutions in relation to their environments. Emphasis is on contemporary industrial and postindustrial society as it expresses its environmental relationships through action defined by policies, laws, and administrative…

  18. Foreword: planning for the future through advance directive instruments.

    PubMed

    Winick, B J

    1998-09-01

    The Foreword traces the development of advance directive instruments and discusses their legal enforceability and many benefits. Despite their advantages, advance directives remain underused and are frequently ignored by service providers. The contributors to this special issue discuss why this is so and offer and debate a variety of remedial proposals. They analyze the various legal, clinical, ethical, and practical issues presented by the use of advance directives for health and mental health care and examine new directions in their application. The Foreword describes the organization of this special issue, summarizes the articles it contains, and comments on their significance. PMID:12803208

  19. Psychiatric advance directives and social workers: an integrative review.

    PubMed

    Van Dorn, Richard A; Scheyett, Anna; Swanson, Jeffrey W; Swartz, Marvin S

    2010-04-01

    Psychiatric advance directives (PADs) are legal documents that allow individuals to express their wishes for future psychiatric care and to authorize a legally appointed proxy to make decisions on their behalf during incapacitating crises. PADs are viewed as an alternative to the coercive interventions that sometimes accompany mental health crises for people with mental illness. Insofar as coercive interventions can abridge clients' autonomy and self-determination--values supported by the NASW Code of Ethics--social workers have a vested interest in finding ways to reduce coercion and increase autonomy and self-determination in their practice. However, PADs are also viewed as having the potential to positively affect a variety of other clinical outcomes, including, but not limited to, treatment engagement, treatment satisfaction, and working alliance. This article reviews the clinical and legal history of PADs and empirical evidence for their implementation and effectiveness. Despite what should be an inherent interest in PADs and the fact that laws authorizing PADs have proliferated in the past decade, there is little theoretical or empirical research on PADS in the social work literature. PMID:20408357

  20. Psychiatric Advance Directives and Social Workers: An Integrative Review

    PubMed Central

    Van Dorn, Richard A.; Scheyett, Anna; Swanson, Jeffrey W.; Swartz, Marvin S.

    2013-01-01

    Psychiatric Advance Directives (PADs) are legal documents that allow individuals to express their wishes for future psychiatric care and to authorize a legally appointed proxy to make decisions on their behalf during incapacitating crises. PADs are viewed as an alternative to the coercive interventions that sometimes accompany mental health crises for persons with mental illness. Insofar as coercive interventions can abridge clients’ autonomy and self-determination -- values supported by the Profession’s Code of Ethics -- social workers have a vested interest in finding ways to reduce coercion and increase autonomy and self-determination in their practice. However, PADs are also viewed as having the potential to positively affect a variety of other clinical outcomes, including but not limited to treatment engagement, treatment satisfaction, and working alliance. This article reviews the clinical and legal history of PADs and empirical evidence for their implementation and effectiveness. Despite what should be an inherent interest in PADs, and the fact that laws authorizing PADs have proliferated in the past decade, there is little theoretical or empirical research in the social work literature. PMID:20408357

  1. Advanced direct coal liquefaction concepts - appendix

    SciTech Connect

    Berger, D.J.; Parker, R.J.; Simpson, P.L.

    1994-07-01

    This detailed appendix presents the results of direct coal liquefaction studies performed by the contractor. Several hundred tables summarizing the chemical compostion for runs of a bench scale reactor are presented.

  2. Nanoelectrodes: Recent Advances and New Directions

    NASA Astrophysics Data System (ADS)

    Cox, Jonathan T.; Zhang, Bo

    2012-07-01

    This article reviews recent work involving the development and application of nanoelectrodes in electrochemistry and related areas. We first discuss common analytical methods for characterizing the size, shape, and quality of nanoelectrodes, including electron microscopy, steady-state cyclic voltammetry, scanning electrochemical microscopy, and surface modification. We then emphasize recent developments in fabrication techniques that have led to structurally well-defined nanoelectrodes. We highlight recent advances in the application of nanoelectrodes in important analytical chemistry areas, such as single-molecule studies, single-nanoparticle electrochemistry, and measurements of neurotransmitters from single neuronal cells.

  3. Integrating Advance Research Directives into the European Legal Framework.

    PubMed

    Andorno, Roberto; Gennet, Eloïse; Jongsma, Karin; Elger, Bernice

    2016-04-01

    The possibility of using advance directives to prospectively consent to research participation in the event of dementia remains largely unexplored in Europe. Moreover, the legal status of advance directives for research is unclear in the European regulations governing biomedical research. The article explores the place that advance research directives have in the current European legal framework, and considers the possibility of integrating them more explicitly into the existing regulations. Special focus is placed on issues regarding informed consent, the role of proxies, and the level of acceptable risks and burdens. PMID:27228684

  4. Advances in direct oxidation methanol fuel cells

    NASA Technical Reports Server (NTRS)

    Surampudi, S.; Narayanan, S. R.; Vamos, E.; Frank, H.; Halpert, G.; Laconti, Anthony B.; Kosek, J.; Prakash, G. K. Surya; Olah, G. A.

    1993-01-01

    Fuel cells that can operate directly on fuels such as methanol are attractive for low to medium power applications in view of their low weight and volume relative to other power sources. A liquid feed direct methanol fuel cell has been developed based on a proton exchange membrane electrolyte and Pt/Ru and Pt catalyzed fuel and air/O2 electrodes, respectively. The cell has been shown to deliver significant power outputs at temperatures of 60 to 90 C. The cell voltage is near 0.5 V at 300 mA/cm(exp 2) current density and an operating temperature of 90 C. A deterrent to performance appears to be methanol crossover through the membrane to the oxygen electrode. Further improvements in performance appear possible by minimizing the methanol crossover rate.

  5. [Nurses' knowledge about the health care proxy and advance directives].

    PubMed

    Georget, Jean-Philippe; Cecire-Denoyer, Catherine

    2015-06-01

    The Basse-Normandie palliative care nurses' group carried out a survey regarding nurses' knowledge of the health care proxy and advance directives. The study revealed a lack of connection between these two arrangements, poor knowledge about advance directives but an understanding of the role of the health care proxy. How, therefore, can patients be effectively informed? How should they be supported in this process of determining themselves the conditions of their end of life? PMID:26146326

  6. Neonatal ethical issues: viability, advance directives, family centered care.

    PubMed

    Sudia-Robinson, Tanya

    2011-01-01

    Ethical issues in perinatal and NICU settings can arise from a variety of situations. This article focuses on issues surrounding viability and the incorporation of advance directives and family-centered care. Prenatal education about infant viability, probable scenarios, and parental involvement in decision-making are addressed. Considerations for advance directives for complex births and critical decisions at the time of birth are also discussed. Implications for nurses and suggested dialogue strategies are provided. PMID:21407121

  7. Controlling death: the false promise of advance directives.

    PubMed

    Perkins, Henry S

    2007-07-01

    Advance directives promise patients a say in their future care but actually have had little effect. Many experts blame problems with completion and implementation, but the advance directive concept itself may be fundamentally flawed. Advance directives simply presuppose more control over future care than is realistic. Medical crises cannot be predicted in detail, making most prior instructions difficult to adapt, irrelevant, or even misleading. Furthermore, many proxies either do not know patients' wishes or do not pursue those wishes effectively. Thus, unexpected problems arise often to defeat advance directives, as the case in this paper illustrates. Because advance directives offer only limited benefit, advance care planning should emphasize not the completion of directives but the emotional preparation of patients and families for future crises. The existentialist Albert Camus might suggest that physicians should warn patients and families that momentous, unforeseeable decisions lie ahead. Then, when the crisis hits, physicians should provide guidance; should help make decisions despite the inevitable uncertainties; should share responsibility for those decisions; and, above all, should courageously see patients and families through the fearsome experience of dying. PMID:17606961

  8. 48 CFR 970.5204-2 - Laws, regulations, and DOE directives.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Laws, regulations, and DOE... SUPPLEMENTARY REGULATIONS DOE MANAGEMENT AND OPERATING CONTRACTS Solicitation Provisions and Contract Clauses for Management and Operating Contracts 970.5204-2 Laws, regulations, and DOE directives. As...

  9. Advanced progress concepts for direct coal liquefaction

    SciTech Connect

    Anderson, R.; Derbyshire, F.; Givens, E.

    1995-09-01

    Given the low cost of petroleum crude, direct coal liquefaction is still not an economically viable process. The DOE objectives are to further reduce the cost of coal liquefaction to a more competitive level. In this project the primary focus is on the use of low-rank coal feedstocks. A particular strength is the use of process-derived liquids rather than model compound solvents. The original concepts are illustrated in Figure 1, where they are shown on a schematic of the Wilsonville pilot plant operation. Wilsonville operating data have been used to define a base case scenario using run {number_sign}263J, and Wilsonville process materials have been used in experimental work. The CAER has investigated: low severity CO pretreatment of coal for oxygen rejection, increasing coal reactivity and mg inhibiting the propensity for regressive reactions; the application of more active. Low-cost Fe and Mo dispersed catalysts; and the possible use of fluid coking for solids rejection and to generate an overhead product for recycle. CONSOL has investigated: oil agglomeration for coal ash rejection, for the possible rejection of ash in the recycled resid, and for catalyst addition and recovery; and distillate dewaxing to remove naphthenes and paraffins, and to generate an improved quality feed for recycle distillate hydrogenation. At Sandia, research has been concerned with the production of active hydrogen donor distillate solvent fractions produced by the hydrogenation of dewaxed distillates and by fluid coking via low severity reaction with H{sub 2}/CO/H{sub 2}O mixtures using hydrous metal oxide and other catalysts.

  10. Competency for creation, use, and revocation of psychiatric advance directives.

    PubMed

    Srebnik, Debra S; Kim, Scott Y

    2006-01-01

    Psychiatric advance directives help promote patient involvement in treatment and expedite psychiatric care. However, clinicians are unsure of how to use directives, partly due to poor clarity regarding standards for capacity to create, use, and revoke them. This article recommends possible capacity standards. Capacity to create directives is a legal presumption, supported by empirical data. Standards are discussed for the subset of cases in which capacity assessment is needed. Use of directives may be triggered by incapacity to provide informed consent to treatment, although tailored, individualized points of activation may also be considered. In many states, revocation of a psychiatric advance directive requires adequate decision-making capacity. Setting a capacity standard for revocation presents challenges, however, in light of obstacles to providing treatment when revocation is attempted and the fact that many patients prefer revocable directives. As more directives are created and used, additional research and statutory refinements are warranted. PMID:17185480

  11. Optimal guidance law development for an advanced launch system

    NASA Technical Reports Server (NTRS)

    Calise, Anthony J.; Leung, Martin S. K.

    1995-01-01

    The objective of this research effort was to develop a real-time guidance approach for launch vehicles ascent to orbit injection. Various analytical approaches combined with a variety of model order and model complexity reduction have been investigated. Singular perturbation methods were first attempted and found to be unsatisfactory. The second approach based on regular perturbation analysis was subsequently investigated. It also fails because the aerodynamic effects (ignored in the zero order solution) are too large to be treated as perturbations. Therefore, the study demonstrates that perturbation methods alone (both regular and singular perturbations) are inadequate for use in developing a guidance algorithm for the atmospheric flight phase of a launch vehicle. During a second phase of the research effort, a hybrid analytic/numerical approach was developed and evaluated. The approach combines the numerical methods of collocation and the analytical method of regular perturbations. The concept of choosing intelligent interpolating functions is also introduced. Regular perturbation analysis allows the use of a crude representation for the collocation solution, and intelligent interpolating functions further reduce the number of elements without sacrificing the approximation accuracy. As a result, the combined method forms a powerful tool for solving real-time optimal control problems. Details of the approach are illustrated in a fourth order nonlinear example. The hybrid approach is then applied to the launch vehicle problem. The collocation solution is derived from a bilinear tangent steering law, and results in a guidance solution for the entire flight regime that includes both atmospheric and exoatmospheric flight phases.

  12. Advanced in turbulence physics and modeling by direct numerical simulations

    NASA Technical Reports Server (NTRS)

    Reynolds, W. C.

    1987-01-01

    The advent of direct numerical simulations of turbulence has opened avenues for research on turbulence physics and turbulence modeling. Direct numerical simulation provides values for anything that the scientist or modeler would like to know about the flow. An overview of some recent advances in the physical understanding of turbulence and in turbulence modeling obtained through such simulations is presented.

  13. Advance directives, dementia, and withholding food and water by mouth.

    PubMed

    Menzel, Paul T; Chandler-Cramer, M Colette

    2014-01-01

    People with dementia who are no longer competent have limited control over how their lives end. But an advance directive to withhold food and water by mouth could be used to ensure that one does not live for years in severe dementia. Such directives are arguably already legal. PMID:24821250

  14. 42 CFR 422.128 - Information on advance directives.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... concerning its policies and procedures on advance directives. (I) Provide for community education regarding... directly or in concert with other providers or entities. Separate community education materials may be... to document its community education efforts. (2) The MA organization— (i) Is not required to...

  15. A direct test of Listing's law--I. Human ocular torsion measured in static tertiary positions.

    PubMed

    Ferman, L; Collewijn, H; Van den Berg, A V

    1987-01-01

    The validity of Listing's law was reinvestigated by means of a direct test. Horizontal, vertical and torsional eye movements were measured simultaneously with a recently developed scleral induction coil. Either eye of 4 subjects was measured monocularly. Eye position were measured in Fick coordinates and ocular torsion values were compared to the theoretical ones predicted by Listing's law. During consecutive measurements in the primary position torsion values were close to zero although considerable fluctuations of torsion were seen. Torsion values in the secondary positions were also close to zero. In the tertiary positions torsion in the direction as predicted by Listing's law and increasing with eccentricity was recorded. In the temporal quadrants mean torsion was quantitatively in agreement with Listing's law; torsion values in the nasal quadrants however showed systematically larger values and this discrepancy increased with eccentricity to more than 50%. Statistical support for this finding however, was seen only in 4 out of 8 eyes. Symmetry could be obtained by shifting the chosen horizontal primary position (gaze parallel to the midplane) in the temporal direction; as a consequence all measured torsion values would exceed the ones specified by Listing's law. Torsion values varied idiosyncratically among subjects and among the left and right eyes of any one subject. It is concluded that Listing's law specifies ocular torsion only approximately: physiological eye movements show considerable stochastical as well as systematical deviations from this law. PMID:3660654

  16. Law.

    ERIC Educational Resources Information Center

    Walker, W. R.; Cox, W. E.

    1978-01-01

    Presents a literature review of the legal issues relative to water quality covering publications of 1977. Consideration is given to federal laws, Supreme Court cases, and the impact of federal environmental laws on local government. A list of 47 references is also presented. (HM)

  17. High-Alpha Research Vehicle Lateral-Directional Control Law Description, Analyses, and Simulation Results

    NASA Technical Reports Server (NTRS)

    Davidson, John B.; Murphy, Patrick C.; Lallman, Frederick J.; Hoffler, Keith D.; Bacon, Barton J.

    1998-01-01

    This report contains a description of a lateral-directional control law designed for the NASA High-Alpha Research Vehicle (HARV). The HARV is a F/A-18 aircraft modified to include a research flight computer, spin chute, and thrust-vectoring in the pitch and yaw axes. Two separate design tools, CRAFT and Pseudo Controls, were integrated to synthesize the lateral-directional control law. This report contains a description of the lateral-directional control law, analyses, and nonlinear simulation (batch and piloted) results. Linear analysis results include closed-loop eigenvalues, stability margins, robustness to changes in various plant parameters, and servo-elastic frequency responses. Step time responses from nonlinear batch simulation are presented and compared to design guidelines. Piloted simulation task scenarios, task guidelines, and pilot subjective ratings for the various maneuvers are discussed. Linear analysis shows that the control law meets the stability margin guidelines and is robust to stability and control parameter changes. Nonlinear batch simulation analysis shows the control law exhibits good performance and meets most of the design guidelines over the entire range of angle-of-attack. This control law (designated NASA-1A) was flight tested during the Summer of 1994 at NASA Dryden Flight Research Center.

  18. Psychiatric Advance Directives and Social Workers: An Integrative Review

    ERIC Educational Resources Information Center

    Van Dorn, Richard A.; Scheyett, Anna; Swanson, Jeffrey W.; Swartz, Marvin S.

    2010-01-01

    Psychiatric advance directives (PADs) are legal documents that allow individuals to express their wishes for future psychiatric care and to authorize a legally appointed proxy to make decisions on their behalf during incapacitating crises. PADs are viewed as an alternative to the coercive interventions that sometimes accompany mental health crises…

  19. 42 CFR 422.128 - Information on advance directives.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Information on advance directives. 422.128 Section 422.128 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) MEDICARE ADVANTAGE PROGRAM Benefits and Beneficiary Protections § 422.128 Information on...

  20. Implementation of an advance directives program in an HMO.

    PubMed

    Houseman, S H

    1994-03-01

    In 1992, Group Health Association (GHA), an HMO in the Washington, DC, metropolitan area, under the auspices of its Ethics Forum, undertook a major and ongoing project to educate its medical staff and patient members about the advantages and uses of advance directives. The following article describes how this project was implemented. PMID:10132938

  1. 42 CFR 422.128 - Information on advance directives.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 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 SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Benefits and Beneficiary Protections §...

  2. University Students' Views on the Utility of Psychiatric Advance Directives

    ERIC Educational Resources Information Center

    Scheyett, Anna M.; Rooks, Adrienne

    2012-01-01

    Objective: Rates of serious mental illnesses (SMIs) among university students are increasing, and universities are struggling with how to respond to students who show SMI symptoms. Psychiatric advance directives (PADs) allow individuals, when well, to document their wishes for treatment during a psychiatric crisis. This project explored the…

  3. The role of advance euthanasia directives as an aid to communication and shared decision-making in dementia.

    PubMed

    Hertogh, C M P M

    2009-02-01

    Recent evaluation of the practice of euthanasia and related medical decisions at the end of life in the Netherlands has shown a slight decrease in the frequency of physician-assisted death since the enactment of the Euthanasia Law in 2002. This paper focuses on the absence of euthanasia cases concerning patients with dementia and a written advance euthanasia directive, despite the fact that the only real innovation of the Euthanasia Law consisted precisely in allowing physicians to act upon such directives. The author discusses two principal reasons for this absence. One relates to the uncertainty about whether patients with advanced dementia truly experience the suffering they formerly feared. There is reason to assume that they don't, as a consequence of psychological adaptation and progressive unawareness (anosognosia). The second, more fundamental reason touches upon the ethical relevance of shared understanding and reciprocity. The author argues that, next to autonomy and mercifulness, "reciprocity" is a condition sine qua non for euthanasia. The absence thereof in advanced dementia renders euthanasia morally inconceivable, even if there are signs of suffering and notwithstanding the presence of an advance euthanasia directive. This does not mean, however, that advance euthanasia directives of patients with dementia are worthless. They might very well have a role in the earlier stages of certain subtypes of the disease. To illustrate this point the author presents a case in which the advance directive helped to create a window of opportunity for reciprocity and shared decision-making. PMID:19181882

  4. Assessing Advance Care Planning: Examining Autonomous Selections in an Advance Directive.

    PubMed

    Klugman, Craig M; Tolwin, Nicole M

    2015-01-01

    We examined the management of completed advance directives including why participants completed a document, what procedures and values they chose, with whom they held end-of-life conversations, and where they stored their document. Participants elected to complete a SurveyMonkey survey that was made available to individuals who wrote an advance directive through TexasLivingWill.org; 491 individuals elected to fill out the survey, aged 19 to 94 years. The survey asked multiple questions about why participants completed an advance directive, where they would store it, and with whom they had conversations about their end-of-life wishes. A list of procedures and values allowed participants to indicate what they refused or requested in their advance directive. Advance directives are most often completed to allow patients to prepare and control the healthcare they wish to receive when dying. One-half to two-thirds of individuals refuse common end-of-life medical procedures, and the rest request the procedures. We found a correlation between the choice to refuse or request a procedure and the age of the participant. Participants reported that their end-of-life conversations most often occurred with their spouse. Respondents often reported that their advance directive was stored with their physician and power of attorney for healthcare, conversations with those individuals rarely happened. Advance directives document patients' requests for and refusals of end-of-life care. Physicians and surrogates need to be better educated so that the documents are part of a meaningful conversation with the patient. Because patients' choices change over their lifespan, these documents need to be revisited regularly and not completed as a onetime event. PMID:26399671

  5. Functional neuroimaging and the law: trends and directions for future scholarship.

    PubMed

    Tovino, Stacey A

    2007-09-01

    Under the umbrella of the burgeoning neurotransdisciplines, scholars are using the principles and research methodologies of their primary and secondary fields to examine developments in neuroimaging, neuromodulation and psychopharmacology. The path for advanced scholarship at the intersection of law and neuroscience may clear if work across the disciplines is collected and reviewed and outstanding and debated issues are identified and clarified. In this article, I organize, examine and refine a narrow class of the burgeoning neurotransdiscipline scholarship; that is, scholarship at the interface of law and functional magnetic resonance imaging (fMRI). PMID:17849344

  6. The application of advanced analytical techniques to direct coal liquefaction

    SciTech Connect

    Brandes, S.D.; Winschel, R.A.; Burke, F.P.; Robbins, G.A.

    1991-12-31

    Consol is coordinating a program designed to bridge the gap between the advanced, modern techniques of the analytical chemist and the application of those techniques by the direct coal liquefaction process developer, and to advance our knowledge of the process chemistry of direct coal liquefaction. The program is designed to provide well-documented samples to researchers who are utilizing techniques potentially useful for the analysis of coal derived samples. The choice of samples and techniques was based on an extensive survey made by Consol of the present status of analytical methodology associated with direct coal liquefaction technology. Sources of information included process developers and analytical chemists. Identified in the survey are a number of broadly characterizable needs. These categories include a need for: A better understanding of the nature of the high molecular weight, non-distillable residual materials (both soluble and insoluble) in the process streams; improved techniques for molecular characterization, heteroatom and hydrogen speciation and a knowledge of the hydrocarbon structural changes across coal liquefaction systems; better methods for sample separation; application of advanced data analysis methods; the use of more advanced predictive models; on-line analytical techniques; and better methods for catalyst monitoring.

  7. Clinical Research Informatics: Recent Advances and Future Directions

    PubMed Central

    2015-01-01

    Summary Objectives To summarize significant developments in Clinical Research Informatics (CRI) over the past two years and discuss future directions. Methods Survey of advances, open problems and opportunities in this field based on exploration of current literature. Results Recent advances are structured according to three use cases of clinical research: Protocol feasibility, patient identification/recruitment and clinical trial execution. Discussion CRI is an evolving, dynamic field of research. Global collaboration, open metadata, content standards with semantics and computable eligibility criteria are key success factors for future developments in CRI. PMID:26293865

  8. Acceptability of an Advance Directive That Limits Food and Liquids in Advanced Dementia.

    PubMed

    Volicer, Ladislav; Stets, Karen

    2016-02-01

    Some individuals fear living with advanced dementia and may even commit suicide if they receive dementia diagnosis. Living with advanced dementia could be prevented if a person who cannot feed himself or herself would not be fed by others. The purpose of the study was to find out how acceptable would be an advance directive that includes discontinuation of feeding at certain stage of dementia for relatives of persons who died with dementia. All participants of 2 focus groups would be willing to indicate at least 1 condition in which they would not want to be fed. Some of them would be willing to make a proxy decision to stop feeding in the absence of advance directives. PMID:25313239

  9. Advance directives and the family: French and American perspectives

    PubMed Central

    Rodríguez-Arias, David; Moutel, Grégoire; Aulisio, Mark P.; Salfati, Alexandra; Coffin, Jean-Christophe; Rodríguez-Arias, J.L.; Calvo, L.; Hervé, Christian

    2007-01-01

    Several studies have explored differences between North American and European doctor-patient relationships. They have focused primarily on differences in philosophical traditions and historic and socio-economic factors between these two regions that might lead to differences in behaviour, as well as divergent concepts in and justifications of medical practice. However, few empirical intercultural studies have been carried out to identify in practice these cultural differences. This lack of standard comparative empirical studies led us to compare differences between France and the USA regarding end-of-life decision making. We tested certain assertions put forward by bioethicists concerning the impact of culture on the acceptance of advance directives in such decisions. In particular, we compared North American and French intensive care professional’s attitudes toward: 1) advance directives and 2) the role of the family in decisions to withhold or withdraw life-support. PMID:21957397

  10. 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. PMID:26427271

  11. Advances and future directions of research on spectral methods

    NASA Technical Reports Server (NTRS)

    Patera, A. T.

    1986-01-01

    Recent advances in spectral methods are briefly reviewed and characterized with respect to their convergence and computational complexity. Classical finite element and spectral approaches are then compared, and spectral element (or p-type finite element) approximations are introduced. The method is applied to the full Navier-Stokes equations, and examples are given of the application of the technique to several transitional flows. Future directions of research in the field are outlined.

  12. 23 CFR 633.203 - Applicability of existing laws, regulations, and directives.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 23 Highways 1 2010-04-01 2010-04-01 false Applicability of existing laws, regulations, and directives. 633.203 Section 633.203 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC OPERATIONS REQUIRED CONTRACT PROVISIONS Federal-Aid Contracts (Appalachian...

  13. 23 CFR 633.203 - Applicability of existing laws, regulations, and directives.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 23 Highways 1 2014-04-01 2014-04-01 false Applicability of existing laws, regulations, and directives. 633.203 Section 633.203 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC OPERATIONS REQUIRED CONTRACT PROVISIONS Federal-Aid Contracts (Appalachian...

  14. 23 CFR 633.203 - Applicability of existing laws, regulations, and directives.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 23 Highways 1 2011-04-01 2011-04-01 false Applicability of existing laws, regulations, and directives. 633.203 Section 633.203 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC OPERATIONS REQUIRED CONTRACT PROVISIONS Federal-Aid Contracts (Appalachian...

  15. 23 CFR 633.203 - Applicability of existing laws, regulations, and directives.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 23 Highways 1 2012-04-01 2012-04-01 false Applicability of existing laws, regulations, and directives. 633.203 Section 633.203 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC OPERATIONS REQUIRED CONTRACT PROVISIONS Federal-Aid Contracts (Appalachian...

  16. 23 CFR 633.203 - Applicability of existing laws, regulations, and directives.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 23 Highways 1 2013-04-01 2013-04-01 false Applicability of existing laws, regulations, and directives. 633.203 Section 633.203 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC OPERATIONS REQUIRED CONTRACT PROVISIONS Federal-Aid Contracts (Appalachian...

  17. Advance treatment directives for people with severe mental illness

    PubMed Central

    Campbell, Leslie Anne; Kisely, Steve R

    2014-01-01

    Background An advance directive is a document specifying a person’s preferences for treatment, should he or she lose capacity to make such decisions in the future. They have been used in end-of-life settings to direct care but should be well suited to the mental health setting. Objectives To examine the effects of advance treatment directives for people with severe mental illness. Search methods We searched the Cochrane Schizophrenia Group’s Register (February 2008), the Cochrane Library (Issue 1 2008), BIOSIS (1985 to February 2008), CINAHL (1982 to February 2008), EMBASE (1980 to February 2008), MEDLINE (1966 to February 2008), PsycINFO (1872 to February 2008), as well as SCISEARCH and Google - Internet search engine (February 2008). We inspected relevant references and contacted first authors of included studies. We updated this search on 17 May 2012 and added the results to the awaiting classification section of the review. Selection criteria We included all randomised controlled trials (RCTs), involving adults with severe mental illness, comparing any form of advance directive with standard care for health service and clinical outcomes. Data collection and analysis We extracted data independently. For homogenous dichotomous data we calculated fixed-effect relative risk (RR) and 95% confidence intervals (CI) on an intention-to-treat basis. For continuous data, we calculated weighted mean differences (WMD) and their 95% confidence interval again using a fixed-effect model. Main results We were able to include two trials involving 321 people with severe mental illnesses. There was no significant difference in hospital admission (n=160, 1 RCT, RR 0.69 0.5 to 1.0), or number of psychiatric outpatient attendances between participants given advanced treatment directives or usual care. Similarly, no significant differences were found for compliance with treatment, self harm or number of arrests. Participants given advanced treatment directives needed less use of

  18. Physician orders to supplement advance directives: rescuing patient autonomy.

    PubMed

    Miller, Ronald B

    2009-01-01

    To adapt Churchill's comment on democracy, "No one pretends that [POLSTs are] perfect..." but physicians' orders about life-sustaining treatments are a very important supplement to advance directives, especially for patients who are extremely or terminally ill, and most particularly for patients who require emergency treatment by first responders or by physicians who do not know them as persons. The standardized orders of limited options, however, are no substitute for a detailed treatment directive of a patient with a known illness, with predictable trajectories and complications. And, in this latter circumstance, a thoroughly informed proxy may also assist physicians in selecting appropriate treatment for patients who have lost decisional capacity and/or the ability to express it. I believe all patients should have an advance directive, preferably a combined proxy-treatment directive, and preferably one that has been thoroughly discussed with the attending physician and with the proxy, successor proxies, and preferably relatives and friends. Nurses, social workers, and chaplains may be very helpful to the patient in thinking through his or her preferences, especially if the severity of illness and the limited efficacy of interventions are such that the patient would wish to omit life-sustaining treatment or to discontinue it after a time-limited trial. Finally, because POLST is new or yet to be initiated in many areas of the country, it behooves all physicians to become knowledgeable of POLST and to initiate discussion of it with colleagues, patients, patients' proxies, and with relatives of patients. Even more recent is the combined advance directive/physician's orders to permit natural dying, actionable immediately for patients suffering severely and irremediably, but actionable at a future time if the patient progresses to advanced stages of dementia or other devastating brain disorders. In order to encourage physicians to initiate advance care planning with

  19. Canadian advanced life support capacities and future directions

    NASA Astrophysics Data System (ADS)

    Bamsey, M.; Graham, T.; Stasiak, M.; Berinstain, A.; Scott, A.; Vuk, T. Rondeau; Dixon, M.

    2009-07-01

    Canada began research on space-relevant biological life support systems in the early 1990s. Since that time Canadian capabilities have grown tremendously, placing Canada among the emerging leaders in biological life support systems. The rapid growth of Canadian expertise has been the result of several factors including a large and technically sophisticated greenhouse sector which successfully operates under challenging climatic conditions, well planned technology transfer strategies between the academic and industrial sectors, and a strong emphasis on international research collaborations. Recent activities such as Canada's contribution of the Higher Plant Compartment of the European Space Agency's MELiSSA Pilot Plant and the remote operation of the Arthur Clarke Mars Greenhouse in the Canadian High Arctic continue to demonstrate Canadian capabilities with direct applicability to advanced life support systems. There is also a significant latent potential within Canadian institutions and organizations with respect to directly applicable advanced life support technologies. These directly applicable research interests include such areas as horticultural management strategies (for candidate crops), growth media, food processing, water management, atmosphere management, energy management, waste management, imaging, environment sensors, thermal control, lighting systems, robotics, command and data handling, communications systems, structures, in-situ resource utilization, space analogues and mission operations. With this background and in collaboration with the Canadian aerospace industry sector, a roadmap for future life support contributions is presented here. This roadmap targets an objective of at least 50% food closure by 2050 (providing greater closure in oxygen, water recycling and carbon dioxide uptake). The Canadian advanced life support community has chosen to focus on lunar surface infrastructure and not low Earth orbit or transit systems (i.e. microgravity

  20. Novel interfaces for light directed neuronal stimulation: advances and challenges

    PubMed Central

    Bareket-Keren, Lilach; Hanein, Yael

    2014-01-01

    Light activation of neurons is a growing field with applications ranging from basic investigation of neuronal systems to the development of new therapeutic methods such as artificial retina. Many recent studies currently explore novel methods for optical stimulation with temporal and spatial precision. Novel materials in particular provide an opportunity to enhance contemporary approaches. Here we review recent advances towards light directed interfaces for neuronal stimulation, focusing on state-of-the-art nanoengineered devices. In particular, we highlight challenges and prospects towards improved retinal prostheses. PMID:24872704

  1. From the Office of the General Counsel. Advance medical directives.

    PubMed

    Orentlicher, D

    1990-05-01

    The American Medical Association's Board of Trustees recently issued a report on advance medical directives, Living Wills, Durable Powers of Attorney, and Durable Powers of Attorney for Health Care (AMA; 1989). Here Orentlicher, writing under the auspices of the AMA's Office of the General Counsel, offers an expanded version of that report. Orentlicher's article discusses the advantages and drawbacks of living wills, the appointment of a proxy decision maker through a living will, a durable power of attorney, or a durable power of attorney for health care, and the physician's role in implementing treatment preferences. PMID:2325236

  2. Direct Simulation Monte Carlo: Recent Advances and Applications

    NASA Astrophysics Data System (ADS)

    Oran, E. S.; Oh, C. K.; Cybyk, B. Z.

    The principles of and procedures for implementing direct simulation Monte Carlo (DSMC) are described. Guidelines to inherent and external errors common in DSMC applications are provided. Three applications of DSMC to transitional and nonequilibrium flows are considered: rarefied atmospheric flows, growth of thin films, and microsystems. Selected new, potentially important advances in DSMC capabilities are described: Lagrangian DSMC, optimization on parallel computers, and hybrid algorithms for computations in mixed flow regimes. Finally, the limitations of current computer technology for using DSMC to compute low-speed, high-Knudsen-number flows are outlined as future challenges.

  3. Making the case for a model mental health advance directive statute.

    PubMed

    Clausen, Judy A

    2014-01-01

    Acute episodes of mental illness temporarily destroy the capacity required to give informed consent and often prevent people from realizing they are sick, causing them to refuse intervention. Once a person refuses treatment, the only way to obtain care is as an involuntary patient. Even in the midst of acute episodes, many people do not meet commitment criteria because they are not likely to injure themselves or others and are still able to care for their basic needs. Left untreated, the episode will likely spiral out of control. By the time the person finally meets strict commitment criteria, devastation has already occurred. This Article argues that an individual should have the right to enter a Ulysses arrangement, a special type of mental health advance directive that authorizes a doctor to administer treatment during a future episode even if the episode causes the individual to refuse care. The Uniform Law Commissioners enacted the Uniform Health-Care Decisions Act as a model statute to address all types of advance health care planning, including planning for mental illness. However, the Act focuses on end-of-life care and fails to address many issues faced by people with mental illness. For example, the Act does not empower people to enter Ulysses arrangements and eliminates writing and witnessing requirements that protect against fraud and coercion. This Article recommends that the Uniform Law Commissioners adopt a model mental health advance directive statute that empowers people to enter Ulysses arrangements and provides safeguards against abuse. Appendix A sets forth model provisions. PMID:25051651

  4. Recent advances in high-performance direct methanol fuel cells

    SciTech Connect

    Narayanan, S.R.; Chun, W.; Valdez, T.I.

    1996-12-31

    Direct methanol fuel cells for portable power applications have been advanced significantly under DARPA- and ARO-sponsored programs over the last five years. A liquid-feed direct methanol fuel cell developed under these programs, employs a proton exchange membrane as electrolyte and operates on aqueous solutions of methanol with air or oxygen as the oxidant. Power densities as high as 320 mW/cm{sup 2} have been demonstrated. Demonstration of five-cell stack based on the liquid-feed concept have been successfully performed by Giner Inc. and the Jet Propulsion Laboratory. Over 2000 hours of life-testing have been completed on these stacks. These fuel cells have been also been demonstrated by USC to operate on alternate fuels such as trimethoxymethane, dimethoxymethane and trioxane. Reduction in the parasitic loss of fuel across the fuel cell, a phenomenon termed as {open_quotes}fuel crossover{close_quotes} has been achieved using polymer membranes developed at USC. As a result efficiencies as high as 40% is considered attainable with this type of fuel cell. The state-of-development has reached a point where it is now been actively considered for stationary, portable and transportation applications. The research and development issues have been the subject of several previous articles and the present article is an attempt to summarize the key advances in this technology.

  5. Scaling law for direct current field emission-driven microscale gas breakdown

    SciTech Connect

    Venkattraman, A.; Alexeenko, A. A.

    2012-12-15

    The effects of field emission on direct current breakdown in microscale gaps filled with an ambient neutral gas are studied numerically and analytically. Fundamental numerical experiments using the particle-in-cell/Monte Carlo collisions method are used to systematically quantify microscale ionization and space-charge enhancement of field emission. The numerical experiments are then used to validate a scaling law for the modified Paschen curve that bridges field emission-driven breakdown with the macroscale Paschen law. Analytical expressions are derived for the increase in cathode electric field, total steady state current density, and the ion-enhancement coefficient including a new breakdown criterion. It also includes the effect of all key parameters such as pressure, operating gas, and field-enhancement factor providing a better predictive capability than existing microscale breakdown models. The field-enhancement factor is shown to be the most sensitive parameter with its increase leading to a significant drop in the threshold breakdown electric field and also to a gradual merging with the Paschen law. The proposed scaling law is also shown to agree well with two independent sets of experimental data for microscale breakdown in air. The ability to accurately describe not just the breakdown voltage but the entire pre-breakdown process for given operating conditions makes the proposed model a suitable candidate for the design and analysis of electrostatic microscale devices.

  6. Scaling law for direct current field emission-driven microscale gas breakdown

    NASA Astrophysics Data System (ADS)

    Venkattraman, A.; Alexeenko, A. A.

    2012-12-01

    The effects of field emission on direct current breakdown in microscale gaps filled with an ambient neutral gas are studied numerically and analytically. Fundamental numerical experiments using the particle-in-cell/Monte Carlo collisions method are used to systematically quantify microscale ionization and space-charge enhancement of field emission. The numerical experiments are then used to validate a scaling law for the modified Paschen curve that bridges field emission-driven breakdown with the macroscale Paschen law. Analytical expressions are derived for the increase in cathode electric field, total steady state current density, and the ion-enhancement coefficient including a new breakdown criterion. It also includes the effect of all key parameters such as pressure, operating gas, and field-enhancement factor providing a better predictive capability than existing microscale breakdown models. The field-enhancement factor is shown to be the most sensitive parameter with its increase leading to a significant drop in the threshold breakdown electric field and also to a gradual merging with the Paschen law. The proposed scaling law is also shown to agree well with two independent sets of experimental data for microscale breakdown in air. The ability to accurately describe not just the breakdown voltage but the entire pre-breakdown process for given operating conditions makes the proposed model a suitable candidate for the design and analysis of electrostatic microscale devices.

  7. [Direct genetic manipulation and criminal code in Venezuela: absolute criminal law void?].

    PubMed

    Cermeño Zambrano, Fernando G De J

    2002-01-01

    The judicial regulation of genetic biotechnology applied to the human genome is of big relevance currently in Venezuela due to the drafting of an innovative bioethical law in the country's parliament. This article will highlight the constitutional normative of Venezuela's 1999 Constitution regarding this subject, as it establishes the framework from which this matter will be legally regulated. The approach this article makes towards the genetic biotechnology applied to the human genome is made taking into account the Venezuelan penal law and by highlighting the violent genetic manipulations that have criminal relevance. The genetic biotechnology applied to the human genome has another important relevance as a consequence of the reformulation of the Venezuelan Penal Code discussed by the country's National Assembly. Therefore, a concise study of the country's penal code will be made in this article to better understand what judicial-penal properties have been protected by the Venezuelan penal legislation. This last step will enable us to identify the penal tools Venezuela counts on to face direct genetic manipulations. We will equally indicate the existing punitive loophole and that should be covered by the penal legislator. In conclusion, this essay concerns criminal policy, referred to the direct genetic manipulations on the human genome that haven't been typified in Venezuelan law, thus discovering a genetic biotechnology paradise. PMID:12379984

  8. [Advance directives in Italy: a goal not yet reached but already passed?].

    PubMed

    Riccioni, Luigi; Gristina, Giuseppe

    2015-10-01

    The advance directives (ADs) have been adopted in many countries to defend patients' autonomy. In Italy, in the past, this topic gave rise to a heated debate involving philosophers, theologians, and politicians. In 2009, the government presented a bill of law on ADs firmly criticized from a scientific, moral and juridical point of view because the bill's content is against the principles of Italian Constitution, Italian Code of Medical Ethics, Oviedo Convention, and official statements of many scientific societies. Although the bill has passed the Low Chamber it lies, even since, in the Senate, lacking in regard any agreement among the political parties. The purpose of this article is to highlight that, in our country, patients, relatives and doctors deserve a law not only related to the specific topic of ADs, but - as in other European countries (Germany, Spain, France, UK) - aimed to deal with the complex issue of end of life care as a whole. This law should take into account the sound evidence existing in regard to the four fundamental principles supporting the best scientific and ethical approaches to the end of life issues: shared decision making process between doctors and patients/relatives; rejection of dying process marked by the suffering; withholding/withdrawing futile treatments together with palliative sedation as two crucial contributions to suppress the patient suffering and pain; clear-cut difference between these clinical/ethical options and euthanasia. At the same time, this law should be able to provide physicians with a legal coverage to make all the clinical and ethical decisions more and more complex because of the continuous evolution of medical science on one hand, and the impressive development of biotechnology on the other hand. PMID:26442974

  9. Advance directives among people living with HIV: room for improvement.

    PubMed

    Barocas, Joshua A; Erlandson, Kristine M; Belzer, Blythe K; Hess, Timothy; Sosman, James

    2015-01-01

    While HIV has become a largely chronic disease, age-associated comorbidities are prevalent in people living with HIV (PLWH). Therefore, PLWH are appropriate for advance care planning (ACP) and advance directives (ADs) completion. We sought to characterize AD completion among outpatient PLWH. We conducted a retrospective chart review of PLWH who receive their routine care at the University of Wisconsin HIV clinic. Data were extracted from the electronic health record. Variables were entered into a stepwise multivariate logistic regression model to assess which factors were independently associated with AD completion. Five hundred and eighty eight charts were reviewed. Eighty-one percent of subjects were male and 72% were white; mean age was 46.8 years. ADs were completed by 134 subjects and 6.7% of those were completed at the HIV clinic. In the final multivariate model, those who had completed an AD were more likely to be older than age 45; ever been diagnosed with AIDS; have cardiovascular disease, neurologic disorder, chronic kidney disease, or malignancy. In this study, a small percentage of patients had documented ADs, with only a small proportion completed in the HIV clinic. The HIV clinic is an underutilized resource to offer ACP. Interventions are needed to provide the necessary ACP resources for PLWH. PMID:25307722

  10. 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…

  11. Recovery Act: Advanced Direct Methanol Fuel Cell for Mobile Computing

    SciTech Connect

    Fletcher, James H.; Cox, Philip; Harrington, William J; Campbell, Joseph L

    2013-09-03

    ABSTRACT Project Title: Recovery Act: Advanced Direct Methanol Fuel Cell for Mobile Computing PROJECT OBJECTIVE The objective of the project was to advance portable fuel cell system technology towards the commercial targets of power density, energy density and lifetime. These targets were laid out in the DOE’s R&D roadmap to develop an advanced direct methanol fuel cell power supply that meets commercial entry requirements. Such a power supply will enable mobile computers to operate non-stop, unplugged from the wall power outlet, by using the high energy density of methanol fuel contained in a replaceable fuel cartridge. Specifically this project focused on balance-of-plant component integration and miniaturization, as well as extensive component, subassembly and integrated system durability and validation testing. This design has resulted in a pre-production power supply design and a prototype that meet the rigorous demands of consumer electronic applications. PROJECT TASKS The proposed work plan was designed to meet the project objectives, which corresponded directly with the objectives outlined in the Funding Opportunity Announcement: To engineer the fuel cell balance-of-plant and packaging to meet the needs of consumer electronic systems, specifically at power levels required for mobile computing. UNF used existing balance-of-plant component technologies developed under its current US Army CERDEC project, as well as a previous DOE project completed by PolyFuel, to further refine them to both miniaturize and integrate their functionality to increase the system power density and energy density. Benefits of UNF’s novel passive water recycling MEA (membrane electrode assembly) and the simplified system architecture it enabled formed the foundation of the design approach. The package design was hardened to address orientation independence, shock, vibration, and environmental requirements. Fuel cartridge and fuel subsystems were improved to ensure effective fuel

  12. Introduction to direct variational and moment methods and an application to the Child-Langmuir law

    NASA Astrophysics Data System (ADS)

    Anderson, D.; Desaix, M.

    2015-11-01

    A short introduction is given of direct variational methods and its relation to Galerkin and moment methods, all flexible and powerful approaches for finding approximate solutions of difficult physical equations. A pedagogical application of moment methods is given to the physically and technically important Child-Langmuir law in electron physics. The analysis is shown to provide simple, yet accurate, approximate solutions of the two-dimensional problem (a problem which does not allow an exact analytical solution) and illustrates the usefulness and the power of moment methods.

  13. Power Law Versus Exponential Form of Slow Crack Growth of Advanced Structural Ceramics: Dynamic Fatigue

    NASA Technical Reports Server (NTRS)

    Choi, Sung R.; Gyekenyesi, John P.

    2002-01-01

    The life prediction analysis based on an exponential crack velocity formulation was examined using a variety of experimental data on glass and advanced structural ceramics in constant stress-rate ("dynamic fatigue") and preload testing at ambient and elevated temperatures. The data fit to the strength versus In (stress rate) relation was found to be very reasonable for most of the materials. It was also found that preloading technique was equally applicable for the case of slow crack growth (SCG) parameter n > 30. The major limitation in the exponential crack velocity formulation, however, was that an inert strength of a material must be known priori to evaluate the important SCG parameter n, a significant drawback as compared to the conventional power-law crack velocity formulation.

  14. The utility of standardized advance directives: the general practitioners' perspective.

    PubMed

    Otte, Ina Carola; Elger, Bernice; Jung, Corinna; Bally, Klaus Walter

    2016-06-01

    Advance directives (AD) are written documents that give patients the opportunity to communicate their preferences regarding treatments they do or do not want to receive in case they become unable to make decisions. Commonly used pre-printed forms have different formats. Some offer space for patients to (a) appoint a surrogate decision maker, and/or (b) to determine future medical treatments and/or (c) give a statement of personal values. So far it is unknown which forms GPs preferably use and why they decide to do so. 23 semi-structured interviews with GPs were analysed using content analysis. Interviewees mainly use short templates (to appoint surrogate decision makers) and medium length templates with checkboxes to indicate patients' preferences in regards to life prolonging measures. Especially when patients faced the progression of a disease, participants use the latter version. Only then, the interviewees remarked, patients are capable to rate concrete situations reliably. GPs also realize the importance of the verbal assessment of patients' preferences; however they rarely keep a written form of the conversation. Some GPs hand out one or more templates and ask their patients to read and think about them at home with the option to talk to them about it later on, while others prefer their patients to fill them out alone at home. Regardless of template usage, most GPs emphasize that ADs require regular updates. GPs tend to see standardized advance directives mainly as a tool to start a conversation with their patients and to identify their real preferences and values. When the patient is still not facing the progression of an already existing disease it could be sufficient to only appoint a surrogate decision maker instead of creating a full AD. However, in all other situations, appointing a surrogate decision maker should be backed up by a written statement of a patient's general values. Patients and their relatives should always have the opportunity to ask

  15. Fundamental issues, recent advances, and future directions in myodynamics.

    PubMed

    Hatze, H

    2002-12-01

    A state-of-the-art report is presented on recent progress in selected areas of myodynamics, but also on problems that severely hamper the further development of the discipline. Significant advances have been made in elucidating the force-producing interaction between actin and the myosin-S1-subunit, including the localization of the most probable molecular site of power stroke initiation. Concerning the architecture of the myostructures, strong experimental evidence has accumulated for numerous intra-, inter-, and extramuscular pathways for lateral force transmission in addition to the serial sarcomere-to-sarcomere myotendinous path. It is shown that contemporary muscle models are inadequate in most respects and lag far behind the requirements an appropriate myodynamic model should fulfil. A similar comment applies to the current approaches designed to solve the myoskeletal indeterminacy problem. These formulations neglect myodynamic properties and do not allow for the implementation of biologically realistic objective functions. The solutions currently obtained are highly unsatisfactory. New research directions to rectify these situations are suggested, also with regard to the identification of subject-specific myodynamic parameters. PMID:12435541

  16. HIV Vaccine: Recent Advances, Current Roadblocks, and Future Directions.

    PubMed

    Rubens, Muni; Ramamoorthy, Venkataraghavan; Saxena, Anshul; Shehadeh, Nancy; Appunni, Sandeep

    2015-01-01

    HIV/AIDS is a leading cause of mortality and morbidity worldwide. In spite of successful interventions and treatment protocols, an HIV vaccine would be the ultimate prevention and control strategy. Ever since identification of HIV/AIDS, there have been meticulous efforts for vaccine development. The specific aim of this paper is to review recent vaccine efficacy trials and associated advancements and discuss the current challenges and future directions. Recombinant DNA technologies greatly facilitated development of many viral products which were later incorporated into vectors for effective vaccines. Over the years, a number of scientific approaches have gained popularity and include the induction of neutralizing antibodies in late 1980s, induction of CD8 T cell in early 1990s, and combination approaches currently. Scientists have hypothesized that stimulation of right sequences of somatic hypermutations could induce broadly reactive neutralizing antibodies (bnAbs) capable of effective neutralization and viral elimination. Studies have shown that a number of host and viral factors affect these processes. Similarly, eliciting specific CD8 T cells immune responses through DNA vaccines hold future promises. In summary, future studies should focus on the continuous fight between host immune responses and ever-evasive viral factors for effective vaccines. PMID:26579546

  17. Recent Advances in PV Research and Future Directions

    NASA Astrophysics Data System (ADS)

    Deb, Satyen K.

    1998-04-01

    The photovoltaic technology is making a major thrust in the commercial arena with 1997 worldwide production of PV modules reaching over 125 MW and growing at the rate of 20-25semiconductor materials and devices are emerging as strong contenders for PV applications even though silicon is still the 'work-horse' of the industry. Ultra-high efficiency solar cells fabricated from gallium arsenide (GaAs) and its ternary alloys like gallium indium phosphide (GaInP2) are finding applications in space technology. Enormous progress has also been made on various thin-film solar cell technologies, which offer the promise for substantially reducing the cost of PV systems. Some of the leading contenders are amorphous and polycrystalline silicon, compound semiconductor thin films such as copper indium diselenide (CuInSe2) based alloys, and cadmium telluride (CdTe) thin films. Exciting new developments are happening in the use of nano-particle semiconductor materials like titanium dioxide (TiO2) for low-cost PV devices. Intense research on these and other materials and devices is making a strong impact on the technology. In this presentation, a brief overview of recent advances in PV research will b e made and the trends and opportunities for future research directions will be identified.

  18. HIV Vaccine: Recent Advances, Current Roadblocks, and Future Directions

    PubMed Central

    Rubens, Muni; Ramamoorthy, Venkataraghavan; Saxena, Anshul; Shehadeh, Nancy; Appunni, Sandeep

    2015-01-01

    HIV/AIDS is a leading cause of mortality and morbidity worldwide. In spite of successful interventions and treatment protocols, an HIV vaccine would be the ultimate prevention and control strategy. Ever since identification of HIV/AIDS, there have been meticulous efforts for vaccine development. The specific aim of this paper is to review recent vaccine efficacy trials and associated advancements and discuss the current challenges and future directions. Recombinant DNA technologies greatly facilitated development of many viral products which were later incorporated into vectors for effective vaccines. Over the years, a number of scientific approaches have gained popularity and include the induction of neutralizing antibodies in late 1980s, induction of CD8 T cell in early 1990s, and combination approaches currently. Scientists have hypothesized that stimulation of right sequences of somatic hypermutations could induce broadly reactive neutralizing antibodies (bnAbs) capable of effective neutralization and viral elimination. Studies have shown that a number of host and viral factors affect these processes. Similarly, eliciting specific CD8 T cells immune responses through DNA vaccines hold future promises. In summary, future studies should focus on the continuous fight between host immune responses and ever-evasive viral factors for effective vaccines. PMID:26579546

  19. [Advanced directives: nurses' and physicians' representations in 2012].

    PubMed

    Ledoux, Mathilde; Rhondali, Wadih; Monnin, Luc; Thollet, Catherine; Gabon, Patricia; Filbet, Marilène

    2013-10-01

    In cancer patients, decision-making process is crucial and patient's involvement is described as a central component. In 2005, a new tool appears to convey patient's opinion even if he is not able to communicate anymore: advanced directives (AD). Unfortunately, their documentation is marginal. The objective of this study was to investigate nurses' and physicians' representations towards AD. A questionnaire had been sent to hospitals, public health facilities and liberal practitioners during February 2012. We collected responses from 42/251 physicians (17 %) and 80/198 nurses (40 %). Sixty percent of participants reported that they were not familiar with the legislative framework for AD. For physicians, main barriers were patient cognitive impairment (P = 0.004) and lack of information on the clinical situation (P = 0.004). For nurses, difficulties were toward end of life and prognosis discussion (P = 0.002), clinical situation evolution since AD documentation (P = 0.008), time frame for AD application (P < 0.001) and the fact that final decision is made by physician alone (P = 0.015). AD should be part of a good medical practice and literature has highlighted the benefit of AD on patient's quality of life. End of life discussion therefore requires dedicated time and specific training for physicians and nurses to improve the rate of patients with AD. PMID:24077035

  20. Upping the Ante: Recent Advances in Direct Reprogramming

    PubMed Central

    Müller, Lars UW; Daley, George Q; Williams, David A

    2009-01-01

    The concept of reversing the characteristics of differentiated tissues to pluripotency through reprogramming was introduced over 50 years ago in the first somatic cell nuclear transfer (SCNT) experiments. More recently, direct reprogramming of differentiated somatic cells by gene transfer of a small number of defined transcription factors has been shown to yield cells that are indistinguishable from inner cell mass–derived embryonic stem (ES) cells. These cells, termed induced pluripotent stem (iPS) cells, offer exciting possibilities for studying mechanism of pluripotency, establishing models for disease-specific investigations, and enabling future applications in regenerative medicine. In this review, we discuss the basic foundation of reestablishing pluripotency and recent progress toward enhancing the efficiency and safety of the process through optimization of the reprogramming factor combination, identification of small molecules that augment efficiency, and assessment of distinct target cells in reprogramming efficiency. We also highlight recent advances that eliminate stable genetic modification from the reprogramming process, and summarize preclinical models that provide proof-of-concept for ES/iPS cell-based regenerative medicine. PMID:19337233

  1. Prevalence of Advance Directives Among Older Adults Admitted to Intensive Care Units and Requiring Mechanical Ventilation.

    PubMed

    Gamertsfelder, Elise M; Seaman, Jennifer Burgher; Tate, Judith; Buddadhumaruk, Praewpannarai; Happ, Mary Beth

    2016-04-01

    Because older adults are at high risk for hospitalization and potential decisional incapacity, advance directives are important components of pre-hospital advanced care planning, as they document individual preferences for future medical care. The prevalence of pre-hospital advance directive completion in 450 critically ill older adults requiring mechanical ventilation from two Mid-Atlantic hospitals is described, and demographic and clinical predictors of pre-hospital advance directive completion are explored. The overall advance directive completion rate was 42.4%, with those in older age groups (75 to 84 years and 85 and older) having approximately two times the odds of completion. No significant differences in the likelihood of advance directive completion were noted by sex, race, or admitting diagnosis. The relatively low prevalence of advance directive completion among older adults with critical illness and high mortality rate (24%) suggest a need for greater awareness and education. [Journal of Gerontological Nursing, 42(4), 34-41.]. PMID:26651862

  2. Processing of alnico permanent magnets by advanced directional solidification methods

    DOE PAGESBeta

    Zou, Min; Johnson, Francis; Zhang, Wanming; Zhao, Qi; Rutkowski, Stephen F.; Zhou, Lin; Kramer, Matthew J.

    2016-07-05

    Advanced directional solidification methods have been used to produce large (>15 cm length) castings of Alnico permanent magnets with highly oriented columnar microstructures. In combination with subsequent thermomagnetic and draw thermal treatment, this method was used to enable the high coercivity, high-Titanium Alnico composition of 39% Co, 29.5% Fe, 14% Ni, 7.5% Ti, 7% Al, 3% Cu (wt%) to have an intrinsic coercivity (Hci) of 2.0 kOe, a remanence (Br) of 10.2 kG, and an energy product (BH)max of 10.9 MGOe. These properties compare favorably to typical properties for the commercial Alnico 9. Directional solidification of higher Ti compositions yieldedmore » anisotropic columnar grained microstructures if high heat extraction rates through the mold surface of at least 200 kW/m2 were attained. This was achieved through the use of a thin walled (5 mm thick) high thermal conductivity SiC shell mold extracted from a molten Sn bath at a withdrawal rate of at least 200 mm/h. However, higher Ti compositions did not result in further increases in magnet performance. Images of the microstructures collected by scanning electron microscopy (SEM) reveal a majority α phase with inclusions of secondary αγ phase. Transmission electron microscopy (TEM) reveals that the α phase has a spinodally decomposed microstructure of FeCo-rich needles in a NiAl-rich matrix. In the 7.5% Ti composition the diameter distribution of the FeCo needles was bimodal with the majority having diameters of approximately 50 nm with a small fraction having diameters of approximately 10 nm. The needles formed a mosaic pattern and were elongated along one <001> crystal direction (parallel to the field used during magnetic annealing). Cu precipitates were observed between the needles. Regions of abnormal spinodal morphology appeared to correlate with secondary phase precipitates. The presence of these abnormalities did not prevent the material from displaying superior magnetic properties in the 7.5% Ti

  3. Processing of alnico permanent magnets by advanced directional solidification methods

    NASA Astrophysics Data System (ADS)

    Zou, Min; Johnson, Francis; Zhang, Wanming; Zhao, Qi; Rutkowski, Stephen F.; Zhou, Lin; Kramer, Matthew J.

    2016-12-01

    Advanced directional solidification methods have been used to produce large (>15 cm length) castings of Alnico permanent magnets with highly oriented columnar microstructures. In combination with subsequent thermomagnetic and draw thermal treatment, this method was used to enable the high coercivity, high-Titanium Alnico composition of 39% Co, 29.5% Fe, 14% Ni, 7.5% Ti, 7% Al, 3% Cu (wt%) to have an intrinsic coercivity (Hci) of 2.0 kOe, a remanence (Br) of 10.2 kG, and an energy product (BH)max of 10.9 MGOe. These properties compare favorably to typical properties for the commercial Alnico 9. Directional solidification of higher Ti compositions yielded anisotropic columnar grained microstructures if high heat extraction rates through the mold surface of at least 200 kW/m2 were attained. This was achieved through the use of a thin walled (5 mm thick) high thermal conductivity SiC shell mold extracted from a molten Sn bath at a withdrawal rate of at least 200 mm/h. However, higher Ti compositions did not result in further increases in magnet performance. Images of the microstructures collected by scanning electron microscopy (SEM) reveal a majority α phase with inclusions of secondary αγ phase. Transmission electron microscopy (TEM) reveals that the α phase has a spinodally decomposed microstructure of FeCo-rich needles in a NiAl-rich matrix. In the 7.5% Ti composition the diameter distribution of the FeCo needles was bimodal with the majority having diameters of approximately 50 nm with a small fraction having diameters of approximately 10 nm. The needles formed a mosaic pattern and were elongated along one <001> crystal direction (parallel to the field used during magnetic annealing). Cu precipitates were observed between the needles. Regions of abnormal spinodal morphology appeared to correlate with secondary phase precipitates. The presence of these abnormalities did not prevent the material from displaying superior magnetic properties in the 7.5% Ti

  4. Revisiting Horton's laws with considerations of the directly drained VS source area

    NASA Astrophysics Data System (ADS)

    Yang, Soohyun; Paik, Kyungrock

    2015-04-01

    River networks have been regarded as excellent examples of self-similar patterns in nature. Fractal characteristics of river networks have been quantified through scaling relations between several morphologic variables (e.g., Hack, 1957; Flint, 1974). In particular, Horton's legendary study on scaling properties between numbers and lengths of streams in different orders (Horton, 1945) has significantly influenced research studies in this subject. Today, Horton's laws are referred to the log-linear relationships of three variables across stream orders, i.e., number, length, and area which is later added by Schumm (1956). In a closer look, there is a conceptual inconsistency between their definitions though. While length is defined as the length of stream of a specific order only, area by its definition includes drainage area of lower order streams. To deal with this inconsistency, there was an attempt to distinguish the average area drained directly by the stream of a particular order in the Hortonian formulation (Marani et al., 1991; Beer and Borgas, 1993). Nevertheless, there remains an interesting problem in the definition of directly drained area for 1st order and for the rest orders in these studies. While the whole area of 1st order stream is regarded as the directly drained area in these studies, for a channel to form it needs the minimum drainage area named source area. In this study, we evaluate how significant considering this zero order area separately is in understanding overall river network organization. To this end, we define new expression for the directly drained area and revisit Horton's laws with a generalized formulation. To test the proposed ideas, several river networks extracted from digital elevation models (DEMs) are analyzed. References Beer, T., & Borgas, M. (1993). Horton's laws and the fractal nature of streams. Water Resources Research, 29(5), 1475-1487. Flint, J. J. (1974). Stream gradient as a function of order, magnitude, and

  5. New Directions for NASA's Advanced Life Support Program

    NASA Technical Reports Server (NTRS)

    Barta, Daniel J.

    2006-01-01

    Exploration Life Support (ELS) Project, under the Exploration Technology Development Program, has recently been initiated to perform directed life support technology development in support of Constellation and the Crew Exploration Vehicle (CEV). ELS) has replaced ALS, with several major differences. Thermal Control Systems have been separated into a new stand alone project (Thermal Systems for Exploration Missions). Tasks in Advanced Food Technology have been relocated to the Human Research Program. Tasks in a new discipline area, Habitation Engineering, have been added. Research and technology development for capabilities required for longer duration stays on the Moon and Mars, including bioregenerative system, have been deferred.

  6. UTILITY OF MECHANISTIC MODELS FOR DIRECTING ADVANCED SEPARATIONS RESEARCH & DEVELOPMENT ACTIVITIES: Electrochemically Modulated Separation Example

    SciTech Connect

    Schwantes, Jon M.

    2009-06-01

    The objective for this work was to demonstrate the utility of mechanistic computer models designed to simulate actinide behavior for use in efficiently and effectively directing advanced laboratory R&D activities associated with developing advanced separations methods.

  7. [Advanced directives document and neurologist-patient relationship].

    PubMed

    Boada Rovira, M

    2004-12-01

    Perception of health and disease, pain and suffering, quality of life, personal relationships, privacy and intimacy, culture and social values, can now be stated in a written document, by way of a living will, giving legal legitimacy to each patient's way of being and understanding life, to be used when the subject cannot express it by him/herself. In this way, the patients will participate in the therapeutic process and will incorporate their desires and decisions through the Informed Consent and the Advanced Directives Document (ADD). Both documents translate and indicate how to treat and care for a patient who will progressively lose his/her cognitive faculties and others will decided for him/her, in the case of dementias. The basis of ADD is respect and promotion of the patient's autonomy, prolonging his/her right to decide in the stages in which he/she cannot do it. It consists in some instructions or orientations for the patient to be cared for in a certain way, according to his/her will. To this effect, a representative will be named who will act in the subject's name and who will help to interpret and make decisions when the patient cannot. Specifically, in Alzheimer's disease, ADD allows the patient to decide, in full lucidity, freedom and autonomy, how to live a progressive and irreversible disease. Explicit mention can be made to the will of making his/her disease known publically or not, the care of its aspect, privacy, type of care, whether institutionalized or home care, limitation of visits, treatment intensity and prolongation, palliative cares, donation of biological samples, participation in drug clinical trials. PMID:15719290

  8. Avoiding another directive: the unstable politics of European Union cross-border health care law.

    PubMed

    Greer, Scott L

    2013-10-01

    The European Union’s (EU) 2011 Directive on cross-border patient mobility codifies the right of any EU citizen to travel abroad for treatment and be reimbursed on the same terms as they would be at home. Governments hoped it would end the string of court cases that had reshaped EU health law but this article argues that it is likely to produce yet more judicial challenges. Patient mobility is an attractive idea with unclear definitions and divergent implementation. In many cases, providers, insurers and governments will not communicate and leave the patient with a bill – almost daring the patient to sue, and the courts to make more policy. Governments should try to prevent this by investing in coordination and alternative redress for patients who might otherwise sue. PMID:23425573

  9. Improving the Advance Directive Request and Retrieval Process in Critical Access Hospitals: Honoring the Patient's Wishes.

    PubMed

    Jones, Faith M; Sabin, Tawnie L; Torma, Linda M

    2016-01-01

    The Patient Self-Determination Act was created to enhance awareness and use of advance directives. Several states also have created registries where the advance directives can be easily retrieved when needed. Quick retrieval is especially important in critical access hospitals where patients are often transferred to other facilities. This article describes an innovative project designed to improve the advance directives request and retrieval process on admission to a critical access hospital. PMID:26681498

  10. How advance directives affect hospital resource use. Systematic review of the literature.

    PubMed Central

    Taylor, J. S.; Heyland, D. K.; Taylor, S. J.

    1999-01-01

    OBJECTIVE: To assess whether advance directives influence resource use by hospitalized patients. DATA SOURCES: A systematic search of computerized medical databases, reference lists from relevant articles, and personal files was conducted to identify studies examining the association between advance directives and resource use. STUDY SELECTION: Primary studies assessing the effect of advance directives on hospital resource use were selected if they had a clear quantitative measure of hospital resource use, hospitalized patients as a study population, a control group for comparison, and a description of the advance directive being studied. Data on the following topics were abstracted from studies meeting inclusion criteria: study methods and design, resource use, source of financial data, description of advance directive, population size and composition, length of assessment. SYNTHESIS: Six studies met inclusion criteria. Three retrospective studies showed significant reductions in resource use associated with documentation of advance directives while three prospective studies (two randomized, one not randomized) showed no association between advance directives and reduced resource use. Studies were limited to narrowly defined patient populations in US tertiary care hospitals. CONCLUSIONS: Little evidence supports the hypothesis that advance directives reduce resource use by hospitalized patients. Some retrospective studies have shown savings, but their conclusions are weakened by shortcomings in study design. Prospective trials, which have better experimental methods, have demonstrated no evidence of cost savings with the use of advance directives. PMID:10540700

  11. Transition of advanced technology to military, homeland security, and law enforcement users

    NASA Astrophysics Data System (ADS)

    Jarrett, Stephen M.

    2004-09-01

    With the attack on the United States and the subsequent war on terror and the wars in Afghanistan and Iraq a need has been exposed for the transition of technology to all of our defenders both combat forces on the foreign battlefield and domestic forces here at home. The establishment of the Department of Homeland Security has also provided a focus on inserting technology to dramatically improve the capability of airport security forces, law enforcement, and all first responder networks. The drastic increase in the use of Special Forces in combat has also required new advanced technology capabilities at a much faster rate of development than the standard military procurement system. Technology developers must address the questions of interoperability, cost, commercialization, of how these groups will use the technology delivered and the adoption criteria of users in the deployment environment. The successful transition to the field must address the formation of complex concepts of operations in the user's adoption criteria. Prototype transition for two systems, a pocket infrared camera and an acoustic/seismic detector, will be highlighted in their effect on the wars in Iraq and Afghanistan and in the heightening of homeland security.

  12. High angle of attack control law development for a free-flight wind tunnel model using direct eigenstructure assignment

    NASA Technical Reports Server (NTRS)

    Wendel, Thomas R.; Boland, Joseph R.; Hahne, David E.

    1991-01-01

    Flight-control laws are developed for a wind-tunnel aircraft model flying at a high angle of attack by using a synthesis technique called direct eigenstructure assignment. The method employs flight guidelines and control-power constraints to develop the control laws, and gain schedules and nonlinear feedback compensation provide a framework for considering the nonlinear nature of the attack angle. Linear and nonlinear evaluations show that the control laws are effective, a conclusion that is further confirmed by a scale model used for free-flight testing.

  13. The views of older Malaysians on advanced directive and advanced care planning: a qualitative study.

    PubMed

    Htut, Y; Shahrul, K; Poi, P J H

    2007-01-01

    The provision of optimum care for the ageing population is dependent on the understanding of their views and values on end of life issues. A qualitative descriptive study was conducted to describe views of elderly Malaysians on Advanced Care Planning (henceforth ACP) and Advanced Directives (henceforth AD), and explore factors influencing these views. Fifteen elderly subjects with ages ranging from 65 to 83 years, representing different ethnic and religious groups in Malaysia were selected for in-depth interviews guided by a questionnaire. Five core themes were extracted from the interviews: 1) Considering the future 2) Contingency plans for future illnesses 3) Attitudes towards life prolonging treatment procedures 4) Doctor-patient relationships and 5) Influence of religion on decisions related to future illness. Despite the lack of knowledge on ACP and AD, older respondents were very receptive to their concept. Although the majority agreed on the importance of planning for future medical management and having open discussion on end of life issues with their doctor, they felt it unnecessary to make a formal written AD. Most felt that the future was best left to fate or God, and none had made any contingency plan for severe future illnesses citing religion as reason for this view. Cardiopulmonary resuscitation, mechanical ventilation and dialysis were considered by most to be invasive life prolonging treatments. We suggest that doctors initiate discussions on end of life care with every older patient and their family so as to promote awareness and introduce the concept of ACP/AD to a Malaysian setting. PMID:18330404

  14. Advance Care Planning Beyond Advance Directives: Perspectives from Patients and Surrogates

    PubMed Central

    McMahan, Ryan; Knight, Sara J.; Fried, Terri R.; Sudore, Rebecca L.

    2014-01-01

    Context Advance care planning (ACP) has focused on documenting life-sustaining treatment preferences in advance directives (ADs). ADs alone may be insufficient to prepare diverse patients and surrogates for complex medical decisions. Objectives To understand what steps best prepare patients and surrogates for decision making. Methods We conducted 13 English/Spanish focus groups with participants from a Veterans Affairs and county hospital and the community. Seven groups included patients (n=38) aged ≥65 years, who reported making serious medical decisions. Six separate groups included surrogates (n=31), aged ≥18 years, who made decisions for others. Semi-structured focus groups asked what activities best prepared participants for decision making. Two investigators independently coded data and performed thematic content analysis. Disputes were resolved by consensus. Results Mean±SD patient age was 78±8 years and 61% were non-white. Mean±SD surrogate age was 57±10 years and 91% were non-white. Qualitative analysis identified four overarching themes about how to best prepare for decision making: 1) identify values based on past experiences and quality of life, 2) choose surrogates wisely and verify they understand their role, 3) decide whether to grant leeway in surrogate decision making, and 4) inform other family and friends of one's wishes to prevent conflict. Conclusion Beyond ADs, patients and surrogates recommend several additional steps to prepare for medical decision making including using past experiences to identify values, verifying the surrogate understands their role, deciding whether to grant surrogates leeway, and informing other family and friends of one's wishes. Future ACP interventions should consider incorporating these additional ACP activities. PMID:23200188

  15. Advances in Research and Practice in Self-Directed Learning.

    ERIC Educational Resources Information Center

    Long, Huey B.; And Others

    Selected papers presented in this book are: "Changing Concepts of Self-Direction in Learning" (Long); "The Transition from Learner-Control to Autodidaxy: More than Meets the Eye" (Candy); "Self-Directed Learning and the Theory of Adult Education" (Jarvis); "On the Theme and Variations of Self-Directed Learning" (Gerstner); "Self-Directed…

  16. Directed molecular evolution to design advanced red fluorescent proteins

    PubMed Central

    Subach, Fedor V; Piatkevich, Kiryl D; Verkhusha, Vladislav V

    2015-01-01

    Fluorescent proteins have become indispensable imaging tools for biomedical research. continuing progress in fluorescence imaging, however, requires probes with additional colors and properties optimized for emerging techniques. Here we summarize strategies for development of red-shifted fluorescent proteins. We discuss possibilities for knowledge-based rational design based on the photochemistry of fluorescent proteins and the position of the chromophore in protein structure. We consider advances in library design by mutagenesis, protein expression systems and instrumentation for high-throughput screening that should yield improved fluorescent proteins for advanced imaging applications. PMID:22127219

  17. Supply-demand balance in outward-directed networks and Kleiber's law

    PubMed Central

    Painter, Page R

    2005-01-01

    Background Recent theories have attempted to derive the value of the exponent α in the allometric formula for scaling of basal metabolic rate from the properties of distribution network models for arteries and capillaries. It has recently been stated that a basic theorem relating the sum of nutrient currents to the specific nutrient uptake rate, together with a relationship claimed to be required in order to match nutrient supply to nutrient demand in 3-dimensional outward-directed networks, leads to Kleiber's law (b = 3/4). Methods The validity of the supply-demand matching principle and the assumptions required to prove the basic theorem are assessed. The supply-demand principle is evaluated by examining the supply term and the demand term in outward-directed lattice models of nutrient and water distribution systems and by applying the principle to fractal-like models of mammalian arterial systems. Results Application of the supply-demand principle to bifurcating fractal-like networks that are outward-directed does not predict 3/4-power scaling, and evaluation of water distribution system models shows that the matching principle does not match supply to demand in such systems. Furthermore, proof of the basic theorem is shown to require that the covariance of nutrient uptake and current path length is 0, an assumption unlikely to be true in mammalian arterial systems. Conclusion The supply-demand matching principle does not lead to a satisfactory explanation for the approximately 3/4-power scaling of mammalian basal metabolic rate. PMID:16283939

  18. New avenues in the directed deprotometallation of aromatics: recent advances in directed cupration.

    PubMed

    Harford, Philip J; Peel, Andrew J; Chevallier, Floris; Takita, Ryo; Mongin, Florence; Uchiyama, Masanobu; Wheatley, Andrew E H

    2014-10-14

    Recent advances in the selective deprotometallation of aromatic reagents using alkali metal cuprates are reported. The ability of these synergic bases to effect deprotonation under the influence of a directing group is explored in the context of achieving new and more efficient organic transformations whilst encouraging greater ancillary group tolerance by the base. Developments in our understanding of the structural chemistry of alkali metal cuprates are reported, with both Gilman cuprates of the type R2CuLi and Lipshutz and related cuprates of the type R2Cu(X)Li2 (X = inorganic anion) elucidated and rationalised in terms of ligand sterics. The generation of new types of cuprate motif are introduced through the development of adducts between different classes of cuprate. The use of DFT methods to interrogate the mechanistic pathways towards deprotonative metallation is described. Theoretical modelling of in situ rearrangements undergone by the cuprate base are discussed, with a view to understanding the relationship between R2CuLi and R2Cu(X)Li2, their interconversion and the implications of this for cuprate reactivity. The advent of a new class of adduct between different cuprate types is developed and interpreted in terms of the options for expelling LiX from R2Cu(X)Li2. Applications in the field of medicinal chemistry and (hetero)arene derivatization are explored. PMID:24919957

  19. Effect of Health Literacy on the Utilization of Advance Directives Based on the Health Belief Model

    ERIC Educational Resources Information Center

    Henkelman, Wallace J.

    2010-01-01

    Research has demonstrated that only a small proportion of individuals in the United States complete advance directives as part of their planning for end-of-life care. This study sought to determine if health literacy is a significant factor in advance directive completion as has been posited by previous researchers. Analysis of the data collected…

  20. Psychiatric epidemiology: selected recent advances and future directions.

    PubMed Central

    Kessler, R. C.

    2000-01-01

    Reviewed in this article are selected recent advances and future challenges for psychiatric epidemiology. Major advances in descriptive psychiatric epidemiology in recent years include the development of reliable and valid fully structured diagnostic interviews, the implementation of parallel cross-national surveys of the prevalences and correlates of mental disorders, and the initiation of research in clinical epidemiology. Remaining challenges include the refinement of diagnostic categories and criteria, recognition and evaluation of systematic underreporting bias in surveys of mental disorders, creation and use of accurate assessment tools for studying disorders of children, adolescents, the elderly, and people in less developed countries, and setting up systems to carry out small area estimations for needs assessment and programme planning. Advances in analytical and experimental epidemiology have been more modest. A major challenge is for psychiatric epidemiologists to increase the relevance of their analytical research to their colleagues in preventative psychiatry as well as to social policy analysts. Another challenge is to develop interventions aimed at increasing the proportion of people with mental disorders who receive treatment. Despite encouraging advances, much work still needs to be conducted before psychiatric epidemiology can realize its potential to improve the mental health of populations. PMID:10885165

  1. 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. PMID:9271918

  2. Advanced Gasoline Turbocharged Direction Injection (GTDI) Engine Development

    SciTech Connect

    Wagner, Terrance

    2015-12-31

    This program was undertaken in response to US Department of Energy Solicitation DE-FOA-0000079, resulting in a cooperative agreement with Ford and MTU to demonstrate improvement of fuel efficiency in a vehicle equipped with an advanced GTDI engine. Ford Motor Company has invested significantly in GTDI engine technology as a cost effective, high volume, fuel economy solution, marketed globally as EcoBoost technology. Ford envisions additional fuel economy improvement in the medium and long term by further advancing EcoBoost technology. The approach for the project was to engineer a comprehensive suite of gasoline engine systems technologies to achieve the project objectives, and to progressively demonstrate the objectives via concept analysis / computer modeling, single-cylinder and multi-cylinder engine testing on engine dynamometer, and vehicle level testing on chassis rolls.

  3. Smoke-Free Laws and Direct Democracy Initiatives on Smoking Bans in Germany: A Systematic Review and Quantitative Assessment

    PubMed Central

    Kohler, Stefan; Minkner, Philipp

    2014-01-01

    Background: Germany’s 16 states regulate smoking differently within health protection principles laid down in the federal law. All state smoke-free laws in Germany have undergone at least one change since taking effect. Methods: We systematically review federal and state laws regulating smoking, as well as petitions, popular initiatives and referenda that aimed at changing statutory smoking bans. Data generated through the systematic review were correlated with state smoking rates. Results: The protection from the dangers of secondhand smoke is the primary motive for smoking bans in Germany. The first smoke-free laws affecting smoking in pubs, restaurants and several other public places were introduced in 2007. In 2008, the Federal Constitutional Court of Germany ruled in a leading decision on the smoke-free laws of two states that some common smoking ban exemptions of the introduced smoke-free laws violate the basic right to freely exercise a profession and mandated revisions. All states but Bavaria and Saarland, whose smoking bans were more and less comprehensive than those judged by the constitutional court, respectively, needed to change the smoking ban exemptions to reconcile their smoke-free laws with the constitution. Direct democracy initiatives to change smoking bans were only successful in Bavaria in 2010, but a total of 15 initiatives by citizens’ or interest groups attempted to influence non-smokers protection legislation through direct democratic procedures. Early ratification of a smoking ban in a federal state correlates with a higher reduction in the smoking rate from 2005 to 2009 (Spearman’s ρ = 0.51, p = 0.04). Conclusions: The federal government structure and direct democratic participation in smoke-free legislation in Germany has produced a diversity of local smoking bans and exemptions. PMID:24394216

  4. Too Soon to Give Up? Re-examining the Value of Advance Directives

    PubMed Central

    Levi, Benjamin H.; Green, Michael J.

    2013-01-01

    In the face of mounting criticism against advance directives, we describe how a novel, computer-based decision aid addresses some of these important concerns. This decision aid, Making Your Wishes Known: Planning Your Medical Future, translates an individual’s values and goals into a meaningful advance directive that explicitly reflects their healthcare wishes and outlines a plan for how they wish to be treated. It does this by 1) educating users about advance care planning; 2) helping individuals identify, clarify, and prioritize factors that influence their decision-making about future medical conditions; 3) explaining common end-of-life medical conditions and life-sustaining treatment; 4) helping users articulate a coherent set of wishes with regard to advance care planning—in the form of an advance directive readily interpretable by physicians; and 5) helping individuals both choose a spokesperson, and prepare to engage family, friends, and healthcare providers in discussions about advance care planning. PMID:20379910

  5. Advance Care Planning in Nursing Homes: Correlates of Capacity and Possession of Advance Directives

    ERIC Educational Resources Information Center

    Allen, Rebecca S.; DeLaine, Shermetra R.; Chaplin, William F.; Marson, Daniel C.; Bourgeois, Michelle S.; Dijkstra, Katinka; Burgio, Louis D.

    2003-01-01

    Purpose: The identification of nursing home residents who can continue to participate in advance care planning about end-of-life care is a critical clinical and bioethical issue. This study uses high quality observational research to identify correlates of advance care planning in nursing homes, including objective measurement of capacity. Design…

  6. Advanced or advancing nursing practice: what is the future direction for nursing?

    PubMed

    Gray, Alastair

    Advanced nursing practice roles have emerged over the last 25 years in response to two major challenges: first, the significant reduction in available doctors; and, second, the rise in numbers of patients with complex health needs. It is suggested that, with a major drive to respond to the first problem, with its emphasis on the development of medical skills, the development of advanced nursing practice (which has the potential to have a significant impact on the second challenge of the rise in long-term conditions) has very much taken second place. Moreover, advanced nursing practice roles have become so medically focused that not only is advanced nursing practice not evident, but neither are the recognised sub-roles that are fundamental to advancing practice. These include innovation, education, research and clinical leadership. This article argues that in the current climate it is essential that advanced nurse practitioners not only demonstrate advanced practice, but also actively embrace the concept of 'advancing' nursing practice as the dominant feature of new roles. PMID:26768039

  7. Advanced direct liquefaction concepts for PETC generic units

    SciTech Connect

    Not Available

    1992-04-01

    In the Advance Coal Liquefaction Concept Proposal (ACLCP) carbon monoxide (CO) and water have been proposed as the primary reagents in the pretreatment process. The main objective of this project is to develop a methodology for pretreating coal under mild conditions based on a combination of existing processes which have shown great promise in liquefaction, extraction and pyrolysis studies. The aim of this pretreatment process is to partially depolymerise the coal, eliminate oxygen and diminish the propensity for retograde reactions during subsequent liquefaction. The desirable outcome of the CO pretreatment step should be: (1) enhanced liquefaction activity and/or selectivity toward products of higher quality due to chemical modification of the coal structure; (2) cleaner downstream products; (3) overall improvement in operability and process economics.

  8. Immunotherapy for advanced melanoma: Current knowledge and future directions.

    PubMed

    Nakamura, Kenta; Okuyama, Ryuhei

    2016-08-01

    Melanoma is one of the most aggressive cancers and is responsible for a large proportion of skin cancer-related deaths. The recent development of novel immunotherapeutic approaches has led to great advances in melanoma therapy. Because melanoma cells often express tumor-specific neo-antigens, significant therapeutic effects are mediated via immunotherapy-induced activation of cytotoxic T lymphocytes (CTLs); however, the effects depend on the immune status of the patient. At present, various immunotherapies have been approved and new clinical trials are progressing. These immunotherapies act in several ways, including CTL brake release, induction of CTL activation, transfer of CTLs, and modification of the tumor microenvironment to facilitate CTL activation. In the near future, patient-tailored immunotherapies and combination therapies are expected. In addition, it is important to monitor the status of the patient's immune response when selecting the most effective immunotherapy strategy. PMID:27302423

  9. Direct Arbitrary-Lagrangian-Eulerian ADER-MOOD finite volume schemes for multidimensional hyperbolic conservation laws

    NASA Astrophysics Data System (ADS)

    Boscheri, Walter; Loubère, Raphaël; Dumbser, Michael

    2015-07-01

    In this paper we present a new family of efficient high order accurate direct Arbitrary-Lagrangian-Eulerian (ALE) one-step ADER-MOOD finite volume schemes for the solution of nonlinear hyperbolic systems of conservation laws for moving unstructured triangular and tetrahedral meshes. This family is the next generation of the ALE ADER-WENO schemes presented in [16,20]. Here, we use again an element-local space-time Galerkin finite element predictor method to achieve a high order accurate one-step time discretization, while the somewhat expensive WENO approach on moving meshes, used to obtain high order of accuracy in space, is replaced by an a posteriori MOOD loop which is shown to be less expensive but still as accurate. This a posteriori MOOD loop ensures the numerical solution in each cell at any discrete time level to fulfill a set of user-defined detection criteria. If a cell average does not satisfy the detection criteria, then the solution is locally re-computed by progressively decrementing the order of the polynomial reconstruction, following a so-called cascade of predefined schemes with decreasing approximation order. A so-called parachute scheme, typically a very robust first order Godunov-type finite volume method, is employed as a last resort for highly problematic cells. The cascade of schemes defines how the decrementing process is carried out, i.e. how many schemes are tried and which orders are adopted for the polynomial reconstructions. The cascade and the parachute scheme are choices of the user or the code developer. Consequently the iterative MOOD loop allows the numerical solution to maintain some interesting properties such as positivity, mesh validity, etc., which are otherwise difficult to ensure. We have applied our new high order unstructured direct ALE ADER-MOOD schemes to the multi-dimensional Euler equations of compressible gas dynamics. A large set of test problems has been simulated and analyzed to assess the validity of our approach

  10. Advanced direct coal liquefaction concepts. Final report, Volume 2

    SciTech Connect

    Berger, D.J.; Parker, R.J.; Simpson, P.L.

    1994-07-01

    Integration of innovative steps into new advanced processes have the potential to reduce costs for producing liquid fuels. In this program, objective is to develop a new approach to liquefaction that generates an all distillate product slate at a reduced cost of about US$25/barrel of crude oil equivalent. A Counterflow Reactor was developed in cooperation with GfK mbH, Germany. Advantages are low hydrogen recycle rates and low feed preheating requirements. Coal/heavy oil slurry is injected into the top of the reactor while the recycle gas and make up hydrogen is introduced into the bottom; hydrogenation products are withdrawn from the top. PU study resulted in distillable oil yields up to 74 wt % on feed (dry ash free) from coprocessing feed slurries containing 40 wt % Vesta subbituminous coal and 60 wt % Cold Lake heavy vacuum tower bottoms. Technologies developed separately by CED and ARC were combined. A 1-kg/hr integrated continuous flow bench scale unit was constructed at the ARC site in Devon, Alberta, based on modifications to a unit at Nisku, Alberta (the modified unit was used in the preliminary economic evaluation).

  11. Advances and directions of ion nitriding/carburizing

    NASA Technical Reports Server (NTRS)

    Spalvins, Talivaldis

    1989-01-01

    Ion nitriding and carburizing are plasma activated thermodynamic processes for the production of case hardened surface layers not only for ferrous materials, but also for an increasing number of nonferrous metals. When the treatment variables are properly controlled, the use of nitrogenous or carbonaceous glow discharge medium offers great flexibility in tailoring surface/near-surface properties independently of the bulk properties. The ion nitriding process has reached a high level of maturity and has gained wide industrial acceptance, while the more recently introduced ion carburizing process is rapidly gaining industrial acceptance. The current status of plasma mass transfer mechanisms into the surface regarding the formation of compound and diffusion layers in ion nitriding and carbon build-up ion carburizing is reviewed. In addition, the recent developments in design and construction of advanced equipment for obtaining optimized and controlled case/core properties is summarized. Also, new developments and trends such as duplex plasma treatments and alternatives to dc diode nitriding are highlighted.

  12. Advanced Low Conductivity Thermal Barrier Coatings: Performance and Future Directions

    NASA Technical Reports Server (NTRS)

    Zhu, Dongming; Miller, Robert A.

    2008-01-01

    Thermal barrier coatings will be more aggressively designed to protect gas turbine engine hot-section components in order to meet future engine higher fuel efficiency and lower emission goals. In this presentation, thermal barrier coating development considerations and performance will be emphasized. Advanced thermal barrier coatings have been developed using a multi-component defect clustering approach, and shown to have improved thermal stability and lower conductivity. The coating systems have been demonstrated for high temperature combustor applications. For thermal barrier coatings designed for turbine airfoil applications, further improved erosion and impact resistance are crucial for engine performance and durability. Erosion resistant thermal barrier coatings are being developed, with a current emphasis on the toughness improvements using a combined rare earth- and transition metal-oxide doping approach. The performance of the toughened thermal barrier coatings has been evaluated in burner rig and laser heat-flux rig simulated engine erosion and thermal gradient environments. The results have shown that the coating composition optimizations can effectively improve the erosion and impact resistance of the coating systems, while maintaining low thermal conductivity and cyclic durability. The erosion, impact and high heat-flux damage mechanisms of the thermal barrier coatings will also be described.

  13. Advancements and future directions in enzyme technology for biomass conversion.

    PubMed

    Zhang, Zisheng; Donaldson, Adam A; Ma, Xiaoxun

    2012-01-01

    Enzymatic hydrolysis of pre-treated lignocellulosic biomass is an ideal alternative to acid hydrolysis for bio-ethanol production, limited primarily by pre-treatment requirements and economic considerations arising from enzyme production costs and specific activities. The quest for cheaper and better enzymes has prompted years of bio-prospecting, strain optimization through genetic engineering, enzyme characterization for simple and complex lignocellulosic feedstock, and the development of pre-treatment strategies to mitigate inhibitory effects. The recent shift to systematic characterizations of de novo mixtures of purified proteins is a promising indicator of maturation within this field of study, facilitating progression towards feedstock assay-based rapid enzyme mixture optimization. It is imperative that international standards be developed to enable meaningful comparisons between these studies and the construction of a database of enzymatic activities and kinetics, aspects of which are explored here-in. Complementary efforts to improve the economic viability of enzymatic hydrolysis through process integration and reactor design are also considered, where membrane-confinement shows significant promise despite the associated technological challenges. Significant advancements in enzyme technology towards the economic conversion of lignocellulosic biomass should be expected within the next few years as systematic research in enzyme activities conforms to that of traditional reaction engineering. PMID:22306162

  14. Zipf’s word frequency law in natural language: A critical review and future directions

    PubMed Central

    2014-01-01

    The frequency distribution of words has been a key object of study in statistical linguistics for the past 70 years. This distribution approximately follows a simple mathematical form known as Zipf ’ s law. This article first shows that human language has a highly complex, reliable structure in the frequency distribution over and above this classic law, although prior data visualization methods have obscured this fact. A number of empirical phenomena related to word frequencies are then reviewed. These facts are chosen to be informative about the mechanisms giving rise to Zipf’s law and are then used to evaluate many of the theoretical explanations of Zipf’s law in language. No prior account straightforwardly explains all the basic facts or is supported with independent evaluation of its underlying assumptions. To make progress at understanding why language obeys Zipf’s law, studies must seek evidence beyond the law itself, testing assumptions and evaluating novel predictions with new, independent data. PMID:24664880

  15. Using Adult Learning Concepts To Assist Patients in Completing Advance Directives.

    ERIC Educational Resources Information Center

    Meyer, Rose Mary

    2000-01-01

    Advance directives that enable individuals to control their health care are underused due to lack of patient knowledge. Nurses can teach patients about them using adult learning principles, transformation theory, and skills for learning how to learn. (SK)

  16. Status and future directions for advanced accelerator research - conventional and non-conventional collider concepts

    SciTech Connect

    Siemann, R.H.

    1997-01-01

    The relationship between advanced accelerator research and future directions for particle physics is discussed. Comments are made about accelerator research trends in hadron colliders, muon colliders, and e{sup +}3{sup {minus}} linear colliders.

  17. 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).…

  18. Advances in direct transesterification of algal oils from wet biomass.

    PubMed

    Park, Ji-Yeon; Park, Min S; Lee, Young-Chul; Yang, Ji-Won

    2015-05-01

    An interest in biodiesel as an alternative fuel for diesel engines has been increasing because of the issue of petroleum depletion and environmental concerns related to massive carbon dioxide emissions. Researchers are strongly driven to pursue the next generation of vegetable oil-based biodiesel. Oleaginous microalgae are considered to be a promising alternative oil source. To commercialize microalgal biodiesel, cost reductions in oil extraction and downstream biodiesel conversion are stressed. Herein, starting from an investigation of oil extraction from wet microalgae, a review is conducted of transesterification using enzymes, homogeneous and heterogeneous catalysts, and yield enhancement by ultrasound, microwave, and supercritical process. In particular, there is a focus on direct transesterification as a simple and energy efficient process that omits a separate oil extraction step and utilizes wet microalgal biomass; however, it is still necessary to consider issues such as the purification of microalgal oils and upgrading of biodiesel properties. PMID:25466997

  19. Advances in directional borehole radar data analysis and visualization

    USGS Publications Warehouse

    Smith, D.V.G.; Brown, P.J., II

    2002-01-01

    The U.S. Geological Survey is developing a directional borehole radar (DBOR) tool for mapping fractures, lithologic changes, and underground utility and void detection. An important part of the development of the DBOR tool is data analysis and visualization, with the aim of making the software graphical user interface (GUI) intuitive and easy to use. The DBOR software system consists of a suite of signal and image processing routines written in Research Systems' Interactive Data Language (IDL). The software also serves as a front-end to many widely accepted Colorado School of Mines Center for Wave Phenomena (CWP) Seismic UNIX (SU) algorithms (Cohen and Stockwell, 2001). Although the SU collection runs natively in a UNIX environment, our system seamlessly emulates a UNIX session within a widely used PC operating system (MicroSoft Windows) using GNU tools (Noer, 1998). Examples are presented of laboratory data acquired with the prototype tool from two different experimental settings. The first experiment imaged plastic pipes in a macro-scale sand tank. The second experiment monitored the progress of an invasion front resulting from oil injection. Finally, challenges to further development and planned future work are discussed.

  20. Advancing the Field Elder Abuse: Future Directions and Policy Implications

    PubMed Central

    Dong, XinQi

    2012-01-01

    Elder abuse, sometime called elder mistreatment or elder maltreatment, includes psychological, physical, and sexual abuse, neglect (caregiver neglect and self-neglect), and financial exploitation. Evidence suggests that 1 out of 10 older adult experiences some form of elder abuse, and only 1 of out 25 cases are actually reported to social services agencies. At the same time, elder abuse is associated with significant morbidity and premature mortality. Despite these findings, there is a great paucity in research, practice, and policy dealing with the pervasive issues of elder abuse. Through my experiences as a American Political Sciences Association Congressional Policy Fellow/Health and Aging Policy Fellow working with Administration on Community Living (ACL) (Previously known at Administration on Aging (AoA)) for the last two years, I will describe the major functions of the ACL; and highlight on two major pieces of federal legislation: The Older Americans Act (OAA) and the Elder Justice Act (EJA). Moreover, I will highlight major research gaps and future policy relevant research directions for the field of elder abuse. PMID:23110488

  1. Recent developments and near term directions for Navy laser weapons system (LaWS) testbed

    NASA Astrophysics Data System (ADS)

    Pawlak, Robert J.

    2012-11-01

    The Laser Weapons System (LaWS) testbed has been a demonstrator of many High Energy Laser (HEL)-related technologies for the Navy. LaWS employs a sharedaperture design with incoherent beam combining, and makes extensive use of Commercial Off-The-Shelf (COTS) technologies in the areas of inertial sensing, fiber lasers, sensors, and video trackers. Since the system has demonstrated the art of the possible with COTS elements, it is useful to examine where performance can be increased with the greatest possible effect, as well as which modifications are necessary to support better integration with ships' systems. A review of past test events, architectures, and further plans will be provided, while emphasizing the past and future evolution of the LaWS system. These evolutions will relate within the context of technical drivers that most affected system development.

  2. Direct measurement of the effective pressure law: Deformation of joints subject to pore and confining pressures

    SciTech Connect

    Boitnott, G.N.; Scholz, C.H. )

    1990-11-10

    When describing the deformation of poro-elastic materials subject to pore pressure (P{sub p}) and confining pressure (P{sub c}), the concept of effective pressure is commonly used. In such a description the deformation is described in terms of a single stress parameter, the effective stress (P{sub e}). Experimental studies which attempt to describe the effective pressure law are troubled by the fact that deformation of geologic materials invariably exhibits loading path dependence (hysteresis). Here the authors develop an experimental technique for measuring the effective pressure law which is useful for many properties of interest, including those that are highly nonlinear and exhibit common types of hysteresis. They experimentally derive an effective pressure law which describes the values of pore and confining pressure consistent with a given joint closure for a law which describes the values of pore and confining pressure consistent with a given joint closure for a loading path of constant closure. The study can be viewed as an attempt to include both pore and confining pressure in a single constitutive law for joint closure. The constant closure loading path is such that the measurement is not affected by hysteresis caused by joint closure. The results provide insight into the microgeometrical and micromechanical properties of joints. The data are not consistent with a simple extension of commonly used linear elastic constitutive models for joint deformation which have compared favorably with experiments in the absence of pore pressure. For smooth lapped glass joints, the effective pressure relation is found to be dependent on the local joint stiffness, with the relationship between the effective pressure law and the local joint stiffness being insensitive to the measured surface topography. Similar measurements on lapped and fractured rock provide some constraints on the effective pressure behavior of jointed rock.

  3. Advances in Focal Plane Wavefront Estimation for Directly Imaging Exoplanets

    NASA Astrophysics Data System (ADS)

    Eldorado Riggs, A. J.; Kasdin, N. Jeremy; Groff, Tyler Dean

    2015-01-01

    To image cold exoplanets directly in visible light, an instrument on a telescope needs to suppress starlight by about 9 orders of magnitude at small separations from the star. A coronagraph changes the point spread function to create regions of high contrast where exoplanets or disks can be seen. Aberrations on the optics degrade the contrast by several orders of magnitude, so all high-contrast imaging systems incorporate one or more deformable mirrors (DMs) to recover regions of high contrast. With a coronagraphic instrument planned for the WFIRST-AFTA space telescope, there is a pressing need for faster, more robust estimation and control schemes for the DMs. Non-common path aberrations limit conventional phase conjugation schemes to medium star-to-planet contrast ratios of about 1e-6. High-contrast imaging requires estimation and control of both phase and amplitude in the same beam path as the science camera. Field estimation is a challenge since only intensity is measured; the most common approach, including that planned for WFIRST-AFTA, is to use DMs to create diversity, via pairs of small probe shapes, thereby allowing disambiguation of the electric field. Most implementations of DM Diversity require at least five images per electric field estimate and require narrowband measurements. This paper describes our new estimation algorithms that improve the speed (by using fewer images) and bandwidth of focal plane wavefront estimation. For narrowband estimation, we are testing nonlinear, recursive algorithms such as an iterative extended Kalman filter (IEKF) to use three images each iteration and build better, more robust estimates. We are also exploring the use of broadband estimation without the need for narrowband sub-filters and measurements. Here we present simulations of these algorithms with realistic noise and small signals to show how they might perform for WFIRST-AFTA. Once validated in simulations, we will test these algorithms experimentally in

  4. Inapplicability of advance directives in a paternalistic setting: the case of a post-communist health system

    PubMed Central

    2011-01-01

    Background The Albanian medical system and Albanian health legislation have adopted a paternalistic position with regard to individual decision making. This reflects the practices of a not-so-remote past when state-run facilities and a totalitarian philosophy of medical care were politically imposed. Because of this history, advance directives concerning treatment refusal and do-not-resuscitate decisions are still extremely uncommon in Albania. Medical teams cannot abstain from intervening even when the patient explicitly and repeatedly solicits therapeutic abstinence. The Albanian law on health care has no provisions regarding limits or withdrawal of treatment. This restricts the individual's healthcare choices. Discussion The question of 'medically futile' interventions and pointless life-prolonging treatment has been discussed by several authors. Dutch physicians call such interventions 'medisch zinloos' (senseless), and the Netherlands, as one of the first states to legislate on end-of-life situations, actually regulates such issues through appropriate laws. In contrast, leaving an 'advance directive' is not a viable option for Albanian ailing individuals of advanced age. Verbal requests are provided during periods of mental competence, but unfortunately such instructions are rarely taken seriously, and none of them has ever been upheld in a legal or other official forum. Summary End-of-life decisions, treatment refusal and do-not-resuscitate policies are hazardous options in Albania, from the legal point of view. Complying with them involves significant risk on the part of the physician. Culturally, the application of such instructions is influenced from a mixture of religious beliefs, death coping-behaviors and an immense confusion concerning the role of proxies as decision-makers. Nevertheless, Albanian tradition is familiar with the notion of 'amanet', a sort of living will that mainly deals the property and inheritance issues. Such living wills, verbally

  5. [End of life in neonatal medicine under the direction of French law].

    PubMed

    Dageville, C; Rameix, S; Andrini, P; Betrémieux, P; Jarreau, P-H; Kuhn, P; Oriot, D

    2007-10-01

    Two recent laws have significantly reformed the French Public Health Code: the law of March 4th 2002, related to the patient's rights and the quality of the health care system and the law of April 22nd 2005, related to the patient's rights and the end of life. These changes have prompted health care professionals involved in perinatal and neonatal medicine to update their considerations on the ethical aspects of the end of life in neonatal medicine. Therefore, the authors examined the clauses of the law related to the patient's rights and to the end of life, confronting them with the distinctive features of neonatal medicine. In this paper, the medical practices, which are either prohibited or authorized in the course of end of life are considered: prohibition of euthanasia, authorization for alleviating pain at the risk of shortening life, authorization for restricting, withholding or withdrawing treatments. Next, the justifications provided by the legislation to authorize these practices are analysed: prohibition of unreasonable obstinacy and respect for individual wishes. Then, the conditions required by the law to determine and to implement these acts are discussed: consultation with the healthcare staff and justified advice from a consulting physician, consideration of parental opinion, registration of the decision and its justifications into the patient's medical file, protection of the dying patient's dignity and preservation of his life quality by providing palliative care. Lastly, we report the terms of the ethical dilemma which may occur in the area of neonatal medicine in spite of genuine and persevering efforts in order to conciliate legal requirement and ethical responsibility. PMID:17728119

  6. Advancing sexual health through human rights: The role of the law

    PubMed Central

    Kismödi, Eszter; Cottingham, Jane; Gruskin, Sofia; Miller, Alice M.

    2015-01-01

    Since the International Conference on Population and Development, definitions of sexuality and sexual health have been greatly elaborated alongside widely accepted recognition that sexual health requires respect, protection and fulfilment of human rights. Considerable progress has also been made in enacting or changing laws that affect sexuality and sexual health, in line with human rights standards. These measures include legal guarantees against non-discrimination and violence, decriminalisation of consensual sexual conduct and guaranteeing availability, accessibility, acceptability and quality of sexual health information and services to all. Such legal actions have had positive effects on health and specifically on sexual health, particularly for marginalised populations. Yet in all regions of the world, laws still exist which jeopardise health, including sexual health, and violate human rights. In order to ensure accountability for the rights and health of their populations, states have an obligation to bring their laws into line with international, regional and national human rights standards. These rights-based legal guarantees, while insufficient alone, are essential for effective systems of accountability, achieving positive sexual health outcomes and the respect and protection of human rights. PMID:25539286

  7. Advancing sexual health through human rights: the role of the law.

    PubMed

    Kismödi, Eszter; Cottingham, Jane; Gruskin, Sofia; Miller, Alice M

    2015-01-01

    Since the International Conference on Population and Development, definitions of sexuality and sexual health have been greatly elaborated alongside widely accepted recognition that sexual health requires respect, protection and fulfilment of human rights. Considerable progress has also been made in enacting or changing laws that affect sexuality and sexual health, in line with human rights standards. These measures include legal guarantees against non-discrimination and violence, decriminalisation of consensual sexual conduct and guaranteeing availability, accessibility, acceptability and quality of sexual health information and services to all. Such legal actions have had positive effects on health and specifically on sexual health, particularly for marginalised populations. Yet in all regions of the world, laws still exist which jeopardise health, including sexual health, and violate human rights. In order to ensure accountability for the rights and health of their populations, states have an obligation to bring their laws into line with international, regional and national human rights standards. These rights-based legal guarantees, while insufficient alone, are essential for effective systems of accountability, achieving positive sexual health outcomes and the respect and protection of human rights. PMID:25539286

  8. Similarity laws for cathode-directed streamers in gaps with an inhomogeneous field at elevated air pressures

    SciTech Connect

    Bolotov, O. V.; Golota, V. I.; Kadolin, B. B.; Karas', V. I.; Ostroushko, V. N.; Zavada, L. M.; Shulika, A. Yu.

    2010-11-15

    Results are presented from experimental studies of cathode-directed streamers in the gap closure regime without a transition into spark breakdown. Spatiotemporal, electrodynamic, and spectroscopic characteristics of streamer discharges in air at different pressures were studied. Similarity laws for streamer discharges were formulated. These laws allow one to compare the discharge current characteristics and streamer propagation dynamics at different pressures. Substantial influence of gas photoionization on the deviations from the similarity laws was revealed. The existence of a pressure range in which the discharges develop in a similar way was demonstrated experimentally. In particular, for fixed values of the product pd and discharge voltage U, the average streamer velocity is also fixed. It is found that, although the similarity laws are violated in the interstreamer pause of the discharge, the average discharge current and the product of the pressure and the streamer repetition period remain the same at different pressures. The radiation spectra of the second positive system of nitrogen (the C{sup 3{Pi}}{sub u}-B{sup 3{Pi}}{sub g} transitions) in a wavelength range of 300-400 nm at air pressures of 1-3 atm were recorded. It is shown that, in the entire pressure range under study, the profiles of the observed radiation bands practically remain unchanged and the relative intensities of the spectral lines corresponding to the {sup 3{Pi}}{sub u}-B{sup 3{Pi}}{sub g} transitions are preserved.

  9. Direct and indirect effects of unilateral divorce law on marital stability.

    PubMed

    Kneip, Thorsten; Bauer, Gerrit; Reinhold, Steffen

    2014-12-01

    Previous research examining the impact of unilateral divorce law (UDL) on the prevalence of divorce has provided mixed results. Studies based on cross-sectional cross-country/cross-state survey data have received criticism for disregarding unobserved heterogeneity across countries, as have studies using country-level panel data for failing to account for possible mediating mechanisms at the micro level. We seek to overcome both shortcomings by using individual-level event-history data from 11 European countries (SHARELIFE) and controlling for unobserved heterogeneity over countries and cohorts. We find that UDL in total increased the incidence of marital breakdown by about 20 %. This finding, however, neglects potential selection effects into marriage. Accordingly, the estimated effect of unilateral divorce laws becomes much larger when we control for age at marriage, which is used as indicator for match quality. Moreover, we find that UDL particularly affects marital stability in the presence of children. PMID:25354572

  10. Development of advanced direct perception displays for nuclear power plants to enhance monitoring, control and fault management. Progress report

    SciTech Connect

    Jones, B.; Shaheen, S.; Moray, N.; Sanderson, P.; Reising, D.V.

    1993-05-21

    With recent theoretical and empirical research in basic and applied psychology, human factors, and engineering, it is now sufficient to define an integrated approach to the deign of advanced displays for present and future nuclear power plants. Traditionally, the conventional displays have shown operators the individual variables on gauges, meters, strip charts, etc. This design approach requires the operators to mentally integrate the separately displayed variables and determine the implications for the plant state. This traditional approach has been known as the single-sensor-single-indicator display design and it places an intolerable amount of mental workload on operators during transients and abnormal conditions. This report discusses a new alternative approach which is the use of direct perception interfaces. Direct perception a interfaces display the underlying physical and system constraints of the situation in a directly perceptual way, such that the viewer need not reason about what is seen to identify system states, but can identify the state of the system perceptually. It is expected that displays which show the dynamics of fundamental physical laws should better support operator decisions and diagnoses of plant states. The purpose of this research project is to develop a suite of direct perception displays for PWR nuclear power plant operations.

  11. Advance Directives

    MedlinePlus

    ... disease, medical care to promote your well-being ( palliative care ) continues. This type of care includes treatment to ... the patient’s behalf. Contact the National Hospice and Palliative Care Organization for more information about companies that provide ...

  12. Advance Directives

    MedlinePlus

    ... Local Offices Volunteer Employment Become a Supplier Report Fraud or ... reserved. The American Cancer Society is a qualified 501(c)(3) tax-exempt organization. Cancer.org is provided courtesy of ...

  13. A direct method for synthesizing low-order optimal feedback control laws with application to flutter suppression

    NASA Technical Reports Server (NTRS)

    Mukhopadhyay, V.; Newsom, J. R.; Abel, I.

    1980-01-01

    A direct method of synthesizing a low-order optimal feedback control law for a high order system is presented. A nonlinear programming algorithm is employed to search for the control law design variables that minimize a performance index defined by a weighted sum of mean square steady state responses and control inputs. The controller is shown to be equivalent to a partial state estimator. The method is applied to the problem of active flutter suppression. Numerical results are presented for a 20th order system representing an aeroelastic wind-tunnel wing model. Low-order controllers (fourth and sixth order) are compared with a full order (20th order) optimal controller and found to provide near optimal performance with adequate stability margins.

  14. Advances in the study of mechanical properties and constitutive law in the field of wood research

    NASA Astrophysics Data System (ADS)

    Zhao, S.; Zhao, J. X.; Han, G. Z.

    2016-07-01

    This paper presents an overview of mechanical properties and constitutive law for wood. Current research on the mechanical properties of wood have mostly focused on density, grain, moisture, and other natural factors. It has been established that high density, dense grain, and high moisture lead to higher strength. In most literature, wood has been regarded as an anisotropic material because of its fiber. A microscopic view is used in research of wood today, in this way, which has allowed for clear observation of anisotropy. In general, wood has higher strength under a dynamic load, and no densification. The constitutive model is the basis of numerical analysis. An anisotropic model of porous and composite materials has been used for wood, but results were poor, and new constitutions have been introduced. According to the literature, there is no single theory that is widely accepted for the dynamic load. Research has shown that grain and moisture are key factors in wood strength, but there has not been enough study on dynamic loads so far. Hill law has been the most common method of simulation. Models that consider high strain rate are attracting more and more attention.

  15. Civil Rights Laws as Tools to Advance Health in the Twenty-First Century.

    PubMed

    McGowan, Angela K; Lee, Mary M; Meneses, Cristina M; Perkins, Jane; Youdelman, Mara

    2016-01-01

    To improve health in the twenty-first century, to promote both access to and quality of health care services and delivery, and to address significant health disparities, legal and policy approaches, specifically those focused on civil rights, could be used more intentionally and strategically. This review describes how civil rights laws, and their implementation and enforcement, help to encourage health in the United States, and it provides examples for peers around the world. The review uses a broad lens to define health for both classes of individuals and their communities--places where people live, learn, work, and play. Suggestions are offered for improving health and equity broadly, especially within societal groups and marginalized populations. These recommendations include multisectorial approaches that focus on the social determinants of health. PMID:26789383

  16. 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

  17. Reconfigurable multivariable control law for commercial airplane using a direct digital output feedback design

    NASA Technical Reports Server (NTRS)

    Ostroff, A. J.; Hueschen, R. M.

    1984-01-01

    The ability of a pilot to reconfigure the control surfaces on an airplane after a failure, allowing the airplane to recover to a safe condition for landing, becomes more difficult with increasing airplane complexity. Techniques are needed to stabilize and control the airplane immediately after a failure, allowing the pilot time to make longer range decisions. This paper shows a design of a discrete multivariable control law using four controls for the longitudinal channel of a B-737. Single control element failures are allowed in three of the four controls. The four controls design and failure cases are analyzed by means of a digital airplane simulation, with regard to tracking capability and ability to overcome severe windshear and turbulence during the aproach and landing phase of flight.

  18. Do Geriatricians Practice What They Preach?: Geriatricians' Personal Establishment of Advance Directives

    ERIC Educational Resources Information Center

    Lester, Paula E.; Sykora, Alzbeta; Wolf-Klein, Gisele P.; Pekmezaris, Renee; Auerbach, Charles; Feuerman, Martin

    2009-01-01

    Previous research has been conducted regarding preferences of physicians for life-sustaining treatments for themselves, but there is a dearth of data on personal use of advance directives (ADs) by geriatricians specifically. Using a phone survey, we contacted all graduates of the geriatric fellowship program to assess their personal use of advance…

  19. 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…

  20. 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…

  1. 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…

  2. Online, directed journaling in community health advanced practice nursing clinical education.

    PubMed

    Daroszewski, Ellen Beth; Kinser, Anita G; Lloyd, Susan L

    2004-04-01

    The sharing of experiences in advanced practice nursing clinical courses allows for application of core principals to different facets of practice, with the potential to promote discussions beyond the course objectives, create opportunities for mentoring, foster critical thinking, and facilitate change and socialization into advanced practice. A pilot test of online, directed journaling, an innovative sharing and reflection strategy, was incorporated in a two-quarter community health advanced practice nursing clinical course in an attempt to enhance clinical learning. Six female graduate nursing students completed the journaling. A 10-item evaluation measure demonstrated that the online journaling strategy was highly effective and valuable for the students. An assessment of the journaling entries found multiple examples of discussion, mentoring, critical thinking, and socialization. Innovative online strategies should become the standard for sharing in advanced practice nursing education. PMID:15098912

  3. Real-time approximate optimal guidance laws for the advanced launch system

    NASA Technical Reports Server (NTRS)

    Speyer, Jason L.; Feeley, Timothy; Hull, David G.

    1989-01-01

    An approach to optimal ascent guidance for a launch vehicle is developed using an expansion technique. The problem is to maximize the payload put into orbit subject to the equations of motion of a rocket over a rotating spherical earth. It is assumed that the thrust and gravitational forces dominate over the aerodynamic forces. It is shown that these forces can be separated by a small parameter epsilon, where epsilon is the ratio of the atmospheric scale height to the radius of the earth. The Hamilton-Jacobi-Bellman or dynamic programming equation is expanded in a series where the zeroth-order term (epsilon = 0) can be obtained in closed form. The zeroth-order problem is that of putting maximum payload into orbit subject to the equations of motion of a rocket in a vacuum over a flat earth. The neglected inertial and aerodynamic terms are included in higher order terms of the expansion, which are determined from the solution of first-order linear partial differential equations requiring only quadrature integrations. These quadrature integrations can be performed rapidly, so that real-time approximate optimization can be used to construct the launch guidance law.

  4. Advanced shortwave infrared and Raman hyperspectral sensors for homeland security and law enforcement operations

    NASA Astrophysics Data System (ADS)

    Klueva, Oksana; Nelson, Matthew P.; Gardner, Charles W.; Gomer, Nathaniel R.

    2015-05-01

    Proliferation of chemical and explosive threats as well as illicit drugs continues to be an escalating danger to civilian and military personnel. Conventional means of detecting and identifying hazardous materials often require the use of reagents and/or physical sampling, which is a time-consuming, costly and often dangerous process. Stand-off detection allows the operator to detect threat residues from a safer distance minimizing danger to people and equipment. Current fielded technologies for standoff detection of chemical and explosive threats are challenged by low area search rates, poor targeting efficiency, lack of sensitivity and specificity or use of costly and potentially unsafe equipment such as lasers. A demand exists for stand-off systems that are fast, safe, reliable and user-friendly. To address this need, ChemImage Sensor Systems™ (CISS) has developed reagent-less, non-contact, non-destructive sensors for the real-time detection of hazardous materials based on widefield shortwave infrared (SWIR) and Raman hyperspectral imaging (HSI). Hyperspectral imaging enables automated target detection displayed in the form of image making result analysis intuitive and user-friendly. Application of the CISS' SWIR-HSI and Raman sensing technologies to Homeland Security and Law Enforcement for standoff detection of homemade explosives and illicit drugs and their precursors in vehicle and personnel checkpoints is discussed. Sensing technologies include a portable, robot-mounted and standalone variants of the technology. Test data is shown that supports the use of SWIR and Raman HSI for explosive and drug screening at checkpoints as well as screening for explosives and drugs at suspected clandestine manufacturing facilities.

  5. HER Story: The Next Chapter in HER-2-Directed Therapy for Advanced Breast Cancer

    PubMed Central

    Joy, Anil A.; Rayson, Daniel; McLeod, Deanna; Brezden-Masley, Christine; Boileau, Jean-François; Gelmon, Karen A.

    2013-01-01

    Untreated human epidermal growth factor receptor-2 (HER-2)-positive advanced breast cancer (ABC) is an aggressive disease, associated with a poor prognosis and short overall survival. HER-2-directed therapy prolongs both time to disease progression and overall survival when combined with chemotherapy and has become the standard of care for those with HER-2-positive breast cancer in the early and advanced settings. Despite the remarkable therapeutic impact HER-2-directed therapy has had on disease outcomes, some patients with HER-2-positive disease will have primary resistant disease and others will respond initially but will eventually have progression, underscoring the need for other novel therapeutic options. This article reviews recent phase III trial data and discusses a practical approach to sequencing of HER-2-directed therapy in patients with HER-2-positive ABC. The significant cumulative survival gains seen in these trials are slowly reshaping the landscape of HER-2-positive ABC outcomes. PMID:24212500

  6. HER story: the next chapter in HER-2-directed therapy for advanced breast cancer.

    PubMed

    Verma, Sunil; Joy, Anil A; Rayson, Daniel; McLeod, Deanna; Brezden-Masley, Christine; Boileau, Jean-François; Gelmon, Karen A

    2013-01-01

    Untreated human epidermal growth factor receptor-2 (HER-2)-positive advanced breast cancer (ABC) is an aggressive disease, associated with a poor prognosis and short overall survival. HER-2-directed therapy prolongs both time to disease progression and overall survival when combined with chemotherapy and has become the standard of care for those with HER-2-positive breast cancer in the early and advanced settings. Despite the remarkable therapeutic impact HER-2-directed therapy has had on disease outcomes, some patients with HER-2-positive disease will have primary resistant disease and others will respond initially but will eventually have progression, underscoring the need for other novel therapeutic options. This article reviews recent phase III trial data and discusses a practical approach to sequencing of HER-2-directed therapy in patients with HER-2-positive ABC. The significant cumulative survival gains seen in these trials are slowly reshaping the landscape of HER-2-positive ABC outcomes. PMID:24212500

  7. The desire to die: making treatment decisions for suicidal patients who have an advance directive.

    PubMed

    Salter, Erica K

    2014-01-01

    This article enumerates and critically examines the potential grounds on which we might treat the case of a patient with an advance directive who attempted suicide, differently from one whose injuries were the result of an accident. Grounds for differentiation are distilled into two potential justifications. The first addresses the concern that withholding or withdrawing care from a patient with self-inflicted injuries would be aiding and abetting suicide.The second examines concerns about the patient's decisionmaking capacity. Ultimately, it is argued that while there might be legitimate reasons to hold the advance directive of a suicidal patient to a different standard of scrutiny, the fact that the patient's medical state was self-inflicted should not, in and of itself, necessarily invalidate the guidance of the directive. Finally, four practical recommendations are offered for negotiating similar cases. PMID:24779318

  8. End-of-life communication in Korean older adults: With focus on advance care planning and advance directives.

    PubMed

    Shin, Dong Wook; Lee, Ji Eun; Cho, BeLong; Yoo, Sang Ho; Kim, SangYun; Yoo, Jun-Hyun

    2016-04-01

    The present article aimed to provide a comprehensive review of current status of end-of-life (EOL) care and sociocultural considerations in Korea, with focus on the EOL communication and use of advance directives (AD) in elderly Koreans. Through literature review, we discuss the current status of EOL care and sociocultural considerations in Korea, and provide a look-ahead. In Korea, patients often receive life-sustaining treatment until the very end of life. Advance care planning is rare, and most do-not-resuscitate decisions are made between the family and physician at the very end of patient's life. Koreans, influenced mainly by Confucian tradition, prefer a natural death and discontinuation of life-sustaining treatment. Although Koreans generally believe that death is natural and unavoidable, they tend not to think about or discuss death, and regard preparation for death as unnecessary. As a result, AD are completed by just 4.7% of the general adult population. This situation can be explained by several sociocultural characteristics including opting for natural death, wish not to burden others, preference for family involvement and trust in doctor, avoidance of talking about death, and filial piety. Patients often receive life-sustaining treatment until the very EOL, advance care planning and the use of AD is not common in Korea. This was related to unique sociocultural characteristics of Korea. A more active role of physicians, development of a more deliberate EOL discussion process, development of culturally appropriate AD and promotion of advance care planning might be required to provide good EOL care in Korea. PMID:26459613

  9. Marine legislation--the ultimate 'horrendogram': international law, European directives & national implementation.

    PubMed

    Boyes, Suzanne J; Elliott, Michael

    2014-09-15

    The EU is a pre-eminent player in sustainable development, adopting more than 200 pieces of legislation that have direct repercussions for marine environmental policy and management. Over five decades, measures have aimed to protect the marine environment by tackling the impact of human activities, but maritime affairs have been dealt with by separate sectoral policies without fully integrating all relevant sectors. Such compartmentalisation has resulted in a patchwork of EU legislation and resultant national legislation leading to a piecemeal approach to marine protection. These are superimposed on international obligations emanating from UN and other bodies and are presented here as complex 'horrendograms' showing the complexity across vertical governance. These horrendograms have surprised marine experts despite them acknowledging the many uses and users of the marine environment. Encouragingly since 2000, the evolution in EU policy has progressed to more holistic directives and here we give an overview of this change. PMID:25088540

  10. Dying tax free: the modern advance directive and patients' financial values.

    PubMed

    Kirk, Timothy W; Luck, George R

    2010-03-01

    Advance directives are often used to help patients articulate their end-of-life treatment preferences and guide proxy decision makers in making health care decisions when patients cannot. This case study and commentary puts forth a situation in which a palliative care consultation team encountered a patient with an advance directive that instructed her proxy decision maker to consider estate tax implications when making end-of-life decisions. Following presentation of the case, the authors focus on two ethical issues: 1) the appropriateness of considering patients' financial goals and values in medical decision making and 2) whether certain kinds of patient values should be considered more or less relevant than others as reasons for expressed treatment preferences. Clinicians are encouraged to accept a wide range of patient values as relevant to the clinical decision-making process and to balance the influence of those values with more traditional notions of clinical harm and benefit. PMID:20303033

  11. [Respect for autonomy of "incompetent" patients?--the ethical problem of advanced directives].

    PubMed

    Rehbock, Theda

    2005-12-01

    In addressing the ethical and legal problems of advanced directives, the article discusses whether respect for the autonomy of the so-called "incompetent" patients is possible and morally required. Starting with a critique of how modern medicine threatens patient autonomy and care (2.), the author goes on to highlight the mutual interdependence between respect for autonomy and patient care as two moral requirements arising from respect for human dignity (3.). Finally; the article elucidates the practical consequences as they relate to a treatment approach for each patient that is simultaneously caring and respectful of their autonomy, commenting on the ramifications for a sensitive and conscientious approach to advanced medical directives and for the special -role of nursing in this context. PMID:16398303

  12. Extending the Surrogacy Analogy: Applying the Advance Directive Model to Biobanks

    PubMed Central

    Mongoven, Ann

    2014-01-01

    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 the Five 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 protection of donor interests more robustly through time than current “informed consent” processes in biobanking. PMID:25074323

  13. Experimental ground-based Bridgman CdTe growth in NASA's advanced automated directional solidification furnace

    NASA Technical Reports Server (NTRS)

    Bostrup, G.; Viola, J.; Gertner, E.; Aldrich, W.

    1988-01-01

    The role of gravity-induced phenomena in bulk CdTe crystal growth is studied with emphasis placed on the negative effects of buoyancy-driven convection, container effects, and hydrostatic pressure. An earth-bound crystal growth data base utilizing NASA's prototype advanced automated directional solidification furnace is described. Growth procedures that can be employed in a microgravity environment aboard the Space Shuttle or Space Station are presented. It is found that NASA's directional solidification furnace can produce Bridgman-type CdTe and has the potential for producing it in space.

  14. Impact of California's Air Pollution Laws on Black Carbon and their Implications for Direct Radiative Forcing

    NASA Astrophysics Data System (ADS)

    Bahadur, R.; Feng, Y.; Russell, L. M.; Ramanathan, V.

    2010-12-01

    We examine the temporal and the spatial trends in the concentrations of black carbon (BC) - recorded by the IMPROVE monitoring network for the past 20 years - in California. Annual average BC concentrations in California have decreased by about 50% from 0.46 μg m-3 in 1989 to 0.24 μgm-3 in 2008 compared to a corresponding reductions in diesel BC emissions (also about 50%) from a peak of 0.013 Tg Yr-1 in 1990 to 0.006 Tg Yr-1 by 2008. We attribute the observed negative trends to the deployment of diesel particulate filters. Our conclusion that the reduction in diesel emissions is the primary cause of the observed BC reduction is also substantiated by a significant decrease in the ratio of BC to non-BC aerosols. The absorption efficiency of aerosols at visible wavelengths - determined from the observed scattering coefficient and the observed BC - also decreased by about 50% leading to a model-inferred negative direct radiative forcing (a cooling effect) of -1.4 Wm-2 (±60%) over California. Figure 1 (a) Annual means of measured Black Carbon (left axis) and BC fossil fuel emissions (right axis) in California from 1985 to 2008. Error bars correspond to standard deviation between measurements at each station. Dashed lines indicate a linear fit. Aerosol measurements from the IMPROVE network, emission inventories from (1) CARB, (2) [Ito and Penner, 2005] (b) Annual means of BC measured in Southern (South of 35 N), Northern (North of 38 N), and Central California (c) Annual means of measured Sulfate, Nitrate, and OC from IMPROVE network.

  15. Nitroreductase gene-directed enzyme prodrug therapy: insights and advances toward clinical utility.

    PubMed

    Williams, Elsie M; Little, Rory F; Mowday, Alexandra M; Rich, Michelle H; Chan-Hyams, Jasmine V E; Copp, Janine N; Smaill, Jeff B; Patterson, Adam V; Ackerley, David F

    2015-10-15

    This review examines the vast catalytic and therapeutic potential offered by type I (i.e. oxygen-insensitive) nitroreductase enzymes in partnership with nitroaromatic prodrugs, with particular focus on gene-directed enzyme prodrug therapy (GDEPT; a form of cancer gene therapy). Important first indications of this potential were demonstrated over 20 years ago, for the enzyme-prodrug pairing of Escherichia coli NfsB and CB1954 [5-(aziridin-1-yl)-2,4-dinitrobenzamide]. However, it has become apparent that both the enzyme and the prodrug in this prototypical pairing have limitations that have impeded their clinical progression. Recently, substantial advances have been made in the biodiscovery and engineering of superior nitroreductase variants, in particular development of elegant high-throughput screening capabilities to enable optimization of desirable activities via directed evolution. These advances in enzymology have been paralleled by advances in medicinal chemistry, leading to the development of second- and third-generation nitroaromatic prodrugs that offer substantial advantages over CB1954 for nitroreductase GDEPT, including greater dose-potency and enhanced ability of the activated metabolite(s) to exhibit a local bystander effect. In addition to forging substantial progress towards future clinical trials, this research is supporting other fields, most notably the development and improvement of targeted cellular ablation capabilities in small animal models, such as zebrafish, to enable cell-specific physiology or regeneration studies. PMID:26431849

  16. Consciousness in humans and non-human animals: recent advances and future directions

    PubMed Central

    Boly, Melanie; Seth, Anil K.; Wilke, Melanie; Ingmundson, Paul; Baars, Bernard; Laureys, Steven; Edelman, David B.; Tsuchiya, Naotsugu

    2013-01-01

    This joint article reflects the authors' personal views regarding noteworthy advances in the neuroscience of consciousness in the last 10 years, and suggests what we feel may be promising future directions. It is based on a small conference at the Samoset Resort in Rockport, Maine, USA, in July of 2012, organized by the Mind Science Foundation of San Antonio, Texas. Here, we summarize recent advances in our understanding of subjectivity in humans and other animals, including empirical, applied, technical, and conceptual insights. These include the evidence for the importance of fronto-parietal connectivity and of “top-down” processes, both of which enable information to travel across distant cortical areas effectively, as well as numerous dissociations between consciousness and cognitive functions, such as attention, in humans. In addition, we describe the development of mental imagery paradigms, which made it possible to identify covert awareness in non-responsive subjects. Non-human animal consciousness research has also witnessed substantial advances on the specific role of cortical areas and higher order thalamus for consciousness, thanks to important technological enhancements. In addition, much progress has been made in the understanding of non-vertebrate cognition relevant to possible conscious states. Finally, major advances have been made in theories of consciousness, and also in their comparison with the available evidence. Along with reviewing these findings, each author suggests future avenues for research in their field of investigation. PMID:24198791

  17. The Impact of Advanced Pharmacy Practice Experiences on Students' Readiness for Self-directed Learning

    PubMed Central

    Haines, Stuart T.; Plaza, Cecilia M.; Sturpe, Deborah A.; Williams, Greg; Rodriguez de Bittner, Magaly A.; Roffman, David S.

    2009-01-01

    Objective To evaluate the impact of advanced pharmacy practice experiences (APPEs) on doctor of pharmacy (PharmD) students' readiness for self-directed learning. Methods The Self-Directed Learning Readiness Scale (SDLRS) was administered to students prior to and after completing their APPEs. SDLRS is a validated instrument that determines the relative degree to which students have the attitudes and motivation to engage in self-directed learning. Results Seventy-seven (64%) students completed the SDLRS prior to starting their APPEs and 80 (67%) students completed the instrument after completing their APPEs. Forty-six (38%) students completed both. Prior to starting their APPEs, 74% of students scored greater than 150 on the SDLRS, indicating a high level of readiness for self-directed learning. No significant difference was found between the mean scores of students who took the SDLRS both prior to (159 ± 20) and after completing their APPEs (159 ± 24; p > 0.05). Conclusion Students at our institution appear to be ready for self-directed learning but APPEs had a minimal impact on their readiness for self-directed learning. PMID:19657498

  18. Progress in the Development of Direct Osmotic Concentration Wastewater Recovery Process for Advanced Life Support Systems

    NASA Technical Reports Server (NTRS)

    Cath, Tzahi Y.; Adams, Dean V.; Childress, Amy; Gormly, Sherwin; Flynn, Michael

    2005-01-01

    Direct osmotic concentration (DOC) has been identified as a high potential technology for recycling of wastewater to drinking water in advanced life support (ALS) systems. As a result the DOC process has been selected for a NASA Rapid Technology Development Team (RTDT) effort. The existing prototype system has been developed to a Technology Readiness Level (TRL) 3. The current project focuses on advancing the development of this technology from TRL 3 to TRL 6 (appropriate for human rated testing). A new prototype of a DOC system is been designed and fabricated that addresses the deficiencies encountered during the testing of the original system and allowing the new prototype to achieve TRL 6. Background information is provided about the technologies investigated and their capabilities, results from preliminary tests, and the milestones plan and activities for the RTDT program intended to develop a second generation prototype of the DOC system.

  19. Innovative pacing: Recent advances, emerging technologies, and future directions in cardiac pacing.

    PubMed

    Austin, Christopher; Kusumoto, Fred

    2016-07-01

    The field of cardiovascular medicine is rapidly evolving as advancements in technology and engineering provide clinicians new and exciting ways to care for an aging population. Cardiac pacing, in particular, has seen a series of game-changing technologies emerge in the past several years spurred by low-power electronics, high density batteries, improved catheter delivery systems and innovative software design. We look at several of these emerging pacemaker technologies, discussing the rationale, current state and future directions of these pioneering developments in electrophysiology. PMID:27017442

  20. (AADSF) Advanced Automated Directional Solidification Furnace Onboard STS-87 USMP-4

    NASA Technical Reports Server (NTRS)

    1997-01-01

    The purpose of the experiments for the Advanced Automated Directional Solidification Furnace (AADSF) is to determine how gravity-driven convection affects the composition and properties of alloys (mixtures of two or more materials, usually metal). During the USMP-4 mission, the AADSF will solidify crystals of lead tin telluride and mercury cadmium telluride, alloys of compound semiconductor materials used to make infrared detectors and lasers, as experiment samples. Although these materials are used for the same type application their properties and compositional uniformity are affected differently during the solidification process.

  1. Wild Orangutan Males Plan and Communicate Their Travel Direction One Day in Advance

    PubMed Central

    van Schaik, Carel P.; Damerius, Laura; Isler, Karin

    2013-01-01

    The ability to plan for the future beyond immediate needs would be adaptive to many animal species, but is widely thought to be uniquely human. Although studies in captivity have shown that great apes are capable of planning for future needs, it is unknown whether and how they use this ability in the wild. Flanged male Sumatran orangutans (Pongo abelii) emit long calls, which females use to maintain earshot associations with them. We tested whether long calls serve to communicate a male's ever-changing predominant travel direction to facilitate maintaining these associations. We found that the direction in which a flanged male emits his long calls predicts his subsequent travel direction for many hours, and that a new call indicates a change in his main travel direction. Long calls given at or near the night nest indicate travel direction better than random until late afternoon on the next day. These results show that male orangutans make their travel plans well in advance and announce them to conspecifics. We suggest that such a planning ability is likely to be adaptive for great apes, as well as in other taxa. PMID:24040357

  2. Psychiatric Advance Directives, a Possible Way to Overcome Coercion and Promote Empowerment

    PubMed Central

    Khazaal, Yasser; Manghi, Rita; Delahaye, Marie; Machado, Ariella; Penzenstadler, Louise; Molodynski, Andrew

    2014-01-01

    Psychiatric advance directives (ADs) allow an individual to state their preferences for future treatment at times when they may be unable to make considered decisions. There are differences in their form and legal value and the process associated with their use and completion. Several studies have now been completed to assess the impact of ADs on service use and coercion. Their results give a mixed picture but directives nevertheless have the potential to support the empowerment process, minimize experienced coercion, and improve coping strategies. These may in turn reduce the frequency of in-patient service use. Further studies on the different processes of facilitation involved and on different populations are necessary to improve our knowledge and use of these potentially powerful interventions. PMID:24809041

  3. The Recent Revolution in the Design and Manufacture of Cranial Implants: Modern Advancements and Future Directions.

    PubMed

    Bonda, David J; Manjila, Sunil; Selman, Warren R; Dean, David

    2015-11-01

    Large format (i.e., >25 cm) cranioplasty is a challenging procedure not only from a cosmesis standpoint, but also in terms of ensuring that the patient's brain will be well-protected from direct trauma. Until recently, when a patient's own cranial flap was unavailable, these goals were unattainable. Recent advances in implant computer-aided design and 3-dimensional (3-D) printing are leveraging other advances in regenerative medicine. It is now possible to 3-D-print patient-specific implants from a variety of polymer, ceramic, or metal components. A skull template may be used to design the external shape of an implant that will become well integrated in the skull, while also providing beneficial distribution of mechanical force in the event of trauma. Furthermore, an internal pore geometry can be utilized to facilitate the seeding of banked allograft cells. Implants may be cultured in a bioreactor along with recombinant growth factors to produce implants coated with bone progenitor cells and extracellular matrix that appear to the body as a graft, albeit a tissue-engineered graft. The growth factors would be left behind in the bioreactor and the graft would resorb as new host bone invades the space and is remodeled into strong bone. As we describe in this review, such advancements will lead to optimal replacement of cranial defects that are both patient-specific and regenerative. PMID:26171578

  4. [The periodic health examination: from law to the directive of the German Federal Joint Committee (G-BA)].

    PubMed

    Perleth, Matthias; Matthias, Katja

    2014-01-01

    Since 1989 a periodic health examination beginning at the age of 35 for the early detection of "common diseases" (especially cardiovascular and kidney diseases as well as diabetes) by means of history-taking, physical examination, blood and urine tests and counselling has been available in Germany. Altogether, the respective directive of the Federal Joint Committee (G-BA) was revised six times, but a substantive change took place only once (i. e., the cancellation of uric acid, creatinine, and resting ECG in 1999). However, additional examinations (e.g., glaucoma screening) were not added to the health check after systematic assessments of the evidence were completed. In the mid-1990s, several evaluations were performed which showed that new diagnoses were established in a significant proportion of patients, and measures were initiated such as nutrition counselling. A patient-relevant benefit in terms of avoided adverse events (such as heart attacks) could, however, not be demonstrated due to methodological reasons. Criticism of the health examination is not new, in particular concerning the lack of evidence of benefit for the diagnostic procedures of the health examination. A draft law issued by the former Federal Government proposing an amendment to the health examination has recently been rejected in the Bundesrat (upper house of the German parliament). PMID:24889707

  5. Responses of advanced directives by Jehovah’s Witnesses on a gynecologic oncology service

    PubMed Central

    Nagarsheth, Nimesh P; Gupta, Nikhil; Gupta, Arpeta; Moshier, Erin; Gretz, Herbert; Shander, Aryeh

    2015-01-01

    Objectives To review the responses of advance directives signed by Jehovah’s Witness patients prior to undergoing surgery at a gynecologic oncology service. Study design A retrospective chart review of gynecologic oncology patients undergoing surgery at a bloodless surgery center from 1998–2007 was conducted. Demographic, pathologic, and clinical data were recorded. The proportion of patients who accepted and refused various blood-derived products was determined and was compared to previously published results from a similar study of labor and delivery unit patients. Results No gynecologic oncology patients agreed to accept transfusions of whole blood, red cells, white cells, platelets, or plasma under any circumstance, whereas 9.8% of pregnant patients accepted transfusion (P=0.0385). However, 98% of gynecologic oncology patients agreed to accept some blood products, including fractions such as albumin, immunoglobulins, and clotting factors, while only 39% of pregnant patients agreed (P<0.0001). In addition, all gynecologic oncology patients (100%) accepted intraoperative hemodilution, compared to 55% of pregnant patients (P<0.0001). Conclusion Our results confirm the commonly held belief that the majority of Jehovah’s Witness patients refuse to accept major blood components. However, Jehovah’s Witness patients at a gynecologic oncology service will accept a variety of blood-derived products (minor fractions) and interventions designed to optimize outcomes when undergoing transfusion-free surgery. Patients presenting to a gynecologic oncology service respond differently to advanced directives related to bloodless surgery, as compared to patients from an obstetrical service. PMID:25565911

  6. Proceedings of the advanced research and technology development direct utilization, instrumentation and diagnostics contractors' review meeting

    SciTech Connect

    Geiling, D.W. ); Goldberg, P.M. )

    1990-01-01

    The 1990 Advanced Research and Technology Development (AR TD) Direct Utilization, and Instrumentation and Diagnostics Contractors Review Meeting was held September 16--18, 1990, at the Hyatt at Chatham Center in Pittsburgh, PA. The meeting was sponsored by the US Department of Energy (DOE), Office of Fossil Energy, and the Pittsburgh and Morgantown Energy Technology Centers. Each year the meeting provides a forum for the exchange of information among the DOE AR TD contractors and interested parties. This year's meeting was hosted by the Pittsburgh Energy Technology Center and was attended by 120 individuals from industry, academia, national laboratories, and other governmental agencies. Papers were presented on research addressing coal surface, science, devolatilization and combustion, ash behavior, emission controls for gases particulates, fluid bed combustion and utilization in diesels and turbines. Individual reports are processed separately for the data bases.

  7. Advanced leading edge thermal-structure concept. Direct bond reusable surface insulation to a composite structure

    NASA Technical Reports Server (NTRS)

    Riccitiello, S. R.; Figueroa, H.; Coe, C. F.; Kuo, C. P.

    1984-01-01

    An advanced leading-edge concept was analyzed using the space shuttle leading edge system as a reference model. The comparison indicates that a direct-bond system utilizing a high temperature (2700 F) fibrous refractory composite insulation tile bonded to a high temperature (PI/graphite) composite structure can result in a weight savings of up to 800 lb. The concern that tile damage or loss during ascent would result in adverse entry aerodynamics if a leading edge tile system were used is addressed. It was found from experiment that missing tiles (as many as 22) on the leading edge would not significantly affect the basic force-and-moment aerodynamic coefficients. Additionally, this concept affords a degree of redundancy to a thermal protection system in that the base structure (being a composite material) ablates and neither melts nor burns through when subjected to entry heating in the event tiles are actually lost or damaged during ascent.

  8. Degradation pathways of lamotrigine under advanced treatment by direct UV photolysis, hydroxyl radicals, and ozone.

    PubMed

    Keen, Olya S; Ferrer, Imma; Michael Thurman, E; Linden, Karl G

    2014-12-01

    Lamotrigine is recently recognized as a persistent pharmaceutical in the water environment and wastewater effluents. Its degradation was studied under UV and ozone advanced oxidation treatments with reaction kinetics of lamotrigine with ozone (≈4 M(-1)s(-1)), hydroxyl radical [(2.1 ± 0.3) × 10(9)M(-1)s(-1)] and by UV photolysis with low and medium pressure mercury vapor lamps [quantum yields ≈0 and (2.7 ± 0.4)× 10(-4) respectively] determined. All constants were measured at pH 6 and at temperature ≈20°C. The results indicate that lamotrigine is slow to respond to direct photolysis or oxidation by ozone and no attenuation of the contaminant is expected in UV or ozone disinfection applications. The compound reacts rapidly with hydroxyl radicals indicating that advanced oxidation processes would be effective for its treatment. Degradation products were identified under each treatment process using accurate mass time-of-flight spectrometry and pathways of decay were proposed. The main transformation pathways in each process were: dechlorination of the benzene ring during direct photolysis; hydroxyl group addition to the benzene ring during the reaction with hydroxyl radicals; and triazine ring opening after reaction with ozone. Different products that form in each process may be to a varying degree less environmentally stable than the parent lamotrigine. In addition, a novel method of ozone quenching without addition of salts is presented. The new quenching method would allow subsequent mass spectrometry analysis without a solid phase extraction clean-up step. The method involves raising the pH of the sample to approximately 10 for a few seconds and lowering it back and is therefore limited to applications for which temporary pH change is not expected to affect the outcome of the analysis. PMID:25150682

  9. Advanced direct liquefaction concepts for PETC generic units. Final report, Phase I

    SciTech Connect

    1995-03-01

    The Advanced Concepts for Direct Coal Liquefaction program was initiated by the Department of Energy in 1991 to develop technologies that could significantly reduce the cost of producing liquid fuels by the direct liquefaction of coal. The advanced 2-stage liquefaction technology that was developed at Wilsonville over the past 10 years has contributed significantly toward decreasing the cost of producing liquids from coal to about $33/bbl. It remains, however, the objective of DOE to further reduce this cost to a level more competitive with petroleum based products. This project, among others, was initiated to investigate various alternative approaches to develop technologies that might ultimately lead to a 25 % reduction in cost of product. In this project a number of novel concepts were investigated, either individually or in a coupled configuration that had the potential to contribute toward meeting the DOE goal. The concepts included mature technologies or ones closely related to them, such as coal cleaning by oil agglomeration, fluid coking and distillate hydrotreating and dewaxing. Other approaches that were either embryonic or less developed were chemical pretreatment of coal to remove oxygen, and dispersed catalyst development for application in the 2-stage liquefaction process. This report presents the results of this project. It is arranged in four sections which were prepared by participating organizations responsible for that phase of the project. A summary of the overall project and the principal results are given in this section. First, however, an overview of the process economics and the process concepts that were developed during the course of this program is presented.

  10. Early experience with digital advance care planning and directives, a novel consumer-driven program

    PubMed Central

    Yang, Zhiyong; Spivey, Christy; Boardman, Bonnie; Courtney, Maureen

    2016-01-01

    Barriers to traditional advance care planning (ACP) and advance directive (AD) creation have limited the promise of ACP/AD for individuals and families, the healthcare team, and society. Our objectives were to determine the results of a digital ACP/AD through which consumers create, store, locate, and retrieve their ACP/AD at no charge and with minimal physician involvement, and the ACP/AD can be integrated into the electronic health record. The authors chose 900 users of MyDirectives, a digital ACP/AD tool, to achieve proportional representation of all 50 states by population size and then reviewed their responses. The 900 participants had an average age of 50.8 years (SD = 16.6); 84% of the men and 91% of the women were in self-reported good health when signing their ADs. Among the respondents, 94% wanted their physicians to consult a supportive and palliative care team if they were seriously ill; nearly 85% preferred cessation of life-sustaining treatments during their final days; 76% preferred to spend their final days at home or in a hospice; and 70% would accept attempted cardiopulmonary resuscitation in limited circumstances. Most respondents wanted an autopsy under certain conditions, and 62% wished to donate their organs. In conclusion, analysis of early experience with this ACP/AD platform demonstrates that individuals of different ages and conditions can engage in an interrogatory process about values, develop ADs that are more nuanced than traditional paper-based ADs in reflecting those values, and easily make changes to their ADs. Online ADs have the potential to remove barriers to ACP/AD and thus further improve patient-centered end-of-life care. PMID:27365867

  11. Early experience with digital advance care planning and directives, a novel consumer-driven program.

    PubMed

    Fine, Robert L; Yang, Zhiyong; Spivey, Christy; Boardman, Bonnie; Courtney, Maureen

    2016-07-01

    Barriers to traditional advance care planning (ACP) and advance directive (AD) creation have limited the promise of ACP/AD for individuals and families, the healthcare team, and society. Our objectives were to determine the results of a digital ACP/AD through which consumers create, store, locate, and retrieve their ACP/AD at no charge and with minimal physician involvement, and the ACP/AD can be integrated into the electronic health record. The authors chose 900 users of MyDirectives, a digital ACP/AD tool, to achieve proportional representation of all 50 states by population size and then reviewed their responses. The 900 participants had an average age of 50.8 years (SD = 16.6); 84% of the men and 91% of the women were in self-reported good health when signing their ADs. Among the respondents, 94% wanted their physicians to consult a supportive and palliative care team if they were seriously ill; nearly 85% preferred cessation of life-sustaining treatments during their final days; 76% preferred to spend their final days at home or in a hospice; and 70% would accept attempted cardiopulmonary resuscitation in limited circumstances. Most respondents wanted an autopsy under certain conditions, and 62% wished to donate their organs. In conclusion, analysis of early experience with this ACP/AD platform demonstrates that individuals of different ages and conditions can engage in an interrogatory process about values, develop ADs that are more nuanced than traditional paper-based ADs in reflecting those values, and easily make changes to their ADs. Online ADs have the potential to remove barriers to ACP/AD and thus further improve patient-centered end-of-life care. PMID:27365867

  12. Tuberculosis--advances in development of new drugs, treatment regimens, host-directed therapies, and biomarkers.

    PubMed

    Wallis, Robert S; Maeurer, Markus; Mwaba, Peter; Chakaya, Jeremiah; Rustomjee, Roxana; Migliori, Giovanni Battista; Marais, Ben; Schito, Marco; Churchyard, Gavin; Swaminathan, Soumya; Hoelscher, Michael; Zumla, Alimuddin

    2016-04-01

    Tuberculosis is the leading infectious cause of death worldwide, with 9·6 million cases and 1·5 million deaths reported in 2014. WHO estimates 480,000 cases of these were multidrug resistant (MDR). Less than half of patients who entered into treatment for MDR tuberculosis successfully completed that treatment, mainly due to high mortality and loss to follow-up. These in turn illustrate weaknesses in current treatment regimens and national tuberculosis programmes, coupled with operational treatment challenges. In this Review we provide an update on recent developments in the tuberculosis drug-development pipeline (including new and repurposed antimicrobials and host-directed drugs) as they are applied to new regimens to shorten and improve outcomes of tuberculosis treatment. Several new or repurposed antimicrobial drugs are in advanced trial stages for MDR tuberculosis, and two new antimicrobial drug candidates are in early-stage trials. Several trials to reduce the duration of therapy in MDR and drug-susceptible tuberculosis are ongoing. A wide range of candidate host-directed therapies are being developed to accelerate eradication of infection, prevent new drug resistance, and prevent permanent lung injury. As these drugs have been approved for other clinical indications, they are now ready for repurposing for tuberculosis in phase 2 clinical trials. We assess risks associated with evaluation of new treatment regimens, and highlight opportunities to advance tuberculosis research generally through regulatory innovation in MDR tuberculosis. Progress in tuberculosis-specific biomarkers (including culture conversion, PET and CT imaging, and gene expression profiles) can support this innovation. Several global initiatives now provide unique opportunities to tackle the tuberculosis epidemic through collaborative partnerships between high-income countries and middle-income and low-income countries for clinical trials training and research, allowing funders to

  13. A direct-execution parallel architecture for the Advanced Continuous Simulation Language (ACSL)

    NASA Technical Reports Server (NTRS)

    Carroll, Chester C.; Owen, Jeffrey E.

    1988-01-01

    A direct-execution parallel architecture for the Advanced Continuous Simulation Language (ACSL) is presented which overcomes the traditional disadvantages of simulations executed on a digital computer. The incorporation of parallel processing allows the mapping of simulations into a digital computer to be done in the same inherently parallel manner as they are currently mapped onto an analog computer. The direct-execution format maximizes the efficiency of the executed code since the need for a high level language compiler is eliminated. Resolution is greatly increased over that which is available with an analog computer without the sacrifice in execution speed normally expected with digitial computer simulations. Although this report covers all aspects of the new architecture, key emphasis is placed on the processing element configuration and the microprogramming of the ACLS constructs. The execution times for all ACLS constructs are computed using a model of a processing element based on the AMD 29000 CPU and the AMD 29027 FPU. The increase in execution speed provided by parallel processing is exemplified by comparing the derived execution times of two ACSL programs with the execution times for the same programs executed on a similar sequential architecture.

  14. Advanced Insights into Functional Brain Connectivity by Combining Tensor Decomposition and Partial Directed Coherence

    PubMed Central

    Leistritz, Lutz; Witte, Herbert; Schiecke, Karin

    2015-01-01

    Quantification of functional connectivity in physiological networks is frequently performed by means of time-variant partial directed coherence (tvPDC), based on time-variant multivariate autoregressive models. The principle advantage of tvPDC lies in the combination of directionality, time variance and frequency selectivity simultaneously, offering a more differentiated view into complex brain networks. Yet the advantages specific to tvPDC also cause a large number of results, leading to serious problems in interpretability. To counter this issue, we propose the decomposition of multi-dimensional tvPDC results into a sum of rank-1 outer products. This leads to a data condensation which enables an advanced interpretation of results. Furthermore it is thereby possible to uncover inherent interaction patterns of induced neuronal subsystems by limiting the decomposition to several relevant channels, while retaining the global influence determined by the preceding multivariate AR estimation and tvPDC calculation of the entire scalp. Finally a comparison between several subjects is considerably easier, as individual tvPDC results are summarized within a comprehensive model equipped with subject-specific loading coefficients. A proof-of-principle of the approach is provided by means of simulated data; EEG data of an experiment concerning visual evoked potentials are used to demonstrate the applicability to real data. PMID:26046537

  15. 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

  16. On the link between particle size and deviations from the Beer-Lambert-Bouguer law for direct transmission

    NASA Astrophysics Data System (ADS)

    Larsen, Michael L.; Clark, Aaron S.

    2014-01-01

    Ballistic photon models of radiative transfer in discrete absorbing random media have demonstrated deviations from the Beer-Lambert-Bouguer law of exponential attenuation. A number of theoretical constructs to quantify the deviation from the Beer-Lambert-Bouguer law have appeared in the literature, several of which rely principally on a statistical measure related to the statistics of the absorber spatial positions alone. Here, we utilize a simple computational model to explore the interplay between the geometric size of the absorbing obstacles and the statistics governing the placement of the absorbers in the volume. We find that a description of the volume that depends on particle size and the spatial statistics of absorbers is not sufficient to fully characterize deviations from the Beer-Lambert-Bouguer law. Implications for future further theoretical and computational explorations of the problem are explored.

  17. A growth model for directed complex networks with power-law shape in the out-degree distribution

    NASA Astrophysics Data System (ADS)

    Esquivel-Gómez, J.; Stevens-Navarro, E.; Pineda-Rico, U.; Acosta-Elias, J.

    2015-01-01

    Many growth models have been published to model the behavior of real complex networks. These models are able to reproduce several of the topological properties of such networks. However, in most of these growth models, the number of outgoing links (i.e., out-degree) of nodes added to the network is constant, that is all nodes in the network are born with the same number of outgoing links. In other models, the resultant out-degree distribution decays as a poisson or an exponential distribution. However, it has been found that in real complex networks, the out-degree distribution decays as a power-law. In order to obtain out-degree distribution with power-law behavior some models have been proposed. This work introduces a new model that allows to obtain out-degree distributions that decay as a power-law with an exponent in the range from 0 to 1.

  18. A growth model for directed complex networks with power-law shape in the out-degree distribution.

    PubMed

    Esquivel-Gómez, J; Stevens-Navarro, E; Pineda-Rico, U; Acosta-Elias, J

    2015-01-01

    Many growth models have been published to model the behavior of real complex networks. These models are able to reproduce several of the topological properties of such networks. However, in most of these growth models, the number of outgoing links (i.e., out-degree) of nodes added to the network is constant, that is all nodes in the network are born with the same number of outgoing links. In other models, the resultant out-degree distribution decays as a poisson or an exponential distribution. However, it has been found that in real complex networks, the out-degree distribution decays as a power-law. In order to obtain out-degree distribution with power-law behavior some models have been proposed. This work introduces a new model that allows to obtain out-degree distributions that decay as a power-law with an exponent in the range from 0 to 1. PMID:25567141

  19. A growth model for directed complex networks with power-law shape in the out-degree distribution

    PubMed Central

    Esquivel-Gómez, J.; Stevens-Navarro, E.; Pineda-Rico, U.; Acosta-Elias, J.

    2015-01-01

    Many growth models have been published to model the behavior of real complex networks. These models are able to reproduce several of the topological properties of such networks. However, in most of these growth models, the number of outgoing links (i.e., out-degree) of nodes added to the network is constant, that is all nodes in the network are born with the same number of outgoing links. In other models, the resultant out-degree distribution decays as a poisson or an exponential distribution. However, it has been found that in real complex networks, the out-degree distribution decays as a power-law. In order to obtain out-degree distribution with power-law behavior some models have been proposed. This work introduces a new model that allows to obtain out-degree distributions that decay as a power-law with an exponent in the range from 0 to 1. PMID:25567141

  20. Recent advances in direct methanol fuel cells at Los Alamos National Laboratory

    NASA Astrophysics Data System (ADS)

    Ren, Xiaoming; Zelenay, Piotr; Thomas, Sharon; Davey, John; Gottesfeld, Shimshon

    This paper describes recent advances in the science and technology of direct methanol fuel cells (DMFCs) made at Los Alamos National Laboratory (LANL). The effort on DMFCs at LANL includes work devoted to portable power applications, funded by the Defense Advanced Research Project Agency (DARPA), and work devoted to potential transport applications, funded by the US DOE. We describe recent results with a new type of DMFC stack hardware that allows to lower the pitch per cell to 2 mm while allowing low air flow and air pressure drops. Such stack technology lends itself to both portable power and potential transport applications. Power densities of 300 W/l and 1 kW/l seem achievable under conditions applicable to portable power and transport applications, respectively. DMFC power system analysis based on the performance of this stack, under conditions applying to transport applications (joint effort with U.C. Davis), has shown that, in terms of overall system efficiency and system packaging requirements, a power source for a passenger vehicle based on a DMFC could compete favorably with a hydrogen-fueled fuel cell system, as well as with fuel cell systems based on fuel processing on board. As part of more fundamental studies performed, we describe optimization of anode catalyst layers in terms of PtRu catalyst nature, loading and catalyst layer composition and structure. We specifically show that, optimized content of recast ionic conductor added to the catalyst layer is a sensitive function of the nature of the catalyst. Other elements of membrane/electrode assembly (MEA) optimization efforts are also described, highlighting our ability to resolve, to a large degree, a well-documented problem of polymer electrolyte DMFCs, namely "methanol crossover". This was achieved by appropriate cell design, enabling fuel utilization as high as 90% in highly performing DMFCs.

  1. Psychiatric Advance Directives as a complex and multistage intervention: a realist systematic review.

    PubMed

    Nicaise, Pablo; Lorant, Vincent; Dubois, Vincent

    2013-01-01

    Psychiatric Advance Directives (PADs) are documents that allow users with severe and chronic mental illnesses to notify their treatment preferences for future crisis relapses and to appoint a surrogate decision-maker for a period of incompetence. Despite many supposed clinical and organisational benefits, their take-up rate has remained very low and their clinical evaluation has given contradictory results for organisational outcomes. Intermediary results are available, however, which rely on different theoretical views about how PADs are supposed to work. We carried out a realist systematic review that considered the PAD as a multistage intervention including the definition of the document, its completion and its access and honouring. We identified the theoretical frameworks underlying this kind of intervention and examined the available evidence that supported or contradicted the expectations at each stage of the intervention. Forty-seven references were retrieved, ranging from 1996 to 2009. Three frameworks underlie a PAD intervention: enhancement of the autonomy of the user, improvement of the therapeutic alliance and integration of care through partnership working. Although designed in the first place with a view to sustaining the user's autonomy, results indicate that the intervention is more efficient within a therapeutic alliance framework. Moreover, much is known about the completion process and the content of the document, but very little about its access and honouring. The mixture of expectations makes the purpose of PADs unclear, for example, crisis relapse prevention or management, advance planning of long-term or emergency care, or reduction in the resort to coercion. This may explain their low take-up rates. Hence, frameworks and purpose have to be clarified. The shape of the whole intervention at each stage relies on such clarification. More research is needed, particularly on the later stages of the intervention, as the evidence for how PADs should

  2. Perspectives on advance directives in Japanese society: A population-based questionnaire survey

    PubMed Central

    Akabayashi, Akira; Slingsby, Brian Taylor; Kai, Ichiro

    2003-01-01

    Background In Japan, discussion concerning advance directives (ADs) has been on the rise during the past decade. ADs are one method proposed to facilitate the process of communication among patients, families and health care providers regarding the plan of care of a patient who is no longer capable of communicating. In this paper, we report the results of the first in-depth survey on the general population concerning the preferences and use of ADs in Japan. Method A self-administered questionnaire was sent via mail to a stratified random sampling of 560 residents listed in the residential registry of one district of Tokyo, Japan (n = 165,567). Association between correlating factors and specific preferences toward ADs was assessed using contingency table bivariate analysis and multivariate regression model to estimate independent contribution. Results Of the 560 questionnaires sent out, a total of 425 participants took part in the survey yielding a response rate of 75.9 %. The results of the present study indicate that: 1) the most important components to be addressed are the specifics of medical treatment at the end of life stage and disclosure of diagnosis and prognosis; 2) the majority of participants found it suitable to express their directives by word to family and/or physician and not by written documentation; 3) there is no strong need for legal measures in setting up an AD; 4) it is permissible for family and physician to loosely interpret one's directives; 5) the most suitable proxy is considered to be a family member, relative, or spouse. Multivariate analysis found the following five factors as significantly associated with preferences: 1) awareness regarding living wills, 2) experience with the use of ADs, 3) preferences for end-of-life treatment, 4) preferences for information disclosure, and 5) intentions of creating a will. Conclusions Written ADs might be useful in the Japanese setting when the individual either wishes: 1) to not provide a lot of

  3. 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 Approach" (Heidi Byrnes,…

  4. Lightning Radio Source Retrieval Using Advanced Lightning Direction Finder (ALDF) Networks

    NASA Technical Reports Server (NTRS)

    Koshak, William J.; Blakeslee, Richard J.; Bailey, J. C.

    1998-01-01

    A linear algebraic solution is provided for the problem of retrieving the location and time of occurrence of lightning ground strikes from an Advanced Lightning Direction Finder (ALDF) network. The ALDF network measures field strength, magnetic bearing and arrival time of lightning radio emissions. Solutions for the plane (i.e., no Earth curvature) are provided that implement all of tile measurements mentioned above. Tests of the retrieval method are provided using computer-simulated data sets. We also introduce a quadratic planar solution that is useful when only three arrival time measurements are available. The algebra of the quadratic root results are examined in detail to clarify what portions of the analysis region lead to fundamental ambiguities in source location. Complex root results are shown to be associated with the presence of measurement errors when the lightning source lies near an outer sensor baseline of the ALDF network. In the absence of measurement errors, quadratic root degeneracy (no source location ambiguity) is shown to exist exactly on the outer sensor baselines for arbitrary non-collinear network geometries. The accuracy of the quadratic planar method is tested with computer generated data sets. The results are generally better than those obtained from the three station linear planar method when bearing errors are about 2 deg. We also note some of the advantages and disadvantages of these methods over the nonlinear method of chi(sup 2) minimization employed by the National Lightning Detection Network (NLDN) and discussed in Cummins et al.(1993, 1995, 1998).

  5. The Attitudes of Chinese Cancer Patients and Family Caregivers toward Advance Directives.

    PubMed

    Zhang, Qiu; Xie, Chuanbo; Xie, Shanghang; Liu, Qing

    2016-01-01

    Advance directives (ADs) have been legislated in many countries to protect patient autonomy regarding medical decisions at the end of life. China is facing a serious cancer burden and cancer patients' quality at the end of life should be a concern. However, limited studies have been conducted locally to gather information about attitudes toward ADs. The purpose of this study was to investigate the attitudes of Chinese cancer patients and family caregivers toward ADs and to explore the predictors that are associated with attitudes. The study indicated that although there was low awareness of ADs, most cancer patients and family caregivers had positive attitudes toward ADs after related information was explained to them. Participants preferred to discuss ADs with medical staff when they were diagnosed with a life-threatening disease. Preferences for refusing life-sustaining treatment and choosing Hospice-Palliative Care (HPC) at the end of life would increase the likelihood of agreeing with ADs. This suggests that some effective interventions to help participants better understand end-of-life treatments are helpful in promoting ADs. Moreover, the development of HPC would contribute to Chinese cancer patients and family caregivers agreeing with ADs. PMID:27529264

  6. The Attitudes of Chinese Cancer Patients and Family Caregivers toward Advance Directives

    PubMed Central

    Zhang, Qiu; Xie, Chuanbo; Xie, Shanghang; Liu, Qing

    2016-01-01

    Advance directives (ADs) have been legislated in many countries to protect patient autonomy regarding medical decisions at the end of life. China is facing a serious cancer burden and cancer patients’ quality at the end of life should be a concern. However, limited studies have been conducted locally to gather information about attitudes toward ADs. The purpose of this study was to investigate the attitudes of Chinese cancer patients and family caregivers toward ADs and to explore the predictors that are associated with attitudes. The study indicated that although there was low awareness of ADs, most cancer patients and family caregivers had positive attitudes toward ADs after related information was explained to them. Participants preferred to discuss ADs with medical staff when they were diagnosed with a life-threatening disease. Preferences for refusing life-sustaining treatment and choosing Hospice-Palliative Care (HPC) at the end of life would increase the likelihood of agreeing with ADs. This suggests that some effective interventions to help participants better understand end-of-life treatments are helpful in promoting ADs. Moreover, the development of HPC would contribute to Chinese cancer patients and family caregivers agreeing with ADs. PMID:27529264

  7. [Physicians' views and perspectives on advanced directives in patients with incipient dementia].

    PubMed

    Mattiussi, Mercedes; Dawidowski, Adriana; Restibo, Jimena; Pollán, Javier; Pezzano, Laura; Cámera, Luis

    2012-01-01

    Dementia is a progressive disease in which patients lose their ability to decide and communicate. Advance directives (AD) allow patients to express their preferences on end of life care in the early stages of the disease. Primary care practitioners (PCP) are in the best position to promote AD. The aim of this study was to elicit PCPs views about the discussion of AD with early stage dementia patients. A qualitative approach was taken, focus groups and individual interviews to elderly patients' PCPs from the Hospital italiano de buenos aires were conducted. A purposive sampling was performed, conforming homogeneous groups according to age and seniority. The discussion was stimulated by a vignette. We performed thematic content analysis in an interdisciplinary team. Twelve PCPs = 30 year of age, 32 middle-aged and 8 over 45 years participated of the study. The youngest group favored the discussion of AD while those over 45 regarded the family as the decision maker, and thus, the discussion as useless. Besides, they expressed that our society is not mature enough to discuss AD. Difficulties in AD implementation, in predicting the evolution of a patient's disease, the span of time between the discussion and AD implementation, lack of legislation and specific institutional policies were other factors that conditioned the discussion. Younger PCPs expressed concern on the lack of communication skills and difficulties to broach this subject with patients. PCPs perspectives on AD vary, their age should be taken into account when designing strategies to their implementation. PMID:22892082

  8. Awareness and Completion of Advance Directives Among Korean American Older Adults

    PubMed Central

    Dobbs, Debra; Park, Nan Sook; Jang, Yuri; Meng, Hongdao

    2014-01-01

    There has been growing concerns about racial and ethnic disparities in completion rates of advance directives (ADs) among community-dwelling older populations. While differences in AD completion rates in non-Hispanic Whites and African Americans have been reported, not much is known about the awareness and completion of ADs in other groups of ethnic minorities. Using a sample of community-dwelling Korean American older adults (n = 675) as a target, factors associated with their awareness and completion of ADs were explored. Guided by Andersen's behavioral health model, predisposing (age, sex, marital status, and education), need (chronic conditions and functional disability), and enabling variables (health insurance and acculturation) were included in the separate logistic regression models of AD awareness and AD completion. In both models, acculturation was found to be a significant predictor; those who had a higher level of acculturation were more likely to be aware of ADs and to have completed ADs. This study contributes to the knowledge about the role of acculturation in explaining AD awareness and completion among Korean American older adults and provides practice implications for possible AD educational interventions for this older adult minority population. PMID:25803787

  9. Intricate decision making: ambivalences and barriers when fulfilling an advance directive

    PubMed Central

    Schröder, Lars; Hommel, Gerhard; Sahm, Stephan

    2016-01-01

    Background Despite a recent statutory ruling stating the binding nature of advance directives (ADs), only a minority of the population has signed one. Yet, a majority deem it of utmost importance to ensure their wishes are followed through in case they are no longer able to decide. The reasons for this discrepancy have not yet been investigated sufficiently. Patients and methods This article is based on a survey of patients using a well-established structured questionnaire. First, patients were asked about their attitudes with respect to six therapeutic options at the end of life: intravenous fluids, artificial feeding, antibiotics, analgesia, chemotherapy/dialysis, and artificial ventilation; and second, they were asked about the negative effects related to the idea of ADs surveying their apprehensions: coercion to fulfill an AD, dictatorial reading of what had been laid down, and abuse of ADs. Results A total of 1,260 interviewees completed the questionnaires. A significant percentage of interviewees were indecisive with respect to therapeutic options, ranging from 25% (analgesia) to 45% (artificial feeding). There was no connection to health status. Apprehensions about unwanted effects of ADs were widespread, at 51%, 35%, and 43% for coercion, dictatorial reading, and abuse, respectively. Conclusion A significant percentage of interviewees were unable to anticipate decisions about treatment options at the end of life. Apprehensions about negative adverse effects of ADs are widespread. PMID:27574407

  10. Direct synthesis and coating of advanced nanocomposite negative electrodes for Li-ion batteries via electrospraying

    NASA Astrophysics Data System (ADS)

    Valvo, M.; García-Tamayo, E.; Lafont, U.; Kelder, E. M.

    A direct approach for the synthesis and coating of advanced nanocomposite negative electrodes via a single-step process at low temperature is presented. Metal-oxide/PVdF nanocomposites are obtained in one step by electrospray pyrolysis of precursor solutions containing dissolved metal salts together with polyvinylidene fluoride (PVdF) as binder. In this way, small oxide nanoparticles are generated and dispersed in situ in the binder creating nanocomposite structures, while being coated at once as thin electrode layers on stainless steel coin cell cans. The intimate contact between the nanoparticles and the binder favours enhanced adhesion of the materials in the overall electrode structure and adequate electrochemical performances are obtained without any conductive additive. Three nanocomposite oxide/PVdF materials (i.e. SnO 2, CoO and Fe 2O 3) are reported here as preliminary examples of negative electrodes. The results show that this approach is suitable, not only for the fabrication of nanocomposite electrodes for Li-ion batteries, but also for other novel applications.

  11. Therapeutic Rationales, Progresses, Failures, and Future Directions for Advanced Prostate Cancer

    PubMed Central

    Wadosky, Kristine M; Koochekpour, Shahriar

    2016-01-01

    Patients with localized prostate cancer (PCa) have several therapeutic options with good prognosis. However, survival of patients with high-risk, advanced PCa is significantly less than patients with early-stage, organ-confined disease. Testosterone and other androgens have been directly linked to PCa progression since 1941. In this review, we chronicle the discoveries that led to modern therapeutic strategies for PCa. Specifically highlighted is the biology of androgen receptor (AR), the nuclear receptor transcription factor largely responsible for androgen-stimulated and castrate-recurrent (CR) PCa. Current PCa treatment paradigms can be classified into three distinct but interrelated categories: targeting AR at pre-receptor, receptor, or post-receptor signaling. The continuing challenge of disease relapse as CR and/or metastatic tumors, destined to occur within three years of the initial treatment, is also discussed. We conclude that the success of PCa therapies in the future depends on targeting molecular mechanisms underlying tumor recurrence that still may affect AR at pre-receptor, receptor, and post-receptor levels. PMID:27019626

  12. Advanced thermal control for french-german direct broadcasting satellites TDF1/TVSAT

    NASA Astrophysics Data System (ADS)

    Giovagnoli, F.

    The joint French-German programme of direct broadcasting is comprised of two distinct phases, i.e. 1. the development of the preoperational spacecraft (D3, F3), with 3 active channels out of 5 installed; 2. the production of operational satellites (D5, F5) with 5 channels active, each of them redundant. Aerospatiale is in charge among others of the Thermal Control of the Spacecraft. This paper deals with: thermal concept, analyses and tests programme. The developed platforms should also permit an easy adaptation to various payloads characterized by higher electrical power levels. The high power levels involved imply advanced thermal control for both Main Body and Antenna Module. The thermal control concept must have the following capabilities: • to transfer the concentrated, high power dissipations involved toward outer space, • to maintain in shadow phase (no emission) the correct temperatures with low or zero heating power, • to ensure, in transfer orbit phase (maximum duration about 300 h), satisfactory temperatures with reduced electrical power (satellite 3-axis stabilized, solar generator partially deployed), • to allow extremely non-symmetrical functionings. To solve these various problems, so far never simultaneously encountered on existing satellites, the following devices are used: • various heat pipe networks (D3/F3; 88 heat pipes, total length approx. 118 m), • large quantity of Optical Solar Reflectors (silica mirror, area approx. 6.3 m 2), • lightweight superinsulations, • various types of heaters, • Thermal Control Electronic (TCE) to switch ON/OFF heaters and monitor thermistors.

  13. Default options in advance directives: study protocol for a randomised clinical trial

    PubMed Central

    Gabler, Nicole B; Cooney, Elizabeth; Small, Dylan S; Troxel, Andrea B; Arnold, Robert M; White, Douglas B; Angus, Derek C; Loewenstein, George; Volpp, Kevin G; Bryce, Cindy L; Halpern, Scott D

    2016-01-01

    Introduction Although most seriously ill Americans wish to avoid burdensome and aggressive care at the end of life, such care is often provided unless patients or family members specifically request otherwise. Advance directives (ADs) were created to provide opportunities to set limits on aggressive care near life's end. This study tests the hypothesis that redesigning ADs such that comfort-oriented care is provided as the default, rather than requiring patients to actively choose it, will promote better patient-centred outcomes. Methods and analysis This multicentre trial randomises seriously ill adults to receive 1 of 3 different ADs: (1) a traditional AD that requires patients to actively choose their goals of care or preferences for specific interventions (eg, feeding tube insertion) or otherwise have their care guided by their surrogates and the prevailing societal default toward aggressive care; (2) an AD that defaults to life-extending care and receipt of life-sustaining interventions, enabling patients to opt out from such care; or (3) an AD that defaults to comfort care, enabling patients to opt into life-extending care. We seek to enrol 270 patients who return complete, legally valid ADs so as to generate sufficient power to detect differences in the primary outcome of hospital-free days (days alive and not in an acute care facility). Secondary outcomes include hospital and intensive care unit admissions, costs of care, hospice usage, decision conflict and satisfaction, quality of life, concordance of preferences with care received and bereavement outcomes for surrogates of patients who die. Ethics and dissemination This study has been approved by the Institutional Review Boards at all trial centres, and is guided by a data safety and monitoring board and an ethics advisory board. Study results will be disseminated using methods that describe the results in ways that key stakeholders can best understand and implement. Trial registration number NCT02017548

  14. Barcelona 2002: law, ethics, and human rights. Advancing research and access to HIV vaccines: a framework for action.

    PubMed

    Avrett, Sam

    2002-12-01

    In light of the continuing spread of HIV infection and the devastating impact of the disease on lives, communities, and economies, particularly in the developing world, the investment in new treatments, vaccines, and microbicides has clearly been inadequate. Efforts must be intensified to develop effective HIV vaccines and to ensure that they are accessible to people in all parts of the world. This article is a summary of a paper by Sam Avrett presented at "Putting Third First: Vaccines, Access to Treatments and the Law," a satellite meeting held at Barcelona on 5 July 2002 and organized by the Canadian HIV/AIDS Legal Network, the AIDS Law Project, South Africa, and the Lawyers Collective HIV/AIDS Unit, India. In the article, Avrett calls for immediate action to increase commitment and funding for HIV vaccines, enhance public support and involvement, accelerate vaccine development, and plan for the eventual delivery of the vaccines. The article briefly outlines steps that governments need to take to implement each of these objectives. The article also provides a menu of potential actions for vaccine advocates to consider as they lobby governments. PMID:14743820

  15. Advancements in the development of a directional-position sensing fast neutron detector using acoustically tensioned metastable fluids

    NASA Astrophysics Data System (ADS)

    Archambault, Brian C.; Webster, Jeffrey A.; Grimes, Thomas F.; Fischer, Kevin F.; Hagen, Alex R.; Taleyakhan, Rusi P.

    2015-06-01

    Advancements in the development of a direction and position sensing fast neutron detector which utilizes the directional acoustic tensioned metastable fluid detector (D-ATMFD) are described. The resulting D-ATMFD sensor is capable of determining the direction of neutron radiation with a single compact detector versus use of arrays of detectors in conventional directional systems. Directional neutron detection and source positioning offer enhanced detection speeds in comparison to traditional proximity searching; including enabling determination of the neutron source shape, size, and strength in near real time. This paper discusses advancements that provide the accuracy and precision of ascertaining directionality and source localization information utilizing enhanced signal processing-cum-signal analysis, refined computational algorithms, and on-demand enlargement capability of the detector sensitive volume. These advancements were accomplished utilizing experimentation and theoretical modeling. Benchmarking and qualifications studies were successfully conducted with random and fission based special nuclear material (SNM) neutron sources (239Pu-Be and 252Cf). These results of assessments have indicated that the D-ATMFD compares well in technical performance with banks of competing directional fast neutron detector technologies under development worldwide, but it does so with a single detector unit, an unlimited field of view, and at a significant reduction in both cost and size while remaining completely blind to common background (e.g., beta-gamma) radiation. Rapid and direct SNM neutron source imaging with two D-ATMFD sensors was experimentally demonstrated, and furthermore, validated via multidimensional nuclear particle transport simulations utilizing MCNP-PoliMi. Characterization of a scaled D-ATMFD based radiation portal monitor (RPM) as a cost-effective and efficient 3He sensor replacement was performed utilizing MCNP-PoliMi simulations, the results of which

  16. Advance directives and nursing home stays associated with less aggressive end-of-life care for patients with severe dementia.

    PubMed

    Nicholas, Lauren H; Bynum, Julie P W; Iwashyna, Theodore J; Weir, David R; Langa, Kenneth M

    2014-04-01

    The number of older adults with cognitive impairment is increasing, and such adults often require a surrogate to make decisions about health care. However, little is known about the aggressiveness of end-of-life care for these people, especially those who reside in the community. We found that cognitive impairment is common among older adults approaching the end of life, whether they live in the community or in a nursing home, and that nearly 30 percent of patients with severe dementia remained in the community until death. Among those patients, having an advance directive in the form of a living will was associated with significantly less aggressive care at the end of life, compared to similar patients without an advance directive-as measured by Medicare spending ($11,461 less per patient), likelihood of in-hospital death (17.9 percentage points lower), and use of the intensive care unit (9.4 percentage points lower). In contrast, advance directives were not associated with differences in care for people with normal cognition or mild dementia, whether they resided in the community or in a nursing home. Timely advance care planning after a diagnosis of cognitive impairment may be particularly important for older adults who reside in the community. PMID:24711329

  17. Sigma Team for Advanced Actinide Recycle FY2015 Accomplishments and Directions

    SciTech Connect

    Moyer, Bruce A.

    2015-09-30

    noncomplexing aqueous solution and submission of this scientific breakthrough as a paper in Science; The first-ever co-crystallization of Am(VI) with UO2(NO3)2 ∙ 6H2O, opening the door to a new approach for separating hexavalent actinides as a group; Results showing that three potentially problematic metals will not present risk in ALSEP; Improvement in ALSEP contactor stripping kinetics to acceptable performance; A comparison of centrifugal contactors vs mixer-settlers showing the former performs better in ALSEP stripping; Synthesis of new mixed N,O-donor extractants with enhanced solubility and strength for selective trivalent actinide extraction; Development of computational methods showing promise in prediction of the selectivity of new extractants for trivalent actinides vs lanthanides; An order-of-magnitude improvement in aqueous Am/Eu complexation selectivity of an alternative macrocyclic stripping agent for ALSEP, potentially enabling an option for an Am product stream free from both Ln and Cm. An alternative aqueous combination of dipicolinate complexant and malonate buffer that may present options for ALSEP and TALSPEAK (Trivalent Actinide-Lanthanide Separations by Phosphorus-reagent Extraction from Aqueous Komplexes) type separations. The ALSEP concept is advancing toward a benchtop flowsheet demonstration planned for FY 2016, and a bench-scale test bed at Idaho National Laboratory (INL) will be employed to demonstrate at least one tandem Am oxidation and separation concept. This report outlines the goals of the STAAR, significance of achieving these goals, STAAR organization around the above aims and questions, recent highlights, and future directions. The report also includes a listing of publications, reports, patents, and dissertations.

  18. Epidemiology of Advance Directives in Extended Care Facility Patients Presenting to the Emergency Department

    PubMed Central

    Wall, Jessica; Hiestand, Brian; Caterino, Jeffrey

    2015-01-01

    Introduction We conducted an epidemiologic evaluation of advance directives and do-not-resuscitate (DNR) prevalence among residents of extended care facilities (ECF) presenting to the emergency department (ED). Methods We performed a retrospective medical record review on ED patients originating from an ECF. Data were collected on age, sex, race, triage acuity, ED disposition, DNR status, power-of attorney (POA) status, and living will (LW) status. We generated descriptive statistics, and used logistic regression to evaluate predictors of DNR status. Results A total of 754 patients over 20 months met inclusion criteria; 533 (70.7%) were white, 351 (46.6%) were male, and the median age was 66 years (IQR 54–78). DNR orders were found in 124 (16.4%, 95% CI [13.9–19.1%]) patients. In univariate analysis, there was a significant difference in DNR by gender (10.5% female vs. 6.0% male with DNR, p=0.013), race (13.4% white vs. 3.1% non-white with DNR, p=0.005), and age (4.0% <65 years; 2.9% 65–74 years, p=0.101; 3.3% 75–84 years, p=0.001; 6.2% >84 years, p<0.001). Using multivariate logistic regression, we found that factors associated with DNR status were gender (OR 1.477, p=0.358, note interaction term), POA status (OR 6.612, p<0.001), LW (18.032, p<0.001), age (65–74 years OR 1.261, p=0.478; 75–84 years OR 1.737, p=0.091, >84 years OR 5.258, P<0.001), with interactions between POA and gender (OR 0.294, P=0.016) and between POA and LW (OR 0.227, p<0.005). Secondary analysis demonstrated that DNR orders were not significantly associated with death during admission (p=0.084). Conclusion Age, gender, POA, and LW use are predictors of ECF patient DNR use. Further, DNR presence is not a predictor of death in the hospital. PMID:26759640

  19. Advance Directives and Communication Skills of Prehospital Physicians Involved in the Care of Cardiovascular Patients.

    PubMed

    Gigon, Fabienne; Merlani, Paolo; Ricou, Bara

    2015-12-01

    Advance directives (AD) were developed to respect patient autonomy. However, very few patients have AD, even in cases when major cardiovascular surgery is to follow. To understand the reasons behind the low prevalence of AD and to help decision making when patients are incompetent, it is necessary to focus on the impact of prehospital practitioners, who may contribute to an increase in AD by discussing them with patients. The purpose of this study was to investigate self-rated communication skills and the attitudes of physicians potentially involved in the care of cardiovascular patients toward AD.Self-administered questionnaires were sent to general practitioners, cardiologists, internists, and intensivists, including the Quality of Communication Score, divided into a General Communication score (QOCgen 6 items) and an End-of-life Communication score (QOCeol 7 items), as well as questions regarding opinions and practices in terms of AD.One hundred sixty-four responses were received. QOCgen (mean (±SD)): 9.0/10 (1.0); QOCeol: 7.2/10 (1.7). General practitioners most frequently start discussions about AD (74/149 [47%]) and are more prone to designate their own specialty (30/49 [61%], P < 0.0001). Overall, only 57/159 (36%) physicians designated their own specialty; 130/158 (82%) physicians ask potential cardiovascular patients if they have AD and 61/118 (52%) physicians who care for cardiovascular patients talk about AD with some of them.The characteristics of physicians who do not talk about AD with patients were those who did not personally have AD and those who work in private practices.One hundred thirty-three (83%) physicians rated the systematic mention of patients' AD in the correspondence between physicians as good, while 114 (71%) at the patients' first registration in the private practice.Prehospital physicians rated their communication skills as good, whereas end-of-life communication was rated much lower. Only half of those surveyed speak about AD

  20. Direct numerical simulation of the Ekman layer: A step in Reynolds number, and cautious support for a log law with a shifted origin

    NASA Astrophysics Data System (ADS)

    Spalart, Philippe R.; Coleman, Gary N.; Johnstone, Roderick

    2008-10-01

    Results at Ekman Reynolds numbers Re ranging from 1000 to 2828 expand the direct numerical simulation (DNS) contribution to the theory of wall-bounded turbulence. An established spectral method is used, with rules for domain size and grid resolution at each Reynolds number derived from the theory. The Re increase is made possible by better computers and by optimizing the grid in relation to the wall shear-stress direction. The boundary-layer thickness in wall units δ+ varies here by a factor of about 5.3, and reaches values near 5000, or 22 times the minimum at which turbulence has been sustained. An equivalent channel Reynolds number, based on the pressure gradient in wall units, would reach about Reτ=1250. The principal goal of the analysis, the impartial identification of a log law, is summarized in the local "Karman measure" d(ln z+)/dU+. The outcome differs from that for Hoyas and Jiménez [Phys. Fluids 18, 011702 (2006)] and for Hu et al. [AIAA J. 44, 1541 (2006)] in channel-flow DNS at similar Reynolds numbers, for reasons unknown: Here, the law of the wall is gradually established up to a z+ around 400, with little statistical scatter. To leading order, it is consistent with the experiments of Österlund et al. [Phys. Fluids 12, 1 (2000)] in boundary layers. With the traditional expression, a logarithmic law is not present, in that the Karman measure drifts from about 0.41 at z+≈70 to the 0.37-0.38 range for z+≈500, with Re=2828. However, if a virtual origin is introduced with a shift of a+=7.5 wall units, the data support a long logarithmic layer with κ =0.38 a good fit to d(ln[z++a+])/dU+. A determination of the Karman constant from the variation of the skin-friction coefficients with Reynolds numbers also yields values near 0.38. The uncertainty is about ±0.01. These values are close to the boundary-layer experiments, but well below the accepted range of [0.40,0.41] and the experimental pipe-flow results near 0.42. The virtual-origin concept is

  1. Nonlinear Dynamic Inversion Baseline Control Law: Flight-Test Results for the Full-scale Advanced Systems Testbed F/A-18 Airplane

    NASA Technical Reports Server (NTRS)

    Miller, Christopher J.

    2011-01-01

    A model reference nonlinear dynamic inversion control law has been developed to provide a baseline controller for research into simple adaptive elements for advanced flight control laws. This controller has been implemented and tested in a hardware-in-the-loop simulation and in flight. The flight results agree well with the simulation predictions and show good handling qualities throughout the tested flight envelope with some noteworthy deficiencies highlighted both by handling qualities metrics and pilot comments. Many design choices and implementation details reflect the requirements placed on the system by the nonlinear flight environment and the desire to keep the system as simple as possible to easily allow the addition of the adaptive elements. The flight-test results and how they compare to the simulation predictions are discussed, along with a discussion about how each element affected pilot opinions. Additionally, aspects of the design that performed better than expected are presented, as well as some simple improvements that will be suggested for follow-on work.

  2. A model for emergency department end-of-life communications after acute devastating events--part I: decision-making capacity, surrogates, and advance directives.

    PubMed

    Limehouse, Walter E; Feeser, V Ramana; Bookman, Kelly J; Derse, Arthur

    2012-09-01

    Making decisions for a patient affected by sudden devastating illness or injury traumatizes a patient's family and loved ones. Even in the absence of an emergency, surrogates making end-of-life treatment decisions may experience negative emotional effects. Helping surrogates with these end-of-life decisions under emergent conditions requires the emergency physician (EP) to be clear, making medical recommendations with sensitivity. This model for emergency department (ED) end-of-life communications after acute devastating events comprises the following steps: 1) determine the patient's decision-making capacity; 2) identify the legal surrogate; 3) elicit patient values as expressed in completed advance directives; 4) determine patient/surrogate understanding of the life-limiting event and expectant treatment goals; 5) convey physician understanding of the event, including prognosis, treatment options, and recommendation; 6) share decisions regarding withdrawing or withholding of resuscitative efforts, using available resources and considering options for organ donation; and 7) revise treatment goals as needed. Emergency physicians should break bad news compassionately, yet sufficiently, so that surrogate and family understand both the gravity of the situation and the lack of long-term benefit of continued life-sustaining interventions. EPs should also help the surrogate and family understand that palliative care addresses comfort needs of the patient including adequate treatment for pain, dyspnea, or anxiety. Part I of this communications model reviews determination of decision-making capacity, surrogacy laws, and advance directives, including legal definitions and application of these steps; Part II (which will appear in a future issue of AEM) covers communication moving from resuscitative to end-of-life and palliative treatment. EPs should recognize acute devastating illness or injuries, when appropriate, as opportunities to initiate end-of-life discussions and to

  3. Nanoscale Graphene Disk: A Natural Functionally Graded Material-How is Fourier's Law Violated along Radius Direction of 2D Disk.

    PubMed

    Yang, Nuo; Hu, Shiqian; Ma, Dengke; Lu, Tingyu; Li, Baowen

    2015-01-01

    In this Paper, we investigate numerically and analytically the thermal conductivity of nanoscale graphene disks (NGDs), and discussed the possibility to realize functionally graded material (FGM) with only one material, NGDs. Different from previous studies on divergence/non-diffusive of thermal conductivity in nano-structures with different size, we found a novel non-homogeneous (graded) thermal conductivity along the radius direction in a single nano-disk structure. We found that, instead of a constant value, the NGD has a graded thermal conductivity along the radius direction. That is, Fourier's law of heat conduction is not valid in two dimensional graphene disk structures Moreover, we show the dependent of NGDs' thermal conductivity on radius and temperature. Our study might inspire experimentalists to develop NGD based versatile FGMs, improve understanding of the heat removal of hot spots on chips, and enhance thermoelectric energy conversion efficiency by two dimensional disk with a graded thermal conductivity. PMID:26443206

  4. Nanoscale Graphene Disk: A Natural Functionally Graded Material-How is Fourier’s Law Violated along Radius Direction of 2D Disk

    NASA Astrophysics Data System (ADS)

    Yang, Nuo; Hu, Shiqian; Ma, Dengke; Lu, Tingyu; Li, Baowen

    2015-10-01

    In this Paper, we investigate numerically and analytically the thermal conductivity of nanoscale graphene disks (NGDs), and discussed the possibility to realize functionally graded material (FGM) with only one material, NGDs. Different from previous studies on divergence/non-diffusive of thermal conductivity in nano-structures with different size, we found a novel non-homogeneous (graded) thermal conductivity along the radius direction in a single nano-disk structure. We found that, instead of a constant value, the NGD has a graded thermal conductivity along the radius direction. That is, Fourier’s law of heat conduction is not valid in two dimensional graphene disk structures Moreover, we show the dependent of NGDs’ thermal conductivity on radius and temperature. Our study might inspire experimentalists to develop NGD based versatile FGMs, improve understanding of the heat removal of hot spots on chips, and enhance thermoelectric energy conversion efficiency by two dimensional disk with a graded thermal conductivity.

  5. Nanoscale Graphene Disk: A Natural Functionally Graded Material–How is Fourier’s Law Violated along Radius Direction of 2D Disk

    PubMed Central

    Yang, Nuo; Hu, Shiqian; Ma, Dengke; Lu, Tingyu; Li, Baowen

    2015-01-01

    In this Paper, we investigate numerically and analytically the thermal conductivity of nanoscale graphene disks (NGDs), and discussed the possibility to realize functionally graded material (FGM) with only one material, NGDs. Different from previous studies on divergence/non-diffusive of thermal conductivity in nano-structures with different size, we found a novel non-homogeneous (graded) thermal conductivity along the radius direction in a single nano-disk structure. We found that, instead of a constant value, the NGD has a graded thermal conductivity along the radius direction. That is, Fourier’s law of heat conduction is not valid in two dimensional graphene disk structures Moreover, we show the dependent of NGDs’ thermal conductivity on radius and temperature. Our study might inspire experimentalists to develop NGD based versatile FGMs, improve understanding of the heat removal of hot spots on chips, and enhance thermoelectric energy conversion efficiency by two dimensional disk with a graded thermal conductivity. PMID:26443206

  6. Advanced Life Support Water Recycling Technologies Case Studies: Vapor Phase Catalytic Ammonia Removal and Direct Osmotic Concentration

    NASA Technical Reports Server (NTRS)

    Flynn, Michael

    2004-01-01

    Design for microgravity has traditionally not been well integrated early on into the development of advanced life support (ALS) technologies. NASA currently has a many ALS technologies that are currently being developed to high technology readiness levels but have not been formally evaluated for microgravity compatibility. Two examples of such technologies are the Vapor Phase Catalytic Ammonia Removal Technology and the Direct Osmotic Concentration Technology. This presentation will cover the design of theses two systems and will identify potential microgravity issues.

  7. Impact of a Care Directives Activity Tab in the Electronic Health Record on Documentation of Advance Care Planning

    PubMed Central

    Turley, Marianne; Wang, Susan; Meng, Di; Kanter, Michael; Garrido, Terhilda

    2016-01-01

    Context: To ensure patient-centered end-of-life care, advance care planning (ACP) must be documented in the medical record and readily retrieved across care settings. Objective: To describe use of the Care Directives Activity tab (CDA), a single-location feature in the electronic health record for collecting and viewing ACP documentation in inpatient and ambulatory care settings, and to assess its association with ACP documentation rates. Design: Retrospective pre- and postimplementation analysis in 2012 and 2013 at Kaiser Permanente Southern California among 113,309 patients aged 65 years and older with ACP opportunities during outpatient or inpatient encounters. Main Outcome Measures: Providers’ CDA use rates and documentation rates of advance directives and physician orders for life-sustaining treatments stratified by CDA use. Results: Documentation rates of advance directives and physician orders for life-sustaining treatments among patients with outpatient and inpatient encounters were 3.5 to 9.6 percentage points higher for patients with CDA use vs those without it. The greatest differences were for orders for life-sustaining treatments among patients with inpatient encounters and for advance directives among patients with outpatient encounters; both were 9.6 percentage points higher among those with CDA use than those without it. All differences were significant after controlling for yearly variation (p < 0.001). Conclusion: Statistically significant differences in documentation rates between patients with and without CDA use suggest the potential of a standardized location in the electronic health record to improve ACP documentation. Further research is required to understand effects of CDA use on retrieval of preferences and end-of-life care. PMID:27057820

  8. New molecularly targeted therapies against advanced hepatocellular carcinoma: From molecular pathogenesis to clinical trials and future directions.

    PubMed

    Chuma, Makoto; Terashita, Katsumi; Sakamoto, Naoya

    2015-10-01

    Hepatocellular carcinoma (HCC) can be lethal due to its aggressive course and lack of effective systemic therapies for advanced disease. Sorafenib is the only systemic therapy that has demonstrated an overall survival benefit in patients with advanced HCC, and new agents for treatment of advanced HCC are needed. The multiple pathways involved in HCC oncogenesis, proliferation and survival provide many opportunities for the development of molecularly targeted therapies. Molecular targets of interest have expanded from angiogenesis to cancer cell-directed oncogenic signaling pathways for treatment of advanced HCC. Agents targeting vascular endothelial growth factor receptor, epidermal growth factor receptor, fibroblast growth factor receptor, platelet-derived growth factor receptor, c-mesenchymal-epithelial transition factor-1 and mammalian target of rapamycin signaling have been actively explored. This article focuses on the evaluation of molecular agents targeting pathogenic HCC and provides a review of recently completed phase III drug studies (e.g. involving sorafenib, sunitinib, brivanib, linifanib, erlotinib, everolimus, ramucirumab or orantinib) and ongoing drug studies (e.g. involving lenvatinib, regorafenib, tivantinib or cabozantinib) of molecularly targeted agents in advanced HCC, including a brief description of the biologic rationale behind these agents. PMID:25472913

  9. 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…

  10. A Qualitative Analysis of an Advanced Practice Nurse-Directed Transitional Care Model Intervention

    ERIC Educational Resources Information Center

    Bradway, Christine; Trotta, Rebecca; Bixby, M. Brian; McPartland, Ellen; Wollman, M. Catherine; Kapustka, Heidi; McCauley, Kathleen; Naylor, Mary D.

    2012-01-01

    Purpose: The purpose of this study was to describe barriers and facilitators to implementing a transitional care intervention for cognitively impaired older adults and their caregivers lead by advanced practice nurses (APNs). Design and Methods: APNs implemented an evidence-based protocol to optimize transitions from hospital to home. An…

  11. Advances in Instructional Technology. New Directions for Community Colleges, Number 55.

    ERIC Educational Resources Information Center

    Voegel, George H., Ed.

    1986-01-01

    The essays in this collection focus on recent advances in instructional technology and their use in community colleges. The collection includes: (1) "Telecourses: Using Technology to Serve Distant Learners," by Leslie N. Purdy; (2) "Satellites Stop Beeping and Start Teaching," by Peter Vander Haeghen; (3) "Change through Cooperation: The NILRC…

  12. The Biopsychosocial Approach to Chronic Pain: Scientific Advances and Future Directions

    ERIC Educational Resources Information Center

    Gatchel, Robert J.; Peng, Yuan Bo; Peters, Madelon L.; Fuchs, Perry N.; Turk, Dennis C.

    2007-01-01

    The prevalence and cost of chronic pain is a major physical and mental health care problem in the United States today. As a result, there has been a recent explosion of research on chronic pain, with significant advances in better understanding its etiology, assessment, and treatment. The purpose of the present article is to provide a review of…

  13. Status of the DOE/SERI amorphous silicon research project - Recent advances and future directions

    NASA Astrophysics Data System (ADS)

    Stafford, B. L.; Luft, W.; von Roedern, B.; Wallace, W. L.

    Recent advances in material, cell, and module research in the US Department of Energy/Solar Energy Research Institute (DOE/SERI) Amorphous Silicon Research Project (ASRP) are reviewed. Advances in transparent conductive oxides, high-performance back reflectors, cell interconnection/patterning schemes, and encapsulants are surveyed. The program phase that began in 1990 has major research goals of reproducible, cost-effective multijunction modules with stabilized efficiencies of 10 percent for same-bandgap modules and 12 percent for different-bandgap modules. The issue of stability and reliability of amorphous silicon modules is reviewed. Multijunction cell/module structures have demonstrated improved stability in R&D cells and modules over single-junction structures.

  14. Research directions and progress in the SERI advanced high efficiency concept program

    SciTech Connect

    Cole, L A; Benner, J P

    1984-06-01

    The inherent electro-optical properties of gallium arsenide (GaAs) and related III-V compounds make this class of semiconductors an optimum choice for use in very high efficiency solar cells. The ability to alloy GaAs with other column III and V elements while maintaining the single crystal zincblende structure allows the photovoltaic properties to be tailored to specific needs. The current understanding and control of the properties of these materials is more advanced than for any other semiconductor except single crystal silicon. For these reasons, the Advanced High Efficiency Concepts Program supports materials research to improve the properties of III-V semiconductors needed to achieve the maximum attainable photovoltaic conversion efficiencies.

  15. The Teaching of Constitutional Law in American Law Schools.

    ERIC Educational Resources Information Center

    Haimbaugh, George D., Jr.

    1981-01-01

    A survey of the teaching of constitutional law used questionnaires sent to the dean of every law school approved by the Association of American Law Schools or the American Bar Association. Responses describe the basic course, advanced courses and seminars, teachers, goals, and examinations. (MLW)

  16. A new direction for Antarctic ice cores: reconstructing Pacific decadal variability and Australian drought history from the Law Dome ice core.

    NASA Astrophysics Data System (ADS)

    Vance, Tessa; Roberts, Jason; Plummer, Chris; Kiem, Anthony; van Ommen, Tas

    2015-04-01

    Decadal scale SST oscillations in the Pacific significantly influence rainfall variability and drought risk across and beyond the Pacific region. Understanding long-term decadal SST behavior in the Pacific is necessary to assess past and future climate, particularly drought risk. However, short instrumental records through much of the Pacific region, in particular the South Pacific, make such assessments difficult. A new reconstruction of Pacific decadal variability covering the last millennium has been produced from the Law Dome ice core, a high snow accumulation site in East Antarctica. The Law Dome ice core samples (at sub-annual resolution) a broad mid-latitude swathe of the Indian and South West Pacific region. This region exhibits wind speed and direction anomalies that are coherent with the phase of the Interdecadal Pacific Oscillation (IPO), an index measuring the decadal-scale Pacific SST state. This is the first millennial length IPO reconstruction and is based on the annual accumulation (snowfall) and sub-annual sea salt (wind proxy) records from Law Dome. To demonstrate the versatility of this new IPO reconstruction, we used it to explore drought history in eastern Australia, a region where drought risk is elevated during IPO positive phases. To do this, we super-imposed the 1000 year IPO reconstruction on a Law Dome proxy for eastern Australian rainfall (previously shown to represent rainfall with high significance during IPO positive phases (r =0.406-0.677, p <0.0001-0.01). Eight 'mega-droughts' (dry periods >5 years duration) were identified over the last millennium. Six mega-droughts occurred between AD 1000-1320 including one 39 y drought (AD 1174-1212). Water resources and infrastructure planning in Australia has been based on very limited statistical certainty around drought risk due to the short (~100 year) instrumental record and lack of rainfall proxies. This study shows that, similar to SW North America, Australia also experienced mega

  17. Future directions of C3 research at DARPA (Defense Advanced Research Projects Agency)

    NASA Astrophysics Data System (ADS)

    Perry, D. G.; Dahmann, J. S.

    Research into C3 related problems is a major effort of the Information Science and Technology Office of the Defense Advanced Research Projects Agency. The major thrusts of projects are in the area of future, high-risk efforts, often resulting in the development of a conceptual model or prototype. Some of these prototypes are then further developed to provide an infrastructure for future research. The programs can be divided into two groups: base technology research programs and testbed programs. The testbeds provide a focus for the technology programs.

  18. An update on current management of advanced renal cell cancer, biomarkers, and future directions

    PubMed Central

    Zhi, Wanqing Iris; Kim, Jenny J.

    2015-01-01

    In the past decade, metastatic renal cell carcinoma (mRCC) treatment underwent significant advancement that resulted in an unprecedented improvement in the prognosis of this disease. This review will provide an updated review of currently approved treatment options, namely antiangiogenic and immunotherapy, as well as treatment guideline recommended by the National Comprehensive Cancer Network (NCCN). We will summarize studies ongoing in determining prognostic and predictive biomarkers in maximizing therapeutic benefit in the treatment of this disease. Lastly, we will discuss promising agents in clinical testing. PMID:25722991

  19. Future directions of C3 research at DARPA (Defense Advanced Research Projects Agency)

    SciTech Connect

    Perry, D.G.; Dahmann, J.S.

    1987-01-01

    Research into C3 related problems is a major effort of the Information Science and Technology Office of the Defense Advanced Research Projects Agency. The major thrusts of projects is in the area of future, high-risk efforts, often resulting in the development of a conceptual model or prototype. Some of these prototypes are then further developed to provide an infrastructure for future research. The programs can be divided into two groups: base technology research programs and testbed programs. The testbeds provide a focus for the technology programs.

  20. Efficacy of Skin-Directed Therapy for Cutaneous Metastases From Advanced Cancer: A Meta-Analysis

    PubMed Central

    Spratt, Daniel E.; Gordon Spratt, Elizabeth A.; Wu, Shenhong; DeRosa, Antonio; Lee, Nancy Y.; Lacouture, Mario E.; Barker, Christopher A.

    2014-01-01

    Purpose To perform the first meta-analysis of the efficacy of skin-directed therapies for cutaneous metastases. Methods MEDLINE, EMBASE, The Cochrane Library, and ClinicalTrials.gov databases were searched for reports of prospective clinical studies published between 1960 and 2013 that assessed the response of skin-directed therapy for cutaneous metastases (47 of 2,955 unique studies were selected). Primary end points of the study were complete and objective response rates. Secondary analyses were preplanned and included subgroup analyses by skin-directed therapy, histology, and recurrence rates. Meta-analyses were performed with random-effect modeling, and extent of heterogeneity between studies was determined with the Cochran Q and I2 tests. Results After applying exclusion criteria, 47 prospective studies of 4,313 cutaneous metastases were assessed. Five skin-directed therapies were identified: electrochemotherapy, photodynamic therapy, radiotherapy, intralesional therapy, and topical therapy. Among all cutaneous metastases, complete response rate was 35.5% (95% CI, 27.6% to 44.3%) and objective response rate was 60.2% (95% CI, 50.6% to 69.0%). Overall recurrence rate was estimated to be 9.2% (95% CI, 3.7% to 21.2%). Melanoma and breast carcinoma comprised 96.8% of all cutaneous metastases studied and had similar objective response rates (54.5% [95% CI, 48.3% to 60.7%] and 54.0% [95% CI, 48.3% to 59.7%], respectively). Grade ≥ 3 toxicity was reported in less than 6% of patients. Conclusion Response to skin-directed therapy for cutaneous metastases is high but heterogeneous across treatment modalities, with low rates of recurrence post-treatment. Treatment was generally well tolerated and conferred improvements in quality of life. Standardization of response criteria for cutaneous metastases and treatment algorithms to optimally use the available skin-directed therapies are needed. PMID:25154827

  1. Recent advances in the template-directed synthesis of porphyrin nanorings.

    PubMed

    Wang, Shu-Ping; Shen, Yan-Feng; Zhu, Ben-Yue; Wu, Jing; Li, Shijun

    2016-08-11

    The template-directed strategy is a powerful method to construct porphyrin nanorings with high complexities, wherein metalloporphyrin precursors pre-organize via supramolecular interactions of the porphyrin or its central metal with a carefully selected template, and then react with each other to deliver a final cyclic multiporphyrin structure. In this article, we review the recent breakthroughs in the template-directed synthesis methods and new structures of porphyrin or metalloporphyrin nanorings, as well as their applications in host-guest chemistry and artificial light-harvesting. PMID:27378382

  2. Investigation of Ruthenium Dissolution in Advanced Membrane Electrode Assemblies for Direct Methanol Based Fuel Cells Stacks

    NASA Technical Reports Server (NTRS)

    Valdez, T. I.; Firdosy, S.; Koel, B. E.; Narayanan, S. R.

    2005-01-01

    This viewgraph presentation gives a detailed review of the Direct Methanol Based Fuel Cell (DMFC) stack and investigates the Ruthenium that was found at the exit of the stack. The topics include: 1) Motivation; 2) Pathways for Cell Degradation; 3) Cell Duration Testing; 4) Duration Testing, MEA Analysis; and 5) Stack Degradation Analysis.

  3. Objectification Theory and Psychology of Women: A Decade of Advances and Future Directions

    ERIC Educational Resources Information Center

    Moradi, Bonnie; Huang, Yu-Ping

    2008-01-01

    Fredrickson and Roberts (1997) proposed objectification theory as an integrative framework for understanding how women's socialization and experiences of sexual objectification are translated into mental health problems. This article reviews the past decade of research grounded in objectification theory and highlights needed directions for future…

  4. Recent advances in direct C–H arylation: Methodology, selectivity and mechanism in oxazole series

    PubMed Central

    Verrier, Cécile; Lassalas, Pierrik; Théveau, Laure; Quéguiner, Guy; Trécourt, François; Marsais, Francis

    2011-01-01

    Summary Catalytic direct (hetero)arylation of (hetero)arenes is an attractive alternative to traditional Kumada, Stille, Negishi and Suzuki–Miyaura cross-coupling reactions, notably as it avoids the prior preparation and isolation of (hetero)arylmetals. Developments of this methodology in the oxazole series are reviewed in this article. Methodologies, selectivity, mechanism and future aspects are presented. PMID:22238536

  5. Numerical Simulations of the Geodynamo and Scaling Laws

    NASA Astrophysics Data System (ADS)

    Oruba, L.; Dormy, E.

    2013-12-01

    State of the art numerical models of the Geodynamo are still performed in a parameter regime extremely remote from the values relevant to the physics of the Earth core. In order to establish a connection between dynamo modeling and the geophysical motivation, it is necessary to use scaling laws. Such laws establish the dependency of essential quantities (such as the magnetic field strength) on measured or controlled quantities. They allow for a direct confrontation of advanced models with geophysical constraints. We will present a detailed analysis of scaling laws based on a wide database of 185 direct numerical simulations (courtesy of U. Christensen) and test various existing scaling laws. Our main concern is to stress the risks of a direct numerical fit free from physical insight. We show that different a priori hypothesis can yield contradictory dependences, in particular concerning the dependence of the magnetic field strength on the rotation rate as well as on the viscosity.

  6. Simulation model of the F/A-18 high angle-of-attack research vehicle utilized for the design of advanced control laws

    NASA Technical Reports Server (NTRS)

    Strickland, Mark E.; Bundick, W. Thomas; Messina, Michael D.; Hoffler, Keith D.; Carzoo, Susan W.; Yeager, Jessie C.; Beissner, Fred L., Jr.

    1996-01-01

    The 'f18harv' six degree-of-freedom nonlinear batch simulation used to support research in advanced control laws and flight dynamics issues as part of NASA's High Alpha Technology Program is described in this report. This simulation models an F/A-18 airplane modified to incorporate a multi-axis thrust-vectoring system for augmented pitch and yaw control power and actuated forebody strakes for enhanced aerodynamic yaw control power. The modified configuration is known as the High Alpha Research Vehicle (HARV). The 'f18harv' simulation was an outgrowth of the 'f18bas' simulation which modeled the basic F/A-18 with a preliminary version of a thrust-vectoring system designed for the HARV. The preliminary version consisted of two thrust-vectoring vanes per engine nozzle compared with the three vanes per engine actually employed on the F/A-18 HARV. The modeled flight envelope is extensive in that the aerodynamic database covers an angle-of-attack range of -10 degrees to +90 degrees, sideslip range of -20 degrees to +20 degrees, a Mach Number range between 0.0 and 2.0, and an altitude range between 0 and 60,000 feet.

  7. Advanced direct liquefaction concepts for PETC generic units. Quarterly technical progress report, January--March 1992

    SciTech Connect

    Not Available

    1992-04-01

    In the Advance Coal Liquefaction Concept Proposal (ACLCP) carbon monoxide (CO) and water have been proposed as the primary reagents in the pretreatment process. The main objective of this project is to develop a methodology for pretreating coal under mild conditions based on a combination of existing processes which have shown great promise in liquefaction, extraction and pyrolysis studies. The aim of this pretreatment process is to partially depolymerise the coal, eliminate oxygen and diminish the propensity for retograde reactions during subsequent liquefaction. The desirable outcome of the CO pretreatment step should be: (1) enhanced liquefaction activity and/or selectivity toward products of higher quality due to chemical modification of the coal structure; (2) cleaner downstream products; (3) overall improvement in operability and process economics.

  8. [Research advances on directional induction and differentiation in vitro from human pluripotent stem cells into erythrocytes].

    PubMed

    Liu, Sen-Quan; Zhang, Li-Fei; Wang, Ye-Bo; Huang, He

    2014-02-01

    Red blood cell transfusion is an effective method to treat acute hemorrhage and severe anemia. However, blood source from donors is very limited, and transfusion-transmitted diseases occurred frequently, thus threatening human health. Therefore, the safe, abundant and functional blood source is needed. Generation of blood cells from human pluripotent stem cells(hPSC) will offer alternative approach. Lots of studies have been focused on erythroid cell differentiation in vitro, including how to enhance efficiency and improve their function. In this review, the research advances on differentiation methods and the regulatory mechanism are summarized. In addition, the progress in PSC differentiation into erythrocytes and the problems to be solved are discussed briefly. PMID:24598681

  9. Advancing Scientific Reasoning in Upper Elementary Classrooms: Direct Instruction Versus Task Structuring

    NASA Astrophysics Data System (ADS)

    Lazonder, Ard W.; Wiskerke-Drost, Sjanou

    2015-02-01

    Several studies found that direct instruction and task structuring can effectively promote children's ability to design unconfounded experiments. The present study examined whether the impact of these interventions extends to other scientific reasoning skills by comparing the inquiry activities of 55 fifth-graders randomly assigned to one of three conditions. Children in the control condition investigated a four-variable inquiry task without additional support. Performance of this task in the direct instruction condition was preceded by a short training in experimental design, whereas children in the task structuring condition, who did not receive the introductory training, were given a version of the task that addressed the four variables one at a time. Analysis of children's experimentation behavior confirmed that direct instruction and task structuring are equally effective and superior to unguided inquiry. Both interventions also evoked more determinate predictions and valid inferences. These findings demonstrate that the effect of short-term interventions designed to promote unconfounded experimentation extends beyond the control of variables.

  10. Recent developments in health care law: partners in innovation.

    PubMed

    Berry, Roberta M; Bliss, Lisa; Caley, Sylvia; Lombardo, Paul A; Rooker, Jerri Nims; Todres, Jonathan; Wolf, Leslie E

    2010-06-01

    This article reviews recent developments in health care law, focusing on the engagement of law as a partner in health care innovation. The article addresses: the history and contents of recent United States federal law restricting the use of genetic information by insurers and employers; the recent federal policy recommending routine HIV testing; the recent revision of federal policy regarding the funding of human embryonic stem cell research; the history, current status, and need for future attention to advance directives; the recent emergence of medical-legal partnerships and their benefits for patients; the obesity epidemic and its implications for the child's right to health under international conventions. PMID:20490620

  11. 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. PMID:25939286

  12. 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

  13. Cost-effective technology advancement directions for electric propulsion transportation systems in earth-orbital missions

    NASA Technical Reports Server (NTRS)

    Regetz, J. D., Jr.; Terwilliger, C. H.

    1979-01-01

    The directions that electric propulsion technology should take to meet the primary propulsion requirements for earth-orbital missions in the most cost effective manner are determined. The mission set requirements, state of the art electric propulsion technology and the baseline system characterized by it, adequacy of the baseline system to meet the mission set requirements, cost optimum electric propulsion system characteristics for the mission set, and sensitivities of mission costs and design points to system level electric propulsion parameters are discussed. The impact on overall costs than specific masses or costs of propulsion and power systems is evaluated.

  14. Micropen direct-write technique for fabrication of advanced electroceramic and optical materials

    NASA Astrophysics Data System (ADS)

    Sun, Jingjing

    Direct-write technologies, a subset of the rapid prototyping, have been applied for many applications including electronics, photonics and biomedical engineering. Among them, Micropen(TM) is a promising technique, providing precision deposition of materials with various viscosities, on-line design changes and writing on nonplanar substrates. The objective of this project was to directly write two- and three-dimensional novel structures by Micropen(TM) for potential optical and transducer applications. First, to gain a basic understanding of Micropen(TM) operation, poly(methyl methacrylate) (PMMA) solutions were developed as a model system. The effects of solution rheological properties on deposition conditions were investigated. Secondly, PMMA/SiO2 hybrids were developed using sol-gel process. The effects of organic/inorganic ratios on thermal stability, microstructure and optical properties were studied. The solution with 80 wt% PMMA loading was chosen to deposit lines for optical applications. Another application was the direct-write of lead zirconate titanate (PZT) thick films (6-70 mum) for MEMS or high frequency medical imaging applications. Pastes consisting of 15-30 vol% ceramic loading in a sol-gel solution were prepared for the deposition of films on various substrates. The PZT sol was used as a binder as well as to achieve low temperature heat treatment of the films. Using the 15 vol% paste with a 250-mum pen tip, a four-layer film was deposited on a silicon substrate. This 16-mum film with 1 cm 2 area had K of 870, tandelta of 4.1%, Pr of 12.2 muC/cm 2 and Ec of 27 kV/cm. Furthermore, Micropen(TM) was utilized for the direct-write of ceramic skeletal structures to develop PZT ceramic/polymer composites with 2-2 connectivity for medical ultrasound transducers. Ceramic/binder based pastes were developed as writing materials. The 35 vol% paste exhibited shear thinning with a viscosity of 45 Pa˙s at lower shear rate and 3 Pa˙s at higher shear rate. Using a

  15. [Advances in the research of early goal-directed therapy in severe sepsis and septic shock].

    PubMed

    Sun, W; Yuan, H X; An, Y Z

    2016-05-20

    Nowadays, severe infection has become one of the common problems in clinic. The morbidity of severe sepsis and septic shock is increasing, which becomes a big threat to patients with burn wounds or chronic diseases. It has become a key subject about how to cure severe sepsis and septic shock. In recent years, mortality of patients in such condition has declined slightly, which might be attributed to the application of early goal-directed therapy (EGDT) in certain degree. This article reviews application of EGDT in severe sepsis and septic shock, in order to analyze its effectiveness and boundedness, as well as predict its development. PMID:27188487

  16. Imaging-Genetics in Autism Spectrum Disorder: Advances, Translational Impact, and Future Directions

    PubMed Central

    Ameis, Stephanie H.; Szatmari, Peter

    2012-01-01

    Autism Spectrum Disorder (ASD) refers to a group of heterogeneous neurodevelopmental disorders that are unified by impairments in reciprocal social communication and a pattern of inflexible behaviors. Recent genetic advances have resolved some of the complexity of the genetic architecture underlying ASD by identifying several genetic variants that contribute to the disorder. Different etiological pathways associated with ASD may converge through effects on common molecular mechanisms, such as synaptogenesis, neuronal motility, and axonal guidance. Recently, with more sophisticated techniques, neuroimaging, and neuropathological studies have provided some consistency of evidence that altered structure, activity, and connectivity within complex neural networks is present in ASD, compared to typically developing children. The imaging-genetics approach promises to help bridge the gap between genetic variation, resultant biological effects on the brain, and production of complex neuropsychiatric symptoms. Here, we review recent findings from the developing field of imaging-genetics applied to ASD. Studies to date have indicated that relevant risk genes are associated with alterations in circuits that mediate socio-emotional, visuo-spatial, and language processing. Longitudinal studies ideally focused on early development, in conjunction with investigation for gene–gene, and gene–environment interactions may move the promise of imaging-genetics in ASD closer to the clinical domain. PMID:22615702

  17. Completion of advanced care directives is associated with willingness to donate.

    PubMed Central

    Thornton, J. Daryl; Curtis, J. Randall; Allen, Margaret D.

    2006-01-01

    OBJECTIVES: A useful framework for initiating organ donation discussions in the primary care setting may help increase willingness to donate and thereby increase the frequency of organ transplantation. Given the lower willingness to donate among African Americans and that a higher proportion of African Americans die while waiting for an organ transplant, this is an important group to consider in such an approach. We examined the association among completion of a living will and willingness to donate and the influence of race in this relationship. METHODS: A nationwide telephone interview survey using random digit dialing of households in high- and low-density African-American census blocks. Results: One hundred-eighty-eight adults participated (41% cooperation rate). In a multivariate model, factors associated with willingness to donate included having signed a living will (OR=2.43, 95% CI=1.13-5.23), talking with a physician about organ donation (OR=3.04, 95% CI=1.07-8.67) and white race (OR=2.5, 95% CI=1.23-5). CONCLUSION: The public is generally supportive of organ donation although African Americans remain less willing to donate after controlling for confounding variables. Physicians interested in increasing donation rates should consider incorporating organ donation into discussions of advance care planning and end-of-life care. PMID:16775911

  18. Advanced Low Conductivity Thermal Barrier Coatings: Performance and Future Directions (Invited paper)

    NASA Technical Reports Server (NTRS)

    Zhu, Dongming; Miller, Robert A.

    2008-01-01

    Thermal barrier coatings will be more aggressively designed to protect gas turbine engine hot-section components in order to meet future engine higher fuel efficiency and lower emission goals. In this presentation, thermal barrier coating development considerations and performance will be emphasized. Advanced thermal barrier coatings have been developed using a multi-component defect clustering approach, and shown to have improved thermal stability and lower conductivity. The coating systems have been demonstrated for high temperature combustor applications. For thermal barrier coatings designed for turbine airfoil applications, further improved erosion and impact resistance are crucial for engine performance and durability. Erosion resistant thermal barrier coatings are being developed, with a current emphasis on the toughness improvements using a combined rare earth- and transition metal-oxide doping approach. The performance of the toughened thermal barrier coatings has been evaluated in burner rig and laser heat-flux rig simulated engine erosion and thermal gradient environments. The results have shown that the coating composition optimizations can effectively improve the erosion and impact resistance of the coating systems, while maintaining low thermal conductivity and cyclic durability. The erosion, impact and high heat-flux damage mechanisms of the thermal barrier coatings will also be described.

  19. [Effects of advance visual cue utilization on anticipation of ball direction].

    PubMed

    Miyoshi, Satoko; Mori, Shuji; Hirose, Nobuyuki

    2012-08-01

    We examined skill-based differences in the anticipation of ball direction during the catching of a grounder in baseball. In Experiment 1, we used film stimuli which included a sequence of pitching and hitting action from the shortstop's customary perspective, and participants judged the ball's direction (left or right). Also, we used white-circle stimuli, and participants reported whether the circle was displaced to the left or to the right. Baseball players responded faster than non-players in the film task, but there was no significant difference between the two groups in the white-circle task. In Experiment 2, we used film stimuli which were cut off at four different temporal occlusion periods to examine the time of extraction of important visual cues. Accuracy exceeded the chance level prior to the bat-ball contact in both groups, but was earlier for players than for non-players. Our results suggest that players may extract anticipatory visual cues more effectively and earlier than non-players. PMID:23012821

  20. Advances in directed self assembly integration and manufacturability at 300 mm

    NASA Astrophysics Data System (ADS)

    Rathsack, Benjamen; Somervell, Mark; Muramatsu, Makato; Tanouchi, Keiji; Kitano, Takahiro; Nishimura, Eiichi; Yatsuda, Koichi; Nagahara, Seiji; Iwaki, Hiroyuki; Akai, Keiji; Ozawa, Mariko; Romo Negreira, Ainhoa; Tahara, Shigeru; Nafus, Kathleen

    2013-03-01

    Directed self-assembly (DSA) has the potential to extend scaling for both line/space and hole patterns. DSA has shown the capability for pitch reduction (multiplication), hole shrinks, CD self-healing as well as a pathway towards LWR and pattern collapse improvement [1-10]. TEL has developed a DSA development ecosystem (collaboration with customers, consortia, inspection vendors and material suppliers) to successfully demonstrate directed PS-PMMA DSA patterns using chemo-epitaxy (lift-off and etch guide) and grapho-epitaxy integrations on 300 mm wafers. New processes are being developed to simplify process integration, to reduce defects and to address design integration challenges with the long term goal of robust manufacturability. For hole DSA applications, a wet development process has been developed that enables traditional post-develop metrology through the high selectivity removal of PMMA cylindrical cores. For line/ space DSA applications, new track, cleans and etch processes have been developed to improve manufacturability. In collaboration with universities and consortia, fundamental process studies and simulations are used to drive process improvement and defect investigation. To extend DSA resolution beyond a PS-PMMA system, high chi materials and processes are also explored. In this paper, TEL's latest process solutions for both hole and line/space DSA process integrations are presented.

  1. Proton exchange membrane materials for the advancement of direct methanol fuel-cell technology

    DOEpatents

    Cornelius, Christopher J.

    2006-04-04

    A new class of hybrid organic-inorganic materials, and methods of synthesis, that can be used as a proton exchange membrane in a direct methanol fuel cell. In contrast with Nafion.RTM. PEM materials, which have random sulfonation, the new class of materials have ordered sulfonation achieved through self-assembly of alternating polyimide segments of different molecular weights comprising, for example, highly sulfonated hydrophilic PDA-DASA polyimide segment alternating with an unsulfonated hydrophobic 6FDA-DAS polyimide segment. An inorganic phase, e.g., 0.5 5 wt % TEOS, can be incorporated in the sulfonated polyimide copolymer to further improve its properties. The new materials exhibit reduced swelling when exposed to water, increased thermal stability, and decreased O.sub.2 and H.sub.2 gas permeability, while retaining proton conductivities similar to Nafion.RTM.. These improved properties may allow direct methanol fuel cells to operate at higher temperatures and with higher efficiencies due to reduced methanol crossover.

  2. 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

    ... of funds when payment is made directly to the carrier by my agency? 302-10.301 Section 302-10.301... TRANSPORTATION AND STORAGE OF PROPERTY 10-ALLOWANCES FOR TRANSPORTATION OF MOBILE HOMES AND BOATS USED AS A PRIMARY RESIDENCE Advance of Funds § 302-10.301 May I receive an advance of funds when payment is...

  3. 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, 2011 CFR

    2011-07-01

    ... of funds when payment is made directly to the carrier by my agency? 302-10.301 Section 302-10.301... TRANSPORTATION AND STORAGE OF PROPERTY 10-ALLOWANCES FOR TRANSPORTATION OF MOBILE HOMES AND BOATS USED AS A PRIMARY RESIDENCE Advance of Funds § 302-10.301 May I receive an advance of funds when payment is...

  4. Cost-effective technology advancement directions for electric propulsion transportation systems in earth-orbital missions

    NASA Technical Reports Server (NTRS)

    Regetz, J. D., Jr.; Terwilliger, C. H., Jr.

    1979-01-01

    This paper presents the results of a study to determine the directions that electric propulsion technology should take to meet the primary propulsion requirements for earth-orbital missions of the next three decades in the most cost-effective manner. Discussed are the mission set requirements, state-of-the-art electric propulsion technology and the baseline system characterized by it, adequacy of the baseline system to meet the mission set requirements, cost-optimum electric propulsion system characteristics for the mission set, and sensitivities of mission costs and design points to system-level electric propulsion parameters. It is found that the efficiency-specific impulse characteristic generally has a more significant impact on overall costs than specific masses or costs of propulsion and power systems.

  5. Advancing lignocellulose bioconversion through direct assessment of enzyme action on insoluble substrates.

    PubMed

    Goacher, Robyn E; Selig, Michael J; Master, Emma R

    2014-06-01

    Microbial utilization of lignocellulose from plant cell walls is integral to carbon cycling on Earth. Correspondingly, secreted enzymes that initiate lignocellulose depolymerization serve a crucial step in the bioconversion of lignocellulosic biomass to fuels and chemicals. Genome and metagenome sequencing efforts that span the past decade reveal the diversity of enzymes that have evolved to transform lignocellulose from wood, herbaceous plants and grasses. Nevertheless, there are relatively few examples where 'omic' technologies have identified novel enzyme activities or combinations thereof that dramatically improve the economics of lignocellulose bioprocessing and utilization. A likely factor contributing to the discrepancy between sequence-based enzyme discovery and enzyme application is the common practice to screen enzyme candidates based on activity measurements using soluble model compounds. In this context, the development and application of imaging, physicochemical, and spectromicroscopic techniques that allow direct assessment of enzyme action on relevant lignocellulosic substrates is reviewed. PMID:24525082

  6. 48 CFR 225.7402-4 - Law of war training.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 3 2011-10-01 2011-10-01 false Law of war training. 225... States 225.7402-4 Law of war training. (a) Basic training. Basic law of war training is required for all...= en-US. (b) Advanced law of war training. (1) The types of personnel that must obtain advanced law...

  7. 48 CFR 225.7402-4 - Law of war training.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 3 2013-10-01 2013-10-01 false Law of war training. 225... States 225.7402-4 Law of war training. (a) Basic training. Basic law of war training is required for all...= en-US. (b) Advanced law of war training. (1) The types of personnel that must obtain advanced law...

  8. 48 CFR 225.7402-4 - Law of war training.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 3 2012-10-01 2012-10-01 false Law of war training. 225... States 225.7402-4 Law of war training. (a) Basic training. Basic law of war training is required for all...=en-US. (b) Advanced law of war training. (1) The types of personnel that must obtain advanced law...

  9. 48 CFR 225.7402-4 - Law of war training.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 3 2014-10-01 2014-10-01 false Law of war training. 225... States 225.7402-4 Law of war training. (a) Basic training. Basic law of war training is required for all...=en-US. (b) Advanced law of war training. (1) The types of personnel that must obtain advanced law...

  10. 48 CFR 225.7402-4 - Law of war training.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Law of war training. 225... States 225.7402-4 Law of war training. (a) Basic training. Basic law of war training is required for all...= en-US. (b) Advanced law of war training. (1) The types of personnel that must obtain advanced law...

  11. California Library Laws, 2009

    ERIC Educational Resources Information Center

    Smith, Paul G., Ed.

    2009-01-01

    California Library Laws 2009 is a selective guide to state laws and related materials that most directly affect the everyday operations of public libraries and organizations that work with public libraries. It is intended as a convenient reference, not as a replacement for the annotated codes or for legal advice. The guide is organized as follows.…

  12. California Library Laws, 2008

    ERIC Educational Resources Information Center

    Smith, Paul G., Ed.

    2008-01-01

    "California Library Laws 2008" is a selective guide to state laws and related materials that most directly affect the everyday operations of public libraries and organizations that work with public libraries. It is intended as a convenient reference, not as a replacement for the annotated codes or for legal advice. The guide is organized as…

  13. Teachers and the Law.

    ERIC Educational Resources Information Center

    Fischer, Louis; And Others

    This book is designed to promote legal literacy for public school teachers. It examines a wide range of constitutional, statutory, and case law that directly affects their work. Its purpose is to provide teachers with the knowledge necessary to comply with the law, assert their rights, and bring violations to the attention of administrators and…

  14. Future directions in risk stratification and therapy for advanced pediatric genitourinary rhabdomyosarcoma.

    PubMed

    Harel, Miriam; Ferrer, Fernando A; Shapiro, Linda H; Makari, John H

    2016-02-01

    Rhabdomyosarcoma (RMS) represents the most common soft tissue sarcoma in infants and children and the third most common pediatric solid tumor, accounting for 5% to 15% of all childhood solid tumors. Of these, 15% to 20% arise from the genitourinary tract, with the most common sites originating from the prostate, bladder, and paratesticular regions, followed by the vagina and uterus. Although upfront radical surgery was used at the initiation of Intergroup RMS Study-I (1972-1978), the treatment paradigm has shifted to include initial biopsy with the goal of organ preservation, systemic chemotherapy for all patients, and local control involving surgical resection with or without radiation therapy for most patients. Collaborative group clinical trials have led to dramatic improvement in survival rates from 1960 to 1996 among patients with low- or intermediate-risk disease; however, outcomes appear to have plateaued in more recent years, and the prognosis for patients with metastatic or relapsed/refractory disease remains poor. Current management goals include minimizing toxicity while maintaining the excellent outcomes in low-risk disease, as well as improving outcomes in patients with intermediate- and high-risk disease. Advances in genetic analysis have allowed further refinement in risk stratification of patients. Perhaps the most significant recent development in RMS research was the discovery of an association of alveolar RMS (ARMS) with translocations t(2;13) and t(1;13). Translocation fusion-positive tumors comprise 80% of ARMS and are more aggressive. Fusion-negative ARMS may have a clinical course similar to embryonal RMS. Future Children's Oncology Group sarcoma studies will likely incorporate fusion status into risk stratification and treatment allocation. Newer radiotherapy modalities hold promise for providing local control of disease while minimizing morbidity. The addition of traditional cytotoxic chemotherapeutic agents does not seem to improve

  15. Advancing predictive models for particulate formation in turbulent flames via massively parallel direct numerical simulations

    PubMed Central

    Bisetti, Fabrizio; Attili, Antonio; Pitsch, Heinz

    2014-01-01

    Combustion of fossil fuels is likely to continue for the near future due to the growing trends in energy consumption worldwide. The increase in efficiency and the reduction of pollutant emissions from combustion devices are pivotal to achieving meaningful levels of carbon abatement as part of the ongoing climate change efforts. Computational fluid dynamics featuring adequate combustion models will play an increasingly important role in the design of more efficient and cleaner industrial burners, internal combustion engines, and combustors for stationary power generation and aircraft propulsion. Today, turbulent combustion modelling is hindered severely by the lack of data that are accurate and sufficiently complete to assess and remedy model deficiencies effectively. In particular, the formation of pollutants is a complex, nonlinear and multi-scale process characterized by the interaction of molecular and turbulent mixing with a multitude of chemical reactions with disparate time scales. The use of direct numerical simulation (DNS) featuring a state of the art description of the underlying chemistry and physical processes has contributed greatly to combustion model development in recent years. In this paper, the analysis of the intricate evolution of soot formation in turbulent flames demonstrates how DNS databases are used to illuminate relevant physico-chemical mechanisms and to identify modelling needs. PMID:25024412

  16. Advanced Compositional Analysis of Nanoparticle-polymer Composites Using Direct Fluorescence Imaging.

    PubMed

    Crick, Colin R; Noimark, Sacha; Peveler, William J; Bear, Joseph C; Ivanov, Aleksandar P; Edel, Joshua B; Parkin, Ivan P

    2016-01-01

    The fabrication of polymer-nanoparticle composites is extremely important in the development of many functional materials. Identifying the precise composition of these materials is essential, especially in the design of surface catalysts, where the surface concentration of the active component determines the activity of the material. Antimicrobial materials which utilize nanoparticles are a particular focus of this technology. Recently swell encapsulation has emerged as a technique for inserting antimicrobial nanoparticles into a host polymer matrix. Swell encapsulation provides the advantage of localizing the incorporation to the external surfaces of materials, which act as the active sites of these materials. However, quantification of this nanoparticle uptake is challenging. Previous studies explore the link between antimicrobial activity and surface concentration of the active component, but this is not directly visualized. Here we show a reliable method to monitor the incorporation of nanoparticles into a polymer host matrix via swell encapsulation. We show that the surface concentration of CdSe/ZnS nanoparticles can be accurately visualized through cross-sectional fluorescence imaging. Using this method, we can quantify the uptake of nanoparticles via swell encapsulation and measure the surface concentration of encapsulated particles, which is key in optimizing the activity of functional materials. PMID:27500449

  17. Advanced unidirectional photocurrent generation via cytochrome c as reaction partner for directed assembly of photosystem I.

    PubMed

    Stieger, Kai R; Feifel, Sven C; Lokstein, Heiko; Lisdat, Fred

    2014-08-01

    Conversion of light into an electrical current based on biohybrid systems mimicking natural photosynthesis is becoming increasingly popular. Photosystem I (PSI) is particularly useful in such photo-bioelectrochemical devices. Herein, we report on a novel biomimetic approach for an effective assembly of photosystem I with the electron transfer carrier cytochrome c (cyt c), deposited on a thiol-modified gold-surface. Atomic force microscopy and surface plasmon resonance measurements have been used for characterization of the assembly process. Photoelectrochemical experiments demonstrate a cyt c mediated generation of an enhanced unidirectional cathodic photocurrent. Here, cyt c can act as a template for the assembly of an oriented and dense layer of PSI and as wiring agent to direct the electrons from the electrode towards the photosynthetic reaction center of PSI. Furthermore, three-dimensional protein architectures have been formed via the layer-by-layer deposition technique resulting in a successive increase in photocurrent densities. An intermittent cyt c layer is essential for an efficient connection of PSI layers with the electrode and for an improvement of photocurrent densities. PMID:24957935

  18. Advancing predictive models for particulate formation in turbulent flames via massively parallel direct numerical simulations.

    PubMed

    Bisetti, Fabrizio; Attili, Antonio; Pitsch, Heinz

    2014-08-13

    Combustion of fossil fuels is likely to continue for the near future due to the growing trends in energy consumption worldwide. The increase in efficiency and the reduction of pollutant emissions from combustion devices are pivotal to achieving meaningful levels of carbon abatement as part of the ongoing climate change efforts. Computational fluid dynamics featuring adequate combustion models will play an increasingly important role in the design of more efficient and cleaner industrial burners, internal combustion engines, and combustors for stationary power generation and aircraft propulsion. Today, turbulent combustion modelling is hindered severely by the lack of data that are accurate and sufficiently complete to assess and remedy model deficiencies effectively. In particular, the formation of pollutants is a complex, nonlinear and multi-scale process characterized by the interaction of molecular and turbulent mixing with a multitude of chemical reactions with disparate time scales. The use of direct numerical simulation (DNS) featuring a state of the art description of the underlying chemistry and physical processes has contributed greatly to combustion model development in recent years. In this paper, the analysis of the intricate evolution of soot formation in turbulent flames demonstrates how DNS databases are used to illuminate relevant physico-chemical mechanisms and to identify modelling needs. PMID:25024412

  19. RECENT ADVANCES OF GENETIC ANCESTRY TESTING IN BIOMEDICAL RESEARCH AND DIRECT TO CONSUMER TESTING

    PubMed Central

    Via, Marc; Ziv, Elad; Burchard, Esteban González

    2010-01-01

    In the post-Human Genome Project era, the debate on the concept of race/ethnicity and its implications for biomedical research are dependent on two critical issues: whether and how to classify individuals and whether biological factors play a role in health disparities. The advent of reliable estimates of genetic (or biogeographic) ancestry has provided this debate with a quantitative and more objective tool. The estimation of genetic ancestry allows investigators to control for population stratification in association studies and helps to detect biological causation behind population-specific differences in disease and drug response. New techniques such as admixture mapping can specifically detect population-specific risk alleles for a disease in admixed populations. However, researchers have to be mindful of the correlation between genetic ancestry and socioeconomic and environmental factors that could underlie these differences. More importantly, researchers must avoid the stigmatization of individuals based on perceived or real genetic risks. The latter point will become increasingly sensitive as several “for profit companies” are offering ancestry and genetic testing directly to consumers and the consequences of the spread of the services of these companies is still unforeseeable. PMID:19793051

  20. Advanced direct coal liquefaction concepts. Quarterly report, October 1, 1993--December 31, 1993

    SciTech Connect

    Berger, D.J.; Parker, R.J.; Simpson, P.L.

    1993-12-31

    Six runs on the bench unit were successfully completed this quarter. The runs covered twenty five different operating conditions and yield periods, and involved 336 hours of operation. In the bench unit, increased temperature of first stage operation (410{degree}C) and direct addition of the powdered solid sodium aluminate to the feed as first stage catalyst improved both coal and carbon monoxide conversion. To achieve 90%+ overall coal conversion, temperatures of 430{degree}C+ were required in the second stage. Oil yields (pentane soluble liquid product) in excess of 65 wt % based on MAF Black Thunder coal, were achieved both with iron oxide/dimethyl disulfide and ammonium molybdate/carbon disulfide second stage catalysts. C{sub l}-C{sub 3} hydrogen gas yields were modest, generally 7-8 wt % on MAF coal, and overall hydrogen consumption (including first stage shift hydrogen) was in the order of 7-8 wt % on MAF coal. The ammonium molybdate catalyst system appeared to give slightly higher oil yields and hydrogen consumption, as was expected, but the differences may not be significant.

  1. Advanced flow-control mechanisms for the sockets direct protocol over infiniband.

    SciTech Connect

    Balaji, P.; Bhagvat, S.; Panda, D. K.; Thakur, R.; Gropp, W.; Mathematics and Computer Science; Dell Inc.; Ohio State Univ.

    2007-01-01

    The Sockets Direct Protocol (SDP) is an industry standard to allow existing TCP/IP applications to be executed on high-speed networks such as InfiniBand (IB). Like many other high-speed networks, IB requires the receiver process to inform the network interface card (NIC), before the data arrives, about buffers in which incoming data has to be placed. To ensure that the receiver process is ready to receive data, the sender process typically performs flow-control on the data transmission. Existing designs of SDP flow-control are naive and do not take advantage of several interesting features provided by IB. Specifically, features such as RDMA are only used for performing zero-copy communication, although RDMA has more capabilities such as sender-side buffer management (where a sender process can manage SDP resources for the sender as well as the receiver). Similarly, IB also provides hardware flow-control capabilities that have not been studied in previous literature. In this paper, we utilize these capabilities to improve the SDP flow-control over IB using two designs: RDMA-based flow-control and NIC-assisted RDMA-based flow-control. We evaluate the designs using micro-benchmarks and real applications. Our evaluations reveal that these designs can improve the resource usage of SDP and consequently its performance by an order-of-magnitude in some cases. Moreover we can achieve 10-20% improvement in performance for various applications.

  2. Why I wrote my advance decision to refuse life-prolonging treatment: and why the law on sanctity of life remains problematic.

    PubMed

    Gillon, Raanan

    2016-06-01

    This paper, pursuing themes indefatigably defended in this journal and elsewhere by Professors Jenny and Celia Kitzinger, explains what led me to write my own advance decision (AD) to refuse life-prolonging treatment if I become legally incapacitated to make my own healthcare decisions for longer than 3 months and am medically assessed as very unlikely to regain such legal capacity. I attach my Advance Decision to Refuse Life Prolonging Treatment to the online version of this paper for comment advice and possible general interest. I argue that while a Supreme Court judgement in 2013, followed by a Court of Protection judgement in 2015 greatly ameliorate my earlier concerns about excessive judicial emphasis on the sanctity of life, certain current requirements in the Code of Practice to the Mental Capacity Act 2005 and in the Rules of the Court of Protection, especially Practice Direction 9E, concerning permanent vegetative state and minimally conscious state, seem clearly to contradict aspects of that Supreme Court judgement. If the logical implications of those legal requirements were thoroughly implemented medical practice would be substantially and undesirably skewed towards provision of treatments to prolong life that are unwanted, non-beneficial and wasteful of healthcare resources. I urge that these legal requirements are modified to make them consistent with the Supreme Court's judgement in Aintree v James. PMID:27118692

  3. Advancements in high-power high-brightness laser bars and single emitters for pumping and direct diode application

    NASA Astrophysics Data System (ADS)

    An, Haiyan; Jiang, Ching-Long J.; Xiong, Yihan; Zhang, Qiang; Inyang, Aloysius; Felder, Jason; Lewin, Alexander; Roff, Robert; Heinemann, Stefan; Schmidt, Berthold; Treusch, Georg

    2015-03-01

    We have continuously optimized high fill factor bar and packaging design to increase power and efficiency for thin disc laser system pump application. On the other hand, low fill factor bars packaged on the same direct copper bonded (DCB) cooling platform are used to build multi-kilowatt direct diode laser systems. We have also optimized the single emitter designs for fiber laser pump applications. In this paper, we will give an overview of our recent advances in high power high brightness laser bars and single emitters for pumping and direct diode application. We will present 300W bar development results for our next generation thin disk laser pump source. We will also show recent improvements on slow axis beam quality of low fill factor bar and its application on performance improvement of 4-5 kW TruDiode laser system with BPP of 30 mm*mrad from a 600 μm fiber. Performance and reliability results of single emitter for multiemitter fiber laser pump source will be presented as well.

  4. Advanced direct coal liquefaction. Quarterly technical progress report No. 2, December 1983-February 1984

    SciTech Connect

    Paranjape, A.S.

    1984-04-30

    Five Bench-Scale coal liquefaction runs were completed with Wyoming subbituminous coal in a two-stage process scheme. In this process scheme, LDAR, the lighter fraction of ash-free resid, was fed to the catalytic stage prior to its recycle to the thermal stage, whereas DAR, the heavy fraction of the deashed resid, was directly recycled to the thermal stage without any intermediate processing step. The results indicate that increasing coal space rate in the dissolver resulted in lower coal conversion and reduced distillate yield in this process configuration. The coal conversions decreased from 92 wt% to 89 wt% (MAF coal) and the distillate yield was reduced from 50 wt% to less than 40 wt% (MAF coal), as the coal space velocity increased. Attempts to duplicate the yields of Run 32, at comparable process conditions in Runs 37 and 38, were unsuccessful. Several process parameters were investigated but failed to show why the yields of Run 32 could not be duplicated. Valuable process related information was gained as a result of process parameter studies completed during these runs. At comparable process conditions, coal conversions were lower by about 3 to 4 relative percent and were only in the 87 wt% (MAF coal) range. Similarly, the distillate yield was about 40 wt% (MAF coal) which is about 10 wt% lower than observed in Run 32. Although no exact cause for these results could be determined, it appeared that the H/C atomic ratio of the solvent and possibly the flow pattern (plug-flow versus back-mixed) could have affected the coal conversion and quantity of distillate product produced. A significant decrease in coal conversion of 4 to 5 wt% was observed when the disposable catalyst (iron oxide) was removed from the reaction mixture and therefore substantiates the need for a disposable catalyst in the liquefaction of Wyoming subbituminous coal.

  5. Predictive scaling laws for spherical rotating dynamos

    NASA Astrophysics Data System (ADS)

    Oruba, L.; Dormy, E.

    2014-08-01

    State of the art numerical models of the Geodynamo are still performed in a parameter regime extremely remote from the values relevant to the physics of the Earth's core. In order to establish a connection between dynamo modelling and the geophysical motivation, it is necessary to use scaling laws. Such scaling laws establish the dependence of essential quantities (such as the magnetic field strength) on measured or controlled quantities. They allow for a direct confrontation of advanced models with geophysical constraints. We combine a numerical approach, based on a multiple linear regression method in the form of power laws, applied to a database of 102 direct numerical simulations (courtesy of U. Christensen), and a physical approach, based on energetics and forces balances. We show that previous empirical scaling laws for the magnetic field strength essentially reflect the statistical balance between energy production and dissipation for saturated dynamos. Such power based scaling laws are thus necessarily valid for any dynamo in statistical equilibrium and applicable to any numerical model, irrespectively of the dynamo mechanism. We show that direct numerical fits can provide contradictory results owing to biases in the parameters space covered in the numerics and to the role of a priori hypothesis on the fraction of ohmic dissipation. We introduce predictive scaling laws, that is relations involving input parameters of the governing equations only. We guide our reasoning on physical considerations. We show that our predictive scaling laws can properly describe the numerical database and reflect the dominant forces balance at work in these numerical simulations. We highlight the dependence of the magnetic field strength on the rotation rate. Finally, our results stress that available numerical models operate in a viscous dynamical regime, which is not relevant to the Earth's core.

  6. ADVANCED BYPRODUCT RECOVERY: DIRECT CATALYTIC REDUCTION OF SO2 TO ELEMENTAL SULFUR

    SciTech Connect

    Robert S. Weber

    1999-05-01

    Arthur D. Little, Inc., together with its commercialization partner, Engelhard Corporation, and its university partner Tufts, investigated a single-step process for direct, catalytic reduction of sulfur dioxide from regenerable flue gas desulfurization processes to the more valuable elemental sulfur by-product. This development built on recently demonstrated SO{sub 2}-reduction catalyst performance at Tufts University on a DOE-sponsored program and is, in principle, applicable to processing of regenerator off-gases from all regenerable SO{sub 2}-control processes. In this program, laboratory-scale catalyst optimization work at Tufts was combined with supported catalyst formulation work at Engelhard, bench-scale supported catalyst testing at Arthur D. Little and market assessments, also by Arthur D. Little. Objectives included identification and performance evaluation of a catalyst which is robust and flexible with regard to choice of reducing gas. The catalyst formulation was improved significantly over the course of this work owing to the identification of a number of underlying phenomena that tended to reduce catalyst selectivity. The most promising catalysts discovered in the bench-scale tests at Tufts were transformed into monolith-supported catalysts at Engelhard. These catalyst samples were tested at larger scale at Arthur D. Little, where the laboratory-scale results were confirmed, namely that the catalysts do effectively reduce sulfur dioxide to elemental sulfur when operated under appropriate levels of conversion and in conditions that do not contain too much water or hydrogen. Ways to overcome those limitations were suggested by the laboratory results. Nonetheless, at the end of Phase I, the catalysts did not exhibit the very stringent levels of activity or selectivity that would have permitted ready scale-up to pilot or commercial operation. Therefore, we chose not to pursue Phase II of this work which would have included further bench-scale testing

  7. Advanced direct liquefaction concepts for PETC generic units, Phase 2. Quarterly technical progress report, January--March 1996

    SciTech Connect

    1996-05-01

    The aims of this research program are to advance to bench-scale testing, concepts that have the potential for making net reductions in direct coal liquefaction process costs. The research involves a teaming arrangement between the University of Kentucky Center for Applied Energy Research (CAER), Consolidation Coal Company (CONSOL), Sandia National Laboratories (SNL), and LDP Associates. Progress reports are presented for: Task 2.1.1 development of a catalyst screening test (UK/CAER); Task 2.1.2 activation of impregnated catalysts (UK/CAER); Task 2.2 laboratory support (CONSOL); Task 3 continuous operations/parametric studies (Hydrocarbon Technologies, Inc.) and; Task 4.4 conceptual design, preliminary technical assessment (LDP Associates).

  8. Multi-objective direct optimization of dynamic acceptance and lifetime for potential upgrades of the Advanced Photon Source.

    SciTech Connect

    Borland, M.; Sajaev, V.; Emery, L.; Xiao, A.; Accelerator Systems Division

    2010-08-24

    The Advanced Photon Source (APS) is a 7 GeV storage ring light source that has been in operation for well over a decade. In the near future, the ring may be upgraded, including changes to the lattice such as provision of several long straight sections (LSS). Because APS beamlines are nearly fully built out, we have limited freedom to place LSSs in a symmetric fashion. Arbitrarily-placed LSSs will drastically reduce the symmetry of the optics and would typically be considered unworkable. We apply a recently-developed multi-objective direct optimization technique that relies on particle tracking to compute the dynamic aperture and Touschek lifetime. We show that this technique is able to tune sextupole strengths and select the working point in such a way as to recover the dynamic and momentum acceptances. We also show the results of experimental tests of lattices developed using these techniques.

  9. Basic laws of the processes and the principle of minimum energy consumption during pneumatic transport and distribution of pulverized fuel in direct pulverized fuel preparation systems

    NASA Astrophysics Data System (ADS)

    Leykin, V. Z.

    2015-08-01

    The paper presents analysis of the basic laws and a calculation-based investigation of processes related to the low-concentration pneumatic transport and the distribution of finely dispersed pulverized fuel in direct pulverized fuel preparation systems of boiler units. Based on the principle of the minimum energy consumption, it is shown that, at high (standard) velocities of the turbulent gas flow—of 25-30 m/s, which is by 1.5-2 times higher than the critical speeds—the finely dispersed pulverized fuel can be transported simultaneously in the form of a low-concentration flow in pipelines and a concentrated, to 30% of the flow rate, thin layer on the pipeline walls with the height of the layer equal to 0.02-0.04 of the pipe radius. Consideration of this phenomenon is of great significance in terms of securing the efficient operation of pulverized fuel distribution units. The basic characteristics of the process have been determined and validated by test bench investigations using both model systems and pulverized fuel distribution systems of a number of power-generating units. The obtained results underlie a methodological approach to developing high-efficiency adjustable pulverized fuel distribution units. Also, results of industrial testing are presented that confirm the results of the analysis and of experimental studies.

  10. Do Spanish Hospital Professionals Educate Their Patients About Advance Directives? : A Descriptive Study in a University Hospital in Madrid, Spain.

    PubMed

    Pérez, María; Herreros, Benjamín; Martín, M Dolores; Molina, Julia; Kanouzi, Jack; Velasco, María

    2016-06-01

    It is unknown whether hospital-based medical professionals in Spain educate patients about advance directives (ADs). The objective of this research was to determine the frequency of hospital-based physicians' and nurses' engagement in AD discussions in the hospital and which patient populations merit such efforts. A short question-and-answer-based survey of physicians and nurses taking care of inpatients was conducted at a university hospital in Madrid, Spain. In total, 283 surveys were collected from medical professionals, of whom 71 per cent were female, with an average age of thirty-four years. Eighty-four per cent had never educated patients about ADs because of lack of perceived responsibility, time, or general knowledge of ADs. Patient populations that warranted AD discussions included those with terminal illnesses (77 per cent), chronic diseases (61 per cent), and elderly patients (43 per cent). Regarding degree of AD understanding in medical professionals: 57 per cent of medical professionals claimed sufficient general knowledge of ADs, 19 per cent understood particulars regarding AD document creation, and 16 per cent were aware of AD regulatory policies. Engagement in AD discussions was considered important by 83 per cent of medical professionals, with 79 per cent interested in participating in such discussions themselves. The majority of hospital physicians and nurses do not educate their patients about ADs, despite acknowledging their importance. Patient populations of highest priority included those with terminal diseases or chronic illness or who are of advanced age. PMID:26797513

  11. Advanced direct liquefaction concepts for PETC generic units: Phase 2. Quarterly technical progress report, July--September, 1996

    SciTech Connect

    1996-11-01

    The Advanced Direct Liquefaction Concepts Program sponsored by the DOE Pittsburgh Energy Technology Center was initiated in 1991 with the objective of promoting the development of new and emerging technology that has the potential for reducing the cost of producing liquid fuels by direct coal liquefaction. The laboratory research program (Phase I) was completed in 1995 by UK/CAER, CONSOL, Sandia National Laboratories and LDP Associates. A three year extension was subsequently awarded in October 1995 to further develop several promising concepts derived from the laboratory program. During Phase II, four continuous bench scale runs will be conducted at Hydrocarbon Technologies, Inc. using a 2 kg/hr continuous bench scale unit located at their facility in Lawrenceville, NJ. The first run in this program (ALC-1), conducted between April 19 and May 14, 1996, consisted of five test conditions to evaluate the affect of coal cleaning and recycle solvent modification. A detailed discussion of this run is included in Section Two of this report. Results obtained during this reporting period for all participants in this program are summarized.

  12. Limit laws for Zipf's law

    NASA Astrophysics Data System (ADS)

    Eliazar, Iddo

    2011-01-01

    In this communication we establish stochastic limit laws leading from Zipf's law to Pareto's and Heaps' laws. We consider finite ensembles governed by Zipf's law and study their asymptotic statistics as the ensemble size tends to infinity. A Lorenz-curve analysis establishes three types of limit laws for the ensembles' statistical structure: 'communist', 'monarchic', and Paretian. Further considering a dynamic setting in which the ensembles grow stochastically in time, a functional central limit theorem analysis establishes a Gaussian approximation for the ensembles' stochastic growth. The Gaussian approximation provides a generalized and corrected formulation of Heaps' law.

  13. Degradation mechanism of alachlor during direct ozonation and O(3)/H(2)O(2) advanced oxidation process.

    PubMed

    Qiang, Zhimin; Liu, Chao; Dong, Bingzhi; Zhang, Yalei

    2010-01-01

    The degradation of alachlor by direct ozonation and advanced oxidation process O(3)/H(2)O(2) was investigated in this study with focus on identification of degradation byproducts. The second-order reaction rate constant between ozone and alachlor was determined to be 2.5+/-0.1M(-1)s(-1) at pH 7.0 and 20 degrees C. Twelve and eight high-molecular-weight byproducts (with the benzene ring intact) from alachlor degradation were identified during direct ozonation and O(3)/H(2)O(2), respectively. The common degradation byproducts included N-(2,6-diethylphenyl)-methyleneamine, 8-ethyl-3,4-dihydro-quinoline, 8-ethyl-quinoline, 1-chloroacetyl-2-hydro-3-ketone-7-acetyl-indole, 2-chloro-2',6'-diacetyl-N-(methoxymethyl)acetanilide, 2-chloro-2'-acetyl-6'-ethyl-N-(methoxymethyl)-acetanilide, and two hydroxylated alachlor isomers. In direct ozonation, four more byproducts were also identified including 1-chloroacetyl-2,3-dihydro-7-ethyl-indole, 2-chloro-2',6'-ethyl-acetanilide, 2-chloro-2',6'-acetyl-acetanilide and 2-chloro-2'-ethyl-6'-acetyl-N-(methoxymethyl)-acetanilide. Degradation of alachlor by O(3) and O(3)/H(2)O(2) also led to the formation of low-molecular-weight byproducts including formic, acetic, propionic, monochloroacetic and oxalic acids as well as chloride ion (only detected in O(3)/H(2)O(2)). Nitrite and nitrate formation was negligible. Alachlor degradation occurred via oxidation of the arylethyl group, N-dealkylation, cyclization and cleavage of benzene ring. After O(3) or O(3)/H(2)O(2) treatment, the toxicity of alachlor solution examined by the Daphnia magna bioassay was slightly reduced. PMID:20022076

  14. Advanced care directives

    MedlinePlus

    ... J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. ... URAC's accreditation program is an independent audit to verify that A.D.A.M. follows ...

  15. Advance care directives

    MedlinePlus

    ... order on your medical chart. Fill out an organ donation card and carry it in your wallet. Keep ... your important papers. You can find out about organ donation from your doctor. You can also have this ...

  16. Commission on the Advancement of Women and Minorities in Science, Engineering, and Technology Development Act. Public Law 105-255. 105th Congress.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. House.

    This Public Law (PL-105-255) lays out the reasons for establishing the Commission; the duties of the Commission; membership, directorship, and powers of the commission; and expectations for the Commission's report. (WRM)

  17. Quality of Life and Cost of Care at the End of Life: The Role of Advance Directives

    PubMed Central

    Garrido, Melissa M.; Balboni, Tracy A.; Maciejewski, Paul K.; Bao, Yuhua; Prigerson, Holly G.

    2014-01-01

    Context Advance directives (ADs) are expected to improve patients’ end-of-life outcomes, but retrospective analyses, surrogate recall of patients’ preferences, and selection bias have hampered efforts to determine ADs’ effects on patient outcomes. Objectives To examine associations among ADs, quality of life, and estimated costs of care in the week before death. Methods We used prospective data from interviews of 336 patients with advanced cancer and their caregivers, and analyzed patient baseline interview and caregiver and provider post-mortem evaluation data from the Coping with Cancer study. Cost estimates were from the Healthcare Cost and Utilization Project Nationwide Inpatient Sample and published Medicare payment rates and cost estimates. Outcomes were quality of life (range 0-10) and estimated costs of care received in the week before death. Because patient end-of-life care preferences influence both AD completion and care use, analyses were stratified by preferences regarding heroic endof-life measures (everything possible to remain alive). Results Most patients did not want heroic measures (76%). Do-not-resuscitate (DNR) orders were associated with higher quality of life (β=0.75, standard error=0.30, P=0.01) across the entire sample. There were no statistically significant relationships between DNR orders and outcomes among patients when we stratified by patient preference, or between living wills/durable powers of attorney and outcomes in any of the patient groups. Conclusion The associations between DNR orders and better quality of life in the week before death indicate that documenting preferences against resuscitation in medical orders may be beneficial to many patients. PMID:25498855

  18. Laser Atmospheric Wind Sounder (LAWS) phase 1. Volume 1: Executive summary

    NASA Technical Reports Server (NTRS)

    1990-01-01

    The laser atmospheric wind sounder (LAWS) will provide a new space based capability for the direct measurement of atmospheric winds in the troposphere. LAWS will make a major contribution toward advancing the understanding and prediction of the total Earth system and NASA's Earth Observing System (EOS) Program. LAWS is designed to measure a fundamental atmospheric parameter required to advance weather forecasting accuracies and investigate global climatic change. LAWS has a potential added benefit of providing (global) concentration profiles of large aerosols including visible and subvisible cirrus clouds, volcanic dust, smoke, and other pollutants. The objective of this Phase One study was to develop a LAWS concept and configuration. The instrument design is outlined in this first volume of three.

  19. Impact crater scaling laws

    NASA Technical Reports Server (NTRS)

    Holsapple, K. A.

    1987-01-01

    Impact craters are numerous on planetary bodies and furnish important information about the composition and past histories of those bodies. The interpretation of that information requires knowledge about the fundamental aspects of impact cratering mechanics. Since the typical conditions of impacts are at a size scale and velocity far in excess of experimental capabilities, direct simulations are precluded. Therefore, one must rely on extrapolation from experiments of relatively slow impacts of very small bodies, using physically based scaling laws, or must study the actual cases of interest using numerical code solutions of the fundamental physical laws that govern these processes. A progress report is presented on research on impact cratering scaling laws, on numerical studies that were designed to investigate those laws, and on various applications of the scaling laws developed by the author and his colleagues. These applications are briefly reviewed.

  20. Fast wave direct electron heating in advanced inductive and ITER baseline scenario discharges in DIII-D

    SciTech Connect

    Pinsker, R. I.; Jackson, G. L.; Luce, T. C.; Politzer, P. A.; Austin, M. E.; Diem, S. J.; Kaufman, M. C.; Ryan, P. M.; Doyle, E. J.; Zeng, L.; Grierson, B. A.; Hosea, J. C.; Nagy, A.; Perkins, R.; Solomon, W. M.; Taylor, G.; Maggiora, R.; Milanesio, D.; Porkolab, M.; Turco, F.

    2014-02-12

    Fast Wave (FW) heating and electron cyclotron heating (ECH) are used in the DIII-D tokamak to study plasmas with low applied torque and dominant electron heating characteristic of burning plasmas. FW heating via direct electron damping has reached the 2.5 MW level in high performance ELMy H-mode plasmas. In Advanced Inductive (AI) plasmas, core FW heating was found to be comparable to that of ECH, consistent with the excellent first-pass absorption of FWs predicted by ray-tracing models at high electron beta. FW heating at the ∼2 MW level to ELMy H-mode discharges in the ITER Baseline Scenario (IBS) showed unexpectedly strong absorption of FW power by injected neutral beam (NB) ions, indicated by significant enhancement of the D-D neutron rate, while the intended absorption on core electrons appeared rather weak. The AI and IBS discharges are compared in an effort to identify the causes of the different response to FWs.

  1. Non-CAR resists and advanced materials for Massively Parallel E-Beam Direct Write process integration

    NASA Astrophysics Data System (ADS)

    Pourteau, Marie-Line; Servin, Isabelle; Lepinay, Kévin; Essomba, Cyrille; Dal'Zotto, Bernard; Pradelles, Jonathan; Lattard, Ludovic; Brandt, Pieter; Wieland, Marco

    2016-03-01

    The emerging Massively Parallel-Electron Beam Direct Write (MP-EBDW) is an attractive high resolution high throughput lithography technology. As previously shown, Chemically Amplified Resists (CARs) meet process/integration specifications in terms of dose-to-size, resolution, contrast, and energy latitude. However, they are still limited by their line width roughness. To overcome this issue, we tested an alternative advanced non-CAR and showed it brings a substantial gain in sensitivity compared to CAR. We also implemented and assessed in-line post-lithographic treatments for roughness mitigation. For outgassing-reduction purpose, a top-coat layer is added to the total process stack. A new generation top-coat was tested and showed improved printing performances compared to the previous product, especially avoiding dark erosion: SEM cross-section showed a straight pattern profile. A spin-coatable charge dissipation layer based on conductive polyaniline has also been tested for conductivity and lithographic performances, and compatibility experiments revealed that the underlying resist type has to be carefully chosen when using this product. Finally, the Process Of Reference (POR) trilayer stack defined for 5 kV multi-e-beam lithography was successfully etched with well opened and straight patterns, and no lithography-etch bias.

  2. Goal-directed transthoracic echocardiography during advanced cardiac life support: A pilot study using simulation to assess ability

    PubMed Central

    Greenstein, Yonatan Y.; Martin, Thomas J.; Rolnitzky, Linda; Felner, Kevin; Kaufman, Brian

    2015-01-01

    Introduction Goal-directed echocardiography (GDE) is used to answer specific clinical questions which provide invaluable information to physicians managing a hemodynamically unstable patient. We studied perception and ability of housestaff previously trained in GDE to accurately diagnose common causes of cardiac arrest during simulated advanced cardiac life support (ACLS); we compared their results to those of expert echocardiographers. Methods Eleven pulmonary and critical care medicine fellows, seven emergency medicine residents, and five cardiologists board-certified in echocardiography were enrolled. Baseline ability to acquire four transthoracic echocardiography views was assessed and participants were exposed to six simulated cardiac arrests and were asked to perform a GDE during ACLS. Housestaff performance was compared to the performance of five expert echocardiographers. Results Average baseline and scenario views by housestaff were of good or excellent quality 89% and 83% of the time, respectively. Expert average baseline and scenario views were always of good or excellent quality. Housestaff and experts made the correct diagnosis in 68% and 77% of cases, respectively. On average, participants required 1.5 pulse checks to make the correct diagnosis. 94% of housestaff perceived this study as an accurate assessment of ability. Conclusions In an ACLS compliant manner, housestaff are capable of diagnosing management altering pathologies the majority of the time and they reach similar diagnostic conclusions in the same amount of time as expert echocardiographers in a simulated cardiac arrest scenario. PMID:25932707

  3. Advanced byproduct recovery: Direct catalytic reduction of sulfur dioxide to elemental sulfur. Fourth quarterly technical progress report

    SciTech Connect

    1997-01-01

    The team of Arthur D. Little, Tufts University and Engelhard Corporation are conducting Phase 1 of a four and a half year, two-phase effort to develop and scale-up an advanced byproduct recovery technology that is a direct, single-stage, catalytic process for converting sulfur dioxide to elemental sulfur. This catalytic process reduces SO{sub 2} over a fluorite-type oxide (such as ceria and zirconia). The catalytic activity can be significantly promoted by active transition metals, such as copper. More than 95% elemental sulfur yield, corresponding to almost complete sulfur dioxide conversion, was obtained over a Cu-Ce-O oxide catalyst as part of an on-going DOE-sponsored, University Coal Research Program. This type of mixed metal oxide catalyst has stable activity, high selectivity for sulfur production, and is resistant to water and carbon dioxide poisoning. Tests with CO and CH{sub 4} reducing gases indicate that the catalyst has the potential for flexibility with regard to the composition of the reducing gas, making it attractive for utility use. The performance of the catalyst is consistently good over a range of SO{sub 2} inlet concentration (0.1 to 10%) indicating its flexibility in treating SO{sub 2} tail gases as well as high concentration streams.

  4. Assessing the effectiveness of interventions to promote advance directives among older adults: a systematic review and multi-level analysis.

    PubMed

    Bravo, Gina; Dubois, Marie-France; Wagneur, Bernard

    2008-10-01

    Many studies have investigated the effectiveness of interventions in promoting advance directives (ADs) but there is uncertainty as to what works best, and in whom. We conducted a systematic review of the evidence in this regard, using both classical meta-analysis approaches and multi-level analyses. Eleven databases were searched for relevant reports published through March 2007. All prospective studies were eligible, whether involving a single group or several and, in the latter case, regardless of the allocation mechanism. Outcomes included formal and informal ADs assessed by chart review or self-report. Heterogeneous sets of outcomes were pooled under a random-effects model. The search yielded 55 studies, half of which targeted outpatients. Most groups of subjects were educated in a single session led by one healthcare professional. Outcomes were measured within six months of the intervention in 73% of cases. The largest set of single-arm studies yielded an overall AD completion rate of 45.6%. Across randomized trials, the largest pooled odds ratio was 4.0, decreasing to 2.6 when all comparative studies were included. Multi-variable analyses identified the provision of oral information over multiple sessions as the most successful intervention. This was true regardless of the target population. These findings support the effectiveness of educational interventions in increasing the formulation of ADs and provide practical advice on how best to achieve this goal. PMID:18644667

  5. Analysis of the entrainment law of a dry, shear-free convective boundary layer growing into a linearly stratified fluid using direct numerical simulation

    NASA Astrophysics Data System (ADS)

    Garcia, J.; Mellado, J.

    2013-12-01

    Despite the good performance of the zero-order model (ZOM) in predicting the entrainment rate for a dry, shear-free convective boundary layer growing into a linearly stratified fluid, it is well-known that, due to its assumption of an infinitesimally thin capping layer, parameters in the entrainment rate equation such as the entrainment ratio and buoyancy increment are not accurately provided by the ZOM (Federovich et al. 2004). These parameters become relevant in cases of added complexity, like cloud formation or transition into a sheared CBL. Hence, extensions of the basic ZOM framework have been proposed to take into account the effect of the finite thickness, such as general structure models (Fedorovich and Mironov 1995, Fedorovich et al. 2004). To bring entrainment ratio measurements closer to the ZOM framework, Sullivan et al. (1998) concluded that the finite thickness contributes by increasing the entrainment ratio and should therefore be included. However, reliable data of the capping layer is still missing (Sullivan and Patton 2011). Hence, we do direct numerical simulation of the dry, shear-free CBL and use our data to eliminate uncertainty due to the sub-grid scale turbulence model when evaluating the exact equation for the entrainment rate. Contrary to previous findings, we find out that the finite thickness term is not only negligible but is of opposite sign, further decreasing the entrainment ratio that is already smaller than the reference value 0.2. The exact equation shows that it is actually a particular definition of the buoyancy jump that results from the exact equation that compensates for the smaller entrainment ratio. This buoyancy jump is different from a first-order model buoyancy jump and the buoyancy jump definition used by Sullivan et al. (1998). The entrainment ratio and the appropriate buoyancy jump are related by an exact equation, meaning the two cannot be chosen independently without possible violation of this equation. We also

  6. 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. PMID:26823112

  7. Contribution of Morphological Awareness and Lexical Inferencing Ability to L2 Vocabulary Knowledge and Reading Comprehension among Advanced EFL Learners: Testing Direct and Indirect Effects

    ERIC Educational Resources Information Center

    Zhang, Dongbo; Koda, Keiko

    2012-01-01

    Within the Structural Equation Modeling framework, this study tested the direct and indirect effects of morphological awareness and lexical inferencing ability on L2 vocabulary knowledge and reading comprehension among advanced Chinese EFL readers in a university in China. Using both regular z-test and the bootstrapping (data-based resampling)…

  8. 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...

  9. Environmental Barrier Coating Development for SiC/SiC Ceramic Matrix Composites: Recent Advances and Future Directions

    NASA Technical Reports Server (NTRS)

    Zhu, Dongming

    2016-01-01

    This presentation briefly reviews the SiC/SiC major environmental and environment-fatigue degradations encountered in simulated turbine combustion environments, and thus NASA environmental barrier coating system evolution for protecting the SiC/SiC Ceramic Matrix Composites for meeting the engine performance requirements. The presentation will review several generations of NASA EBC materials systems, EBC-CMC component system technologies for SiC/SiC ceramic matrix composite combustors and turbine airfoils, highlighting the temperature capability and durability improvements in simulated engine high heat flux, high pressure, high velocity, and with mechanical creep and fatigue loading conditions. This paper will also focus on the performance requirements and design considerations of environmental barrier coatings for next generation turbine engine applications. The current development emphasis is placed on advanced NASA candidate environmental barrier coating systems for SiC/SiC CMCs, their performance benefits and design limitations in long-term operation and combustion environments. The efforts have been also directed to developing prime-reliant, self-healing 2700F EBC bond coat; and high stability, lower thermal conductivity, and durable EBC top coats. Major technical barriers in developing environmental barrier coating systems, the coating integrations with next generation CMCs having the improved environmental stability, erosion-impact resistance, and long-term fatigue-environment system durability performance will be described. The research and development opportunities for turbine engine environmental barrier coating systems by utilizing improved compositions, state-of-the-art processing methods, and simulated environment testing and durability modeling will be briefly discussed.

  10. Advanced byproduct recovery: Direct catalytic reduction of sulfur dioxide to elemental sulfur. Quarterly report, April 1--June 30, 1997

    SciTech Connect

    1997-12-31

    The team of Arthur D. Little, Tufts University and Engelhard Corporation are conducting Phase 1 of a four and a half year, two-phase effort to develop and scale-up an advanced byproduct recovery technology that is a direct, single-stage, catalytic process for converting sulfur dioxide to elemental sulfur. This catalytic process reduces SO{sub 2} over a fluorite-type oxide (such as ceria and zirconia). The catalytic activity can be significantly promoted by active transition metals, such as copper. More than 95% elemental sulfur yield, corresponding to almost complete sulfur dioxide conversion, was obtained over a Cu-Ce-O oxide catalyst as part of an on-going DOE-sponsored, University Coal Research Program. This type of mixed metal oxide catalyst has stable activity, high selectivity for sulfur production, and is resistant to water and carbon dioxide poisoning. Tests with CO and CH{sub 4} reducing gases indicate that the catalyst has the potential for flexibility with regard to the composition of the reducing gas, making it attractive for utility use. The performance of the catalyst is consistently good over a range of SO{sub 2} inlet concentration (0.1 to 10%) indicating its flexibility in treating SO{sub 2} tail gases as well as high concentration streams. The principal objective of the Phase 1 program is to identify and evaluate the performance of a catalyst which is robust and flexible with regard to choice of reducing gas. In order to achieve this goal, the authors have planned a structured program including: Market/process/cost/evaluation; Lab-scale catalyst preparation/optimization studies; Lab-scale, bulk/supported catalyst kinetic studies; Bench-scale catalyst/process studies; and Utility review. Progress is reported from all three organizations.

  11. Examining single-source secondary impacts estimated from brute-force, decoupled direct method, and advanced plume treatment approaches

    NASA Astrophysics Data System (ADS)

    Kelly, James T.; Baker, Kirk R.; Napelenok, Sergey L.; Roselle, Shawn J.

    2015-06-01

    In regulatory assessments, there is a need for reliable estimates of the impacts of precursor emissions from individual sources on secondary PM2.5 (particulate matter with aerodynamic diameter less than 2.5 microns) and ozone. Three potential methods for estimating these impacts using Eulerian grid photochemical models are the brute-force (B-F) method, the decoupled direct method (DDM), and advanced plume treatment (APT). Here, we systematically inter-compare and assess the B-F, DDM, and APT approaches using hypothetical sources in a consistent modeling platform for a wide range of source conditions (i.e., emissions amount and composition, location within two California air basins, and stack parameters). The impacts of NOx and VOC sources on ozone and SO2 sources on PM2.5 sulfate calculated by these methods are in general agreement. The agreement is evident in the similar magnitudes, spatial patterns, and strong correlations among the impacts. This result, along with previous model evaluations based on similar Eulerian grid modeling, builds confidence in the reliability of the impact estimates. Disagreement among methods is evident in calculations of PM2.5 nitrate impacts associated with NH3 and NOx sources. Numerical instabilities in DDM sensitivity calculations compromise the nitrate impact estimates from that approach. The B-F and APT methods, which use brute-force differencing to identify impacts, are affected by numerical artifacts to a lesser degree than (H)DDM, with the artifacts being more prominent for APT than B-F. Overall, our results indicate that the (H)DDM, B-F, and APT approaches are viable for use in estimating single-source impacts for ozone and secondary PM2.5 sulfate, while the B-F method appears to be the most reliable for estimating nitrate impacts. There is a need for additional field study measurements to better constrain model estimates of single-source secondary impacts.

  12. Comparison of advance medical directive inquiry and documentation for hospital inpatients in three medical services: implications for policy changes.

    PubMed

    Anunobi, Echezona; Detweiler, Mark B; Sethi, Roopa; Thomas, Reena; Lutgens, Brian; Detweiler, Jonna G

    2015-01-01

    Following the introduction of the Patient Self-Determination Act of 1990, the Veterans Health Administration developed its own advance medical directive (AMD) policy, which most recently states that documentation is mandatory for all hospital patients in all settings. The object of this study was to assess the effectiveness of AMD documentation at a local Veterans Affairs Medical Center. AMD documentation was compared among three inpatient services: surgery, medicine, and psychiatry. Retrospective in nature, 594 inpatient cases were compared. Results revealed that, overall, the rate of AMD documentation was 37.7%. AMD documentation on surgery was statistically more frequent (45.6%) than for either medicine (33.2%) or psychiatry (34.5%). The difference between the numbers of days to AMD documentation for all three services was not statistically significant. While there was no statistically significant difference across gender, Caucasians had AMDs documented more frequently than African Americans (p < .001). Logistic regression reveals that social worker and physician intervention, not patient-specific variables, are the primary predictors of AMD incidence. Policy makers may need to consider the realities of hospital care, especially in emergency settings, and be more specific in the steps of implementation of the policy in the evenings, weekends, and holidays. True adherence to policy implementation may require hospital administrators to increase staff and educational efforts so that the concept of AMD communication and documentation is completely explained to all staff and patients. Policy should include an electronic record reminder that is renewed every 3 years and provisions for accommodating patients who arrive on weekends and holidays, with special awareness of the particular communication needs of minority groups. The study conclusions are that further inquiry is needed to understand these policy nuances to enable the Veterans Affairs Administration to

  13. Advanced product recovery: Direct catalytic reduction of sulfur dioxide to elemental sulfur. Third quarterly technical progress report

    SciTech Connect

    1996-07-01

    More than 170 wet scrubber systems applied to 72,000 MW of US, coal-fired, utility boilers are in operation or under construction. In these systems, the sulfur dioxide removed form the boiler flue gas is permanently bound to a sorbent material, such as lime or limestone. The sulfated sorbent must be disposed of as a waste product or, in some cases, sold as a byproduct (e.g. gypsum). The use of regenerable sorbent technologies has the potential to reduce or eliminate solid waste production, transportation and disposal. Arthur D. Little, Inc., together with its industry and commercialization advisor, Engelhard Corporation, and its university partner, Tufts, plans to develop and scale-up an advanced, byproduct recovery technology that is a direct, catalytic process for reducing sulfur dioxide to elemental sulfur. The principal objective of the Phase 1 program is to identify and evaluate the performance of a catalyst which is robust and flexible with regard to choice of reducing gas. In order to achieve this goal, they have planned a structured program including: market/process/cost/evaluation; lab-scale catalyst preparation/optimization studies; lab-scale, bulk/supported catalyst kinetic studies; bench-scale catalyst/process studies; and utility review. This catalytic process reduces SO{sub 2} over a fluorite-type oxide (such as ceria and zirconia). The catalytic activity can be significantly promoted by active transition metals, such as copper. This type of mixed metal oxide catalyst has stable activity, high selectivity for sulfur production, and is resistant to water and carbon dioxide poisoning.

  14. Space Law

    NASA Astrophysics Data System (ADS)

    Hermida, Julian

    2006-01-01

    This chapter examines the salient characteristics of Space Law. It analyzes the origins and evolution of Space Law, its main international principles, and some current topics of interest to the scientific community: the delimitation of airspace and outer space, intellectual property, and criminal responsibility.

  15. Law 302.

    ERIC Educational Resources Information Center

    Manitoba Dept. of Education, Winnipeg.

    This publication outlines a law course intended as part of a business education program in the secondary schools of Manitoba, Canada. The one credit course of study should be taught over a period of 110-120 hours of instruction. It provides students with an introduction to the principles, practices, and consequences of law with regard to torts,…

  16. Zipf's law, power laws and maximum entropy

    NASA Astrophysics Data System (ADS)

    Visser, Matt

    2013-04-01

    Zipf's law, and power laws in general, have attracted and continue to attract considerable attention in a wide variety of disciplines—from astronomy to demographics to software structure to economics to linguistics to zoology, and even warfare. A recent model of random group formation (RGF) attempts a general explanation of such phenomena based on Jaynes' notion of maximum entropy applied to a particular choice of cost function. In the present paper I argue that the specific cost function used in the RGF model is in fact unnecessarily complicated, and that power laws can be obtained in a much simpler way by applying maximum entropy ideas directly to the Shannon entropy subject only to a single constraint: that the average of the logarithm of the observable quantity is specified.

  17. The gap between law and ethics in human embryonic stem cell research: overcoming the effect of U.S. federal policy on research advances and public benefit.

    PubMed

    Taylor, Patrick L

    2005-10-01

    Key ethical issues arise in association with the conduct of stem cell research by research institutions in the United States. These ethical issues, summarized in detail, receive no adequate translation into federal laws or regulations, also described in this article. U.S. Federal policy takes a passive approach to these ethical issues, translating them simply into limitations on taxpayer funding, and foregoes scientific and ethical leadership while protecting intellectual property interests through a laissez faire approach to stem cell patents and licenses. Those patents and licenses, far from being scientifically and ethically neutral in effect, virtually prohibit commercially sponsored research that could otherwise be a realistic alternative to the federal funding gap. The lack of federal funding and related data-sharing principles, combined with the effect of U.S. patent policy, the lack of key agency guidance, and the proliferation of divergent state laws arising from the lack of Federal leadership, significantly impede ethical stem cell research in the United States, without coherently supporting any consensus ethical vision. Research institutions must themselves implement steps, described in the article, to integrate addressing ethical review with the many legal compliance issues U.S. federal and state laws create. PMID:16279757

  18. Revenge, or Moon (over) Your Law School.

    ERIC Educational Resources Information Center

    Schlegel, John Henry

    1990-01-01

    Law reviews should contain articles that are more than useless compendia of rules. They should be about law, the legal system and how it operates or might operate, so they become truly practical knowledge. Editors should boldly reject articles that do not advance understanding about law. (MSE)

  19. The girl child and law.

    PubMed

    Jain, A

    1995-01-01

    This article discusses the flaws in India's legislation dealing with female children and equality, marriage age, rape, adoption, child care, and inheritance. India's national policies treat children as commodities and not human beings with their own rights. The best interests of a child are not generally served in a manner that advances their welfare. Exploitation of children for labor and sexual abuse of children is widespread. Only some children have such basic needs met as education, nutrition, food, health, clothing, shelter. Children are defined by the UN as human beings below the age of 18 years. However, in India the Constitution protects only children younger than 14 in employment. The prostitution act protects children younger than 16. The juvenile justice protects girls under the age of 18 years and boys under the age of 16 years. Hindus recognize inheritance of family property only for sons. This custom contributes to the abortion of female fetuses. The practice of equal protection under the law has enough loopholes to safeguard the interests of masculine patriarchal values, norms, and structure. The Act of Marriage does not deal directly with the issue of validity and only recommends a suitable age of marriage. Women can seek divorce on the grounds she was too young to marry only if the marriage occurred before the age of 15 years. Sexual intercourse with a woman under 16 years old is rape, with or without her consent. However, in practice men receive a lesser punishment for rape if the woman is his own wife and not under 12 years of age. The rape must be reported within a year of its occurrence. India's laws penalize the adults involved in child marriages, but the Hindu Marriage Act punishes only the parties married, including the child. Marriage registration is not compulsory. India's protective laws distinguish between prostitutes and men who use prostitutes, husbands versus wives in fidelity disputes, married versus unmarried or "unchaste" women

  20. Enhancing the supportive care of parents with advanced cancer: development of a self-directed educational manual.

    PubMed

    Turner, Jane; Clavarino, Alexandra; Yates, Patsy; Hargraves, Maryanne; Connors, Veronica; Hausmann, Sue

    2008-08-01

    Diagnosing and treating young patients with cancer can be stressful for health professionals; however, when the prognosis is poor and the patient has dependent children, even experienced clinicians can feel distressed and helpless. Parents with advanced cancer commonly express anxiety about the impact of the disease on their children, yet health professionals often feel unable to respond constructively because of lack of training, or concern that discussion about such difficult issues will compound parental distress. In response to this problem, an educational manual has been devised to assist oncology staff to better understand the emotional impact of parental advanced cancer, encompassing information about specific reactions of children, including strategies to help children and families cope. This paper describes the development and content of the resource which provides clinically relevant information and evidence-based recommendations to guide supportive care. The manual differs from the more traditional didactic resources in that it examines the very personal impact for professionals working with parents with advanced disease, encouraging reflection and engages the reader in clinical exercises which encourage active learning and application of knowledge into authentic clinical contexts. Although the manual is designed primarily for nurses, it is clear that much of the information is relevant for all health professionals involved in the care of parents with advanced cancer. PMID:18375118

  1. 7 CFR 1948.88 - Direct land acquisition by FmHA or its successor agency under Public Law 103-354.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... exceed its fair market value; and suitable alternate sites are not available; (6) The land is not Indian... 7 Agriculture 13 2010-01-01 2009-01-01 true Direct land acquisition by FmHA or its successor... DEVELOPMENT Section 601 Energy Impacted Area Development Assistance Program § 1948.88 Direct land...

  2. Control definition study for advanced vehicles

    NASA Technical Reports Server (NTRS)

    Lapins, M.; Martorella, R. P.; Klein, R. W.; Meyer, R. C.; Sturm, M. J.

    1983-01-01

    The low speed, high angle of attack flight mechanics of an advanced, canard-configured, supersonic tactical aircraft designed with moderate longitudinal relaxed static stability (Static Margin, SM = 16% C sub W at M = 0.4) was investigated. Control laws were developed for the longitudinal axis (""G'' or maneuver and angle of attack command systems) and for the lateral/directional axes. The performance of these control laws was examined in engineering simulation. A canard deflection/rate requirement study was performed as part of the ""G'' command law evaluation at low angles of attack. Simulated coupled maneuvers revealed the need for command limiters in all three aircraft axes to prevent departure from controlled flight. When modified with command/maneuver limiters, the control laws were shown to be adequate to prevent aircraft departure during aggressive air combat maneuvering.

  3. Recent advances and future directions in the management of knee osteoarthritis: Can biological joint reconstruction replace joint arthroplasty and when?

    PubMed Central

    Paschos, Nikolaos K

    2015-01-01

    In this article, a concise description of the recent advances in the field of osteoarthritis management is presented. The main focus is to highlight the most promising techniques that emerge in both biological joint replacement and artificial joint arthroplasty. A critical view of high quality evidence regarding outcome and safety profile of these techniques is presented. The potential role of kinematically aligned total knee replacement, navigation, and robotic-assisted surgery is outlined. A critical description of both primary and stem cell-based therapies, the cell homing theory, the use of biologic factors and recent advancements in tissue engineering and regenerative medicine is provided. Based on the current evidence, some thoughts on a realistic approach towards answering these questions are attempted. PMID:26495242

  4. Pulse advancement and delay in an integrated-optical two-port ring-resonator circuit: direct experimental observations.

    PubMed

    Uranus, H P; Zhuang, L; Roeloffzen, C G H; Hoekstra, H J W M

    2007-09-01

    We report experimental observations of the negative-group-velocity (v(g)) phenomenon in an integrated-optical two-port ring-resonator circuit. We demonstrate that when the v(g) is negative, the (main) peak of output pulse appears earlier than the peak of a reference pulse, while for a positive v(g), the situation is the other way around. We observed that a pulse splitting phenomenon occurs in the neighborhood of the critical-coupling point. This pulse splitting limits the maximum achievable delay and advancement of a single device as well as facilitating a smooth transition from highly advanced to highly delayed pulse, and vice versa, across the critical-coupling point. PMID:17767325

  5. Recent advances and future directions in the management of knee osteoarthritis: Can biological joint reconstruction replace joint arthroplasty and when?

    PubMed

    Paschos, Nikolaos K

    2015-10-18

    In this article, a concise description of the recent advances in the field of osteoarthritis management is presented. The main focus is to highlight the most promising techniques that emerge in both biological joint replacement and artificial joint arthroplasty. A critical view of high quality evidence regarding outcome and safety profile of these techniques is presented. The potential role of kinematically aligned total knee replacement, navigation, and robotic-assisted surgery is outlined. A critical description of both primary and stem cell-based therapies, the cell homing theory, the use of biologic factors and recent advancements in tissue engineering and regenerative medicine is provided. Based on the current evidence, some thoughts on a realistic approach towards answering these questions are attempted. PMID:26495242

  6. School Law.

    ERIC Educational Resources Information Center

    Splitt, David A.

    1985-01-01

    Discusses (1) a Michigan court decision concerning reverse discrimination and voluntary affirmative action policies; (2) the Massachusetts Supreme Court's rejection of the work-to-rule strategy; and (3) an Arkansas law that will allow teachers failing a basic skills and literacy test to be fired only when their state certification expires. (MLF)

  7. School Law.

    ERIC Educational Resources Information Center

    Splitt, David A.

    1982-01-01

    Summarizes three current issues in school law, including school district suits over potentially carcinogenic asbestos insulation, a California judge's finding that captionless educational television discriminates against hearing-impaired students, and the federal government's attempt to keep the Fairfax (Virginia) school system from charging…

  8. School Law.

    ERIC Educational Resources Information Center

    Splitt, David A.

    1986-01-01

    Reviews four recent court decisions affecting school law. A Circuit Court of Appeals ruling upheld Norfolk Schools' decision to abolish busing and reinstate neighborhood schools. The United States Supreme Court dismissed appeals to lower court decisions involving a minimum grade prerequisite, a teacher's privacy rights, and an "adult" movie…

  9. The constructal law and the evolution of design in nature

    NASA Astrophysics Data System (ADS)

    Bejan, Adrian; Lorente, Sylvie

    2011-10-01

    The constructal law accounts for the universal phenomenon of generation and evolution of design (configuration, shape, structure, pattern, rhythm). This phenomenon is observed across the board, in animate, inanimate and human systems. The constructal law states the time direction of the evolutionary design phenomenon. It defines the concept of design evolution in physics. Along with the first and second law, the constructal law elevates thermodynamics to a science of systems with configuration. In this article we review the more recent work of our group, with emphasis on the advances made with the constructal law in the natural sciences. Highlighted are the oneness of animate and inanimate designs, the origin of finite-size organs on animals and vehicles, the flow of stresses as the generator of design in solid structures (skeletons, vegetation), the universality and rigidity of hierarchy in all flow systems, and the global design of human flows. Noteworthy is the tapestry of distributed energy systems, which balances nodes of production with networks of distribution on the landscape, and serves as key to energy sustainability and empowerment. At the global level, the constructal law accounts for the geography and design of human movement, wealth and communications.

  10. Considering economic analyses in the revision of the preventive vaccination law: a new direction for health policy-making in Japan?

    PubMed

    Akazawa, Manabu; Yongue, Julia; Ikeda, Shunya; Satoh, Toshihiko

    2014-10-01

    Evidence of a significant vaccine policy shift can be witnessed not only in the number of new vaccines available in Japan but also in the way that vaccine policy is being formulated. In 2010, policy makers decided for the first time ever to commission economic analyses as a reference in their consideration of subsidy allocation. This research offers a first hand account of the recent changes in vaccine policies by examining the decision-making process from the perspective of the researchers commissioned to perform the economic evaluations. In order to understand the vaccine policy-making process, a review was made of all the documents that were distributed and discussed during the government committee meetings from February 2010 when the revision of the Preventive Vaccination Law was initially proposed to May 2012 when the final recommendations were made. Economic evaluations were conducted for seven vaccines under consideration in the routine immunization program (Haemophilus influenzae type b or Hib, pneumococcal disease for children and adults, human papillomavirus, varicella, mumps, and hepatitis B). All were cost-effective options, except the Hib and hepatitis B vaccines. Nonetheless, all the vaccines were recommended equally for inclusion in the routine immunization program. While it is significant that policy-makers decided to commission economic assessments at all, various issues remain regarding the influence of external pressure, the choice of evaluation methods and the implications of using cost-effectiveness analyses on the future of Japanese health policy-making. PMID:25139708

  11. The Spectrum of Caregiving in Palliative Care for Serious, Advanced, Rare Diseases: Key Issues and Research Directions.

    PubMed

    Adams, Lynn S; Miller, Jeri L; Grady, Patricia A

    2016-07-01

    Rare diseases are often life-limiting conditions, the majority of which require constant caregiving needs. The realization of a spectrum of palliative care throughout the trajectory of rare diseases could ensure individualized and caregiver-focused approaches to the care of patients and families. In June 2015, the National Institute of Nursing Research (NINR), the lead institute at the National Institutes of Health for end-of-life research, in conjunction with the National Center for Advancing Translational Sciences, Office of Rare Diseases Research (ORDR) held an interdisciplinary workshop on the unique challenges of caregiving and palliative care in adult and pediatric rare diseases. The panel identified gaps in current knowledge, and afforded suggestions for research opportunities in palliative care science to improve the care of individuals with serious, advanced, rare diseases and their caregivers. This meeting provided an in-depth opportunity to incorporate new concepts into palliative and end-of-life care for individuals with a range of rare diseases and their caregivers. This report presents a summary of the workshop. PMID:27249541

  12. Property Tax Laws of Texas. A Summary.

    ERIC Educational Resources Information Center

    Howell, Jay D., Jr.

    This booklet is basically a summary of a law book on the same subject by the same author. Although the 25 chapters of the larger work correspond directly to the chapters of the summary, this publication is not a law book in the usual sense. Rather, it is intended primarily to provide a simplified view of the property tax laws of Texas for tax…

  13. Critical roles of microRNAs in the pathogenesis of systemic sclerosis: New advances, challenges and potential directions.

    PubMed

    Miao, Cheng-Gui; Xiong, You-Yi; Yu, Hao; Zhang, Xiao-Lin; Qin, Mei-Song; Song, Tong-Wen; Du, Chuan-Lai

    2015-09-01

    Systemic sclerosis (SSc) is an autoimmune disease characterized by immune disorders, vascular obliteration, excessive extracellular matrix deposition, skin fibrosis, and further pathological change of internal organs. To date, the exact etiology of this complicated disease remains unknown. Over the past few years, the roles of epigenetic modifications caused by environmental factors have been intensively studied in relation to the disease pathogenesis, and important advances have been made. This review focuses on the new advances of microRNAs (miRNAs) in the field of SSc research, including the upstream regulatory factors of miRNAs, the downstream targets, and the feedback mechanisms between miRNAs and their targets. We also discussed the correlation of miRNAs and DNA methylation, the miRNAs and the gene polymorphism. Overall, the findings presented in this review illustrated how miRNAs play important roles in the pathogenesis of SSc. However, several unanswered questions continue to impede our understanding of this complex disease. Future research should focus on the identification of new biomarkers for early diagnosis and prognosis, which will help us improve the clinical treatment of patients with SSc. In addition, we discussed the challenges of miRNA study in SSc in the future. Since the miRNA injection may be a promising therapeutic approach for SSc treatment, one of the challenges in the future is to evaluate the therapeutic effects of miRNA and anti-miRNAs using SSc model animals. In light of the fact that one miRNA can target many mRNAs, and one mRNA is targeted by many miRNAs, the effect of miRNA changes on other gene expression should be investigated to evaluate the treatment safety of miRNA injection in vivo. PMID:26241784

  14. Facing the Millenium: Law Schools, Law Librarians, and Information Technology.

    ERIC Educational Resources Information Center

    Danner, Richard A.

    1996-01-01

    Discussion of the role of advancing technology in legal education looks at the administrative and organizational questions it poses, solutions developed at the Duke University (North Carolina) law school, and new possible roles for library directors in managing and planning the growing integration of information technology into all aspects of…

  15. A Universal Power Law Governing Pedestrian Interactions

    NASA Astrophysics Data System (ADS)

    Karamouzas, Ioannis; Skinner, Brian; Guy, Stephen J.

    2015-03-01

    Human crowds often bear a striking resemblance to interacting particle systems, and this has prompted many researchers to describe pedestrian dynamics in terms of interaction forces and potential energies. The correct quantitative form of this interaction, however, has remained an open question. Here, we introduce a novel statistical-mechanical approach to directly measure the interaction energy between pedestrians. This analysis, when applied to a large collection of human motion data, reveals a simple power law interaction that is based not on the physical separation between pedestrians but on their projected time to a potential future collision, and is therefore fundamentally anticipatory in nature. Remarkably, this simple law is able to describe human interactions across a wide variety of situations, speeds and densities. We further show, through simulations, that the interaction law we identify is sufficient to reproduce many known crowd phenomena. Work at Argonne National Laboratory is supported by the U.S. Department of Energy, under Contract No. DE-AC02-06CH11357. Work at the University of Minnesota is supported by MnDRIVE Initiative on Robotics, Sensors, and Advanced Manufacturing.

  16. Responses to the advanced notice of proposed rulemaking EPA published on June 6, 1996 regarding changes to the EPA allowance auctions and elimination of the direct sale

    SciTech Connect

    Critchfield, L.R.

    1997-12-31

    On June 6, 1996, EPA`s Acid Rain Program published an advance notice of proposed rulemaking (ANPRM) in the Federal Register seeking comment on: (1) whether to change the design of the annual sulfur dioxide (SO{sub 2}) allowance auctions; (2) whether to change the timing of the allowance auctions; (3) whether to change the requirement that the minimum price of offered allowances must be in whole dollars, and (4) whether EPA should propose the ability to submit allowance transfers electronically. EPA also published on that day a proposed and direct final rule on whether to eliminate the direct sale. This paper documents the issues addressed in the ANPRM, the comments EPA received, and EPA`s responses to those comments. EPA received comments from 14 separate commenters.

  17. Rediscovering Kepler's Third Law using NASA data

    NASA Astrophysics Data System (ADS)

    Keith, Jason; Springsteen, Paul

    2009-10-01

    Kepler's three laws of planetary motion were discovered around four hundred years ago using data that was meticulously gathered by Tycho Brahe through naked eye observations. Here we will show that the same Kepler's result illustrated in his third planetary law still holds today, by using modern data from NASA. In addition, we discuss how all three of Kepler's laws of planetary motion can be derived directly from Newton's Gravitational law.

  18. Advances in Methane Isotope Measurements via Direct Absorption Spectroscopy with Applications to Oil and Gas Source Characterization

    NASA Astrophysics Data System (ADS)

    Yacovitch, T. I.; Herndon, S. C.; Roscioli, J. R.; Petron, G.; Shorter, J. H.; Jervis, D.; McManus, J. B.; Nelson, D. D.; Zahniser, M. S.; Kolb, C. E., Jr.

    2015-12-01

    Instrumental developments in the measurement of multiple isotopes of methane (12CH4, 13CH4 and 12CH3D) are presented. A first generation 8-micron instrument quantifies 12CH4 and 13CH4 at a 1-second rate via tunable infrared direct absorption spectroscopy (TILDAS). A second generation instrument uses two 3-micron intraband cascade lasers in an Aerodyne dual laser chassis for simultaneous measurement of 12CH4, 13CH4 and 12CH3D. Sensitivity and noise performance improvements are examined. The isotopic signature of methane provides valuable information for emission source identification of this greenhouse gas. A first generation spectrometer has been deployed in the field on a mobile laboratory along with a sophisticated 4-tank calibration system. Calibrations are done on an agressive schedule, allowing for the correction of measured isotope ratios to an absolute isotope scale. Distinct isotopic signatures are found for a number of emission sources in the Denver-Julesburg Basin: oil and gas gathering stations, compressor stations and processing plants; a municipal landfill, and dairy/cattle operations. The isotopic signatures are compared with measured ethane/methane ratios. These direct absorption measurements have larger uncertainties than samples measured via gas chromatography-mass spectrometry, but have several advantages over canister sampling methods: individual sources of short duration are easier to isolate; calibrated isotope ratio results are available immediately; replicate measurements on a single source are easily performed; and the number of sources sampled is not limited by canister availability and processing time.

  19. Preoperative Direct Puncture Embolization of Advanced Juvenile Nasopharyngeal Angiofibroma in Combination with Transarterial Embolization: An Analysis of 22 Consecutive Patients

    SciTech Connect

    Lv Mingming Fan, Xin-dong; Su Lixin; Chen Dong

    2013-02-15

    ObjectiveThis study was designed to evaluate the clinical application of preoperative auxiliary embolization for juvenile nasopharyngeal angiofibroma (JNA) by direct puncture embolization (DPE) of the tumor in combination with transarterial embolization (TAE). The study included 22 patients. An 18-gauge needle was used to puncture directly into the tumor, and 20-25 % N-butyl cyanoacrylate was injected under the guidance of fluoroscopy after confirming the placement of the needle into the JNA and no leaking into the surrounding tissue. Tumors were obstructed later via TAE. The supplying arteries of JNA were from branches of the internal carotid and external carotid arteries. Control angiography showed the obliteration of contrast stain in the entire tumor mass and the distal supplying arteries disappeared after DPE in combination with TAE. Surgical resection was performed within 4 days after embolization and none of the patients required blood transfusion. The use of DPE in combination with TAE was a safe, feasible, and efficacious method. It can devascularize effectively the JNAs and reduce intraoperative bleeding when JNAs are extirpated.

  20. Community-based treatment of advanced HIV disease: introducing DOT-HAART (directly observed therapy with highly active antiretroviral therapy).

    PubMed Central

    Farmer, P.; Léandre, F.; Mukherjee, J.; Gupta, R.; Tarter, L.; Kim, J. Y.

    2001-01-01

    In 2000, acquired immunodeficiency syndrome (AIDS) overtook tuberculosis (TB) as the world's leading infectious cause of adult deaths. In affluent countries, however, AIDS mortality has dropped sharply, largely because of the use of highly active antiretroviral therapy (HAART). Antiretroviral agents are not yet considered essential medications by international public health experts and are not widely used in the poor countries where human immunodeficiency virus (HIV) takes its greatest toll. Arguments against the use of HAART have mainly been based on the high cost of medications and the lack of the infrastructure necessary for using them wisely. We re- examine these arguments in the setting of rising AIDS mortality in developing countries and falling drug prices, and describe a small community-based treatment programme based on lessons gained in TB control. With the collaboration of Haitian community health workers experienced in the delivery of home-based and directly observed treatment for TB, an AIDS-prevention project was expanded to deliver HAART to a subset of HIV patients deemed most likely to benefit. The inclusion criteria and preliminary results are presented. We conclude that directly observed therapy (DOT) with HAART, "DOT-HAART", can be delivered effectively in poor settings if there is an uninterrupted supply of high-quality drugs. PMID:11799447

  1. Development of advanced direct perception displays for nuclear power plants to enhance monitoring, control and fault management

    SciTech Connect

    Jones, B.G.; Shaheen, S.; Moray, N.

    1997-08-01

    Traditional Single-Sensor-Single Indicator (SSSI) displays are poorly matched to the cognitive abilities of operators, especially for large and complex systems. It is difficult for operators to monitor very large arrays of displays and controls, and to integrate the information displayed therein. In addition, standard operating procedures (SOPs) are bulky (running to many hundreds of pages) and difficult to use, and operators may become lost. For these reasons, and also because it is becoming increasingly difficult to find replacements for aging hardware components, there is a trend towards computerized graphical interfaces for nuclear power plants (NPPs). There is, however, little rational theory for display design in this domain. This report describes some recent theoretical developments and shows how to develop displays which will greatly reduce the cognitive load on the operator and allow the use of perceptual rather than cognitive mechanisms while using SON and to support state diagnosis and fault management. The report outlines the conceptual framework within which such a new approach could be developed, and provides an example of how the operating procedures for the start-up sequence of a NPP could be realized. A detailed description of a set of displays for a graphical interface for the SON of the feedwater system is provided as an example of how the proposed approach could be realized, and a general account of how it would fit into the overall start-up sequence is given. Examples of {open_quotes}direct perception{close_quotes} or {open_quotes}ecological{close_quotes} configural state space displays to support the use of the proposed direct manipulation SOP interface are provided, and also a critical discussion which identifies some difficulties which may be anticipated should the general approach herein advocated be adopted.

  2. Administrative Law: The Hidden Comparative Law Course.

    ERIC Educational Resources Information Center

    Strauss, Peter L.

    1996-01-01

    Argues that the main contribution of the Administrative Law course to law students is that it presents problems which contrast with those of the standard court-centered curriculum and can illuminate other areas of law, repeatedly confronting students with doctrinal differences. Offers several examples from civil procedure, constitutional law, and…

  3. Generalized second law for cosmology

    NASA Astrophysics Data System (ADS)

    Bousso, Raphael; Engelhardt, Netta

    2016-01-01

    We conjecture a novel generalized second law that can be applied in cosmology, regardless of whether an event horizon is present: the generalized entropy increases monotonically outside of certain hypersurfaces we call past Q-screens. A past Q-screen is foliated by surfaces whose generalized entropy (sum of area and entanglement entropy) is stationary along one future null direction and increasing along the other. We prove that our generalized second law holds in spacetimes obeying the quantum focusing conjecture. An analogous law applies to future Q-screens, which appear inside evaporating black holes and in collapsing regions.

  4. Facile synthesis of Pt-Pd@Silicon nanostructure as an advanced electrocatalyst for direct methanol fuel cells

    NASA Astrophysics Data System (ADS)

    Ensafi, Ali A.; Jafari-Asl, M.; Rezaei, B.; Abarghoui, M. Mokhtari; Farrokhpour, H.

    2015-05-01

    In this work, platinum-palladium (Pt-Pd) is assembled in-situ on the surface of porous silicon flour (PSiF) through chemical reduction of PtCl62-/PdCl42- and oxidation of the precursor solution SiF64-. The components and the morphological properties of the Pt-Pd on PSiF is investigated by means of transmission electron microscopy, energy dispersive X-ray spectroscopy, X-ray photoelectron spectroscopy, and X-ray diffraction techniques. In the next stage, screen printed graphene electrode (SPGE) is prepared by electro-reduction of exfoliated graphene oxide at the surface of a screen printed carbon electrode (SPCE), which is subsequently characterized by FT-IR, Raman spectroscopy, FE-SEM, and electrochemical methods. Finally, a combination of Pt-Pd@PSi nanostructure and SPGE is used for the electro-oxidation of methanol in direct methanol fuel cell. The electrochemical results demonstrate that the Pt-Pd@PSiF-SPGE exhibits an excellent electrocatalytic activity for methanol oxidation. In addition, the electron transfer kinetic of methanol oxidation on Pt-Pd@PSiF-SPGE is investigated by electrochemical impedance spectroscopy. The results showed that the surface of Pt-Pd@PSiF-SPGE is not affected (poisoned) by intermediate products such as CO.

  5. Development of two rhenium- containing superalloys for single- crystal blade and directionally solidified vane applications in advanced turbine engines

    NASA Astrophysics Data System (ADS)

    Harris, K.; Erickson, G. L.; Sikkenga, S. L.; Brentnall, W. D.; Aurrecoechea, J. M.; Kubarych, K. G.

    1993-08-01

    A team approach involving several turbine engine companies using the concepts of simultaneous engi-neering has been used to successfully develop CMSX-4 ® alloy for turbine blade applications. CMSX-4 al-loy is a second-generation, single-crystal cast nickel-base superalloy containing 3% Re and approximately 70% volume fraction of γ. The high level of balanced properties determined by labora-tory evaluation has been confirmed during field testing of the Solarγ Mars T-14000 industrial gas turbine with CMSX-4 single-crystal (SX) blades in both the coated and bare condition. A similar collaborative ap-proach has resulted in the successful development of CM 186 LCγ alloy for complex, directionally solidi-fied (DS) columnar grain vane segments. CM 186 LC alloy is a second-generation DS columnar grain cast nickel-base superalloy containing 3% Re and approximately 65% volume fraction of γ. Excellent com-ponent producibility and quality is demonstrated. Turbine engine testing is scheduled to commence by the end of 1993.

  6. Advancing-side directivity and retreating-side interactions of model rotor blade-vortex interaction noise

    NASA Technical Reports Server (NTRS)

    Martin, R. M.; Splettstoesser, W. R.; Elliott, J. W.; Schultz, K.-J.

    1988-01-01

    Acoustic data are presented from a 40 percent scale model of the four-bladed BO-105 helicopter main rotor, tested in a large aerodynamic wind tunnel. Rotor blade-vortex interaction (BVI) noise data in the low-speed flight range were acquired using a traversing in-flow microphone array. Acoustic results presented are used to assess the acoustic far field of BVI noise, to map the directivity and temporal characteristics of BVI impulsive noise, and to show the existence of retreating-side BVI signals. The characterics of the acoustic radiation patterns, which can often be strongly focused, are found to be very dependent on rotor operating condition. The acoustic signals exhibit multiple blade-vortex interactions per blade with broad impulsive content at lower speeds, while at higher speeds, they exhibit fewer interactions per blade, with much sharper, higher amplitude acoustic signals. Moderate-amplitude BVI acoustic signals measured under the aft retreating quadrant of the rotor are shown to originate from the retreating side of the rotor.

  7. A Low NO(x) Lean-Direct Injection, Multipoint Integrated Module Combuster Concept for Advanced Aircraft Gas Turbines

    NASA Technical Reports Server (NTRS)

    Tacina, Robert; Wey, Changlie; Laing, Peter; Mansour, Adel

    2002-01-01

    A low NO(x) emissions combustor has been demonstrated in flame-tube tests. A multipoint, lean-direct injection concept was used. Configurations were tested that had 25- and 36- fuel injectors in the size of a conventional single fuel injector. An integrated-module approach was used for the construction where chemically etched laminates, diffusion bonded together, combine the fuel injectors, air swirlers and fuel manifold into a single element. Test conditions were inlet temperatures up to 810 K, inlet pressures up to 2760 kPa, and flame temperatures up to 2100 K. A correlation was developed relating the NO(x) emissions with the inlet temperature, inlet pressure, fuel-air ratio and pressure drop. Assuming that 10 percent of the combustion air would be used for liner cooling and using a hypothetical engine cycle, the NO(x) emissions using the correlation from flame-tube tests were estimated to be less than 20 percent of the 1996 ICAO standard.

  8. Advances in the simulation and automated measurement of well-sorted granular material: 2. Direct measures of particle properties

    USGS Publications Warehouse

    Buscombe, Daniel D.; Rubin, David M.

    2012-01-01

    1. In this, the second of a pair of papers on the structure of well-sorted natural granular material (sediment), new methods are described for automated measurements from images of sediment, of: 1) particle-size standard deviation (arithmetic sorting) with and without apparent void fraction; and 2) mean particle size in material with void fraction. A variety of simulations of granular material are used for testing purposes, in addition to images of natural sediment. Simulations are also used to establish that the effects on automated particle sizing of grains visible through the interstices of the grains at the very surface of a granular material continue to a depth of approximately 4 grain diameters and that this is independent of mean particle size. Ensemble root-mean squared error between observed and estimated arithmetic sorting coefficients for 262 images of natural silts, sands and gravels (drawn from 8 populations) is 31%, which reduces to 27% if adjusted for bias (slope correction between observed and estimated values). These methods allow non-intrusive and fully automated measurements of surfaces of unconsolidated granular material. With no tunable parameters or empirically derived coefficients, they should be broadly universal in appropriate applications. However, empirical corrections may need to be applied for the most accurate results. Finally, analytical formulas are derived for the one-step pore-particle transition probability matrix, estimated from the image's autocorrelogram, from which void fraction of a section of granular material can be estimated directly. This model gives excellent predictions of bulk void fraction yet imperfect predictions of pore-particle transitions.

  9. Advancing Solar Irradiance Measurement for Climate-Related Studies: Accurate Constraint on Direct Aerosol Radiative Effect (DARE)

    NASA Technical Reports Server (NTRS)

    Tsay, Si-Chee; Ji, Q. Jack

    2011-01-01

    Earth's climate is driven primarily by solar radiation. As summarized in various IPCC reports, the global average of radiative forcing for different agents and mechanisms, such as aerosols or CO2 doubling, is in the range of a few W/sq m. However, when solar irradiance is measured by broadband radiometers, such as the fleet of Eppley Precision Solar Pyranometers (PSP) and equivalent instrumentation employed worldwide, the measurement uncertainty is larger than 2% (e.g., WMO specification of pyranometer, 2008). Thus, out of the approx. 184 W/sq m (approx.263 W/sq m if cloud-free) surface solar insolation (Trenberth et al. 2009), the measurement uncertainty is greater than +/-3.6 W/sq m, overwhelming the climate change signals. To discern these signals, less than a 1 % measurement uncertainty is required and is currently achievable only by means of a newly developed methodology employing a modified PSP-like pyranometer and an updated calibration equation to account for its thermal effects (li and Tsay, 2010). In this talk, we will show that some auxiliary measurements, such as those from a collocated pyrgeometer or air temperature sensors, can help correct historical datasets. Additionally, we will also demonstrate that a pyrheliometer is not free of the thermal effect; therefore, comparing to a high cost yet still not thermal-effect-free "direct + diffuse" approach in measuring surface solar irradiance, our new method is more economical, and more likely to be suitable for correcting a wide variety of historical datasets. Modeling simulations will be presented that a corrected solar irradiance measurement has a significant impact on aerosol forcing, and thus plays an important role in climate studies.

  10. A Control Model: Interpretation of Fitts' Law

    NASA Technical Reports Server (NTRS)

    Connelly, E. M.

    1984-01-01

    The analytical results for several models are given: a first order model where it is assumed that the hand velocity can be directly controlled, and a second order model where it is assumed that the hand acceleration can be directly controlled. Two different types of control-laws are investigated. One is linear function of the hand error and error rate; the other is the time-optimal control law. Results show that the first and second order models with the linear control-law produce a movement time (MT) function with the exact form of the Fitts' Law. The control-law interpretation implies that the effect of target width on MT must be a result of the vertical motion which elevates the hand from the starting point and drops it on the target at the target edge. The time optimal control law did not produce a movement-time formula simular to Fitt's Law.

  11. Advance directives in the perioperative setting: Managing ethical and legal issues when patient rights and perceived obligations of the healthcare provider conflict.

    PubMed

    Williams, Stephen P; Howe, Christopher L

    2013-01-01

    Perhaps individual wishes are not always acknowledged or accepted when it comes to end-of-life care. This possibility, in conjunction with the experiences of healthcare risk managers, should cause concern in the healthcare risk management community. One particularly concerning issue where a persistent failure to honor a patient's wishes exists is with Do Not Resuscitate (DNR) orders in the perioperative arena. Despite a strong focus on informed consent and advance directives, evidence suggests a number of healthcare organizations either have no policy in place regarding DNR orders during the perioperative period, or, for those organizations that do have a policy, many call for automatic suspension of the DNR order without consultation with the patient. This latter practice poses many ethical, medico-legal, and regulatory concerns, and healthcare organizations with such a policy in place should strongly consider revisiting this practice. PMID:23609975

  12. Implementation of an advanced hybrid MPC-PID control system using PAT tools into a direct compaction continuous pharmaceutical tablet manufacturing pilot plant.

    PubMed

    Singh, Ravendra; Sahay, Abhishek; Karry, Krizia M; Muzzio, Fernando; Ierapetritou, Marianthi; Ramachandran, Rohit

    2014-10-01

    It is desirable for a pharmaceutical final dosage form to be manufactured through a quality by design (QbD)-based approach rather than a quality by testing (QbT) approach. An automatic feedback control system coupled with PAT tools that is part of the QbD paradigm shift, has the potential to ensure that the pre-defined end product quality attributes are met in a time and cost efficient manner. In this work, an advanced hybrid MPC-PID control architecture coupled with real time inline/online monitoring tools and principal components analysis (PCA) based additional supervisory control layer has been proposed for a continuous direct compaction tablet manufacturing process. The advantages of both MPC and PID have been utilized in a hybrid scheme. The control hardware and software integration and implementation of the control system has been demonstrated using feeders and blending unit operation of a continuous tablet manufacturing pilot plant and an NIR based PAT tool. The advanced hybrid MPC-PID control scheme leads to enhanced control loop performance of the critical quality attributes in comparison to a regulatory (e.g. PID) control scheme indicating its potential to improve pharmaceutical product quality. PMID:24974987

  13. Fourier's law: insight from a simple derivation.

    PubMed

    Dubi, Y; Di Ventra, M

    2009-04-01

    The onset of Fourier's law in a one-dimensional quantum system is addressed via a simple model of weakly coupled quantum systems in contact with thermal baths at their edges. Using analytical arguments we show that the crossover from the ballistic (invalid Fourier's law) to diffusive (valid Fourier's law) regimes is characterized by a thermal length scale, which is directly related to the profile of the local temperature. In the same vein, dephasing is shown to give rise to classical Fourier's law, similarly to the onset of Ohm's law in mesoscopic conductors. PMID:19518279

  14. An overview on the advanced oxidation processes applied for the treatment of water pollutants defined in the recently launched Directive 2013/39/EU.

    PubMed

    Ribeiro, Ana R; Nunes, Olga C; Pereira, Manuel F R; Silva, Adrián M T

    2015-02-01

    Environmental pollution is a recognized issue of major concern since a wide range of contaminants has been found in aquatic environment at ngL(-1) to μgL(-1) levels. In the year 2000, a strategy was defined to identify the priority substances concerning aquatic ecosystems, followed by the definition of environmental quality standards (EQS) in 2008. Recently it was launched the Directive 2013/39/EU that updates the water framework policy highlighting the need to develop new water treatment technologies to deal with such problem. This review summarizes the data published in the last decade regarding the application of advanced oxidation processes (AOPs) to treat priority compounds and certain other pollutants defined in this Directive, excluding the inorganic species (cadmium, lead, mercury, nickel and their derivatives). The Directive 2013/39/EU includes several pesticides (aldrin, dichlorodiphenyltrichloroethane, dicofol, dieldrin, endrin, endosulfan, isodrin, heptachlor, lindane, pentachlorophenol, chlorpyrifos, chlorfenvinphos, dichlorvos, atrazine, simazine, terbutryn, diuron, isoproturon, trifluralin, cypermethrin, alachlor), solvents (dichloromethane, dichloroethane, trichloromethane and carbon tetrachloride), perfluorooctane sulfonic acid and its derivatives (PFOS), polychlorinated biphenyls (PCBs), polycyclic aromatic hydrocarbons (PAHs), nonylphenol and octylphenol, as well as the three compounds included in the recommendation for the first watch list of substances (diclofenac, 17-alpha-ethinylestradiol (EE2) and 17-beta-estradiol (E2)). Some particular pesticides (aclonifen, bifenox, cybutryne, quinoxyfen), organotin compounds (tributyltin), dioxins and dioxin-like compounds, brominated diphenylethers, hexabromocyclododecanes and di(2-ethylhexyl)phthalate are also defined in this Directive, but studies dealing with AOPs are missing. AOPs are recognized tools to destroy recalcitrant compounds or, at least, to transform them into biodegradable species

  15. 33 CFR 88.11 - Law enforcement vessels.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false Law enforcement vessels. 88.11... NAVIGATION RULES ANNEX V: PILOT RULES § 88.11 Law enforcement vessels. (a) Law enforcement vessels may display a flashing blue light when engaged in direct law enforcement or public safety activities....

  16. Demonstrating the Gas Laws.

    ERIC Educational Resources Information Center

    Holko, David A.

    1982-01-01

    Presents a complete computer program demonstrating the relationship between volume/pressure for Boyle's Law, volume/temperature for Charles' Law, and volume/moles of gas for Avagadro's Law. The programing reinforces students' application of gas laws and equates a simulated moving piston to theoretical values derived using the ideal gas law.…

  17. Environmental law institute

    SciTech Connect

    Futrell, J.W.

    1993-10-01

    Congress and the Clinton Administration must consider reauthorizing some of the country's most important environmental statutes during a time of increasing environmental concern and decreasing financial resources. The debate over the U.S. environmental direction is fierce; yet if history is any guide, the result of the commotion will be better policy. The constant tugging and pulling may slog the law-making process, but resulting policy is often much better because of it. Fundamental policy issues continue to be as pertinent today as they were in the 1970s.

  18. Using SpaceClaim/TD Direct for Modeling Components with Complex Geometries for the Thermal Desktop-Based Advanced Stirling Radioisotope Generator Model

    NASA Technical Reports Server (NTRS)

    Fabanich, William

    2014-01-01

    SpaceClaim/TD Direct has been used extensively in the development of the Advanced Stirling Radioisotope Generator (ASRG) thermal model. This paper outlines the workflow for that aspect of the task and includes proposed best practices and lessons learned. The ASRG thermal model was developed to predict component temperatures and power output and to provide insight into the prime contractors thermal modeling efforts. The insulation blocks, heat collectors, and cold side adapter flanges (CSAFs) were modeled with this approach. The model was constructed using mostly TD finite difference (FD) surfaces solids. However, some complex geometry could not be reproduced with TD primitives while maintaining the desired degree of geometric fidelity. Using SpaceClaim permitted the import of original CAD files and enabled the defeaturing repair of those geometries. TD Direct (a SpaceClaim add-on from CRTech) adds features that allowed the mark-up of that geometry. These so-called mark-ups control how finite element (FE) meshes were generated and allowed the tagging of features (e.g. edges, solids, surfaces). These tags represent parameters that include: submodels, material properties, material orienters, optical properties, and radiation analysis groups. TD aliases were used for most tags to allow analysis to be performed with a variety of parameter values. Domain-tags were also attached to individual and groups of surfaces and solids to allow them to be used later within TD to populate objects like, for example, heaters and contactors. These tools allow the user to make changes to the geometry in SpaceClaim and then easily synchronize the mesh in TD without having to redefine these objects each time as one would if using TD Mesher.The use of SpaceClaim/TD Direct has helped simplify the process for importing existing geometries and in the creation of high fidelity FE meshes to represent complex parts. It has also saved time and effort in the subsequent analysis.

  19. Using SpaceClaimTD Direct for Modeling Components with Complex Geometries for the Thermal Desktop-Based Advanced Stirling Radioisotope Generator Model

    NASA Technical Reports Server (NTRS)

    Fabanich, William A., Jr.

    2014-01-01

    SpaceClaim/TD Direct has been used extensively in the development of the Advanced Stirling Radioisotope Generator (ASRG) thermal model. This paper outlines the workflow for that aspect of the task and includes proposed best practices and lessons learned. The ASRG thermal model was developed to predict component temperatures and power output and to provide insight into the prime contractor's thermal modeling efforts. The insulation blocks, heat collectors, and cold side adapter flanges (CSAFs) were modeled with this approach. The model was constructed using mostly TD finite difference (FD) surfaces/solids. However, some complex geometry could not be reproduced with TD primitives while maintaining the desired degree of geometric fidelity. Using SpaceClaim permitted the import of original CAD files and enabled the defeaturing/repair of those geometries. TD Direct (a SpaceClaim add-on from CRTech) adds features that allowed the "mark-up" of that geometry. These so-called "mark-ups" control how finite element (FE) meshes are to be generated through the "tagging" of features (e.g. edges, solids, surfaces). These tags represent parameters that include: submodels, material properties, material orienters, optical properties, and radiation analysis groups. TD aliases were used for most tags to allow analysis to be performed with a variety of parameter values. "Domain-tags" were also attached to individual and groups of surfaces and solids to allow them to be used later within TD to populate objects like, for example, heaters and contactors. These tools allow the user to make changes to the geometry in SpaceClaim and then easily synchronize the mesh in TD without having to redefine the objects each time as one would if using TDMesher. The use of SpaceClaim/TD Direct helps simplify the process for importing existing geometries and in the creation of high fidelity FE meshes to represent complex parts. It also saves time and effort in the subsequent analysis.

  20. Eldercare at Home: Advanced Directives

    MedlinePlus

    ... with Alzheimer's disease, after surgery, and during a terminal illness, coma, or stroke. When this happens, you ... want done medically in the case of a terminal illness or in the event of a coma ...

  1. Teaching Global Law.

    ERIC Educational Resources Information Center

    Wojtan, Linda S.

    1980-01-01

    Addresses problem of American students' limited knowledge of international issues and laws. Provides articles for secondary school students on law around the world, South Africa, Russia, folk law, and alternatives to the adversary system and suggests relevant resources. (KC)

  2. PSYCHIATRY AND THE LAW

    PubMed Central

    Zeifert, Mark

    1957-01-01

    In Rex vs. Arnold (1724) it was held that to avail himself of the defense of insanity “a man must be totally deprived of his understanding and memory, so as not to know what he is doing, no more than an infant, a brute, or a wild beast.” Although there has been some modification of this formula in most jurisdictions, the courts still operate under the McNaghten Rule (1843) which is no more logical and actually is more difficult to apply. That such a situation exists in 1956 is a reflection on the indifference of society—and particularly the courts which it elects—as well as on the failure of modern psychiatry to communicate its viewpoint to society. If we are to correct the sad formulae of the “right and wrong” and “policeman at the elbow” tests, we must have more study and better methods of communication in this area. A similar state of confusion exists in the methods of commitment of mentally ill people to psychiatric hospitals. The methods prescribed by law are archaic and cruel—and again reflect the failure of modern psychiatry to communicate its understanding to the legislatures and courts. There are many other areas of conflict between law (which looks to the past for its insights) and psychiatry (which seeks for its concepts in the current scientific advances). PMID:13383383

  3. On the generalized Wertheim law in integrated photoelasticity.

    PubMed

    Ainola, Leo; Aben, Hillar

    2008-08-01

    Two-dimensional photoelasticity is based on the classical Wertheim law. The integral Wertheim law can be used in integrated photoelasticity only in the case when the directions of the secondary principal stresses are constant on the light beam. We generalize the integral Wertheim law for the case when a slight rotation of the secondary principal directions takes place. PMID:18677345

  4. Faraday's Law and Seawater Motion

    ERIC Educational Resources Information Center

    De Luca, R.

    2010-01-01

    Using Faraday's law, one can illustrate how an electromotive force generator, directly utilizing seawater motion, works. The conceptual device proposed is rather simple in its components and can be built in any high school or college laboratory. The description of the way in which the device generates an electromotive force can be instructive not…

  5. Scaling Laws for Mesoscale and Microscale Systems

    SciTech Connect

    Spletzer, Barry

    1999-08-23

    The set of laws developed and presented here is by no means exhaustive. Techniques have been present to aid in the development of additional scaling laws and to combine these and other laws to produce additional useful relationships. Some of the relationships produced here have yielded perhaps surprising results. Examples include the fifth order scaling law for electromagnetic motor torque and the zero order scaling law for capacitive motor power. These laws demonstrate important facts about actuators in small-scale systems. The primary intent of this introduction into scaling law analysis is to provide needed tools to examine possible areas of the research in small-scale systems and direct research toward more fruitful areas. Numerous examples have been included to show the validity of developing scaling laws based on first principles and how real world systems tend to obey these laws even when many other variables may potentially come into play. Development of further laws may well serve to provide important high-level direction to the continued development of small-scale systems.

  6. Teaching Environmental Law: Some Observations on Curriculum and Materials.

    ERIC Educational Resources Information Center

    Mintz, Joel A.

    1983-01-01

    The response of American law schools to the rapid development of environmental law is examined, and a curricular framework is proposed, covering the basic course content and the organization of available texts. Some possible future directions are suggested. (MSE)

  7. Learning Experiences for elementary Law-Related Education.

    ERIC Educational Resources Information Center

    Dulaney, Beverly; And Others

    1980-01-01

    Outlines learning activities related to law-related education at the elementary school level. Activities include creating a classroom constitution, a law-related scavenger hunt, and case studies. Learning outcomes and curriculum correlation are included in directions. (KC)

  8. 33 CFR 88.11 - Law enforcement vessels.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... display a flashing blue light when engaged in direct law enforcement or public safety activities. This... lights. (b) The blue light described in this section may be displayed by law enforcement vessels of...

  9. The cultural context of patient’s autonomy and doctor’s duty: passive euthanasia and advance directives in Germany and Israel

    PubMed Central

    Raz, Aviad; Shalev, Carmel

    2010-01-01

    The moral discourse surrounding end-of-life (EoL) decisions is highly complex, and a comparison of Germany and Israel can highlight the impact of cultural factors. The comparison shows interesting differences in how patient’s autonomy and doctor’s duties are morally and legally related to each other with respect to the withholding and withdrawing of medical treatment in EoL situations. Taking the statements of two national expert ethics committees on EoL in Israel and Germany (and their legal outcome) as an example of this discourse, we describe the similarity of their recommendations and then focus on the differences, including the balancing of ethical principles, what is identified as a problem, what social role professionals play, and the influence of history and religion. The comparison seems to show that Israel is more restrictive in relation to Germany, in contrast with previous bioethical studies in the context of the moral and legal discourse regarding the beginning of life, in which Germany was characterized as far more restrictive. We reflect on the ambivalence of the cultural reasons for this difference and its expression in various dissenting views on passive euthanasia and advance directives, and conclude with a comment on the difficulty in classifying either stance as more or less restrictive. PMID:20680469

  10. Advanced byproduct recovery: Direct catalytic reduction of SO{sub 2} to elemental sulfur. First quarterly technical progress report, [October--December 1995

    SciTech Connect

    Benedek, K.; Flytzani-Stephanopoulos, M.

    1996-02-01

    The team of Arthur D. Little, Tufts University and Engelhard Corporation will be conducting Phase I of a four and a half year, two-phase effort to develop and scale-up an advanced byproduct recovery technology that is a direct, single-stage, catalytic process for converting sulfur dioxide to elemental sulfur. this catalytic process reduces SO{sub 2} over a fluorite-type oxide (such as ceria or zirconia). The catalytic activity can be significantly promoted by active transition metals, such as copper. More than 95% elemental sulfur yield, corresponding to almost complete sulfur dioxide conversion, was obtained over a Cu-Ce-O oxide catalyst as part of an ongoing DOE-sponsored University Coal Research Program. This type of mixed metal oxide catalyst has stable activity, high selectivity for sulfur production, and is resistant to water and carbon dioxide poisoning. Tests with CO and CH{sub 4} reducing gases indicates that the catalyst has the potential for flexibility with regard to the composition of the reducing gas, making it attractive for utility use. the performance of the catalyst is consistently good over a range of SO{sub 2} inlet concentration (0.1 to 10%) indicating its flexibility in treating SO{sub 2} tail gases as well as high concentration streams.

  11. Innovations in Law.

    ERIC Educational Resources Information Center

    Martz, Carlton

    2000-01-01

    This issue of "Bill of Rights in Action" looks at historical and recent innovations in law. The first article examines the code of laws developed by the ancient Hebrews which influenced Roman law, English law, and the U.S. Declaration of Independence and Constitution. The second article explores Thomas Jefferson's writing of the Declaration of…

  12. Students and the Law.

    ERIC Educational Resources Information Center

    South Carolina State Dept. of Education, Columbia. Office of Vocational Education.

    Designed as a practical approach to the study of law, this publication offers seven lesson plans focusing on legal topics that have potential significance to high school students preparing to enter the world of work. Lesson plans address the following topics: minors and the law, automobile insurance, employment law, sports and the law, computer…

  13. Law As a Career.

    ERIC Educational Resources Information Center

    American Bar Association, Chicago, IL. Public Education Div.

    Intended as a guide for people considering a career in law, this booklet addresses the following questions: (1) "What is the lawyer's role in society?" (2) "Should you be a lawyer?" (3) "What about jobs?" (4) "How much do lawyers make?" (5) "How do you choose a law school?" (6) "How to get into law school?" (7) "What is law school like?" (8) "How…

  14. Teaching Human Rights Law.

    ERIC Educational Resources Information Center

    Berman, Howard R.

    1985-01-01

    The international community has developed a system of human rights law relevant to many areas of legal encounter, which American law schools have been slow to incorporate into curricula. Teaching human rights law provides an opportunity for law schools to enrich the learning process and contribute creatively to the respect for rights in society.…

  15. [Teaching about Family Law].

    ERIC Educational Resources Information Center

    Ryan, John Paul, Ed.

    1992-01-01

    This issue of "Focus on Law Studies""contains a special emphasis on teaching about law and the family", in the form of the following three articles: "Teaching Family Law: Growing Pains and All" (Susan Frelich Appleton); "The Family Goes to Court: Including Law in a Sociological Perspective on the Family" (Mary Ann Lamanna); and Michael Grossberg's…

  16. Investigating Coulomb's Law.

    ERIC Educational Resources Information Center

    Noll, Ellis; Koehlinger, Mervin; Kowalski, Ludwik; Swackhamer, Gregg

    1998-01-01

    Describes the use of a computer-linked camera to demonstrate Coulomb's law. Suggests a way of reducing the difficulties in presenting Coulomb's law by teaching the inverse square law of gravity and the inverse square law of electricity in the same unit. (AIM)

  17. [Review of the development in European Legislation on the harmonisation of the laws for medicinal products].

    PubMed

    Lehmann, Birka

    2008-07-01

    The harmonisation of the legislation for medicinal products is an on-going process even after 40 years of development. The first step for harmonising the requirements for the marketing authorisation and monitoring took place with the introduction of the first pharmaceutical directive in 1965. Further components of European legislation such as directives, which have to be transposed into national law by the Member States, and regulations, which take effect immediately, have been adopted since then. The latest fundamental progress made in the process of harmonising the European market for medicinal products was the adoption of Directive 2004/27/EG in the framework of the Pharma-Review 2002. In addition to the existing centralised procedure and mutual recognition procedure a decentralised procedure and the enlargement of the area of authority of the European Medicines Agency were introduced. Lately new laws for medicinal products for children and advanced therapies were introduced through a regulation. PMID:18584107

  18. The neuroeconomic path of the law.

    PubMed Central

    Hoffman, Morris B

    2004-01-01

    Advances in evolutionary biology, experimental economics and neuroscience are shedding new light on age-old questions about right and wrong, justice, freedom, the rule of law and the relationship between the individual and the state. Evidence is beginning to accumulate suggesting that humans evolved certain fundamental behavioural predispositions grounded in our intense social natures, that those predispositions are encoded in our brains as a distribution of probable behaviours, and therefore that there may be a core of universal human law. PMID:15590608

  19. Living Wills in Italy: Ethical and Comparative Law Approaches.

    PubMed

    Veshi, Denard; Neitzke, Gerald

    2015-03-01

    In this article, advance directives will be analysed through ethical and comparative law approaches. Their importance, the two different types of advance directives and the so-called three steps hierarchy, will be discussed. Living wills will be treated in detail, considering the criticism they have attracted, as well as their known benefits. A thorough examination of the latest version of Arts. 3 and 4 of Italian Bill No. 2350, as approved by the Italian Senate in March 2009 and then amended by the Chamber of Deputies in July 2011, is included. This bill grants advance directives advisory force, limits their application in time and does not allow the validity of oral declarations. This political decision limits autonomy. Furthermore, there are doubts about the constitutionality of this bill, especially with respect to Arts. 2, 13 and 32 of the Italian Constitution, related to the right of self-determination. Further, this article will include a comparative approach of the legal aspects, with particular attention to the French and German models. To conclude, some ethical principles that the Italian legislator must take into consideration are indicated. In addition, some possible modifications of this Bill are suggested based on the experience of other European legislation. PMID:26387259

  20. Law and the Courts: A Handbook about United States Law and Court Procedures, with a Glossary of Legal Terms. You and the Law Series.

    ERIC Educational Resources Information Center

    American Bar Association, Chicago, IL. Public Education Div.

    For most people, law and the courts are veiled in mystery. Even though the law is made by legislators elected by the public and interpreted by judges chosen directly or indirectly by the public, and even though great strides have been made in making the law and its special language more understandable to people, the general public is still often…

  1. Review of Planning for uncertainty: living wills and other advance directives for you and your family, 2nd edition by David John Doukas, M.D., and William Reichel, M.D

    PubMed Central

    Bernal, Ellen W

    2008-01-01

    Advance directives are useful ways to express one's wishes about end of life care, but even now most people have not completed one of the documents. David Doukas and William Reichel strongly encourage planning for end of life care. Although Planning for Uncertainty is at times fairly abstract for the general reader, it does provide useful background and practical steps.

  2. NASA and the practice of space law

    NASA Technical Reports Server (NTRS)

    Hosenball, S. N.

    1985-01-01

    The paper discusses the need for increased awareness in space law due to advances in space technology and a trend toward commercialization of space. A list of national and international treaties, conventions, agreements, laws, and regulations relevant to space activities is presented. NASA lawyers specialize in international and municipal laws that affect the NASA space mission; an example of the lawyers working with insurance companies in negotiating the first Space Shuttle liability policy is provided. The increased participation of the public sector in space activities, for example, the commercialization of the Space Shuttle transportation system, is examined.

  3. [Does population ecology have general laws?].

    PubMed

    Turchin, P V

    2002-01-01

    There is a widespread opinion among ecologists that ecology lacks general laws. In this paper the author argues that this opinion is mistaken. Taking the case of population dynamics, the author points out that there are several very general law-like propositions that provide the theoretical basis for most population dynamics models that were developed to address specific issues. Some of these foundational principles, like the law of exponential growth, are logically very similar to certain law of physics (Newton's law of intertia, for example, is almost a direct analogue of exponential growth). The author discusses two other principles (population self-limitation and resource-consumer oscillations), as well as the more elementary postulates that underlie them. None of the "laws" that the author proposes for population ecology are new. Collectively ecologists have been using these general principles in guiding development of their models and experiments since the days of Lotka, Volterra, and Gause. PMID:11881213

  4. Rephrasing Faraday's Law

    NASA Astrophysics Data System (ADS)

    Hill, S. Eric

    2010-09-01

    As physics educators, we must often find the balance between simplicity and accuracy. Particularly in introductory courses, it can be a struggle to give students the level of understanding for which they're ready without misrepresenting reality. Of course, it's in these introductory courses that our students begin to construct the conceptual framework that they'll flesh out over a physics curriculum. So a misrepresentation at this early stage will seed difficulties and stubborn misconceptions that can persist or even strengthen through subsequent courses, especially since many upper-level texts focus more on techniques and would not directly challenge mistaken concepts. In the worst cases, our students retain misunderstandings past graduation, and even pass them on to their own students. One important case is the common representation of Faraday's law as showing that a time-varying magnetic field causes a circulating electric field.

  5. Civil Law Glossary.

    ERIC Educational Resources Information Center

    Update on Law-Related Education, 1997

    1997-01-01

    Presents a glossary of civil law terms originally compiled for journalists by the American Bar Association. Defines many essential civil law concepts and practices including compensatory damages, jurisdiction, motion to dismiss, discovery, and remedy. (MJP)

  6. Constructing cities, deconstructing scaling laws

    PubMed Central

    Arcaute, Elsa; Hatna, Erez; Ferguson, Peter; Youn, Hyejin; Johansson, Anders; Batty, Michael

    2015-01-01

    Cities can be characterized and modelled through different urban measures. Consistency within these observables is crucial in order to advance towards a science of cities. Bettencourt et al. have proposed that many of these urban measures can be predicted through universal scaling laws. We develop a framework to consistently define cities, using commuting to work and population density thresholds, and construct thousands of realizations of systems of cities with different boundaries for England and Wales. These serve as a laboratory for the scaling analysis of a large set of urban indicators. The analysis shows that population size alone does not provide us enough information to describe or predict the state of a city as previously proposed, indicating that the expected scaling laws are not corroborated. We found that most urban indicators scale linearly with city size, regardless of the definition of the urban boundaries. However, when nonlinear correlations are present, the exponent fluctuates considerably. PMID:25411405

  7. Health care law versus constitutional law.

    PubMed

    Hall, Mark A

    2013-04-01

    National Federation of Independent Business v. Sebelius, the Supreme Court's ruling on the Patient Protection and Affordable Care Act, is a landmark decision - both for constitutional law and for health care law and policy. Others will study its implications for constitutional limits on a range of federal powers beyond health care. This article considers to what extent the decision is also about health care law, properly conceived. Under one view, health care law is the subdiscipline that inquires how courts and government actors take account of the special features of medicine that make legal or policy issues especially problematic - rather than regarding health care delivery and finance more generically, like most any other economic or social enterprise. Viewed this way, the opinions from the Court's conservative justices are mainly about general constitutional law principles. In contrast, Justice Ruth Bader Ginsburg's dissenting opinion for the four more liberal justices is just as much about health care law as it is about constitutional law. Her opinion gives detailed attention to the unique features of health care finance and delivery in order to inform her analysis of constitutional precedents and principles. Thus, the Court's multiple opinions give a vivid depiction of the compelling contrasts between communal versus individualistic conceptions of caring for those in need, and between health care and health insurance as ordinary commodities versus ones that merit special economic, social, and legal status. PMID:23262771

  8. School of Law

    ERIC Educational Resources Information Center

    Olsen, Ken

    2005-01-01

    This article explains how Street Law helps teachers to defuse tensions between students and police through a combination of education, empathy, and expertise. Street Law was born at Georgetown in 1972. Every year, it sends two dozen law students like Courtney Donovan into Washington, D.C., high schools to help teach the year long course. Street…

  9. Education on Environmental Law.

    ERIC Educational Resources Information Center

    Cano, Guillermo J.

    1981-01-01

    Argues that environmental law, as part of legal science, should be taught at universities; discusses the development of environmental law and its relationship to other sciences; and proposes a framework for studying environmental law as a university course for study. (DC)

  10. Henry's Law: A Retrospective

    ERIC Educational Resources Information Center

    Rosenberg, Robert M.; Peticolas, Warner L.

    2004-01-01

    A retrospective view of Henry's law and its applicability in any specific system at a finite concentration is tested. It can be concluded that Henry's law is only a limiting law and is adequate at low mole fractions but is useful for practical purposes where high precision is not required.

  11. Law of Empires.

    ERIC Educational Resources Information Center

    Martz, Carlton

    2001-01-01

    This issue of "Bill of Rights in Action" explores issues raised by empires and imperial law. The first article, "Clash of Empires: The Fight for North America," looks at the clash of empires and the fight for North America during the 18th century. The second article, "When Roman Law Ruled the Western World," examines Roman Law, which helped hold…

  12. The Constitutional Law Sessions

    ERIC Educational Resources Information Center

    White, Daniel O.

    1972-01-01

    Teachers, attorneys, and law educators met to evaluate 1971 workshops in law education and to plan improved learning experiences at future workshops. Coordination between substantive law sessions and teaching methodology sessions was cited as a major necessity. Teachers were encouraged to develop their own material. (JB)

  13. The Copyright Law: Implications for the Principal. A Legal Memorandum.

    ERIC Educational Resources Information Center

    National Association of Secondary School Principals, Reston, VA.

    School principals are informed of their responsibilities concerning the Copyright Law of 1976 in this brief leaflet. The leaflet begins with a short explanation of the law and of the guidelines developed after the law was enacted. The guidelines have direct implications for the classroom teacher. An outline of the more important concerns, with…

  14. Educational Reform in Brazil. The Law of 1961.

    ERIC Educational Resources Information Center

    Harrell, William A.

    On December 21, 1961 the Brazilian Congress passed the Law of Directives and Bases of National Education, implementing the educational provisions of the Constitution of 1946. This Law of 1961 was Brazil's first general education law and was widely publicized as decentralizing the administration of and the responsibility for Brazilian education,…

  15. International law and law enforcement firearms.

    PubMed

    Jussila, Jorma; Normia, Pertti

    2004-01-01

    Several international agreements set constraints on the legitimate use of firearms as representing lethal force. Their meaning in terms of weapons technology must take into account their operational frame of reference, and legitimate warfare can be regarded as a law enforcement operation with similar principles on the use of force. Changes in weapons technology, such as new types of ammunition, transforming firearms into weapons with less-lethal and even humanitarian options, require new interpretations of the legislation. A division into lethal and non-lethal weapons is an oversimplification and the separation of international humanitarian law into military and law enforcement provisions can be questioned from the technical aspect. The type of technology acceptable for law enforcement use of firearms should be defined. An assessment for weapon injury should not be based on lethality, but rather on the potential for tissue damage and its reversibility. PMID:15015547

  16. On the application of subcell resolution to conservation laws with stiff source terms

    NASA Technical Reports Server (NTRS)

    Chang, Shih-Hung

    1989-01-01

    LeVeque and Yee recently investigated a one-dimensional scalar conservation law with stiff source terms modeling the reacting flow problems and discovered that for the very stiff case most of the current finite difference methods developed for non-reacting flows would produce wrong solutions when there is a propagating discontinuity. A numerical scheme, essentially nonoscillatory/subcell resolution - characteristic direction (ENO/SRCD), is proposed for solving conservation laws with stiff source terms. This scheme is a modification of Harten's ENO scheme with subcell resolution, ENO/SR. The locations of the discontinuities and the characteristic directions are essential in the design. Strang's time-splitting method is used and time evolutions are done by advancing along the characteristics. Numerical experiment using this scheme shows excellent results on the model problem of LeVeque and Yee. Comparisons of the results of ENO, ENO/SR, and ENO/SRCD are also presented.

  17. Reproductive technology and the law in Canada.

    PubMed

    Knoppers, B

    1986-06-01

    Even leaving aside the question of the impact of reproductive technology on property law, successions, commercial law and the legal qualification to be given to some of the relationships it entails (e.g. 'deposit' of genetic material, 'lease and hire' of wombs, 'gifts' of embryos), there is no doubt that, like the discovery of the atom, no other scientific advance portends such an enormous potential for human benefits or harm. No other scientific advance will so affect the personal, intimate life of the individual person in its public or private aspects. Beginning then with the positive law (Part I), we will attempt to trace, albeit summarily, possible legal approaches to reproductive technology in Canada and to conclude with an overview of proposed reforms (Part II). PMID:3558768

  18. The law's interface with expanding technology

    NASA Technical Reports Server (NTRS)

    Green, H. P.

    1972-01-01

    The role of the law in technology assessment is described in generalized terms of a legal system as it confronts expanding technology. The functions of a technology assessment are considered to be twofold; provide for legislative action designed to channel technological advance along lines which are regarded as optimal from the standpoint of society's interests; and encourage and promote legislative action which will deal decisively with the potential disruptions and injuries caused by technology at a much earlier stage of the growth of the technology than is feasible under the present legal system. It is concluded that since new law always has a disruptive effect on expectations and commitments arrived at under old law, it is generally desirable that new legislation should make the least possible change in the law consistant with accomplishing the desired objective.

  19. 150 Years of the Mass Action Law

    PubMed Central

    Voit, Eberhard O.; Martens, Harald A.; Omholt, Stig W.

    2015-01-01

    This year we celebrate the 150th anniversary of the law of mass action. This law is often assumed to have been “there” forever, but it has its own history, background, and a definite starting point. The law has had an impact on chemistry, biochemistry, biomathematics, and systems biology that is difficult to overestimate. It is easily recognized that it is the direct basis for computational enzyme kinetics, ecological systems models, and models for the spread of diseases. The article reviews the explicit and implicit role of the law of mass action in systems biology and reveals how the original, more general formulation of the law emerged one hundred years later ab initio as a very general, canonical representation of biological processes. PMID:25569257

  20. Computational mechanics - Advances and trends; Proceedings of the Session - Future directions of Computational Mechanics of the ASME Winter Annual Meeting, Anaheim, CA, Dec. 7-12, 1986

    NASA Technical Reports Server (NTRS)

    Noor, Ahmed K. (Editor)

    1986-01-01

    The papers contained in this volume provide an overview of the advances made in a number of aspects of computational mechanics, identify some of the anticipated industry needs in this area, discuss the opportunities provided by new hardware and parallel algorithms, and outline some of the current government programs in computational mechanics. Papers are included on advances and trends in parallel algorithms, supercomputers for engineering analysis, material modeling in nonlinear finite-element analysis, the Navier-Stokes computer, and future finite-element software systems.

  1. Advances in Quantitative Analyses and Reference Materials Related to Laser Ablation ICP-MS: A Look at Methods and New Directions

    NASA Astrophysics Data System (ADS)

    Koenig, A. E.; Ridley, W. I.

    2009-12-01

    The role of laser ablation ICP-MS (LA-ICP-MS) continues to expand both in geological sciences and other fields. As the technique continues to gain popularity, so too does the need for good reference materials and methods development and validation. Matrix matched reference materials (RMs) are required for calibration and quality control of LA-ICP-MS analyses. New advances in technology such as <200nm lasers and femtosecond lasers have reduced the dependence on matrix matching to some degree, but general matrix matching is still preferred. Much work has revolved around the available RMs such as the NIST 61x silicate glasses and several series of basaltic composition glasses such as the USGS natural basaltic glasses BCR-2g and synthetic basaltic glasses, the GS series (e.g. GSD-1g). While many quantitative hurdles have been recognized by analogous techniques such as EPMA and SIMS, some of these hurdles have not been fully addressed or validated for some cases of LA-ICP-MS. Trace element mapping by LA-ICP-MS is rapidly becoming more widespread for samples. Here relative differences in raw signal can be easily and rapidly obtained. However as too often is the case the magnitude of the relative differences in raw intensity are a function of different ablation yields, sample density or other factors. Methods of quantification for trace element mapping will be presented. The USGS has been developing microanalytical RMs intended for LA-ICP-MS for several years. The widely popular basaltic rock powders BCR-2, BIR-1 and BHVO-2 have all been successfully converted to homogeneous glasses suitable for LA-ICP-MS and have been in use by many workers. The newer synthetic basaltic glass GS series consists of 4 glasses of basaltic composition artificially doped at nominal concentrations of almost of trace elements at 400, 40, 4 and < 1 ppm. Additional developments in non-silcate or basaltic materials include the previously released MASS-1 Cu, Fe, Zn sulfide calibration RM (Wilson et

  2. A generalization of Snell's law

    NASA Astrophysics Data System (ADS)

    Hawkins, Michael L.

    1990-06-01

    This thesis presents several derivations of Snell's Law of Refraction and one of the principle of reflection. In all of these, we place different constraints upon the problem and produce the familiar laws governing reflection and refraction. The main result of this research is the expression found for Snell's Law of Refraction in which the velocity of the light particles in the medium depends upon direction. We also use inverse problems to find the index of refraction needed to move along any desired family of curves. Finally, we derive a general expression that generates a family of curves given any index of refraction. This research has several applications in the area of acoustical and optical wave propagation. In the area of acoustics, the inverse problems enable us to predict the path followed by sound waves for a given medium. This has a military use in the area of prosecuting submarine contacts and in ocean bottom surveys. The inverse problems also have applications to the bending of light rays used in laser technology. Although this paper derives several generalizations of Snell's Law of Refraction there are still areas that require further research.

  3. Derivation of the Biot-Savart Law from Ampere's Law Using the Displacement Current

    NASA Astrophysics Data System (ADS)

    Buschauer, Robert

    2013-12-01

    The equation describing the magnetic field due to a single, nonrelativistic charged particle moving at constant velocity is often referred to as the "Biot-Savart law for a point charge." Introductory calculus-based physics books usually state this law without proof.2 Advanced texts often present it either without proof or as a special case of a complicated mathematical formalism.3 Either way, little or no physical insight is provided to the student regarding the underlying physics. This paper presents a novel, basic, and transparent derivation of the Biot-Savart law for a point charge based only on Maxwell's displacement current term in Ampere's law. This derivation can serve many pedagogical purposes. For example, it can be used as lecture material at any academic level to obtain the Biot-Savart law for a point charge from simple principles. It can also serve as a practical example of the important fact that a changing electric flux produces a magnetic field.

  4. Water, law, science

    SciTech Connect

    Narasimhan, T.N.

    2007-10-17

    In a world with water resources severely impacted bytechnology, science must actively contribute to water law. To this end,this paper is an earth scientist s attempt to comprehend essentialelements of water law, and to examine their connections to science.Science and law share a common logical framework of starting with apriori prescribed tenets, and drawing consistent inferences. In science,observationally established physical laws constitute the tenets, while inlaw, they stem from social values. The foundations of modern water law inEurope and the New World were formulated nearly two thousand years ago byRoman jurists who were inspired by Greek philosophy of reason.Recognizing that vital natural elements such as water, air, and the seawere governed by immutable natural laws, they reasoned that theseelements belonged to all humans, and therefore cannot be owned as privateproperty. Legally, such public property was to be governed by jusgentium, the law of all people or the law of all nations. In contrast,jus civile or civil law governed private property. Remarkably, jusgentium continues to be relevant in our contemporary society in whichscience plays a pivotal role in exploiting vital resources common to all.This paper examines the historical roots of modern water law, followstheir evolution through the centuries, and examines how the spirit ofscience inherent in jus gentium is profoundly influencing evolving waterand environmental laws in Europe, the United States and elsewhere. In atechnological world, scientific knowledge has to lie at the core of waterlaw. Yet, science cannot formulate law. It is hoped that a philosophicalunderstanding of the relationships between science and law willcontribute to their constructively coming together in the service ofsociety.

  5. Improving Law Enforcement Cross Cultural Competencies through Continued Education

    ERIC Educational Resources Information Center

    Sereni-Massinger, Christine; Wood, Nancy

    2016-01-01

    Over the last thirty years Community Oriented Policing (COP) has spawned advancements in creating community partnerships with law enforcement agencies. Agencies that focus on such partnerships have served to reduce crime and resolve conflict. However, community opinions towards law enforcement have become increasingly negative due to recent civil…

  6. Study by Correspondence; An Enquiry Into Correspondence Study for Examinations for Degrees and Other Advanced Qualifications, Carried Out Under the Direction of Professor E.G. Wedell.

    ERIC Educational Resources Information Center

    Glatter, Ronald; Subramanian, S.

    This study centered on the extent of adult correspondence study in Great Britain, student objectives, and reasons for success or failure in study for the General Certificate of Education, higher degrees, and other advanced qualifications. Enrollment questionnaires from 13,304 students, and 2,090 responses to a retrospective survey, were used.…

  7. Approaches for Advancing Girls' Education in Ghana: A Symposium To Examine Current Practices and Identify Future Directions (1st, Ajumako, Central Region, Ghana, June 25-26, 2001).

    ERIC Educational Resources Information Center

    Academy for Educational Development, Washington, DC.

    The Girls' Education Unit (GEU) of the Basic Education Division of Ghana Education Service (GES) organized this Approaches for Advancing Girls' Education (AAGE) symposium to address the issues of girls' education, to construct a comprehensive picture of what interventions related to girls' education are currently being implemented, and identify…

  8. FY2001 Final Report Laboratory Directed Research and Development (LDRD) on Advanced Nuclear Fuel Design in the Future Nuclear Energy Market

    SciTech Connect

    Christensen, D.; Choi, J.-S.; DiSabatino, A.; Wirth, B.

    2001-09-30

    This study is to research the maturity of advanced nuclear fuel and cladding technology and to explore the suitability of existing technology for addressing the emerging requirements for Generation IV reactors and emerging thermal/fast spectrum reactors, while simultaneously addressing nuclear waste management, and proliferation resistance concerns.

  9. Derivation of the Biot-Savart Law from Ampere's Law Using the Displacement Current

    ERIC Educational Resources Information Center

    Buschauer, Robert

    2013-01-01

    The equation describing the magnetic field due to a single, nonrelativistic charged particle moving at constant velocity is often referred to as the "Biot-Savart law for a point charge." Introductory calculus-based physics books usually state this law without proof. Advanced texts often present it either without proof or as a special…

  10. Teaching Commercial Law in the Third Year: A Short Report on a Business Organizations and Commercial Law Clinic.

    ERIC Educational Resources Information Center

    Dolan, John F.; McNair, Russell A., Jr.

    1995-01-01

    The development and implementation of a clinic to offer advanced study in business organizations and commercial law transactions for third-year law students at Wayne State University (Michigan) are described. The course builds vertically on prior study and puts students in contact with practicing lawyers in an academic setting. Considerations…

  11. Law-Based Degree Programs in Business and Their Departments: What's in a Name? (A Comprehensive Study of Undergraduate Law-Based Degrees in AACSB-Accredited Universities)

    ERIC Educational Resources Information Center

    Miller, Carol J.; Crain, Susan J.

    2007-01-01

    This study examines undergraduate law-based degree programs in the 404 U.S. universities with undergraduate degrees in business that had Association to Advance Collegiate Schools of Business (AACSB) accreditation in 2005. University Web sites were used to identify and compare law-based undergraduate programs inside business to law-related programs…

  12. Genetically modified plants for law enforcement applications

    NASA Astrophysics Data System (ADS)

    Stewart, C. Neal, Jr.

    2002-08-01

    Plants are ubiquitous in the environment and have the unique ability to respond to their environment physiologically and through altered gene expression profiles (they cannot walk away). In addition, plant genetic transformation techniques and genomic information in plants are becoming increasingly advanced. We have been performing research to express the jellyfish green fluorescent protein (GFP) in plants. GFP emits green light when excited by blue or UV light. In addition, my group and collaborators have developed methods to detect GFP in plants by contact instruments and at a standoff. There are several law enforcement applications for this technology. One involves using tagging and perhaps modifying drug plants genetically. In one instance, we could tag them for destruction. In another, we could adulterate them directly. Another application is one that falls into the chemical terrorism and bioterrorism countermeasures category. We are developing plants to sense toxins and whole organisms covertly. Plants are well adapted to monitor large geographic areas; biosurveillance. Some examples of research being performed focus on plants with plant pathogen inducible promoters fused to GFP for disease sensing, and algae biosensors for chemicals.

  13. Direct Conversion of Energy.

    ERIC Educational Resources Information Center

    Corliss, William R.

    This publication is one of a series of information booklets for the general public published by the United States Atomic Energy Commission. Direct energy conversion involves energy transformation without moving parts. The concepts of direct and dynamic energy conversion plus the laws governing energy conversion are investigated. Among the topics…

  14. Shallow-water conservation laws

    NASA Astrophysics Data System (ADS)

    Ostapenko, V. V.

    2015-10-01

    The derivation of basic conservation laws in the shallow-water theory from the multidimensional integral laws of conservation of mass and total momentum describing the plane-parallel flow of an ideal incompressible fluid above a horizontal bottom is proposed. The restrictions on flow parameters arising in this case have the integral form and are much weaker in comparison with the requirement of flow potentiality and the condition of long-wavelength approximation. The last fact substantiates the use of the shallow-water model for the mathematical modeling of a much wider class of wave flows, the parameters of which are not related directly to the restrictions of the long-wavelength approximation.

  15. Advance directives in action in a regional palliative care service: "road testing" the provisions of the Medical Treatment Act 1988 (VIC).

    PubMed

    Brown, Margaret; Fisher, John W; Brumley, David J; Ashby, Michael A; Milliken, Jan

    2005-11-01

    In order to explore the usefulness and acceptability of the provisions of the Medical Treatment Act 1988 (Vic) for palliative care patients in a rural region in Victoria, Australia, between July and December 2004 patients were given information explaining the Act and the opportunity to discuss it with the research officer. Grounded theory methodology was used to evaluate client responses. Findings suggested that palliative care patients are willing to engage in advance care planning but they have to be well enough and need skilled, practical, face-to-face assistance to complete the required legal forms. Written materials alone are not adequate, but provide the opportunity for medical staff to have conversations about death and dying. Doctors and nurses should understand the provisions of the Act to assist patients and families. It is recommended that advance care planning, appropriate to the jurisdiction, be an integral part of the palliative care assessment process. PMID:16304759

  16. Current management and future directions in the treatment of advanced renal cell carcinoma-a latin american perspective: 10 years in review.

    PubMed

    Smaletz, Oren

    2015-01-01

    The worldwide incidence of kidney cancer is estimated at 337,860 new cases per year in the International Agency for Research on Cancer's GLOBOCAN 2012 update, with an estimated 143,369 deaths annually. Over the past 10 years, there have been significant advances in the treatment of advanced/metastatic renal cell carcinoma, including the development of targeted therapies. Currently recommended first-line treatments include sunitinib, temsirolimus, bevacizumab plus interferon, and pazopanib, or high-dose interleukin-2 or sorafenib for selected patients. Recommended second-line treatments include all of the above agents, as well as everolimus and axitinib. Unfortunately, combination therapies have generally resulted in increased toxicity and little improvement in efficacy. Recent studies focused on identification of predictive biomarkers for responses to specific targeted therapies and have not been successful to date. Despite recent advances in targeted treatment for metastatic renal cell carcinoma, important questions regarding biomarkers of efficacy, and optimal combination and sequencing of agents remain to be answered. This paper reviews literature concerned with first-and second-line treatment of metastatic renal cell carcinoma and will discuss key issues in Latin America. PMID:26689508

  17. Current management and future directions in the treatment of advanced renal cell carcinoma–a latin american perspective: 10 years in review

    PubMed Central

    Smaletz, Oren

    2015-01-01

    ABSTRACT The worldwide incidence of kidney cancer is estimated at 337,860 new cases per year in the International Agency for Research on Cancer's GLOBOCAN 2012 update, with an estimated 143,369 deaths annually. Over the past 10 years, there have been significant advances in the treatment of advanced/metastatic renal cell carcinoma, including the development of targeted therapies. Currently recommended first-line treatments include sunitinib, temsirolimus, bevacizumab plus interferon, and pazopanib, or high-dose interleukin-2 or sorafenib for selected patients. Recommended second-line treatments include all of the above agents, as well as everolimus and axitinib. Unfortunately, combination therapies have generally resulted in increased toxicity and little improvement in efficacy. Recent studies focused on identification of predictive biomarkers for responses to specific targeted therapies and have not been successful to date. Despite recent advances in targeted treatment for metastatic renal cell carcinoma, important questions regarding biomarkers of efficacy, and optimal combination and sequencing of agents remain to be answered. This paper reviews literature concerned with first-and second-line treatment of metastatic renal cell carcinoma and will discuss key issues in Latin America. PMID:26689508

  18. Medical innovation laws: an unnecessary innovation.

    PubMed

    Richards, Bernadette

    2016-06-01

    Objective This paper aims to demonstrate that any suggestion that there is a need for specific innovation laws is flawed. Innovation is central to good medical practice and is adequately supported by current law. Methods The paper reviews the nature of medical innovation and outlines recent attempts in the UK to introduce specific laws aimed at 'encouraging' and 'supporting' innovation. The current legal framework is outlined and the role of the law in relation to medical innovation explored. Results The analysis demonstrates the cyclic relationship between medical advancement and the law and concludes that there is no requirement for specific innovation laws. Conclusions The law not only supports innovation and development in medical treatment but encourages it as central to a functioning medical system. There is no need to introduce specific laws aimed at medical innovation; to do so represents an unnecessary legal innovation and serves to complicate matters. What is known about the topic? Over recent months, there has been a great deal of discussion surrounding the law in the context of medical innovation. This was driven by the attempts in the UK to introduce specific laws in the Medical Innovation Bill. The general subject matter - negligence and the expected standard of care in the provision of treatment - is very well understood, but not in cases where the treatment can be described as innovative. The general rhetoric in both the UK and Australia around the Medical Innovation Bill demonstrates a lack of understanding of the position of the law with regards to innovative treatment. What does this paper add? This paper adds clarity to the debate. It presents the law and explains the manner in which the law can operate around innovative treatment. The paper asserts that medical innovation is both supported and encouraged by existing legal principles. What are the implications for practitioners? The paper presents an argument that can guide the policy position

  19. School Law Update...Preventive School Law.

    ERIC Educational Resources Information Center

    Jones, Thomas N., Ed.; Semler, Darel P., Ed.

    A wide variety of contemporary legal issues are addressed in the 15 separate papers that make up this volume. The introductory chapter by William C. Bednar, Jr. provides a broad-based rationale for "Preventive School Law." Chapters 2 and 3, both by Gerald A. Caplan, review "Current Issues in Reduction-in-Force" and "First Amendment Claims by…

  20. Economics of mining law

    USGS Publications Warehouse

    Long, K.R.

    1995-01-01

    Modern mining law, by facilitating socially and environmentally acceptable exploration, development, and production of mineral materials, helps secure the benefits of mineral production while minimizing environmental harm and accounting for increasing land-use competition. Mining investments are sunk costs, irreversibly tied to a particular mineral site, and require many years to recoup. Providing security of tenure is the most critical element of a practical mining law. Governments owning mineral rights have a conflict of interest between their roles as a profit-maximizing landowner and as a guardian of public welfare. As a monopoly supplier, governments have considerable power to manipulate mineral-rights markets. To avoid monopoly rent-seeking by governments, a competitive market for government-owned mineral rights must be created by artifice. What mining firms will pay for mineral rights depends on expected exploration success and extraction costs. Landowners and mining firms will negotlate respective shares of anticipated differential rents, usually allowing for some form of risk sharing. Private landowners do not normally account for external benefits or costs of minerals use. Government ownership of mineral rights allows for direct accounting of social prices for mineral-bearing lands and external costs. An equitable and efficient method is to charge an appropriate reservation price for surface land use, net of the value of land after reclamation, and to recover all or part of differential rents through a flat income or resource-rent tax. The traditional royalty on gross value of production, essentially a regressive income tax, cannot recover as much rent as a flat income tax, causes arbitrary mineral-reserve sterilization, and creates a bias toward development on the extensive margin where marginal environmental costs are higher. Mitigating environmental costs and resolving land-use conflicts require local evaluation and planning. National oversight ensures

  1. Science and the Law.

    ERIC Educational Resources Information Center

    Kennedy, Donald; Merrill, Richard A.

    2000-01-01

    Explaines the role of the Carnegie Commission which was formed to explore the relationship between the disciplines of science, technology, and the law. Discusses concerns about the individual right of privacy in projects such as the Human Genome Project. Focuses on the panel on Science, Technology, and Law which was established in 1999. (YDS)

  2. Language and the Law.

    ERIC Educational Resources Information Center

    Gibbons, John

    1999-01-01

    Discusses the language of law and its general interest to the field of applied linguistics. Specific focus is on legal language, the problems and remedies of legal communication (e.g., language and disadvantage before the law, improving legal communication) the legislation of language (e.g., language rights, language crimes), and forensic…

  3. Law and You.

    ERIC Educational Resources Information Center

    Schurr, Sandra

    Fourteen activity units are presented to help elementary and junior high students learn about laws, rules, and respect for others. A pretest introduces the materials by asking students why society has rules and laws, which ones apply to children, and what reactions students have to the word "cop." The subsequent units involve the students in group…

  4. Civil Law: 12 Activities.

    ERIC Educational Resources Information Center

    Dresbach, Debra

    These learning activities on civil law are intended to supplement the secondary level Scholastic materials "Living Law." Case studies, simulations, and role-play activities are included. Information provided for each activity includes a brief overview, background information, teacher instructions and a description of each activity. Activities…

  5. School Law Update, 1986.

    ERIC Educational Resources Information Center

    Jones, Thomas N., Ed.; Semler, Darel P., Ed.

    A wide variety of contemporary legal issues, involving all levels of public and private education, are addressed in the 20 separate chapters comprising this volume. The titles and authors of the chapters are as follows: (1) Due Process of Law: Loudermill v. Cleveland Board of Education (Hooker); (2) Schools, Technology and the Law (Helm); (3)…

  6. Laws for Young Mountaineers.

    ERIC Educational Resources Information Center

    Kanawha County Board of Education, Charleston, WV.

    This booklet introduces secondary grade students to the criminal laws of West Virginia. It can easily be adapted and used by educators in other states. The authors believe that young people must recognize and understand these laws and the mechanisms which society uses to implement and enforce them if they are to function as an integral, important,…

  7. Nanotechnology and the Law

    NASA Astrophysics Data System (ADS)

    Desmoulin-Canselier, Sonia; Lacour, Stéphanie

    Law and nanotechnology form a vast subject. The aim here will be to examine them from the societal standpoint of nanoethics, if necessary without due reference to the work that has been undertaken. For while law differs from ethics, as we shall attempt to explain throughout this reflection, it must also be studied in its relationship with social realities.

  8. Lotka's Law Revisited.

    ERIC Educational Resources Information Center

    Potter, William Gray

    1981-01-01

    Discusses the literature that has become associated with Lotka's Law of Scientific Productivity (a general theoretical estimate of author productivity in the sciences) and attempts to identify the important factors of Lotka's original methodology that should be considered when attempting to test applicability of Lotka's Law. Forty-seven references…

  9. The Law of Elasticity

    ERIC Educational Resources Information Center

    Cocco, Alberto; Masin, Sergio Cesare

    2010-01-01

    Participants estimated the imagined elongation of a spring while they were imagining that a load was stretching the spring. This elongation turned out to be a multiplicative function of spring length and load weight--a cognitive law analogous to Hooke's law of elasticity. Participants also estimated the total imagined elongation of springs joined…

  10. Teaching Information Technology Law

    ERIC Educational Resources Information Center

    Taylor, M. J.; Jones, R. P.; Haggerty, J.; Gresty, D.

    2009-01-01

    In this paper we discuss an approach to the teaching of information technology law to higher education computing students that attempts to prepare them for professional computing practice. As information technology has become ubiquitous its interactions with the law have become more numerous. Information technology practitioners, and in particular…

  11. Reinventing Howard's Law School.

    ERIC Educational Resources Information Center

    Glenn, Gwendolyn

    2001-01-01

    Describes efforts by Alice Gresham Bullock, dean of the Howard University School of Law, to improve the school (including building a new library and improving relations with faculty) and restore Howard to its previous stature as a leader in civil rights law. (EV)

  12. Social Studies: Law Education.

    ERIC Educational Resources Information Center

    Curriculum Review, 1979

    1979-01-01

    Reviews 11 series, texts, supplements, kits, and professional references for law instruction, including civil and criminal law, the Bill of Rights, and controversial legal issues: arson, gun control, capital punishment, and euthanasia. While all grade levels are covered, the emphasis is on secondary-level materials. (SJL)

  13. Indian Law Enforcement History.

    ERIC Educational Resources Information Center

    Etheridge, David

    Written as a tribute to American Indian law enforcement officers and the Indian Criminal Justice System, this monographh details the history of the legislative, judicial, financial, and cultural problems associated with the development of Indian law enforcement. Citing numerous court cases, pieces of legislation, and individual and organizational…

  14. Law and Marine Science

    ERIC Educational Resources Information Center

    Bockrath, Joseph

    1976-01-01

    The University of Delaware Marine Studies has implemented courses in coastal zone law and policy and maritime law. The courses attempt to integrate the scientist's or engineer's work with public policy formation. The program emphasizes historical and current issues and the economic, cultural, and political forces operating in decision-making…

  15. Charles' Law of Gases.

    ERIC Educational Resources Information Center

    Petty, John T.

    1995-01-01

    Describes an experiment that uses air to test Charles' law. Reinforces the student's intuitive feel for Charles' law with quantitative numbers they can see, introduces the idea of extrapolating experimental data to obtain a theoretical value, and gives a physical quantitative meaning to the concept of absolute zero. (JRH)

  16. Pop Goes the Law

    ERIC Educational Resources Information Center

    Harper, Steven J.

    2013-01-01

    The Law School Admission Council recently reported that applications were heading toward a 30-year low, reflecting, as a "New York Times" article put it, "increased concern over soaring tuition, crushing student debt, and diminishing prospects of lucrative employment upon graduation." Since 2004 the number of law-school applicants has dropped from…

  17. International resources law

    SciTech Connect

    Not Available

    1991-01-01

    This book covers: Historical origins of civil code legal systems; Modern civil law practice for mineral lawyers; Treaties and agreements for protection of international investments; Europe 1992-toward a single energy market; Dispute resolution in international agreements; Assessment of political risk; Reducing political risk; Protecting mineral investments from upheaval in developing countries; Typical world petroleum arrangements; government take in the Pacific Rim - Papua New Guinea; Mineral base of the USSR and prospects of investment; International taxation for the mining practitioner; Tax considerations - branch versus subsidiary; Doing business in the host country - nontax considerations; Impact of host-country laws on operations and profits; Mineral development and native rights - New Zealand; Designing the investment vehicle: mining; International oil and gas joint ventures; Selected U.S. laws with extraterritorial effect; U.S. tax and securities laws applied to foreign joint venturers; and Extraterritorial effect of U.S. laws.

  18. Technical Advance: Introducing a novel metric, directionality time, to quantify human neutrophil chemotaxis as a function of matrix composition and stiffness

    PubMed Central

    O'Brien, Xian M.; Loosley, Alex J.; Oakley, Katie E.; Tang, Jay X.; Reichner, Jonathan S.

    2014-01-01

    A direct consequence of cellular movement and navigation, migration incorporates elements of speed, direction, and persistence of motion. Current techniques to parameterize the trajectory of a chemotaxing cell most commonly pair migration speed with some measure of persistence by calculating MSD, RMS speed, TAD, and/or CI. We address inherent limitations in TAD and CI for comparative analysis by introducing two new analytical tools to quantify persistence: directionality index and directionality time. With the use of these tools, we show that the mechanical properties of the underlying substrate contribute significantly to the regulation of human neutrophil chemotaxis toward fMLP on Fgn-, Col-, and Fn-coated gels of varying elasticity. The β1-integrin ligand Col demonstrated mechanosensitive speed. In contrast, β2-integrin ligand Fgn supported mechanosensitive persistence. Fn, recognized by β1 and β2 integrins, mechanoregulated speed and persistence. Blocking β2 integrins of cells migrating on Fn identified an underlying β2-integrin-directed modulation of persistence. These data demonstrate that individual components of the neutrophil chemotactic response show integrin dependence and are finely tunable with different ligand, mechanotactic, and chemotactic cues, underscoring the need for sensitive analytical methods. PMID:24511103

  19. Critical Opportunities for Public Health Law: A Call for Action

    PubMed Central

    Wood, Jennifer; Burris, Scott; Wagenaar, Alexander C.; Ibrahim, Jennifer K.; Swanson, Jeffrey W.

    2013-01-01

    Although legal interventions are responsible for many sentinel public health achievements, law is underutilized as a tool for advancing population health. Our purpose was to identify critical opportunities for public health lawmaking. We articulated key criteria and illustrated their use with 5 examples. These opportunities involve significant health problems that are potentially amenable to change through law and for which an effective legal intervention is available: optimizing graduated driver licensing laws, increasing tax rates on alcoholic beverages, regulating sodium in foods, enacting laws to facilitate reversal of opioid overdoses, and improving mental health interventions in the college setting. We call for a national conversation about critical opportunities for public health law to advance evidence-based policymaking. PMID:24028265

  20. Ohm's law for a current sheet

    NASA Technical Reports Server (NTRS)

    Lyons, L. R.; Speiser, T. W.

    1985-01-01

    The paper derives an Ohm's law for single-particle motion in a current sheet, where the magnetic field reverses in direction across the sheet. The result is considerably different from the resistive Ohm's law often used in MHD studies of the geomagnetic tail. Single-particle analysis is extended to obtain a self-consistency relation for a current sheet which agrees with previous results. The results are applicable to the concept of reconnection in that the electric field parallel to the current is obtained for a one-dimensional current sheet with constant normal magnetic field. Dissipated energy goes directly into accelerating particles within the current sheet.

  1. Chemical Laws, Idealization and Approximation

    ERIC Educational Resources Information Center

    Tobin, Emma

    2013-01-01

    This paper examines the notion of laws in chemistry. Vihalemm ("Found Chem" 5(1):7-22, 2003) argues that the laws of chemistry are fundamentally the same as the laws of physics they are all "ceteris paribus" laws which are true "in ideal conditions". In contrast, Scerri (2000) contends that the laws of chemistry are…

  2. The new energy law

    SciTech Connect

    Allen, Z.

    1997-05-01

    Foreign companies, as well as Polish companies, have long awaited the introduction of a new environment for doing business in Poland`s energy sector. The adoption by the Sejm (lower house of the Polish Parliament) of a new Energy Law (Prawo Energetyczne) promises to move Poland into a brave new world for energy sector businesses. With this law, Poland hopes to leapfrog into the vanguard of European countries in terms of privatization and demonopolization of its energy sectors. Only the United Kingdom may be more progressive in this regard. During the past several months, a draft law was passed by the Sejm and sent to the Senate. The Senate introduced nearly 50 changes, passed the law and returned it to the Sejm. At that point, the Sejm committee responsible for this law recommended against almost all the Senate`s changes, returning the draft law to its original form. The actions by the Sejm, now awaited, will be final with only the signature of the president needed to put the law into force. Subsequently, this examination of the law is based upon the draft as originally passed by the Sejm and expected to be signed by Poland`s president. There are several key provisions of the proposed new law that make it so different from the current regulatory structure. The key terms that the Polish government likes to use are privatization and demonopolization, of which the latter is to come first. It is a leap forward from an energy sector that was owned entirely by the State, and where prices at all levels, from the coal mines to the residential consumer, were set without regard to cost.

  3. A Control Law Design Method Facilitating Control Power, Robustness, Agility, and Flying Qualities Tradeoffs: CRAFT

    NASA Technical Reports Server (NTRS)

    Murphy, Patrick C.; Davidson, John B.

    1998-01-01

    A multi-input, multi-output control law design methodology, named "CRAFT", is presented. CRAFT stands for the design objectives addressed, namely, Control power, Robustness, Agility, and Flying Qualities Tradeoffs. The methodology makes use of control law design metrics from each of the four design objective areas. It combines eigenspace assignment, which allows for direct specification of eigenvalues and eigenvectors, with a graphical approach for representing the metrics that captures numerous design goals in one composite illustration. Sensitivity of the metrics to eigenspace choice is clearly displayed, enabling the designer to assess the cost of design tradeoffs. This approach enhances the designer's ability to make informed design tradeoffs and to reach effective final designs. An example of the CRAFT methodology applied to an advanced experimental fighter and discussion of associated design issues are provided.

  4. Symbolic computation of conservation laws of nonlinear partial differential equations in multi-dimensions

    NASA Astrophysics Data System (ADS)

    Hereman, Willy

    A direct method for the computation of polynomial conservation laws of polynomial systems of nonlinear partial differential equations (PDEs) in multi-dimensions is presented. The method avoids advanced differential-geometric tools. Instead, it is solely based on calculus, variational calculus, and linear algebra. Densities are constructed as linear combinations of scaling homogeneous terms with undetermined coefficients. The variational derivative (Euler operator) is used to compute the undetermined coefficients. The homotopy operator is used to compute the fluxes. The method is illustrated with nonlinear PDEs describing wave phenomena in fluid dynamics, plasma physics, and quantum physics. For PDEs with parameters, the method determines the conditions on the parameters so that a sequence of conserved densities might exist. The existence of a large number of conservation laws is a predictor of complete integrability. The method is algorithmic, applicable to a variety of PDEs, and can be implemented in computer algebra systems such as Mathematica, Maple, and REDUCE.

  5. The Fourth Law of Behavior Genetics

    PubMed Central

    Chabris, Christopher F.; Lee, James J.; Cesarini, David; Benjamin, Daniel J.; Laibson, David I.

    2015-01-01

    Behavior genetics is the study of the relationship between genetic variation and psychological traits. Turkheimer (2000) proposed “Three Laws of Behavior Genetics” based on empirical regularities observed in studies of twins and other kinships. On the basis of molecular studies that have measured DNA variation directly, we propose a Fourth Law of Behavior Genetics: “A typical human behavioral trait is associated with very many genetic variants, each of which accounts for a very small percentage of the behavioral variability.” This law explains several consistent patterns in the results of gene discovery studies, including the failure of candidate gene studies to robustly replicate, the need for genome-wide association studies (and why such studies have a much stronger replication record), and the crucial importance of extremely large samples in these endeavors. We review the evidence in favor of the Fourth Law and discuss its implications for the design and interpretation of gene-behavior research. PMID:26556960

  6. Benford's Law in Astronomy

    NASA Astrophysics Data System (ADS)

    Alexopoulos, Theodoros; Leontsinis, Stefanos

    2014-12-01

    Benford's law predicts the occurrence of the n-th digit of numbers in datasets originating from various sources all over the world, ranging from financial data to atomic spectra. It is intriguing that although many features of Benford's law have been proven, it is still not fully understood mathematically. In this paper we investigate the distances of galaxies and stars by comparing the first, second and third significant digit probabilities with Benford's predictions. It is found that the distances of galaxies follow the first digit law reasonable well, and that the star distances agree very well with the first, second and third significant digit.

  7. Sexuality and Australian law.

    PubMed

    Kirby, Michael

    2005-01-01

    The author describes the changing legal environment concerning same-sex relationships in the common law world with special reference to Australia. He refers to shifts in public opinion recorded in opinion polls; important decisions of human rights courts and tribunals; and changes in national law and court decisions. He then reviews the Australian constitutional setting which divides lawmaking responsibility on such subjects between the federal, State and Territory legislatures. He describes initiatives adopted in the States and Territories and the more modest changes effected in federal law and practice. He concludes on a note of optimism concerning Australia's future reforms affecting discrimination on the grounds of sexuality. PMID:15814500

  8. Anomalous law of cooling

    SciTech Connect

    Lapas, Luciano C.; Ferreira, Rogelma M. S.; Rubí, J. Miguel; Oliveira, Fernando A.

    2015-03-14

    We analyze the temperature relaxation phenomena of systems in contact with a thermal reservoir that undergoes a non-Markovian diffusion process. From a generalized Langevin equation, we show that the temperature is governed by a law of cooling of the Newton’s law type in which the relaxation time depends on the velocity autocorrelation and is then characterized by the memory function. The analysis of the temperature decay reveals the existence of an anomalous cooling in which the temperature may oscillate. Despite this anomalous behavior, we show that the variation of entropy remains always positive in accordance with the second law of thermodynamics.

  9. Anomalous law of cooling.

    PubMed

    Lapas, Luciano C; Ferreira, Rogelma M S; Rubí, J Miguel; Oliveira, Fernando A

    2015-03-14

    We analyze the temperature relaxation phenomena of systems in contact with a thermal reservoir that undergoes a non-Markovian diffusion process. From a generalized Langevin equation, we show that the temperature is governed by a law of cooling of the Newton's law type in which the relaxation time depends on the velocity autocorrelation and is then characterized by the memory function. The analysis of the temperature decay reveals the existence of an anomalous cooling in which the temperature may oscillate. Despite this anomalous behavior, we show that the variation of entropy remains always positive in accordance with the second law of thermodynamics. PMID:25770525

  10. Anomalous law of cooling

    NASA Astrophysics Data System (ADS)

    Lapas, Luciano C.; Ferreira, Rogelma M. S.; Rubí, J. Miguel; Oliveira, Fernando A.

    2015-03-01

    We analyze the temperature relaxation phenomena of systems in contact with a thermal reservoir that undergoes a non-Markovian diffusion process. From a generalized Langevin equation, we show that the temperature is governed by a law of cooling of the Newton's law type in which the relaxation time depends on the velocity autocorrelation and is then characterized by the memory function. The analysis of the temperature decay reveals the existence of an anomalous cooling in which the temperature may oscillate. Despite this anomalous behavior, we show that the variation of entropy remains always positive in accordance with the second law of thermodynamics.

  11. Electrodynamic force law controversy.

    PubMed

    Graneau, P; Graneau, N

    2001-05-01

    Cavalleri et al. [Phys. Rev. E 52, 2505 (1998); Eur. J. Phys. 17, 205 (1996)] have attempted to resolve the electrodynamic force law controversy. This attempt to prove the validity of either the Ampère or Lorentz force law by theory and experiment has revealed only that the two are equivalent when predicting the force on part of a circuit due to the current in the complete circuit. However, in our analysis of internal stresses, only Ampère's force law agrees with experiment. PMID:11415053

  12. 37 CFR 10.85 - Representing a client within the bounds of the law.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... the bounds of the law. 10.85 Section 10.85 Patents, Trademarks, and Copyrights UNITED STATES PATENT... within the bounds of the law. (a) In representation of a client, a practitioner shall not: (1) Initiate... another. (2) Knowingly advance a claim or defense that is unwarranted under existing law, except that...

  13. Laws of valley growth

    NASA Astrophysics Data System (ADS)

    Seybold, Hansjoerg; Yi, Robert; Willenbring, Jane; Kirchner, James; Rothman, Daniel

    2015-04-01

    The question of how the channel heads advance has long been debated [1,2]. By studying a simplified setting - channels incised by re-emerging groundwater flow - we seek insight into the headward growth of channel networks, by combining theoretical modeling with field observations. A concept for how such seepage channel systems form was first proposed by T. Dunne in the early 1980s [2]. A small bulge in the sidewall of a stream focuses ground water flow. This results in a larger flux and therefore a higher erosion rate in this direction. Over time such small perturbations grow into newly formed streams, but how they do so and how erosion depends on the water flux is unclear. The theory of diffusive growth provides a theoretical framework to describe channelization in response to groundwater flow. For this system the underlying physical equations are well-defined, and numerical and analytical predictions can be obtained and tested in the field. If a stream advances at a rate v˜ q^η, where q is the discharge of ground water into the tip, theory predicts that η has to be smaller than a critical value η^star to obtain ramified networks [3]. We test this hypothesis by measuring erosion rates in a field site in the Florida Panhandle, which provides a natural laboratory to study channel incision by re-emerging groundwater flow [4]. Our theoretical network reconstruction yields tip growth rates which we can directly compare to observational rates obtained from cosmogenic 10Be measurements. This comparison of theory and observation allows us to verify the existence of a constitutive discharge-erosion relation, and to better characterize growth and competition of streams at the channel head. [1] Montgommery, D. R. and Dietrich, W. E. Where do channels begin?, Nature, 336, no. 6196 (1988): 232-234 [2] Dunne, T. Formation and controls of channel networks, Prog. Phys. Geogr., 4 (1980): 211-239 [3] Carleson, L. and Makarov, N. Laplacian path models, J. Anal. Math., 87, no. 1

  14. Multi-scale 3D X-ray Imaging Capabilities at the Advanced Photon Source - Current status and future direction (Invited)

    NASA Astrophysics Data System (ADS)

    DeCarlo, F.; Xiao, X.; Khan, F.; Glowacki, A.; Schwarz, N.; Jacobsen, C.

    2013-12-01

    In x-ray computed μ-tomography (μ-XCT), a thin scintillator screen is coupled to a visible light lens and camera system to obtain micrometer-scale transmission imaging of specimens as large as a few millimeters. Recent advances in detector technology allow collecting these images at unprecedented frame rates. For a high x-ray flux density synchrotron facility like the Advanced Photon Source (APS), the detector exposure time ranges from hundreds of milliseconds to hundreds of picoseconds, making possible to acquire a full 3D micrometer-resolution dataset in less than one second. The micron resolution limitation of parallel x-ray beam projection systems can be overcame by Transmission X-ray Microscopes (TXM) where part of the image magnification is done in x-ray regime using x-ray optics like capillary condensers and Fresnel zone plates. These systems, when installed on a synchrotron x-ray source, can generate 2D images with up to 20 nm resolution with second exposure time and collect a full 3D nano-resolution dataset in few minutes. μ-XCT and TXM systems available at the x-ray imaging beamlines of the APS are routinely used in material science and geoscience applications where high-resolution and fast 3D imaging are instrumental in extracting in situ four-dimensional dynamic information. In this presentation we describe the computational challenges associated with μ-XCT and TXM systems and present the framework and infrastructure developed at the APS to allow for routine multi-scale data integration between the two systems.

  15. Multi-scale 3D X-ray Imaging Capabilities at the Advanced Photon Source - Current status and future direction (Invited)

    NASA Astrophysics Data System (ADS)

    DeCarlo, F.; Xiao, X.; Khan, F.; Glowacki, A.; Schwarz, N.; Jacobsen, C.

    2011-12-01

    In x-ray computed μ-tomography (μ-XCT), a thin scintillator screen is coupled to a visible light lens and camera system to obtain micrometer-scale transmission imaging of specimens as large as a few millimeters. Recent advances in detector technology allow collecting these images at unprecedented frame rates. For a high x-ray flux density synchrotron facility like the Advanced Photon Source (APS), the detector exposure time ranges from hundreds of milliseconds to hundreds of picoseconds, making possible to acquire a full 3D micrometer-resolution dataset in less than one second. The micron resolution limitation of parallel x-ray beam projection systems can be overcame by Transmission X-ray Microscopes (TXM) where part of the image magnification is done in x-ray regime using x-ray optics like capillary condensers and Fresnel zone plates. These systems, when installed on a synchrotron x-ray source, can generate 2D images with up to 20 nm resolution with second exposure time and collect a full 3D nano-resolution dataset in few minutes. μ-XCT and TXM systems available at the x-ray imaging beamlines of the APS are routinely used in material science and geoscience applications where high-resolution and fast 3D imaging are instrumental in extracting in situ four-dimensional dynamic information. In this presentation we describe the computational challenges associated with μ-XCT and TXM systems and present the framework and infrastructure developed at the APS to allow for routine multi-scale data integration between the two systems.

  16. The LSU Law Center -- Canada Bijuralism Conference. Introduction: Global Law and the Law School Curriculum.

    ERIC Educational Resources Information Center

    Costonis, John J.

    2002-01-01

    Introduces papers from a conference focused on the bijural programs of Louisiana State University Law Center and McGill University Faculty of Law. The programs educate all first-degree law students in both the common law and civil law traditions, preparing them for the increasing globalization of legal practice. (EV)

  17. Relativity, nonextensivity, and extended power law distributions.

    PubMed

    Silva, R; Lima, J A S

    2005-11-01

    A proof of the relativistic theorem by including nonextensive effects is given. As it happens in the nonrelativistic limit, the molecular chaos hypothesis advanced by Boltzmann does not remain valid, and the second law of thermodynamics combined with a duality transformation implies that the parameter lies on the interval [0,2]. It is also proven that the collisional equilibrium states (null entropy source term) are described by the relativistic power law extension of the exponential Juttner distribution which reduces, in the nonrelativistic domain, to the Tsallis power law function. As a simple illustration of the basic approach, we derive the relativistic nonextensive equilibrium distribution for a dilute charged gas under the action of an electromagnetic field . Such results reduce to the standard ones in the extensive limit, thereby showing that the nonextensive entropic framework can be harmonized with the space-time ideas contained in the special relativity theory. PMID:16383791

  18. Potential conservation laws

    SciTech Connect

    Kunzinger, Michael; Popovych, Roman O.

    2008-10-15

    We prove that potential conservation laws have characteristics depending only on local variables if and only if they are induced by local conservation laws. Therefore, characteristics of pure potential conservation laws have to essentially depend on potential variables. This statement provides a significant generalization of results of the recent paper by Bluman et al. [J. Math. Phys. 47, 113505 (2006)]. Moreover, we present extensions to gauged potential systems, Abelian and general coverings, and general foliated systems of differential equations. An example illustrating possible applications of these results is given. A special version of the Hadamard lemma for fiber bundles and the notions of weighted jet spaces are proposed as new tools for the investigation of potential conservation laws.

  19. Teaching Criminal Law.

    ERIC Educational Resources Information Center

    Levin, Sandy

    1989-01-01

    Presents learning activities and resources for teaching senior level criminal law courses. Topics covered include arrest, search and seizure, bail, trial procedures, sentencing, and prisons. Objective is to encourage students to address societal issues. (LS)

  20. What Is Benford's Law?

    ERIC Educational Resources Information Center

    Bradley, Jonathan R.; Farnsworth, David L.

    2009-01-01

    The surprising property of many data sets that their first significant digits follow Benford's Law provides examples that can pique and hold students' interest. Several ideas for student activities are presented.

  1. Disobeying Immoral Laws.

    ERIC Educational Resources Information Center

    Israel, Elfie

    1994-01-01

    Describes how one teacher continued to teach after becoming pregnant, even though this was against school policy. Reminds teachers that Henry Thoreau claimed it is moral to disobey an immoral law. (HB)

  2. Stokes' Law Revisited

    ERIC Educational Resources Information Center

    Wray, E. M.

    1977-01-01

    Discusses limitations and corrections to be made in physics experiments involving the investigations of drag and terminal velocity on spheres falling through a liquid in accordance with Stokes' law. (SL)

  3. Infusing CD19-Directed T Cells to Augment Disease Control in Patients Undergoing Autologous Hematopoietic Stem-Cell Transplantation for Advanced B-Lymphoid Malignancies

    PubMed Central

    Kebriaei, Partow; Huls, Helen; Jena, Bipulendu; Munsell, Mark; Jackson, Rineka; Lee, Dean A.; Hackett, Perry B.; Rondon, Gabriela; Shpall, Elizabeth; Champlin, Richard E.

    2012-01-01

    Abstract Limited curative treatment options exist for patients with advanced B-lymphoid malignancies, and new therapeutic approaches are needed to augment the efficacy of hematopoietic stem-cell transplantation (HSCT). Cellular therapies, such as adoptive transfer of T cells that are being evaluated to target malignant disease, use mechanisms independent of chemo- and radiotherapy with nonoverlapping toxicities. Gene therapy is employed to generate tumor-specific T cells, as specificity can be redirected through enforced expression of a chimeric antigen receptor (CAR) to achieve antigen recognition based on the specificity of a monoclonal antibody. By combining cell and gene therapies, we have opened a new Phase I protocol at the MD Anderson Cancer Center (Houston, TX) to examine the safety and feasibility of administering autologous genetically modified T cells expressing a CD19-specific CAR (capable of signaling through chimeric CD28 and CD3-ζ) into patients with high-risk B-lymphoid malignancies undergoing autologous HSCT. The T cells are genetically modified by nonviral gene transfer of the Sleeping Beauty system and CAR+ T cells selectively propagated in a CAR-dependent manner on designer artificial antigen-presenting cells. The results of this study will lay the foundation for future protocols including CAR+ T-cell infusions derived from allogeneic sources. PMID:22107246

  4. The minus sign in Faraday’s law revisited

    NASA Astrophysics Data System (ADS)

    O'Sullivan, Colm; Hurley, Donal

    2013-01-01

    By introducing the mathematical concept of orientation, the significance of the minus sign in Faraday’s law may be made clear to students with some knowledge of vector calculus. For many students, however, the traditional approach of treating the law as a relationship between positive scalars and of relying on Lenz’s law to provide the information on the direction of the induced electromotive force may be a preferable pedagogical practice.

  5. Application of Hamilton's Law of Varying Action

    NASA Technical Reports Server (NTRS)

    Bailey, C. D.

    1973-01-01

    The application of Hamilton's Law to the direct solution of nonstationary as well as stationary problems in mechanics of solids is discussed. Solutions are demonstrated for conservative and monconservative, stationary and/or nonstationary particle motion. Mathematical models are developed to establish the relationships of the parameters.

  6. [Medical Devices Law for pain therapists].

    PubMed

    Regner, M; Sabatowski, R

    2016-08-01

    Medical Devices Law is a relatively new legal system, which has replaced the Medical Devices Regulations still well-known in Germany. German Medical Devices Law is based on European directives, which are, in turn, incorporated into national law by the Medical Devices Act. The Medical Devices Act is a framework law and covers a number of regulations that address specific topics within Medical Devices Law. In turn, in individual regulations, reference is made to guidelines, recommendations, etc. from other sources that provide detailed technical information on specific topics. Medical Devices Law is a very complex legal system, which needs to be permanently observed due to constant updating and adjustment. In the current article, the design and the structure of the system will be described, but special emphasis will be laid on important problem areas that need to be considered when applying and operating medical products, in this case by pain therapists in particular. PMID:27333770

  7. Robust Neighboring Optimal Guidance for the Advanced Launch System

    NASA Technical Reports Server (NTRS)

    Hull, David G.

    1993-01-01

    In recent years, optimization has become an engineering tool through the availability of numerous successful nonlinear programming codes. Optimal control problems are converted into parameter optimization (nonlinear programming) problems by assuming the control to be piecewise linear, making the unknowns the nodes or junction points of the linear control segments. Once the optimal piecewise linear control (suboptimal) control is known, a guidance law for operating near the suboptimal path is the neighboring optimal piecewise linear control (neighboring suboptimal control). Research conducted under this grant has been directed toward the investigation of neighboring suboptimal control as a guidance scheme for an advanced launch system.

  8. Recent advances in thermal desorption-gas chromatography-mass spectrometery method to eliminate the matrix effect between air and water samples: application to the accurate determination of Henry's law constant.

    PubMed

    Kim, Yong-Hyun; Kim, Ki-Hyun

    2014-05-16

    Accurate values for the Henry's law constants are essential to describe the environmental dynamics of a solute, but substantial errors are recognized in many reported data due to practical difficulties in measuring solubility and/or vapor pressure. Despite such awareness, validation of experimental approaches has scarcely been made. An experimental approach based on thermal desorption-gas chromatography-mass spectrometery (TD-GC-MS) method was developed to concurrently allow the accurate determination of target compounds from the headspace and aqueous samples in closed equilibrated system. The analysis of six aromatics and eight non-aromatic oxygenates was then carried out in a static headspace mode. An estimation of the potential bias and mass balance (i.e., sum of mass measured individually from gas and liquid phases vs. the mass initially added to the system) demonstrates compound-specific phase dependency so that the best results are obtained by aqueous (less soluble aromatics) and headspace analysis (more soluble non-aromatics). Accordingly, we were able to point to the possible sources of biases in previous studies and provide the best estimates for the Henry's constants (Matm(-1)): benzene (0.17), toluene (0.15), p-xylene (0.13), m-xylene (0.13), o-xylene (0.19), styrene (0.27); propionaldehyde (9.26), butyraldehyde (6.19), isovaleraldehyde (2.14), n-valeraldehyde (3.98), methyl ethyl ketone (10.5), methyl isobutyl ketone (3.93), n-butyl acetate (2.41), and isobutyl alcohol (22.2). PMID:24704185

  9. Definition and preliminary design of the LAWS (Laser Atmospheric Wind Sounder), volume 2, phase 2

    NASA Technical Reports Server (NTRS)

    1992-01-01

    Accurate knowledge of winds is critical to our understanding of the earth's climate and to our ability to predict climate change. Winds are a fundamental component of highly nonlinear interactions between oceans, land surfaces, and the atmosphere. Interactions at these interfaces are the focus of much climate change research. Although wind information is critical for advancing our understanding, currently most of our description of atmospheric motion is obtained indirectly - i.e., derived from observations of temperature and moisture through geostrophic relationships. Direct measurement of winds over the globe is limited to land-based rawinsonde surface stations and a few ship/aircraft reports. Cloud track winds using satellite imagery are calculated but must be used with great care. The LAWS mission objective, therefore, is to provide diurnal and global direct observations of winds - an observation that will incrementally enhance our knowledge of the earth's climate and physical processes responsible for its change. This document is Volume 2 of the LAWS Phase 2 Final Study Report and describes the definition and preliminary design of the LAWS instrument, together with details of the laser breadboard program conducted during the last 18 months of the program.

  10. Nurturing Respect for the Law.

    ERIC Educational Resources Information Center

    Ioffe, M. G.

    1978-01-01

    Describes the content and methodology of elective courses which expand Soviet student's understanding of the Soviet state and the courts, the structure of power, and the basic rights and duties of the citizen. Courses in labor law, love and family law, criminal law, and constitutional law expand the current social studies curriculum. (KC)

  11. Modeling and controlling a robotic convoy using guidance laws strategies.

    PubMed

    Belkhouche, Fethi; Belkhouche, Boumediene

    2005-08-01

    This paper deals with the problem of modeling and controlling a robotic convoy. Guidance laws techniques are used to provide a mathematical formulation of the problem. The guidance laws used for this purpose are the velocity pursuit, the deviated pursuit, and the proportional navigation. The velocity pursuit equations model the robot's path under various sensors based control laws. A systematic study of the tracking problem based on this technique is undertaken. These guidance laws are applied to derive decentralized control laws for the angular and linear velocities. For the angular velocity, the control law is directly derived from the guidance laws after considering the relative kinematics equations between successive robots. The second control law maintains the distance between successive robots constant by controlling the linear velocity. This control law is derived by considering the kinematics equations between successive robots under the considered guidance law. Properties of the method are discussed and proven. Simulation results confirm the validity of our approach, as well as the validity of the properties of the method. Index Terms-Guidance laws, relative kinematics equations, robotic convoy, tracking. PMID:16128462

  12. 5 CFR 1315.16 - Relationship to other laws.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 3 2011-01-01 2011-01-01 false Relationship to other laws. 1315.16 Section 1315.16 Administrative Personnel OFFICE OF MANAGEMENT AND BUDGET OMB DIRECTIVES PROMPT PAYMENT § 1315.16 Relationship to other laws. (a) Contract Disputes Act of 1978 (41 U.S.C. 605). (1) A claim...

  13. 5 CFR 1315.16 - Relationship to other laws.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Relationship to other laws. 1315.16 Section 1315.16 Administrative Personnel OFFICE OF MANAGEMENT AND BUDGET OMB DIRECTIVES PROMPT PAYMENT § 1315.16 Relationship to other laws. (a) Contract Disputes Act of 1978 (41 U.S.C. 605). (1) A claim...

  14. 7 CFR 766.155 - Conflict with State law.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 7 2010-01-01 2010-01-01 false Conflict with State law. 766.155 Section 766.155... AGRICULTURE SPECIAL PROGRAMS DIRECT LOAN SERVICING-SPECIAL Homestead Protection Program § 766.155 Conflict with State law. If there is a conflict between a borrower's homestead protection rights and...

  15. 5 CFR 1315.16 - Relationship to other laws.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 3 2013-01-01 2013-01-01 false Relationship to other laws. 1315.16 Section 1315.16 Administrative Personnel OFFICE OF MANAGEMENT AND BUDGET OMB DIRECTIVES PROMPT PAYMENT § 1315.16 Relationship to other laws. (a) Contract Disputes Act of 1978 (41 U.S.C. 605). (1) A claim...

  16. Law-Related Education: Implications for Teaching Gifted Students.

    ERIC Educational Resources Information Center

    Furlong, Mary

    1982-01-01

    The article demonstrates how the theories and methods of law-related education can provide direction for instructors of gifted children. Four goals of law-related education (including improvement of critical thinking skills) are discussed, and specific teaching strategies are suggested. (Author/SW)

  17. 99mTc-Sestamibi Using a Direct Conversion Molecular Breast Imaging System to Assess Tumor Response to Neoadjuvant Chemotherapy in Women With Locally Advanced Breast Cancer

    PubMed Central

    Mitchell, David; Hruska, Carrie B.; Boughey, Judy C.; Wahner-Roedler, Dietlind L.; Jones, Katie N.; Tortorelli, Cindy; Conners, Amy Lynn; O’Connor, Michael K.

    2014-01-01

    Purpose The objective of this study was to determine the ability of breast imaging with 99mTc-sestamibi and a direct conversion–molecular breast imaging (MBI) system to predict early response to neoadjuvant chemotherapy (NAC). Methods Patients undergoing NAC for breast cancer were imaged with a direct conversion–MBI system before (baseline), at 3 to 5 weeks after onset, and after completion of NAC. Tumor size and tumor-to-background (T/B) uptake ratio measured from MBI images were compared with extent of residual disease at surgery using the residual cancer burden. Results Nineteen patients completed imaging and proceeded to surgical resection after NAC. Mean reduction in T/B ratio from baseline to 3 to 5 weeks for patients classified as RCB-0 (no residual disease), RCB-1 and RCB-2 combined, and RCB-3 (extensive residual disease) was 56% (SD, 0.20), 28% (SD, 0.20), and 4% (SD, 0.15), respectively. The reduction in the RCB-0 group was significantly greater than in RCB-1/2 (P = 0.036) and RCB-3 (P = 0.001) groups. The area under the receiver operator characteristic curve for determining the presence or absence of residual disease was 0.88. Using a threshold of 50% reduction in T/B ratio at 3 to 5 weeks, MBI predicted presence of residual disease at surgery with a diagnostic accuracy of 89.5% (95% confidence interval [CI], 0.64%–0.99%), sensitivity of 92.3% (95% CI, 0.74%–0.99%), and specificity of 83.3% (95% CI, 0.44%–0.99%). The reduction in tumor size at 3 to 5 weeks was not statistically different between RCB groups. Conclusions Changes in T/B ratio on MBI images performed at 3 to 5 weeks following initiation of NAC were accurate at predicting the presence or absence of residual disease at NAC completion. PMID:24152645

  18. Physical Laws for Mechanobiology

    NASA Technical Reports Server (NTRS)

    Freed, Alan D.

    2007-01-01

    Higher-level physical laws applicable to biological tissues are presented that will permit the modeling of metabolic activity at the cellular level, including variations in the mass of a tissue. Here the tissue is represented as a fluid/solid mixture, wherein molecular solutes transport within the fluid, and cells can migrate throughout the porous solid. Variations in mass can arise via exchanges in mass between the constituent phases within a control volume such that mass is conserved in the tissue overall. The governing balance laws for mass, momentum, energy, and entropy are a special case of those describing a chemically reacting mixture with diffusion. Thermodynamic constraints on the constitutive structure are addressed. Biophysics; Biomechanics; Brownian motion; Cell migration; Mixture theory; Thermodynamic laws; Tissue mechanics

  19. Advanced byproduct recovery: Direct catalytic reduction of sulfur dioxide to elemental sulfur. Second quarterly technical progress report, January--March 1996

    SciTech Connect

    1996-05-01

    In the more than 170 wet scrubber systems in 72,000 MW of US, coal-fired, utility boilers, the SO{sub 2} removed from the boiler flue gas is sorbed, and the sulfated sorbent must be disposed of. The use of regenerable sorbents has the potential to reduce this disposal problem. The team of Arthur D. Little, Tufts Univ., and Engelhard Corp. are conducting Phase I of a 4.5-year, two-phase effort to develop and scale-up a direct, single-stage, catalytic process for converting SO{sub 2} to S. This catalytic process reduces SO{sub 2} over a fluorite-type oxide such as ceria and zirconia; the catalytic activity can be promoted by active transition metals such as Cu. The Phase I program includes the following work elements: market/process/cost/evaluation; lab-scale catalyst preparation/optimization, lab-scale bulk/supported catalyst kinetic studies, bench-scale catalyst/process studies, and utility review.

  20. Law of the Sea

    SciTech Connect

    Borgese, E.M.

    1983-03-01

    Seabed development will proceed even though the US declined to join 119 nations signing the Law of the Sea Treaty. The new law replaces laissez faire development with management of the seas. The US, Soviet Union, and 15 other countries, while withholding their signatures from the convention, did sign the Final Act of the Conference and can sign as full participants in the future if they choose. The new management approach considers global socio-economic and resource needs. It emphasizes international cooperation in the areas of economic development, disarmament, and in establishing rules and regulations for exploring the seabed. (DCK)