Estimating the waiting time of multi-priority emergency patients with downstream blocking.

PubMed

Lin, Di; Patrick, Jonathan; Labeau, Fabrice

2014-03-01

To characterize the coupling effect between patient flow to access the emergency department (ED) and that to access the inpatient unit (IU), we develop a model with two connected queues: one upstream queue for the patient flow to access the ED and one downstream queue for the patient flow to access the IU. Building on this patient flow model, we employ queueing theory to estimate the average waiting time across patients. Using priority specific wait time targets, we further estimate the necessary number of ED and IU resources. Finally, we investigate how an alternative way of accessing ED (Fast Track) impacts the average waiting time of patients as well as the necessary number of ED/IU resources. This model as well as the analysis on patient flow can help the designer or manager of a hospital make decisions on the allocation of ED/IU resources in a hospital.

The Future of Women's Athletics: Entertainment or Education?

ERIC Educational Resources Information Center

Park, Roberta J.

A well-rounded program of extramural opportunities for females which provides experience between the intramural model and the existing male intercollegiate models is presently nonexistent. Five possible alternatives to guide the future of athletics are suggested: (a) women could demand access to the existing model of male athletics; (b) women…

The Macroeconomic Consequences of Renouncing to Universal Access to Antiretroviral Treatment for HIV in Africa: A Micro-Simulation Model

PubMed Central

Ventelou, Bruno; Arrighi, Yves; Greener, Robert; Lamontagne, Erik; Carrieri, Patrizia; Moatti, Jean-Paul

2012-01-01

Aim Previous economic literature on the cost-effectiveness of antiretroviral treatment (ART) programs has been mainly focused on the microeconomic consequences of alternative use of resources devoted to the fight against the HIV pandemic. We rather aim at forecasting the consequences of alternative scenarios for the macroeconomic performance of countries. Methods We used a micro-simulation model based on individuals aged 15–49 selected from nationally representative surveys (DHS for Cameroon, Tanzania and Swaziland) to compare alternative scenarios : 1-freezing of ART programs to current levels of access, 2- universal access (scaling up to 100% coverage by 2015, with two variants defining ART eligibility according to previous or current WHO guidelines). We introduced an “artificial” ageing process by programming methods. Individuals could evolve through different health states: HIV negative, HIV positive (with different stages of the syndrome). Scenarios of ART procurement determine this dynamics. The macroeconomic impact is obtained using sample weights that take into account the resulting age-structure of the population in each scenario and modeling of the consequences on total growth of the economy. Results Increased levels of ART coverage result in decreasing HIV incidence and related mortality. Universal access to ART has a positive impact on workers' productivity; the evaluations performed for Swaziland and Cameroon show that universal access would imply net cost-savings at the scale of the society, when the full macroeconomic consequences are introduced in the calculations. In Tanzania, ART access programs imply a net cost for the economy, but 70% of costs are covered by GDP gains at the 2034 horizon, even in the extended coverage option promoted by WHO guidelines initiating ART at levels of 350 cc/mm3 CD4 cell counts. Conclusion Universal Access ART scaling-up strategies, which are more costly in the short term, remain the best economic choice in the long term. Renouncing or significantly delaying the achievement of this goal, due to “legitimate” short term budgetary constraints would be a misguided choice. PMID:22514619

Atomistic modeling of alternating access of a mitochondrial ADP/ATP membrane transporter with molecular simulations

PubMed Central

Hayashi, Shigehiko

2017-01-01

The mitochondrial ADP/ATP carrier (AAC) is a membrane transporter that exchanges a cytosolic ADP for a matrix ATP. Atomic structures in an outward-facing (OF) form which binds an ADP from the intermembrane space have been solved by X-ray crystallography, and revealed their unique pseudo three-fold symmetry fold which is qualitatively different from pseudo two-fold symmetry of most transporters of which atomic structures have been solved. However, any atomic-level information on an inward-facing (IF) form, which binds an ATP from the matrix side and is fixed by binding of an inhibitor, bongkrekic acid (BA), is not available, and thus its alternating access mechanism for the transport process is unknown. Here, we report an atomic structure of the IF form predicted by atomic-level molecular dynamics (MD) simulations of the alternating access transition with a recently developed accelerating technique. We successfully obtained a significantly stable IF structure characterized by newly formed well-packed and -organized inter-domain interactions through the accelerated simulations of unprecedentedly large conformational changes of the alternating access without a prior knowledge of the target protein structure. The simulation also shed light on an atomistic mechanism of the strict transport selectivity of adenosine nucleotides over guanosine and inosine ones. Furthermore, the IF structure was shown to bind ATP and BA, and thus revealed their binding mechanisms. The present study proposes a qualitatively novel view of the alternating access of transporters having the unique three-fold symmetry in atomic details and opens the way for rational drug design targeting the transporter in the dynamic functional cycle. PMID:28727843

Economic feasibility of alternative practitioners for provision of dental care to the underserved.

PubMed

Matthiesen, Anne

2012-01-01

This study assesses the viability of three alternative practitioner types for provision of dental care to the underserved. Key factors modeled include compensation, training and practice costs, productivity, and payer mix scenarios. Utilizing dental therapists or dental health aide therapists is cost-effective for enhancing access. However, to be sustainable, the practices will require a subsidy or a better reimbursement than modeled. Without tuition support, the debt burden will deter applicants mostlikely to treat the underserved.

A qualitative case study of the legislative process of the hygienist-therapist bill in a large Midwestern state.

PubMed

Dollins, Haley E; Bray, Kimberly Krust; Gadbury-Amyot, Cynthia C

2013-10-01

Inequitable access to dental care contributes to oral health disparities. Midlevel dental provider models are utilized across the globe as a way to bridge the gap between preventive and restorative dental professionals and increase access to dental care. The purpose of this study was threefold: to examine lessons learned from the state legislative process related to creation of the hygienist-therapist in a Midwestern state, to improve understanding of the relationship between alternative oral health delivery models and public policy and to inform the development and passage of future policies aimed at addressing the unmet dental needs of the public. This research investigation utilized a qualitative research methodology to examine the process of legislation relating to an alternative oral health delivery model (hygienist-therapist) through the eyes of key stakeholders. Interview data was analyzed and then triangulated with 3 data sources: interviews with key stakeholders, documents and researcher participant field notes. Data analysis resulted in consensus on 3 emergent themes with accompanying categories. The themes that emerged included social justice, partnerships and coalitions, and the legislative process. This qualitative case study suggests that the creation of a new oral health workforce model was a long and arduous process involving multiple stakeholders and negotiation between the parties involved. The creation of this new workforce model was recognized as a necessary step to increasing access to dental care at the state and national level. The research in this case study may serve to inform advocates of access to oral health care as other states pursue their own workforce models.

Usage of Data-Encoded Web Maps with Client Side Color Rendering for Combined Data Access, Visualization and Modeling Purposes

NASA Technical Reports Server (NTRS)

Pliutau, Denis; Prasad, Narashimha S.

2013-01-01

Current approaches to satellite observation data storage and distribution implement separate visualization and data access methodologies which often leads to the need in time consuming data ordering and coding for applications requiring both visual representation as well as data handling and modeling capabilities. We describe an approach we implemented for a data-encoded web map service based on storing numerical data within server map tiles and subsequent client side data manipulation and map color rendering. The approach relies on storing data using the lossless compression Portable Network Graphics (PNG) image data format which is natively supported by web-browsers allowing on-the-fly browser rendering and modification of the map tiles. The method is easy to implement using existing software libraries and has the advantage of easy client side map color modifications, as well as spatial subsetting with physical parameter range filtering. This method is demonstrated for the ASTER-GDEM elevation model and selected MODIS data products and represents an alternative to the currently used storage and data access methods. One additional benefit includes providing multiple levels of averaging due to the need in generating map tiles at varying resolutions for various map magnification levels. We suggest that such merged data and mapping approach may be a viable alternative to existing static storage and data access methods for a wide array of combined simulation, data access and visualization purposes.

A Comparison of Speech Sound Intervention Delivered by Telepractice and Side-by-Side Service Delivery Models

ERIC Educational Resources Information Center

Grogan-Johnson, Sue; Schmidt, Anna Marie; Schenker, Jason; Alvares, Robin; Rowan, Lynne E.; Taylor, Jacquelyn

2013-01-01

Telepractice has the potential to provide greater access to speech-language intervention services for children with communication impairments. Substantiation of this delivery model is necessary for telepractice to become an accepted alternative delivery model. This study investigated the progress made by school-age children with speech sound…

Alternating-script priming in Japanese: Are Katakana and Hiragana characters interchangeable?

PubMed

Perea, Manuel; Nakayama, Mariko; Lupker, Stephen J

2017-07-01

Models of written word recognition in languages using the Roman alphabet assume that a word's visual form is quickly mapped onto abstract units. This proposal is consistent with the finding that masked priming effects are of similar magnitude from lowercase, uppercase, and alternating-case primes (e.g., beard-BEARD, BEARD-BEARD, and BeArD-BEARD). We examined whether this claim can be readily generalized to the 2 syllabaries of Japanese Kana (Hiragana and Katakana). The specific rationale was that if the visual form of Kana words is lost early in the lexical access process, alternating-script repetition primes should be as effective as same-script repetition primes at activating a target word. Results showed that alternating-script repetition primes were less effective at activating lexical representations of Katakana words than same-script repetition primes-indeed, they were no more effective than partial primes that contained only the Katakana characters from the alternating-script primes. Thus, the idiosyncrasies of each writing system do appear to shape the pathways to lexical access. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Patient-Centered Appointment Scheduling Using Agent-Based Simulation

PubMed Central

Turkcan, Ayten; Toscos, Tammy; Doebbeling, Brad N.

2014-01-01

Enhanced access and continuity are key components of patient-centered care. Existing studies show that several interventions such as providing same day appointments, walk-in services, after-hours care, and group appointments, have been used to redesign the healthcare systems for improved access to primary care. However, an intervention focusing on a single component of care delivery (i.e. improving access to acute care) might have a negative impact other components of the system (i.e. reduced continuity of care for chronic patients). Therefore, primary care clinics should consider implementing multiple interventions tailored for their patient population needs. We collected rapid ethnography and observations to better understand clinic workflow and key constraints. We then developed an agent-based simulation model that includes all access modalities (appointments, walk-ins, and after-hours access), incorporate resources and key constraints and determine the best appointment scheduling method that improves access and continuity of care. This paper demonstrates the value of simulation models to test a variety of alternative strategies to improve access to care through scheduling. PMID:25954423

Origami: A Versatile Modeling System for Visualising Chemical Structure and Exploring Molecular Function

ERIC Educational Resources Information Center

Davis, James; Leslie, Ray; Billington, Susan; Slater, Peter R.

2010-01-01

The use of "Origami" is presented as an accessible and transferable modeling system through which to convey the intricacies of molecular shape and highlight structure-function relationships. The implementation of origami has been found to be a versatile alternative to conventional ball-and-stick models, possessing the key advantages of being both…

Website accessibility in the tourism industry: an analysis of official national tourism organization websites around the world.

PubMed

Domínguez Vila, Trinidad; Alén González, Elisa; Darcy, Simon

2017-08-09

To analyze the accessibility of official national tourism organization websites of countries around the world, in order to establish possible common patterns and rankings of those with exemplary practice through to those with the highest number of issues. The purpose for undertaking such an analysis is to provide a quasi-indicator of inclusive organizational practice for online accessibility for both destination managers and their accessible tourism consumers - domestic and overseas people with disability visiting the websites. The official tourism websites of 210 countries included in the latest World Tourism Organization report were analyzed. A website accessibility evaluation tool (website accessible test) was used in the analysis, according to AA and AAA levels of conformance to Web Content Accessibility Guidelines 2.0 requirements. Different patterns compliance to Web Content Accessibility Guidelines 2.0 were established for the clusters, which were rather similar for both AA and AAA conformance levels. The main issues in the least accessible websites were also identified, mainly focused on the following guidelines: navigable, compatible, adaptability, text alternatives and also referred to other assistive technologies. Once the main issues were established several alternatives are suggested to address them, such as implementing more prescriptive laws and regulations, complying with mandatory benchmark standards and/or having external agencies audit website designs. However, in addition to using benchmark standards, efforts to improve this situation should also be made by programmers, who should also rely on preexistent experiences and develop more dynamic knowledge. This knowledge may include text alternatives for any nontext content; creation of content that can be presented in different ways without losing information; provide ways to help users navigate, find content, determine where they are and navigate websites to maximize compatibility with assistive technologies and user agents. Implications for rehabilitation Access to information - in this case, online information - is an important factor in the process of rehabilitation for people with disability and those supporting them. Failure to apply homogeneous criteria for website accessibility around the world can hamper access to information by people with disabilities. Travel planning requires access to mainstream tourist distribution networks where online inclusive practice is a precursor to information searching. Documents for destination managers and programmers the main problems of accessibility to websites and examples of models or solutions to follow and not. Establish the main inclusive website design criteria on which to focus on improving the access of people with disabilities to websites (e.g., text alternatives, content presented in different ways, navigating and improving compatibility with assistive technologies etc.).

Society of Gynecologic Oncology Future of Physician Payment Reform Task Force report: The Endometrial Cancer Alternative Payment Model (ECAP).

PubMed

Ko, Emily M; Havrilesky, Laura J; Alvarez, Ronald D; Zivanovic, Oliver; Boyd, Leslie R; Jewell, Elizabeth L; Timmins, Patrick F; Gibb, Randall S; Jhingran, Anuja; Cohn, David E; Dowdy, Sean C; Powell, Matthew A; Chalas, Eva; Huang, Yongmei; Rathbun, Jill; Wright, Jason D

2018-05-01

Health care in the United States is in the midst of a significant transformation from a "fee for service" to a "fee for value" based model. The Medicare Access and CHIP Reauthorization Act of 2015 has only accelerated this transition. Anticipating these reforms, the Society of Gynecologic Oncology developed the Future of Physician Payment Reform Task Force (PPRTF) in 2015 to develop strategies to ensure fair value based reimbursement policies for gynecologic cancer care. The PPRTF elected as a first task to develop an Alternative Payment Model for thesurgical management of low risk endometrial cancer. The history, rationale, and conceptual framework for the development of an Endometrial Cancer Alternative Payment Model are described in this white paper, as well as directions forfuture efforts. Copyright © 2018 Elsevier Inc. All rights reserved.

Reasoning with alternative explanations in physics: The cognitive accessibility rule

NASA Astrophysics Data System (ADS)

Heckler, Andrew F.; Bogdan, Abigail M.

2018-06-01

A critical component of scientific reasoning is the consideration of alternative explanations. Recognizing that decades of cognitive psychology research have demonstrated that relative cognitive accessibility, or "what comes to mind," strongly affects how people reason in a given context, we articulate a simple "cognitive accessibility rule", namely that alternative explanations are considered less frequently when an explanation with relatively high accessibility is offered first. In a series of four experiments, we test the cognitive accessibility rule in the context of consideration of alternative explanations for six physical scenarios commonly found in introductory physics curricula. First, we administer free recall and recognition tasks to operationally establish and distinguish between the relative accessibility and availability of common explanations for the physical scenarios. Then, we offer either high or low accessibility explanations for the physical scenarios and determine the extent to which students consider alternatives to the given explanations. We find two main results consistent across algebra- and calculus-based university level introductory physics students for multiple answer formats. First, we find evidence that, at least for some contexts, most explanatory factors are cognitively available to students but not cognitively accessible. Second, we empirically verify the cognitive accessibility rule and demonstrate that the rule is strongly predictive, accounting for up to 70% of the variance of the average student consideration of alternative explanations across scenarios. Overall, we find that cognitive accessibility can help to explain biases in the consideration of alternatives in reasoning about simple physical scenarios, and these findings lend support to the growing number of science education studies demonstrating that tasks relevant to science education curricula often involve rapid, automatic, and potentially predictable processes and outcomes.

Clinician accessible tools for GUI computational models of transcranial electrical stimulation: BONSAI and SPHERES.

PubMed

Truong, Dennis Q; Hüber, Mathias; Xie, Xihe; Datta, Abhishek; Rahman, Asif; Parra, Lucas C; Dmochowski, Jacek P; Bikson, Marom

2014-01-01

Computational models of brain current flow during transcranial electrical stimulation (tES), including transcranial direct current stimulation (tDCS) and transcranial alternating current stimulation (tACS), are increasingly used to understand and optimize clinical trials. We propose that broad dissemination requires a simple graphical user interface (GUI) software that allows users to explore and design montages in real-time, based on their own clinical/experimental experience and objectives. We introduce two complimentary open-source platforms for this purpose: BONSAI and SPHERES. BONSAI is a web (cloud) based application (available at neuralengr.com/bonsai) that can be accessed through any flash-supported browser interface. SPHERES (available at neuralengr.com/spheres) is a stand-alone GUI application that allow consideration of arbitrary montages on a concentric sphere model by leveraging an analytical solution. These open-source tES modeling platforms are designed go be upgraded and enhanced. Trade-offs between open-access approaches that balance ease of access, speed, and flexibility are discussed. Copyright © 2014 Elsevier Inc. All rights reserved.

Extended vs. brief intermittent access to palatable food differently promote binge-like intake, rejection of less preferred food, and weight cycling in female rats.

PubMed

Kreisler, A D; Garcia, M G; Spierling, S R; Hui, B E; Zorrilla, E P

2017-08-01

Palatable food access promotes obesity leading some to diet. Here, we modeled the roles of duration, intermittency and choice of access in bingeing, escalation of daily intake, and underacceptance of alternatives. Female rats with ("Choice") or without continuous chow access, received chow or continuous (Chocolate), intermittent (MWF) long (24h, Int-Long), or intermittent short (30min, Int-Short) access to a sucrose-rich, chocolate-flavored diet (CHOC). Int-Long rats showed cycling body weight; they overate CHOC, had increased feed efficiency on access days and underate chow and lost weight on non-access days, the latter correlating with their reduced brown fat. Int-Short rats had the greatest 30-min intake upon CHOC access, but did not underaccept chow or weight cycle. Individual vulnerability for intermittent access-induced feeding adaptations was seen. Continuous access rats gained fat disproportionate, but in direct relation, to their normalized energy intake and persistently underaccepted chow despite abstinence and return to normal weight. Abstinence reduced the binge-like CHOC intake of Int-Short rats and increased that of continuous access rats, but not to levels associated with intermittent access history. Choice increased daily CHOC intake under Continuous access and binge-like intake under Int-Short access. Intermittency and duration of past access to palatable food have dissociable, individually-vulnerable influences on its intake and that of alternatives. With extended access, daily intake reflects the palatability of available food, rather than metabolic need. Ongoing restrictedness of access or a history of intermittency each drive binge-like intake. Aspects of palatable food availability, similar and different to drug availability, promote disordered eating. Copyright © 2017 Elsevier Inc. All rights reserved.

Analysis of safety impacts of access management alternatives using the surrogate safety assessment model : final report.

DOT National Transportation Integrated Search

2017-06-01

The purpose of this study was to evaluate if the Surrogate Safety Assessment Model (SSAM) could be used to assess the safety of a highway segment or an intersection in terms of the number and type of conflicts and to compare the safety effects of mul...

Economic models for prevention: making a system work for patients

PubMed Central

2015-01-01

The purpose of this article is to describe alternative means of providing patient centered, preventive based, services using an alternative non-profit, economic model. Hard to reach, vulnerable groups, including children, adults and elders, often have difficulties accessing traditional dental services for a number of reasons, including economic barriers. By partnering with community organizations that serve these groups, collaborative services and new opportunities for access are provided. The concept of a dental home is well accepted as a means of providing care, and, for these groups, provision of such services within community settings provides a sustainable means of delivery. Dental homes provided through community partnerships can deliver evidence based dental care, focused on a preventive model to achieve and maintain oral health. By using a non-profit model, the entire dental team is provided with incentives to deliver measurable quality improvements in care, rather than a more traditional focus on volume of activity alone. Examples are provided that demonstrate how integrated oral health services can deliver improved health outcomes with the potential to reduce total costs while improving quality. PMID:26391814

Evaluating the impact of climate policies on regional food availability and accessibility using an Integrated Assessment Model

NASA Astrophysics Data System (ADS)

Gilmore, E.; Cui, Y. R.; Waldhoff, S.

2015-12-01

Beyond 2015, eradicating hunger will remain a critical part of the global development agenda through the Sustainable Development Goals (SDG). Efforts to limit climate change through both mitigation of greenhouse gas emissions and land use policies may interact with food availability and accessibility in complex and unanticipated ways. Here, we develop projections of regional food accessibility to 2050 under the alternative futures outlined by the Shared Socioeconomic Pathways (SSPs) and under different climate policy targets and structures. We use the Global Change Assessment Model (GCAM), an integrated assessment model (IAM), for our projections. We calculate food access as the weighted average of consumption of five staples and the portion of income spend on those commodities and extend the GCAM calculated universal global producer price to regional consumer prices drawing on historical relationships of these prices. Along the SSPs, food access depends largely on expectations of increases in population and economic status. Under a more optimistic scenario, the pressures on food access from increasing demand and rising prices can be counterbalanced by faster economic development. Stringent climate policies that increase commodity prices, however, may hinder vulnerable regions, namely Sub-Saharan Africa, from achieving greater food accessibility.

Future considerations for clinical dermatology in the setting of 21st century American policy reform: The Medicare Access and Children's Health Insurance Program Reauthorization Act and Alternative Payment Models in dermatology.

PubMed

Barbieri, John S; Miller, Jeffrey J; Nguyen, Harrison P; Forman, Howard P; Bolognia, Jean L; VanBeek, Marta J

2017-06-01

With the introduction of the Medicare Access and Children's Health Insurance Program Reauthorization Act, clinicians who are not eligible for an exemption must choose to participate in 1 of 2 new reimbursement models: the Merit-based Incentive Payment System or Alternative Payment Models (APMs). Although most dermatologists are expected to default into the Merit-based Incentive Payment System, some may have an interest in exploring APMs, which have associated financial incentives. However, for dermatologists interested in the APM pathway, there are currently no options other than joining a qualifying Accountable Care Organization, which make up only a small subset of Accountable Care Organizations overall. As a result, additional APMs relevant to dermatologists are needed to allow those interested in the APMs to explore this pathway. Fortunately, the Medicare Access and Children's Health Insurance Program Reauthorization Act establishes a process for new APMs to be approved and the creation of bundled payments for skin diseases may represent an opportunity to increase the number of APMs available to dermatologists. In this article, we will provide a detailed review of APMs under the Medicare Access and Children's Health Insurance Program Reauthorization Act and discuss the development and introduction of APMs as they pertain to dermatology. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

A Generalized DBMS to Support Diversified Data.

DTIC Science & Technology

1987-07-21

interest on bonds ). Hence. they require a definition of subtraction which yields 30 days as the answer to the above computation. Only a user-defined...STON85]. Alternately. one can follow the standard scheduler model [BERNS1] in which a module is callable by code in the access methods when a...direction for evolution . These could include when to cease investigating alternate plans. and the ability to specify one’s own optimizer parameters

Image contrast mechanisms in dynamic friction force microscopy: Antimony particles on graphite

NASA Astrophysics Data System (ADS)

Mertens, Felix; Göddenhenrich, Thomas; Dietzel, Dirk; Schirmeisen, Andre

2017-01-01

Dynamic Friction Force Microscopy (DFFM) is a technique based on Atomic Force Microscopy (AFM) where resonance oscillations of the cantilever are excited by lateral actuation of the sample. During this process, the AFM tip in contact with the sample undergoes a complex movement which consists of alternating periods of sticking and sliding. Therefore, DFFM can give access to dynamic transition effects in friction that are not accessible by alternative techniques. Using antimony nanoparticles on graphite as a model system, we analyzed how combined influences of friction and topography can effect different experimental configurations of DFFM. Based on the experimental results, for example, contrast inversion between fractional resonance and band excitation imaging strategies to extract reliable tribological information from DFFM images are devised.

Accessibility and distribution of the Norwegian National Air Emergency Service: 1988-1998.

PubMed

Heggestad, Torhild; Børsheim, Knut Yngve

2002-01-01

To evaluate the accessibility and distribution of the Norwegian National Air Emergency Service in the 10-year period from 1988 to 1998. The primary material was annual standardized activity data that included all helicopter missions. A multivariate model of determinants for use of the helicopter service was computed by linear regression. Accessibility was measured as the percentage of the population reached in different flying times, and we evaluated the service using a simulation of alternative locations for the helicopter bases. The helicopter service (HEMS) has short access times, with a mean reaction time of 8 minutes and a mean response time of 26 minutes for acute missions. Nearly all patients (98%) are reached within 1 hour. A simulation that tested alternative locations of the helicopter bases compared with current locations showed no increase in accessibility. The use of the service shows large regional differences. Multivariate analyses showed that the distances of the patients from the nearest helicopter base and the nearest hospital are significant determinants for the use of HEMS. Establishment of a national service has given the Norwegian population better access to highly qualified prehospital emergency services. Furthermore, the HEMS has a compensating effect in adjusting for differences in traveling distances to a hospital. Safety, cost-containment, and gatekeeper functions remain challenges.

Can hydro-economic river basin models simulate water shadow prices under asymmetric access?

PubMed

Kuhn, A; Britz, W

2012-01-01

Hydro-economic river basin models (HERBM) based on mathematical programming are conventionally formulated as explicit 'aggregate optimization' problems with a single, aggregate objective function. Often unintended, this format implicitly assumes that decisions on water allocation are made via central planning or functioning markets such as to maximize social welfare. In the absence of perfect water markets, however, individually optimal decisions by water users will differ from the social optimum. Classical aggregate HERBMs cannot simulate that situation and thus might be unable to describe existing institutions governing access to water and might produce biased results for alternative ones. We propose a new solution format for HERBMs, based on the format of the mixed complementarity problem (MCP), where modified shadow price relations express spatial externalities resulting from asymmetric access to water use. This new problem format, as opposed to commonly used linear (LP) or non-linear programming (NLP) approaches, enables the simultaneous simulation of numerous 'independent optimization' decisions by multiple water users while maintaining physical interdependences based on water use and flow in the river basin. We show that the alternative problem format allows the formulation HERBMs that yield more realistic results when comparing different water management institutions.

African American Female Offender's Use of Alternative and Traditional Health Services After Re-Entry: Examining the Behavioral Model for Vulnerable Populations.

PubMed

Oser, Carrie B; Bunting, Amanda M; Pullen, Erin; Stevens-Watkins, Danelle

2016-01-01

This is the first known study to use the Gelberg-Andersen Behavioral Model for Vulnerable Populations to predict African American women's use of three types of health services (alternative, hospitalization, and ambulatory) in the 18 months after release from prison. In the multivariate models, the most robust predictors of all three types of service utilization were in the vulnerable theoretical domains. Alternative health services were predicted by ethnic community membership, higher religiosity, and HIV/HCV. Hospitalizations were predicted by the lack of barriers to health care and disability. Ambulatory office visits were predicted by more experiences of gendered racism, a greater number of physical health problems, and HIV/HCV. Findings highlight the importance of cultural factors and HIV/HCV in obtaining both alternative and formal health care during community re-entry. Clinicians and policymakers should consider the salient role that the vulnerable domain plays in offender's accessing health services.

African American Female Offender’s Use of Alternative and Traditional Health Services After Re-Entry: Examining the Behavioral Model for Vulnerable Populations

PubMed Central

Oser, Carrie B.; Bunting, Amanda M.; Pullen, Erin; Stevens-Watkins, Danelle

2016-01-01

This is the first known study to use the Gelberg-Andersen Behavioral Model for Vulnerable Populations to predict African American women’s use of three types of health services (alternative, hospitalization, and ambulatory) in the 18 months after release from prison. In the multivariate models, the most robust predictors of all three types of service utilization were in the vulnerable theoretical domains. Alternative health services were predicted by ethnic community membership, higher religiosity, and HIV/HCV. Hospitalizations were predicted by the lack of barriers to health care and disability. Ambulatory office visits were predicted by more experiences of gendered racism, a greater number of physical health problems, and HIV/HCV. Findings highlight the importance of cultural factors and HIV/HCV in obtaining both alternative and formal health care during community re-entry. Clinicians and policy makers should consider the salient role that the vulnerable domain plays in offender’s accessing health services. PMID:27133515

Alternate Service Delivery Models in Cancer Genetic Counseling: A Mini-Review.

PubMed

Buchanan, Adam Hudson; Rahm, Alanna Kulchak; Williams, Janet L

2016-01-01

Demand for cancer genetic counseling has grown rapidly in recent years as germline genomic information has become increasingly incorporated into cancer care, and the field has entered the public consciousness through high-profile celebrity publications. Increased demand and existing variability in the availability of trained cancer genetics clinicians place a priority on developing and evaluating alternate service delivery models for genetic counseling. This mini-review summarizes the state of science regarding service delivery models, such as telephone counseling, telegenetics, and group counseling. Research on comparative effectiveness of these models in traditional individual, in-person genetic counseling has been promising for improving access to care in a manner acceptable to patients. Yet, it has not fully evaluated the short- and long-term patient- and system-level outcomes that will help answer the question of whether these models achieve the same beneficial psychosocial and behavioral outcomes as traditional cancer genetic counseling. We propose a research agenda focused on comparative effectiveness of available service delivery models and how to match models to patients and practice settings. Only through this rigorous research can clinicians and systems find the optimal balance of clinical quality, ready and secure access to care, and financial sustainability. Such research will be integral to achieving the promise of genomic medicine in oncology.

Health insurance and use of alternative medicine in Mexico

PubMed Central

van Gameren, Edwin

2014-01-01

Objectives I analyze the effect of coverage by health insurance on the use of alternative medicine such as folk healers and homeopaths, in particular if it complements or substitutes conventional services. Methods Panel data from the Mexican Health and Aging Study (MHAS) is used to estimate bivariate probit models in order to explain the use of alternative medicine while allowing the determinant of interest, access to health insurance, to be an endogenous factor. Results The findings indicate that households with insurance coverage less often use alternative medicine, and that the effect is much stronger among poor than among rich households. Conclusions Poor households substitute away from traditional medicine towards conventional medicine. PMID:20546965

Food capacities and satisfaction in participants in food security community interventions in Montreal, Canada.

PubMed

Roncarolo, Federico; Adam, Caroline; Bisset, Sherri; Potvin, Louise

2016-12-01

Food insecurity is steadily increasing in Canada. The objective of this paper is to determine if food capacities and satisfaction of recently enrolled participants in food security interventions are associated with the intervention having either a traditional or an alternative type of approach. Participants having recently accessed traditional (n = 711) or alternative community interventions (n = 113) in the Montreal metropolitan area, Canada, were interviewed with a questionnaire. The categorizing variable was participation in a community organization providing either traditional interventions, aimed to help people cope with the urgent need of food, or alternative interventions, aimed at first assistance, in addition to the creation of long-term solutions such as social integration and skills development. Participants' food and nutrition-related capacities and food satisfaction are studied. Multilevel regression models were used to assess whether participants took part in a traditional or alternative interventions. These interventions do not reach the same population. Relative to participants in alternative food security interventions, participants in traditional interventions demonstrated less capacity for accessing information about food safety and healthiness, and perceived their diet as less healthy. Traditional food security participants also paid less attention to the nutritional properties of food and reported less satisfaction with quantity, variety and taste of the food they accessed. The reasons why individuals who may benefit the most from alternative interventions were unlikely to participate should be investigated. The potential that food security interventions may inadvertently reinforce social inequalities in health should be considered in future intervention research. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Excluding the poor from accessing biomedical literature: a rights violation that impedes global health.

PubMed

Yamey, Gavin

2008-01-01

Most biomedical journals charge readers a hefty access toll to read the full text version of a published research article. These tolls bring enormous profits to the traditional corporate publishing industry, but they make it impossible for most people worldwide--particularly in low and middle income countries--to access the biomedical literature. Traditional publishers also insist on owning the copyright on these articles, making it illegal for readers to freely distribute and photocopy papers, translate them, or create derivative educational works. This article argues that excluding the poor from accessing and freely using the biomedical research literature is harming global public health. Health care workers, for example, are prevented from accessing the information they need to practice effective medicine, while policymakers are prevented from accessing the essential knowledge they require to build better health care systems. The author proposes that the biomedical literature should be considered a global public good, basing his arguments upon longstanding and recent international declarations that enshrine access to scientific and medical knowledge as a human right. He presents an emerging alternative publishing model, called open access, and argues that this model is a more socially responsive and equitable approach to knowledge dissemination.

Access to augmentative and alternative communication: new technologies and clinical decision-making.

PubMed

Fager, Susan; Bardach, Lisa; Russell, Susanne; Higginbotham, Jeff

2012-01-01

Children with severe physical impairments require a variety of access options to augmentative and alternative communication (AAC) and computer technology. Access technologies have continued to develop, allowing children with severe motor control impairments greater independence and access to communication. This article will highlight new advances in access technology, including eye and head tracking, scanning, and access to mainstream technology, as well as discuss future advances. Considerations for clinical decision-making and implementation of these technologies will be presented along with case illustrations.

Expanding Access: An Evaluation of ReadCube Access as an ILL Alternative.

PubMed

Grabowsky, Adelia

2016-01-01

ReadCube Access is a patron-driven, document delivery system that provides immediate access to articles from journals owned by Nature Publishing Group. The purpose of this study was to evaluate the use of ReadCube Access as an interlibrary loan (ILL) alternative for nonsubscribed Nature journals at Auburn University, a research university with a School of Pharmacy and a School of Veterinary Medicine. An analysis of ten months' usage and costs are presented along with the results of a user satisfaction survey. Auburn University Libraries found ReadCube to be an acceptable alternative to ILL for unsubscribed Nature journals and at current levels of use and cost, consider ReadCube to be financially sustainable.

Side-chain mobility in the folded state of Myoglobin

NASA Astrophysics Data System (ADS)

Lammert, Heiko; Onuchic, Jose

We study the accessibility of alternative side-chain rotamer configurations in the native state of Myoglobin, using an all-atom structure-based model. From long, unbiased simulation trajectories we determine occupancies of rotameric states and also estimate configurational and vibrational entropies. Direct sampling of the full native-state dynamics, enabled by the simple model, reveals facilitation of side-chain motions by backbone dynamics. Correlations between different dihedral angles are quantified and prove to be weak. We confirm global trends in the mobilities of side-chains, following burial and also the chemical character of residues. Surface residues loose little configurational entropy upon folding; side-chains contribute significantly to the entropy of the folded state. Mobilities of buried side-chains vary strongly with temperature. At ambient temperature, individual side-chains in the core of the protein gain substantial access to alternative rotamers, with occupancies that are likely observable experimentally. Finally, the dynamics of buried side-chains may be linked to the internal pockets, available to ligand gas molecules in Myoglobin.

Design Sketches For Optical Crossbar Switches Intended For Large-Scale Parallel Processing Applications

NASA Astrophysics Data System (ADS)

Hartmann, Alfred; Redfield, Steve

1989-04-01

This paper discusses design of large-scale (1000x 1000) optical crossbar switching networks for use in parallel processing supercom-puters. Alternative design sketches for an optical crossbar switching network are presented using free-space optical transmission with either a beam spreading/masking model or a beam steering model for internodal communications. The performances of alternative multiple access channel communications protocol-unslotted and slotted ALOHA and carrier sense multiple access (CSMA)-are compared with the performance of the classic arbitrated bus crossbar of conventional electronic parallel computing. These comparisons indicate an almost inverse relationship between ease of implementation and speed of operation. Practical issues of optical system design are addressed, and an optically addressed, composite spatial light modulator design is presented for fabrication to arbitrarily large scale. The wide range of switch architecture, communications protocol, optical systems design, device fabrication, and system performance problems presented by these design sketches poses a serious challenge to practical exploitation of highly parallel optical interconnects in advanced computer designs.

Implementing a Facial Recognition System to Improve Accessibility and Increase Utilization of Entry Control Points at Military Installations

DTIC Science & Technology

2011-06-01

event simulation is used to model three alternatives to the ECP system. The baseline system which contains two manned kiosks, a fully automated system...experience is traffic delays in the morning for government employees accessing the bases. If one or two lanes were dedicated to 3 completely or even semi...purpose of clarity, the figure below displays only the two lowest levels of functions. This final functional decomposition identifies the sub functions

Oral Health Care for Children in Countries Using Dental Therapists in Public, School-Based Programs, Contrasted with That of the United States, Using Dentists in a Private Practice Model

PubMed Central

Friedman, Jay W.; Nash, David A.

2013-01-01

The United States faces a significant problem with access to oral health care, particularly for children. More than 50 countries have developed an alternative dental provider, a dental therapist, practicing in public, school-based programs, to address children’s access to care. This delivery model has been demonstrated to improve access to care and oral health outcomes while providing quality care economically. We summarize elements of a recent major review of the global literature on the use of dental therapists, “A Review of the Global Literature on Dental Therapists: In the Context of the Movement to Add Dental Therapists to the Oral Health Workforce in the United States.” We contrast the success of a school-based model of caring for children by dental therapists with that of the US model of dentists providing care for children in private practices. PMID:23865650

Beyond Access: Methods and Models for Increasing Retention and Learning among Minority Students. New Directions for Community Colleges, Issue 112. The Jossey-Bass Higher and Adult Education Series.

ERIC Educational Resources Information Center

Aragon, Steven R., Ed.

2000-01-01

This edition of New Directions for Community Colleges offers community college educators alternative models, approaches, and perspectives to consider in working with ethnic minority students. The volume addresses issues of assessment, career and educational goals, learning enhancement, success courses, mentoring programs, campus climate,…

A Decision Support System for Energy Policy Analysis.

DTIC Science & Technology

1980-07-01

new realities or hypothesized realities to the modeling system. Lack of a PDL would make the system inflexible and accessible only to a patient ... expert . Certainly, given the present ratio of costs of personnel to costs of computers, the alternative of presenting data in its raw form is acceptable

Evolving bipartite authentication graph partitions

DOE PAGES

Pope, Aaron Scott; Tauritz, Daniel Remy; Kent, Alexander D.

2017-01-16

As large scale enterprise computer networks become more ubiquitous, finding the appropriate balance between user convenience and user access control is an increasingly challenging proposition. Suboptimal partitioning of users’ access and available services contributes to the vulnerability of enterprise networks. Previous edge-cut partitioning methods unduly restrict users’ access to network resources. This paper introduces a novel method of network partitioning superior to the current state-of-the-art which minimizes user impact by providing alternate avenues for access that reduce vulnerability. Networks are modeled as bipartite authentication access graphs and a multi-objective evolutionary algorithm is used to simultaneously minimize the size of largemore » connected components while minimizing overall restrictions on network users. Lastly, results are presented on a real world data set that demonstrate the effectiveness of the introduced method compared to previous naive methods.« less

Evolving bipartite authentication graph partitions

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

Pope, Aaron Scott; Tauritz, Daniel Remy; Kent, Alexander D.

As large scale enterprise computer networks become more ubiquitous, finding the appropriate balance between user convenience and user access control is an increasingly challenging proposition. Suboptimal partitioning of users’ access and available services contributes to the vulnerability of enterprise networks. Previous edge-cut partitioning methods unduly restrict users’ access to network resources. This paper introduces a novel method of network partitioning superior to the current state-of-the-art which minimizes user impact by providing alternate avenues for access that reduce vulnerability. Networks are modeled as bipartite authentication access graphs and a multi-objective evolutionary algorithm is used to simultaneously minimize the size of largemore » connected components while minimizing overall restrictions on network users. Lastly, results are presented on a real world data set that demonstrate the effectiveness of the introduced method compared to previous naive methods.« less

Facilitating Access to Emotions: Neural Signature of EMDR Stimulation

PubMed Central

Herkt, Deborah; Tumani, Visal; Grön, Georg; Kammer, Thomas; Hofmann, Arne; Abler, Birgit

2014-01-01

Background Eye Movement Desensitisation and Reprocessing (EMDR) is a method in psychotherapy effective in treating symptoms of posttraumatic stress disorder. The client attends to alternating bilateral visual, auditory or sensory stimulation while confronted with emotionally disturbing material. It is thought that the bilateral stimulation as a specific element of EMDR facilitates accessing and processing of negative material while presumably creating new associative links. We hypothesized that the putatively facilitated access should be reflected in increased activation of the amygdala upon bilateral EMDR stimulation even in healthy subjects. Methods We investigated 22 healthy female university students (mean 23.5 years) with fMRI. Subjects were scanned while confronted with blocks of disgusting and neutral picture stimuli. One third of the blocks was presented without any additional stimulation, one third with bilateral simultaneous auditory stimulation, and one third with bilateral alternating auditory stimulation as used in EMDR. Results Contrasting disgusting vs. neutral picture stimuli confirmed the expected robust effect of amygdala activation for all auditory stimulation conditions. The interaction analysis with the type of auditory stimulation revealed a specific increase in activation of the right amygdala for the bilateral alternating auditory stimulation. Activation of the left dorsolateral prefrontal cortex showed the opposite effect with decreased activation. Conclusions We demonstrate first time evidence for a putative neurobiological basis of the bilateral alternating stimulation as used in the EMDR method. The increase in limbic processing along with decreased frontal activation is in line with theoretical models of how bilateral alternating stimulation could help with therapeutic reintegration of information, and present findings may pave the way for future research on EMDR in the context of posttraumatic stress disorder. PMID:25165974

77 FR 9882 - Arsenic Small Systems Compliance and Alternative Affordability Criteria Working Group; public...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-21

... held via the Internet using a Webcast and teleconference. Registrants will receive an Internet access... period or individuals without Internet access seeking alternative means to participate in the meeting...

The Medicare Access And CHIP Reauthorization Act: Effects On Medicare Payment Policy And Spending.

PubMed

Hussey, Peter S; Liu, Jodi L; White, Chapin

2017-04-01

In 2015, Congress repealed the Sustainable Growth Rate formula for Medicare physician payment, eliminating mandatory payment cuts when spending exceeded what was budgeted. In its place, Congress enacted the Medicare Access and CHIP Reauthorization Act (MACRA), which established a two-track performance-based payment system that encourages physicians to participate in alternative payment models. MACRA could have huge effects on health care delivery, but the nature of those effects is highly uncertain. Using the RAND Corporation's Health Care Payment and Delivery Simulation Model, we estimated the effects of MACRA on Medicare spending and utilization and examined how effects would differ under various scenarios. We estimate that MACRA will decrease Medicare spending on physician services by -$35 to -$106 billion (-2.3 percent to -7.1 percent) and change spending on hospital services by $32 to -$250 billion (0.7 percent to -5.1 percent) in 2015-30. The spending effects are critically dependent on the strength of incentives in the alternative payment models, particularly the incentives for physicians to reduce hospital spending and physician responses to MACRA payment rates. Project HOPE—The People-to-People Health Foundation, Inc.

Data Integration Using SOAP in the VSO

NASA Astrophysics Data System (ADS)

Tian, K. Q.; Bogart, R. S.; Davey, A.; Dimitoglou, G.; Gurman, J. B.; Hill, F.; Martens, P. C.; Wampler, S.

2003-05-01

The Virtual Solar Observatory (VSO) project has implemented a time interval search for all four participating data archives. The back-end query services are implemented as web services, and are accessible via SOAP. SOAP (Simple Object Access Protocol) defines an RPC (Remote Procedure Call) mechanism that employs HTTP as its transport and encodes the client-server interactions (request and response messages) in XML (eXtensible Markup Language) documents. In addition to its core function of identifying relevant datasets in the local archive, the SOAP server at each data provider acts as a "wrapper" that maps descriptions in an abstract data model to those in the provider-specific data model, and vice versa. It is in this way that VSO integrates heterogeneous data services and allows access to them using a common interface. Our experience with SOAP has been fruitful. It has proven to be a better alternative to traditional web access methods, namely POST and GET, because of its flexibility and interoperability.

Alternative Payment Models in Radiology: The Legislative and Regulatory Roadmap for Reform.

PubMed

Silva, Ezequiel; McGinty, Geraldine B; Hughes, Danny R; Duszak, Richard

2016-10-01

The Medicare Access and CHIP Reauthorization Act (MACRA) replaces the sustainable growth rate with a payment system based on the Merit-Based Incentive Payment System and incentives for alternative payment model participation. It is important that radiologists understand the statutory requirements of MACRA. This includes the nature of the Merit-Based Incentive Payment System composite performance score and its impact on payments. The timeline for MACRA implementation is fairly aggressive and includes a robust effort to define episode groups, which include radiologic services. A number of organizations, including the ACR, are commenting on the structure of MACRA-directed initiatives. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Limited access atrial septal defect closure and the evolution of minimally invasive surgery.

PubMed

Izzat, M B; Yim, A P; El-Zufari, M H

1998-04-01

While minimizing the "invasiveness" in general surgery has been equated with minimizing "access", what constitutes minimally invasive intra-cardiac surgery remains controversial. Many surgeons doubt the benefits of minimizing access when the need for cardiopulmonary bypass cannot be waived. Recognizing that median sternotomy itself does entail significant morbidity, we investigated the value of alternative approaches to median sternotomy using atrial septal defect closure as our investigative model. We believe that some, but not all minimal access approaches are associated with reduced postoperative morbidity and enhanced recovery. Our current strategy is to use a mini-sternotomy approach in adult patients, whereas conventional median sternotomy remains our standard approach in the pediatric population. Considerable clinical experiences coupled with documented clinical benefits are fundamental before a certain approach is adopted in routine practice.

Using iPad Tablets for Self-modeling with Preschoolers: Videos versus Photos

ERIC Educational Resources Information Center

McCoy, Dacia M.; Morrison, Julie Q.; Barnett, Dave W.; Kalra, Hilary D.; Donovan, Lauren K.

2017-01-01

As technology becomes more accessible and acceptable in the preschool setting, teachers need effective strategies of incorporating it to address challenging behaviors. A nonconcurrent delayed multiple baseline design in combination with an alternating treatment design was utilized to investigate the effects of using iPad tablets to display video…

The University-Center Baccalaureate Degree in California: A Multiple Case Study

ERIC Educational Resources Information Center

Rhoades, Jeffrey T.

2014-01-01

The community college baccalaureate and the university-center baccalaureate models are gaining traction in the state of California as alternatives to addressing the need for greater access to baccalaureate degree programs and to increase the baccalaureate-educated workforce. Little is known about the characteristics and factors associated with the…

Use of Vendedores (Mobile Food Vendors), Pulgas (Flea Markets), and Vecinos o Amigos (Neighbors or Friends) as Alternative Sources of Food for Purchase among Mexican-origin Households in Texas Border Colonias

PubMed Central

Sharkey, Joseph R.; Dean, Wesley R.; Johnson, Cassandra M.

2012-01-01

There is a paucity of studies acknowledging the existence of alternative food sources, and factors associated with food purchasing from three common alternative sources: vendedores (mobile food vendors), pulgas (flea markets), and vecinos/amigos (neighbors/friends). This analysis aims to examine the use of alternative food sources by Mexican-origin women from Texas-border colonias and determine factors associated with their use. The design was cross-sectional. Promotora-researchers (promotoras de salud trained in research methods) recruited 610 Mexican-origin women from 44 colonias and conducted in-person surveys. Surveys included participant characteristics and measures of food environment use and household food security. Statistical analyses included separate logistic regressions, modeled for food purchase from mobile food vendors, pulgas, or neighbors/friends (NFs). Child food insecurity was associated with purchasing food from mobile food vendors, while household food security was associated with using pulgas or NFs. School nutrition program participants were more likely to live in households that depend on alternative food sources. Efforts to increase healthful food consumption such as fruits and vegetables should acknowledge all potential food sources (traditional, convenience, non-traditional, and alternative), especially those preferred by colonia residents. Current findings support the conceptual broadening of the retail food environment, and the importance of linking use with spatial access (proximity) to more accurately depict access to food sources. PMID:22709775

Alternatives to animal testing: information resources via the Internet and World Wide Web.

PubMed

Hakkinen, P J Bert; Green, Dianne K

2002-04-25

Many countries, including the United States, Canada, European Union member states, and others, require that a comprehensive search for possible alternatives be completed before beginning some or all research involving animals. Completing comprehensive alternatives searches and keeping current with information associated with alternatives to animal testing is a challenge that will be made easier as people throughout the world gain access to the Internet and World Wide Web. Numerous Internet and World Wide Web resources are available to provide guidance and other information on in vitro and other alternatives to animal testing. A comprehensive Web site is Alternatives to Animal Testing on the Web (Altweb), which serves as an online clearinghouse for resources, information, and news about alternatives to animal testing. Examples of other important Web sites include the joint one for the (US) Interagency Coordinating Committee on the Validation of Alternative Methods (ICCVAM) and the National Toxicology Program (NTP) Interagency Center for the Evaluation of Alternative Toxicological Methods (NICEATM) and the Norwegian Reference Centre for Laboratory Animal Science and Alternatives (The NORINA database). Internet mailing lists and online access to bulletin boards, discussion areas, newsletters, and journals are other ways to access and share information to stay current with alternatives to animal testing.

Probing Aircraft Flight Test Hazard Mitigation for the Alternative Fuel Effects on Contrails & Cruise Emissions (ACCESS) Research Team

NASA Technical Reports Server (NTRS)

Kelly, Michael J.

2013-01-01

The Alternative Fuel Effects on Contrails & Cruise Emissions (ACCESS) Project Integration Manager requested in July 2012 that the NASA Engineering and Safety Center (NESC) form a team to independently assess aircraft structural failure hazards associated with the ACCESS experiment and to identify potential flight test hazard mitigations to ensure flight safety. The ACCESS Project Integration Manager subsequently requested that the assessment scope be focused predominantly on structural failure risks to the aircraft empennage raft empennage.

Access, delivery and perceived efficacy of physiotherapy and use of complementary and alternative therapies by people with progressive multiple sclerosis in the United Kingdom: An online survey.

PubMed

Campbell, Evan; Coulter, Elaine; Mattison, Paul; McFadyen, Angus; Miller, Linda; Paul, Lorna

2017-02-01

All people with progressive MS in the United Kingdom should have access to physiotherapy through the National Health Service (NHS). However levels of access and delivery are unknown. Furthermore there is no research on perceived efficacy of physiotherapy or the use of complementary and alternative medicine in people with progressive MS in the United Kingdom. An online survey was carried out via the UK MS Register. Inclusion criteria were diagnosis of progressive MS, a member of UK MS Register and 18 years or older. The survey asked participants regarding access and delivery of physiotherapy; perceived efficacy of physiotherapy and interventions received; barriers to accessing physiotherapy and use of complementary and alternative medicine. The following additional data were supplied from the UK MS Register: demographics, EQ5D, MSIS-29 physical and psychological sub-scales and geographical data. Total number of respondents was 1,298 from an identified 2,538 potential registrants: 87% could access physiotherapy services, 77% received physiotherapy from the NHS and 32% were currently receiving physiotherapy. The most common interventions received were home exercise programme (86%), exercises with a physiotherapist (74%) and advice/education (67%). 40% had recently used complementary and alternative medicine. Perceived efficacy of physiotherapy was high with 70% reporting it to be either 'beneficial' or 'very beneficial'. Main barriers to accessing physiotherapy were mobility, fatigue, continence, transport issues, requiring someone to go with them and pain. Access to physiotherapy was high with most people reporting it as beneficial. However 13% reported not having access indicating a gap in accessibility. Considering some of the barriers reported may allow physiotherapy services to address this gap in accessibility. Copyright © 2017 Elsevier B.V. All rights reserved.

Sandy Hook : alternative access concept plan and vehicle replacement study

DOT National Transportation Integrated Search

2009-06-01

This study addresses two critical issues of concern to the Sandy Hook Unit of Gateway National : Recreational Area: (1) options for alternative access to Sandy Hook during peak summer season, : particularly when the park is closed to private vehicles...

Two-Step Optimization for Spatial Accessibility Improvement: A Case Study of Health Care Planning in Rural China

PubMed Central

Luo, Jing; Tian, Lingling; Luo, Lei; Yi, Hong

2017-01-01

A recent advancement in location-allocation modeling formulates a two-step approach to a new problem of minimizing disparity of spatial accessibility. Our field work in a health care planning project in a rural county in China indicated that residents valued distance or travel time from the nearest hospital foremost and then considered quality of care including less waiting time as a secondary desirability. Based on the case study, this paper further clarifies the sequential decision-making approach, termed “two-step optimization for spatial accessibility improvement (2SO4SAI).” The first step is to find the best locations to site new facilities by emphasizing accessibility as proximity to the nearest facilities with several alternative objectives under consideration. The second step adjusts the capacities of facilities for minimal inequality in accessibility, where the measure of accessibility accounts for the match ratio of supply and demand and complex spatial interaction between them. The case study illustrates how the two-step optimization method improves both aspects of spatial accessibility for health care access in rural China. PMID:28484707

Two-Step Optimization for Spatial Accessibility Improvement: A Case Study of Health Care Planning in Rural China.

PubMed

Luo, Jing; Tian, Lingling; Luo, Lei; Yi, Hong; Wang, Fahui

2017-01-01

A recent advancement in location-allocation modeling formulates a two-step approach to a new problem of minimizing disparity of spatial accessibility. Our field work in a health care planning project in a rural county in China indicated that residents valued distance or travel time from the nearest hospital foremost and then considered quality of care including less waiting time as a secondary desirability. Based on the case study, this paper further clarifies the sequential decision-making approach, termed "two-step optimization for spatial accessibility improvement (2SO4SAI)." The first step is to find the best locations to site new facilities by emphasizing accessibility as proximity to the nearest facilities with several alternative objectives under consideration. The second step adjusts the capacities of facilities for minimal inequality in accessibility, where the measure of accessibility accounts for the match ratio of supply and demand and complex spatial interaction between them. The case study illustrates how the two-step optimization method improves both aspects of spatial accessibility for health care access in rural China.

The training of a 'stone doctor'.

PubMed

Talati, Jamsheer J

2012-09-01

To propose alternative models of training for doctors treating patients with stones, and to identify their relative value, as such doctors are trained through urology programmes which sometimes cannot be expanded to meet the need, are short of teachers, too comprehensive and lengthy. This review explores new pathways for training to provide competence in the care of patients with stones. Previous reports were identified and existing training models collectively categorised as Model 1. Three alternative models were constructed and compared in the context of advantages, acceptability, feasibility, educational impact and applicability in different geosocio-political contexts. In Model 2, urological and stone training diverge as options after common basic courses and experience. In Model 3, individuals access training through a common educational matrix (EM) for nurses, physicians, etc., according to the match between their capacities, entry requirements, personal desires and willingness for further responsibility. Stone doctors with no urological background cannot fulfil other service and educational commitments, and might create unwelcome dependence on other colleagues for complex situations. Programmes involving a common EM affect professional boundaries and are not easily acceptable. There is a lack of clarity on methods for medical certification and re-certification. However, the lack of technically competent stone experts in developing worlds requires an exploration of alternative models of training and practice. The ability to provide exemplary care after abbreviated training makes alternative models attractive. Worldwide debate, further exploration and pilot implementation are required, perhaps first in the developing world, in which much of the 'stone belt' exists.

Alternative Model of Funding for Academic Research in Nigerian Universities

ERIC Educational Resources Information Center

Olayiwola, Shina

2010-01-01

Funding of academic research in Nigerian universities by Government (5 per cent recurrent grants) is a policy dictated by the National Universities Commission (NUC) as the central body for allocating research funds. This research fund, little as it is, is irregular and inadequate and to make it worse is difficult to access. These aforementioned…

Medical approaches to suffering are limited, so why critique Improving Access to Psychological Therapies from the same ideology.

PubMed

Binnie, James

2018-04-01

Although the article by Scott rightly questions the dynamics of the Improving Access to Psychological Therapies system and re-examines the recovery rates, finding quite shocking results, his recommendations are ultimately flawed. There is a strong critique of the diagnostic procedures in Improving Access to Psychological Therapies services, but the answer is not to diagnose more rigorously and to adhere more strictly to a manualised approach to psychotherapy. The opposite may be required. Alternatives to the medical model of distress offer a less stigmatising and more human approach to helping people with their problems. Perhaps psychological therapists and the people they work alongside would be better served by a psychological approach rather than a psychiatric one.

Information campaign and advocacy efforts to promote access to emergency contraception in Mexico.

PubMed

Ellertson, Charlotte; Heimburger, Angela; Acevedo-Garcia, Dolores; Schiavon, Raffaela; Mejia, Guillermina; Corona, Georgina; del Castillo, Eduardo; Langer, Ana

2002-11-01

Emergency contraception (EC) has the potential to reduce unwanted pregnancy significantly, in Mexico as elsewhere. Recent years have seen tremendous growth in programs and research devoted to expanding access to emergency methods worldwide. In Mexico we developed a comprehensive model introduction effort that included four components: provider training, public information (through a dedicated hotline and website, free media, paid radio and TV spots, participation in talk shows, and alternative media channels), collaboration with the public sector to include EC in the official family planning norms, and assistance to partner with commercial firms to register a dedicated EC product. Ongoing efforts to combat misperceptions and overcome opposition are crucial to informing the public and ensuring greater access to the method.

Traditional Payment Models in Radiology: Historical Context for Ongoing Reform.

PubMed

Silva, Ezequiel; McGinty, Geraldine B; Hughes, Danny R; Duszak, Richard

2016-10-01

The passage of the Medicare Access and CHIP Reauthorization Act (MACRA) replaces the sustainable growth rate with a payment system based on quality and alternative payment model participation. The general structure of payment under MACRA is included in the statute, but the rules and regulations defining its implementation are yet to be formalized. It is imperative that the radiology profession inform policymakers on their role in health care under MACRA. This will require a detailed understanding of prior legislative and nonlegislative actions that helped shape MACRA. To that end, the authors provide a detailed historical context for payment reform, focusing on the payment quality initiatives and alternative payment model demonstrations that helped provide the foundation of future MACRA-driven payment reform. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

45 CFR 148.128 - State flexibility in individual market reforms-alternative mechanisms.

Code of Federal Regulations, 2012 CFR

2012-10-01

...-alternative mechanisms. 148.128 Section 148.128 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE INDIVIDUAL HEALTH INSURANCE MARKET... more health insurance issuers), or combination of these mechanisms, that is designed to provide access...

Marginalized Student Access to Technology Education

NASA Astrophysics Data System (ADS)

Kurtcu, Wanda M.

The purpose of this paper is to investigate how a teacher can disrupt an established curriculum that continues the cycle of inequity of access to science, technology, engineering, and math (STEM) curriculum by students in alternative education. For this paper, I will focus on the technology components of the STEM curriculum. Technology in the United States, if not the world economy, is developing at a rapid pace. Many areas of day to day living, from applying for a job to checking one's bank account online, involve a component of science and technology. The 'gap' in technology education is emphasized between the 'haves and have-nots', which is delineated along socio-economic lines. Marginalized students in alternative education programs use this equipment for little else than remedial programs and credit recovery. This level of inequity further widens in alternative education programs and affects the achievement of marginalized students in credit recovery or alternative education classes instead of participation technology classes. For the purposes of this paper I focus on how can I decrease the inequity of student access to 21st century technology education in an alternative education program by addressing the established curriculum of the program and modifying structural barriers of marginalized student access to a technology focused curriculum.

Gardening in the desert: a spatial optimization approach to locating gardens in rapidly expanding urban environments.

PubMed

Mack, Elizabeth A; Tong, Daoqin; Credit, Kevin

2017-10-16

Food access is a global issue, and for this reason, a wealth of studies are dedicated to understanding the location of food deserts and the benefits of urban gardens. However, few studies have linked these two strands of research together to analyze whether urban gardening activity may be a step forward in addressing issues of access for food desert residents. The Phoenix, Arizona metropolitan area is used as a case to demonstrate the utility of spatial optimization models for siting urban gardens near food deserts and on vacant land. The locations of urban gardens are derived from a list obtained from the Maricopa County Cooperative Extension office at the University of Arizona which were geo located and aggregated to Census tracts. Census tracts were then assigned to one of three categories: tracts that contain a garden, tracts that are immediately adjacent to a tract with a garden, and all other non-garden/non-adjacent census tracts. Analysis of variance is first used to ascertain whether there are statistical differences in the demographic, socio-economic, and land use profiles of these three categories of tracts. A maximal covering spatial optimization model is then used to identify potential locations for future gardening activities. A constraint of these models is that gardens be located on vacant land, which is a growing problem in rapidly urbanizing environments worldwide. The spatial analysis of garden locations reveals that they are centrally located in tracts with good food access. Thus, the current distribution of gardens does not provide an alternative food source to occupants of food deserts. The maximal covering spatial optimization model reveals that gardens could be sited in alternative locations to better serve food desert residents. In fact, 53 gardens may be located to cover 96.4% of all food deserts. This is an improvement over the current distribution of gardens where 68 active garden sites provide coverage to a scant 8.4% of food desert residents. People in rapidly urbanizing environments around the globe suffer from poor food access. Rapid rates of urbanization also present an unused vacant land problem in cities around the globe. This paper highlights how spatial optimization models can be used to improve healthy food access for food desert residents, which is a critical first step in ameliorating the health problems associated with lack of healthy food access including heart disease and obesity.

Use of vendedores (mobile food vendors), pulgas (flea markets), and vecinos o amigos (neighbors or friends) as alternative sources of food for purchase among Mexican-origin households in Texas border colonias.

PubMed

Sharkey, Joseph R; Dean, Wesley R; Johnson, Cassandra M

2012-05-01

There is a paucity of studies acknowledging the existence of alternative food sources, and factors associated with food purchasing from three common alternative sources: vendedores (mobile food vendors), pulgas (flea markets), and vecinos/amigos (neighbors/friends). This analysis aims to examine the use of alternative food sources by Mexican-origin women from Texas-border colonias and determine factors associated with their use. The design was cross-sectional. Promotora-researchers (promotoras de salud trained in research methods) recruited 610 Mexican-origin women from 44 colonias and conducted in-person surveys. Surveys included participant characteristics and measures of food environment use and household food security. Statistical analyses included separate logistic regressions, modeled for food purchase from mobile food vendors, pulgas, or neighbors/friends. Child food insecurity was associated with purchasing food from mobile food vendors, while household food security was associated with using pulgas or neighbors/friends. School nutrition program participants were more likely to live in households that depend on alternative food sources. Efforts to increase healthful food consumption such as fruits and vegetables should acknowledge all potential food sources (traditional, convenience, nontraditional, and alternative), especially those preferred by colonia residents. Current findings support the conceptual broadening of the retail food environment, and the importance of linking use with spatial access (proximity) to more accurately depict access to food sources. Copyright © 2012 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Rethinking family-centred care for the child and family in hospital.

PubMed

Tallon, Mary M; Kendall, Garth E; Snider, Paul D

2015-05-01

This paper presents and discusses an alternative model of family-centred care (FCC) that focuses on optimising the health and developmental outcomes of children through the provision of appropriate support to the child's family. The relevance, meaning and effectiveness of FCC have been challenged recently. Studies show that parents in hospital often feel unsupported, judged by hospital staff and uncertain about what care they should give to their child. With no convincing evidence relating FCC to improved child health outcomes, it has been suggested that FCC should be replaced with a new improved model to guide the care of children in hospital. This integrative review discusses theory and evidence-based literature that supports the practice of an alternative model of FCC that is focused on the health and developmental outcomes of children who are seriously ill, rather than the organisational requirements of children's hospitals. Theories and research findings in a wide range of disciplines including epidemiology, psychology, sociology, anthropology and neuroscience were accessed for this discussion. Nursing literature regarding partnership building, communication and FCC was also accessed. This paper discusses the benefits of applying a bioecological model of human development, the family and community resource framework, the concepts of allostatic load and biological embedding, empowerment theory, and the nurse-family partnership model to FCC. While there is no direct evidence showing that the implementation of this alternative model of FCC in the hospital setting improves the health and developmental outcomes of children who are seriously ill, there is a great deal of evidence from community nursing practice that suggests it is very likely to do so. Application of these theoretical concepts to practice has the potential to underpin a theory of nursing that is relevant for all nurses irrespective of the age of those they care for and the settings within which they work. © 2015 John Wiley & Sons Ltd.

An evaluation of three methods of saying "no" to avoid an escalating response class hierarchy.

PubMed

Mace, F Charles; Pratt, Jamie L; Prager, Kevin L; Pritchard, Duncan

2011-01-01

We evaluated the effects of three different methods of denying access to requested high-preference activities on escalating problem behavior. Functional analysis and response class hierarchy (RCH) assessment results indicated that 4 topographies of problem behaviors displayed by a 13-year-old boy with high-functioning autism constituted an RCH maintained by positive (tangible) reinforcement. Identification of the RCH comprised the baseline phase, during which computer access was denied by saying "no" and providing an explanation for the restriction. Two alternative methods of saying "no" were then evaluated. These methods included (a) denying computer access while providing an opportunity to engage in an alternative preferred activity and (b) denying immediate computer access by arranging a contingency between completion of a low-preference task and subsequent computer access. Results indicated that a hierarchy of problem behavior may be identified in the context of denying access to a preferred activity and that it may be possible to prevent occurrences of escalating problem behavior by either presenting alternative options or arranging contingencies when saying "no" to a child's requests.

Modeling water demand when households have multiple sources of water

NASA Astrophysics Data System (ADS)

Coulibaly, Lassina; Jakus, Paul M.; Keith, John E.

2014-07-01

A significant portion of the world's population lives in areas where public water delivery systems are unreliable and/or deliver poor quality water. In response, people have developed important alternatives to publicly supplied water. To date, most water demand research has been based on single-equation models for a single source of water, with very few studies that have examined water demand from two sources of water (where all nonpublic system water sources have been aggregated into a single demand). This modeling approach leads to two outcomes. First, the demand models do not capture the full range of alternatives, so the true economic relationship among the alternatives is obscured. Second, and more seriously, economic theory predicts that demand for a good becomes more price-elastic as the number of close substitutes increases. If researchers artificially limit the number of alternatives studied to something less than the true number, the price elasticity estimate may be biased downward. This paper examines water demand in a region with near universal access to piped water, but where system reliability and quality is such that many alternative sources of water exist. In extending the demand analysis to four sources of water, we are able to (i) demonstrate why households choose the water sources they do, (ii) provide a richer description of the demand relationships among sources, and (iii) calculate own-price elasticity estimates that are more elastic than those generally found in the literature.

Importance-Performance Matrix Analysis (IPMA) Of Transport Disadvantage Variables on Social Exclusion in a Rural Context

NASA Astrophysics Data System (ADS)

Larasati, Ophilia; Puspita Dirgahayani, Eng., Dr.

2018-05-01

Transport services are essential to support daily life. A lack of transport supply leads to the existence of transport disadvantaged (TDA) groups who are vulnerable to social exclusion, which happens when a particular group or individual is having difficulties to access certain activities that are considered normal in society. To tackle this phenomenon, the understanding of the influence of TDA variables on social exclusion is needed. The aim of this study is to analyze the influences of TDA variables on social exclusion in a rural context, with Cibeureum Village (Bandung Barat Regency) and Bunikasih Village (Subang Regency) as the study case. Both case studies provide different characteristics of accessibility. Partial Least Squares (PLS) Structural Equation Modeling (SEM) is chosen as the method to analyze the influences of TDA variables on social exclusion. The PLS-SEM model is developed according to the social exclusion variable and four TDA variables, i.e., accessibility, individual characteristics, private vehicle existence, and travel behavior. IPMA is done after the PLS-SEM model is evaluated. The study reveals that among four of the TDA variables, accessibility has the most influence on social exclusion, hence interventions related to improving accessibility are needed to tackle social exclusion. More specifically, the provision of alternative modes is needed in both study areas, while in Bunikasih Village the cost of travel is also an important variable to consider.

Job Proximity and the Urban Employment Problem: Do Suitable Nearby Jobs Improve Neighbourhood Employment Rates?: A Comment.

ERIC Educational Resources Information Center

Houston, Donald

1998-01-01

Discusses methodology to examine the problem of spatial mismatch of jobs, showing how the simple accessibility measures used by Daniel Immergluck (1998) are poor reflections of the availability of jobs to an individual and explaining why a gravity model is a favorable alternative. Also discusses the unsuitability of aggregate data for testing the…

Theory and Techniques for Assessing the Demand and Supply of Outdoor Recreation in the United States

Treesearch

H. Ken Cordell; John C. Bergstrom

1989-01-01

As the central analysis for the 1989 Renewable Resources planning Act Assessment, a household market model covering 37 recreational activities was computed for the United States. Equilibrium consumption and costs were estimated, as were likely future changes in consumption and costs in response to expected demand growth and alternative development and access policies...

Should All Patients Be Included in Alternative Payment Models for Primary Total Hip Arthroplasty and Total Knee Arthroplasty?

PubMed

Rozell, Joshua C; Courtney, Paul M; Dattilo, Jonathan R; Wu, Chia H; Lee, Gwo-Chin

2016-09-01

Alternative payment models in total joint replacement incentivize cost effective health care delivery and reward reductions in length of stay (LOS), complications, and readmissions. If not adjusted for patient comorbidities, they may encourage restrictive access to health care. We prospectively evaluated 802 consecutive primary total hip arthroplasty and total knee arthroplasty patients evaluating comorbidities associated with increased LOS and readmissions. During this 9-month period, 115 patients (14.3%) required hospitalization >3 days and 16 (1.99%) were readmitted within 90 days. Univariate analysis demonstrated that preoperative narcotic use, heart failure, stroke, chronic kidney disease (CKD), chronic obstructive pulmonary disease (COPD), and liver disease were more likely to require hospitalization >3 days. In multivariate analysis, CKD and COPD were independent risk factors for LOS >3 days. A Charlson comorbidity index >5 points was associated with increased LOS and readmissions. Patients with CKD, COPD, and Charlson comorbidity index >5 points should not be included in alternative payment model for THA and TKA. Copyright © 2016 Elsevier Inc. All rights reserved.

Probing Aircraft Flight Test Hazard Mitigation for the Alternative Fuel Effects on Contrails and Cruise Emissions (ACCESS) Research Team . Volume 2; Appendices

NASA Technical Reports Server (NTRS)

Kelly, Michael J.

2013-01-01

The Alternative Fuel Effects on Contrails and Cruise Emissions (ACCESS) Project Integration Manager requested in July 2012 that the NASA Engineering and Safety Center (NESC) form a team to independently assess aircraft structural failure hazards associated with the ACCESS experiment and to identify potential flight test hazard mitigations to ensure flight safety. The ACCESS Project Integration Manager subsequently requested that the assessment scope be focused predominantly on structural failure risks to the aircraft empennage (horizontal and vertical tail). This report contains the Appendices to Volume I.

Patents or patients? Global access to pharmaceuticals and social justice.

PubMed

de Wildt, Gilles; Khoon, Chan Chee

2008-01-01

Innovation, vaccine development, and world-wide equitable access to necessary pharmaceuticals are hindered by current patenting arrangements and the orientation of pharmaceutical research. Plausible alternatives exist, including instituting the right of national or international agencies to act in the public interest and to buy patents selectively with a view to innovation and equitable access. Alternatives could partly or wholly finance themselves and lower pharmaceutical prices globally. Countries, individuals or groups of patients could help promote alternatives by calling into question the current emphasis on commercialization and profit, and by demanding globally equitable arrangements when sharing data that are important for research or when individuals or communities volunteer as research participants.

The future for follow-up of gynaecological cancer in Europe. Summary of available data and overview of ongoing trials.

PubMed

Leeson, S C; Beaver, K; Ezendam, N P M; Mačuks, R; Martin-Hirsch, P L; Miles, T; Jeppesen, M M; Jensen, P T; Zola, P

2017-03-01

After completing treatment, most patients follow a pre-determined schedule of regular hospital outpatient appointments, which includes clinical examinations, consultations and routine tests. After several years of surveillance, patients are transferred back to primary care. However, there is limited evidence to support the effectiveness and efficiency of this approach. This paper examines the current rationale and evidence base for hospital-based follow-up after treatment for gynaecological cancer. We investigate what alternative models of care have been formally evaluated and what research is currently in progress in Europe, in order to make tentative recommendations for a model of follow-up. The evidence base for traditional hospital based follow-up is limited. Alternative models have been reported for other cancer types but there are few evaluations of alternative approaches for gynaecological cancers. We identified five ongoing European studies; four were focused on endometrial cancer patients and one feasibility study included all gynaecological cancers. Only one study had reached the reporting stage. Alternative models included nurse-led telephone follow-up and comparisons of more intensive versus less intensive regimes. Outcomes included survival, quality of life, psychological morbidity, patient satisfaction and cost effectiveness of service. More work is needed on alternative strategies for all gynaecological cancer types. New models will be likely to include risk stratification with early discharge from secondary care for early stage disease with fast track access to specialist services for suspected cancer recurrence or other problems. Copyright © 2017 Elsevier B.V. All rights reserved.

Alternative Computer Access for Young Handicapped Children: A Systematic Selection Procedure.

ERIC Educational Resources Information Center

Morris, Karen J.

The paper describes the type of computer access products appropriate for use by handicapped children and presents a systematic procedure for selection of such input and output devices. Modification of computer input is accomplished by three strategies: modifying the keyboard, adding alternative keyboards, and attaching switches to the keyboard.…

14 CFR 161.205 - Required analysis of proposed restriction and alternatives.

Code of Federal Regulations, 2010 CFR

2010-01-01

... of the anticipated or actual costs and benefits of the proposed noise or access restriction; (2) A... not involve aircraft restrictions, and a comparison of the costs and benefits of such alternative measures to costs and benefits of the proposed noise or access restriction. (b) In preparing the analyses...

78 FR 14843 - Temporary Scope Expansion of the Post-Investigation Alternative Dispute Resolution Program

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-07

... Documents Access and Management System (ADAMS): You may access publicly available documents online in the... may examine and purchase copies of public documents at the NRC's PDR, Room O1-F21, One White Flint... Resolution Review Team (ART) Pilot Program Recommendations for Using Alternative Dispute Resolution (ADR...

Access to a Car and the Self-Reported Health and Mental Health of People Aged 65 and Older in Northern Ireland.

PubMed

Doebler, Stefanie

2016-05-01

This article examines relationships between access to a car and the self-reported health and mental health of older people. The analysis is based on a sample of N = 65,601 individuals aged 65 years and older from the Northern Ireland Longitudinal Study linked to 2001 and 2011 census returns. The findings from hierarchical linear and binary logistic multilevel path models indicate that having no access to a car is related to a considerable health and mental health disadvantage particularly for older people who live alone. Rural-urban health and mental health differences are mediated by access to a car. The findings support approaches that emphasize the importance of autonomy and independence for the well-being of older people and indicate that not having access to a car can be a problem for older people not only in rural but also in intermediate and urban areas, if no sufficient alternative forms of mobility are provided. © The Author(s) 2015.

Comparison of Traditional and Open-Access Appointment Scheduling for Exponentially Distributed Service Time.

PubMed

Yan, Chongjun; Tang, Jiafu; Jiang, Bowen; Fung, Richard Y K

2015-01-01

This paper compares the performance measures of traditional appointment scheduling (AS) with those of an open-access appointment scheduling (OA-AS) system with exponentially distributed service time. A queueing model is formulated for the traditional AS system with no-show probability. The OA-AS models assume that all patients who call before the session begins will show up for the appointment on time. Two types of OA-AS systems are considered: with a same-session policy and with a same-or-next-session policy. Numerical results indicate that the superiority of OA-AS systems is not as obvious as those under deterministic scenarios. The same-session system has a threshold of relative waiting cost, after which the traditional system always has higher total costs, and the same-or-next-session system is always preferable, except when the no-show probability or the weight of patients' waiting is low. It is concluded that open-access policies can be viewed as alternative approaches to mitigate the negative effects of no-show patients.

Shared Housing Arrangements in Germany—An Equitable Alternative to Long Term Care Services beyond Homes and Institutions?

PubMed Central

Frisina Doetter, Lorraine; Schmid, Achim

2018-01-01

Given the saliency of socio-demographic pressures, the highly restrictive definition of “need for care” characterizing the German long-term care system at its foundations in 1994 has since been subject to various expansionary reforms. This has translated into greater interest in innovative care models that provide more choice and flexibility to beneficiaries. One such model is ‘shared housing arrangements’ (“ambulant betreute Wohngemeinschaften”), where a small group of people rent private rooms, while sharing a common space, domestic support, and nursing care. Using interview and secondary data, this study examines the potential for such arrangements to provide an equitable alternative to care that is accessible to a larger population of beneficiaries than presently seen in Germany. PMID:29443948

The LUGPA Alternative Payment Model for Initial Therapy of Newly Diagnosed Patients With Organ-confined Prostate Cancer: Rationale and Development.

PubMed

Kapoor, Deepak A; Shore, Neal D; Kirsh, Gary M; Henderson, Jonathan; Cohen, Todd D; Latino, Kathleen

2017-01-01

Over the past several decades, rapid expansion in healthcare expenditures has exposed the utilization incentives inherent in fee-for-service payment models. The passage of Medicare Access and CHIP Reauthorization Act of 2015 heralded a transition toward value-based care, creating incentives for practitioners to accept bidirectional risk linked to outcome and utilization metrics. At present, the limited availability of these vehicles excludes all but a handful of providers from participation in alternative payment models (APMs). The LUGPA APM supports the goals of the triple aim in improving the patient experience, enhancing population health and reducing expenditures. By requiring utilization of certified electronic health record technologies, tying payment to quality metrics, and requiring practices to bear more than nominal risk, the LUGPA APM qualifies as an advanced APM, thereby easing the reporting burden and creating opportunities for participating practices.

The LUGPA Alternative Payment Model for Initial Therapy of Newly Diagnosed Patients With Organ-confined Prostate Cancer: Rationale and Development

PubMed Central

Kapoor, Deepak A.; Shore, Neal D.; Kirsh, Gary M.; Henderson, Jonathan; Cohen, Todd D.; Latino, Kathleen

2017-01-01

Over the past several decades, rapid expansion in healthcare expenditures has exposed the utilization incentives inherent in fee-for-service payment models. The passage of Medicare Access and CHIP Reauthorization Act of 2015 heralded a transition toward value-based care, creating incentives for practitioners to accept bidirectional risk linked to outcome and utilization metrics. At present, the limited availability of these vehicles excludes all but a handful of providers from participation in alternative payment models (APMs). The LUGPA APM supports the goals of the triple aim in improving the patient experience, enhancing population health and reducing expenditures. By requiring utilization of certified electronic health record technologies, tying payment to quality metrics, and requiring practices to bear more than nominal risk, the LUGPA APM qualifies as an advanced APM, thereby easing the reporting burden and creating opportunities for participating practices. PMID:29726849

Alternative Fuels Data Center

Science.gov Websites

Alternative Fuel Infrastructure Grants The Maryland Energy Administration administers the Maryland Alternative Fuel Infrastructure Program (AFIP), which provides grants to develop public access alternative fueling and charging infrastructure. Only Maryland-based private businesses are eligible, and projects

Open Genetic Code: on open source in the life sciences.

PubMed

Deibel, Eric

2014-01-01

The introduction of open source in the life sciences is increasingly being suggested as an alternative to patenting. This is an alternative, however, that takes its shape at the intersection of the life sciences and informatics. Numerous examples can be identified wherein open source in the life sciences refers to access, sharing and collaboration as informatic practices. This includes open source as an experimental model and as a more sophisticated approach of genetic engineering. The first section discusses the greater flexibly in regard of patenting and the relationship to the introduction of open source in the life sciences. The main argument is that the ownership of knowledge in the life sciences should be reconsidered in the context of the centrality of DNA in informatic formats. This is illustrated by discussing a range of examples of open source models. The second part focuses on open source in synthetic biology as exemplary for the re-materialization of information into food, energy, medicine and so forth. The paper ends by raising the question whether another kind of alternative might be possible: one that looks at open source as a model for an alternative to the commodification of life that is understood as an attempt to comprehensively remove the restrictions from the usage of DNA in any of its formats.

An alternative resource sharing scheme for land mobile satellite services

NASA Technical Reports Server (NTRS)

Yan, Tsun-Yee; Sue, Miles K.

1990-01-01

A preliminary comparison between the two competing channelization concepts for the Land Mobile Satellite Services (LMSS), namely frequency division (FD) and code division (CD), is presented. Both random access and demand-assigned approaches are considered under these concepts. The CD concept is compared with the traditional FD concept based on the system consideration and a projected traffic model. It is shown that CD is not particularly attractive for the first generation Mobile Satellite Services because of the spectral occupancy of the network bandwidth. However, the CD concept is a viable alternative for future systems such as the personal access satellite system (PASS) in the Ka-band spectrum where spectral efficiency is not of prime concern. The effects of power robbing and voice activity factor are incorporated. It was shown that the traditional rule of thumb of dividing the number of raw channels by the voice activity factor to obtain the effective number of channels is only valid asymptotically as the aggregated traffic approaches infinity.

An alternative resource sharing scheme for land mobile satellite services

NASA Astrophysics Data System (ADS)

Yan, Tsun-Yee; Sue, Miles K.

A preliminary comparison between the two competing channelization concepts for the Land Mobile Satellite Services (LMSS), namely frequency division (FD) and code division (CD), is presented. Both random access and demand-assigned approaches are considered under these concepts. The CD concept is compared with the traditional FD concept based on the system consideration and a projected traffic model. It is shown that CD is not particularly attractive for the first generation Mobile Satellite Services because of the spectral occupancy of the network bandwidth. However, the CD concept is a viable alternative for future systems such as the personal access satellite system (PASS) in the Ka-band spectrum where spectral efficiency is not of prime concern. The effects of power robbing and voice activity factor are incorporated. It was shown that the traditional rule of thumb of dividing the number of raw channels by the voice activity factor to obtain the effective number of channels is only valid asymptotically as the aggregated traffic approaches infinity.

Evolving nutritional strategies in the presence of competition: a geometric agent-based model.

PubMed

Senior, Alistair M; Charleston, Michael A; Lihoreau, Mathieu; Buhl, Jerome; Raubenheimer, David; Simpson, Stephen J

2015-03-01

Access to nutrients is a key factor governing development, reproduction and ultimately fitness. Within social groups, contest-competition can fundamentally affect nutrient access, potentially leading to reproductive asymmetry among individuals. Previously, agent-based models have been combined with the Geometric Framework of nutrition to provide insight into how nutrition and social interactions affect one another. Here, we expand this modelling approach by incorporating evolutionary algorithms to explore how contest-competition over nutrient acquisition might affect the evolution of animal nutritional strategies. Specifically, we model tolerance of nutrient excesses and deficits when ingesting nutritionally imbalanced foods, which we term 'nutritional latitude'; a higher degree of nutritional latitude constitutes a higher tolerance of nutritional excess and deficit. Our results indicate that a transition between two alternative strategies occurs at moderate to high levels of competition. When competition is low, individuals display a low level of nutritional latitude and regularly switch foods in search of an optimum. When food is scarce and contest-competition is intense, high nutritional latitude appears optimal, and individuals continue to consume an imbalanced food for longer periods before attempting to switch to an alternative. However, the relative balance of nutrients within available foods also strongly influences at what levels of competition, if any, transitions between these two strategies occur. Our models imply that competition combined with reproductive skew in social groups can play a role in the evolution of diet breadth. We discuss how the integration of agent-based, nutritional and evolutionary modelling may be applied in future studies to further understand the evolution of nutritional strategies across social and ecological contexts.

Automated analysis of timber access road alternatives.

Treesearch

Doyle Burke

1974-01-01

The evaluation of timber access road alternatives is one of the primary tasks in timber harvest planning and design. During the planning stages, it is also one of the most difficult to accomplish quantitatively because a basis for comparison is related to such values as grade, length, horizontal and vertical curvature, and volumes of excavation and embankment. Within...

NGO Provision of Basic Education: Alternative or Complementary Service Delivery to Support Access to the Excluded?

ERIC Educational Resources Information Center

Rose, Pauline

2009-01-01

This paper focuses on approaches by non-government organisations (NGOs) to reach primary school-aged children excluded from access to the conventional state education system. It highlights recent shifts in international literature and agency priorities from the portrayal of NGO provision as a (non-formal) "alternative" to (formal) state…

Value for money - recasting the problem in terms of dynamic access prioritisation.

PubMed

Taylor, William J; Laking, George

2010-01-01

To develop an approach for achieving value for money in rehabilitation based on dynamic prioritisation of access to services according to individual capacity to benefit. A critical review of economic evaluation and adaptation of a prioritisation method used in determining access to elective surgical services in New Zealand to a rehabilitation context. The cost-effectiveness frontier is not straight but curved, suggesting that some people benefit more from a given intervention than others. An approach that identifies those most likely to benefit from inpatient rehabilitation following stroke (as an example) and enables access in order of capacity to benefit is presented in the context of a quality improvement programme. The approach is operationalised as a prioritisation tool that is dynamic in the sense that is can be reapplied subject to changes in the patient's clinical status. The steps proposed to develop such a tool include qualitative research with expert clinicians, pair-wise comparison of alternative scenarios (1000Minds survey), construction of an economic model of the tool's operation and an observational cohort study to help populate the model and calibrate the tool. A dynamic prioritisation approach to guide access to scarce health-care resources (such as inpatient rehabilitation following stroke) offers a transparent and equitable way of achieving value for money in the delivery of rehabilitation services.

Open access to an outpatient intravenous diuresis program in a systolic heart failure disease management program.

PubMed

Hebert, Kathy; Dias, Andre; Franco, Emiliana; Tamariz, Leonardo; Steen, Dylan; Arcement, Lee M

2011-01-01

In order to provide efficient utilization of resources in an outpatient setting for acute exacerbation of heart failure (HF), the authors piloted an open-access outpatient intravenous (IV) diuretic program (IVDP) to evaluate utilization in an HF disease management program (HFDMP), patient characteristics for users of the program, and safety. An outpatient HFDMP at Jackson Memorial Hospital in Miami, Florida, enrolling 577 patients 18 years and older with an ejection fraction ≤40% was implemented. For symptoms or weight gain ≥5 pounds, patients were eligible to use an open-access IVDP during clinic hours. A total of 130 HFDM patients (22.5%) used the IVDP. IVDP users were more likely to be diabetic, with lower body mass indices than non-IVDP users. New York Heart Association class IV patients and previously hospitalized patients were more likely to use the IVDP. There were no documented adverse reactions for patients receiving treatment and no difference in mortality between groups. This open-access outpatient IVDP model for patients with HF was readily utilized by the HFDMP participants and appears safe for use in this population. This unique model may provide alternative access for acute HF treatment. Congest Heart Fail. © 2011 Wiley Periodicals, Inc.

[How do immigrant women access health services in the Basque Country? Perceptions of health professionals].

PubMed

Pérez-Urdiales, Iratxe; Goicolea, Isabel

2017-09-12

To determine the perception of health professionals working in alternative health centres on the barriers and facilitators in the access by immigrant women to general public health services and sexual and reproductive health in the Basque Country. Basque Country. Analysis of qualitative content based on 11 individual interviews. Health professionals working in alternative health centres of Primary Care and sexual and reproductive health. Data collection was performed between September and December 2015 in four alternative health centres. After transcription, the units of meaning, codes and categories were identified. Four categories emerged from the analysis, which represented how the characteristics of immigrant women (Tell me how you are and I will tell you how to access), the attitude of the administrative and health staff ("When they are already taken care of"), the functioning of the health system (Inflexible, passive and needs-responsive health system), and health policies ("If you do not meet the requirements, you do not go in. The law is the law") influence access to health services of immigrant women. This study shows that there are a considerable number of barriers and few facilitators to the access by immigrant women to public health and sexual and reproductive health services in the Basque Country. The alternative health centres were presented as favouring the improvement of the health of the immigrant population and in their access. Copyright © 2017. Publicado por Elsevier España, S.L.U.

Synchrotron Protein Footprinting Supports Substrate Translocation by ClpA via ATP-Induced Movements of the D2 Loop

PubMed Central

Bohon, Jen; Jennings, Laura D.; Phillips, Christine M.; Licht, Stuart; Chance, Mark R.

2010-01-01

SUMMARY Synchrotron x-ray protein footprinting is used to study structural changes upon formation of the ClpA hexamer. Comparative solvent accessibilities between ClpA monomer and ClpA hexamer samples are in agreement throughout most of the sequence with calculations based on two previously proposed hexameric models. The data differ substantially from the proposed models in two parts of the structure: the D1 sensor 1 domain and the D2 loop region. The results suggest that these two regions can access alternate conformations in which their solvent protection is greater than in the structural models based on crystallographic data. In combination with previously reported structural data, the footprinting data provide support for a revised model in which the D2 loop contacts the D1 sensor 1 domain in the ATP-bound form of the complex. These data provide the first direct experimental support for the nucleotide-dependent D2 loop conformational change previously proposed to mediate substrate translocation. PMID:18682217

Ability or Access-Ability: Differential Item Functioning of Items on Alternate Performance-Based Assessment Tests for Students with Visual Impairments

ERIC Educational Resources Information Center

Zebehazy, Kim T.; Zigmond, Naomi; Zimmerman, George J.

2012-01-01

Introduction: This study investigated differential item functioning (DIF) of test items on Pennsylvania's Alternate System of Assessment (PASA) for students with visual impairments and severe cognitive disabilities and what the reasons for the differences may be. Methods: The Wilcoxon signed ranks test was used to analyze differences in the scores…

Developing Collections With Get It Now: A Pilot Project for a Hybrid Collection.

PubMed

Hendler, Gail Y; Gudenas, Jean

2016-01-01

As health sciences libraries transition from print to online journal collections that require significant institutional funding, librarians are investigating the use of on demand services in order to meet customer need and contain costs. In 2014 a three-year pilot project to determine if unmediated access to the Copyright Clearance Center's Get It Now service would expand access to needed content and provide usage data to inform collections decision making. The service provides rapid, automated delivery of unsubscribed, high-quality journal articles directly to the customer. The three-year pilot project aims to compare the cost of Get It Now to the traditional subscription model to learn if the service is a cost-effective and sustainable alternative that improves customer satisfaction and that can transform collection development with a hybrid model for journal acquisitions.

Widening Access to Higher Education: An Evaluative Case Study of a Foundation Year Alternative to Access

ERIC Educational Resources Information Center

Reddy, Peter A.; Moores, Elisabeth

2008-01-01

Universities are encouraged to widen access to a broad range of applicants, including mature students taking Access qualifications. Admissions tutors can find it difficult to compare and choose between Access and A-level applications, and Access applicants for popular courses may be disadvantaged relative to students with good A-levels. In this…

Heroin and saccharin demand and preference in rats.

PubMed

Schwartz, Lindsay P; Kim, Jung S; Silberberg, Alan; Kearns, David N

2017-09-01

Several recent studies have investigated the choice between heroin and a non-drug alternative reinforcer in rats. A common finding in these studies is that there are large individual differences in preference, with some rats preferring heroin and some preferring the non-drug alternative. The primary goal of the present study was to determine whether individual differences in how heroin or saccharin is valued, based on demand analysis, predicts choice. Rats lever-pressed for heroin infusions and saccharin reinforcers on fixed-ratio schedules. The essential value of each reinforcer was obtained from resulting demand curves. Rats were then trained on a mutually exclusive choice procedure where pressing one lever resulted in heroin and pressing another resulted in saccharin. After seven sessions of increased access to heroin or saccharin, rats were reexposed to the demand and choice procedures. Demand for heroin was more elastic than demand for saccharin (i.e., heroin had lower essential value than saccharin). When allowed to choose, most rats preferred saccharin. The essential value of heroin, but not saccharin, predicted preference. The essential value of both heroin and saccharin increased following a week of increased access to heroin, but similar saccharin exposure had no effect on essential value. Preference was unchanged after increased access to either reinforcer. Heroin-preferring rats differed from saccharin-preferring rats in how they valued heroin, but not saccharin. To the extent that choice models addiction-related behavior, these results suggest that overvaluation of opioids specifically, rather than undervaluation of non-drug alternatives, could identify susceptible individuals. Copyright © 2017 Elsevier B.V. All rights reserved.

The Open Access Association? EAHIL's new model for sustainability.

PubMed

McSean, Tony; Jakobsson, Arne

2009-12-01

To discover a governance structure and a business model for the European Association for Health Information and Libraries (EAHIL) which will be economically sustainable in the medium term, arresting a long-term gradual decline in membership numbers and implementing new revenue streams to sustain association activity. Reviewed survival strategies of other professional associations, investigated potential of emerging interactive web technologies, investigated alternative revenue streams based around the 'franchise' of the annual EAHIL conferences and workshops. A fully worked-through and costed alternative structure was produced, based on abolition of the subscription, web-based procedures and functions, increased income from advertising and sponsorship and a large measure of member participation and engagement. Statutes and Rules of Procedure were rewritten to reflect the changes. This plan was put through the Association's approval cycle and implemented in 2005. The new financial model has proved itself sustainable on the basis of the first 2 years' operations. The long-term gradual decline in membership was reversed, with membership numbers trebling across the EAHIL region. The software worked with minimal problems, including the online electoral process. With no identified precedent from other professional associations, the changes represented a considerable risk, which was justifiable because long-term projections made it clear that continuing the traditional model was not viable. The result is a larger, healthier association with a stronger link to its membership. Long-term risks include the high level of member commitment and expertise. There are also important questions about scalability-diseconomies of scale probably limit the applicability of the overall open access model to larger associations.

Effects of irrigation water supply variations on limited resource farming in Conejos County, Colorado

NASA Astrophysics Data System (ADS)

Eckert, Jerry B.; Wang, Erda

1993-02-01

Farms in NE Conejos County, Colorado, are characterized by limited resources, uncertain surface flow irrigation systems, and mixed crop-livestock enterprise combinations which are dependent on public grazing resources. To model decision making on these farms, a linear program is developed stressing enterprise choices under conditions of multiple resource constraints. Differential access to grazing resources and irrigation water is emphasized in this research. Regarding the water resource, the model reflects farms situated alternatively on high-, medium-, and low-priority irrigation ditches within the Alamosa-La Jara river system, each with and without supplemental pumping. Differences are found in optimum enterprise mixes, net returns, choice of cropping technology, level of marketings, and other characteristics in response to variations in the availability of irrigation water. Implications are presented for alternative improvement strategies.

The Myth of the Lone Physician: Toward a Collaborative Alternative

PubMed Central

Saba, George W.; Villela, Teresa J.; Chen, Ellen; Hammer, Hali; Bodenheimer, Thomas

2012-01-01

Cultural values and beliefs about the primary care physician bolster the myth of the lone physician: a competent professional who is esteemed by colleagues and patients for his or her willingness to sacrifice self, accept complete responsibility for care, maintain continuity and accessibility, and assume the role of lone decision maker in clinical care. Yet the reality of current primary care models is often fragmented, impersonal care for patients and isolation and burnout for many primary care physicians. An alternative to the mythological lone physician would require a paradigm shift that places the primary care physician within the context of a highly functioning health care team. This new mythology better fulfills the collaborative, interprofessional, patient-centered needs of new models of care, and might help to ensure that the work of primary care physicians remains compassionate, gratifying, and meaningful. PMID:22412010

Comparisons of Prevention Programs for Homeless Youth

PubMed Central

Rotheram-Borus, Mary Jane

2014-01-01

There are six HIV prevention programs for homeless youth whose efficacy has been or is currently being evaluated: STRIVE, the Community Reinforcement Approach, Strengths-Based Case Management, Ecologically-Based Family Therapy, Street Smart, and AESOP (street outreach access to resources). Programs vary in their underlying framework and theoretical models for understanding homelessness. All programs presume that the youths’ families lack the ability to support their adolescent child. Some programs deemphasize family involvement while others focus on rebuilding connections among family members. The programs either normalize current family conflicts or, alternatively, provide education about the importance of parental monitoring. All programs aim to reduce HIV-related sexual and drug use acts. A coping skills approach is common across programs: Problem-solving skills are specifically addressed in four of the six programs; alternatively, parents in other programs are encouraged to contingently reward their children. Each program also engineers ongoing social support for the families and the youth, either by providing access to needed resources or by substituting a new, supportive relationship for the existing family caretaker. All of the interventions provide access to health and mental health services as basic program resources. A comparison of HIV prevention programs for homeless youth identifies the robust components of each and suggests which programs providers may choose to replicate. PMID:19067164

Comparisons of prevention programs for homeless youth.

PubMed

Arnold, Elizabeth Mayfield; Rotheram-Borus, Mary Jane

2009-03-01

There are six HIV prevention programs for homeless youth whose efficacy has been or is currently being evaluated: STRIVE, the Community Reinforcement Approach, Strengths-Based Case Management, Ecologically-Based Family Therapy, Street Smart, and AESOP (street outreach access to resources). Programs vary in their underlying framework and theoretical models for understanding homelessness. All programs presume that the youths' families lack the ability to support their adolescent child. Some programs deemphasize family involvement while others focus on rebuilding connections among family members. The programs either normalize current family conflicts or, alternatively, provide education about the importance of parental monitoring. All programs aim to reduce HIV-related sexual and drug use acts. A coping skills approach is common across programs: Problem-solving skills are specifically addressed in four of the six programs; alternatively, parents in other programs are encouraged to contingently reward their children. Each program also engineers ongoing social support for the families and the youth, either by providing access to needed resources or by substituting a new, supportive relationship for the existing family caretaker. All of the interventions provide access to health and mental health services as basic program resources. A comparison of HIV prevention programs for homeless youth identifies the robust components of each and suggests which programs providers may choose to replicate.

An Integrated Chemical Environment to Support 21st-Century Toxicology.

PubMed

Bell, Shannon M; Phillips, Jason; Sedykh, Alexander; Tandon, Arpit; Sprankle, Catherine; Morefield, Stephen Q; Shapiro, Andy; Allen, David; Shah, Ruchir; Maull, Elizabeth A; Casey, Warren M; Kleinstreuer, Nicole C

2017-05-25

SUMMARY : Access to high-quality reference data is essential for the development, validation, and implementation of in vitro and in silico approaches that reduce and replace the use of animals in toxicity testing. Currently, these data must often be pooled from a variety of disparate sources to efficiently link a set of assay responses and model predictions to an outcome or hazard classification. To provide a central access point for these purposes, the National Toxicology Program Interagency Center for the Evaluation of Alternative Toxicological Methods developed the Integrated Chemical Environment (ICE) web resource. The ICE data integrator allows users to retrieve and combine data sets and to develop hypotheses through data exploration. Open-source computational workflows and models will be available for download and application to local data. ICE currently includes curated in vivo test data, reference chemical information, in vitro assay data (including Tox21 TM /ToxCast™ high-throughput screening data), and in silico model predictions. Users can query these data collections focusing on end points of interest such as acute systemic toxicity, endocrine disruption, skin sensitization, and many others. ICE is publicly accessible at https://ice.ntp.niehs.nih.gov. https://doi.org/10.1289/EHP1759.

An Integrated Chemical Environment to Support 21st-Century Toxicology

PubMed Central

Bell, Shannon M.; Phillips, Jason; Sedykh, Alexander; Tandon, Arpit; Sprankle, Catherine; Morefield, Stephen Q.; Shapiro, Andy; Allen, David; Shah, Ruchir; Maull, Elizabeth A.; Casey, Warren M.

2017-01-01

Summary: Access to high-quality reference data is essential for the development, validation, and implementation of in vitro and in silico approaches that reduce and replace the use of animals in toxicity testing. Currently, these data must often be pooled from a variety of disparate sources to efficiently link a set of assay responses and model predictions to an outcome or hazard classification. To provide a central access point for these purposes, the National Toxicology Program Interagency Center for the Evaluation of Alternative Toxicological Methods developed the Integrated Chemical Environment (ICE) web resource. The ICE data integrator allows users to retrieve and combine data sets and to develop hypotheses through data exploration. Open-source computational workflows and models will be available for download and application to local data. ICE currently includes curated in vivo test data, reference chemical information, in vitro assay data (including Tox21TM/ToxCast™ high-throughput screening data), and in silico model predictions. Users can query these data collections focusing on end points of interest such as acute systemic toxicity, endocrine disruption, skin sensitization, and many others. ICE is publicly accessible at https://ice.ntp.niehs.nih.gov. https://doi.org/10.1289/EHP1759 PMID:28557712

Scaling predictive modeling in drug development with cloud computing.

PubMed

Moghadam, Behrooz Torabi; Alvarsson, Jonathan; Holm, Marcus; Eklund, Martin; Carlsson, Lars; Spjuth, Ola

2015-01-26

Growing data sets with increased time for analysis is hampering predictive modeling in drug discovery. Model building can be carried out on high-performance computer clusters, but these can be expensive to purchase and maintain. We have evaluated ligand-based modeling on cloud computing resources where computations are parallelized and run on the Amazon Elastic Cloud. We trained models on open data sets of varying sizes for the end points logP and Ames mutagenicity and compare with model building parallelized on a traditional high-performance computing cluster. We show that while high-performance computing results in faster model building, the use of cloud computing resources is feasible for large data sets and scales well within cloud instances. An additional advantage of cloud computing is that the costs of predictive models can be easily quantified, and a choice can be made between speed and economy. The easy access to computational resources with no up-front investments makes cloud computing an attractive alternative for scientists, especially for those without access to a supercomputer, and our study shows that it enables cost-efficient modeling of large data sets on demand within reasonable time.

Random walks with random velocities.

PubMed

Zaburdaev, Vasily; Schmiedeberg, Michael; Stark, Holger

2008-07-01

We consider a random walk model that takes into account the velocity distribution of random walkers. Random motion with alternating velocities is inherent to various physical and biological systems. Moreover, the velocity distribution is often the first characteristic that is experimentally accessible. Here, we derive transport equations describing the dispersal process in the model and solve them analytically. The asymptotic properties of solutions are presented in the form of a phase diagram that shows all possible scaling regimes, including superdiffusive, ballistic, and superballistic motion. The theoretical results of this work are in excellent agreement with accompanying numerical simulations.

Open Access Alternatives

ERIC Educational Resources Information Center

Tenopir, Carol

2004-01-01

Open access publishing is a hot topic today. But open access publishing can have many different definitions, and pros and cons vary with the definitions. Open access publishing is especially attractive to companies and small colleges or universities that are likely to have many more readers than authors. A downside is that a membership fee sounds…

76 FR 45300 - Notice of Issuance of Materials License SUA-1597 and Record of Decision for Uranerz Energy...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-28

... considered but eliminated from detailed analysis include conventional uranium mining and milling, conventional mining and heap leach processing, alternative site location, alternate lixiviants, and alternate...'s Agencywide Document Access and Management System (ADAMS), which provides text and image files of...

On the Suitability of MPI as a PGAS Runtime

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

Daily, Jeffrey A.; Vishnu, Abhinav; Palmer, Bruce J.

2014-12-18

Partitioned Global Address Space (PGAS) models are emerging as a popular alternative to MPI models for designing scalable applications. At the same time, MPI remains a ubiquitous communication subsystem due to its standardization, high performance, and availability on leading platforms. In this paper, we explore the suitability of using MPI as a scalable PGAS communication subsystem. We focus on the Remote Memory Access (RMA) communication in PGAS models which typically includes {\\em get, put,} and {\\em atomic memory operations}. We perform an in-depth exploration of design alternatives based on MPI. These alternatives include using a semantically-matching interface such as MPI-RMA,more » as well as not-so-intuitive interfaces such as MPI two-sided with a combination of multi-threading and dynamic process management. With an in-depth exploration of these alternatives and their shortcomings, we propose a novel design which is facilitated by the data-centric view in PGAS models. This design leverages a combination of highly tuned MPI two-sided semantics and an automatic, user-transparent split of MPI communicators to provide asynchronous progress. We implement the asynchronous progress ranks approach and other approaches within the Communication Runtime for Exascale which is a communication subsystem for Global Arrays. Our performance evaluation spans pure communication benchmarks, graph community detection and sparse matrix-vector multiplication kernels, and a computational chemistry application. The utility of our proposed PR-based approach is demonstrated by a 2.17x speed-up on 1008 processors over the other MPI-based designs.« less

The Geographic Distribution of Physicians Revisited

PubMed Central

Rosenthal, Meredith B; Zaslavsky, Alan; Newhouse, Joseph P

2005-01-01

Context While there is debate over whether the U.S. is training too many physicians, many seem to agree that physicians are geographically maldistributed, with too few in rural areas. Objective Official definitions of shortage areas assume the market for physician services is based on county boundaries. We wished to ascertain how the picture of a possible shortage changes using alternative measures of geographic access. We measure geographic access by the number of full-time equivalent physicians serving a community divided by the expected number of patients (possibly both from within the community and outside) receiving care from those physicians. Moreover, we wished to determine how the geographic distribution of physicians had changed since previous studies, in light of the large increase in physician numbers. Design Cross-sectional data analyses of alternative measures of geographic access to physicians in 23 states with low physician–population ratios. Results Between 1979 and 1999, the number of physicians doubled in the sample states. Although most specialties experienced greater diffusion everywhere, smaller specialties had not yet diffused to the smallest towns. Multiple measures of geographic access, including physician-to-population ratios, average distance traveled to the nearest physician, and projected average caseload per physician, confirm that residents of metropolitan areas have better geographic access to physicians. Physician-to-population ratios exhibit the largest degree of geographic disparity, but ratios in rural counties adjacent to metropolitan areas are smaller than in those not adjacent to metropolitan areas. Distance-traveled and caseload models that allow patients to cross county lines show less disparity and indicate that residents of isolated rural counties have less access than those living in counties adjacent to metropolitan areas. Conclusion Geographic access to physicians has continued to improve over the past two decades, although some smaller specialties have not diffused to the most rural areas. While substantial variation in the supply of physicians across communities remains, current measures of geographic access to physicians overstate the extent of maldistribution and yield an incorrect ranking of areas according to geographic accessibility of physicians. PMID:16336557

On Hierarchical Threshold Access Structures

DTIC Science & Technology

2010-11-01

One of the recent generalizations of (t, n) secret sharing for hierarchical threshold access structures is given by Tassa, where he answers the...of theoretical background. We give a conceptually simpler alternative for the understanding of the realization of hierarchical threshold access

Evolving Nutritional Strategies in the Presence of Competition: A Geometric Agent-Based Model

PubMed Central

Senior, Alistair M.; Charleston, Michael A.; Lihoreau, Mathieu; Buhl, Jerome; Raubenheimer, David; Simpson, Stephen J.

2015-01-01

Access to nutrients is a key factor governing development, reproduction and ultimately fitness. Within social groups, contest-competition can fundamentally affect nutrient access, potentially leading to reproductive asymmetry among individuals. Previously, agent-based models have been combined with the Geometric Framework of nutrition to provide insight into how nutrition and social interactions affect one another. Here, we expand this modelling approach by incorporating evolutionary algorithms to explore how contest-competition over nutrient acquisition might affect the evolution of animal nutritional strategies. Specifically, we model tolerance of nutrient excesses and deficits when ingesting nutritionally imbalanced foods, which we term ‘nutritional latitude’; a higher degree of nutritional latitude constitutes a higher tolerance of nutritional excess and deficit. Our results indicate that a transition between two alternative strategies occurs at moderate to high levels of competition. When competition is low, individuals display a low level of nutritional latitude and regularly switch foods in search of an optimum. When food is scarce and contest-competition is intense, high nutritional latitude appears optimal, and individuals continue to consume an imbalanced food for longer periods before attempting to switch to an alternative. However, the relative balance of nutrients within available foods also strongly influences at what levels of competition, if any, transitions between these two strategies occur. Our models imply that competition combined with reproductive skew in social groups can play a role in the evolution of diet breadth. We discuss how the integration of agent-based, nutritional and evolutionary modelling may be applied in future studies to further understand the evolution of nutritional strategies across social and ecological contexts. PMID:25815976

Medicare Program; Merit-Based Incentive Payment System (MIPS) and Alternative Payment Model (APM) Incentive Under the Physician Fee Schedule, and Criteria for Physician-Focused Payment Models. Final rule with comment period.

PubMed

2016-11-04

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) repeals the Medicare sustainable growth rate (SGR) methodology for updates to the physician fee schedule (PFS) and replaces it with a new approach to payment called the Quality Payment Program that rewards the delivery of high-quality patient care through two avenues: Advanced Alternative Payment Models (Advanced APMs) and the Merit-based Incentive Payment System (MIPS) for eligible clinicians or groups under the PFS. This final rule with comment period establishes incentives for participation in certain alternative payment models (APMs) and includes the criteria for use by the Physician-Focused Payment Model Technical Advisory Committee (PTAC) in making comments and recommendations on physician-focused payment models (PFPMs). Alternative Payment Models are payment approaches, developed in partnership with the clinician community, that provide added incentives to deliver high-quality and cost-efficient care. APMs can apply to a specific clinical condition, a care episode, or a population. This final rule with comment period also establishes the MIPS, a new program for certain Medicare-enrolled practitioners. MIPS will consolidate components of three existing programs, the Physician Quality Reporting System (PQRS), the Physician Value-based Payment Modifier (VM), and the Medicare Electronic Health Record (EHR) Incentive Program for Eligible Professionals (EPs), and will continue the focus on quality, cost, and use of certified EHR technology (CEHRT) in a cohesive program that avoids redundancies. In this final rule with comment period we have rebranded key terminology based on feedback from stakeholders, with the goal of selecting terms that will be more easily identified and understood by our stakeholders.

The U.S. Market For Broadband Over Powerline, 3. edition

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

NONE

2007-07-15

The report provides a study of the potential market for BPL technology in the U.S. including a look at the past, present, and future state of Broadband Over Powerline (BPL) in the U.S. The Scope of the report includes the following topics: a description of the history of powerline communications (PLC) and broadband over powerline (BPL) technology; an analysis of key drivers of BPL within the electric utility and internet access industries; an overview of BPL technology and architecture; a comparison of BPL with alternative broadband access methods; an analysis of technological, regulatory, and business barriers to BPL's success; identificationmore » of the key applications and markets for BPL; a description of business models for BPL; an analysis of key market trends in broadband internet access; a review of the market development of cable modem broadband access; profiles of major U.S. BPL market participants; and, profiles of major U.S. BPL projects.« less

Memory-Intensive Benchmarks: IRAM vs. Cache-Based Machines

NASA Technical Reports Server (NTRS)

Biswas, Rupak; Gaeke, Brian R.; Husbands, Parry; Li, Xiaoye S.; Oliker, Leonid; Yelick, Katherine A.; Biegel, Bryan (Technical Monitor)

2002-01-01

The increasing gap between processor and memory performance has lead to new architectural models for memory-intensive applications. In this paper, we explore the performance of a set of memory-intensive benchmarks and use them to compare the performance of conventional cache-based microprocessors to a mixed logic and DRAM processor called VIRAM. The benchmarks are based on problem statements, rather than specific implementations, and in each case we explore the fundamental hardware requirements of the problem, as well as alternative algorithms and data structures that can help expose fine-grained parallelism or simplify memory access patterns. The benchmarks are characterized by their memory access patterns, their basic control structures, and the ratio of computation to memory operation.

Extreme cognitions are associated with diminished ability to use disconfirming evidence.

PubMed

Haigh, Matthew; Dodd, Alyson L

2017-03-01

An Integrative Cognitive Model of mood swings and bipolar disorder proposes that cognitive styles characterized by extreme self-referent appraisals of internal states (e.g., 'If I have a bad night's sleep it means that I am about to have a breakdown') interfere with mood regulation. The aim of this study is to determine whether strong endorsement of such appraisals is predicted by a diminished ability to access disconfirming counterexamples. We examined whether the ability to access two different categories of counterexample (known as Disabling Conditions and Alternative Causes) would predict endorsement of extreme appraisals (measured by the Hypomanic Attitudes and Positive Predictions Inventory; HAPPI) and mania risk (measured by the Hypomanic Personality Scale; HPS). A non-clinical sample of 150 students completed the HAPPI, the HPS and a conditional reasoning task that indexed the ability to access Disabling Conditions and Alternative Causes. Current mood was controlled for using the Internal States Scale. The ability to make use of disabling counterexamples during the reasoning task was inversely related with scores on the HAPPI (r = -.19, p < .05); participants that were less able to make use of disabling counterexamples endorsed extreme self-referent appraisals to a greater extent. There was no association between the use of alternative cause counterexamples and the HAPPI, and no association between either measure of counterexample generation and the HPS. A diminished ability to use disconfirming evidence when reasoning about the world may reinforce problematic cognitive styles such as extreme, personalized appraisals of experience, which can interfere with mood regulation. Problematic cognitive styles such as extreme, personalized appraisals of experience may be reinforced by the inability to produce or access evidence that disconfirms these maladaptive beliefs. This reasoning bias may be associated with cognitive styles underlying psychopathology. There may be clinical utility in exploring the use of disabler generation in psychological interventions, to help disconfirm maladaptive beliefs. © 2016 The British Psychological Society.

Acoustic accessibility investigation for ultrasound mediated treatment of glycogen storage disease type Ia patients.

PubMed

Wang, Shutao; Raju, Balasundar I; Leyvi, Evgeniy; Weinstein, David A; Seip, Ralf

2011-09-01

Glycogen storage disease type Ia (GSDIa) is caused by an inherited defect in the glucose-6-phosphatase gene. The recent advent of targeted ultrasound-mediated delivery (USMD) of plasmid DNA (pDNA) to the liver in conjunction with microbubbles may provide an alternative treatment option. This study focuses on determining the acoustically accessible liver volume in GSDIa patients using transducer models of various geometries with an image-based geometry-driven approach. Results show that transducers with longer focal lengths and smaller apertures (up to an f/number of 2) are able to access larger liver volumes in GSDIa patients while still being capable of delivering the required ultrasound dose in situ (2.5 MPa peak negative pressure at the focus). With sufficiently large acoustic windows and the ability to use glucose to easily assess efficacy, GSD appears to be a good model for testing USMD as proof of principle as a potential therapy for liver applications in general. Copyright © 2011 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

Technology innovation for infectious diseases in the developing world.

PubMed

So, Anthony D; Ruiz-Esparza, Quentin

2012-10-25

Enabling innovation and access to health technologies remains a key strategy in combating infectious diseases in low- and middle-income countries (LMICs). However, a gulf between paying markets and the endemicity of such diseases has contributed to the dearth of R&D in meeting these public health needs. While the pharmaceutical industry views emerging economies as potential new markets, most of the world's poorest bottom billion now reside in middle-income countries--a fact that has complicated tiered access arrangements. However, product development partnerships--particularly those involving academic institutions and small firms--find commercial opportunities in pursuing even neglected diseases; and a growing pharmaceutical sector in BRICS countries offers hope for an indigenous base of innovation. Such innovation will be shaped by 1) access to building blocks of knowledge; 2) strategic use of intellectual property and innovative financing to meet public health goals; 3) collaborative norms of open innovation; and 4) alternative business models, some with a double bottom line. Facing such resource constraints, LMICs are poised to develop a new, more resource-effective model of innovation that holds exciting promise in meeting the needs of global health.

Alternative futures of proactive tools for a citizen's own wellbeing.

PubMed

Meristö, Tarja; Tuohimaa, Hanna; Leppimäki, Sami; Laitinen, Jukka

2009-01-01

The aim of this paper is to create the basis for a vision of an empowered citizen who can control his/her life, especially in relation to health and personal wellbeing with the use of new ICT-tools. The methods used in the study are based on futures studies, especially on scenario methodology. Alternative future paths, i.e. scenarios are constructed using the scenario filter model that we have developed, with market, technology and society perspectives. Scenarios not resulting in the vision are described in what if - analysis as well. The scenarios are combined with Viherä's model on citizen's skills, access and motivation to use new ICT-tools. The concept COPER is targeted to different user groups with an adaptable user interface and its development is user centered. We will consider the effects and the appropriate elements of COPER in every scenario, as well as the possibilities and challenges nursing will confront. As a result we will gain information of the characteristic of COPER that advance the vision. For the future development of COPER the alternative scenarios give the basis for flexibility planning, too.

Effects of intraosseous epinephrine in a cardiac arrest swine model.

PubMed

Wong, Marc R; Reggio, Matt J; Morocho, Freddy R; Holloway, Monica M; Garcia-Blanco, Jose C; Jenkins, Constance; Johnson, Arthur D

2016-04-01

Interruptions in cardiopulmonary resuscitation (CPR) to obtain vascular access reduces blood flow to vital organs. Tibial intraosseous (TIO) access may be a faster alternative to intravenous (IV) access for delivery of vasoactive medications. The purpose of this study was to examine the differences in pharmacokinetics and pharmacodynamics of TIO- and IV-delivered epinephrine. A prospective, between subjects, experimental design comparing Cmax, Tmax, return of spontaneous circulation (ROSC), and time to ROSC. Adult male swine were divided into three equal groups (n = 7) all received CPR and defibrillation: the second group received IV epinephrine and the third group received tibial intraosseous epinephrine. Swine were placed in cardiac arrest for 2 min before CPR was initiated. After 2 min of CPR, epinephrine was delivered by IV or TIO, and serial blood samples were collected over 4 min. There were no significant differences between IV versus TIO epinephrine in achieving ROSC, time to ROSC, and Cmax. A one-way analysis of variance demonstrated a significant difference between the IV and TIO groups in Tmax (P = 0.025). A Fisher exact test demonstrated a significant difference between IV epinephrine versus CPR/Defib only (P = 0.035) and TIO epinephrine versus CPR/Defib only (P = 0.010) in achieving ROSC. A multivariate analysis of variance showed significant differences in IV versus intraosseous epinephrine concentration at specific time intervals: 60 (P = 0.023), 90 (P = 0.001), and 120 (P < 0.000) sec. In the context of ROSC, epinephrine delivered via TIO route is a clinically relevant alternative to IV administration. When IV access cannot be immediately obtained in cardiac arrest patients, TIO access should be considered. Published by Elsevier Inc.

Intraosseous Vascular Access through the Anterior Mandible – A Cadaver Model Pilot Study

PubMed Central

Goldschalt, Christin; Doll, Sara; Ihle, Brit; Kirsch, Joachim; Mutzbauer, Till Sebastian

2014-01-01

Background Several insertion sites have been described for intraosseous puncture in cases of emergencies when a conventional vascular access cannot be established. This pilot study has been designed to evaluate the feasibility of the mandibular bone for the use of an intraosseous vascular access in a cadaver model. Methodology/Principal Findings 17 dentistry and 16 medical students participating in a voluntary course received a short introduction into the method and subsequently used the battery powered EZ-IO system with a 15 mm cannula for a puncture of the anterior mandible in 33 cadavers. The time needed to perform each procedure was evaluated. India ink was injected into the accesses and during the anatomy course cadavers were dissected to retrace the success or failure of the puncture. Dental students needed 25.5±18.9(mean±standard deviation)s and medical students 33±20.4 s for the procedure (p = 0.18). Floor of mouth extravasation occurred in both groups in 3 cases. Success rates were 82 and 75% (p = 0.93). Conclusions/Significance Despite floor of mouth extravasation of injected fluid into a mandibular intraosseous access might severely complicate this procedure, the anterior mandible may be helpful as an alternative to other intraosseous and intravenous insertion sites when these are not available in medical emergencies. PMID:25405476

Optimal location of radiation therapy centers with respect to geographic access.

PubMed

Santibáñez, Pablo; Gaudet, Marc; French, John; Liu, Emma; Tyldesley, Scott

2014-07-15

To develop a framework with which to evaluate locations of radiation therapy (RT) centers in a region based on geographic access. Patient records were obtained for all external beam radiation therapy started in 2011 for the province of British Columbia, Canada. Two metrics of geographic access were defined. The primary analysis was percentage of patients (coverage) within a 90-minute drive from an RT center (C90), and the secondary analysis was the average drive time (ADT) to an RT center. An integer programming model was developed to determine optimal center locations, catchment areas, and capacity required under different scenarios. Records consisted of 11,096 courses of radiation corresponding to 161,616 fractions. Baseline geographic access was estimated at 102.5 minutes ADT (each way, per fraction) and 75.9% C90. Adding 2 and 3 new centers increased C90 to 88% and 92%, respectively, and decreased ADT by between 43% and 61%, respectively. A scenario in which RT was provided in every potential location that could support at least 1 fully utilized linear accelerator resulted in 35.3 minutes' ADT and 93.6% C90. The proposed framework and model provide a data-driven means to quantitatively evaluate alternative configurations of a regional RT system. Results suggest that the choice of location for future centers can significantly improve geographic access to RT. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

Transit and trail connections: assessment of visitor access to National Wildlife Refuges

DOT National Transportation Integrated Search

2010-12-01

The purpose of the study is to characterize the use of transit and non-motorized transportation modes for visitor access to National Wildlife Refuges (NWRs), as well as identify opportunities for and constraints to alternative transportation access. ...

A Randomized Cadaver Study Comparing First-Attempt Success Between Tibial and Humeral Intraosseous Insertions Using NIO Device by Paramedics: A Preliminary Investigation.

PubMed

Szarpak, Lukasz; Truszewski, Zenon; Smereka, Jacek; Krajewski, Paweł; Fudalej, Marcin; Adamczyk, Piotr; Czyzewski, Lukasz

2016-05-01

Medical personnel may encounter difficulties in obtaining intravenous (IV) access during cardiac arrest. The 2015 American Heart Association guidelines and the 2015 European Resuscitation Council guidelines for cardiopulmonary resuscitation (CPR) suggest that rescuers establish intraosseous (IO) access if an IV line is not easily obtainable.The aim of the study was to compare the success rates of the IO proximal tibia and proximal humerus head access performed by paramedics using the New Intraosseous access device (NIO; Persys Medical, Houston, TX, USA) in an adult cadaver model during simulated CPR.In an interventional, randomized, crossover, single-center cadaver study, a semi-automatic spring-load driven NIO access device was investigated. In total, 84 paramedics with less than 5-year experience in Emergency Medical Service participated in the study. The trial was performed on 42 adult cadavers. In each cadaver, 2 IO accesses to the humerus head, and 2 IO accesses to the proximal tibia were obtained.The success rate of the first IO attempt was 89.3% (75/84) for tibial access, and 73.8% (62/84) for humeral access (P = 0.017). The procedure times were significantly faster for tibial access [16.8 (interquartile range, IQR, 15.1-19.9] s] than humeral access [26.7 (IQR, 22.1-30.9) s] (P < 0.001).Tibial IO access is easier and faster to put in place than humeral IO access. Humeral IO access can be an alternative method to tibial IO access. clinicaltrials.gov Identifier: NCT02700867.

A structural model for the osmosensor, transporter, and osmoregulator ProP of Escherichia coli.

PubMed

Wood, Janet M; Culham, Doreen E; Hillar, Alexander; Vernikovska, Yaroslava I; Liu, Feng; Boggs, Joan M; Keates, Robert A B

2005-04-19

Transporter ProP of Escherichia coli, a member of the major facilitator superfamily (MFS), acts as an osmosensor and an osmoregulator in cells and after purification and reconstitution in proteoliposomes. H(+)-osmoprotectant symport via ProP is activated when medium osmolality is elevated with membrane impermeant osmolytes. The three-dimensional structure of ProP was modeled with the crystal structure of MFS member GlpT as a template. This GlpT structure represents the inward (or cytoplasm)-facing conformation predicted by the alternating access model for transport. LacZ-PhoA fusion analysis and site-directed fluorescence labeling substantiated the membrane topology and orientation predicted by this model and most hydropathy analyses. The model predicts the presence of a proton pathway within the N-terminal six-helix bundle of ProP (as opposed to the corresponding pathway found within the C-terminal helix bundle of its paralogue, LacY). Replacement of residues within the N-terminal helix bundle impaired the osmotic activation of ProP, providing the first indication that residues outside the C-terminal domain are involved in osmosensing. Some residues that were accessible from the periplasmic side, as predicted by the structural model, were more susceptible to covalent labeling in permeabilized membrane fractions than in intact bacteria. These residues may be accessible from the cytoplasmic side in structures not represented by our current model, or their limited exposure in vivo may reflect constraints on transporter structure that are related to its osmosensory mechanism.

Interfacing modeling suite Physics Of Eclipsing Binaries 2.0 with a Virtual Reality Platform

NASA Astrophysics Data System (ADS)

Harriett, Edward; Conroy, Kyle; Prša, Andrej; Klassner, Frank

2018-01-01

To explore alternate methods for modeling eclipsing binary stars, we extrapolate upon PHOEBE’s (PHysics Of Eclipsing BinariEs) capabilities in a virtual reality (VR) environment to create an immersive and interactive experience for users. The application used is Vizard, a python-scripted VR development platform for environments such as Cave Automatic Virtual Environment (CAVE) and other off-the-shelf VR headsets. Vizard allows the freedom for all modeling to be precompiled without compromising functionality or usage on its part. The system requires five arguments to be precomputed using PHOEBE’s python front-end: the effective temperature, flux, relative intensity, vertex coordinates, and orbits; the user can opt to implement other features from PHOEBE to be accessed within the simulation as well. Here we present the method for making the data observables accessible in real time. An Occulus Rift will be available for a live showcase of various cases of VR rendering of PHOEBE binary systems including detached and contact binary stars.

Video feedforward for rapid learning of a picture-based communication system.

PubMed

Smith, Jemma; Hand, Linda; Dowrick, Peter W

2014-04-01

This study examined the efficacy of video self modeling (VSM) using feedforward, to teach various goals of a picture exchange communication system (PECS). The participants were two boys with autism and one man with Down syndrome. All three participants were non-verbal with no current functional system of communication; the two children had long histories of PECS failure. A series of replications, with different length baselines, was used to examine whether video self modeling could replace the PECS method of teaching to achieve the same goals. All three participants showed rapid learning of their target behavior when introduced to their self modeling videos, and effects generalized without the need for further intervention. We conclude that VSM, using feedforward, can provide a fast, simple way of teaching the use of a picture-based communication system without the need for prompts or intensive operant conditioning. VSM may provide an accessible, easy-to-use alternative to common methods of teaching augmentative and alternative communication systems.

Effects of payment changes on trends in post-acute care.

PubMed

Buntin, Melinda Beeuwkes; Colla, Carrie Hoverman; Escarce, José J

2009-08-01

To test how the implementation of new Medicare post-acute payment systems affected the use of inpatient rehabilitation facilities (IRFs), skilled nursing facilities (SNFs), and home health agencies. Medicare acute hospital, IRF, and SNF claims; provider of services file; enrollment file; and Area Resource File data. We used multinomial logit models to measure realized access to post-acute care and to predict how access to alternative sites of care changed in response to prospective payment systems. A file was constructed linking data for elderly Medicare patients discharged from acute care facilities between 1996 and 2003 with a diagnosis of hip fracture, stroke, or lower extremity joint replacement. Although the effects of the payment systems on the use of post-acute care varied, most reduced the use of the site of care they directly affected and boosted the use of alternative sites of care. Payment system changes do not appear to have differentially affected the severely ill. Payment system incentives play a significant role in determining where Medicare beneficiaries receive their post-acute care. Changing these incentives results in shifting of patients between post-acute sites.

Optimizing Perioperative Decision Making: Improved Information for Clinical Workflow Planning

PubMed Central

Doebbeling, Bradley N.; Burton, Matthew M.; Wiebke, Eric A.; Miller, Spencer; Baxter, Laurence; Miller, Donald; Alvarez, Jorge; Pekny, Joseph

2012-01-01

Perioperative care is complex and involves multiple interconnected subsystems. Delayed starts, prolonged cases and overtime are common. Surgical procedures account for 40–70% of hospital revenues and 30–40% of total costs. Most planning and scheduling in healthcare is done without modern planning tools, which have potential for improving access by assisting in operations planning support. We identified key planning scenarios of interest to perioperative leaders, in order to examine the feasibility of applying combinatorial optimization software solving some of those planning issues in the operative setting. Perioperative leaders desire a broad range of tools for planning and assessing alternate solutions. Our modeled solutions generated feasible solutions that varied as expected, based on resource and policy assumptions and found better utilization of scarce resources. Combinatorial optimization modeling can effectively evaluate alternatives to support key decisions for planning clinical workflow and improving care efficiency and satisfaction. PMID:23304284

Optimizing perioperative decision making: improved information for clinical workflow planning.

PubMed

Doebbeling, Bradley N; Burton, Matthew M; Wiebke, Eric A; Miller, Spencer; Baxter, Laurence; Miller, Donald; Alvarez, Jorge; Pekny, Joseph

2012-01-01

Perioperative care is complex and involves multiple interconnected subsystems. Delayed starts, prolonged cases and overtime are common. Surgical procedures account for 40-70% of hospital revenues and 30-40% of total costs. Most planning and scheduling in healthcare is done without modern planning tools, which have potential for improving access by assisting in operations planning support. We identified key planning scenarios of interest to perioperative leaders, in order to examine the feasibility of applying combinatorial optimization software solving some of those planning issues in the operative setting. Perioperative leaders desire a broad range of tools for planning and assessing alternate solutions. Our modeled solutions generated feasible solutions that varied as expected, based on resource and policy assumptions and found better utilization of scarce resources. Combinatorial optimization modeling can effectively evaluate alternatives to support key decisions for planning clinical workflow and improving care efficiency and satisfaction.

Modeling the mental health service utilization decisions of university undergraduates: A discrete choice conjoint experiment.

PubMed

Cunningham, Charles E; Zipursky, Robert B; Christensen, Bruce K; Bieling, Peter J; Madsen, Victoria; Rimas, Heather; Mielko, Stephanie; Wilson, Fiona; Furimsky, Ivana; Jeffs, Lisa; Munn, Catharine

2017-01-01

We modeled design factors influencing the intent to use a university mental health service. Between November 2012 and October 2014, 909 undergraduates participated. Using a discrete choice experiment, participants chose between hypothetical campus mental health services. Latent class analysis identified three segments. A Psychological/Psychiatric Service segment (45.5%) was most likely to contact campus health services delivered by psychologists or psychiatrists. An Alternative Service segment (39.3%) preferred to talk to peer-counselors who had experienced mental health problems. A Hesitant segment (15.2%) reported greater distress but seemed less intent on seeking help. They preferred services delivered by psychologists or psychiatrists. Simulations predicted that, rather than waiting for standard counseling, the Alternative Service segment would prefer immediate access to E-Mental health. The Usual Care and Hesitant segments would wait 6 months for standard counseling. E-Mental Health options could engage students who may not wait for standard services.

Picking Deep Filter Responses for Fine-Grained Image Recognition (Open Access Author’s Manuscript)

DTIC Science & Technology

2016-12-16

stages. Our method explores a unified framework based on two steps of deep filter response picking. The first picking step is to find distinctive... filters which respond to specific patterns significantly and consistently, and learn a set of part detectors via iteratively alternating between new...positive sample mining and part model retraining. The second picking step is to pool deep filter responses via spatially weighted combination of Fisher

ReRouting biomedical innovation: observations from a mapping of the alternative research and development (R&D) landscape.

PubMed

Greenberg, Alexandra; Kiddell-Monroe, Rachel

2016-09-14

In recent years, the world has witnessed the tragic outcomes of multiple global health crises. From Ebola to high prices to antibiotic resistance, these events highlight the fundamental constraints of the current biomedical research and development (R&D) system in responding to patient needs globally.To mitigate this lack of responsiveness, over 100 self-identified "alternative" R&D initiatives, have emerged in the past 15 years. To begin to make sense of this panoply of initiatives working to overcome the constraints of the current system, UAEM began an extensive, though not comprehensive, mapping of the alternative biomedical R&D landscape. We developed a two phase approach: (1) an investigation, via the RE:Route Mapping, of both existing and proposed initiatives that claim to offer an alternative approach to R&D, and (2) evaluation of those initiatives to determine which are in fact achieving increased access to and innovation in medicines. Through phase 1, the RE:Route Mapping, we examined 81 initiatives that claim to redress the inequity perpetuated by the current system via one of five commonly recognized mechanisms necessary for truly alternative R&D.Preliminary analysis of phase 1 provides the following conclusions: 1. No initiative presents a completely alternative model of biomedical R&D. 2. The majority of initiatives focus on developing incentives for drug discovery. 3. The majority of initiatives focus on rare diseases or diseases of the poor and marginalized. 4. There is an increasing emphasis on the use of push, pull, pool, collaboration and open mechanisms alongside the concept of delinkage in alternative R&D. 5. There is a trend towards public funding and launching of initiatives by the Global South. Given the RE:Route Mapping's inevitable limitations and the assumptions made in its methodology, it is not intended to be the final word on a constantly evolving and complex field; however, its findings are significant. The Mapping's value lies in its timely and unique insight into the importance of ongoing efforts to develop a new global framework for biomedical R&D. As we progress to phase 2, an evaluation tool for initiatives focused on identifying which approaches have truly achieved increased innovation and access for patients, we aim to demonstrate that there are a handful of initiatives which represent some, but not all, of the building blocks for a new approach to R&D.Through this mapping and our forthcoming evaluation, UAEM aims to initiate an evidence-based conversation around a truly alternative biomedical R&D model that serves people rather than profits.

CABS-fold: Server for the de novo and consensus-based prediction of protein structure.

PubMed

Blaszczyk, Maciej; Jamroz, Michal; Kmiecik, Sebastian; Kolinski, Andrzej

2013-07-01

The CABS-fold web server provides tools for protein structure prediction from sequence only (de novo modeling) and also using alternative templates (consensus modeling). The web server is based on the CABS modeling procedures ranked in previous Critical Assessment of techniques for protein Structure Prediction competitions as one of the leading approaches for de novo and template-based modeling. Except for template data, fragmentary distance restraints can also be incorporated into the modeling process. The web server output is a coarse-grained trajectory of generated conformations, its Jmol representation and predicted models in all-atom resolution (together with accompanying analysis). CABS-fold can be freely accessed at http://biocomp.chem.uw.edu.pl/CABSfold.

CABS-fold: server for the de novo and consensus-based prediction of protein structure

PubMed Central

Blaszczyk, Maciej; Jamroz, Michal; Kmiecik, Sebastian; Kolinski, Andrzej

2013-01-01

The CABS-fold web server provides tools for protein structure prediction from sequence only (de novo modeling) and also using alternative templates (consensus modeling). The web server is based on the CABS modeling procedures ranked in previous Critical Assessment of techniques for protein Structure Prediction competitions as one of the leading approaches for de novo and template-based modeling. Except for template data, fragmentary distance restraints can also be incorporated into the modeling process. The web server output is a coarse-grained trajectory of generated conformations, its Jmol representation and predicted models in all-atom resolution (together with accompanying analysis). CABS-fold can be freely accessed at http://biocomp.chem.uw.edu.pl/CABSfold. PMID:23748950

Collaboration Between Medical Providers and Dental Hygienists in Pediatric Health Care.

PubMed

Braun, Patricia A; Cusick, Allison

2016-06-01

Basic preventive oral services for children can be provided within the medical home through the collaborative care of medical providers and dental hygienists to expand access for vulnerable populations. Because dental caries is a largely preventable disease, it is untenable that it remains the most common chronic disease of childhood. Leveraging the multiple visits children have with medical providers has potential to expand access to early preventive oral services. Developing interprofessional relationships between dental providers, including dental hygienists, and medical providers is a strategic approach to symbiotically expand access to dental care. Alternative care delivery models that provide dental services in the medical home expand access to these services for vulnerable populations. The purpose of this article is to explore 4 innovative care models aimed to expand access to dental care. Current activities in Colorado and around the nation are described regarding the provision of basic preventive oral health services (eg, fluoride varnish) by medical providers with referral to a dentist (expanded coordinated care), the colocation of dental hygiene services into the medical home (colocated care), the integration of a dental hygienist into the medical care team (integrated care), and the expansion of the dental home into the community setting through telehealth-enabled teams (virtual dental home). Gaps in evidence regarding the impacts of these models are elucidated. Bringing preventive and restorative dental services to the patient both in the medical home and in the community has potential to reduce long-standing barriers to receive these services, improve oral health outcomes of vulnerable patients, and decrease oral health disparities. Copyright © 2016 Elsevier Inc. All rights reserved.

Institutional open access funds: now is the time.

PubMed

Eckman, Charles D; Weil, Beth T

2010-05-25

To date, the Berkeley OA fund has ensured that 43 articles are free to be read immediately upon publication and 44 additional articles are now in the pipeline. The full scope of OA publishing during this period was significantly larger, at least by a factor of four. The OA fund allocation will continue to be carefully managed over the coming years. We are tracking our potential liability assuming the OA landscape grows with additional publishers and OA options. The amount predicted as necessary to maintain the fund based on the initial 18-month uptake data is US$45,000. This is less than 1% of the US$6.2 million the library invests in subscribing to closed-access digital journals. We are paying attention in particular to the attempts by the California Digital Library, which negotiates major journal publisher licenses on behalf of the UC campuses, to include terms within the licenses that enable UC authors to take advantage of publishers'hybrid OA options [16]. And it comes with far less of the myriad overhead costs associated with those closed-access subscriptions because that subscription price doesn't tell the full story of the actual cost of maintaining the subscription. Those subscriptions involve staff-intensive license negotiations. Institutions develop and maintain systems architectures in order to ensure that only authorized users have access and respond to challenges from publishers of the content when actual or potential breaches of the licenses are identified (publishers invest hugely in monitoring use of their content in order to ensure the license terms are not breached and are quite willing to contact the institutional subscriber when any untoward activity appears on their logs). They must, in certain instances, maintain the confidentiality of certain clauses in the licenses and increasingly respond to freedom of information, public records act requests related to the investments of public resources in those contracts. The need to experiment is particularly heightened during this economic crisis when investments in subscriptions are increasingly difficult to justify, particularly given the alternate forms of open access to content and decreasing ability for libraries to reliably distinguish OA and non-OA content within the journal. We believe that institutions (and the sub-institutional units that manage collection funds) should be open to exploring alternative funding models for scholarly communication. Institutions should highly value funding models that promote universal access to their research output. And during an economic crisis, these institutions should question the extensive financial and human resource investments required by the subscription model, a model that both excludes nonauthorized users and entails large-scale and complex licensing and legal obligations. The time is now for broad-scale adoption of institutional OA funds.

Genomic Prediction Accounting for Genotype by Environment Interaction Offers an Effective Framework for Breeding Simultaneously for Adaptation to an Abiotic Stress and Performance Under Normal Cropping Conditions in Rice.

PubMed

Ben Hassen, Manel; Bartholomé, Jérôme; Valè, Giampiero; Cao, Tuong-Vi; Ahmadi, Nourollah

2018-05-09

Developing rice varieties adapted to alternate wetting and drying water management is crucial for the sustainability of irrigated rice cropping systems. Here we report the first study exploring the feasibility of breeding rice for adaptation to alternate wetting and drying using genomic prediction methods that account for genotype by environment interactions. Two breeding populations (a reference panel of 284 accessions and a progeny population of 97 advanced lines) were evaluated under alternate wetting and drying and continuous flooding management systems. The predictive ability of genomic prediction for response variables (index of relative performance and the slope of the joint regression) and for multi-environment genomic prediction models were compared. For the three traits considered (days to flowering, panicle weight and nitrogen-balance index), significant genotype by environment interactions were observed in both populations. In cross validation, predictive ability for the index was on average lower (0.31) than that of the slope of the joint regression (0.64) whatever the trait considered. Similar results were found for progeny validation. Both cross-validation and progeny validation experiments showed that the performance of multi-environment models predicting unobserved phenotypes of untested entrees was similar to the performance of single environment models with differences in predictive ability ranging from -6% to 4% depending on the trait and on the statistical model concerned. The predictive ability of multi-environment models predicting unobserved phenotypes of entrees evaluated under both water management systems outperformed single environment models by an average of 30%. Practical implications for breeding rice for adaptation to alternate wetting and drying system are discussed. Copyright © 2018, G3: Genes, Genomes, Genetics.

Contingency Management and Deliberative Decision-Making Processes.

PubMed

Regier, Paul S; Redish, A David

2015-01-01

Contingency management is an effective treatment for drug addiction. The current explanation for its success is rooted in alternative reinforcement theory. We suggest that alternative reinforcement theory is inadequate to explain the success of contingency management and produce a model based on demand curves that show how little the monetary rewards offered in this treatment would affect drug use. Instead, we offer an explanation of its success based on the concept that it accesses deliberative decision-making processes. We suggest that contingency management is effective because it offers a concrete and immediate alternative to using drugs, which engages deliberative processes, improves the ability of those deliberative processes to attend to non-drug options, and offsets more automatic action-selection systems. This theory makes explicit predictions that can be tested, suggests which users will be most helped by contingency management, and suggests improvements in its implementation.

Contingency Management and Deliberative Decision-Making Processes

PubMed Central

Regier, Paul S.; Redish, A. David

2015-01-01

Contingency management is an effective treatment for drug addiction. The current explanation for its success is rooted in alternative reinforcement theory. We suggest that alternative reinforcement theory is inadequate to explain the success of contingency management and produce a model based on demand curves that show how little the monetary rewards offered in this treatment would affect drug use. Instead, we offer an explanation of its success based on the concept that it accesses deliberative decision-making processes. We suggest that contingency management is effective because it offers a concrete and immediate alternative to using drugs, which engages deliberative processes, improves the ability of those deliberative processes to attend to non-drug options, and offsets more automatic action-selection systems. This theory makes explicit predictions that can be tested, suggests which users will be most helped by contingency management, and suggests improvements in its implementation. PMID:26082725

Free Web resources on alternatives.

PubMed

Donnelly, Thomas M

2004-03-01

Access to many online databases for alternatives searches requires a paid subscription and these fees may be expensive for small or not-for-profit institutions. The author provides a list of free sites that can be used to fulfill the legal requirement for an alternatives search.

Understanding access to healthcare among Indigenous peoples: A comparative analysis of biomedical and postcolonial perspectives.

PubMed

Horrill, Tara; McMillan, Diana E; Schultz, Annette S H; Thompson, Genevieve

2018-03-25

As nursing professionals, we believe access to healthcare is fundamental to health and that it is a determinant of health. Therefore, evidence suggesting access to healthcare is problematic for many Indigenous peoples is concerning. While biomedical perspectives underlie our current understanding of access, considering alternate perspectives could expand our awareness of and ability to address this issue. In this paper, we critique how access to healthcare is understood through a biomedical lens, how a postcolonial theoretical lens can extend that understanding, and the subsequent implications this alternative view raises for the nursing profession. Drawing on peer-reviewed published and gray literature concerning healthcare access and Indigenous peoples to inform this critique, we focus on the underlying theoretical lens shaping our current understanding of access. A postcolonial analysis provides a way of understanding healthcare as a social space and social relationship, presenting a unique perspective on access to healthcare. The novelty of this finding is of particular importance for the profession of nursing, as we are well situated to influence these social aspects, improving access to healthcare services broadly, and among Indigenous peoples specifically. © 2018 The Authors Nursing Inquiry published by John Wiley & Sons Ltd.

National study of health insurance type and reasons for emergency department use.

PubMed

Capp, Roberta; Rooks, Sean P; Wiler, Jennifer L; Zane, Richard D; Ginde, Adit A

2014-04-01

The rates of emergency department (ED) utilization vary substantially by type of health insurance, but the association between health insurance type and patient-reported reasons for seeking ED care is unknown. We evaluated the association between health insurance type and self-perceived acuity or access issues among individuals discharged from the ED. This was a cross-sectional analysis of the 2011 National Health Interview Survey. Adults whose last ED visit did not result in hospitalization (n = 4,606) were asked structured questions about reasons for seeking ED care. We classified responses as 1) perceived need for immediate evaluation (acuity issues), or 2) barriers to accessing outpatient services (access issues). We analyzed survey-weighted data using multivariable logistic regression models to test the association between health insurance type and reasons for ED visits, while adjusting for sociodemographic characteristics. Overall, 65.0% (95% CI 63.0-66.9) of adults reported ≥ 1 acuity issue and 78.9% (95% CI 77.3-80.5) reported ≥ 1 access issue. Among those who reported no acuity issue leading to the most recent ED visit, 84.2% reported ≥ 1 access issue. Relative to those with private insurance, adults with Medicaid (OR 1.05; 95% CI 0.79-1.40) and those with Medicare (OR 0.98; 95% CI 0.66-1.47) were similarly likely to seek ED care due to an acuity issue. Adults with Medicaid (OR 1.50; 95% CI 1.06-2.13) and Medicaid + Medicare (dual eligible) (OR 1.94; 95% CI 1.18-3.19) were more likely than those with private insurance to seek ED care for access issues. Variability in reasons for seeking ED care among discharged patients by health insurance type may be driven more by lack of access to alternate care, rather than by differences in patient-perceived acuity. Policymakers should focus on increasing access to alternate sites of care, particularly for Medicaid beneficiaries, as well as strategies to increase care coordination that involve ED patients and providers.

Effects of a proposed rural dental school on regional dental workforce and access to care.

PubMed

Wanchek, Tanya N; Rephann, Terance J

2013-01-01

Southwest Virginia is a rural, low-income region with a relatively small dentist workforce and poor oral health outcomes. The opening of a dental school in the region has been proposed by policy-makers as one approach to improving the size of the dentist workforce and oral health outcomes. A policy simulation was conducted to assess how a hypothetical dental school in rural Southwest Virginia would affect the availability of dentists and utilization levels of dental services. The simulation focuses on two channels through which the dental school would most likely affect the region. First, the number of graduates who are expected to remain in the region was varied, based on the extensiveness of the education pipeline used to attract local students. Second, the number of patients treated in the dental school clinic under different dental school clinical models, including the traditional model, a patient-centered clinic model and a community-based clinic model, was varied in the simulation to obtain a range of additional dentists and utilization rates under differing dental school models. Under a set of plausible assumptions, the low yield scenario (ie private school with a traditional clinic) would result in three additional dentists residing in the region and a total of 8090 additional underserved patients receiving care. Under the high yield scenario (ie dental pipeline program with community based clinics) nine new dentists would reside in the region and as many as 18 054 underserved patients would receive care. Even with the high yield scenario and the strong assumption that these patients would not otherwise access care, the utilization rate increases to 68.9% from its current 60.1%. While the new dental school in Southwest Virginia would increase the dentist workforce and utilization rates, the high cost combined with the continued low rate of dental utilization suggests that there may be more effective alternatives to improving oral health in rural areas. Alternative policies that have shown considerable promise in expanding access to disadvantaged populations include virtual dental homes, enhanced Medicaid reimbursement programs, and school-based dental care systems.

GRID Alternatives: Solar Programs in Underserved Communities

EPA Pesticide Factsheets

Introduces GRID Alternatives: Solar Programs in Underserved Communities, a program that partners with a variety of organizations to help low-income communities access the benefits of solar technology.

Model-assisted development of a laminography inspection system

NASA Astrophysics Data System (ADS)

Grandin, R.; Gray, J.

2012-05-01

Traditional computed tomography (CT) is an effective method of determining the internal structure of an object through non-destructive means; however, inspection of certain objects, such as those with planar geometrics or with limited access, requires an alternate approach. An alternative is laminography and has been the focus of a number of researchers in the past decade for both medical and industrial inspections. Many research efforts rely on geometrically-simple analytical models, such as the Shepp-Logan phantom, for the development of their algorithms. Recent work at the Center for Non-Destructive Evaluation makes extensive use of a forward model, XRSIM, to study artifacts arising from the reconstruction method, the effects of complex geometries and known issues such as high density features on the laminography reconstruction process. The use of a model provides full knowledge of all aspects of the geometry and provides a means to quantitatively evaluate the impact of methods designed to reduce artifacts generated by the reconstruction methods or that are result of the part geometry. We will illustrate the use of forward simulations to quantitatively assess reconstruction algorithm development and artifact reduction.

77 FR 58416 - Comparative Environmental Evaluation of Alternatives for Handling Low-Level Radioactive Waste...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-20

... NUCLEAR REGULATORY COMMISSION [NRC-2012-0218] Comparative Environmental Evaluation of Alternatives... public comment the Draft Comparative Environmental Evaluation of Alternatives for Handling Low-Level.... Availability of Documents ADAMS Accession No. Document title ML12256A965 Draft Comparative Environmental...

Accessible, almost ab initio multi-scale modeling of entangled polymers via slip-links

NASA Astrophysics Data System (ADS)

Andreev, Marat

It is widely accepted that dynamics of entangled polymers can be described by the tube model. Here we advocate for an alternative approach to entanglement modeling known as slip-links. Recently, slip-links were shown to possess important advantages over tube models, namely they have strong connections to atomistic, multichain levels of description, agree with non-equilibrium thermodynamics, are applicable to any chain architecture and can be used in linear or non-linear rheology. We present a hierarchy of slip-link models that are connected to each other through successive coarse graining. Models in the hierarchy are consistent in their overlapping domains of applicability in order to allow a straightforward mapping of parameters. In particular, the most--detailed level of description has four parameters, three of which can be determined directly from atomistic simulations. On the other hand, the least--detailed member of the hierarchy is numerically accessible, and allows for non-equilibrium flow predictions of complex chain architectures. Using GPU implementation these predictions can be obtained in minutes of computational time on a single desktop equipped with a mainstream gaming GPU. The GPU code is available online for free download.

Skin models for the testing of transdermal drugs

PubMed Central

Abd, Eman; Yousef, Shereen A; Pastore, Michael N; Telaprolu, Krishna; Mohammed, Yousuf H; Namjoshi, Sarika; Grice, Jeffrey E; Roberts, Michael S

2016-01-01

The assessment of percutaneous permeation of molecules is a key step in the evaluation of dermal or transdermal delivery systems. If the drugs are intended for delivery to humans, the most appropriate setting in which to do the assessment is the in vivo human. However, this may not be possible for ethical, practical, or economic reasons, particularly in the early phases of development. It is thus necessary to find alternative methods using accessible and reproducible surrogates for in vivo human skin. A range of models has been developed, including ex vivo human skin, usually obtained from cadavers or plastic surgery patients, ex vivo animal skin, and artificial or reconstructed skin models. Increasingly, largely driven by regulatory authorities and industry, there is a focus on developing standardized techniques and protocols. With this comes the need to demonstrate that the surrogate models produce results that correlate with those from in vivo human studies and that they can be used to show bioequivalence of different topical products. This review discusses the alternative skin models that have been developed as surrogates for normal and diseased skin and examines the concepts of using model systems for in vitro–in vivo correlation and the demonstration of bioequivalence. PMID:27799831

Protonation-dependent conformational dynamics of the multidrug transporter EmrE

PubMed Central

Dastvan, Reza; Mishra, Smriti; Meiler, Jens; Mchaourab, Hassane S.

2016-01-01

The small multidrug transporter from Escherichia coli, EmrE, couples the energetically uphill extrusion of hydrophobic cations out of the cell to the transport of two protons down their electrochemical gradient. Although principal mechanistic elements of proton/substrate antiport have been described, the structural record is limited to the conformation of the substrate-bound state, which has been shown to undergo isoenergetic alternating access. A central but missing link in the structure/mechanism relationship is a description of the proton-bound state, which is an obligatory intermediate in the transport cycle. Here we report a systematic spin labeling and double electron electron resonance (DEER) study that uncovers the conformational changes of EmrE subsequent to protonation of critical acidic residues in the context of a global description of ligand-induced structural rearrangements. We find that protonation of E14 leads to extensive rotation and tilt of transmembrane helices 1–3 in conjunction with repacking of loops, conformational changes that alter the coordination of the bound substrate and modulate its access to the binding site from the lipid bilayer. The transport model that emerges from our data posits a proton-bound, but occluded, resting state. Substrate binding from the inner leaflet of the bilayer releases the protons and triggers alternating access between inward- and outward-facing conformations of the substrate-loaded transporter, thus enabling antiport without dissipation of the proton gradient. PMID:26787875

An "XL" endodontics intervention for dental students required to repeat the course: changing frustration to improved grades and attitudes.

PubMed

Alcota, Marcela; Fuenzalida, Alejandra; Barrientos, Claudia; Garrido, Mauricio; Ruiz de Gauna, Pilar; González, Fermín E

2015-04-01

Given the psychological and financial costs involved with failing a clinical course, especially in developing countries, an alternative educational method was tested with students who had to repeat the year-long endodontic course at the University of Chile Faculty of Dentistry. The objectives of the intervention were to deepen theoretical knowledge and practical experiences, as well as to reinforce personal confidence in an endodontic clinical setting for students who failed the regular endodontic course. The aim of this study was to evaluate the success of this new model of educational intervention. In the study, 28 students who had failed the endodontic course repeated it with an alternative teaching method. The students attended patients immediately following practical competence exams, and they had access to simulated models that used rotary instruments and access cavities and had emergency care practice. Feedback sessions were held after each clinical session. Final grades were compared with those of other students who repeated the course without the intervention from 2007 to 2009. A survey was administered to understand the causes of initial failure and their opinions of the intervention. Students who participated in the alternative course did significantly better than their counterparts from previous years who did not receive the intervention (5.7±0.3 vs. 5.4±0.2; p<0.05). Their overall perception of the intervention was positive, and the main cause for previous course failure was personal insecurity and slow clinical care performance (54.2% of the students). The intervention course not only improved grades but also generated interest in endodontics, a contrasting perspective to the frustration students usually express after repeating the course. The results of this study support the introduction of similar interventions in endodontics and perhaps other courses.

Hospital admissions and emergency department presentations for dental conditions indicate access to hospital, rather than poor access to dental health care in the community.

PubMed

Yap, Matthew; Kok, Mei-Ruu; Nanda, Soniya; Vickery, Alistair; Whyatt, David

2018-03-01

High rates of dental-related potentially preventable hospitalisations are thought to reflect poor access to non-hospital dental services. The association between accessibility (geographic and financial) to non-hospital dentists and potentially preventable hospitalisations was examined in Western Australia. Areas with persistently high rates of dental-related potentially preventable hospitalisations and emergency department (ED) presentations were mapped. Statistical models examined factors associated with these events. Persistently high rates of dental-related potentially preventable hospitalisations were clustered in metropolitan areas that were socioeconomically advantaged and had more dentists per capita (RR 1.06, 95% CI 1.04-1.08) after adjusting for age, sex, socioeconomics, and Aboriginality. Persistently high rates of ED presentations were clustered in socioeconomically disadvantaged areas near metropolitan EDs and with fewer dentists per capita (RR 0.91, 0.88-0.94). A positive association between dental-related potentially preventable hospitalisations and poor (financial or geographic) access to dentists was not found. Rather, rates of such events were positively associated with socioeconomic advantage, plus greater access to hospitals and non-hospital dental services. Furthermore, ED presentations for dental conditions are inappropriate indicators of poor access to non-hospital dental services because of their relationship with hospital proximity. Health service planners and policymakers should pursue alternative indicators of dental service accessibility.

Access to healthcare and alternative health-seeking strategies among undocumented migrants in Denmark

PubMed Central

2011-01-01

Background As in many European countries, undocumented migrants in Denmark have restricted access to healthcare. The aim of this study is to describe and analyse undocumented migrants' experiences of access to healthcare, use of alternative health-seeking strategies; and ER nurses' experiences in encounters with undocumented migrants. Methods Qualitative design using semi-structured interviews and observations. The participants included ten undocumented South Asian migrants and eight ER nurses. Results Undocumented migrants reported difficulties accessing healthcare. The barriers to healthcare were: limited medical rights, arbitrariness in healthcare professionals' attitudes, fear of being reported to the police, poor language skills, lack of network with Danish citizens, lack of knowledge about the healthcare system and lack of knowledge about informal networks of healthcare professionals. These barriers induced alternative health-seeking strategies, such as self-medication, contacting doctors in home countries and borrowing health insurance cards from Danish citizens. ER nurses expressed willingness to treat all patients regardless of their migratory status, but also reported challenges in the encounters with undocumented migrants. The challenges for ER nurses were: language barriers, issues of false identification, insecurities about the correct standard procedures and not always being able to provide appropriate care. Conclusions Undocumented migrants face formal and informal barriers to the Danish healthcare system, which lead to alternative health-seeking strategies that may have adverse effects on their health. This study shows the need for policies and guidelines, which in accordance with international human rights law, ensure access to healthcare for undocumented migrants and give clarity to healthcare professionals. PMID:21752296

Petersburg National Battlefield : alternative transportation feasibility study

DOT National Transportation Integrated Search

2012-11-13

This report studies the feasibility of alternative solutions to several transportation problems affecting Petersburg National Battlefield in Petersburg, Virginia. Current transportation problems include site-specific access issues, wayfinding and nav...

Modeling Temporal and Spatial Flows of Ecosystem Services in Chittenden County, VT

NASA Astrophysics Data System (ADS)

Voigt, B. G.; Bagstad, K.; Johnson, G.; Villa, F.

2010-12-01

This paper documents the integration of ARIES (ARtificial Intelligence for Ecosystem Services) with the land use change model UrbanSim to explore the impacts of current and future land use patterns on flood protection and water provision services in Chittenden County, VT. ARIES, an open source modeling platform, is particularly well-suited for measuring, mapping, and modeling the temporal and spatial flows of ecosystem services across the landscape, linking the areas of provision (sources) with human beneficiaries (users) through a spatially explicit agent-based modeling approach. UrbanSim is an open source agent-based land use model designed to facilitate a wide-range of scenarios based on user-specified behavioral assumptions, zoning regulations, and demographic, economic, and infrastructure (e.g. transportation, water, sewer, etc.) parameters. Ecosystem services travel through time and space and are susceptible to disruption and destruction from both natural and anthropogenic perturbations. The conversion of forested or agricultural land to urbanizing uses is replete with a long history of hydrologic impairment, habitat fragmentation, and the degradation of sensitive landscapes. Development decisions are predicated on the presence of landscape characteristics that meet the needs of developers and satisfy the desires of consumers, with minimal consideration of access to or effect on the provision of ecosystem services. The County houses nearly 25% of the state’s population and several employment centers that draw labor from throughout the region. Additionally, the County is expected to maintain modest residential and employment growth over the next 30 years, and will continue to serve as the state’s population and employment center. Expected future growth is likely to adversely affect the remaining farm and forest land in the County in the absence of policies to support sustainable development. We demonstrate how ARIES can be used to quantify changes in ecosystem service provision based on the outcomes of alternative land use change model scenarios. Stakeholder workshops were hosted to develop scenarios relevant to planning for future growth in the County, including alternative zoning regulations, road network improvements, and a range of future population projections. The results of the land use change simulations were passed to ARIES to model flood protection and water provision services for each of the alternative scenarios. We present Bayesian models of the ecosystem services as individual source, sink, and use components coupled with models of temporal and spatial flows of services across the landscape. Specific beneficiaries include homeowners, farmers, and other business property owners. The location choice decisions of residential and non-residential agents under the alternative scenarios resulted in varying access to ecosystem services depending on development density, habitat fragmentation, and the degree of hydrological impairment, among other factors. Modeled outputs include maps depicting flow paths (linking sources to beneficiaries), changes in land use, hotspot locations that are critical to sustain the flow of services across the landscape, and the demand for and supply of the modeled services.

Technical Note [cmUse of a Snare Wire to Perform Nephrostomy Access in the Presence of Obstructive Staghorn Calculi

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

Nosher, John L.; Siegel, Randall L.; Bodner, Leonard J.

1996-05-15

We describe a technique for gaining access to the central collecting system via a chosen calyx, utilizing an alternative entry point to that calyx. An Amplatz nitinol loop snare is then used to convert this access to a traditional approach.

Enhancing Access to Situational Vocabulary by Leveraging Geographic Context

ERIC Educational Resources Information Center

Patel, Rupal; Radhakrishnan, Rajiv

2007-01-01

Users of augmentative and alternative communication (AAC) aids could benefit from novel methods for accelerating access to contextually relevant vocabulary. This paper describes our initial efforts toward improving access to situational vocabulary through the use of geographic context to predict vocabulary. A corpus of spoken data produced by one…

30 CFR 291.100 - What is the purpose of this part?

Code of Federal Regulations, 2011 CFR

2011-07-01

..., DEPARTMENT OF THE INTERIOR APPEALS OPEN AND NONDISCRIMINATORY ACCESS TO OIL AND GAS PIPELINES UNDER THE OUTER... transporter has denied a shipper of production from the OCS open and nondiscriminatory access to a pipeline... of resolving pipeline access disputes through either Hotline-assisted procedures or alternative...

Promising Practices for Providing Alternative Media to Postsecondary Students with Print Disabilities

ERIC Educational Resources Information Center

Wolfe, Gerri L.; Lee, Christopher

2007-01-01

For postsecondary students with disabilities influencing reading performance, printed class materials pose a substantial barrier and have a negative impact on academic achievement. Digital technologies offer alternative ways of accessing print materials for students with print-related disabilities. Alternative media is a broad term that…

Unintended Consequences in Cancer Care Delivery Created by the Medicare Part B Proposal: Is the Clinical Rationale for the Experiment Flawed?

PubMed

Gordan, Lucio; Grogg, Amy; Blazer, Marlo; Fortner, Barry

2017-02-01

Medicare currently enrolls ≥ 45 million adults, and by 2030 this is projected to increase to ≥ 80 million beneficiaries. With this growth, the Centers for Medicare & Medicaid Services (CMS) issued a proposal, the Medicare Part B Drug Payment Model, to shrink drug expenditures, a major contributor to overall health care costs. For this to not adversely affect patient outcomes, lower-cost alternative medications with equivalent efficacy and no increased toxicity must be available. This is often not true in the treatment of cancer. Herein, we examine the flaws in the rationale of the CMS and the potential unintended consequences of this experiment. We identified the top three oncology expenditures (rituximab, bevacizumab, and trastuzumab) and their vetted alternatives (per the National Comprehensive Cancer Network guidelines) to ascertain whether lower-cost equivalent alternatives are available. Drug cost was based on April 2016 average sale price. We explored both efficacy of the agents and, when applicable, toxicity to compare alternatives to these high-dollar medications. For the largest Medicare oncology drug expenditures, there is not a lower-cost option with equal efficacy for their primary indications. Without lower-cost alternatives, the unintended consequence of this CMS experiment may include curtailing access to care or an increase in patient/program costs. The CMS proposal, by simply lowering reimbursement for drugs, does not acknowledge the value of these agents and could unintentionally reduce quality of care. Alternative approaches to value-based care, such as the Oncology Care Model and similar frameworks, should be explored.

Modelling high data rate communication network access protocol

NASA Technical Reports Server (NTRS)

Khanna, S.; Foudriat, E. C.; Paterra, Frank; Maly, Kurt J.; Overstreet, C. Michael

1990-01-01

Modeling of high data rate communication systems is different from the low data rate systems. Three simulations were built during the development phase of Carrier Sensed Multiple Access/Ring Network (CSMA/RN) modeling. The first was a model using SIMCRIPT based upon the determination and processing of each event at each node. The second simulation was developed in C based upon isolating the distinct object that can be identified as the ring, the message, the node, and the set of critical events. The third model further identified the basic network functionality by creating a single object, the node which includes the set of critical events which occur at the node. The ring structure is implicit in the node structure. This model was also built in C. Each model is discussed and their features compared. It should be stated that the language used was mainly selected by the model developer because of his past familiarity. Further the models were not built with the intent to compare either structure or language but because the complexity of the problem and initial results contained obvious errors, so alternative models were built to isolate, determine, and correct programming and modeling errors. The CSMA/RN protocol is discussed in sufficient detail to understand modeling complexities. Each model is described along with its features and problems. The models are compared and concluding observations and remarks are presented.

Optimal Location of Radiation Therapy Centers With Respect to Geographic Access

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

Santibáñez, Pablo; Gaudet, Marc; French, John

2014-07-15

Purpose: To develop a framework with which to evaluate locations of radiation therapy (RT) centers in a region based on geographic access. Methods and Materials: Patient records were obtained for all external beam radiation therapy started in 2011 for the province of British Columbia, Canada. Two metrics of geographic access were defined. The primary analysis was percentage of patients (coverage) within a 90-minute drive from an RT center (C90), and the secondary analysis was the average drive time (ADT) to an RT center. An integer programming model was developed to determine optimal center locations, catchment areas, and capacity required undermore » different scenarios. Results: Records consisted of 11,096 courses of radiation corresponding to 161,616 fractions. Baseline geographic access was estimated at 102.5 minutes ADT (each way, per fraction) and 75.9% C90. Adding 2 and 3 new centers increased C90 to 88% and 92%, respectively, and decreased ADT by between 43% and 61%, respectively. A scenario in which RT was provided in every potential location that could support at least 1 fully utilized linear accelerator resulted in 35.3 minutes' ADT and 93.6% C90. Conclusions: The proposed framework and model provide a data-driven means to quantitatively evaluate alternative configurations of a regional RT system. Results suggest that the choice of location for future centers can significantly improve geographic access to RT.« less

Routes to DNA accessibility: alternative pathways for nucleosome unwinding.

PubMed

Schlingman, Daniel J; Mack, Andrew H; Kamenetska, Masha; Mochrie, Simon G J; Regan, Lynne

2014-07-15

The dynamic packaging of DNA into chromatin is a key determinant of eukaryotic gene regulation and epigenetic inheritance. Nucleosomes are the basic unit of chromatin, and therefore the accessible states of the nucleosome must be the starting point for mechanistic models regarding these essential processes. Although the existence of different unwound nucleosome states has been hypothesized, there have been few studies of these states. The consequences of multiple states are far reaching. These states will behave differently in all aspects, including their interactions with chromatin remodelers, histone variant exchange, and kinetic properties. Here, we demonstrate the existence of two distinct states of the unwound nucleosome, which are accessible at physiological forces and ionic strengths. Using optical tweezers, we measure the rates of unwinding and rewinding for these two states and show that the rewinding rates from each state are different. In addition, we show that the probability of unwinding into each state is dependent on the applied force and ionic strength. Our results demonstrate not only that multiple unwound states exist but that their accessibility can be differentially perturbed, suggesting possible roles for these states in gene regulation. For example, different histone variants or modifications may facilitate or suppress access to DNA by promoting unwinding into one state or the other. We anticipate that the two unwound states reported here will be the basis for future models of eukaryotic transcriptional control. Copyright © 2014 Biophysical Society. Published by Elsevier Inc. All rights reserved.

Hybrid optical CDMA-FSO communications network under spatially correlated gamma-gamma scintillation.

PubMed

Jurado-Navas, Antonio; Raddo, Thiago R; Garrido-Balsells, José María; Borges, Ben-Hur V; Olmos, Juan José Vegas; Monroy, Idelfonso Tafur

2016-07-25

In this paper, we propose a new hybrid network solution based on asynchronous optical code-division multiple-access (OCDMA) and free-space optical (FSO) technologies for last-mile access networks, where fiber deployment is impractical. The architecture of the proposed hybrid OCDMA-FSO network is thoroughly described. The users access the network in a fully asynchronous manner by means of assigned fast frequency hopping (FFH)-based codes. In the FSO receiver, an equal gain-combining technique is employed along with intensity modulation and direct detection. New analytical formalisms for evaluating the average bit error rate (ABER) performance are also proposed. These formalisms, based on the spatially correlated gamma-gamma statistical model, are derived considering three distinct scenarios, namely, uncorrelated, totally correlated, and partially correlated channels. Numerical results show that users can successfully achieve error-free ABER levels for the three scenarios considered as long as forward error correction (FEC) algorithms are employed. Therefore, OCDMA-FSO networks can be a prospective alternative to deliver high-speed communication services to access networks with deficient fiber infrastructure.

75 FR 12505 - New England Fishery Management Council; Public Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-16

... alternatives and Committee motions related to inclusion of alternatives in the DEIS. Other issues may be raised... physically accessible to people with disabilities. Requests for sign language interpretation or other...

The structural basis of secondary active transport mechanisms.

PubMed

Forrest, Lucy R; Krämer, Reinhard; Ziegler, Christine

2011-02-01

Secondary active transporters couple the free energy of the electrochemical potential of one solute to the transmembrane movement of another. As a basic mechanistic explanation for their transport function the model of alternating access was put forward more than 40 years ago, and has been supported by numerous kinetic, biochemical and biophysical studies. According to this model, the transporter exposes its substrate binding site(s) to one side of the membrane or the other during transport catalysis, requiring a substantial conformational change of the carrier protein. In the light of recent structural data for a number of secondary transport proteins, we analyze the model of alternating access in more detail, and correlate it with specific structural and chemical properties of the transporters, such as their assignment to different functional states in the catalytic cycle of the respective transporter, the definition of substrate binding sites, the type of movement of the central part of the carrier harboring the substrate binding site, as well as the impact of symmetry on fold-specific conformational changes. Besides mediating the transmembrane movement of solutes, the mechanism of secondary carriers inherently involves a mechanistic coupling of substrate flux to the electrochemical potential of co-substrate ions or solutes. Mainly because of limitations in resolution of available transporter structures, this important aspect of secondary transport cannot yet be substantiated by structural data to the same extent as the conformational change aspect. We summarize the concepts of coupling in secondary transport and discuss them in the context of the available evidence for ion binding to specific sites and the impact of the ions on the conformational state of the carrier protein, which together lead to mechanistic models for coupling. Copyright © 2010 Elsevier B.V. All rights reserved.

Technology innovation for infectious diseases in the developing world

PubMed Central

2012-01-01

Enabling innovation and access to health technologies remains a key strategy in combating infectious diseases in low- and middle-income countries (LMICs). However, a gulf between paying markets and the endemicity of such diseases has contributed to the dearth of R&D in meeting these public health needs. While the pharmaceutical industry views emerging economies as potential new markets, most of the world’s poorest bottom billion now reside in middle-income countries--a fact that has complicated tiered access arrangements. However, product development partnerships--particularly those involving academic institutions and small firms--find commercial opportunities in pursuing even neglected diseases; and a growing pharmaceutical sector in BRICS countries offers hope for an indigenous base of innovation. Such innovation will be shaped by 1) access to building blocks of knowledge; 2) strategic use of intellectual property and innovative financing to meet public health goals; 3) collaborative norms of open innovation; and 4) alternative business models, some with a double bottom line. Facing such resource constraints, LMICs are poised to develop a new, more resource-effective model of innovation that holds exciting promise in meeting the needs of global health. PMID:23849080

Using Epidemiological Principles to Explain Fungicide Resistance Management Tactics: Why do Mixtures Outperform Alternations?

PubMed

Elderfield, James A D; Lopez-Ruiz, Francisco J; van den Bosch, Frank; Cunniffe, Nik J

2018-07-01

Whether fungicide resistance management is optimized by spraying chemicals with different modes of action as a mixture (i.e., simultaneously) or in alternation (i.e., sequentially) has been studied by experimenters and modelers for decades. However, results have been inconclusive. We use previously parameterized and validated mathematical models of wheat Septoria leaf blotch and grapevine powdery mildew to test which tactic provides better resistance management, using the total yield before resistance causes disease control to become economically ineffective ("lifetime yield") to measure effectiveness. We focus on tactics involving the combination of a low-risk and a high-risk fungicide, and the case in which resistance to the high-risk chemical is complete (i.e., in which there is no partial resistance). Lifetime yield is then optimized by spraying as much low-risk fungicide as is permitted, combined with slightly more high-risk fungicide than needed for acceptable initial disease control, applying these fungicides as a mixture. That mixture rather than alternation gives better performance is invariant to model parameterization and structure, as well as the pathosystem in question. However, if comparison focuses on other metrics, e.g., lifetime yield at full label dose, either mixture or alternation can be optimal. Our work shows how epidemiological principles can explain the evolution of fungicide resistance, and also highlights a theoretical framework to address the question of whether mixture or alternation provides better resistance management. It also demonstrates that precisely how spray tactics are compared must be given careful consideration. [Formula: see text] Copyright © 2018 The Author(s). This is an open access article distributed under the CC BY 4.0 International license .

A Study of Two Instructional Sequences Informed by Alternative Learning Progressions in Genetics

NASA Astrophysics Data System (ADS)

Duncan, Ravit Golan; Choi, Jinnie; Castro-Faix, Moraima; Cavera, Veronica L.

2017-12-01

Learning progressions (LPs) are hypothetical models of how learning in a domain develops over time with appropriate instruction. In the domain of genetics, there are two independently developed alternative LPs. The main difference between the two progressions hinges on their assumptions regarding the accessibility of classical (Mendelian) versus molecular genetics and the order in which they should be taught. In order to determine the relative difficulty of the different genetic ideas included in the two progressions, and to test which one is a better fit with students' actual learning, we developed two modules in classical and molecular genetics and alternated their sequence in an implementation study with 11th grade students studying biology. We developed a set of 56 ordered multiple-choice items that collectively assessed both molecular and classical genetic ideas. We found significant gains in students' learning in both molecular and classical genetics, with the largest gain relating to understanding the informational content of genes and the smallest gain in understanding modes of inheritance. Using multidimensional item response modeling, we found no statistically significant differences between the two instructional sequences. However, there was a trend of slightly higher gains for the molecular-first sequence for all genetic ideas.

10 CFR 62.13 - Contents of a request for emergency access: Alternatives.

Code of Federal Regulations, 2010 CFR

2010-01-01

... radioactive waste in a licensed storage facility; (3) Obtaining access to a disposal facility by voluntary... disposal at a Federal low-level radioactive waste disposal facility in the case of a Federal or defense... EMERGENCY ACCESS TO NON-FEDERAL AND REGIONAL LOW-LEVEL WASTE DISPOSAL FACILITIES Request for a Commission...

Beyond the Yellow Bus: Promising Practices for Maximizing Access to Opportunity through Innovations in Student Transportation

ERIC Educational Resources Information Center

Vincent, Jeffrey M.; Makarewicz, Carrie; Miller, Ruth; Ehrman, Julia; McKoy, Deborah L.

2014-01-01

Access to safe, affordable, and convenient transportation shapes the 'geography of opportunity' for many children and youth. This study looks at how ?localities acrossthe country are implementing new and innovative alternative approaches to student transportation that expand regionaltransportation access for K-12 students, improve…

Advanced Placement and Rural Schools: Access, Success, and Exploring Alternatives

ERIC Educational Resources Information Center

Gagnon, Douglas J.; Mattingly, Marybeth J.

2016-01-01

Completing Advanced Placement (AP) coursework is an important part of the selective college admissions process, and access to AP coursework can be viewed as a measure of equal opportunity. Relatively little research has fully examined how access to AP coursework is mediated by school characteristics. Rural schools are at a particular disadvantage…

Developing Guidelines for Evaluating the Adaptation of Accessible Web-Based Learning Materials

ERIC Educational Resources Information Center

Radovan, Marko; Perdih, Mojca

2016-01-01

E-learning is a rapidly developing form of education. One of the key characteristics of e-learning is flexibility, which enables easier access to knowledge for everyone. Information and communications technology (ICT), which is e-learning's main component, enables alternative means of accessing the web-based learning materials that comprise the…

Alternatives for Monitoring and Limiting Network Access to Students in Network-Connected Classrooms

ERIC Educational Resources Information Center

Almeroth, Kevin; Zhang, Hangjin

2013-01-01

With the advent of laptop computers and network technology, many classrooms are now being equipped with Internet connections, either through wired connections or wireless infrastructure. Internet access provides students an additional source from which to obtain course-related information. However, constant access to the Internet can be a…

Alternative scenarios: harnessing mid-level providers and evidence-based practice in primary dental care in England through operational research.

PubMed

Wanyonyi, Kristina L; Radford, David R; Harper, Paul R; Gallagher, Jennifer E

2015-09-15

In primary care dentistry, strategies to reconfigure the traditional boundaries of various dental professional groups by task sharing and role substitution have been encouraged in order to meet changing oral health needs. The aim of this research was to investigate the potential for skill mix use in primary dental care in England based on the undergraduate training experience in a primary care team training centre for dentists and mid-level dental providers. An operational research model and four alternative scenarios to test the potential for skill mix use in primary care in England were developed, informed by the model of care at a primary dental care training centre in the south of England, professional policy including scope of practice and contemporary evidence-based preventative practice. The model was developed in Excel and drew on published national timings and salary costs. The scenarios included the following: "No Skill Mix", "Minimal Direct Access", "More Prevention" and "Maximum Delegation". The scenario outputs comprised clinical time, workforce numbers and salary costs required for state-funded primary dental care in England. The operational research model suggested that 73% of clinical time in England's state-funded primary dental care in 2011/12 was spent on tasks that may be delegated to dental care professionals (DCPs), and 45- to 54-year-old patients received the most clinical time overall. Using estimated National Health Service (NHS) clinical working patterns, the model suggested alternative NHS workforce numbers and salary costs to meet the dental demand based on each developed scenario. For scenario 1:"No Skill Mix", the dentist-only scenario, 81% of the dentists currently registered in England would be required to participate. In scenario 2: "Minimal Direct Access", where 70% of examinations were delegated and the primary care training centre delegation patterns for other treatments were practised, 40% of registered dentists and eight times the number of dental therapists currently registered would be required; this would save 38% of current salary costs cf. "No Skill Mix". Scenario 3: "More Prevention", that is, the current model with no direct access and increasing fluoride varnish from 13.1% to 50% and maintaining the same model of delegation as scenario 2 for other care, would require 57% of registered dentists and 4.7 times the number of dental therapists. It would achieve a 1% salary cost saving cf. "No Skill Mix". Scenario 4 "Maximum Delegation" where all care within dental therapists' jurisdiction is delegated at 100%, together with 50% of restorations and radiographs, suggested that only 30% of registered dentists would be required and 10 times the number of dental therapists registered; this scenario would achieve a 52% salary cost saving cf. "No Skill Mix". Alternative scenarios based on wider expressed treatment need in national primary dental care in England, changing regulations on the scope of practice and increased evidence-based preventive practice suggest that the majority of care in primary dental practice may be delegated to dental therapists, and there is potential time and salary cost saving if the majority of diagnostic tasks and prevention are delegated. However, this would require an increase in trained DCPs, including role enhancement, as part of rebalancing the dental workforce.

Experiences with http/WebDAV protocols for data access in high throughput computing

NASA Astrophysics Data System (ADS)

Bernabeu, Gerard; Martinez, Francisco; Acción, Esther; Bria, Arnau; Caubet, Marc; Delfino, Manuel; Espinal, Xavier

2011-12-01

In the past, access to remote storage was considered to be at least one order of magnitude slower than local disk access. Improvement on network technologies provide the alternative of using remote disk. For those accesses one can today reach levels of throughput similar or exceeding those of local disks. Common choices as access protocols in the WLCG collaboration are RFIO, [GSI]DCAP, GRIDFTP, XROOTD and NFS. HTTP protocol shows a promising alternative as it is a simple, lightweight protocol. It also enables the use of standard technologies such as http caching or load balancing which can be used to improve service resilience and scalability or to boost performance for some use cases seen in HEP such as the "hot files". WebDAV extensions allow writing data, giving it enough functionality to work as a remote access protocol. This paper will show our experiences with the WebDAV door for dCache, in terms of functionality and performance, applied to some of the HEP work flows in the LHC Tier1 at PIC.

WDM-PON access network with lightwave source centralized full-duplex link based on SSB-OOFDM for wired and 60 GHz band wireless alternative accesses

NASA Astrophysics Data System (ADS)

Ma, Jianxin; Wang, Zhao; Zheng, Guoli

2014-04-01

A novel lightwave centralized full-duplex WDM-PON access network based on single sideband optical orthogonal frequency-division multiplexing (SSB-OOFDM) is proposed for providing wired and 60-GHz band wireless accesses alternately. At the OLT, the multi-channels with 10-Gb/s 4-QAM-RF-OFDM signals are SSB modulated on the optical local oscillators (OLOs). At the RN, one OOFDM signal along with two OLOs is abstracted and switched to the corresponding HONU, where the signal can be downconverted to the 10-GHz or 60-GHz band RF-OFDM signal by one OLO for wired or wireless access, while the other one is used to bear the uplink signal. Since the HONU is free from the light sources, the system complexity and cost are reduced. Full duplex transmission over 25 km fiber have been demonstrated that the error vector magnitude (EVM) of the down- and up-link signals are much below the FEC limit for both the wired and 60-GHz band wireless access services.

Sharing Resources In Mobile/Satellite Communications

NASA Technical Reports Server (NTRS)

Yan, Tsun-Yee; Sue, Miles K.

1992-01-01

Report presents preliminary theoretical analysis of several alternative schemes for allocation of satellite resource among terrestrial subscribers of landmobile/satellite communication system. Demand-access and random-access approaches under code-division and frequency-division concepts compared.

Renewable Hydrogen-Economically Viable: Integration into the U.S. Transportation Sector

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

Kurtz, Jennifer; Peters, Mike; Muratori, Matteo

The U.S. transportation sector is expected to meet numerous goals in differing applications. These goals address security, safety, fuel source, emissions reductions, advanced mobility models, and improvements in quality and accessibility. Solutions to meeting these goals include a variety of alternative-fuel technologies, including batteries, fuel cells, synthetic fuels, and biofuels, as well as modifying how current transportation systems are used and integrating new systems, such as storing renewable energy. Overall, there are many combinations of problems, objectives, and solutions.

No Evidence for an Item Limit in Change Detection (Open Access)

DTIC Science & Technology

2013-02-28

memory : a reconsideration of mental storage capacity. Behav Brain Sci 24: 87–114. 17. Eng HY, Chen D, Jiang Y (2005) Visual working memory for simple...working memory can hold no more than a fixed number of items (‘‘item-limit models’’). Recent findings force us to consider the alternative view that working... memory is limited by the precision in stimulus encoding, with mean precision decreasing with increasing set size (‘‘continuous-resource models

Alternative Fueling Station Locator - Android

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

The Alternative Fueling Station Locator app helps users locate fueling stations that offer electricity, natural gas, biodiesel, E85, propane, or hydrogen. The users' current location or a custom location can be used to find the 20 closest stations within a 30-mile radius. View the stations on a map or see a list of stations ordered by distance from your location. Select your alternative fuel of choice and adjust the custom filters to fit your needs. Select a station from the map or list to view contact info and other details: address, phone number, and hours of operation; payment types accepted;more » public or private access; special services; compression (natural gas); vehicle size access (natural gas); number and types of chargers (electric); blends available (biodiesel); and blender pumps (ethanol) The app draws information from the U.S. Department of Energy's Alternative Fuels Data Center, which houses the most comprehensive, up-to-date database of alternative fueling stations in the United States. The database contains location information for more than 20,000 alternative fueling stations throughout the country.« less

Nantucket National Wildlife Refuge alternative transportation study

DOT National Transportation Integrated Search

2014-10-01

This study for the Fish and Wildlife Service (FWS) identifies and analyzes options for enhancing alternative transportation access to the Nantucket National Wildlife Refuge (Nantucket NWR) at Great Point in Nantucket, Massachusetts. The study team de...

DART: Delta Advanced Reusable Transport. An alternate manned space system proposal

NASA Technical Reports Server (NTRS)

1991-01-01

The Delta Advanced Reusable Transport (DART) craft is being developed to add, multiple, rapid, and cost effective space access to the U.S. capability and to further the efforts towards a permanent space presence. The DART craft provides an augmentative and an alternative system to the Shuttle. As a supplement launch vehicle, the DART adds low cost and easily accessible transport of crew and cargo to specific space destinations to the U.S. program. This adds significant opportunities for manned rated missions that do not require Shuttle capabilities. In its alternative role, the DART can provide emergency space access and satellite repair, the continuation of scientific research, and the furthering of U.S. manned efforts in the event of Shuttle incapabilities. In addition, the DART is being designed for Space Station Freedom compatibility, including its use as a 'lifeboat' emergency reentry craft for Freedom astronauts, as well as the transport of crew and cargo for station resupply.

SIMS: addressing the problem of heterogeneity in databases

NASA Astrophysics Data System (ADS)

Arens, Yigal

1997-02-01

The heterogeneity of remotely accessible databases -- with respect to contents, query language, semantics, organization, etc. -- presents serious obstacles to convenient querying. The SIMS (single interface to multiple sources) system addresses this global integration problem. It does so by defining a single language for describing the domain about which information is stored in the databases and using this language as the query language. Each database to which SIMS is to provide access is modeled using this language. The model describes a database's contents, organization, and other relevant features. SIMS uses these models, together with a planning system drawing on techniques from artificial intelligence, to decompose a given user's high-level query into a series of queries against the databases and other data manipulation steps. The retrieval plan is constructed so as to minimize data movement over the network and maximize parallelism to increase execution speed. SIMS can recover from network failures during plan execution by obtaining data from alternate sources, when possible. SIMS has been demonstrated in the domains of medical informatics and logistics, using real databases.

Comparison of RF spectrum prediction methods for dynamic spectrum access

NASA Astrophysics Data System (ADS)

Kovarskiy, Jacob A.; Martone, Anthony F.; Gallagher, Kyle A.; Sherbondy, Kelly D.; Narayanan, Ram M.

2017-05-01

Dynamic spectrum access (DSA) refers to the adaptive utilization of today's busy electromagnetic spectrum. Cognitive radio/radar technologies require DSA to intelligently transmit and receive information in changing environments. Predicting radio frequency (RF) activity reduces sensing time and energy consumption for identifying usable spectrum. Typical spectrum prediction methods involve modeling spectral statistics with Hidden Markov Models (HMM) or various neural network structures. HMMs describe the time-varying state probabilities of Markov processes as a dynamic Bayesian network. Neural Networks model biological brain neuron connections to perform a wide range of complex and often non-linear computations. This work compares HMM, Multilayer Perceptron (MLP), and Recurrent Neural Network (RNN) algorithms and their ability to perform RF channel state prediction. Monte Carlo simulations on both measured and simulated spectrum data evaluate the performance of these algorithms. Generalizing spectrum occupancy as an alternating renewal process allows Poisson random variables to generate simulated data while energy detection determines the occupancy state of measured RF spectrum data for testing. The results suggest that neural networks achieve better prediction accuracy and prove more adaptable to changing spectral statistics than HMMs given sufficient training data.

Designing websites for persons with cognitive deficits: Design and usability of a psychoeducational intervention for persons with severe mental illness.

PubMed Central

Rotondi, Armando J.; Sinkule, Jennifer; Haas, Gretchen L.; Spring, Michael B.; Litschge, Christine M.; Newhill, Christina E.; Ganguli, Rohan; Anderson, Carol M.

2013-01-01

The purpose of this study was to develop an understanding of the design elements that influence the ability of persons with severe mental illness (SMI) and cognitive deficits to use a website, and to use this knowledge to design a web-based telehealth application to deliver a psychoeducation program to persons with schizophrenia and their families. Usability testing was conducted with 98 persons with SMI. First, individual website design elements were tested. Based on these results, theoretical website design models were used to create several alternative websites. These designs were tested for their ability to facilitate use by persons with SMI. The final website design is presented. The results indicate that commonly prescribed design models and guidelines produce websites that are poorly suited and confusing to persons with SMI. Our findings suggest an alternative model that should be considered when designing websites and other telehealth interventions for this population. Implications for future studies addressing the characteristics of accessible designs for persons with SMI and cognitive deficits are discussed. PMID:26321884

Effects of Payment Changes on Trends in Post-Acute Care

PubMed Central

Buntin, Melinda Beeuwkes; Colla, Carrie Hoverman; Escarce, José J

2009-01-01

Objective To test how the implementation of new Medicare post-acute payment systems affected the use of inpatient rehabilitation facilities (IRFs), skilled nursing facilities (SNFs), and home health agencies. Data Sources Medicare acute hospital, IRF, and SNF claims; provider of services file; enrollment file; and Area Resource File data. Study Design We used multinomial logit models to measure realized access to post-acute care and to predict how access to alternative sites of care changed in response to prospective payment systems. Data Extraction Methods A file was constructed linking data for elderly Medicare patients discharged from acute care facilities between 1996 and 2003 with a diagnosis of hip fracture, stroke, or lower extremity joint replacement. Principal Findings Although the effects of the payment systems on the use of post-acute care varied, most reduced the use of the site of care they directly affected and boosted the use of alternative sites of care. Payment system changes do not appear to have differentially affected the severely ill. Conclusions Payment system incentives play a significant role in determining where Medicare beneficiaries receive their post-acute care. Changing these incentives results in shifting of patients between post-acute sites. PMID:19490159

The BioMart community portal: an innovative alternative to large, centralized data repositories

PubMed Central

Smedley, Damian; Haider, Syed; Durinck, Steffen; Pandini, Luca; Provero, Paolo; Allen, James; Arnaiz, Olivier; Awedh, Mohammad Hamza; Baldock, Richard; Barbiera, Giulia; Bardou, Philippe; Beck, Tim; Blake, Andrew; Bonierbale, Merideth; Brookes, Anthony J.; Bucci, Gabriele; Buetti, Iwan; Burge, Sarah; Cabau, Cédric; Carlson, Joseph W.; Chelala, Claude; Chrysostomou, Charalambos; Cittaro, Davide; Collin, Olivier; Cordova, Raul; Cutts, Rosalind J.; Dassi, Erik; Genova, Alex Di; Djari, Anis; Esposito, Anthony; Estrella, Heather; Eyras, Eduardo; Fernandez-Banet, Julio; Forbes, Simon; Free, Robert C.; Fujisawa, Takatomo; Gadaleta, Emanuela; Garcia-Manteiga, Jose M.; Goodstein, David; Gray, Kristian; Guerra-Assunção, José Afonso; Haggarty, Bernard; Han, Dong-Jin; Han, Byung Woo; Harris, Todd; Harshbarger, Jayson; Hastings, Robert K.; Hayes, Richard D.; Hoede, Claire; Hu, Shen; Hu, Zhi-Liang; Hutchins, Lucie; Kan, Zhengyan; Kawaji, Hideya; Keliet, Aminah; Kerhornou, Arnaud; Kim, Sunghoon; Kinsella, Rhoda; Klopp, Christophe; Kong, Lei; Lawson, Daniel; Lazarevic, Dejan; Lee, Ji-Hyun; Letellier, Thomas; Li, Chuan-Yun; Lio, Pietro; Liu, Chu-Jun; Luo, Jie; Maass, Alejandro; Mariette, Jerome; Maurel, Thomas; Merella, Stefania; Mohamed, Azza Mostafa; Moreews, Francois; Nabihoudine, Ibounyamine; Ndegwa, Nelson; Noirot, Céline; Perez-Llamas, Cristian; Primig, Michael; Quattrone, Alessandro; Quesneville, Hadi; Rambaldi, Davide; Reecy, James; Riba, Michela; Rosanoff, Steven; Saddiq, Amna Ali; Salas, Elisa; Sallou, Olivier; Shepherd, Rebecca; Simon, Reinhard; Sperling, Linda; Spooner, William; Staines, Daniel M.; Steinbach, Delphine; Stone, Kevin; Stupka, Elia; Teague, Jon W.; Dayem Ullah, Abu Z.; Wang, Jun; Ware, Doreen; Wong-Erasmus, Marie; Youens-Clark, Ken; Zadissa, Amonida; Zhang, Shi-Jian; Kasprzyk, Arek

2015-01-01

The BioMart Community Portal (www.biomart.org) is a community-driven effort to provide a unified interface to biomedical databases that are distributed worldwide. The portal provides access to numerous database projects supported by 30 scientific organizations. It includes over 800 different biological datasets spanning genomics, proteomics, model organisms, cancer data, ontology information and more. All resources available through the portal are independently administered and funded by their host organizations. The BioMart data federation technology provides a unified interface to all the available data. The latest version of the portal comes with many new databases that have been created by our ever-growing community. It also comes with better support and extensibility for data analysis and visualization tools. A new addition to our toolbox, the enrichment analysis tool is now accessible through graphical and web service interface. The BioMart community portal averages over one million requests per day. Building on this level of service and the wealth of information that has become available, the BioMart Community Portal has introduced a new, more scalable and cheaper alternative to the large data stores maintained by specialized organizations. PMID:25897122

The iPad and mobile technology revolution: benefits and challenges for individuals who require augmentative and alternative communication.

PubMed

McNaughton, David; Light, Janice

2013-06-01

The iPad and other mobile technologies provide powerful new tools to potentially enhance communication for individuals with developmental disabilities, acquired neurogenic disorders, and degenerative neurological conditions. These mobile technologies offer a number of potential benefits, including: (a) increased awareness and social acceptance of augmentative and alternative communication (AAC), (b) greater consumer empowerment in accessing AAC solutions, (c) increased adoption of AAC technologies, (d) greater functionality and interconnectivity, and (e) greater diffusion of AAC research and development. However, there remain a number of significant challenges that must be addressed if these benefits are to be fully realized: (a) to ensure the focus is on communication, not just technology, (b) to develop innovative models of AAC service delivery to ensure successful outcomes, (c) to ensure ease of access for all individuals who require AAC, and, (d) to maximize AAC solutions to support a wide variety of communication functions. There is an urgent need for effective collaboration among key stakeholders to support research and development activities, and to ensure the successful implementation of mobile technologies to enhance communication outcomes for individuals who require AAC and their families.

Tibiopedal access for lower extremity arterial intervention: when to use and how to perform.

PubMed

Wiechmann, Bret N

2014-09-01

Tibiopedal artery access is being used with increasing frequency as an alternative access to facilitate procedural success in lower extremity arterial intervention. This technique is usually employed in the setting of critical limb ischemia and tibial artery intervention, but it may offer potential practical advantages for popliteal artery and even superficial femoral artery intervention in unique situations. As in all cases of lower extremity arterial intervention, consideration of access is important not only for initial approach to any obstructing lesion but also for exit strategy. The dorsalis pedis artery and posterior tibial artery can be readily accessed if necessary owing to their relatively superficial position in the foot or the ankle, yet their normal diameter and the presence of significant calcification (a common finding in patients with tibial occlusive disease and critical limb ischemia) can pose difficulties as well. In addition, the peroneal artery in the lower leg can be accessed percutaneously; however, its size and depth may present additional challenges. Meticulous attention to detail is paramount in avoiding complications in what may be the only distal vessel supplying the foot. This article describes common techniques in using tibiopedal artery access as a means of alternative access for successful infrainguinal intervention. Copyright © 2014 Elsevier Inc. All rights reserved.

High-fat hyperphagia in neurotrophin-4 deficient mice reveals potential role of vagal intestinal sensory innervation in long-term controls of food intake.

PubMed

Byerly, Mardi S; Fox, Edward A

2006-06-12

Neurotrophin-4 (NT-4) deficient mice exhibit substantial loss of intestinal vagal afferent innervation and short-term deficits in feeding behavior, suggesting reduced satiation. However, they do not show long-term changes in feeding or body weight because of compensatory behaviors. The present study examined whether high-fat hyperphagia induction would overcome compensation and reveal long-term effects associated with the reduced vagal sensory innervation of NT-4 mutants. First, modifications of a feeding schedule previously developed in rats were examined in wild-type mice to identify the regimen most effective at producing hyperphagia. The most successful schedule, which was run for 26 days, included access to a 43%-fat diet and pelleted chow every other day and access to only powdered chow on the alternate days. On high-fat access days mice consumed 25% more calories than mice with continuous daily access to the same high-fat diet and pelleted chow. This feeding regimen also induced hyperphagia in NT-4 deficient mice and their wild-type controls: on high-fat exposure days mutants consumed 35% more calories relative to continuous-access mutants, and wild types ate 25% more than continuous-access wild types. Moreover, on high-fat access days the alternating NT-4 mutants significantly increased caloric intake by 9% compared to alternating wild types. Thus, high-fat hyperphagia appeared to override compensation, permitting short-term changes in meal consumption by mutants that accrued into long-term changes in total daily food intake. This raises the possibility that intestinal vagal sensory innervation contributes to long-term, as well as to short-term regulation of food intake.

76 FR 410 - Notice of Final Federal Agency Actions on Proposed Highway in Alaska

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-04

... Number ACSTP-0001(277)/56047; Project Location: The KAC Project (Northern Access-Erickson Alternative... downtown Anchorage will go under Government Hill using the Erickson Street alternative with a cut and cover...

Roosevelt-Vanderbilt alternative transportation system planning study : phase 1

DOT National Transportation Integrated Search

2001-08-01

This plan identifies components of a sustainable and effective alternative transportation system that will provide improved access to, and connections among, the Roosevelt-Vanderbilt National Historic Site units. The goal is to reduce the congestion ...

Sediment management alternatives for the Port of Bienville.

DOT National Transportation Integrated Search

2010-02-01

The objective of this report is to present economical, environmentally friendly, and effective alternatives to maintenance : dredging for the Port of Bienville and its access channels. The Port of Bienville is located in Hancock County, directly off ...

Making Astronomy and Space Science Accessible to the Blind and Visually Impaired

NASA Astrophysics Data System (ADS)

Beck-Winchatz, B.; Hoette, V.; Grice, N.

2003-12-01

One of the biggest obstacles blind and visually impaired people face in science is the ubiquity of important graphical information, which is generally not made available in alternate formats accessible to them. Funded by NASA's Initiative to Develop Education through Astronomy and Space Science (IDEAS), we have recently formed a team of scientists and educators from universities, the SOFIA NASA mission, a science museum, an observatory, and schools for the blind. Our goal is to develop and test Braille/tactile space science activities that actively engage students from elementary grades through introductory college-level in space science. We will discuss effective strategies and low-cost technologies that can be used to make graphical information accessible. We will also demonstrate examples, such a thermal expansion graphics created from telescope images of the Moon and other celestial objects, a tactile planisphere, three-dimensional models of near-Earth asteroids and tactile diagrams of their orbits, and an infrared detector activity.

The SCEC Community Modeling Environment (SCEC/CME) - An Overview of its Architecture and Current Capabilities

NASA Astrophysics Data System (ADS)

Maechling, P. J.; Jordan, T. H.; Minster, B.; Moore, R.; Kesselman, C.; SCEC ITR Collaboration

2004-12-01

The Southern California Earthquake Center (SCEC), in collaboration with the San Diego Supercomputer Center, the USC Information Sciences Institute, the Incorporated Research Institutions for Seismology, and the U.S. Geological Survey, is developing the Southern California Earthquake Center Community Modeling Environment (CME) under a five-year grant from the National Science Foundation's Information Technology Research (ITR) Program jointly funded by the Geosciences and Computer and Information Science & Engineering Directorates. The CME system is an integrated geophysical simulation modeling framework that automates the process of selecting, configuring, and executing models of earthquake systems. During the Project's first three years, we have performed fundamental geophysical and information technology research and have also developed substantial system capabilities, software tools, and data collections that can help scientist perform systems-level earthquake science. The CME system provides collaborative tools to facilitate distributed research and development. These collaborative tools are primarily communication tools, providing researchers with access to information in ways that are convenient and useful. The CME system provides collaborators with access to significant computing and storage resources. The computing resources of the Project include in-house servers, Project allocations on USC High Performance Computing Linux Cluster, as well as allocations on NPACI Supercomputers and the TeraGrid. The CME system provides access to SCEC community geophysical models such as the Community Velocity Model, Community Fault Model, Community Crustal Motion Model, and the Community Block Model. The organizations that develop these models often provide access to them so it is not necessary to use the CME system to access these models. However, in some cases, the CME system supplements the SCEC community models with utility codes that make it easier to use or access these models. In some cases, the CME system also provides alternatives to the SCEC community models. The CME system hosts a collection of community geophysical software codes. These codes include seismic hazard analysis (SHA) programs developed by the SCEC/USGS OpenSHA group. Also, the CME system hosts anelastic wave propagation codes including Kim Olsen's Finite Difference code and Carnegie Mellon's Hercules Finite Element tool chain. The CME system can execute a workflow, that is, a series of geophysical computations using the output of one processing step as the input to a subsequent step. Our workflow capability utilizes grid-based computing software that can submit calculations to a pool of computing resources as well as data management tools that help us maintain an association between data files and metadata descriptions of those files. The CME system maintains, and provides access to, a collection of valuable geophysical data sets. The current CME Digital Library holdings include a collection of 60 ground motion simulation results calculated by a SCEC/PEER working group and a collection of Greens Functions calculated for 33 TriNet broadband receiver sites in the Los Angeles area.

Traditional and alternative community food security interventions in Montréal, Québec: different practices, different people.

PubMed

Roncarolo, Federico; Adam, Caroline; Bisset, Sherri; Potvin, Louise

2015-04-01

Food insecurity is steadily increasing in developed countries. Traditional interventions adopted to tackle food insecurity, like food banks, address the urgent need for food. By contrast, alternative interventions, such as community gardens and kitchens, are oriented towards social integration and the development of mutual aid networks. The objective of this paper is to examine whether the populations served by traditional and alternative interventions in food security differ according to measures of vulnerability. We studied newly registered participants to food security interventions. Participants were selected from a random sample of food security community organizations in a two-stage cluster sampling frame. The categorizing variable was participation in a community organization providing either traditional interventions or alternative interventions. Seven measures of vulnerability were used: food security; perceived health; civic participation; perceived social support of the primary network, social isolation, income and education. Regression multilevel models were used to assess associations. 711 participants in traditional interventions and 113 in alternative interventions were enrolled in the study. Between group differences were found with respect to food insecurity, health status perception, civic participation, education and income, but not with respect to social isolation or perceived social support from primary social network. Traditional and alternative food security interventions seem to reach different populations. Participants in traditional interventions were found to have less access to resources, compared to those in alternative interventions. Thus, new participants in traditional interventions may have higher levers of vulnerability than those in alternative interventions.

Beyond the Yellow Bus: Promising Practices for Maximizing Access to Opportunity through Innovations in Student Transportation. Policy Brief 2014

ERIC Educational Resources Information Center

Center for Cities & Schools, 2014

2014-01-01

Access to safe, affordable, and convenient transportation shapes the "geography of opportunity" for many children and youth. This study looks at how ?localities across the country are implementing new and innovative alternative approaches to student transportation that expand regional transportation access for K-12 students, improve…

Access to What? Access, Diversity and Participation in India's Schools. Research Monograph No. 32

ERIC Educational Resources Information Center

Juneja, Nalini

2010-01-01

India has witnessed substantial diversification of provision to basic education. Policy changes from 1980s onwards, has seen the creation of para-formal delivery systems and the inclusion in the system of non state providers. The Education Guarantee Scheme and the Alternate Initiatives in Education programmes have generated new pathways to access.…

Free or Open Access to Scholarly Documentation: Google Scholar or Academic Libraries

ERIC Educational Resources Information Center

Burns, C. Sean

2013-01-01

Soon after the university movement started in the late 1800s, academic libraries became the dominant providers of the tools and services required to locate and access scholarly information. However, with the advent of alternate discovery services, such as Google Scholar, in conjunction with open access scholarly content, researchers now have the…

Alternative Fuels Data Center: U.S. Truck Stop Electrification Locations

Science.gov Websites

bays) Media: Internet, Wireless Payment: American Express, Cash, MasterCard, VISA Access: Public - see : Internet, Wireless Payment: American Express, Cash, MasterCard, VISA Access: Public - see hours Hours: 24 bays) Media: Internet Payment: Gift Card, MasterCard, VISA Access: Public - see hours Hours: 24 hours

Law's Dilemma: Validating Complementary and Alternative Medicine and the Clash of Evidential Paradigms

PubMed Central

Iyioha, Ireh

2011-01-01

This paper examines the (in)compatibility between the diagnostic and therapeutic theories of complementary and alternative medicine (CAM) and a science-based regulatory framework. Specifically, the paper investigates the nexus between statutory legitimacy and scientific validation of health systems, with an examination of its impact on the development of complementary and alternative therapies. The paper evaluates competing theories for validating CAM ranging from the RCT methodology to anthropological perspectives and contends that while the RCT method might be beneficial in the regulation of many CAM therapies, yet dogmatic adherence to this paradigm as the exclusive method for legitimizing CAM will be adverse to the independent development of many CAM therapies whose philosophies and mechanisms of action are not scientifically interpretable. Drawing on history and research evidence to support this argument, the paper sues for a regulatory model that is accommodative of different evidential paradigms in support of a pluralistic healthcare system that balances the imperative of quality assurance with the need to ensure access. PMID:20953428

Biophysical comparison of ATP synthesis mechanisms shows a kinetic advantage for the rotary process.

PubMed

Anandakrishnan, Ramu; Zhang, Zining; Donovan-Maiye, Rory; Zuckerman, Daniel M

2016-10-04

The ATP synthase (F-ATPase) is a highly complex rotary machine that synthesizes ATP, powered by a proton electrochemical gradient. Why did evolution select such an elaborate mechanism over arguably simpler alternating-access processes that can be reversed to perform ATP synthesis? We studied a systematic enumeration of alternative mechanisms, using numerical and theoretical means. When the alternative models are optimized subject to fundamental thermodynamic constraints, they fail to match the kinetic ability of the rotary mechanism over a wide range of conditions, particularly under low-energy conditions. We used a physically interpretable, closed-form solution for the steady-state rate for an arbitrary chemical cycle, which clarifies kinetic effects of complex free-energy landscapes. Our analysis also yields insights into the debated "kinetic equivalence" of ATP synthesis driven by transmembrane pH and potential difference. Overall, our study suggests that the complexity of the F-ATPase may have resulted from positive selection for its kinetic advantage.

Is the digitization of laparoscopic movement using accessible alternative technologies possible?

PubMed

Lorias Espinoza, Daniel; Gutiérrez Gnecchi, José Antonio; Martínez, Arturo Minor

2012-05-01

It is widely documented that laparoscopic surgeons require training, and an objective evaluation of the training that they receive. The most advanced evaluation systems integrate the digitization of the movement of laparoscopic tools. A great number of these systems, however, do not permit the use of real tools and their high cost limits their academic impact. Likewise, it is documented that new and accessible systems need to be developed. The aim of this article is to explore the possibility of digitizing the movement of laparoscopic tools in a three-dimensional workspace, using accessible alternative technology. Our proposal uses a commercial Wii video game control in conjunction with a program for determining kinematic variables during the execution of a recognition task.

Providing animal health services to the poor in Northern Ghana: rethinking the role of community animal health workers?

PubMed

Mockshell, Jonathan; Ilukor, John; Birner, Regina

2014-02-01

The Community Animal Health Workers (CAHWs) system has been promoted as an alternative solution to providing animal health services in marginal areas. Yet, access to quality animal health services still remains a fundamental problem for livestock dependent communities. This paper uses the concepts of accessibility, affordability, and transaction costs to examine the perceptions of livestock keepers about the various animal health service providers. The empirical analysis is based on a survey of 120 livestock-keeping households in the Tolon-Kumbungu and Savelugu-Nanton districts in the Northern Region of Ghana. A multinomial logit model was used to determine the factors that influence households' choice of alternative animal health service providers. The results show that the government para-vets are the most preferred type of animal health service providers while CAHWs are the least preferred. Reasons for this observation include high transaction costs and low performance resulting from limited training. In areas with few or no government para-vets, farmers have resorted to self-treatment or to selling sick animals for consumption, which has undesirable health implications. These practices also result in significant financial losses for farmers. This paper finds that the CAHWs' system is insufficient for providing quality animal health services to the rural poor in marginal areas. Therefore, market-smart alternative solutions requiring strong public sector engagement to support livestock farmers in marginal areas and setting minimum training standards for animal health service providers merit policy consideration.

78 FR 8582 - Final Environmental Impact Statement for Brooks River Visitor Access for Katmai National Park and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-06

... River floating bridge and sites to relocate the existing Naknek Lake barge landing area at the mouth of... barge landing site would be located approximately 200 feet south of the mouth of the Brooks River. A new... new Naknek Lake barge landing site. Alternative 4 (NPS Preferred Alternative): This alternative...

Are alternative investments the right approach for your organization?

PubMed

French, Charles J; Dodd, Thomas H

2010-04-01

The decision by a healthcare provider to implement and monitor an alternative investment program requires careful consideration and planning. There are several things an organization should do when making this decision: Begin slowly. Consider access and liquidity. Don't force the investment to fill a target allocation. View an alternative investment as an opportunity investment."

12 CFR 1235.5 - Record hold.

Code of Federal Regulations, 2014 CFR

2014-01-01

... alternative storage method. (d) Access to and retrieval of records during a record hold. The record retention program of each regulated entity or the Office of Finance shall ensure access to and retrieval of records... records and existing information technology. ...

12 CFR 1235.5 - Record hold.

Code of Federal Regulations, 2013 CFR

2013-01-01

... alternative storage method. (d) Access to and retrieval of records during a record hold. The record retention program of each regulated entity or the Office of Finance shall ensure access to and retrieval of records... records and existing information technology. ...

12 CFR 1235.5 - Record hold.

Code of Federal Regulations, 2012 CFR

2012-01-01

... alternative storage method. (d) Access to and retrieval of records during a record hold. The record retention program of each regulated entity or the Office of Finance shall ensure access to and retrieval of records... records and existing information technology. ...

Roosevelt-Vanderbilt alternative transportation system implementation plan : phase 2

DOT National Transportation Integrated Search

2004-12-01

This is the second phase of a plan to identify components of a sustainable and effective alternative transportation system that will provide improved access to, and connections among, the Roosevelt-Vanderbilt National Historic Site units. The goal is...

Performance of new alternative providers of primary care services in England: an observational study

PubMed Central

Greaves, Felix; Laverty, Anthony A; Pape, Utz; Ratneswaren, Anenta; Majeed, Azeem

2015-01-01

Summary Objectives Health system reforms in England are opening broad areas of clinical practice to new providers of care. As part of these reforms, new entrants – including private companies – have been allowed into the primary care market under ‘alternative provider of medical services’ contracting mechanisms since 2004. The characteristics and performance of general practices working under new alternative provider contracts are not well described. We sought to compare the quality of care provided by new entrant providers to that provided by the traditional model of general practice. Design Open cohort study of English general practices. We used linear regression in cross-sectional and time series analyses, adjusting for practice and population characteristics, to compare quality in practices using alternative provider contracts to traditional practices. We created regression models using practice fixed effects to estimate the impact of practices changing to the new contract type. Setting The English National Health Service. Participants All general practices open from 2008/2009 to 2012/2013. Main outcome measures Seventeen established quality indicators – covering clinical effectiveness, efficiency, access and patient experience. Results In total, 4.1% (347 of 8300) of general practices in England were run by alternative contract providers. These practices tended to be smaller, and serve younger, more diverse and more deprived populations than traditional providers. Practices run by alternative providers performed worse than traditional providers on 15 of 17 indicators after adjusting for practice and population characteristics (p < 0.01 for all). Switching to a new alternative provider contract did not result in improved performance. Conclusions The introduction of new alternative providers to deliver primary care services in England has not led to improvements in quality and may have resulted in worse care. Regulators should ensure that new entrants to clinical provider markets are performing to adequate standards and at least as well as traditional providers. PMID:25908312

Performance of new alternative providers of primary care services in England: an observational study.

PubMed

Greaves, Felix; Laverty, Anthony A; Pape, Utz; Ratneswaren, Anenta; Majeed, Azeem; Millett, Christopher

2015-05-01

Health system reforms in England are opening broad areas of clinical practice to new providers of care. As part of these reforms, new entrants--including private companies--have been allowed into the primary care market under 'alternative provider of medical services' contracting mechanisms since 2004. The characteristics and performance of general practices working under new alternative provider contracts are not well described. We sought to compare the quality of care provided by new entrant providers to that provided by the traditional model of general practice. Open cohort study of English general practices. We used linear regression in cross-sectional and time series analyses, adjusting for practice and population characteristics, to compare quality in practices using alternative provider contracts to traditional practices. We created regression models using practice fixed effects to estimate the impact of practices changing to the new contract type. The English National Health Service. All general practices open from 2008/2009 to 2012/2013. Seventeen established quality indicators--covering clinical effectiveness, efficiency, access and patient experience. In total, 4.1% (347 of 8300) of general practices in England were run by alternative contract providers. These practices tended to be smaller, and serve younger, more diverse and more deprived populations than traditional providers. Practices run by alternative providers performed worse than traditional providers on 15 of 17 indicators after adjusting for practice and population characteristics (p < 0.01 for all). Switching to a new alternative provider contract did not result in improved performance. The introduction of new alternative providers to deliver primary care services in England has not led to improvements in quality and may have resulted in worse care. Regulators should ensure that new entrants to clinical provider markets are performing to adequate standards and at least as well as traditional providers. © The Royal Society of Medicine.

Repair of traumatic tricuspid insufficiency via minimally invasive port access.

PubMed

Kasahara, Hirofumi; Kudo, Mikihiko; Kawajiri, Hiroyuki; Yozu, Ryohei

2010-04-01

We report on a successful tricuspid valve plasty using port-access minimally invasive cardiac surgery (MICS) for severe traumatic tricuspid insufficiency caused by blunt chest trauma suffered 15 years previously. A combination repair procedure, consisting of cleft closures, plication of the anteroseptal commissure, and ring annuloplasty, was necessary to achieve valve competence and proved possible via port access without difficulty. Port-access MICS is an alternative approach for tricuspid valve surgery.

Optimizing multiple-choice tests as tools for learning.

PubMed

Little, Jeri L; Bjork, Elizabeth Ligon

2015-01-01

Answering multiple-choice questions with competitive alternatives can enhance performance on a later test, not only on questions about the information previously tested, but also on questions about related information not previously tested-in particular, on questions about information pertaining to the previously incorrect alternatives. In the present research, we assessed a possible explanation for this pattern: When multiple-choice questions contain competitive incorrect alternatives, test-takers are led to retrieve previously studied information pertaining to all of the alternatives in order to discriminate among them and select an answer, with such processing strengthening later access to information associated with both the correct and incorrect alternatives. Supporting this hypothesis, we found enhanced performance on a later cued-recall test for previously nontested questions when their answers had previously appeared as competitive incorrect alternatives in the initial multiple-choice test, but not when they had previously appeared as noncompetitive alternatives. Importantly, however, competitive alternatives were not more likely than noncompetitive alternatives to be intruded as incorrect responses, indicating that a general increased accessibility for previously presented incorrect alternatives could not be the explanation for these results. The present findings, replicated across two experiments (one in which corrective feedback was provided during the initial multiple-choice testing, and one in which it was not), thus strongly suggest that competitive multiple-choice questions can trigger beneficial retrieval processes for both tested and related information, and the results have implications for the effective use of multiple-choice tests as tools for learning.

77 FR 3017 - Self-Regulatory Organizations; C2 Options Exchange, Incorporated; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-20

... be charged on a per-Login ID basis. Firms may access C2 via either a CMI Client Application [[Page..., using different Login IDs, accessing the same CMI Client Application Server or FIX Port, allowing the firm to only pay the monthly fee once. Alternatively, a firm may use the same Login ID to access...

76 FR 63974 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-14

... charges to assess a fee for each CMI Login ID. Firms may access CBOEdirect via either a CMI Client... Login IDs, accessing the same CMI Client Application Server, allowing the firm to only pay the monthly fee once. Alternatively, a firm may use the same Login ID to access different CMI Client Application...

Implementation of a mezzo-level HOV carpool model for Texas. Final report, September 1986-April 1990

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

Benson, J.D.; Mullins, J.A.; Stokes, R.W.

1989-11-01

The report presents the results of an evaluation and adaptation of three existing high-occupancy vehicle (HOV) lane carpool demand estimation models for possible use in Houston and other large Texas cities. These models use trip tables, networks and zone structures that are consistent with the regional travel demand modeling process currently in use in Texas. By implementing the HOV carpool models in a structure that is consistent with the regional travel demand modeling process, it is possible to estimate the carpool demand for an HOV facility and to evaluate the effects of the following changes in HOV lane configuration andmore » operating strategies: (1) Effects of additional and/or alternative access points; (2) Effects of extending and HOV lane; and (3) Effects of changing the definition of eligible HOV carpools. The models have produced promising results in test applications in Houston.« less

Paying for Primary Care: The Factors Associated with Physician Self-selection into Payment Models.

PubMed

Rudoler, David; Deber, Raisa; Barnsley, Janet; Glazier, Richard H; Dass, Adrian Rohit; Laporte, Audrey

2015-09-01

To determine the factors associated with primary care physician self-selection into different payment models, we used a panel of eight waves of administrative data for all primary care physicians who practiced in Ontario between 2003/2004 and 2010/2011. We used a mixed effects logistic regression model to estimate physicians' choice of three alternative payment models: fee for service, enhanced fee for service, and blended capitation. We found that primary care physicians self-selected into payment models based on existing practice characteristics. Physicians with more complex patient populations were less likely to switch into capitation-based payment models where higher levels of effort were not financially rewarded. These findings suggested that investigations aimed at assessing the impact of different primary care reimbursement models on outcomes, including costs and access, should first account for potential selection effects. Copyright © 2015 John Wiley & Sons, Ltd.

Successful simultaneous ipsilateral stenting of common iliac artery stenosis and transfemoral aortic valve replacement.

PubMed

Aslan, Abdullah Nabi; Kasapkara, Hacı Ahmet; Sivri, Serkan; Güney, Murat Can; Bozkurt, Engin

2017-01-01

Transcatheter aortic valve replacement (TAVR) was designed to treat elderly patients with severe aortic stenosis at high risk for surgery, and is most commonly performed with retrograde approach through femoral arteries. However, in up to 30% of cases, it is either not possible to use this access route or it is considered to have high risk of vascular injury. Alternative approaches have been described for patients with no suitable femoral access: trans-subclavian, transaortic, or direct aortic access; however, since the introduction of new valves deployed with low-profile delivery systems, another alternative transcatheter approach has been discovered. Presently described is experience in 2 cases in which patients were treated with transfemoral TAVR using Edwards SAPIEN 3 transcatheter heart valves immediately following ipsilateral common iliac artery stenting.

38 CFR 18.422 - Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., reassignment of classes or other services to accessible buildings, assignment of aids to beneficiaries, home visits, delivery of health, or other social services at alternate accessible sites, alteration of... handicapped persons in the most integrated setting appropriate. (c) Small health, welfare or other social...

Wheel running, voluntary ethanol consumption, and hedonic substitution.

PubMed

Ozburn, Angela Renee; Harris, R Adron; Blednov, Yuri A

2008-08-01

Few studies have examined the relationship between naturally rewarding behaviors and ethanol drinking behaviors in mice. Although natural and drug reinforcers activate similar brain circuitry, there is behavioral evidence suggesting food and drug rewards differ in perceived value. The primary goal of the present study was to investigate the relationships between naturally reinforcing stimuli and consumption of ethanol in ethanol preferring C57BL/6J mice. Mouse behaviors were observed after the following environmental manipulations: standard or enhanced environment, accessible or inaccessible wheel, and presence or absence of ethanol. Using a high-resolution volumetric drinking monitor and wheel running monitor, we evaluated whether alternating access to wheel running modified ethanol-related behaviors and whether alternating access to ethanol modified wheel running or subsequent ethanol-related behaviors. We found that ethanol consumption remains stable with alternating periods of wheel running. Wheel running increases in the absence of ethanol and decreases upon reintroduction of ethanol. Upon reintroduction of ethanol, an alcohol deprivation effect was seen. Collectively, the results support theories of hedonic substitution and suggest that female C57BL/6J mice express ethanol seeking and craving under these specific conditions.

Specific timely appointments for triage reduced waiting lists in an outpatient physiotherapy service.

PubMed

Harding, K E; Bottrell, J

2016-12-01

Waiting lists with triage systems are commonly used in outpatient physiotherapy but may not be effective. Could an alternative model of access and triage reduce waiting times over a sustained period with no additional resources? Observational study comparing retrospective data for 11 months prior to the introduction of a new model of access compared with data for the equivalent 11 months afterwards. Patients referred to a physiotherapy outpatient department at an outer metropolitan hospital before (n=721) and after (n=707) the introduction of the new model. A model of access and triage known as 'specific timely appointments for triage' (STAT), in which appointment slots are preserved in advance specifically for new patients based on calculation of average demand. Time from referral to first assessment, number of appointments per patient, occasions of non-attendance and total length of stay in the service. Median time from referral to first appointment was 18 days [interquartile range (IQR) 11 to 33 days] in the pre-intervention group, compared with 14 days (IQR 9 to 21 days) in the post-intervention group (P<0.01). The number of physiotherapy appointments also reduced (IQR 2 to 6 vs IQR 1 to 4; P<0.01). There were no changes in non-attendance rates or total time in the service. Waiting time for outpatient physiotherapy was 22% lower in the year following the introduction of the STAT model. While acknowledging the limitations of a pre- and post-measurement design, this model may have potential for reducing waiting times for outpatient physiotherapy without additional resources. Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Introducing linear functions: an alternative statistical approach

NASA Astrophysics Data System (ADS)

Nolan, Caroline; Herbert, Sandra

2015-12-01

The introduction of linear functions is the turning point where many students decide if mathematics is useful or not. This means the role of parameters and variables in linear functions could be considered to be `threshold concepts'. There is recognition that linear functions can be taught in context through the exploration of linear modelling examples, but this has its limitations. Currently, statistical data is easily attainable, and graphics or computer algebra system (CAS) calculators are common in many classrooms. The use of this technology provides ease of access to different representations of linear functions as well as the ability to fit a least-squares line for real-life data. This means these calculators could support a possible alternative approach to the introduction of linear functions. This study compares the results of an end-of-topic test for two classes of Australian middle secondary students at a regional school to determine if such an alternative approach is feasible. In this study, test questions were grouped by concept and subjected to concept by concept analysis of the means of test results of the two classes. This analysis revealed that the students following the alternative approach demonstrated greater competence with non-standard questions.

A novel generalized normal distribution for human longevity and other negatively skewed data.

PubMed

Robertson, Henry T; Allison, David B

2012-01-01

Negatively skewed data arise occasionally in statistical practice; perhaps the most familiar example is the distribution of human longevity. Although other generalizations of the normal distribution exist, we demonstrate a new alternative that apparently fits human longevity data better. We propose an alternative approach of a normal distribution whose scale parameter is conditioned on attained age. This approach is consistent with previous findings that longevity conditioned on survival to the modal age behaves like a normal distribution. We derive such a distribution and demonstrate its accuracy in modeling human longevity data from life tables. The new distribution is characterized by 1. An intuitively straightforward genesis; 2. Closed forms for the pdf, cdf, mode, quantile, and hazard functions; and 3. Accessibility to non-statisticians, based on its close relationship to the normal distribution.

A Novel Generalized Normal Distribution for Human Longevity and other Negatively Skewed Data

PubMed Central

Robertson, Henry T.; Allison, David B.

2012-01-01

Negatively skewed data arise occasionally in statistical practice; perhaps the most familiar example is the distribution of human longevity. Although other generalizations of the normal distribution exist, we demonstrate a new alternative that apparently fits human longevity data better. We propose an alternative approach of a normal distribution whose scale parameter is conditioned on attained age. This approach is consistent with previous findings that longevity conditioned on survival to the modal age behaves like a normal distribution. We derive such a distribution and demonstrate its accuracy in modeling human longevity data from life tables. The new distribution is characterized by 1. An intuitively straightforward genesis; 2. Closed forms for the pdf, cdf, mode, quantile, and hazard functions; and 3. Accessibility to non-statisticians, based on its close relationship to the normal distribution. PMID:22623974

A randomised crossover study to compare the cross-sectional and longitudinal approaches to ultrasound-guided peripheral venepuncture in a model.

PubMed

Griffiths, James; Carnegie, Amadeus; Kendall, Richard; Madan, Rajeev

2017-12-01

Ultrasound-guided peripheral intravenous access may present an alternative to central or intraosseous access in patients with difficult peripheral veins. Using venepuncture of a phantom model as a proxy, we investigated whether novice ultrasound users should adopt a cross-sectional or longitudinal approach when learning to access peripheral veins under ultrasound guidance. This result would inform the development of a structured training method for this procedure. We conducted a randomised controlled trial of 30 medical students. Subjects received 35 min of training, then attempted to aspirate 1 ml of synthetic blood from a deep vein in a training model under ultrasound guidance. Subjects attempted both the cross-sectional and longitudinal approaches. Group 1 used cross-sectional first, followed by longitudinal. Group 2 used longitudinal first, then cross-sectional. We measured the time from first puncture of the model's skin to aspiration of fluid, and the number of attempts required. Subjects also reported difficulty ratings for each approach. Paired sample t-tests were used for statistical analysis. The mean number of attempts was 1.13 using the cross-sectional approach, compared with 1.30 using the longitudinal approach (p = 0.17). Mean time to aspiration of fluid was 45.1 s using the cross-sectional approach and 52.8 s using the longitudinal approach (p = 0.43). The mean difficulty score out of 10 was 3.97 for the cross-sectional approach and 3.93 for the longitudinal approach (p = 0.95). We found no significant difference in effectiveness between the cross-sectional and longitudinal approaches to ultrasound-guided venepuncture when performed on a model. We believe that both approaches should be included when teaching ultrasound-guided peripheral vascular access. To confirm which approach would be best in clinical practice, we advocate future testing of both approaches on patients.

Treating childhood pneumonia in hard-to-reach areas: a model-based comparison of mobile clinics and community-based care.

PubMed

Pitt, Catherine; Roberts, Bayard; Checchi, Francesco

2012-01-10

Where hard-to-access populations (such as those living in insecure areas) lack access to basic health services, relief agencies, donors, and ministries of health face a dilemma in selecting the most effective intervention strategy. This paper uses a decision mathematical model to estimate the relative effectiveness of two alternative strategies, mobile clinics and fixed community-based health services, for antibiotic treatment of childhood pneumonia, the world's leading cause of child mortality. A "Markov cycle tree" cohort model was developed in Excel with Visual Basic to compare the number of deaths from pneumonia in children aged 1 to 59 months expected under three scenarios: 1) No curative services available, 2) Curative services provided by a highly-skilled but intermittent mobile clinic, and 3) Curative services provided by a low-skilled community health post. Parameter values were informed by literature and expert interviews. Probabilistic sensitivity analyses were conducted for several plausible scenarios. We estimated median pneumonia-specific under-5 mortality rates of 0.51 (95% credible interval: 0.49 to 0.541) deaths per 10,000 child-days without treatment, 0.45 (95% CI: 0.43 to 0.48) with weekly mobile clinics, and 0.31 (95% CI: 0.29 to 0.32) with CHWs in fixed health posts. Sensitivity analyses found the fixed strategy superior, except when mobile clinics visited communities daily, where rates of care-seeking were substantially higher at mobile clinics than fixed posts, or where several variables simultaneously differed substantially from our baseline assumptions. Current evidence does not support the hypothesis that mobile clinics are more effective than CHWs. A CHW strategy therefore warrants consideration in high-mortality, hard-to-access areas. Uncertainty remains, and parameter values may vary across contexts, but the model allows preliminary findings to be updated as new or context-specific evidence becomes available. Decision analytic modelling can guide needed field-based research efforts in hard-to-access areas and offer evidence-based insights for decision-makers.

Performance Prediction Toolkit

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

Chennupati, Gopinath; Santhi, Nanadakishore; Eidenbenz, Stephen

The Performance Prediction Toolkit (PPT), is a scalable co-design tool that contains the hardware and middle-ware models, which accept proxy applications as input in runtime prediction. PPT relies on Simian, a parallel discrete event simulation engine in Python or Lua, that uses the process concept, where each computing unit (host, node, core) is a Simian entity. Processes perform their task through message exchanges to remain active, sleep, wake-up, begin and end. The PPT hardware model of a compute core (such as a Haswell core) consists of a set of parameters, such as clock speed, memory hierarchy levels, their respective sizes,more » cache-lines, access times for different cache levels, average cycle counts of ALU operations, etc. These parameters are ideally read off a spec sheet or are learned using regression models learned from hardware counters (PAPI) data. The compute core model offers an API to the software model, a function called time_compute(), which takes as input a tasklist. A tasklist is an unordered set of ALU, and other CPU-type operations (in particular virtual memory loads and stores). The PPT application model mimics the loop structure of the application and replaces the computational kernels with a call to the hardware model's time_compute() function giving tasklists as input that model the compute kernel. A PPT application model thus consists of tasklists representing kernels and the high-er level loop structure that we like to think of as pseudo code. The key challenge for the hardware model's time_compute-function is to translate virtual memory accesses into actual cache hierarchy level hits and misses.PPT also contains another CPU core level hardware model, Analytical Memory Model (AMM). The AMM solves this challenge soundly, where our previous alternatives explicitly include the L1,L2,L3 hit-rates as inputs to the tasklists. Explicit hit-rates inevitably only reflect the application modeler's best guess, perhaps informed by a few small test problems using hardware counters; also, hard-coded hit-rates make the hardware model insensitive to changes in cache sizes. Alternatively, we use reuse distance distributions in the tasklists. In general, reuse profiles require the application modeler to run a very expensive trace analysis on the real code that realistically can be done at best for small examples.« less

Strong-field plasmonic photoemission in the mid-IR at <1 GW/cm² intensity.

PubMed

Teichmann, S M; Rácz, P; Ciappina, M F; Pérez-Hernández, J A; Thai, A; Fekete, J; Elezzabi, A Y; Veisz, L; Biegert, J; Dombi, P

2015-01-12

We investigated nonlinear photoemission from plasmonic films with femtosecond, mid-infrared pulses at 3.1 μm wavelength. Transition between regimes of multi-photon-induced and tunneling emission is demonstrated at an unprecedentedly low intensity of <1 GW/cm(2). Thereby, strong-field nanophysics can be accessed at extremely low intensities by exploiting nanoscale plasmonic field confinement, enhancement and ponderomotive wavelength scaling at the same time. Results agree well with quantum mechanical modelling. Our scheme demonstrates an alternative paradigm and regime in strong-field physics.

Telemedicine and other care models in pediatric rheumatology: an exploratory study of parents' perceptions of barriers to care and care preferences.

PubMed

Bullock, Danielle R; Vehe, Richard K; Zhang, Lei; Correll, Colleen K

2017-07-11

The United States pediatric rheumatology workforce is committed to a mission of providing children access to pediatric rheumatology care. With a limited number and distribution of pediatric rheumatologists, telemedicine has been proposed as one way to meet this mission, yet the adoption of this modality has been slower than expected. The purpose of this study was to explore the parent perspective on barriers to accessing pediatric rheumatology care and to explore the acceptability of telemedicine and other alternative care models. Over a period of six weeks, all new and return English-speaking parents/guardians of patients visiting a single center were offered an opportunity to complete a survey which assessed barriers to care and interest in alternative models of care. Responses were analyzed using descriptive statistics. Survey response rate was 72% (159/221). Twenty-eight percent (45/159) traveled more than three hours to the pediatric rheumatology clinic, and 43% (65/152) reported travel as inconvenient. An overwhelming majority of respondents (95%, 144/152) reported a preference for in-person visits over the option of telemedicine. This preference was similar regardless of whether respondents reported travel to the clinic as inconvenient vs convenient (inconvenient 92%, 60/65; convenient 97%, 84/87; p = 0.2881) and despite those reporting travel as inconvenient also reporting greater difficulty with several barriers to care. Those familiar with telemedicine were more likely to report a preference for telemedicine over in-person visits (27%, 3/11 vs 3%, 4/140; p = 0.0087). The option of an outreach clinic was acceptable to a majority (63%, 97/154); however, adult rheumatology and shared-care options were less acceptable (22%, 35/156 and 34%, 53/156 respectively). Among survey respondents, in-person visits were preferred over the option of telemedicine, even when travel was noted to be inconvenient. Telemedicine familiarity increased its acceptability. Outreach clinics were acceptable to a majority. Ultimately, the parent perspective can shape acceptable ways to address barriers and provide accessible care.

Expanding oral care opportunities: direct access care provided by dental hygienists in the United States.

PubMed

Naughton, Doreen K

2014-06-01

Dental hygienists expand access to oral care in the United States. Many Americans have access to oral health care in traditional dental offices however millions of Americans have unmet dental needs. For decades dental hygienists have provided opportunities for un-served and under-served Americans to receive preventive services in a variety of alternate delivery sites, and referral to licensed dentists for dental care needs. Publications, state practice acts, state public health departments, the American Dental Hygienists' Association, and personal interviews of dental hygiene practitioners were accessed for information and statistical data. Dental hygienists in 36 states can legally provide direct access care. Dental hygienists are providing preventive services in a variety of settings to previously un-served and under-served Americans, with referral to dentists for dental needs. Dental hygienists have provided direct access to care in the United States for decades. The exact number of direct access providers in the United States is unknown. Limited research and anecdotal information demonstrate that direct access care has facilitated alternate entry points into the oral health systems for thousands of previously un-served and underserved Americans. Older adults, persons with special needs, children in schools, pregnant women, minority populations, rural populations, and others have benefited from the availability of many services provided by direct access dental hygienists. Legislatures and private groups are becoming increasingly aware of the impact that direct access has made on the delivery of oral health care. Many factors continue to drive the growth of direct access care. Additional research is needed to accumulate qualitative and quantitative outcome data related to direct access care provided by dental hygienists and other mid level providers of oral health services. Copyright © 2014 Elsevier Inc. All rights reserved.

Mobile multiple access study

NASA Technical Reports Server (NTRS)

1977-01-01

Multiple access techniques (FDMA, CDMA, TDMA) for the mobile user and attempts to identify the current best technique are discussed. Traffic loading is considered as well as voice and data modulation and spacecraft and system design. Emphasis is placed on developing mobile terminal cost estimates for the selected design. In addition, design examples are presented for the alternative techniques of multiple access in order to compare with the selected technique.

A rat in the labyrinth of anorexia nervosa: contributions of the activity-based anorexia rodent model to the understanding of anorexia nervosa.

PubMed

Gutierrez, Emilio

2013-05-01

Activity-based anorexia (ABA) is an analogous animal model of anorexia nervosa where food-restricted rats develop excessive running activity when given free access to a running wheel; their body weight sharply decreases, and finally self-starvation and death ensue unless animals are removed from the experimental conditions. The parallel of this animal model with major signs in the human disorder has been the focus of much attention from researchers and clinicians as a platform for translational research. The paper reviews the historical antecedents of ABA, research characterizing its occurrence, and its main limitations and strengths as a model of AN. As a symptomatic model of AN, the ABA model can provide clinicians with innovative and alternative routes for improving the treatment of AN. Copyright © 2013 Wiley Periodicals, Inc.

Information Retrieval Systems Retrieved? An Alternative to Present Dial Access Systems

ERIC Educational Resources Information Center

Hofmann, Norbert

1976-01-01

The expense of a dial access information retrieval system (DIARS) is weighed against its benefits. Problems of usage and efficacy for the student are outlined. A fully automated system is proposed instead, and its cost-saving features are pointed out. (MS)

Information Graphic Classification, Decomposition and Alternative Representation

ERIC Educational Resources Information Center

Gao, Jinglun

2012-01-01

This thesis work is mainly focused on two problems related to improving accessibility of information graphics for visually impaired users. The first problem is automated analysis of information graphics for information extraction and the second problem is multi-modal representations for accessibility. Information graphics are graphical…

Theory of perceived access to breast health care in African American women.

PubMed

Garmon, Sandra C

2012-01-01

The theory presented in this article proposes an alternative view of access to care on the basis of an African American woman's perception of the necessity, availability, and appropriateness of breast health care. The theory of perceived access to breast health care in African American women may also be useful in framing future research studies exploring the relationship between access to care and utilization of primary, secondary, and tertiary clinical preventive services related to breast health care.

Novel Method for Exchange of Impella Circulatory Assist Catheter: The "Trojan Horse" Technique.

PubMed

Phillips, Colin T; Tamez, Hector; Tu, Thomas M; Yeh, Robert W; Pinto, Duane S

2017-07-01

Patients with an indwelling Impella may require escalation of hemodynamic support or exchange to another circulatory assistance platform. As such, preservation of vascular access is preferable in cases where anticoagulation cannot be discontinued or to facilitate exchange to an alternative catheter or closure device. Challenges exist in avoiding bleeding and loss of wire access in these situations. We describe a single-access "Trojan Horse" technique that minimizes bleeding while maintaining arterial access for rapid exchange of this percutaneous ventricular assist device.

Consideration of What May Influence Student Outcomes on Alternate Assessment.

ERIC Educational Resources Information Center

Browder, Diane M.; Fallin, Kathy; Davis, Stephanie; Karvonen, Meagan

2003-01-01

This article describes variables that may influence alternate assessment outcomes for students with disabilities and offers recommendations to enhance student achievement. These variables include technical quality, curriculum access, data collection, instructional effectiveness, risk factors, and resources allocated to instruction. Two of four…

Free-choice feeding of free-range meat chickens

USDA-ARS?s Scientific Manuscript database

Alternative feeding methods should be considered for free-range, organic, and other alternative poultry production. The number of small- and medium-scale producers raising specialty chickens for local and regional markets is growing and many of these producers do not have access to the nutritional ...

Community Access Video.

ERIC Educational Resources Information Center

Frederiksen, H. Allan

In the belief that "the spread of technological development and the attendant rapidly changing environment creates the necessity for multi-source feedback systems to maximize the alternatives available in dealing with global problems," the author shows how to participate in the process of alternate video. He offers detailed information…

Intron-mediated alternative splicing of Arabidopsis P5CS1 and its association with natural variation in proline and climate adaptation

PubMed Central

Kesari, Ravi; Lasky, Jesse R.; Villamor, Joji Grace; Des Marais, David L.; Chen, Ying-Jiun C.; Liu, Tzu-Wen; Juenger, Thomas E.; Verslues, Paul E.

2012-01-01

Drought-induced proline accumulation is widely observed in plants but its regulation and adaptive value are not as well understood. Proline accumulation of the Arabidopsis accession Shakdara (Sha) was threefold less than that of Landsberg erecta (Ler) and quantitative trait loci mapping identified a reduced function allele of the proline synthesis enzyme Δ1-pyrroline-5-carboxylate synthetase1 (P5CS1) as a basis for the lower proline of Sha. Sha P5CS1 had additional TA repeats in intron 2 and a G-to-T transversion in intron 3 that were sufficient to promote alternative splicing and production of a nonfunctional transcript lacking exon 3 (exon 3-skip P5CS1). In Sha, and additional accessions with the same intron polymorphisms, the nonfunctional exon 3-skip P5CS1 splice variant constituted as much as half of the total P5CS1 transcript. In a larger panel of Arabidopsis accessions, low water potential-induced proline accumulation varied by 10-fold and variable production of exon 3-skip P5CS1 among accessions was an important, but not the sole, factor underlying variation in proline accumulation. Population genetic analyses suggest that P5CS1 may have evolved under positive selection, and more extensive correlation of exon 3-skip P5CS1 production than proline abundance with climate conditions of natural accessions also suggest a role of P5CS1 in local adaptation to the environment. These data identify a unique source of alternative splicing in plants, demonstrate a role of exon 3-skip P5CS1 in natural variation of proline metabolism, and suggest an association of P5CS1 and its alternative splicing with environmental adaptation. PMID:22615385

The first 100 feet: New options for Internet and broadband access. Final report, June 1, 1996--January 31, 1998

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

Branscomb, L.; Hurley, D.; Keller, J.

1998-04-01

This project was undertaken to explore new options for connecting homes and small businesses to high-speed communications networks, such as the Internet. Fundamental to this inquiry was an interest in looking at options which are newly enabled through changes in technology and regulation, and which go beyond the traditional topdown, centralized model for local access. In particular, the authors focused on opportunities for end-user and community-level investment. This project was intended to investigate the opportunities presented by the decreasing cost of computing and networking platforms, the unbundling of local exchange network elements, and the intelligent endpoints model of networking bestmore » exemplified by the Internet. Do these factors, along with communications technologies such as spread spectrum wireless, digital subscriber line services, and the ability to modulate a communications signal over the electric power line infrastructure, enable new models for end-user investment in intelligent infrastructure as a leverage point for accessing the broadband network? This question was first explored through a two-day conference held at the Freedom Forum in Arlington, Virginia, October 29 and 30, 1996. The workshop addressed issues in the consumer adoption of new communications technologies, use of the electric power line infrastructure, the role of municipalities, and the use of alternative technologies, such as XDSL, satellite, spread spectrum wireless, LMDS, and others. The best of these papers have been further developed, with editorial guidance provided by Harvard, and compiled in the form of a book (The First 100 Feet: New Options for Internet and Broadband Access, Deborah Hurley and James Keller, eds., MIT Press, 1998) to be published as part of the MIT Press Spring 1998 catalogue. A summary of topics covered by the book is given in this report.« less

SCI Hospital in Home Program: Bringing Hospital Care Home for Veterans With Spinal Cord Injury.

PubMed

Madaris, Linda L; Onyebueke, Mirian; Liebman, Janet; Martin, Allyson

2016-01-01

The complex nature of spinal cord injury (SCI) and the level of care required for health maintenance frequently result in repeated hospital admissions for recurrent medical complications. Prolonged hospitalizations of persons with SCI have been linked to the increased risk of hospital-acquired infections and development or worsening pressure ulcers. An evidence-based alternative for providing hospital-level care to patients with specific diagnoses who are willing to receive that level of care in the comfort of their home is being implemented in a Department of Veterans Affairs SCI Home Care Program. The SCI Hospital in Home (HiH) model is similar to a patient-centered interdisciplinary care model that was first introduced in Europe and later tested as part of a National Demonstration and Evaluation Study through Johns Hopkins School of Medicine and School of Public Health. This was funded by the John A. Hartford Foundation and the Department of Veterans Affairs. The objectives of the program are to support veterans' choice and access to patient-centered care, reduce the reliance on inpatient medical care, allow for early discharge, and decrease medical costs. Veterans with SCI who are admitted to the HiH program receive daily oversight by a physician, daily visits by a registered nurse, access to laboratory services, oxygen, intravenous medications, and nursing care in the home setting. In this model, patients may typically access HiH services either as an "early discharge" from the hospital or as a direct admit to the program from the emergency department or SCI clinic. Similar programs providing acute hospital-equivalent care in the home have been previously implemented and are successfully demonstrating decreased length of stay, improved patient access, and increased patient satisfaction.

The importance of creating a social business to produce low-cost hearing aids.

PubMed

Caccamo, Samantha; Voloshchenko, Anastasia; Dankyi, Nana Yaa

2014-09-01

The World Health Organization (WHO) estimates that about 280 million people worldwide have a bilateral hearing loss, mostly living in poor countries. Hearing loss causes heavy social burdens on individuals, families, communities and countries. However, due to the lack of accessibility and affordability, the vast majority of people in the world who need hearing aids do not have access to them. Low-income countries are thus pulled into a disability/poverty spiral. From this standpoint, the production of available, accessible and affordable hearing aids for the poorest populations of our planet should be one of the main issues in global hearing healthcare. Designing and producing a brand new low-cost hearing aid is the most effective option. Involving a large producer of hearing aids in the creation of a social business to solve the problem of access to affordable hearing aids is an essential step to reduce hearing disability on a large scale globally. Today's technology allows for the creation of a "minimal design" product that does not exceed $100-$150, that can be further lowered when purchased in large quantities and dispensed with alternative models. It is conceivable that by making a sustainable social business, the low cost product could be sold with a cross-subsidy model in order to recover the overhead costs. Social business is an economic model that has the potential to produce and distribute affordable hearing aids in low- and middle-income countries. Rehabilitation of hearing impaired children will be carried out in partnership with Sahic (Society of Assistance to Hearing Impaired Children) in Dhaka, Bangladesh and the ENT Department of Ospedale Burlo di Trieste, Dr. Eva Orzan.

A longitudinal study of independent scholar-published open access journals.

PubMed

Björk, Bo-Christer; Shen, Cenyu; Laakso, Mikael

2016-01-01

Open Access (OA) is nowadays increasingly being used as a business model for the publishing of scholarly peer reviewed journals, both by specialized OA publishing companies and major, predominantly subscription-based publishers. However, in the early days of the web OA journals were mainly founded by independent academics, who were dissatisfied with the predominant print and subscription paradigm and wanted to test the opportunities offered by the new medium. There is still an on-going debate about how OA journals should be operated, and the volunteer model used by many such 'indie' journals has been proposed as a viable alternative to the model adopted by big professional publishers where publishing activities are funded by authors paying expensive article processing charges (APCs). Our longitudinal quantitative study of 250 'indie' OA journals founded prior to 2002, showed that 51% of these journals were still in operation in 2014 and that the median number of articles published per year had risen from 11 to 18 among the survivors. Of these surviving journals, only 8% had started collecting APCs. A more detailed qualitative case study of five such journals provided insights into how such journals have tried to ensure the continuity and longevity of operations.

'Enhance her pleasure - and your grip strength': Men's Health magazine and pseudo-reciprocal pleasure.

PubMed

Porter, Chelsey Nicole; Douglas, Nick; Collumbien, Martine

2017-07-01

This paper provides a snapshot of the Top Ten free, digital Men's Health magazine articles, accessed on a randomly selected day, that can be viewed as a collection; both a product for readership consumption and a construct of readership priorities. Through close textual analysis, we examine how discourses about masculinity, heterosex and consumerism have intersected to create a model of masculinity based on the discipline of male pleasure, which impacts on men's approach to female pleasure and gender dynamics. The analysis contributes to the developing research about the sexual and bodily discourses the magazine promotes and identifies a model of masculinity where men can 'have their cake and eat it'; seeming to adhere to ideals of gender equality and reciprocity while retaining their traditional patriarchal position of producer/provider. They are encouraged to do so by approaching female orgasm as a product, which they can 'purchase' through adhering to Men's Health magazine's sexual advice and bodily labour at control, delay and discipline of their own pleasure and orgasm. We argue that this approach to sex disenfranchises men, and in turn their partners, of opportunities to access alternative models of embodied pleasure.

A longitudinal study of independent scholar-published open access journals

PubMed Central

Björk, Bo-Christer; Laakso, Mikael

2016-01-01

Open Access (OA) is nowadays increasingly being used as a business model for the publishing of scholarly peer reviewed journals, both by specialized OA publishing companies and major, predominantly subscription-based publishers. However, in the early days of the web OA journals were mainly founded by independent academics, who were dissatisfied with the predominant print and subscription paradigm and wanted to test the opportunities offered by the new medium. There is still an on-going debate about how OA journals should be operated, and the volunteer model used by many such ‘indie’ journals has been proposed as a viable alternative to the model adopted by big professional publishers where publishing activities are funded by authors paying expensive article processing charges (APCs). Our longitudinal quantitative study of 250 ‘indie’ OA journals founded prior to 2002, showed that 51% of these journals were still in operation in 2014 and that the median number of articles published per year had risen from 11 to 18 among the survivors. Of these surviving journals, only 8% had started collecting APCs. A more detailed qualitative case study of five such journals provided insights into how such journals have tried to ensure the continuity and longevity of operations. PMID:27190709

Walk, Bicycle, and Transit Trips of Transit-Dependent and Choice Riders in the 2009 United States National Household Travel Survey.

PubMed

Lachapelle, Ugo

2015-08-01

Previous research has shown that public transit use may be associated with active transportation. Access to a car may influence active transportation of transit riders. Using the 2009 United States National Household Travel Survey (NHTS), transit users ≥ 16 years old (n = 25,550) were categorized according to driver status and number of cars and drivers in the household. This typology ranged from choice transit riders (ie, "fully motorized drivers") to transit-dependent riders (ie, "unmotorized nondriver"). Transit trips, walking trips, and bicycling trips of transit users are estimated in negative binomial models against the car availability typology. Sixteen percent of participants took transit in the past month; most (86%) lived in car-owning households. As income increased, car availability also increased. Transit user groups with lower car availability were generally more likely than fully motorized drivers to take more public transit, walking, and bicycle trips. Transit riders have varying levels of vehicle access; their use of combinations of alternative modes of transportation fluctuates accordingly. Transit-dependent individuals without cars or sharing cars used active transportation more frequently than car owners. Policies to reduce vehicle ownership in households may enable increases in the use of alternative modes of transportation for transit users, even when cars are still owned.

The BioMart community portal: an innovative alternative to large, centralized data repositories.

PubMed

Smedley, Damian; Haider, Syed; Durinck, Steffen; Pandini, Luca; Provero, Paolo; Allen, James; Arnaiz, Olivier; Awedh, Mohammad Hamza; Baldock, Richard; Barbiera, Giulia; Bardou, Philippe; Beck, Tim; Blake, Andrew; Bonierbale, Merideth; Brookes, Anthony J; Bucci, Gabriele; Buetti, Iwan; Burge, Sarah; Cabau, Cédric; Carlson, Joseph W; Chelala, Claude; Chrysostomou, Charalambos; Cittaro, Davide; Collin, Olivier; Cordova, Raul; Cutts, Rosalind J; Dassi, Erik; Di Genova, Alex; Djari, Anis; Esposito, Anthony; Estrella, Heather; Eyras, Eduardo; Fernandez-Banet, Julio; Forbes, Simon; Free, Robert C; Fujisawa, Takatomo; Gadaleta, Emanuela; Garcia-Manteiga, Jose M; Goodstein, David; Gray, Kristian; Guerra-Assunção, José Afonso; Haggarty, Bernard; Han, Dong-Jin; Han, Byung Woo; Harris, Todd; Harshbarger, Jayson; Hastings, Robert K; Hayes, Richard D; Hoede, Claire; Hu, Shen; Hu, Zhi-Liang; Hutchins, Lucie; Kan, Zhengyan; Kawaji, Hideya; Keliet, Aminah; Kerhornou, Arnaud; Kim, Sunghoon; Kinsella, Rhoda; Klopp, Christophe; Kong, Lei; Lawson, Daniel; Lazarevic, Dejan; Lee, Ji-Hyun; Letellier, Thomas; Li, Chuan-Yun; Lio, Pietro; Liu, Chu-Jun; Luo, Jie; Maass, Alejandro; Mariette, Jerome; Maurel, Thomas; Merella, Stefania; Mohamed, Azza Mostafa; Moreews, Francois; Nabihoudine, Ibounyamine; Ndegwa, Nelson; Noirot, Céline; Perez-Llamas, Cristian; Primig, Michael; Quattrone, Alessandro; Quesneville, Hadi; Rambaldi, Davide; Reecy, James; Riba, Michela; Rosanoff, Steven; Saddiq, Amna Ali; Salas, Elisa; Sallou, Olivier; Shepherd, Rebecca; Simon, Reinhard; Sperling, Linda; Spooner, William; Staines, Daniel M; Steinbach, Delphine; Stone, Kevin; Stupka, Elia; Teague, Jon W; Dayem Ullah, Abu Z; Wang, Jun; Ware, Doreen; Wong-Erasmus, Marie; Youens-Clark, Ken; Zadissa, Amonida; Zhang, Shi-Jian; Kasprzyk, Arek

2015-07-01

The BioMart Community Portal (www.biomart.org) is a community-driven effort to provide a unified interface to biomedical databases that are distributed worldwide. The portal provides access to numerous database projects supported by 30 scientific organizations. It includes over 800 different biological datasets spanning genomics, proteomics, model organisms, cancer data, ontology information and more. All resources available through the portal are independently administered and funded by their host organizations. The BioMart data federation technology provides a unified interface to all the available data. The latest version of the portal comes with many new databases that have been created by our ever-growing community. It also comes with better support and extensibility for data analysis and visualization tools. A new addition to our toolbox, the enrichment analysis tool is now accessible through graphical and web service interface. The BioMart community portal averages over one million requests per day. Building on this level of service and the wealth of information that has become available, the BioMart Community Portal has introduced a new, more scalable and cheaper alternative to the large data stores maintained by specialized organizations. © The Author(s) 2015. Published by Oxford University Press on behalf of Nucleic Acids Research.

Does walking explain associations between access to greenspace and lower mortality?

PubMed Central

Lachowycz, Kate; Jones, Andy P.

2014-01-01

Despite emerging evidence that access to greenspace is associated with longer life expectancy, little is understood about what causal mechanisms may explain this relationship. Based on social-ecological theories of health, greenspace has multifaceted potential to influence mortality but the potential alternative mediating pathways have not been empirically tested. This study evaluates relationships between access to greenspace, walking and mortality. Firstly, we test for an association between access to greenspace and self-reported levels of walking using a survey of 165,424 adults across England collected during 2007 and 2008. Negative binomial regression multilevel models were used to examine associations between greenspace access and self reported number of days walked in the last month, in total and for recreational and health purposes, after controlling for relevant confounders. Secondly we use an area level analysis of 6781 middle super output areas across England to examine if recreational walking mediates relationships between greenspace access and reduced premature mortality from circulatory disease. Results show clear evidence of better greenspace access being associated with higher reported recreational walking. There were between 13% and 18% more days of recreational walking in the greenest quintile compared with the least green after adjustment for confounders. Tests for mediation found no evidence that recreational walking explain the associations between greenspace and mortality. Futhermore, whilst the relationship between greenspace access and walking was observed for all areas, the relationship between greenspace access and reduced mortality was only apparent in the most deprived areas. These findings indicate that the association between greenspace and mortality, if causal, may be explained by mediators other than walking, such as psychosocial factors. Future research should concentrate on understanding the causal mechanisms underlying observed associations. PMID:24602966

Research Investigation of Information Access Methods

ERIC Educational Resources Information Center

Heinrichs, John H.; Sharkey, Thomas W.; Lim, Jeen-Su

2006-01-01

This study investigates the satisfaction of library users at Wayne State University who utilize alternative information access methods. The LibQUAL+[TM] desired and perceived that satisfaction ratings are used to determine the user's "superiority gap." By focusing limited library resources to address "superiority gap" issues identified by each…

Test Design Considerations for Students with Significant Cognitive Disabilities

ERIC Educational Resources Information Center

Anderson, Daniel; Farley, Dan; Tindal, Gerald

2015-01-01

Students with significant cognitive disabilities present an assessment dilemma that centers on access and validity in large-scale testing programs. Typically, access is improved by eliminating construct-irrelevant barriers, while validity is improved, in part, through test standardization. In this article, one state's alternate assessment data…

ARCHITECTURAL FLOOR PLAN OF PROCESS AND ACCESS AREAS HOT PILOT ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

ARCHITECTURAL FLOOR PLAN OF PROCESS AND ACCESS AREAS HOT PILOT PLANT (CPP-640). INL DRAWING NUMBER 200-0640-00-279-111679. ALTERNATE ID NUMBER 8952-CPP-640-A-2. - Idaho National Engineering Laboratory, Idaho Chemical Processing Plant, Fuel Reprocessing Complex, Scoville, Butte County, ID

45 CFR 1153.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... FOUNDATION ON THE ARTS AND THE HUMANITIES NATIONAL ENDOWMENT FOR THE ARTS ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE NATIONAL ENDOWMENT FOR THE ARTS...), alternative methods of achieving program accessibility include— (i) Using audio-visual materials and devices...

45 CFR 1153.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2012 CFR

2012-10-01

... FOUNDATION ON THE ARTS AND THE HUMANITIES NATIONAL ENDOWMENT FOR THE ARTS ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE NATIONAL ENDOWMENT FOR THE ARTS...), alternative methods of achieving program accessibility include— (i) Using audio-visual materials and devices...

45 CFR 1153.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2013 CFR

2013-10-01

... FOUNDATION ON THE ARTS AND THE HUMANITIES NATIONAL ENDOWMENT FOR THE ARTS ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE NATIONAL ENDOWMENT FOR THE ARTS...), alternative methods of achieving program accessibility include— (i) Using audio-visual materials and devices...

45 CFR 1153.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2014 CFR

2014-10-01

... FOUNDATION ON THE ARTS AND THE HUMANITIES NATIONAL ENDOWMENT FOR THE ARTS ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE NATIONAL ENDOWMENT FOR THE ARTS...), alternative methods of achieving program accessibility include— (i) Using audio-visual materials and devices...

45 CFR 1153.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... FOUNDATION ON THE ARTS AND THE HUMANITIES NATIONAL ENDOWMENT FOR THE ARTS ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE NATIONAL ENDOWMENT FOR THE ARTS...), alternative methods of achieving program accessibility include— (i) Using audio-visual materials and devices...

Evaluation of innovative devices to control traffic entering from low-volume access points within a land closure.

DOT National Transportation Integrated Search

2014-04-01

This report describes the methodology and results of analyses performed to identify and evaluate : alternative methods to control traffic entering a lane closure on a two-lane, two-way road from low-volume : access points. Researchers documented the ...

77 FR 53194 - Combined Notice of Filings #1

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-31

... Market Based Tariff filings. Filed Date: 8/17/12. Accession Number: 20120817-5103. Comments Due: 5 p.m..., 2012 Application for market-based rate authorization. Filed Date: 8/17/12. Accession Number: 20120817... Wholesale, LLC. Description: Amendment to Application for Market-Based Rate Authority of Energy Alternatives...

45 CFR 153.330 - State alternate risk adjustment methodology.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 1 2012-10-01 2012-10-01 false State alternate risk adjustment methodology. 153.330 Section 153.330 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS STANDARDS RELATED TO REINSURANCE, RISK CORRIDORS, AND RISK ADJUSTMENT UNDER THE...

45 CFR 153.330 - State alternate risk adjustment methodology.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 1 2014-10-01 2014-10-01 false State alternate risk adjustment methodology. 153.330 Section 153.330 Public Welfare Department of Health and Human Services REQUIREMENTS RELATING TO HEALTH CARE ACCESS STANDARDS RELATED TO REINSURANCE, RISK CORRIDORS, AND RISK ADJUSTMENT UNDER THE...

45 CFR 153.330 - State alternate risk adjustment methodology.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 1 2013-10-01 2013-10-01 false State alternate risk adjustment methodology. 153.330 Section 153.330 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS STANDARDS RELATED TO REINSURANCE, RISK CORRIDORS, AND RISK ADJUSTMENT UNDER THE...

75 FR 81972 - New England Fishery Management Council; Public Meeting; Correction

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-29

... Committee will continue development of catch monitoring alternatives for inclusion in Amendment 5 to the... management alternatives for inclusion in Amendment 5 Draft EIS (catch monitoring program, measures to address... physically accessible to people with disabilities. Requests for sign language interpretation or other...

75 FR 38463 - New England Fishery Management Council; Public Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-02

... Committee will continue development of catch monitoring alternatives for inclusion in Amendment 5 to the... to developing catch monitoring alternatives for inclusion in Amendment 5 to the Atlantic Herring FMP... meeting is physically accessible to people with disabilities. Requests for sign language interpretation or...

Single-Sex Computer Classes: An Effective Alternative.

ERIC Educational Resources Information Center

Swain, Sandra L.; Harvey, Douglas M.

2002-01-01

Advocates single-sex computer instruction as a temporary alternative educational program to provide middle school and secondary school girls with access to computers, to present girls with opportunities to develop positive attitudes towards technology, and to make available a learning environment conducive to girls gaining technological skills.…

30 CFR 47.53 - Alternative for hazardous waste.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Alternative for hazardous waste. 47.53 Section... waste. If the mine produces or uses hazardous waste, the operator must provide potentially exposed miners and designated representatives access to available information for the hazardous waste that— (a...

Teachers' Work and Innovation in Alternative Schools

ERIC Educational Resources Information Center

Bascia, Nina; Maton, Rhiannon

2016-01-01

Toronto boasts a large and diverse system of public alternative schools: schools where democratic practices, student access and a commitment to public education are fundamental. There are academic schools; schools with thematically focused curricula; schools driven by social movement principles such as antiracism and global education; schools for…

Using focus groups to design systems science models that promote oral health equity.

PubMed

Kum, Susan S; Northridge, Mary E; Metcalf, Sara S

2018-06-04

While the US population overall has experienced improvements in oral health over the past 60 years, oral diseases remain among the most common chronic conditions across the life course. Further, lack of access to oral health care contributes to profound and enduring oral health inequities worldwide. Vulnerable and underserved populations who commonly lack access to oral health care include racial/ethnic minority older adults living in urban environments. The aim of this study was to use a systematic approach to explicate cause and effect relationships in creating a causal map, a type of concept map in which the links between nodes represent causality or influence. To improve our mental models of the real world and devise strategies to promote oral health equity, methods including system dynamics, agent-based modeling, geographic information science, and social network simulation have been leveraged by the research team. The practice of systems science modeling is situated amidst an ongoing modeling process of observing the real world, formulating mental models of how it works, setting decision rules to guide behavior, and from these heuristics, making decisions that in turn affect the state of the real world. Qualitative data were obtained from focus groups conducted with community-dwelling older adults who self-identify as African American, Dominican, or Puerto Rican to elicit their lived experiences in accessing oral health care in their northern Manhattan neighborhoods. The findings of this study support the multi-dimensional and multi-level perspective of access to oral health care and affirm a theorized discrepancy in fit between available dental providers and patients. The lack of information about oral health at the community level may be compromising the use and quality of oral health care among racial/ethnic minority older adults. Well-informed community members may fill critical roles in oral health promotion, as they are viewed as highly credible sources of information and recommendations for dental providers. The next phase of this research will involve incorporating the knowledge gained from this study into simulation models that will be used to explore alternative paths toward improving oral health and health care for racial/ethnic minority older adults.

Snacks, beverages, vending machines, and school stores: a comparison of alternative and regular schools in Minnesota, 2002 to 2008.

PubMed

Kubik, Martha Y; Davey, Cynthia; MacLehose, Richard F; Coombes, Brandon; Nanney, Marilyn S

2015-01-01

In US secondary schools, vending machines and school stores are a common source of low-nutrient, energy-dense snacks and beverages, including sugar-sweetened beverages, high-fat salty snacks, and candy. However, little is known about the prevalence of these food practices in alternative schools, which are educational settings for students at risk of academic failure due to truancy, school expulsion, and behavior problems. Nationwide, more than 5,000 alternative schools enroll about one-half million students who are disproportionately minority and low-income youth. Principal survey data from a cross-sectional sample of alternative (n=104) and regular (n=339) schools collected biennially from 2002-2008 as part of the Centers for Disease Control and Prevention Minnesota School Health Profiles were used to assess and compare food practice prevalence over time. Generalized estimating equation models were used to estimate prevalence, adjusting for school demographics. Over time, food practice prevalence decreased significantly for both alternative and regular schools, although declines were mostly modest. However, the decrease in high-fat, salty snacks was significantly less for alternative than regular schools (-22.9% vs -42.2%; P<0.0001). Efforts to improve access to healthy food choices at school should reach all schools, including alternative schools. Study findings suggest high-fat salty snacks are more common in vending machines and school stores in alternative schools than regular schools, which may contribute to increased snacking behavior among students and extra consumption of salt, fat, and sugar. Study findings support the need to include alternative schools in future efforts that aim to reform the school food environment. Copyright © 2015 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Snacks, beverages, vending machines and school stores: A comparison of alternative and regular schools in Minnesota, 2002 to 2008

PubMed Central

Davey, Cynthia; MacLehose, Richard F.; Coombes, Brandon; Nanney, Marilyn S.

2014-01-01

In US secondary schools, vending machines and school stores are a common source of low-nutrient, energy-dense snacks and beverages, including sugar-sweetened beverages, high fat salty snacks and candy. However, little is known about the prevalence of these food practices in alternative schools, educational settings for students at risk of academic failure due to truancy, school expulsion and behavioral problems. Nationwide, over 5000 alternative schools enroll about one-half million students, who are disproportionately minority and low-income youth. Principal survey data from a cross-sectional sample of alternative (n=104) and regular (n=339) schools collected biennially from 2002–2008 as part of the Centers for Disease Control and Prevention Minnesota School Health Profiles were used to assess and compare food practice prevalence over time. Generalized estimating equation models were used to estimate prevalence, adjusting for school demographics. Over time, food practice prevalence decreased significantly for both alternative and regular schools, although declines were mostly modest. However, the decrease in high fat, salty snacks was significantly less for alternative than regular schools (−22.9% versus −42.2%; p<0.0001). Efforts to improve access to healthy food choice at school should reach all schools, including alternative schools. Study findings suggest high fat salty snacks are more common in vending machines and school stores in alternative schools than regular schools, which may contribute to increased snacking behavior among students and extra consumption of salt, fat and sugar. Study findings support the need to include alternative schools in future efforts that aim to reform the school food environment. PMID:25132120

LSST Resources for the Community

NASA Astrophysics Data System (ADS)

Jones, R. Lynne

2011-01-01

LSST will generate 100 petabytes of images and 20 petabytes of catalogs, covering 18,000-20,000 square degrees of area sampled every few days, throughout a total of ten years of time -- all publicly available and exquisitely calibrated. The primary access to this data will be through Data Access Centers (DACs). DACs will provide access to catalogs of sources (single detections from individual images) and objects (associations of sources from multiple images). Simple user interfaces or direct SQL queries at the DAC can return user-specified portions of data from catalogs or images. More complex manipulations of the data, such as calculating multi-point correlation functions or creating alternative photo-z measurements on terabyte-scale data, can be completed with the DAC's own resources. Even more data-intensive computations requiring access to large numbers of image pixels on petabyte-scale could also be conducted at the DAC, using compute resources allocated in a similar manner to a TAC. DAC resources will be available to all individuals in member countries or institutes and LSST science collaborations. DACs will also assist investigators with requests for allocations at national facilities such as the Petascale Computing Facility, TeraGrid, and Open Science Grid. Using data on this scale requires new approaches to accessibility and analysis which are being developed through interactions with the LSST Science Collaborations. We are producing simulated images (as might be acquired by LSST) based on models of the universe and generating catalogs from these images (as well as from the base model) using the LSST data management framework in a series of data challenges. The resulting images and catalogs are being made available to the science collaborations to verify the algorithms and develop user interfaces. All LSST software is open source and available online, including preliminary catalog formats. We encourage feedback from the community.

National Surface Water Survey, western wilderness area lakes: environmental assessment. Draft

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

Not Available

1985-03-01

The US Environmental Protection Agency (EPA) is proposing to sample 498 lakes in federally designated wilderness areas and national parks during the western part of the National Surface Water Survey (NSW). The NSWS has been undertaken to provide high quality data for evaluating the nature and extent of acid deposition throughout the United States. Sampling protocols established for the national survey call for the use of helicopters to gain access to lakes for sampling. Helicopters have already been used in the eastern and midwestern parts of the survey. The US Forest Service (FS) and the National Park Service (NPS) willmore » have to decide which sampling plan for wilderness areas, if any, can be approved under the Wilderness Act of 1964. This Environmental Assessment (EA) has been prepared to evaluate the environmental consequences of alternative means of gaining access to wilderness areas to meet the objectives of the NSWS. Based on this evaluation, EPA has reviewed the possible sampling alternatives and reached a conclusion on the preferred alternative. This assessment is being provided to the FS and the NPS for their use in evaluating the alternatives, including EPA's preferred one. As a result of its evaluation, EPA believes that wilderness area lakes should be included in the survey and that the preferred means of access is using helicopters. 94 references, 14 figures, 18 tables.« less

Remedial Action Assessment System: A computer-based methodology for conducting feasibility studies

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

White, M.K.; Buelt, J.L.; Stottlemyre, J.A.

1991-02-01

Because of the complexity and number of potential waste sites facing the US Department of Energy (DOE) for potential cleanup, DOE is supporting the development of a computer-based methodology to streamline the remedial investigation/feasibility study process. The Remedial Action Assessment System (RAAS), can be used for screening, linking, and evaluating established technology processes in support of conducting feasibility studies. It is also intended to do the same in support of corrective measures studies. The user interface employs menus, windows, help features, and graphical information while RAAS is in operation. Object-oriented programming is used to link unit processes into sets ofmore » compatible processes that form appropriate remedial alternatives. Once the remedial alternatives are formed, the RAAS methodology can evaluate them in terms of effectiveness, implementability, and cost. RAAS will access a user-selected risk assessment code to determine the reduction of risk after remedial action by each recommended alternative. The methodology will also help determine the implementability of the remedial alternatives at a site and access cost estimating tools to provide estimates of capital, operating, and maintenance costs. This paper presents the characteristics of two RAAS prototypes currently being developed. These include the RAAS Technology Information System, which accesses graphical, tabular and textual information about technologies, and the main RAAS methodology, which screens, links, and evaluates remedial technologies. 4 refs., 3 figs., 1 tab.« less

Cloud-based simulations on Google Exacycle reveal ligand modulation of GPCR activation pathways

NASA Astrophysics Data System (ADS)

Kohlhoff, Kai J.; Shukla, Diwakar; Lawrenz, Morgan; Bowman, Gregory R.; Konerding, David E.; Belov, Dan; Altman, Russ B.; Pande, Vijay S.

2014-01-01

Simulations can provide tremendous insight into the atomistic details of biological mechanisms, but micro- to millisecond timescales are historically only accessible on dedicated supercomputers. We demonstrate that cloud computing is a viable alternative that brings long-timescale processes within reach of a broader community. We used Google's Exacycle cloud-computing platform to simulate two milliseconds of dynamics of a major drug target, the G-protein-coupled receptor β2AR. Markov state models aggregate independent simulations into a single statistical model that is validated by previous computational and experimental results. Moreover, our models provide an atomistic description of the activation of a G-protein-coupled receptor and reveal multiple activation pathways. Agonists and inverse agonists interact differentially with these pathways, with profound implications for drug design.

Swarm Verification

NASA Technical Reports Server (NTRS)

Holzmann, Gerard J.; Joshi, Rajeev; Groce, Alex

2008-01-01

Reportedly, supercomputer designer Seymour Cray once said that he would sooner use two strong oxen to plow a field than a thousand chickens. Although this is undoubtedly wise when it comes to plowing a field, it is not so clear for other types of tasks. Model checking problems are of the proverbial "search the needle in a haystack" type. Such problems can often be parallelized easily. Alas, none of the usual divide and conquer methods can be used to parallelize the working of a model checker. Given that it has become easier than ever to gain access to large numbers of computers to perform even routine tasks it is becoming more and more attractive to find alternate ways to use these resources to speed up model checking tasks. This paper describes one such method, called swarm verification.

Wall Modeled Large Eddy Simulation of Airfoil Trailing Edge Noise

NASA Astrophysics Data System (ADS)

Kocheemoolayil, Joseph; Lele, Sanjiva

2014-11-01

Large eddy simulation (LES) of airfoil trailing edge noise has largely been restricted to low Reynolds numbers due to prohibitive computational cost. Wall modeled LES (WMLES) is a computationally cheaper alternative that makes full-scale Reynolds numbers relevant to large wind turbines accessible. A systematic investigation of trailing edge noise prediction using WMLES is conducted. Detailed comparisons are made with experimental data. The stress boundary condition from a wall model does not constrain the fluctuating velocity to vanish at the wall. This limitation has profound implications for trailing edge noise prediction. The simulation over-predicts the intensity of fluctuating wall pressure and far-field noise. An improved wall model formulation that minimizes the over-prediction of fluctuating wall pressure is proposed and carefully validated. The flow configurations chosen for the study are from the workshop on benchmark problems for airframe noise computations. The large eddy simulation database is used to examine the adequacy of scaling laws that quantify the dependence of trailing edge noise on Mach number, Reynolds number and angle of attack. Simplifying assumptions invoked in engineering approaches towards predicting trailing edge noise are critically evaluated. We gratefully acknowledge financial support from GE Global Research and thank Cascade Technologies Inc. for providing access to their massively-parallel large eddy simulation framework.

The applied technologies to access clean water for remote communities

NASA Astrophysics Data System (ADS)

Rabindra, I. B.

2018-01-01

A lot of research is done to overcome the remote communities to access clean water, yet very little is utilized and implemented by the community. Various reasons can probably be made for, which is the application of research results is assessed less practical. The aims of this paper is seeking a practical approach, how to establish criteria for the design can be easier applied, at the proper locations, the simple construction, effectively producing a volume and quality of clean water designation. The methods used in this paper is a technological model assessment of treatment/filtering clean water produced a variety of previous research, to establish a model of appropriate technology for remote communities. Various research results collected from the study of literature, while the identification of opportunities and threats to its application is done using a SWOT analysis. This article discussion is looking for alternative models of clean water filtration technology from the previous research results, to be selected as appropriate technology, easily applied and bring of many benefits to the remote communities. The conclusions resulting from the discussion in this paper, expected to be used as the basic criteria of design model of clean water filtration technologies that can be accepted and applied effectively by the remote communities.

Prototyping an online wetland ecosystem services model using open model sharing standards

USGS Publications Warehouse

Feng, M.; Liu, S.; Euliss, N.H.; Young, Caitlin; Mushet, D.M.

2011-01-01

Great interest currently exists for developing ecosystem models to forecast how ecosystem services may change under alternative land use and climate futures. Ecosystem services are diverse and include supporting services or functions (e.g., primary production, nutrient cycling), provisioning services (e.g., wildlife, groundwater), regulating services (e.g., water purification, floodwater retention), and even cultural services (e.g., ecotourism, cultural heritage). Hence, the knowledge base necessary to quantify ecosystem services is broad and derived from many diverse scientific disciplines. Building the required interdisciplinary models is especially challenging as modelers from different locations and times may develop the disciplinary models needed for ecosystem simulations, and these models must be identified and made accessible to the interdisciplinary simulation. Additional difficulties include inconsistent data structures, formats, and metadata required by geospatial models as well as limitations on computing, storage, and connectivity. Traditional standalone and closed network systems cannot fully support sharing and integrating interdisciplinary geospatial models from variant sources. To address this need, we developed an approach to openly share and access geospatial computational models using distributed Geographic Information System (GIS) techniques and open geospatial standards. We included a means to share computational models compliant with Open Geospatial Consortium (OGC) Web Processing Services (WPS) standard to ensure modelers have an efficient and simplified means to publish new models. To demonstrate our approach, we developed five disciplinary models that can be integrated and shared to simulate a few of the ecosystem services (e.g., water storage, waterfowl breeding) that are provided by wetlands in the Prairie Pothole Region (PPR) of North America.

Peripheral arteriovenous fistula as vascular access for long-term chemotherapy.

PubMed

Kovalyov, Oleksiy O; Kostyuk, Oleksandr G; Tkachuk, Tetyana V

To provide long-term vascular access in clinical oncology peripheral forearm veins (up to 95% of patients in Ukraine), central venous access and "complete implanted vascular systems" are used most often. Many oncology patients have contraindications to catheterization of superior vena cava. Besides, exploitation of central veins is associated with potential technical and infectious complications. The aim - to study short-term and long-term results of arteriovenous fistula exploitation as vascular access for continuous anticancer therapy. Peripheral venous bed status in 41 oncology patients taking long-term chemotherapy treatment is analyzed in the article. Doppler sonography, morphologic and immune histochemical analyses were used in the study. Doppler sonography found qualitative and quantitative changes in forearm veins at different time periods after initiation of chemotherapy in the majority of patients. The major morphologic manifestations of venous wall damage were chemical phlebitis, local or extended hardening of venous wall, venous thrombosis and extravasations with necrosis and subsequent paravasal tissue sclerosis. Alternative vascular access created in 12 patients completely met the adequacy criteria (safety, multiple use, longevity, realization of the designed therapy program). The conclusion was made about inapplicability of forearm veins for long-term administration of cytostatic agents. If it is impossible to use central veins, arteriovenous fistula can become an alternative vascular access.

Quantum random oracle model for quantum digital signature

NASA Astrophysics Data System (ADS)

Shang, Tao; Lei, Qi; Liu, Jianwei

2016-10-01

The goal of this work is to provide a general security analysis tool, namely, the quantum random oracle (QRO), for facilitating the security analysis of quantum cryptographic protocols, especially protocols based on quantum one-way function. QRO is used to model quantum one-way function and different queries to QRO are used to model quantum attacks. A typical application of quantum one-way function is the quantum digital signature, whose progress has been hampered by the slow pace of the experimental realization. Alternatively, we use the QRO model to analyze the provable security of a quantum digital signature scheme and elaborate the analysis procedure. The QRO model differs from the prior quantum-accessible random oracle in that it can output quantum states as public keys and give responses to different queries. This tool can be a test bed for the cryptanalysis of more quantum cryptographic protocols based on the quantum one-way function.

In vitro experimental investigation of voice production

PubMed Central

Horáčcek, Jaromír; Brücker, Christoph; Becker, Stefan

2012-01-01

The process of human phonation involves a complex interaction between the physical domains of structural dynamics, fluid flow, and acoustic sound production and radiation. Given the high degree of nonlinearity of these processes, even small anatomical or physiological disturbances can significantly affect the voice signal. In the worst cases, patients can lose their voice and hence the normal mode of speech communication. To improve medical therapies and surgical techniques it is very important to understand better the physics of the human phonation process. Due to the limited experimental access to the human larynx, alternative strategies, including artificial vocal folds, have been developed. The following review gives an overview of experimental investigations of artificial vocal folds within the last 30 years. The models are sorted into three groups: static models, externally driven models, and self-oscillating models. The focus is on the different models of the human vocal folds and on the ways in which they have been applied. PMID:23181007

Measuring patient-centered medical home access and continuity in clinics with part-time clinicians.

PubMed

Rosland, Ann-Marie; Krein, Sarah L; Kim, Hyunglin Myra; Greenstone, Clinton L; Tremblay, Adam; Ratz, David; Saffar, Darcy; Kerr, Eve A

2015-05-01

Common patient-centered medical home (PCMH) performance measures value access to a single primary care provider (PCP), which may have unintended consequences for clinics that rely on part-time PCPs and team-based care. Retrospective analysis of 110,454 primary care visits from 2 Veterans Health Administration clinics from 2010 to 2012. Multi-level models examined associations between PCP availability in clinic, and performance on access and continuity measures. Patient experiences with access and continuity were compared using 2012 patient survey data (N = 2881). Patients of PCPs with fewer half-day clinic sessions per week were significantly less likely to get a requested same-day appointment with their usual PCP (predicted probability 17% for PCPs with 2 sessions/week, 20% for 5 sessions/week, and 26% for 10 sessions/week). Among requests that did not result in a same-day appointment with the usual PCP, there were no significant differences in same-day access to a different PCP, or access within 2 to 7 days with patients' usual PCP. Overall, patients had >92% continuity with their usual PCP at the hospital-based site regardless of PCP sessions/week. Patients of full-time PCPs reported timely appointments for urgent needs more often than patients of part-time PCPs (82% vs 71%; P < .01), but reported similar experiences with routine access and continuity. Part-time PCP performance appeared worse when using measures focused on same-day access to patients' usual PCP. However, clinic-level same-day access, same-week access to the usual PCP, and overall continuity were similar for patients of part-time and full-time PCPs. Measures of in-person access to a usual PCP do not capture alternate access approaches encouraged by PCMH, and often used by part-time providers, such as team-based or non-face-to-face care.

Defining alternative rules in water and sanitation.

PubMed

Robert, J

1995-11-01

While the conventional water and sanitation package remains most prominent, alternatives exist to conventional waterworks and sanitation practices. Some alternate courses of action are considered. Promising an unprecedented availability of piped water, water development projects foster a pump-and-dump mentality even before they are completed. Often simply announcing the impending implementation of such projects encourages the intention among future beneficiaries to waste water resources. Alternatives to the domestic waste of water must be sought and implemented. Disestablishing water development, styles of alternative water technologies, decision-making and decision-makers, water policy scale, regenerating community access to sources, and water pricing are discussed.

Isochoric Implosions for Fast Ignition

NASA Astrophysics Data System (ADS)

Clark, Daniel; Tabak, Max

2006-10-01

Various gain models have shown the potentially great advantages of Fast Ignition (FI) Inertial Confinement Fusion (ICF) over its conventional hotspot ignition counterpart. These gain models, however, all assume nearly uniform-density fuel assemblies. By contrast, typical ICF implosions yield hollowed fuel assemblies with a high-density shell of fuel surrounding a low-density, high-pressure hotspot. To realize fully the advantages of FI, then, an alternative implosion design must be found which yields nearly isochoric fuel assemblies without substantial hotspots. Here, it is shown that a self-similar spherical implosion of the type originally studied by Guderley [Luftfahrtforschung 19, 302 (1942)] may be employed to yield precisely such quasi-isochoric imploded states. The difficulty remains, however, of accessing these self-similarly imploding configurations from initial conditions representing an actual ICF target, namely a uniform, solid-density shell at rest. Furthermore, these specialized implosions must be realized for practicable drive parameters, i.e., accessible peak pressures, shell aspect ratios, etc. An implosion scheme is presented which meets all of these requirements, suggesting the possibility of genuinely isochoric implosions for FI.

SwissADME: a free web tool to evaluate pharmacokinetics, drug-likeness and medicinal chemistry friendliness of small molecules

PubMed Central

Daina, Antoine; Michielin, Olivier; Zoete, Vincent

2017-01-01

To be effective as a drug, a potent molecule must reach its target in the body in sufficient concentration, and stay there in a bioactive form long enough for the expected biologic events to occur. Drug development involves assessment of absorption, distribution, metabolism and excretion (ADME) increasingly earlier in the discovery process, at a stage when considered compounds are numerous but access to the physical samples is limited. In that context, computer models constitute valid alternatives to experiments. Here, we present the new SwissADME web tool that gives free access to a pool of fast yet robust predictive models for physicochemical properties, pharmacokinetics, drug-likeness and medicinal chemistry friendliness, among which in-house proficient methods such as the BOILED-Egg, iLOGP and Bioavailability Radar. Easy efficient input and interpretation are ensured thanks to a user-friendly interface through the login-free website http://www.swissadme.ch. Specialists, but also nonexpert in cheminformatics or computational chemistry can predict rapidly key parameters for a collection of molecules to support their drug discovery endeavours. PMID:28256516

Learning Relational Policies from Electronic Health Record Access Logs

PubMed Central

Malin, Bradley; Nyemba, Steve; Paulett, John

2011-01-01

Modern healthcare organizations (HCOs) are composed of complex dynamic teams to ensure clinical operations are executed in a quick and competent manner. At the same time, the fluid nature of such environments hinders administrators' efforts to define access control policies that appropriately balance patient privacy and healthcare functions. Manual efforts to define these policies are labor-intensive and error-prone, often resulting in systems that endow certain care providers with overly broad access to patients' medical records while restricting other providers from legitimate and timely use. In this work, we propose an alternative method to generate these policies by automatically mining usage patterns from electronic health record (EHR) systems. EHR systems are increasingly being integrated into clinical environments and our approach is designed to be generalizable across HCOs, thus assisting in the design and evaluation of local access control policies. Our technique, which is grounded in data mining and social network analysis theory, extracts a statistical model of the organization from the access logs of its EHRs. In doing so, our approach enables the review of predefined policies, as well as the discovery of unknown behaviors. We evaluate our approach with five months of access logs from the Vanderbilt University Medical Center and confirm the existence of stable social structures and intuitive business operations. Additionally, we demonstrate that there is significant turnover in the interactions between users in the HCO and that policies learned at the department level afford greater stability over time. PMID:21277996

75 FR 25195 - Kake to Petersburg Transmission Line Intertie Project

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-07

... existing roads for construction and long-term maintenance access where possible. New road segments would be.... Both routes would use existing roads for construction and long-term maintenance access where possible...). Both alternative routes follow existing logging roads for the majority of their lengths. In addition...

Alternate Access Interface for Mouse and Touchpad Input. Final Report.

ERIC Educational Resources Information Center

Kelso, David; And Others

This final report describes a federally funded project (September 1987-August 1989) which developed the "Trace Transparent Access Module," a device which interfaces with standard computers thus allowing children with physical disabilities to participate fully with nondisabled children in classrooms. The module is a small, microprocessor…

Badging, Real ID

Science.gov Websites

. REAL ID LANL Impacts and Solutions The federal government has determined New Mexico is non-compliant Identification Cards whom will also become Non-Compliant. Access through LANL Vehicle Access Portals unaffected alternate ID if they are coming from "non-compliant" REAL-ID states LANS and the Field Office have

Fe-Catalyzed Cycloisomerization of Aryl Allenyl Ketones: Access to 3-Arylidene-indan-1-ones.

PubMed

Teske, Johannes; Plietker, Bernd

2018-04-20

A cycloisomerization of aryl allenyl ketones to 3-arylidene-indan-1-ones using a cationic Fe-complex as a catalyst is reported. The catalyst opens a synthetically interesting reaction pathway to this surprisingly underrepresented class of indanones that are not accessible using alternative catalytic systems.

78 FR 26663 - Exelon Generation Company, LLC, License Renewal of Nuclear Plants and Public Meetings for the...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-07

... and reasonable alternative energy sources. DATES: Submit comments by June 27, 2013. Comments [email protected] . For technical questions, contact the individual(s) listed in the FOR FURTHER INFORMATION... accessing information and submitting comments, see ``Accessing Information and Submitting Comments'' in the...

Remote Patron Validation: Posting a Proxy Server at the Digital Doorway.

ERIC Educational Resources Information Center

Webster, Peter

2002-01-01

Discussion of remote access to library services focuses on proxy servers as a method for remote access, based on experiences at Saint Mary's University (Halifax). Topics include Internet protocol user validation; browser-directed proxies; server software proxies; vendor alternatives for validating remote users; and Internet security issues. (LRW)

75 FR 2565 - Northern States Power Company, LLC; Monticello Nuclear Generating Plant Final Environmental...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-15

... turbine, and components containing radioactive materials. Based on the licensee's evaluation, the annual... savings and still require additional generating capacity. Alternative energy sources such as wind energy.../adams.html . Persons who do not have access to ADAMS or who encounter problems in accessing the...

Writing for Change: Engaging Juveniles through Alternative Literacy Education

ERIC Educational Resources Information Center

Jacobi, Tobi

2008-01-01

Research on incarceration and educational access continues to reveal the stark reality for many adjudicated youth: without access to educational opportunities recidivism is probable. Yet conventional methods of teaching critical reading, writing, and thinking skills are not always successful for juveniles who have found little success (or hope) in…

PACE: A Browsable Graphical Interface.

ERIC Educational Resources Information Center

Beheshti, Jamshid; And Others

1996-01-01

Describes PACE (Public Access Catalogue Extension), an alternative interface designed to enhance online catalogs by simulating images of books and library shelves to help users browse through the catalog. Results of a test in a college library against a text-based online public access catalog, including student attitudes, are described.…

45 CFR 146.119 - HMO affiliation period as an alternative to a preexisting condition exclusion.

Code of Federal Regulations, 2012 CFR

2012-10-01

... preexisting condition exclusion. 146.119 Section 146.119 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE GROUP HEALTH INSURANCE MARKET Requirements Relating to Access and Renewability of Coverage, and Limitations on Preexisting Condition...

76 FR 64049 - Bank Secrecy Act Regulations: Definition of “Monetary Instrument”

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-17

..., and anti-money laundering program requirements on providers and sellers of prepaid access. While the..., stated: \\13\\ See Money Laundering Using New Payment Methods, Financial Action Task Force, October 2010... Money Laundering Strategy stated that prepaid access is ``* * * an emerging cash alternative for both...

78 FR 42026 - Petition for Rulemaking To Eliminate Accessible Cords on Window Covering Products

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-15

... [Docket No. CPSC-2013-0028] Petition for Rulemaking To Eliminate Accessible Cords on Window Covering... Commission to: promulgate a mandatory standard that prohibits any window covering cords, when a feasible cordless alternative exists; and require that all window covering cords be made inaccessible through the...

Educating Girls: Strategies To Increase Access, Persistence, and Achievement.

ERIC Educational Resources Information Center

Tietjen, Karen; Prather, Cynthia, Ed.

This document reviews the interventions, such as policies, programs, and projects, that have been implemented by governments, donors, and other institutions to increase girls' access, persistence, and achievement at the primary school level. It examines both the formal system of primary education and nontraditional, alternative approaches to reach…

Polygyny, mate-guarding, and posthumous fertilization as alternative male mating strategies.

PubMed

Zamudio, K R; Sinervo, B

2000-12-19

Alternative male mating strategies within populations are thought to be evolutionarily stable because different behaviors allow each male type to successfully gain access to females. Although alternative male strategies are widespread among animals, quantitative evidence for the success of discrete male strategies is available for only a few systems. We use nuclear microsatellites to estimate the paternity rates of three male lizard strategies previously modeled as a rock-paper-scissors game. Each strategy has strengths that allow it to outcompete one morph, and weaknesses that leave it vulnerable to the strategy of another. Blue-throated males mate-guard their females and avoid cuckoldry by yellow-throated "sneaker" males, but mate-guarding is ineffective against aggressive orange-throated neighbors. The ultradominant orange-throated males are highly polygynous and maintain large territories; they overpower blue-throated neighbors and cosire offspring with their females, but are often cuckolded by yellow-throated males. Finally, yellow-throated sneaker males sire offspring via secretive copulations and often share paternity of offspring within a female's clutch. Sneaker males sire more offspring posthumously, indicating that sperm competition may be an important component of their strategy.

75 FR 27056 - FTA Supplemental Fiscal Year 2010 Apportionments, Allocations, and Corrections

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-13

... notice to apportion the full amount of FY 2010 formula funds. In addition, this Notice revises the Job Access and Reverse Commute (JARC) and Alternatives Analysis program carryover tables, Small Transit... projects under the Alternative Analysis program. FOR FURTHER INFORMATION CONTACT: For general information...

76 FR 76640 - Telecommunications Act Accessibility Guidelines; Electronic and Information Technology...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-08

... benefits and costs, and recommended alternatives. The Board also invites the public to identify any gaps in... guidelines, alternative policies to those presented, and information on benefits and costs. After reviewing... with considerable potential cost in relation to the benefit. Because this requirement potentially would...

Alternative Pathways into University: Are Tertiary Preparation Programs a Viable Option?

ERIC Educational Resources Information Center

Chesters, Jenny; Rutter, Kerry; Nelson, Karen; Watson, Louis

2018-01-01

During the past three decades, the student populations of Australian universities have become more heterogeneous as the higher education sector expanded and new alternative entry pathways were established. Broadening access to university study and, therefore, to professional and semi-professional occupations, provides avenues for social mobility.…

The 2% Transition: Supporting Access to State Assessments for Students with Disabilities

ERIC Educational Resources Information Center

Jamgochian, Elisa M.; Ketterlin-Geller, Leanne R.

2015-01-01

Most students with disabilities participate in state assessments with or without accommodations [based on each student's Individualized Education Program (IEP)]. A small number of students with the most severe or profound intellectual disabilities participate in an alternate assessment based on alternate achievement standards (AA-AAS). Until…

Development of guidelines for operationally effective raised medians and the use of alternative movements on urban roadways.

DOT National Transportation Integrated Search

2012-10-01

The development of raised medians is an important access management technique commonly used in urban settings. It : can be used to control or restrict mid-block left turns, U-turns or crossing maneuvers for implementing of alternative : left-turn/U-t...

What Next? Promoting Alternatives to Ability Grouping.

ERIC Educational Resources Information Center

Wheelock, Anne; Hawley, Willis D.

1993-01-01

Suggests ways to eliminate ability grouping in the schools, and explores new alternatives to improve schooling for all students. Specific guidelines are given for the development of academically and racially heterogeneous schooling. The elimination of grouping practices that deny equal access to education is a goal worth pursuing. (SLD)

Another look at retroactive and proactive interference: a quantitative analysis of conversion processes.

PubMed

Blank, Hartmut

2005-02-01

Traditionally, the causes of interference phenomena were sought in "real" or "hard" memory processes such as unlearning, response competition, or inhibition, which serve to reduce the accessibility of target items. I propose an alternative approach which does not deny the influence of such processes but highlights a second, equally important, source of interference-the conversion (Tulving, 1983) of accessible memory information into memory performance. Conversion is conceived as a problem-solving-like activity in which the rememberer tries to find solutions to a memory task. Conversion-based interference effects are traced to different conversion processes in the experimental and control conditions of interference designs. I present a simple theoretical model that quantitatively predicts the resulting amount of interference. In two paired-associate learning experiments using two different types of memory tests, these predictions were corroborated. Relations of the present approach to traditional accounts of interference phenomena and implications for eyewitness testimony are discussed.

The reconstruction of narrative identity during mental health recovery: a complex adaptive systems perspective.

PubMed

Kerr, Douglas J R; Crowe, Trevor P; Oades, Lindsay G

2013-06-01

1) to understand the reconstruction of narrative identity during mental health recovery using a complex adaptive systems perspective, 2) to address the need for alternative approaches that embrace the complexities of health care. A narrative review of published literature was conducted. A complex adaptive systems perspective offers a framework and language that can assist individuals to make sense of their experiences and reconstruct their narratives during an often erratic and uncertain life transition. It is a novel research direction focused on a critical area of recovery and addresses the need for alternative approaches that embrace the complexities of health care. A complexity research approach to narrative identity reconstruction is valuable. It is an accessible model for addressing the complexities of recovery and may underpin the development of simple, practical recovery coaching tools. (PsycINFO Database Record (c) 2013 APA, all rights reserved).

Cost analysis of the Hemodialysis Reliable Outflow (HeRO) Graft compared to the tunneled dialysis catheter.

PubMed

Al Shakarchi, Julien; Inston, Nicholas; Jones, Robert G; Maclaine, Grant; Hollinworth, David

2016-04-01

In end-stage renal disease patients with central venous obstruction, who have limited vascular access options, the Hemodialysis Reliable Outflow (HeRO) Graft is a new alternative with a lower incidence of complications and longer effective device life compared to tunneled dialysis catheters (TDCs). We undertook an economic analysis of introducing the HeRO Graft in the UK. A 1-year cost-consequence decision analytic model was developed comparing management with the HeRO Graft to TDCs from the perspective of the National Health Service in England. The model comprises four 3-month cycles during which the vascular access option either remains functional for hemodialysis or fails, patients can experience access-related infection and device thrombosis, and they can also accrue associated costs. Clinical input data were sourced from published studies and unit cost data from National Health Service 2014-15 Reference Costs. In the base case, a 100-patient cohort managed with the HeRO Graft experienced 6 fewer failed devices, 53 fewer access-related infections, and 67 fewer device thromboses compared to patients managed with TDCs. Although the initial device and placement costs for the HeRO Graft are greater than those for TDCs, savings from the lower incidence of device complications and longer effective device patency reduces these costs. Overall net annual costs are £2600 for each HeRO Graft-managed patient compared to TDC-managed patients. If the National Health Service were to reimburse hemodialysis at a uniform rate regardless of the type of vascular access, net 1-year savings of £1200 per patient are estimated for individuals managed with the HeRO Graft. The base case results showed a marginal net positive cost associated with vascular access with the HeRO Graft compared with TDCs for the incremental clinical benefit of reductions in patency failures, device-related thrombosis, and access-related infection events in a patient population with limited options for dialysis vascular access. Copyright © 2016 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

Accessing key steps of human tumor progression in vivo by using an avian embryo model

NASA Astrophysics Data System (ADS)

Hagedorn, Martin; Javerzat, Sophie; Gilges, Delphine; Meyre, Aurélie; de Lafarge, Benjamin; Eichmann, Anne; Bikfalvi, Andreas

2005-02-01

Experimental in vivo tumor models are essential for comprehending the dynamic process of human cancer progression, identifying therapeutic targets, and evaluating antitumor drugs. However, current rodent models are limited by high costs, long experimental duration, variability, restricted accessibility to the tumor, and major ethical concerns. To avoid these shortcomings, we investigated whether tumor growth on the chick chorio-allantoic membrane after human glioblastoma cell grafting would replicate characteristics of the human disease. Avascular tumors consistently formed within 2 days, then progressed through vascular endothelial growth factor receptor 2-dependent angiogenesis, associated with hemorrhage, necrosis, and peritumoral edema. Blocking of vascular endothelial growth factor receptor 2 and platelet-derived growth factor receptor signaling pathways by using small-molecule receptor tyrosine kinase inhibitors abrogated tumor development. Gene regulation during the angiogenic switch was analyzed by oligonucleotide microarrays. Defined sample selection for gene profiling permitted identification of regulated genes whose functions are associated mainly with tumor vascularization and growth. Furthermore, expression of known tumor progression genes identified in the screen (IL-6 and cysteine-rich angiogenic inducer 61) as well as potential regulators (lumican and F-box-only 6) follow similar patterns in patient glioma. The model reliably simulates key features of human glioma growth in a few days and thus could considerably increase the speed and efficacy of research on human tumor progression and preclinical drug screening. angiogenesis | animal model alternatives | glioblastoma

Models of germ cell development and their application for toxicity studies

PubMed Central

Ferreira, Daniel W.; Allard, Patrick

2015-01-01

Germ cells are unique in their ability to transfer genetic information and traits from generation to generation. As such, the proper development of germ cells and the integrity of their genome are paramount to the health of organisms and the survival of species. Germ cells are also exquisitely sensitive to environmental influences although the testing of germ cell toxicity, especially in females, has proven particularly challenging. In this review, we first describe the remarkable odyssey of germ cells in mammals, with an emphasis on the female germline, from their initial specification during embryogenesis to the generation of mature gametes in adults. We also describe the current methods used in germ cell toxicity testing and their limitations in examining the complex features of mammalian germ cell development. To bypass these challenges, we propose the use of alternative model systems such as Saccharomyces cerevisiae, Drosophila melanogaster, Caenorhabditis elegans and in vitro germ cell methods that have distinct advantages over traditional toxicity models. We discuss the benefits and limitations of each approach, their application to germ cell toxicity studies, and the need for computational approaches to maximize the usefulness of these models. Together, the inclusion of these alternative germ cell toxicity models will be invaluable for the examination of stages not easily accessible in mammals as well as the large scale, high-throughput investigation of germ cell toxicity. PMID:25821157

Global models for synthetic fuels planning

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

Lamontagne, J.

1983-10-01

This study was performed to identify the set of existing global models with the best potential for use in the US Synthetic Fuels Corporation's strategic planning process, and to recommend the most appropriate model. The study was limited to global models with representations that encompass time horizons beyond the year 2000, multiple fuel forms, and significant regional detail. Potential accessibility to the Synthetic Fuels Corporation and adequate documentation were also required. Four existing models (LORENDAS, WIM, IIASA, and IEA/ORAU) were judged to be the best candidates for the SFC's use at this time; none of the models appears to bemore » ideal for the SFC's purposes. On the basis of currently available information, the most promising short-term option open to the SFC is the use of LORENDAS, with careful attention to definition of alternative energy demand scenarios. Longer-term options which deserve further study are coupling LORENDAS with an explicit model of energy demand, and modification of the IEA/ORAU model to include finer time-period definition and additional technological detail.« less

Tapping the potential of alternative medicine.

PubMed

La Puma, J; Eiler, G

1998-04-01

Interest in alternative medicine is growing among healthcare consumers. Health plans and healthcare organizations may be able to improve clinical outcomes and benefit financially by providing patients with access to alternative services. Organizations that can assess their communities' particular needs, draw on interested professional staff to help develop alternative medicine programs and protocols, and study quality outcomes will stand a better chance of making such programs successful. Educating medical staff, designing a credible program, and forging strategic alliances with respected partners can help organizations create a sharply focused brand identity in the community.

Laparoscopic access with a visualizing trocar.

PubMed

Wolf, J S

1997-01-01

Although useful in most situations, there are several inherent disadvantages of the standard laparoscopic access techniques of Veress needle insertion and Hasson-type cannula placement. Veress needle placement may be hazardous in patients at high risk for intraabdominal adhesions and difficult in patients who are obese. The usual alternative, the Hasson-type cannula, often does not provide a good gas seal. As another option, the use of a visualizing trocar (OPTIVIEW) has proven to be effective in the initial experience at the University of Michigan. The inner trocar of the visualizing trocar is hollow except for a clear plastic conical tip with two external ridges. The trocar-cannula assembly is passed through tissue layers to enter the operative space under direct vision from a 10-mm zero-degree laparoscope placed into the trocar. Results suggest that this technique is an excellent alternative to Veress needle placement when laparoscopic access is likely to be hazardous or difficult.

Breach Risk Magnitude: A Quantitative Measure of Database Security.

PubMed

Yasnoff, William A

2016-01-01

A quantitative methodology is described that provides objective evaluation of the potential for health record system breaches. It assumes that breach risk increases with the number of potential records that could be exposed, while it decreases when more authentication steps are required for access. The breach risk magnitude (BRM) is the maximum value for any system user of the common logarithm of the number of accessible database records divided by the number of authentication steps needed to achieve such access. For a one million record relational database, the BRM varies from 5.52 to 6 depending on authentication protocols. For an alternative data architecture designed specifically to increase security by separately storing and encrypting each patient record, the BRM ranges from 1.3 to 2.6. While the BRM only provides a limited quantitative assessment of breach risk, it may be useful to objectively evaluate the security implications of alternative database organization approaches.

Operational models of pharmacological agonism.

PubMed

Black, J W; Leff, P

1983-12-22

The traditional receptor-stimulus model of agonism began with a description of drug action based on the law of mass action and has developed by a series of modifications, each accounting for new experimental evidence. By contrast, in this paper an approach to modelling agonism is taken that begins with the observation that experimental agonist-concentration effect, E/[A], curves are commonly hyperbolic and develops using the deduction that the relation between occupancy and effect must be hyperbolic if the law of mass action applies at the agonist-receptor level. The result is a general model that explicitly describes agonism by three parameters: an agonist-receptor dissociation constant, KA; the total receptor concentration, [R0]; and a parameter, KE, defining the transduction of agonist-receptor complex, AR, into pharmacological effect. The ratio, [R0]/KE, described here as the 'transducer ratio', tau, is a logical definition for the efficacy of an agonist in a system. The model may be extended to account for non-hyperbolic E/[A] curves with no loss of meaning. Analysis shows that an explicit formulation of the traditional receptor-stimulus model is one particular form of the general model but that it is not the simplest. An alternative model is proposed, representing the cognitive and transducer functions of a receptor, that describes agonist action with one fewer parameter than the traditional model. In addition, this model provides a chemical definition of intrinsic efficacy making this parameter experimentally accessible in principle. The alternative models are compared and contrasted with regard to their practical and conceptual utilities in experimental pharmacology.

The Pattern of Genetic Variability in Apomictic Clones of Taraxacum officinale Indicates the Alternation of Asexual and Sexual Histories of Apomicts

PubMed Central

Majeský, Ľuboš; Vašut, Radim J.; Kitner, Miloslav; Trávníček, Bohumil

2012-01-01

Dandelions (genus Taraxacum) comprise a group of sexual diploids and apomictic polyploids with a complicated reticular evolution. Apomixis (clonal reproduction through seeds) in this genus is considered to be obligate, and therefore represent a good model for studying the role of asexual reproduction in microevolutionary processes of apomictic genera. In our study, a total of 187 apomictic individuals composing a set of nine microspecies (sampled across wide geographic area in Europe) were genotyped for six microsatellite loci and for 162 amplified fragment length polymorphism (AFLP) markers. Our results indicated that significant genetic similarity existed within accessions with low numbers of genotypes. Genotypic variability was high among accessions but low within accessions. Clustering methods discriminated individuals into nine groups corresponding to their phenotypes. Furthermore, two groups of apomictic genotypes were observed, which suggests that they had different asexual histories. A matrix compatibility test suggests that most of the variability within accession groups was mutational in origin. However, the presence of recombination was also detected. The accumulation of mutations in asexual clones leads to the establishment of a network of clone mates. However, this study suggests that the clones primarily originated from the hybridisation between sexual and apomicts. PMID:22870257

Palatable Meal Anticipation in Mice

PubMed Central

Hsu, Cynthia T.; Patton, Danica F.; Mistlberger, Ralph E.; Steele, Andrew D.

2010-01-01

The ability to sense time and anticipate events is a critical skill in nature. Most efforts to understand the neural and molecular mechanisms of anticipatory behavior in rodents rely on daily restricted food access, which induces a robust increase of locomotor activity in anticipation of daily meal time. Interestingly, rats also show increased activity in anticipation of a daily palatable meal even when they have an ample food supply, suggesting a role for brain reward systems in anticipatory behavior, and providing an alternate model by which to study the neurobiology of anticipation in species, such as mice, that are less well adapted to “stuff and starve” feeding schedules. To extend this model to mice, and exploit molecular genetic resources available for that species, we tested the ability of wild-type mice to anticipate a daily palatable meal. We observed that mice with free access to regular chow and limited access to highly palatable snacks of chocolate or “Fruit Crunchies” avidly consumed the snack but did not show anticipatory locomotor activity as measured by running wheels or video-based behavioral analysis. However, male mice receiving a snack of high fat chow did show increased food bin entry prior to access time and a modest increase in activity in the two hours preceding the scheduled meal. Interestingly, female mice did not show anticipation of a daily high fat meal but did show increased activity at scheduled mealtime when that meal was withdrawn. These results indicate that anticipation of a scheduled food reward in mice is behavior, diet, and gender specific. PMID:20941366

Alien Biochemistries and Their Metabolic By-Products. Lessons from Synthetic Biology

NASA Astrophysics Data System (ADS)

Benner, S.

2014-03-01

While the metabolisms of terran organisms are accessible for study and their byproducts are, for the most part, well known, the "diversity" of terran biology arises (as far as we know) from a single common ancestor, represents only a small fraction of possible chemical difersity, and may reflect only a fraction of the possible chemical diversity that might support Darwinian evolution [1]. This talk will consider laboratory experiments on origins [2] and synthetic biology [3], asking how they might inform us about alternative biochemistries, and whether we have any chance of observing remotely their by-products, recognizing the uncertanties in both our models for "weird life" and our models of abiotic processes in incompletely defined planetary environments.

An Alternative Option to Dedicated Braille Notetakers for People with Visual Impairments: Universal Technology for Better Access

ERIC Educational Resources Information Center

Hong, Sunggye

2012-01-01

Technology provides equal access to information and helps people with visual impairments to complete tasks more independently. Among various assistive technology options for people with visual impairments, braille notetakers have been considered the most significant because of their technological innovation. Braille notetakers allow users who are…

Marginalized Student Access to Technology Education

ERIC Educational Resources Information Center

Kurtcu, Wanda M.

2017-01-01

The purpose of this paper is to investigate how a teacher can disrupt an established curriculum that continues the cycle of inequity of access to science, technology, engineering, and math (STEM) curriculum by students in alternative education. For this paper, I will focus on the technology components of the STEM curriculum. Technology in the…

Increasing the Literacy Skills of Students Who Require AAC through Modified Direct Instruction and Specific Instructional Feedback

ERIC Educational Resources Information Center

Westover, Jennifer M.

2010-01-01

Literacy skills are fundamental for all learners. For students who require augmentative and alternative communication (AAC), strong literacy skills provide a gateway to generative communication, genuine social networking, improved access to academic opportunities, access to information technology and future employment opportunities. However, many…

Social Reproduction and College Access: Current Evidence, Context, and Potential Alternatives

ERIC Educational Resources Information Center

Serna, Gabriel R.; Woulfe, Rebecca

2017-01-01

Social reproduction theory identifies schooling as a primary means for the perpetuation of the dominant class's ideologies, values, and power. The ability to access college is so closely tied to these constructs that it contributes to this dominance and marginalization. Social stratification is not only mirrored in higher education, but the…

Charter Schools: Limited Access to Facility Financing. Report to Congressional Requesters.

ERIC Educational Resources Information Center

Shaul, Marnie S.

This report determines the degree to which charter schools have access to traditional public school facility financing, and whether alternative sources of facility financing are available to charter schools. Further discussed are potential options generally available to the federal government if it were to assume a larger role in charter school…

78 FR 29151 - Notice of Availability of the Final Environmental Impact Statement for the Proposed Mohave County...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-17

.../energy/wind/mohave.html . The Project is proposed to consist of up to 283 turbines, access roads, and... be supplemented with internal access/service roads to each wind turbine. Proposed ancillary... all action alternatives, Project features within the wind-farm site would include turbines aligned...

Alternative Uses for Course Management Systems: They Aren't Just for Classes Any More

ERIC Educational Resources Information Center

Ullmann, Jill

2009-01-01

Universities are quickly moving from brick and mortar toward online classroom settings. The online setting provides students with increased accessibility and flexibility to attend classes they would normally be unable to attend. Unfortunately, for those students who never attend classes on campus, many campus resources are not accessible. Students…

Information Resources on Online Public Access Catalogs. A Selected ERIC Bibliography.

ERIC Educational Resources Information Center

ERIC Clearinghouse on Information Resources, Syracuse, NY.

Sixteen articles, books, and reports published between 1978 and 1983 and cited in "Resources in Education" and "Current Index to Journals in Education" are listed in this bibliography on online public access catalogs (OPACs). Emphasis is on the movement toward computer-based alternatives to library card catalogs and user…

The Dynamics of Access to Groups in Working Memory

ERIC Educational Resources Information Center

Farrell, Simon; Lelievre, Anna

2012-01-01

The finding that participants leave a pause between groups when attempting serial recall of temporally grouped lists has been taken to indicate access to a hierarchical representation of the list in working memory. An alternative explanation is that the dynamics of serial recall solely reflect output (rather than memorial) processes, with the…

Children, Families and Interagency Work: Experiences of Partnership Work in Primary Education Settings

ERIC Educational Resources Information Center

Milbourne, Linda

2005-01-01

Despite UK government initiatives intended to address social exclusion, those with poor access to social and economic resources continue to experience unresponsive services. In these circumstances, small inter-agency projects may offer accessible alternatives. This article explores the implementation of inter-agency work at a local level, focusing…

Women Choose Their Careers: A Study of Natural Decision Making.

ERIC Educational Resources Information Center

Eisenhart, Margaret A.

1985-01-01

Ethnographic interviews with 23 college-aged women revealed most considered few career alternatives, relied on easily accessible information sources, made choices early in life, stayed with the choice, and decided to either "earn money" or "stay at home." The others considered several alternatives, pursued them, and linked them to relationships…

Tanning beds as an alternative for psoriasis when office-based phototherapy is not accessible.

PubMed

Yentzer, Brad A; Feldman, Steven R

2009-01-01

Many systemic therapies for psoriasis have significant toxicities. Office-based phototherapy is not always practical for many patients. We present a case report and review of using a tanning bed in conjunction with low-dose acitretin as an alternative treatment for moderate to severe plaque psoriasis.

Making Science Accessible to Students with Significant Cognitive Disabilities

ERIC Educational Resources Information Center

Andersen, Lori; Nash, Brooke

2016-01-01

The publication of A Framework for K-12 Science Education (National Research Council, 2012) and the Next Generation Science Standards (NGSS Lead States, 2013) have created a need for new alternate content standards and alternate assessments in science that are linked to the new general education science standards. This article describes how a…

77 FR 26572 - Notice of Availability of the Draft Environmental Impact Statement for the Proposed Mohave County...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-04

... be supplemented with internal access/service roads to each wind turbine. Proposed ancillary... action alternatives, project features within the wind-farm site would include turbines aligned within... maximum of 283 turbines. The Alternative B wind-farm site would encompass approximately 30,872 acres of...

77 FR 36573 - DRAFT General Management Plan and Draft Environmental Impact Statement, Fort Matanzas National...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-19

... Statement (EIS) for the General Management Plan (GMP) for Fort Matanzas National Monument (Monument... EIS/GMP describes the NPS preferred alternative--Alternative B--to guide the management of the... prescriptions to ensure protection, access and enjoyment of the Monument's resources. An up-to-date GMP is...

Early Sentence Productions of 5-Year-Old Children Who Use Augmentative and Alternative Communication

ERIC Educational Resources Information Center

Binger, Cathy; Kent-Walsh, Jennifer; King, Marika; Webb, Eliza; Buenviaje, Elijia

2017-01-01

Four 5-year-old children with receptive language within normal limits and who required augmentative and alternative communication (AAC) received instruction in producing six different semantic--syntactic structures (three treatment and three generalization targets). Participants accessed single-meaning graphic symbols using an AAC app on an iPad…

Medical tourism in the backcountry: alternative health and healing in the Arkansas Ozarks.

PubMed

Nolan, Justin M; Schneider, Mary Jo

2011-01-01

Tourists travel to Arkansas' mountain regions to experience, appreciate, and consume multiple aspects of otherness, including sacred sites and pristine and authentic peoples and environments. A largely unexplored aspect of this consumption of authenticity is alternative medicine, provided to tourists and day travelers in search of physical and emotional restoration. Traditional forms of medicine are deeply rooted in women's social roles as community healers in the region and are perpetuated in part because of the lack of readily accessible forms of so-called modern medicine. Contemporary medical tourism in Arkansas has promoted access to folk health systems, preserving them by incorporating them into tourists' health care services, and also has attracted new and dynamic alternative medical practices while encouraging the transformation of existing forms of traditional medicine. Ultimately, the blend of alternative, folk, and conventional medicine in the Arkansas highlands is evidence of globalizing forces at work in a regional culture. It also serves to highlight a renewed appreciation for the historic continuity and the efficacy of traditional knowledge in the upper South.

Models of service delivery for cancer genetic risk assessment and counseling.

PubMed

Trepanier, Angela M; Allain, Dawn C

2014-04-01

Increasing awareness of and the potentially concomitant increasing demand for cancer genetic services is driving the need to explore more efficient models of service delivery. The aims of this study were to determine which service delivery models are most commonly used by genetic counselors, assess how often they are used, compare the efficiency of each model as well as impact on access to services, and investigate the perceived benefits and barriers of each. Full members of the NSGC Familial Cancer Special Interest Group who subscribe to its listserv were invited to participate in a web-based survey. Eligible respondents were asked which of ten defined service delivery models they use and specific questions related to aspects of model use. One-hundred ninety-two of the approximately 450 members of the listserv responded (42.7%); 177 (92.2%) had provided clinical service in the last year and were eligible to complete all sections of the survey. The four direct care models most commonly used were the (traditional) face-to-face pre- and post-test model (92.2%), the face-to-face pretest without face-to-face post-test model (86.5%), the post-test counseling only for complex results model (36.2%), and the post test counseling for all results model (18.3%). Those using the face-to-face pretest only, post-test all, and post-test complex models reported seeing more new patients than when they used the traditional model and these differences were statistically significantly. There were no significant differences in appointment wait times or distances traveled by patients when comparing use of the traditional model to the other three models. Respondents recognize that a benefit of using alternative service delivery models is increased access to services; however, some are concerned that this may affect quality of care.

A continuum model of transcriptional bursting

PubMed Central

Corrigan, Adam M; Tunnacliffe, Edward; Cannon, Danielle; Chubb, Jonathan R

2016-01-01

Transcription occurs in stochastic bursts. Early models based upon RNA hybridisation studies suggest bursting dynamics arise from alternating inactive and permissive states. Here we investigate bursting mechanism in live cells by quantitative imaging of actin gene transcription, combined with molecular genetics, stochastic simulation and probabilistic modelling. In contrast to early models, our data indicate a continuum of transcriptional states, with a slowly fluctuating initiation rate converting the gene between different levels of activity, interspersed with extended periods of inactivity. We place an upper limit of 40 s on the lifetime of fluctuations in elongation rate, with initiation rate variations persisting an order of magnitude longer. TATA mutations reduce the accessibility of high activity states, leaving the lifetime of on- and off-states unchanged. A continuum or spectrum of gene states potentially enables a wide dynamic range for cell responses to stimuli. DOI: http://dx.doi.org/10.7554/eLife.13051.001 PMID:26896676

Upper limb grafts for hemodialysis access.

PubMed

Shemesh, David; Goldin, Ilya; Verstandig, Anthony; Berelowitz, Daniel; Zaghal, Ibrahim; Olsha, Oded

2015-01-01

Arteriovenous (AV) grafts are required for hemodialysis access when options for native fistulas have been fully exhausted, where they continue to play an important role in hemodialysis patients, offering a better alternative to central vein catheters. When planning autogenous accesses using Doppler ultrasound, adequate arterial inflow and venous outflow must be consciously preserved for future access creation with grafts. Efforts to improve graft patency include changing graft configuration, graft biology and hemodynamics. Industry offers early cannulation grafts to reduce central catheter use and a bioengineered graft is undergoing clinical studies. Although the outcome of AV grafts is inferior to fistulas, grafts can provide long-term hemodialysis access that is a better alternative to central venous catheters. AV grafts have significant drawbacks, mainly poor patency, infection and cost but also have some advantages: early maturation, ease of creation and needling and widespread availability. The outcome of AV graft surgery is variable from center to center. The primary patency rate for AV grafts is 58% at 6 months and the secondary patency rate is 76% at 6 months and 55% at 18 months. There are centers of excellence that report a 1 year secondary patency rate of up to 91%. In this review of the use of AV grafts for hemodialysis access in the upper extremities, technical issues involved in planning the access and performing the surgery in its different configurations are discussed and the role of surveillance and maintenance with their attendant surgical and radiological interventions is described.

Circadian Activity Rhythms and Voluntary Ethanol Intake in Male and Female Ethanol-Preferring Rats: Effects of Long-Term Ethanol Access

PubMed Central

Rosenwasser, Alan M.; McCulley, Walter D.; Fecteau, Matthew

2014-01-01

Chronic alcohol (ethanol) intake alters fundamental properties of the circadian clock. While previous studies have reported significant alterations in free-running circadian period during chronic ethanol access, these effects are typically subtle and appear to require high levels of intake. In the present study we examined the effects of long-term voluntary ethanol intake on ethanol consumption and free-running circadian period in male and female, selectively bred ethanol-preferring P and HAD2 rats. In light of previous reports that intermittent access can result in escalated ethanol intake, an initial 2-week water-only baseline was followed by either continuous or intermittent ethanol access (i.e., alternating 15-day epochs of ethanol access and ethanol deprivation) in separate groups of rats. Thus, animals were exposed to either 135 days of continuous ethanol access or to five 15-day access periods alternating with four 15-day periods of ethanol deprivation. Animals were maintained individually in running-wheel cages under continuous darkness throughout the experiment to allow monitoring of free-running activity and drinking rhythms, and 10% (v/v) ethanol and plain water were available continuously via separate drinking tubes during ethanol access. While there were no initial sex differences in ethanol drinking, ethanol preference increased progressively in male P and HAD2 rats under both continuous and intermittent-access conditions, and eventually exceeded that seen in females. Free-running period shortened during the initial ethanol-access epoch in all groups, but the persistence of this effect showed complex dependence on sex, breeding line, and ethanol-access schedule. Finally, while females of both breeding lines displayed higher levels of locomotor activity than males, there was little evidence for modulation of activity level by ethanol access. These results are consistent with previous findings that chronic ethanol intake alters free-running circadian period, and show further that the development of chronobiological tolerance to ethanol may vary by sex and genotype. PMID:25281289

Sex and menstrual cycle effects on chronic oral cocaine self-administration in rhesus monkeys: Effects of a nondrug alternative reward.

PubMed

Carroll, Marilyn E; Collins, Molly; Kohl, Emily A; Johnson, Seth; Dougen, Ben

2016-08-01

In previous studies, female monkeys self-administered more oral phencyclidine (PCP) than males, and PCP intake differed by phase of menstrual cycle. The purpose of this study was to examine sex and hormonal influences on oral cocaine self-administration in male and female rhesus monkeys in the follicular vs. luteal phases of the menstrual cycle, with concurrent access to an alternative nondrug reward, saccharin (SACC) vs. water. Concurrent access to cocaine (0.2, 0.4, and 0.8 mg/ml) and SACC or water was available from two drinking spouts under concurrent fixed-ratio (FR) 2, 4, and 8 schedules during daily 3-h sessions. Cocaine deliveries were similar in males and females in the females' luteal phase, but cocaine deliveries were higher in females during the follicular phase than the luteal phase and compared to males. When SACC was available, cocaine deliveries were reduced in females in the follicular phase of the cycle, and cocaine intake (mg/kg) was reduced in males and in females' follicular and luteal phases. Access to concurrent SACC (vs. water) reduced cocaine intake (mg/kg) in males and in females during both menstrual phases, and the magnitude of the reduction in cocaine intake was greatest during the females' follicular phase. Thus, a nondrug alternative reward, SACC, is a viable alternative treatment for reducing cocaine's rewarding effects on male and female monkeys, and reductions in cocaine seeking were optimal in the females' luteal phase.

Maternal Strategies to Access Food Differ by Food Security Status.

PubMed

Gorman, Kathleen S; McCurdy, Karen; Kisler, Tiffani; Metallinos-Katsaras, Elizabeth

2017-01-01

Household food insecurity is associated with health and behavior risk. Much less is known about how food insecurity is related to strategies that adults use in accessing food: how and where they shop, use of alternative food sources, and their ability to manage resources. To examine how maternal behaviors, including shopping, accessing alternative sources of food, and managing resources, are related to household food security status (HHFSS). Cross-sectional study collecting survey data on HHFSS, shopping behaviors, use of alternative food sources, and managing resources obtained from low-income mothers of preschool-aged children. One hundred sixty-four low-income mothers of young children (55% Hispanic) from two communities in Rhode Island. HHFSS was measured using 10 items from the 18-item Core Food Security Module to assess adult food security. Mothers were surveyed about where, when, and how often they shopped; the strategies they use when shopping; their use of alternative sources of food, including federal, state, and local assistance; and their ability to manage their resources. Analysis of variance and χ 2 analyses assessed the associations between demographic variables, shopping, accessing alternative food sources, and managing resources, and HHFSS. Multivariate logistic regression assessed the associations between HHFSS and maternal demographic variables, food shopping, strategies, alternative sources of food, and ability to manage resources. Maternal age and language spoken at home were significantly associated with HHFSS; food insecurity was 10% more likely among older mothers (adjusted odds ratio [aOR] 1.10, 95% CI 1.03 to 1.17) and 2.5 times more likely among Spanish-speaking households (compared with non-Spanish speaking [aOR 3.57, 95% CI 1.25 to 10.18]). Food insecurity was more likely among mothers reporting more informal strategies (aOR 1.98, 95% CI 1.28 to 3.01; P<0.05) and perceiving greater inability to manage resources (aOR 1.60, 95% CI 1.30 to 1.98; P<0.05). The results suggest that low-income mothers use a variety of strategies to feed their families and that the strategies they use vary by HHFSS. Community nutrition programs and providers will need to consider these strategies when counseling families at risk for food insecurity and provide guidance to minimize the influence on healthy food choices. Copyright © 2017 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Maternal Strategies to Access Food Differ by Food Security Status

PubMed Central

Gorman, Kathleen S.; McCurdy, Karen; Kisler, Tiffani; Metallinos-Katsaras, Elizabeth

2016-01-01

Background Household food insecurity is associated with health and behavior risk. Much less is known about how food insecurity is related to strategies that adults use in accessing food: how and where they shop, use of alternative food sources and their ability to manage resources. Objective To examine how maternal behaviors including shopping, accessing alternative sources of food and managing resources are related to household food security status (HHFSS). Design Cross-sectional study collecting survey data on HHFSS, shopping behaviors, use of alternative food sources and managing resources obtained from low income mothers of preschoolers. Participants 164 low-income mothers of young children (55% Hispanic) from two communities in Rhode Island. Measures HHFSS was measured using ten items from the 18-item Core Food Security Module to assess adult food security. Mothers were surveyed about where, when and how often they shopped; the strategies they use when shopping; their use of alternative sources of food including federal, state and local assistance; and their ability to manage their resources. Statistical analyses Analysis of Variance and Chi-square analyses assessed the associations between demographic variables, shopping, accessing alternative food sources and managing resources, and HHFSS. Multivariate logistic regression assessed the associations between HHFSS and maternal demographic variables, food shopping strategies, alternative sources of food and ability to manage resources. Results Maternal age and language spoken at home were significantly associated with HHFSS; food insecurity was 10% more likely among older mothers (AOR=1.10; 95% CI 1.03-1.17) and 2.5 times more likely among Spanish speaking households (compared to non-Spanish speaking-AOR=3.57; 95% CI 1.25-10.18). Food insecurity was more likely among mothers reporting more informal strategies (AOR=1.98; 95% CI 1.28-3.01, p<.05) and perceiving greater inability to manage resources (AOR=1.60; 95% CI 1.30-1.98, p<.05). Conclusions The results suggest that low-income mothers use a variety of strategies in order to feed their families and that the strategies they use vary by HHFSS. Community nutrition programs and providers will need to consider these strategies when counseling families at risk for food insecurity and provide guidance to minimize the impact on healthy food choices. PMID:27614689

KENNEDY SPACE CENTER, FLA. - Key officials are poised to cut the ribbon officially dedicating the new Security gates on Kennedy Parkway (Gate 2) and NASA Parkway (Gate 3). From left are Wally Schroeder, with Jones, Edmunds & Associates; Bobby Porter, with Oneida Construction; Daniel Tweed, NASA project manager; Jim Kennedy, Center director; and William Sample, SGS deputy program manager. The new gates were activated Aug. 1, allowing the general public to have access to the new Space Commerce Way, which will provide access to the Research Park and KSC Visitor Complex, and providing an alternate route for the general public between Titusville and Merritt Island that is accessible 24 hours a day. The gates are staffed 24 hours daily.

NASA Image and Video Library

2003-08-27

KENNEDY SPACE CENTER, FLA. - Key officials are poised to cut the ribbon officially dedicating the new Security gates on Kennedy Parkway (Gate 2) and NASA Parkway (Gate 3). From left are Wally Schroeder, with Jones, Edmunds & Associates; Bobby Porter, with Oneida Construction; Daniel Tweed, NASA project manager; Jim Kennedy, Center director; and William Sample, SGS deputy program manager. The new gates were activated Aug. 1, allowing the general public to have access to the new Space Commerce Way, which will provide access to the Research Park and KSC Visitor Complex, and providing an alternate route for the general public between Titusville and Merritt Island that is accessible 24 hours a day. The gates are staffed 24 hours daily.

Extraction, integration and analysis of alternative splicing and protein structure distributed information

PubMed Central

D'Antonio, Matteo; Masseroli, Marco

2009-01-01

Background Alternative splicing has been demonstrated to affect most of human genes; different isoforms from the same gene encode for proteins which differ for a limited number of residues, thus yielding similar structures. This suggests possible correlations between alternative splicing and protein structure. In order to support the investigation of such relationships, we have developed the Alternative Splicing and Protein Structure Scrutinizer (PASS), a Web application to automatically extract, integrate and analyze human alternative splicing and protein structure data sparsely available in the Alternative Splicing Database, Ensembl databank and Protein Data Bank. Primary data from these databases have been integrated and analyzed using the Protein Identifier Cross-Reference, BLAST, CLUSTALW and FeatureMap3D software tools. Results A database has been developed to store the considered primary data and the results from their analysis; a system of Perl scripts has been implemented to automatically create and update the database and analyze the integrated data; a Web interface has been implemented to make the analyses easily accessible; a database has been created to manage user accesses to the PASS Web application and store user's data and searches. Conclusion PASS automatically integrates data from the Alternative Splicing Database with protein structure data from the Protein Data Bank. Additionally, it comprehensively analyzes the integrated data with publicly available well-known bioinformatics tools in order to generate structural information of isoform pairs. Further analysis of such valuable information might reveal interesting relationships between alternative splicing and protein structure differences, which may be significantly associated with different functions. PMID:19828075

A cyclic universe approach to fine tuning

DOE PAGES

Alexander, Stephon; Cormack, Sam; Gleiser, Marcelo

2016-04-05

We present a closed bouncing universe model where the value of coupling constants is set by the dynamics of a ghost-like dilatonic scalar field. We show that adding a periodic potential for the scalar field leads to a cyclic Friedmann universe where the values of the couplings vary randomly from one cycle to the next. While the shuffling of values for the couplings happens during the bounce, within each cycle their time-dependence remains safely within present observational bounds for physically-motivated values of the model parameters. Our model presents an alternative to solutions of the fine tuning problem based on stringmore » landscape scenarios. (C) 2016 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). Funded by SCOAP(3).« less

A cyclic universe approach to fine tuning

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

Alexander, Stephon; Cormack, Sam; Gleiser, Marcelo

We present a closed bouncing universe model where the value of coupling constants is set by the dynamics of a ghost-like dilatonic scalar field. We show that adding a periodic potential for the scalar field leads to a cyclic Friedmann universe where the values of the couplings vary randomly from one cycle to the next. While the shuffling of values for the couplings happens during the bounce, within each cycle their time-dependence remains safely within present observational bounds for physically-motivated values of the model parameters. Our model presents an alternative to solutions of the fine tuning problem based on stringmore » landscape scenarios. (C) 2016 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). Funded by SCOAP(3).« less

Effects of Different Models of Dialysis Care on Patient-Important Outcomes: A Systematic Review and Meta-Analysis.

PubMed

Ramar, Priya; Ahmed, Ahmed T; Wang, Zhen; Chawla, Sagar S; Suarez, Maria Lourdes Gonzalez; Hickson, LaTonya J; Farrell, Ann; Williams, Amy W; Shah, Nilay D; Murad, M Hassan; Thorsteinsdottir, Bjorg

2017-12-01

Ongoing payment reform in dialysis necessitates better patient outcomes and lower costs. Suggested improvements to processes of care for maintenance dialysis patients are abundant; however, their impact on patient-important outcomes is unclear. This systematic review included comparative randomized controlled trials or observational studies with no restriction on language, published from 2000 to 2014, involving at least 5 adult dialysis patients who received a minimum of 6 months of follow-up. The effect size was pooled and stratified by intervention strategy (multidisciplinary care [MDC], home dialysis, alternate dialysis settings, and electronic health record implementation). Heterogeneity (I 2 ) was used to assess the variability in study effects related to study differences rather than chance. Of the 1988 articles screened, 25 international studies with 74,833 maintenance dialysis patients were included. Interventions with MDC or home dialysis were associated with a lower mortality (hazard ratio [HR] = 0.72, 95% confidence interval [CI] 0.61, 0.84, I 2  = 41.6%; HR = 0.57, 95% CI 0.41, 0.81, I 2  = 89.0%; respectively) and hospitalizations (incidence rate ratio [IRR] = 0.68, 95% CI 0.51, 0.91, I 2  = NA; IRR = 0.88, 95% CI 0.64, 1.20, I 2  = 79.6%; respectively). Alternate dialysis settings also were associated with a reduction in hospitalizations (IRR = 0.41, 95% CI 0.25, 0.69, I 2  = 0.0%). This systematic review underscores the importance of multidisciplinary care, and also the value of telemedicine as a means to increase access to providers and enhance outcomes for those dialyzing at home or in alternate settings, including those with limited access to nephrology expertise because of travel distance.

Model Hosting for continuous updating and transparent Water Resources Management

NASA Astrophysics Data System (ADS)

Jódar, Jorge; Almolda, Xavier; Batlle, Francisco; Carrera, Jesús

2013-04-01

Numerical models have become a standard tool for water resources management. They are required for water volume bookkeeping and help in decision making. Nevertheless, numerical models are complex and they can be used only by highly qualified technicians, which are often far from the decision makers. Moreover, they need to be maintained. That is, they require updating of their state, by assimilation of measurements, natural and anthropic actions (e.g., pumping and weather data), and model parameters. Worst, their very complexity implies that are they viewed as obscure and far, which hinders transparency and governance. We propose internet model hosting as an alternative to overcome these limitations. The basic idea is to keep the model hosted in the cloud. The model is updated as new data (measurements and external forcing) becomes available, which ensures continuous maintenance, with a minimal human cost (only required to address modelling problems). Internet access facilitates model use not only by modellers, but also by people responsible for data gathering and by water managers. As a result, the model becomes an institutional tool shared by water agencies to help them not only in decision making for sustainable management of water resources, but also in generating a common discussion platform. By promoting intra-agency sharing, the model becomes the common official position of the agency, which facilitates commitment in their adopted decisions regarding water management. Moreover, by facilitating access to stakeholders and the general public, the state of the aquifer and the impacts of alternative decisions become transparent. We have developed a tool (GAC, Global Aquifer Control) to address the above requirements. The application has been developed using Cloud Computing technologies, which facilitates the above operations. That is, GAC automatically updates the numerical models with the new available measurements, and then simulates numerous management options as required. To this end the application generates as many computing virtual machines as needed, customizing their size (CPU, memory…) accounting for all the particular requirements of every numerical model. Results are presented from a quantitative point of view (i.e. groundwater as a resource), and also from a qualitative perspective (i.e. the use of solute concentrations in groundwater as an environmental vector). In both cases detailed mass balances time series are obtained which can be used jointly with all the input and output model data to solve water conflicts between the different actors using and/or affecting the groundwater of the aquifer.

Long-axis view for ultrasound-guided central venous catheter placement via the internal jugular vein.

PubMed

Mahan, Angel F; McEvoy, Matthew D; Gravenstein, Nikolaus

2016-04-01

In modern practice, real-time ultrasound guidance is commonly employed for the placement of internal jugular vein catheters. With a new tool, such as ultrasound, comes the opportunity to refine and further optimize the ultrasound view during jugular vein catheterization. We describe jugular vein access techniques and use the long-axis view as an alternative to the commonly employed short-axis cross-section view for internal jugular vein access and cannulation. The long-axis ultrasound-guided internal jugular vein approach for internal jugular vein cannulation is a useful alternative technique that can provide better needle tip and guidewire visualization than the more traditional short-axis ultrasound view.

Ultrasound-Guided Renal Access for Percutaneous Nephrolithotomy: A Description of Three Novel Ultrasound-Guided Needle Techniques

PubMed Central

Chu, Carissa; Masic, Selma; Usawachintachit, Manint; Hu, Weiguo; Yang, Wenzeng; Stoller, Marshall; Li, Jianxing

2016-01-01

Abstract Ultrasound-guided renal access for percutaneous nephrolithotomy (PCNL) is a safe, effective, and low-cost procedure commonly performed worldwide, but a technique underutilized by urologists in the United States. The purpose of this article is to familiarize the practicing urologist with methods for ultrasound guidance for percutaneous renal access. We discuss two alternative techniques for gaining renal access for PCNL under ultrasound guidance. We also describe a novel technique of using the puncture needle to reposition residual stone fragments to avoid additional tract dilation. With appropriate training, ultrasound-guided renal access for PCNL can lead to reduced radiation exposure, accurate renal access, and excellent stone-free success rates and clinical outcomes. PMID:26414304

Upper Nasopharyngeal Corridor for Transnasal Endoscopic Drainage of Petroclival Cholesterol Granulomas: Alternative Access in Conchal Sphenoid Patients.

PubMed

Turan, Nefize; Baum, Griffin R; Holland, Christopher M; Ahmad, Faiz U; Henriquez, Oswaldo A; Pradilla, Gustavo

2016-03-01

Background Cholesterol granulomas arising at the petrous apex can be treated via traditional open surgical, endoscopic, and endoscopic-assisted approaches. Endoscopic approaches require access to the sphenoid sinus, which is technically challenging in patients with conchal sphenoidal anatomy. Clinical Presentation A 55-year-old woman presented with intermittent headaches and tinnitus. Formal audiometry demonstrated moderately severe bilateral hearing loss. CT of the temporal bones and sella revealed a well-demarcated expansile lytic mass. MRI of the face, orbit, and neck showed a right petrous apex mass measuring 22 × 18 × 19 mm that was hyperintense on T1- and T2-weighted images without enhancement, consistent with a cholesterol granuloma. The patient had a conchal sphenoidal anatomy. Operative Technique Herein, we present an illustrative case of a low-lying petroclival cholesterol granuloma in a patient with conchal sphenoidal anatomy to describe an alternative high nasopharyngeal corridor for endoscopic transnasal transclival access. Postoperative Course Postoperatively, the patient's symptoms recovered and no complications occurred. Follow-up imaging demonstrated a patent drainage tract without evidence of recurrence. Conclusion In patients with a conchal sphenoid sinus, endoscopic transnasal transclival access can be gained using a high nasopharyngeal approach. This corridor facilitates safe access to these lesions and others in this location.

The versatility of intraosseous vascular access in perioperative medicine: a case series.

PubMed

Anson, Jonathan A; Sinz, Elizabeth H; Swick, John T

2015-02-01

Intraosseous vascular access is a time-tested procedure that is reemerging in popularity. This is primarily a result of the emphasis on intraosseous access in the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Advanced Cardiac Life Support. Modern intraosseous insertion devices are easy to learn and use, suggesting the possibility of use beyond the resuscitation setting. We present a case series of recent intraosseous insertions for a variety of indications by anesthesiologists at our institution to demonstrate the potential utility of this alternative access technique. Copyright © 2014 Elsevier Inc. All rights reserved.

A pH-dependent conformational ensemble mediates proton transport through the influenza A/M2 protein†

PubMed Central

Polishchuk, Alexei L.; Lear, James D.; Ma, Chunlong; Lamb, Robert A.; Pinto, Lawrence H.; DeGrado, William F.

2010-01-01

The influenza A M2 protein exhibits inwardly rectifying, pH-activated proton transport that saturates at low pH. A comparison of high-resolution structures of the transmembrane domain at high and low pH suggests that pH-dependent conformational changes may facilitate proton conduction by alternately changing the accessibility of the N-terminal and C-terminal regions of the channel as a proton transits through the transmembrane domain. Here, we show that M2 functionally reconstituted in liposomes populates at least three different conformational states over a physiologically relevant pH range, with transition midpoints that are consistent with previously reported His37 pKas. We then develop and test two similar, quantitative mechanistic models of proton transport, where protonation shifts the equilibrium between structural states having different proton affinities and solvent accessibilities. The models account well for a collection of experimental data sets over a wide range of pHs and voltages and require only a small number of adjustable parameters to accurately describe the data. While the kinetic models do not require any specific conformation for the protein, they nevertheless are consistent with a large body of structural information based on high-resolution NMR and crystallographic structures, optical spectroscopy, and MD calculations. PMID:20968306

A qualitative study of extended care permit dental hygienists in Kansas.

PubMed

Delinger, Janette; Gadbury-Amyot, Cynthia C; Mitchell, Tanya Villalpando; Williams, Karen B

2014-06-01

Currently, 37 states allow some type of alternative practice settings for dental hygienists. This qualitative study was designed to explore the experiences of the Extended Care Permit (ECP) dental hygienist in the state of Kansas. As a first ever study of this workforce model, a qualitative research design was chosen to illuminate the education and experiences of extended dental hygiene practitioners in order to understand the impact ECP legislation has had on increasing the public's access to oral health care services and define the advantages and limitation of this model as one potential solution to access to oral care. Snowball sampling was used to identify study participants who were actively engaged in extended care practice. Nine subjects, which included one ECP consultant and eight ECP providers, participated in this study. Data obtained via personal interviews and through document analysis data were subsequently coded and thematically analyzed by three examiners. An independent audit was conducted by a fourth examiner to confirm dependability of results. Seven major categories emerged from the data analysis: entrepreneur dental hygienist, partnerships, funding, barriers, sustainability, models of care and the impact of the ECP. The findings of this study revealed that ECP hygienists are making an impact with underserved populations, primarily children, the elderly and special needs patients. Copyright © 2014 The American Dental Hygienists’ Association.

Performance Analysis of the IEEE 802.11p Multichannel MAC Protocol in Vehicular Ad Hoc Networks

PubMed Central

2017-01-01

Vehicular Ad Hoc Networks (VANETs) employ multichannel to provide a variety of safety and non-safety applications, based on the IEEE 802.11p and IEEE 1609.4 protocols. The safety applications require timely and reliable transmissions, while the non-safety applications require efficient and high throughput. In the IEEE 1609.4 protocol, operating interval is divided into alternating Control Channel (CCH) interval and Service Channel (SCH) interval with an identical length. During the CCH interval, nodes transmit safety-related messages and control messages, and Enhanced Distributed Channel Access (EDCA) mechanism is employed to allow four Access Categories (ACs) within a station with different priorities according to their criticality for the vehicle’s safety. During the SCH interval, the non-safety massages are transmitted. An analytical model is proposed in this paper to evaluate performance, reliability and efficiency of the IEEE 802.11p and IEEE 1609.4 protocols. The proposed model improves the existing work by taking serval aspects and the character of multichannel switching into design consideration. Extensive performance evaluations based on analysis and simulation help to validate the accuracy of the proposed model and analyze the capabilities and limitations of the IEEE 802.11p and IEEE 1609.4 protocols, and enhancement suggestions are given. PMID:29231882

Performance Analysis of the IEEE 802.11p Multichannel MAC Protocol in Vehicular Ad Hoc Networks.

PubMed

Song, Caixia

2017-12-12

Vehicular Ad Hoc Networks (VANETs) employ multichannel to provide a variety of safety and non-safety applications, based on the IEEE 802.11p and IEEE 1609.4 protocols. The safety applications require timely and reliable transmissions, while the non-safety applications require efficient and high throughput. In the IEEE 1609.4 protocol, operating interval is divided into alternating Control Channel (CCH) interval and Service Channel (SCH) interval with an identical length. During the CCH interval, nodes transmit safety-related messages and control messages, and Enhanced Distributed Channel Access (EDCA) mechanism is employed to allow four Access Categories (ACs) within a station with different priorities according to their criticality for the vehicle's safety. During the SCH interval, the non-safety massages are transmitted. An analytical model is proposed in this paper to evaluate performance, reliability and efficiency of the IEEE 802.11p and IEEE 1609.4 protocols. The proposed model improves the existing work by taking serval aspects and the character of multichannel switching into design consideration. Extensive performance evaluations based on analysis and simulation help to validate the accuracy of the proposed model and analyze the capabilities and limitations of the IEEE 802.11p and IEEE 1609.4 protocols, and enhancement suggestions are given.

Male sexual polymorphism, alternative reproductive tactics, and androgens in combtooth blennies (pisces: blenniidae).

PubMed

Oliveira, R F; Canario, A V; Grober, M S

2001-09-01

In species in which intense intermale competition for the access to females is present males of lower competitive ability may adopt alternative reproductive tactics (ART) to get access to mates. These ART translate in many cases into male sexual polymorphism, with individuals following distinctly different tactics. Usually two alternative male morphs can be recognized in species with ART: (1) bourgeois males that compete for access to mates invest in typically male behaviors, such as building elaborated nests or displaying ornaments; and (2) parasitic males that take advantage of the success of the bourgeois males in attracting females and attempt "sneaker" fertilizations (e.g., sneaker and satellite males). In combtooth blennies (Blenniidae) the co-occurrence of ART and male sexual polymorphism has been described for two temperate species: the peacock blenny, Salaria pavo, and the Azorean rock-pool blenny, Parablennius sanguinolentus parvicornis. Interestingly, while in the peacock blenny the alternative male morph adopts a sneaker tactic, in the rock-pool blenny parasitic males act as satellites to nest-holder males. Thus, this variation in the ART expressed in these two closely related species allows for a comparative study of the proximate and ultimate factors affecting the expression of the two ART. In this article we summarize the available information on androgen levels in bourgeois and parasitic males of natural populations of the two species and of recent studies on the effect of exogenous administration of androgens on tactic switching in parasitic males of the two species. The information is discussed within the frame of the relative plasticity hypothesis, which predicts that plastic alternative morphs should show differences in hormone levels and that the administration of sex steroids should be effective in promoting the switch from the parasitic to bourgeois tactic. The evidence is only partly consistent with this hypothesis. Alternatively, a social transduction hypothesis that better fits the available data on androgens and ART in teleost is proposed. It states that the observed differences in androgen levels between alternative morphs should not be interpreted as an organization vs activation effect of steroids, but rather as the limited vs lifelong responsiveness of the neuroendocrine axis to social regulation. Copyright 2001 Academic Press.

Accommodating Those Most at Risk. Responding to a Mismatch in Programme Selection Criteria and Foundation Biology Performance

ERIC Educational Resources Information Center

Kirby, Nicola F.; Dempster, Edith R.

2015-01-01

In South Africa, foundation programmes are a well-established alternative access route to tertiary science study for educationally disadvantaged students. Student access to, and performance in, one such foundation programme has been researched by the authors seeking opportunities to improve student retention. The biology module in particular has…

Effects of Reinforcer Magnitude and Distribution on Preference for Work Schedules

ERIC Educational Resources Information Center

Ward-Horner, John C.; Pittenger, Alexis; Pace, Gary; Fienup, Daniel M.

2014-01-01

When the overall magnitude of reinforcement is matched between 2 alternative work schedules, some students prefer to complete all of their work for continuous access to a reinforcer (continuous work) rather than distributed access to a reinforcer while they work (discontinuous work). We evaluated a student's preference for continuous work by…

77 FR 60708 - Additional Waiver Granted to and Alternative Requirement for the Town of Union, New York's CDBG...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-04

.... Village of Endicott Water Plant ($150,000 budgeted) and Western Heights Blvd. Water Tank Access ($6,000... improvements so that water can be provided to the village of Endicott. Union, NY also carefully considered... Plant, Village of Endicott Water Plant, Western Heights Blvd. Water Tank Access, Westover Levee Repair...

10 CFR 62.13 - Contents of a request for emergency access: Alternatives.

Code of Federal Regulations, 2011 CFR

2011-01-01

... EMERGENCY ACCESS TO NON-FEDERAL AND REGIONAL LOW-LEVEL WASTE DISPOSAL FACILITIES Request for a Commission... following: (1) Storage of low-level radioactive waste at the site of generation; (2) Storage of low-level... disposal at a Federal low-level radioactive waste disposal facility in the case of a Federal or defense...

A Lexical Basis for N400 Context Effects: Evidence from MEG

ERIC Educational Resources Information Center

Lau, Ellen; Almeida, Diogo; Hines, Paul C.; Poeppel, David

2009-01-01

The electrophysiological response to words during the "N400" time window (approximately 300-500 ms post-onset) is affected by the context in which the word is presented, but whether this effect reflects the impact of context on "access" of the stored lexical information itself or, alternatively, post-access "integration" processes is still an open…

Access, Quality, and Opportunity: A Case Study of Zambia Open Community Schools (ZOCS)

ERIC Educational Resources Information Center

Mwalimu, Michelle

2011-01-01

Community schools and other approaches to Alternative Primary Education or APE have increased access to primary education for underserved populations in Africa, Asia, and Latin America as a major goal of the Education for All (EFA) movement. In Zambia, a country where an estimated 20 percent of the basic education enrollment now attends community…

Mortality risk prediction in burn injury: Comparison of logistic regression with machine learning approaches.

PubMed

Stylianou, Neophytos; Akbarov, Artur; Kontopantelis, Evangelos; Buchan, Iain; Dunn, Ken W

2015-08-01

Predicting mortality from burn injury has traditionally employed logistic regression models. Alternative machine learning methods have been introduced in some areas of clinical prediction as the necessary software and computational facilities have become accessible. Here we compare logistic regression and machine learning predictions of mortality from burn. An established logistic mortality model was compared to machine learning methods (artificial neural network, support vector machine, random forests and naïve Bayes) using a population-based (England & Wales) case-cohort registry. Predictive evaluation used: area under the receiver operating characteristic curve; sensitivity; specificity; positive predictive value and Youden's index. All methods had comparable discriminatory abilities, similar sensitivities, specificities and positive predictive values. Although some machine learning methods performed marginally better than logistic regression the differences were seldom statistically significant and clinically insubstantial. Random forests were marginally better for high positive predictive value and reasonable sensitivity. Neural networks yielded slightly better prediction overall. Logistic regression gives an optimal mix of performance and interpretability. The established logistic regression model of burn mortality performs well against more complex alternatives. Clinical prediction with a small set of strong, stable, independent predictors is unlikely to gain much from machine learning outside specialist research contexts. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

The Influence of Patient Choice of First Provider on Costs and Outcomes: Analysis From a Physical Therapy Patient Registry.

PubMed

Denninger, Thomas R; Cook, Chad E; Chapman, Cole G; McHenry, Timothy; Thigpen, Charles A

2018-02-01

Study Design Retrospective study. Background Alternative models of care that allow patients to choose direct access to physical therapy have shown promise in terms of cost reduction for neck and back pain. However, real-world exploration within the US health care system is notably limited. Objectives To compare total claims paid and patient outcomes for patients with neck and back pain who received physical therapy intervention via direct access versus medical referral. Methods Data were accessed for patients seeking care for neck or back pain (n = 603) between 2012 and 2014, who chose to begin care either through traditional medical referral or direct access to a physical therapy- led spine management program. All patients received a standardized, pragmatic physical therapy approach, with patient-reported measures of pain and disability assessed before and after treatment. Patient demographics and outcomes data were obtained from the medical center patient registry and combined with total claims paid calculated for the year after the index claim. Linear mixed-effects modeling was used to analyze group differences in pain and disability, visits/time, and annualized costs. Results Patients who chose to enter care via the direct-access physical therapy-led spine management program displayed significantly lower total costs (mean difference, $1543; 95% confidence interval: $51, $3028; P = .04) than those who chose traditional medical referral. Patients in both groups showed clinically important improvements in pain and disability, which were similar between groups (P>.05). Conclusion The initial patient choice to begin care with a physical therapist for back or neck pain resulted in lower cost of care over the next year, while resulting in similar improvements in patient outcomes at discharge from physical therapy. These findings add to the emerging literature suggesting that patients' choice to access physical therapy through direct access may be associated with lower health care expenditures for patients with neck and back pain. Level of Evidence Economic and decision analyses, level 4. J Orthop Sports Phys Ther 2018;48(2):63-71. Epub 26 Oct 2017. doi:10.2519/jospt.2018.7423.

Alternative Sources of Funding Early Childhood Education for School Effectiveness in Nigeria

ERIC Educational Resources Information Center

Olubor, Roseline O.; Inua, Ofe I.

2015-01-01

The authors examined the sources of funding early childhood education in existence in Nigeria with a view towards suggesting alternative sources to boost the revenue base for school effectiveness. The diminishing culture of the extended family system and the need for both parents to be in employment coupled with the need to provide access and…

Implementation of Alternative Transport Networks in University Campuses: The Case of Aristotle University of Thessaloniki, Greece

ERIC Educational Resources Information Center

Pitsiava-Latinopoulou, Magda; Basbas, Socrates; Gavanas, Nikolaos

2013-01-01

Purpose: In order to alleviate the impacts of traffic congestion that undermine the mobility and accessibility conditions of the Aristotle University campus, the paper aims at the presentation and description of a complementary network of alternative modes (i.e. pedestrian and bicycle) and the discussion of the appropriate measures for its…

Alternation between Work and Education. A Study of Educational Leave of Absence at Enterprise Level.

ERIC Educational Resources Information Center

Organisation for Economic Cooperation and Development, Paris (France). Centre for Educational Research and Innovation.

The study reported here involves six countries (Germany, Italy, Yugoslavia, United Kingdom, United States, and Sweden) and focuses on the ways in which those who are actively employed have access to opportunities to alternate education and training with their employment. The first chapter discusses the study structure and defines the field covered…

Model development and validation of geometrically complex eddy current coils using finite element methods

NASA Astrophysics Data System (ADS)

Brown, Alexander; Eviston, Connor

2017-02-01

Multiple FEM models of complex eddy current coil geometries were created and validated to calculate the change of impedance due to the presence of a notch. Capable realistic simulations of eddy current inspections are required for model assisted probability of detection (MAPOD) studies, inversion algorithms, experimental verification, and tailored probe design for NDE applications. An FEM solver was chosen to model complex real world situations including varying probe dimensions and orientations along with complex probe geometries. This will also enable creation of a probe model library database with variable parameters. Verification and validation was performed using other commercially available eddy current modeling software as well as experimentally collected benchmark data. Data analysis and comparison showed that the created models were able to correctly model the probe and conductor interactions and accurately calculate the change in impedance of several experimental scenarios with acceptable error. The promising results of the models enabled the start of an eddy current probe model library to give experimenters easy access to powerful parameter based eddy current models for alternate project applications.

Recommended Methodology for Inter-Service/Agency Automated Message Processing Exchange (I-S/A AMPE). Cost and Schedule Analysis of Security Alternatives.

DTIC Science & Technology

1982-02-23

segregate the computer and storage from the outside world 2. Administrative security to control access to secure computer facilities 3. Network security to...Classification Alternative A- 8 NETWORK KG GENSER DSSCS AMPE TERMINALS TP No. 022-4668-A Figure A-2. Dedicated Switching Architecture Alternative A- 9...communications protocol with the network and GENSER message transmission to the - I-S/A AMPE processor. 7. DSSCS TPU - Handles communications protocol with

Ever Enrolled Medicare Population Estimates from the MCBS Access to Care Files

PubMed Central

Petroski, Jason; Ferraro, David; Chu, Adam

2014-01-01

Objective The Medicare Current Beneficiary Survey’s (MCBS) Access to Care (ATC) file is designed to provide timely access to information on the Medicare population, yet because of the survey’s complex sampling design and expedited processing it is difficult to use the file to make both “always-enrolled” and “ever-enrolled” estimates on the Medicare population. In this study, we describe the ATC file and sample design, and we evaluate and review various alternatives for producing “ever-enrolled” estimates. Methods We created “ever enrolled” estimates for key variables in the MCBS using three separate approaches. We tested differences between the alternative approaches for statistical significance and show the relative magnitude of difference between approaches. Results Even when estimates derived from the different approaches were statistically different, the magnitude of the difference was often sufficiently small so as to result in little practical difference among the alternate approaches. However, when considering more than just the estimation method, there are advantages to using certain approaches over others. Conclusion There are several plausible approaches to achieving “ever-enrolled” estimates in the MCBS ATC file; however, the most straightforward approach appears to be implementation and usage of a new set of “ever-enrolled” weights for this file. PMID:24991484

Impacts on the Voltage Profile of DC Distribution Network with DG Access

NASA Astrophysics Data System (ADS)

Tu, J. J.; Yin, Z. D.

2017-07-01

With the development of electronic, more and more distributed generations (DGs) access into grid and cause the research fever of direct current (DC) distribution network. Considering distributed generation (DG) location and capacity have great impacts on voltage profile, so use IEEE9 and IEEE33 typical circuit as examples, with DGs access in centralized and decentralized mode, to compare voltage profile in alternating and direct current (AC/DC) distribution network. Introducing the voltage change ratio as an evaluation index, so gets the general results on voltage profile of DC distributed network with DG access. Simulation shows that, in the premise of reasonable location and capacity, DC distribution network is more suitable for DG access.

Subxyphoid access of the normal pericardium: a novel drug delivery technique.

PubMed

Laham, R J; Simons, M; Hung, D

1999-05-01

The pericardial space may potentially serve as a drug delivery reservoir that might be used to deliver therapeutic substances to the heart. This study describes a novel delivery technique that enables safe and rapid percutaneous subxyphoid access of the normal pericardium in a large animal model (49 Yorkshire pigs). An epidural introducer needle (Tuohy-17) is advanced gently under fluoroscopic guidance with a continuous positive pressure of 20-30 mm Hg (achieved by saline infusion using an intraflow system). The positive pressure is intended to push the right ventricle (with a lower pressure) away from the needle's path. Entry of the pericardial space is suspected after an increase in the saline flow through the intraflow system. Access to the pericardial space is confirmed by the injection of 1 ml of diluted contrast under fluoroscopy. A soft floppy-tip 0.025" guidewire is then advanced to the pericardial space and the needle is exchanged for an infusion catheter. Access of the pericardial space was achieved in all animals without any adverse events and without any hemodynamic compromise even with the delivery of fluid volumes as large as 50 ml. Histologic examination in 15 animals 4 weeks after pericardial access did not reveal any delivery-related myocardial damage. The safety, ease, and absence of hemodynamic compromise make this technique a potentially useful method for intrapericardial drug delivery and a good alternative to standard pericardiocentesis in patients with small pericardial effusions at higher risk for complications.

Genetic diversity and structure of Brazilian ginger germplasm (Zingiber officinale) revealed by AFLP markers.

PubMed

Blanco, Eleonora Zambrano; Bajay, Miklos Maximiliano; Siqueira, Marcos Vinícius Bohrer Monteiro; Zucchi, Maria Imaculada; Pinheiro, José Baldin

2016-12-01

Ginger is a vegetable with medicinal and culinary properties widely cultivated in the Southern and Southeastern Brazil. The knowledge of ginger species' genetic variability is essential to direct correctly future studies of conservation and genetic improvement, but in Brazil, little is known about this species' genetic variability. In this study, we analyzed the genetic diversity and structure of 55 Brazilian accessions and 6 Colombian accessions of ginger, using AFLP (Amplified Fragment Length Polymorphism) molecular markers. The molecular characterization was based on 13 primers combinations, which generated an average of 113.5 polymorphic loci. The genetic diversity estimates of Nei (Hj), Shannon-Weiner index (I) and an effective number of alleles (n e ) were greater in the Colombian accessions in relation to the Brazilian accessions. The analysis of molecular variance showed that most of the genetic variation occurred between the two countries while in the Brazilian populations there is no genetic structure and probably each region harbors 100 % of genetic variation found in the samples. The bayesian model-based clustering and the dendrogram using the dissimilarity's coefficient of Jaccard were congruent with each other and showed that the Brazilian accessions are highly similar between themselves, regardless of the geographic region of origin. We suggested that the exploration of the interspecific variability and the introduction of new varieties of Z.officinale are viable alternatives for generating diversity in breeding programs in Brazil. The introduction of new genetic materials will certainly contribute to a higher genetic basis of such crop.

Why do we need an oral health care policy in Canada?

PubMed

Leake, James L

2006-05-01

Although health care is a right of citizenship, severe inequities in oral health and access to care persist. This paper provides information on the financing, organization and delivery of oral health services in Canada. It concludes that dental care has largely fallen out of consideration as health care. The increasing costs of dental insurance and disparities in oral health and access to care threaten the system"s sustainability. The legislation that allows the insured to receive tax-free care and requires all taxpayers to subsidize that expenditure is socially unjust. Unless an alternative direction is taken, dentistry will lose its relevance as a profession working for the public good and this will be followed by further erosion of public support for dental education and research. However, never before have we had the opportunity presented by high levels of oral health, the extensive resources already allocated to oral health care, plus the support of other organizations to allow us to consider what else we might do. One of the first steps would be to establish new models for the delivery of preventive measures and care that reach out to those who do not now enjoy access.

UNIX security in a supercomputing environment

NASA Technical Reports Server (NTRS)

Bishop, Matt

1989-01-01

The author critiques some security mechanisms in most versions of the Unix operating system and suggests more effective tools that either have working prototypes or have been implemented, for example in secure Unix systems. Although no computer (not even a secure one) is impenetrable, breaking into systems with these alternate mechanisms will cost more, require more skill, and be more easily detected than penetrations of systems without these mechanisms. The mechanisms described fall into four classes (with considerable overlap). User authentication at the local host affirms the identity of the person using the computer. The principle of least privilege dictates that properly authenticated users should have rights precisely sufficient to perform their tasks, and system administration functions should be compartmentalized; to this end, access control lists or capabilities should either replace or augment the default Unix protection system, and mandatory access controls implementing multilevel security models and integrity mechanisms should be available. Since most users access supercomputing environments using networks, the third class of mechanisms augments authentication (where feasible). As no security is perfect, the fourth class of mechanism logs events that may indicate possible security violations; this will allow the reconstruction of a successful penetration (if discovered), or possibly the detection of an attempted penetration.

Vascular Access Type and Patient and Technique Survival in Home Hemodialysis Patients: The Canadian Organ Replacement Register.

PubMed

Perl, Jeffrey; Nessim, Sharon J; Moist, Louise M; Wald, Ron; Na, Yingbo; Tennankore, Karthik K; Chan, Christopher T

2016-02-01

While central venous catheter (CVC) use has expanded home hemodialysis (HHD) eligibility to many patients who may be unable to self-cannulate an arteriovenous (AV) access, the association between CVC use and mortality has not been directly examined among HHD patients. Registry-based retrospective observational cohort study. Incident HHD patients in The Canadian Organ Replacement Register who had information for vascular access type (CVC vs AV access) within the first year of HHD therapy initiation. Use of a CVC versus an AV access (AV fistula or graft) within the first year of HHD therapy initiation. The composite of all-cause mortality and technique failure (long-term transfer to an alternate dialysis modality). A Cox proportional hazards model was used to evaluate the adjusted composite outcome and each outcome separately. 1,869 patients initiated HHD therapy in Canada in 1996 to 2012, of whom 1,217 had an access type recorded within the first year of HHD therapy initiation. Compared to CVC use (n=523) and during a median follow-up of 513 and 427 days for AV access and CVC patients, respectively, AV access use (n=694) was associated with lower risk for the composite event of death and technique failure (490 events; adjusted HR, 0.78; 95% CI, 0.64-0.94) and lower adjusted all-cause mortality (129 deaths; adjusted HR, 0.63; 95% CI, 0.43-0.91); the risk for technique failure was nominally lower, but this result was not statistically significant (361 events; adjusted HR, 0.84; 95% CI, 0.67-1.05). Results were robust to sensitivity analyses and after missing data imputation. Missing information for vascular access type (n=659[35% of patients]) and lack of information for longitudinal changes in vascular access type. Compared to CVC use, AV access use was associated with superior survival. Minimizing CVC use and maximizing AV access use while addressing barriers to their placement and self-cannulation may improve HHD outcomes. Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Age and choice in health insurance: evidence from a discrete choice experiment.

PubMed

Becker, Karolin; Zweifel, Peter

2008-01-01

A uniform package of benefits and uniform cost sharing are elements of regulation inherent in most social health insurance systems. Both elements risk burdening the population with a welfare loss if preferences for risk and insurance attributes differ. This suggests the introduction of more choice in social health insurance packages may be advantageous; however, it is widely believed that this would not benefit the elderly.A representative telephone survey of 1000 people aged >24 years living in the German- and French-speaking parts of Switzerland was conducted. Participants were asked to compare the status quo (i.e. their current insurance contract) with ten hypothetical alternatives. In addition, participants were asked questions concerning utilization of healthcare services; overall satisfaction with the healthcare system, insurer and insurance policy; and a general preference for new elements in the insurance package. Socioeconomic variables surveyed were age, sex, total household income, education (seven categories ranging from primary school to university degree), place of residence, occupation, and marital status. To examine the relationship between age and willingness to pay (WTP) for additional options in Swiss social health insurance.A representative telephone survey of 1000 people aged >24 years living in the German- and French-speaking parts of Switzerland was conducted. Participants were asked to compare the status quo (i.e. their current insurance contract) with ten hypothetical alternatives. In addition, participants were asked questions concerning utilization of healthcare services; overall satisfaction with the healthcare system, insurer and insurance policy; and a general preference for new elements in the insurance package. Socioeconomic variables surveyed were age, sex, total household income, education (seven categories ranging from primary school to university degree), place of residence, occupation, and marital status. A discrete choice experiment was developed using six attributes (deductibles, co-payment, access to alternative medicines, medication choice, access to innovation, and monthly premium) that are currently in debate within the context of Swiss health insurance. These attributes have been shown to be important in the choice of insurance contract. Using statistical design optimization procedures, the number of choice sets was reduced to 27 and randomly split into three groups. One choice was included twice to test for consistency. Two random effects probit models were developed: a simple model where marginal utilities and WTP values were not allowed to vary according to socioeconomic characteristics, and a more complex model where the values were permitted to depend on socioeconomic variables.A representative telephone survey of 1000 people aged >24 years living in the German- and French-speaking parts of Switzerland was conducted. Participants were asked to compare the status quo (i.e. their current insurance contract) with ten hypothetical alternatives. In addition, participants were asked questions concerning utilization of healthcare services; overall satisfaction with the healthcare system, insurer and insurance policy; and a general preference for new elements in the insurance package. Socioeconomic variables surveyed were age, sex, total household income, education (seven categories ranging from primary school to university degree), place of residence, occupation, and marital status. All chosen elements proved relevant for choice in the simple model. Accounting for socioeconomic characteristics in the comprehensive model reveals preference heterogeneity for contract attributes, but also for the propensity to consider deviating from the status quo and choosing an alternative health insurance contract. The findings suggest that while the elderly do exhibit a stronger status quo bias than younger age groups, they require less rather than more specific compensation for selected cutbacks, indicating a potential for contracts that induce self-rationing in return for lower premiums.

Traditional, complementary, and alternative medicine approaches to mental health care and psychological wellbeing in India and China.

PubMed

Thirthalli, Jagadisha; Zhou, Liang; Kumar, Kishore; Gao, Jie; Vaid, Henna; Liu, Huiming; Hankey, Alex; Wang, Guojun; Gangadhar, Bangalore N; Nie, Jing-Bao; Nichter, Mark

2016-07-01

India and China face the same challenge of having too few trained psychiatric personnel to manage effectively the substantial burden of mental illness within their population. At the same time, both countries have many practitioners of traditional, complementary, and alternative medicine who are a potential resource for delivery of mental health care. In our paper, part of The Lancet and Lancet Psychiatry's Series about the China-India Mental Health Alliance, we describe and compare types of traditional, complementary, and alternative medicine in India and China. Further, we provide a systematic overview of evidence assessing the effectiveness of these alternative approaches for mental illness and discuss challenges in research. We suggest how practitioners of traditional, complementary, and alternative medicine and mental health professionals might forge collaborative relationships to provide more accessible, affordable, and acceptable mental health care in India and China. A substantial proportion of individuals with mental illness use traditional, complementary, and alternative medicine, either exclusively or with biomedicine, for reasons ranging from faith and cultural congruence to accessibility, cost, and belief that these approaches are safe. Systematic reviews of the effectiveness of traditional, complementary, and alternative medicine find several approaches to be promising for treatment of mental illness, but most clinical trials included in these systematic reviews have methodological limitations. Contemporary methods to establish efficacy and safety-typically through randomised controlled trials-need to be complemented by other means. The community of practice built on collaborative relationships between practitioners of traditional, complementary, and alternative medicine and providers of mental health care holds promise in bridging the treatment gap in mental health care in India and China. Copyright © 2016 Elsevier Ltd. All rights reserved.

Polygyny, mate-guarding, and posthumous fertilization as alternative male mating strategies

PubMed Central

Zamudio, Kelly R.; Sinervo, Barry

2000-01-01

Alternative male mating strategies within populations are thought to be evolutionarily stable because different behaviors allow each male type to successfully gain access to females. Although alternative male strategies are widespread among animals, quantitative evidence for the success of discrete male strategies is available for only a few systems. We use nuclear microsatellites to estimate the paternity rates of three male lizard strategies previously modeled as a rock-paper-scissors game. Each strategy has strengths that allow it to outcompete one morph, and weaknesses that leave it vulnerable to the strategy of another. Blue-throated males mate-guard their females and avoid cuckoldry by yellow-throated “sneaker” males, but mate-guarding is ineffective against aggressive orange-throated neighbors. The ultradominant orange-throated males are highly polygynous and maintain large territories; they overpower blue-throated neighbors and cosire offspring with their females, but are often cuckolded by yellow-throated males. Finally, yellow-throated sneaker males sire offspring via secretive copulations and often share paternity of offspring within a female's clutch. Sneaker males sire more offspring posthumously, indicating that sperm competition may be an important component of their strategy. PMID:11106369

Investigating the over-representation of older persons in do-it-yourself home maintenance injury and barriers to prevention.

PubMed

Ashby, K; Ozanne-Smith, J; Fox, B

2007-10-01

To examine why older persons undertake high-risk do-it-yourself (DIY) home maintenance and under what circumstances, what constitutes acceptable low-risk alternatives to DIY, and to assess if alternatives are feasible in the current context. Exploratory qualitative study using focus-group methodology. Fifteen focus groups were conducted, involving 118 persons aged 60 years and older, in two Melbourne communities. Participants resided locally, participated in local seniors groups, or received treatment for a DIY injury at one of two public hospitals serving these communities. Older persons' involvement in DIY ranged from necessity to choice. A number chose DIY for general fitness enhancement, satisfaction and pride in a job well done, and giving meaning and enjoyment to daily tasks. However, some older, frailer seniors were forced into DIY because of difficulties in choosing appropriate alternatives; lack of knowledge of some available resources and services; the challenge of accessing cost-effective and reliable private service providers; and fear of vulnerability to overcharging, overservicing or their personal security. Preferred DIY alternatives were local government providers, local paper advertised services, recommendations to private service providers and family, friends or neighbors. Lack of knowledge of other existing alternatives was an impediment to preventing DIY injury, or accessing DIY alternatives. A number of potentially feasible alternatives to DIY were identified from our review. This research is an important first step in understanding issues facing community-dwelling seniors remaining at home, and provides a basis on which government agencies and other providers can develop services to meet increasing needs.

Stan : A Probabilistic Programming Language

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

Carpenter, Bob; Gelman, Andrew; Hoffman, Matthew D.

Stan is a probabilistic programming language for specifying statistical models. A Stan program imperatively defines a log probability function over parameters conditioned on specified data and constants. As of version 2.14.0, Stan provides full Bayesian inference for continuous-variable models through Markov chain Monte Carlo methods such as the No-U-Turn sampler, an adaptive form of Hamiltonian Monte Carlo sampling. Penalized maximum likelihood estimates are calculated using optimization methods such as the limited memory Broyden-Fletcher-Goldfarb-Shanno algorithm. Stan is also a platform for computing log densities and their gradients and Hessians, which can be used in alternative algorithms such as variational Bayes, expectationmore » propagation, and marginal inference using approximate integration. To this end, Stan is set up so that the densities, gradients, and Hessians, along with intermediate quantities of the algorithm such as acceptance probabilities, are easily accessible. Stan can also be called from the command line using the cmdstan package, through R using the rstan package, and through Python using the pystan package. All three interfaces support sampling and optimization-based inference with diagnostics and posterior analysis. rstan and pystan also provide access to log probabilities, gradients, Hessians, parameter transforms, and specialized plotting.« less

When do combinatorial mechanisms apply in the production of inflected words?

PubMed

Cholin, Joana; Rapp, Brenda; Miozzo, Michele

2010-01-01

A central question for theories of inflected word processing is to determine under what circumstances compositional procedures apply. Some accounts (e.g., the dual-mechanism model; Clahsen, 1999 ) propose that compositional processes only apply to verbs that take productive affixes. For all other verbs, inflected forms are assumed to be stored in the lexicon in a nondecomposed manner. This account makes clear predictions about the consequences of disruption to the lexical access mechanisms involved in the spoken production of inflected forms. Briefly, it predicts that nonproductive forms (which require lexical access) should be more affected than productive forms (which, depending on the language task, may not). We tested these predictions through the detailed analysis of the spoken production of a German-speaking individual with an acquired lexical impairment resulting from a stroke. Analyses of response accuracy, error types, and frequency effects revealed that combinatorial processes are not restricted to verbs that take productive inflections. On this basis, we propose an alternative account, the stem-based assembly model (SAM), which posits that combinatorial processes may be available to all stems and not only to those that combine with productive affixes.

Shape Sensing Techniques for Continuum Robots in Minimally Invasive Surgery: A Survey.

PubMed

Shi, Chaoyang; Luo, Xiongbiao; Qi, Peng; Li, Tianliang; Song, Shuang; Najdovski, Zoran; Fukuda, Toshio; Ren, Hongliang

2017-08-01

Continuum robots provide inherent structural compliance with high dexterity to access the surgical target sites along tortuous anatomical paths under constrained environments and enable to perform complex and delicate operations through small incisions in minimally invasive surgery. These advantages enable their broad applications with minimal trauma and make challenging clinical procedures possible with miniaturized instrumentation and high curvilinear access capabilities. However, their inherent deformable designs make it difficult to realize 3-D intraoperative real-time shape sensing to accurately model their shape. Solutions to this limitation can lead themselves to further develop closely associated techniques of closed-loop control, path planning, human-robot interaction, and surgical manipulation safety concerns in minimally invasive surgery. Although extensive model-based research that relies on kinematics and mechanics has been performed, accurate shape sensing of continuum robots remains challenging, particularly in cases of unknown and dynamic payloads. This survey investigates the recent advances in alternative emerging techniques for 3-D shape sensing in this field and focuses on the following categories: fiber-optic-sensor-based, electromagnetic-tracking-based, and intraoperative imaging modality-based shape-reconstruction methods. The limitations of existing technologies and prospects of new technologies are also discussed.

When do combinatorial mechanisms apply in the production of inflected words?

PubMed Central

Cholin, Joana; Rapp, Brenda; Miozzo, Michele

2010-01-01

A central question for theories of inflected word processing is to determine under what circumstances compositional procedures apply. Some accounts (e.g., the Dual Mechanism Model; Clahsen, 1999) propose that compositional processes only apply to verbs that take productive affixes. For all other verbs, inflected forms are assumed to be stored in the lexicon in a non-decomposed manner. This account makes clear predictions about the consequences of disruption to the lexical access mechanisms involved in the spoken production of inflected forms. Briefly, it predicts that non-productive forms (which require lexical access) should be more affected than productive forms (which, depending on the language task, may not). We tested these predictions through the detailed analysis of the spoken production of a German-speaking individual with an acquired lexical impairment resulting from a stroke. Analyses of response accuracy, error types, and frequency effects revealed that combinatorial processes are not restricted to verbs that take productive inflections. On this basis, we propose an alternative account, the Stem-based Assembly Model (SAM) that posits that combinatorial processes may be available to all stems, and not only those that combine with productive affixes. PMID:21104479

Stan : A Probabilistic Programming Language

DOE PAGES

Carpenter, Bob; Gelman, Andrew; Hoffman, Matthew D.; ...

2017-01-01

Stan is a probabilistic programming language for specifying statistical models. A Stan program imperatively defines a log probability function over parameters conditioned on specified data and constants. As of version 2.14.0, Stan provides full Bayesian inference for continuous-variable models through Markov chain Monte Carlo methods such as the No-U-Turn sampler, an adaptive form of Hamiltonian Monte Carlo sampling. Penalized maximum likelihood estimates are calculated using optimization methods such as the limited memory Broyden-Fletcher-Goldfarb-Shanno algorithm. Stan is also a platform for computing log densities and their gradients and Hessians, which can be used in alternative algorithms such as variational Bayes, expectationmore » propagation, and marginal inference using approximate integration. To this end, Stan is set up so that the densities, gradients, and Hessians, along with intermediate quantities of the algorithm such as acceptance probabilities, are easily accessible. Stan can also be called from the command line using the cmdstan package, through R using the rstan package, and through Python using the pystan package. All three interfaces support sampling and optimization-based inference with diagnostics and posterior analysis. rstan and pystan also provide access to log probabilities, gradients, Hessians, parameter transforms, and specialized plotting.« less

Payment Reform to Enhance Collaboration of Primary Care and Cardiology: A Review.

PubMed

Farmer, Steven A; Casale, Paul N; Gillam, Linda D; Rumsfeld, John S; Erickson, Shari; Kirschner, Neil M; de Regnier, Kevin; Williams, Bruce R; Martin, R Shawn; McClellan, Mark B

2018-01-01

The US health care system faces an unsustainable trajectory of high costs and inconsistent outcomes. The fee-for-service payment model has contributed to inefficiency, and new payment methods are a promising approach to improving value. Health reforms are needed to increase patient access, reduce costs, and improve health care quality, and the landmark Medicare Access and CHIP Reauthorization Act presents a roadmap for reform. The product of a collaboration between primary care and cardiology clinicians, this review describes a conceptual approach to delivery and payment reforms that aim to better support primary care-cardiology comanagement of chronic cardiovascular disease (CVD). Few existing alternative payment models specifically address long-term management of CVD. Primary care medical homes and accountable care organizations come closest, but both emphasize primary care, and cardiologists have often not been well engaged. A collaborative care framework should articulate distinct roles and responsibilities for primary care and cardiology in CVD comanagement. Finally, a series of payment models aim to better support clinicians in providing accountable, seamless, and patient-centered cardiac care. Clinical leadership is essential during this time of change in the health care system. Patients often struggle to navigate a fragmented and expensive system, whereas clinicians often practice with incomplete information about tests, treatments, and recommendations by their colleagues. The payment models described in this review offer an opportunity to create more satisfying approaches to patient care while improving value. These models have potential to support more effective coordination and to facilitate broader health care system transformation.

Using health psychology techniques to manage chronic physical symptoms.

PubMed

Barley, Elizabeth; Lawson, Victoria

2016-12-08

Chest pain and palpitations, non-malignant pain, breathlessness and fatigue often endure despite the receipt of appropriate nursing and medical care. This is distressing for patients, impacts on their quality of life and ability to function and is associated with high healthcare usage and costs. The cognitive behavioural approach offers nurses a model to understand how people's perceptions and beliefs and their emotional, behavioural and physiological reactions are linked. Common 'thinking errors' which can exacerbate symptom severity and impact are highlighted. Understanding of this model may help nurses to help patients cope better with their symptoms by helping them to come up with alternative more helpful beliefs and practices. Many Improving Access to Psychological Therapy services offer support to people with chronic physical symptoms and nurses are encouraged to sign post patients to them.

Sex and menstrual cycle effects on chronic oral cocaine self-administration in rhesus monkeys: Effects of a nondrug alternative reward

PubMed Central

Carroll, Marilyn E.; Collins, Molly; Kohl, Emily A.; Johnson, Seth; Dougen, Ben

2016-01-01

Background In previous studies female monkeys self-administered more oral phencyclidine (PCP) than males, and PCP intake differed by phase of menstrual cycle. Objectives The purpose of this study was to examine sex and hormonal influences on oral cocaine self-administration in male and female rhesus monkeys in the follicular vs. luteal phases of the menstrual cycle, with concurrent access to an alternative nondrug reward, saccharin (SACC) vs. water. Materials and methods Concurrent access to cocaine (0.2, 0.4 and 0.8 mg/ml) and SACC or water was available from two drinking spouts under concurrent fixed-ratio (FR) 2, 4, and 8 schedules during daily 3-h sessions. Results Cocaine deliveries were similar in males and females in the females’ luteal phase, but cocaine deliveries were higher in females during the follicular phase than the luteal phase and compared to males. When SACC was available cocaine deliveries were reduced in females in the follicular phase of the cycle, and cocaine intake (mg/kg) was reduced in males and in females’ follicular and luteal phases. Conclusions Access to concurrent SACC (vs. water) reduced cocaine intake (mg/kg) in males and in females during both menstrual phases, and the magnitude of the reduction in cocaine intake was greatest during the females’ follicular phase. Thus, a nondrug alternative reward, SACC, is a viable alternative treatment for reducing cocaine’s rewarding effects on male and female monkeys, and reductions in cocaine-seeking were optimal in the females’ luteal phase. PMID:27318989

Transcriptomes of Eight Arabidopsis thaliana Accessions Reveal Core Conserved, Genotype- and Organ-Specific Responses to Flooding Stress1[OPEN

PubMed Central

van Veen, Hans; Vashisht, Divya; Akman, Melis; Girke, Thomas; Mustroph, Angelika; Reinen, Emilie; Kooiker, Maarten; van Tienderen, Peter; Voesenek, Laurentius A.C.J.

2016-01-01

Climate change has increased the frequency and severity of flooding events, with significant negative impact on agricultural productivity. These events often submerge plant aerial organs and roots, limiting growth and survival due to a severe reduction in light reactions and gas exchange necessary for photosynthesis and respiration, respectively. To distinguish molecular responses to the compound stress imposed by submergence, we investigated transcriptomic adjustments to darkness in air and under submerged conditions using eight Arabidopsis (Arabidopsis thaliana) accessions differing significantly in sensitivity to submergence. Evaluation of root and rosette transcriptomes revealed an early transcriptional and posttranscriptional response signature that was conserved primarily across genotypes, although flooding susceptibility-associated and genotype-specific responses also were uncovered. Posttranscriptional regulation encompassed darkness- and submergence-induced alternative splicing of transcripts from pathways involved in the alternative mobilization of energy reserves. The organ-specific transcriptome adjustments reflected the distinct physiological status of roots and shoots. Root-specific transcriptome changes included marked up-regulation of chloroplast-encoded photosynthesis and redox-related genes, whereas those of the rosette were related to the regulation of development and growth processes. We identified a novel set of tolerance genes, recognized mainly by quantitative differences. These included a transcriptome signature of more pronounced gluconeogenesis in tolerant accessions, a response that included stress-induced alternative splicing. This study provides organ-specific molecular resolution of genetic variation in submergence responses involving interactions between darkness and low-oxygen constraints of flooding stress and demonstrates that early transcriptome plasticity, including alternative splicing, is associated with the ability to cope with a compound environmental stress. PMID:27208254

Rational learning and information sampling: on the "naivety" assumption in sampling explanations of judgment biases.

PubMed

Le Mens, Gaël; Denrell, Jerker

2011-04-01

Recent research has argued that several well-known judgment biases may be due to biases in the available information sample rather than to biased information processing. Most of these sample-based explanations assume that decision makers are "naive": They are not aware of the biases in the available information sample and do not correct for them. Here, we show that this "naivety" assumption is not necessary. Systematically biased judgments can emerge even when decision makers process available information perfectly and are also aware of how the information sample has been generated. Specifically, we develop a rational analysis of Denrell's (2005) experience sampling model, and we prove that when information search is interested rather than disinterested, even rational information sampling and processing can give rise to systematic patterns of errors in judgments. Our results illustrate that a tendency to favor alternatives for which outcome information is more accessible can be consistent with rational behavior. The model offers a rational explanation for behaviors that had previously been attributed to cognitive and motivational biases, such as the in-group bias or the tendency to prefer popular alternatives. 2011 APA, all rights reserved

The Costs, Benefits, and Cost-Effectiveness of Interventions to Reduce Maternal Morbidity and Mortality in Mexico

PubMed Central

Hu, Delphine; Bertozzi, Stefano M.; Gakidou, Emmanuela; Sweet, Steve; Goldie, Sue J.

2007-01-01

Background In Mexico, the lifetime risk of dying from maternal causes is 1 in 370 compared to 1 in 2,500 in the U.S. Although national efforts have been made to improve maternal services in the last decade, it is unclear if Millennium Development Goal 5 - to reduce maternal mortality by three-quarters by 2015 - will be met. Methodology/Principal Findings We developed an empirically calibrated model that simulates the natural history of pregnancy and pregnancy-related complications in a cohort of 15-year-old women followed over their lifetime. After synthesizing national and sub-national trends in maternal mortality, the model was calibrated to current intervention-specific coverage levels and validated by comparing model-projected life expectancy, total fertility rate, crude birth rate and maternal mortality ratio with Mexico-specific data. Using both published and primary data, we assessed the comparative health and economic outcomes of alternative strategies to reduce maternal morbidity and mortality. A dual approach that increased coverage of family planning by 15%, and assured access to safe abortion for all women desiring elective termination of pregnancy, reduced mortality by 43% and was cost saving compared to current practice. The most effective strategy added a third component, enhanced access to comprehensive emergency obstetric care for at least 90% of women requiring referral. At a national level, this strategy reduced mortality by 75%, cost less than current practice, and had an incremental cost-effectiveness ratio of $300 per DALY relative to the next best strategy. Analyses conducted at the state level yielded similar results. Conclusions/Significance Increasing the provision of family planning and assuring access to safe abortion are feasible, complementary and cost-effective strategies that would provide the greatest benefit within a short-time frame. Incremental improvements in access to high-quality intrapartum and emergency obstetric care will further reduce maternal deaths and disability. PMID:17710149

Co-production as an approach to developing stakeholder partnerships to reduce mental health inequalities: an evaluation of a pilot service.

PubMed

Lwembe, Saumu; Green, Stuart A; Chigwende, Jennifer; Ojwang, Tom; Dennis, Ruth

2017-01-01

Aim This study aimed to evaluate a pilot cross-sector initiative - bringing together public health, a community group, primary mental health teams and patients - in using co-production approaches to deliver a mental health service to meet the needs of the black and minority ethnic communities. Black and minority ethnic communities continue to face inequalities in mental health service access and provision. They are under-represented in low-level interventions as they are less likely to be referred, and more likely to disengage from mainstream mental health services. Effective models that lead to improved access and better outcomes are yet to be established. It has long been recognised that to be effective, services need to be more culturally competent, which may be achieved through a co-production approach. This study aimed to evaluate the role of co-production in the development of a novel community mental health service for black and minority ethnic service users. Qualitative research methods, including semi-structured interviews and focus groups, were used to collect data to examine the use of co-production methods in designing and delivering an improved mental health service. Findings Twenty-five patients enrolled into the study; of these, 10 were signposted for more intensive psychological support. A 75% retention rate was recorded (higher than is generally the case for black and minority ethnic service users). Early indications are that the project has helped overcome barriers to accessing mental health services. Although small scale, this study highlights an alternative model that, if explored and developed further, could lead to delivery of patient-centred services to improve access and patient experience within mental health services, particularly for black and minority ethnic communities.

A dynamic simulation based water resources education tool.

PubMed

Williams, Alison; Lansey, Kevin; Washburne, James

2009-01-01

Educational tools to assist the public in recognizing impacts of water policy in a realistic context are not generally available. This project developed systems with modeling-based educational decision support simulation tools to satisfy this need. The goal of this model is to teach undergraduate students and the general public about the implications of common water management alternatives so that they can better understand or become involved in water policy and make more knowledgeable personal or community decisions. The model is based on Powersim, a dynamic simulation software package capable of producing web-accessible, intuitive, graphic, user-friendly interfaces. Modules are included to represent residential, agricultural, industrial, and turf uses, as well as non-market values, water quality, reservoir, flow, and climate conditions. Supplementary materials emphasize important concepts and lead learners through the model, culminating in an open-ended water management project. The model is used in a University of Arizona undergraduate class and within the Arizona Master Watershed Stewards Program. Evaluation results demonstrated improved understanding of concepts and system interactions, fulfilling the project's objectives.

Growth performance of fast growing broilers reared under different types of production systems with outdoor access: Implications for organic and alternative production systems

USDA-ARS?s Scientific Manuscript database

Outdoor access is an important part of organic and free range poultry production, yet there is limited information on the impact of various housing and production systems on growth performance and colonization of foodborne pathogens. Therefore, the primary purpose of this study was to evaluate the ...

Use of certain alternative fuels in road transport in Poland

NASA Astrophysics Data System (ADS)

Gis, W.; Pielecha, J.; Waśkiewicz, J.; Gis, M.; Menes, M.

2016-09-01

The development of biomethane and hydrogen technology in the road transport in the EU countries is recommended, among the others, in the Directive of the European Parliament and of the Council 2014/94/EU of 22 October 2014. Under the provisions of the said Directive, it is recommended to EU countries to use biomethane and progressively ensure accessibility to hydrogen cars on their territories, and above all to ensure the possibility of driving hydrogen vehicles between the member States. The territorial accessibility for biomethane vehicles is determined by the availability of biomethane refuelling infrastructure in the first place in cities and then on the road network distances recommended in this directive. The territorial accessibility for hydrogen vehicles is determined by the availability of hydrogen refuelling infrastructure, in the first place along the TEN-T network. The article presents the possibilities of using these alternative fuels in Poland, presenting some of the results of research and analysis in this area.

77 FR 37707 - Draft Environmental Impact Statement on Brooks River Visitor Access for Katmai National Park and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-22

... floating bridge and sites to relocate the existing Naknek Lake barge landing area at the mouth of the... landing site on Naknek Lake. Alternative 3: This alternative evaluates construction of a new bridge and... barge landing site would be located approximately 200 feet south of the mouth of the Brooks River. A new...

Technology Learning Activities. Design Brief--Measuring Inaccessible Distances. Alternative Energy Sources: Designing a Wind Powered Generator. Alternative Energy Sources: Designing a Hot Dog Heater Using Solar Energy.

ERIC Educational Resources Information Center

Technology Teacher, 1991

1991-01-01

These three learning activities are on measuring accessible distances, designing a wind powered generator, and designing a hot dog heater using solar energy. Each activity includes description of context, objectives, list of materials and equipment, challenge to students, and evaluation questions. (SK)

Balancing Accession and Retention. Cost and Productivity Tradeoffs.

DTIC Science & Technology

1983-03-01

Alternative ...’ i :. :- : . - :’: .-- . .:. . ,. , . -.- - - i . . . , . . -. - - .- - - . ’ ’:- LIST OF TABLES Page I Rating groups...for bonus payments and second-term pay are more than offset by reductions in recruiting and training costs and first-term pay. Alternatively , holding...discounted value using a 10 percent discount rate. Costs for AFEES processing and training are taken from the Navy Comprehensive Compensation and Supply

Economic comparisons of haul road construction versus forwarding versus longer skid distances

Treesearch

Michael D. Erickson; Curt C. Hassler; Chris B. LeDoux

1992-01-01

There currently exists no set of basic guidelines for Appalachian loggers to use in the decision making process for selecting the best way to harvest a tract of timber. Specifically, guidelines are needed for deciding between the alternatives of constructing truck haul roads to access an area or other alternatives such as skidding or forwarding timber longer distances...

Alternative Pathways to Talent Development in Music: The Narrative of an Eminent Filipino Singer-Songwriter

ERIC Educational Resources Information Center

Garces-Bacsal, Rhoda Myra

2014-01-01

The narrative of an eminent Filipino singer-songwriter, Noel Cabangon, provides a description of an alternative pathway to musical talent development. Most theories on talent development assume that a young artist would have access to the resources required for one to advance in the domain. The results of multiple in-depth interviews suggested…

Accessing the Unsaid: The Role of Scalar Alternatives in Children's Pragmatic Inference

ERIC Educational Resources Information Center

Barner, David; Brooks, Neon; Bale, Alan

2011-01-01

When faced with a sentence like, "Some of the toys are on the table", adults, but not preschoolers, compute a scalar implicature, taking the sentence to imply that not all the toys are on the table. This paper explores the hypothesis that children fail to compute scalar implicatures because they lack knowledge of relevant scalar alternatives to…

Postsecondary Alternatives to Meet the Educational Needs of California's Adults. A Feasibility Study Prepared for the California Legislature. Final Report.

ERIC Educational Resources Information Center

Peterson, Richard E.; And Others

This report explains why California should invest in the continued education of its adult citizens and recommends 17 steps as the most urgently needed investment now. The report has two main themes: First, California should increasingly conceive of providing accessible and diversified postsecondary learning alternatives to meet the educational…

25 CFR 542.21 - What are the minimum internal control standards for drop and count for Tier A gaming operations?

Code of Federal Regulations, 2013 CFR

2013-04-01

.... Alternatively, it may be adequately secured (e.g., locked container to which only accounting personnel can gain... secured (e.g., locked container to which only accounting personnel can gain access) until retrieved by the...) Alternatively, a smart bucket system that electronically identifies and tracks the gaming machine number, and...

25 CFR 542.21 - What are the minimum internal control standards for drop and count for Tier A gaming operations?

Code of Federal Regulations, 2014 CFR

2014-04-01

.... Alternatively, it may be adequately secured (e.g., locked container to which only accounting personnel can gain... secured (e.g., locked container to which only accounting personnel can gain access) until retrieved by the...) Alternatively, a smart bucket system that electronically identifies and tracks the gaming machine number, and...

25 CFR 542.21 - What are the minimum internal control standards for drop and count for Tier A gaming operations?

Code of Federal Regulations, 2011 CFR

2011-04-01

.... Alternatively, it may be adequately secured (e.g., locked container to which only accounting personnel can gain... secured (e.g., locked container to which only accounting personnel can gain access) until retrieved by the...) Alternatively, a smart bucket system that electronically identifies and tracks the gaming machine number, and...

25 CFR 542.21 - What are the minimum internal control standards for drop and count for Tier A gaming operations?

Code of Federal Regulations, 2012 CFR

2012-04-01

.... Alternatively, it may be adequately secured (e.g., locked container to which only accounting personnel can gain... secured (e.g., locked container to which only accounting personnel can gain access) until retrieved by the...) Alternatively, a smart bucket system that electronically identifies and tracks the gaming machine number, and...

"It's the Best Thing I've Done in a Long While": Teenage Mothers' Experiences of Educational Alternatives

ERIC Educational Resources Information Center

Vincent, Kerry

2016-01-01

Pregnant and mothering schoolgirls have been identified as an educationally vulnerable group. Many are not welcomed in their mainstream schools and as a consequence, access a range of educational alternatives. This article presents the views and experiences of 14 young women in the English Midlands, who became pregnant while still of statutory…

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

Calm, J.M.

The Refrigerant Database is an information system on alternative refrigerants, associated lubricants, and their use in air conditioning and refrigeration. It consolidates and facilities access to property, compatibility, environmental, safety, application and other information. It provides corresponding information on older refrigerants, to assist manufacturers and those using alternative refrigerants, to make comparisons and determine differences. The underlying purpose is to accelerate phase out of chemical compounds of environmental concern.

Empirical support for global integrated assessment modeling: Productivity trends and technological change in developing countries' agriculture and electric power sectors

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

Sathaye, Jayant A.

2000-04-01

Integrated assessment (IA) modeling of climate policy is increasingly global in nature, with models incorporating regional disaggregation. The existing empirical basis for IA modeling, however, largely arises from research on industrialized economies. Given the growing importance of developing countries in determining long-term global energy and carbon emissions trends, filling this gap with improved statistical information on developing countries' energy and carbon-emissions characteristics is an important priority for enhancing IA modeling. Earlier research at LBNL on this topic has focused on assembling and analyzing statistical data on productivity trends and technological change in the energy-intensive manufacturing sectors of five developing countries,more » India, Brazil, Mexico, Indonesia, and South Korea. The proposed work will extend this analysis to the agriculture and electric power sectors in India, South Korea, and two other developing countries. They will also examine the impact of alternative model specifications on estimates of productivity growth and technological change for each of the three sectors, and estimate the contribution of various capital inputs--imported vs. indigenous, rigid vs. malleable-- in contributing to productivity growth and technological change. The project has already produced a data resource on the manufacturing sector which is being shared with IA modelers. This will be extended to the agriculture and electric power sectors, which would also be made accessible to IA modeling groups seeking to enhance the empirical descriptions of developing country characteristics. The project will entail basic statistical and econometric analysis of productivity and energy trends in these developing country sectors, with parameter estimates also made available to modeling groups. The parameter estimates will be developed using alternative model specifications that could be directly utilized by the existing IAMs for the manufacturing, agriculture, and electric power sectors.« less

Developmental Pathways from Parental Socioeconomic Status to Adolescent Substance Use: Alternative and Complementary Reinforcement.

PubMed

Lee, Jungeun Olivia; Cho, Junhan; Yoon, Yoewon; Bello, Mariel S; Khoddam, Rubin; Leventhal, Adam M

2018-02-01

Although lower socioeconomic status has been linked to increased youth substance use, much less research has determined potential mechanisms explaining the association. The current longitudinal study tested whether alternative (i.e., pleasure gained from activities without any concurrent use of substances) and complementary (i.e., pleasure gained from activities in tandem with substance use) reinforcement mediate the link between lower socioeconomic status and youth substance use. Further, we tested whether alternative and complementary reinforcement and youth substance use gradually unfold over time and then intersect with one another in a cascading manner. Potential sex differences are also examined. Data were drawn from a longitudinal survey of substance use and mental health among high school students in Los Angeles. Data collection involved four semiannual assessment waves beginning in fall 2013 (N = 3395; M baseline age = 14.1; 47% Hispanic, 16.2% Asian, 16.1% multiethnic, 15.7% White, and 5% Black; 53.4% female). The results from a negative binomial path model suggested that lower parental socioeconomic status (i.e., lower parental education) was significantly related to an increased number of substances used by youth. The final path model revealed that the inverse association was statistically mediated by adolescents' diminished engagement in pleasurable substance-free activities (i.e., alternative reinforcers) and elevated engagement in pleasurable activities paired with substance use (i.e., complementary reinforcers). The direct effect of lower parental education on adolescent substance use was not statistically significant after accounting for the hypothesized mediating mechanisms. No sex differences were detected. Increasing access to and engagement in pleasant activities of high quality that do not need a reinforcement enhancer, such as substances, may be useful in interrupting the link between lower parental socioeconomic status and youth substance use.

Temporal abstraction-based clinical phenotyping with Eureka!

PubMed

Post, Andrew R; Kurc, Tahsin; Willard, Richie; Rathod, Himanshu; Mansour, Michel; Pai, Akshatha Kalsanka; Torian, William M; Agravat, Sanjay; Sturm, Suzanne; Saltz, Joel H

2013-01-01

Temporal abstraction, a method for specifying and detecting temporal patterns in clinical databases, is very expressive and performs well, but it is difficult for clinical investigators and data analysts to understand. Such patterns are critical in phenotyping patients using their medical records in research and quality improvement. We have previously developed the Analytic Information Warehouse (AIW), which computes such phenotypes using temporal abstraction but requires software engineers to use. We have extended the AIW's web user interface, Eureka! Clinical Analytics, to support specifying phenotypes using an alternative model that we developed with clinical stakeholders. The software converts phenotypes from this model to that of temporal abstraction prior to data processing. The model can represent all phenotypes in a quality improvement project and a growing set of phenotypes in a multi-site research study. Phenotyping that is accessible to investigators and IT personnel may enable its broader adoption.

Mobile-Based Dictionary of Information and Communication Technology

NASA Astrophysics Data System (ADS)

Liando, O. E. S.; Mewengkang, A.; Kaseger, D.; Sangkop, F. I.; Rantung, V. P.; Rorimpandey, G. C.

2018-02-01

This study aims to design and build mobile-based dictionary of information and communication technology applications to provide access to information in the form of glossary of terms in the context of information and communication technologies. Applications built in this study using the Android platform, with SQLite database model. This research uses prototype model development method which covers the stages of communication, Quick Plan, Quick Design Modeling, Construction of Prototype, Deployment Delivery & Feedback, and Full System Transformation. The design of this application is designed in such a way as to facilitate the user in the process of learning and understanding the new terms or vocabularies encountered in the world of information and communication technology. Mobile-based dictionary of Information And Communication Technology applications that have been built can be an alternative to learning literature. In its simplest form, this application is able to meet the need for a comprehensive and accurate dictionary of Information And Communication Technology function.

Automatic computer subprogram selection from application program libraries

NASA Technical Reports Server (NTRS)

Drozdowski, J. M.

1972-01-01

The program ALTLIB (ALTernate LIBrary) which allows a user access to an alternate subprogram library with a minimum effort is discussed. The ALTLIB program selects subprograms from an alternate library file and merges them with the user's program load file. Only subprograms that are called for (directly or indirectly) by the user's programs and that are available on the alternate library file will be selected. ALTLIB eliminates the need for elaborate control-card manipulations to add subprograms from a subprogram file. ALTLIB returns to the user his binary file and the selected subprograms in correct order for a call to the loader. The user supplies the alternate library file. Subprogram requests which are not satisfied from the alternate library file will be satisfied at load time from the system library.

36 CFR 1192.87 - Public information system.

Code of Federal Regulations, 2011 CFR

2011-07-01

... COMPLIANCE BOARD AMERICANS WITH DISABILITIES ACT (ADA) ACCESSIBILITY GUIDELINES FOR TRANSPORTATION VEHICLES... digitized human speech messages, to announce stations and provide other passenger information. Alternative...

36 CFR 1192.103 - Public information system.

Code of Federal Regulations, 2011 CFR

2011-07-01

... COMPLIANCE BOARD AMERICANS WITH DISABILITIES ACT (ADA) ACCESSIBILITY GUIDELINES FOR TRANSPORTATION VEHICLES... speech messages, to announce stations and provide other passenger information. Alternative systems or...

Compact instrument for fluorescence image-guided surgery

NASA Astrophysics Data System (ADS)

Wang, Xinghua; Bhaumik, Srabani; Li, Qing; Staudinger, V. Paul; Yazdanfar, Siavash

2010-03-01

Fluorescence image-guided surgery (FIGS) is an emerging technique in oncology, neurology, and cardiology. To adapt intraoperative imaging for various surgical applications, increasingly flexible and compact FIGS instruments are necessary. We present a compact, portable FIGS system and demonstrate its use in cardiovascular mapping in a preclinical model of myocardial ischemia. Our system uses fiber optic delivery of laser diode excitation, custom optics with high collection efficiency, and compact consumer-grade cameras as a low-cost and compact alternative to open surgical FIGS systems. Dramatic size and weight reduction increases flexibility and access, and allows for handheld use or unobtrusive positioning over the surgical field.

The "for-benefit" academic medical center: a solution for survival.

PubMed

Sabeti, Heerad; Kahn, Marc J; Sachs, Benjamin P

2015-05-01

Academic medical centers (AMCs) are the backbone of the U.S. health care system. They provide a disproportionate share of charity care and serve as a training ground for future physicians. Yet, AMCs face profound economic challenges, from changes in funding to changes in the health care market. To survive, many AMCs will need to form integrated health systems, a process expected to cost tens, if not hundreds, of millions of dollars. Nearly all AMCs are structured as not-for- profit entities, which places restrictions on their ability to forge partnerships, pursue joint ventures, and access private capital, often essential elements for forming such integrated systems. An alternative model known as the "for-benefit" corporation can allow AMCs to retain their important social mission and the other advantages of their not-for-profit status while allowing them flexibility and access to both investment and philanthropic capital. To pursue the for-benefit pathway, AMCs have two options-either they could work within the constraints of existing laws to restructure themselves as for-benefit entities, or they could create, under federal law, a new for-benefit AMC model, allowing for the orderly conversion of not-for-profit AMCs. Essential components of a for-benefit AMC include a social purpose, access to multiple forms of capital, the use of earnings to support its purpose, transparency, aligned compensation, and tax exemptions. Restructuring an AMC as a for-benefit entity enables it to both advance shareholder value and further the public good.

Techno-Economic Analysis of FiWi Access Networks Based on 802.11ac WLAN and NG-PON2 Networks

NASA Astrophysics Data System (ADS)

Breskovic, Damir; Begusic, Dinko

2017-05-01

In this article, techno-economic analysis of a fiber-wireless access network is presented. With high bandwidth capacity of the gigabit passive optical network and with cost-effectiveness of very high throughput 802.11ac wireless local area networks that enable user mobility in the wireless segment, fiber-wireless access networks can be considered as an alternative to the fiber-to-the-home architecture for next generation access networks. Analysis based on the proposed scenario here, shows that a fiber-wireless access network is a more cost-effective solution in densely populated areas, but with some introduced improvements, even other geotypes can be considered as a commercially-viable solution.

Circadian activity rhythms and voluntary ethanol intake in male and female ethanol-preferring rats: effects of long-term ethanol access.

PubMed

Rosenwasser, Alan M; McCulley, Walter D; Fecteau, Matthew

2014-11-01

Chronic alcohol (ethanol) intake alters fundamental properties of the circadian clock. While previous studies have reported significant alterations in free-running circadian period during chronic ethanol access, these effects are typically subtle and appear to require high levels of intake. In the present study we examined the effects of long-term voluntary ethanol intake on ethanol consumption and free-running circadian period in male and female, selectively bred ethanol-preferring P and HAD2 rats. In light of previous reports that intermittent access can result in escalated ethanol intake, an initial 2-week water-only baseline was followed by either continuous or intermittent ethanol access (i.e., alternating 15-day epochs of ethanol access and ethanol deprivation) in separate groups of rats. Thus, animals were exposed to either 135 days of continuous ethanol access or to five 15-day access periods alternating with four 15-day periods of ethanol deprivation. Animals were maintained individually in running-wheel cages under continuous darkness throughout the experiment to allow monitoring of free-running activity and drinking rhythms, and 10% (v/v) ethanol and plain water were available continuously via separate drinking tubes during ethanol access. While there were no initial sex differences in ethanol drinking, ethanol preference increased progressively in male P and HAD2 rats under both continuous and intermittent-access conditions, and eventually exceeded that seen in females. Free-running period shortened during the initial ethanol-access epoch in all groups, but the persistence of this effect showed complex dependence on sex, breeding line, and ethanol-access schedule. Finally, while females of both breeding lines displayed higher levels of locomotor activity than males, there was little evidence for modulation of activity level by ethanol access. These results are consistent with previous findings that chronic ethanol intake alters free-running circadian period, and show further that the development of chronobiological tolerance to ethanol may vary by sex and genotype. Copyright © 2014 Elsevier Inc. All rights reserved.

Cost-effectiveness analysis of unsafe abortion and alternative first-trimester pregnancy termination strategies in Nigeria and Ghana.

PubMed

Hu, Delphine; Grossman, Daniel; Levin, Carol; Blanchard, Kelly; Adanu, Richard; Goldie, Sue J

2010-06-01

To explore the policy implications of increasing access to safe abortion in Nigeria and Ghana, we developed a computer-based decision analytic model which simulates induced abortion and its potential complications in a cohort of women, and comparatively assessed the cost-effectiveness of unsafe abortion and three first-trimester abortion modalities: hospital-based dilatation and curettage, hospital- and clinic-based manual vacuum aspiration (MVA), and medical abortion using misoprostol (MA). Assuming all modalities are equally available, clinic-based MVA is the most cost-effective option in Nigeria. If clinic-based MVA is not available, MA is the next best strategy. Conversely, in Ghana, MA is the most cost-effective strategy, followed by clinic-based MVA if MA is not available. From a real world policy perspective, increasing access to safe abortion in favor over unsafe abortion is the single most important factor in saving lives and societal costs, and is more influential than the actual choice of safe abortion modality.

A two-stage flow-based intrusion detection model for next-generation networks.

PubMed

Umer, Muhammad Fahad; Sher, Muhammad; Bi, Yaxin

2018-01-01

The next-generation network provides state-of-the-art access-independent services over converged mobile and fixed networks. Security in the converged network environment is a major challenge. Traditional packet and protocol-based intrusion detection techniques cannot be used in next-generation networks due to slow throughput, low accuracy and their inability to inspect encrypted payload. An alternative solution for protection of next-generation networks is to use network flow records for detection of malicious activity in the network traffic. The network flow records are independent of access networks and user applications. In this paper, we propose a two-stage flow-based intrusion detection system for next-generation networks. The first stage uses an enhanced unsupervised one-class support vector machine which separates malicious flows from normal network traffic. The second stage uses a self-organizing map which automatically groups malicious flows into different alert clusters. We validated the proposed approach on two flow-based datasets and obtained promising results.

A two-stage flow-based intrusion detection model for next-generation networks

PubMed Central

2018-01-01

The next-generation network provides state-of-the-art access-independent services over converged mobile and fixed networks. Security in the converged network environment is a major challenge. Traditional packet and protocol-based intrusion detection techniques cannot be used in next-generation networks due to slow throughput, low accuracy and their inability to inspect encrypted payload. An alternative solution for protection of next-generation networks is to use network flow records for detection of malicious activity in the network traffic. The network flow records are independent of access networks and user applications. In this paper, we propose a two-stage flow-based intrusion detection system for next-generation networks. The first stage uses an enhanced unsupervised one-class support vector machine which separates malicious flows from normal network traffic. The second stage uses a self-organizing map which automatically groups malicious flows into different alert clusters. We validated the proposed approach on two flow-based datasets and obtained promising results. PMID:29329294

The effect of soft budget constraints on access and quality in hospital care.

PubMed

Shen, Yu-Chu; Eggleston, Karen

2009-06-01

Given an increasingly complex web of financial pressures on providers, studies have examined how hospitals' overall financial health affects different aspects of hospital operations. In our study, we develop an empirical proxy for the concept of soft budget constraint (SBC, Kornai, Kyklos 39:3-30, 1986) as an alternative financial measure of a hospital's overall financial health and offer an initial estimate of the effect of SBCs on hospital access and quality. An organization has a SBC if it can expect to be bailed out rather than shut down. Our conceptual model predicts that hospitals facing softer budget constraints will be associated with less aggressive cost control, and their quality may be better or worse, depending on the scope for damage to quality from noncontractible aspects of cost control. We find that hospitals with softer budget constraints are less likely to shut down safety net services. In addition, hospitals with softer budget constraints appear to have better mortality outcomes for elderly heart attack patients.

Disaggregate demand for conventional and alternative fuelled vehicles in the Census Metropolitan Area of Hamilton, Canada

NASA Astrophysics Data System (ADS)

Potoglou, Dimitrios

The focus of this thesis is twofold. First, it offers insight on how households' car-ownership behaviour is affected by urban form and availability of local-transit at the place of residence, after controlling for socio-economic and demographic characteristics. Second, it addresses the importance of vehicle attributes, household and individual characteristics as well as economic incentives and urban form to potential demand for alternative fuelled vehicles. Data for the empirical analyses of the aforementioned research activities were obtained through an innovative Internet survey, which is also documented in this thesis, conducted in the Census Metropolitan Area of Hamilton. The survey included a retrospective questionnaire of households' number and type of vehicles and a stated choices experiment for assessing the potential demand for alternative fuelled vehicles. Established approaches and emerging trends in automobile demand modelling identified early on in this thesis suggest a disaggregate approach and specifically, the estimation of discrete choice models both for explaining car ownership and vehicle-type choice behaviour. It is shown that mixed and diverse land uses as well as short distances between home and work are likely to decrease the probability of households to own a large number of cars. Regarding the demand for alternative fuelled vehicles, while vehicle attributes are particularly important, incentives such as free parking and access to high occupancy vehicle lanes will not influence the choice of hybrids or alternative fuelled vehicles. An improved understating of households' behaviour regarding the number of cars as well as the factors and trade-offs for choosing cleaner vehicles can be used to inform policy designed to reduce car ownership levels and encourage adoption of cleaner vehicle technologies in urban areas. Finally, the Internet survey sets the ground for further research on implementation and evaluation of this data collection method.

Arterioarterial Prosthetic Loop as an Alternative Approach for Hemodialysis Access.

PubMed

Lei, Wenhui; Ji, Jiansong; Wang, Jian; Jin, Lie; Zou, Hai

2015-10-01

In the present study, we performed an arterioarterial prosthetic loop (AAPL) between the femoral artery and deep femoral artery as a new access in patients who did not have adequate vascular conditions for creating an arteriovenous fistula or graft.Between April 2005 and June 2014, 18 patients received AAPL as a vascular access. During the procedure, a polytetrafluoroethylene graft was anastomosed to the femoral artery and deep femoral artery and looped on the thigh. We assessed the reliability and safety of AAPLs by analyzing complication, primary and secondary patency rates, and postoperative blood flow.Eighteen patients (median age, 66 years; range, 43-96 years) underwent AAPL access placement under the general or local anesthesia. All patients were followed up for 3 to 38 months (mean, 24 months). Primary and secondary patency rates at 6 months were 94.5% and 88.8%, respectively, and at 3 years were 61% and 72%, respectively. After operation, one patient had infection, and another one had fat necrosis at the surgical incision site. To maintain the AAPL function, 5 surgical procedures in 4 grafts, including revision, thrombectomy, excision, and repair for bleeding were performed. More than 5000 hemodialyses were performed efficiently in our center.Our study shows that AAPL loop is an unusual but effective and safe procedure that may be a good alternative for the patients who do not allow the conventional hemodialysis access.

Wireless augmented reality communication system

NASA Technical Reports Server (NTRS)

Devereaux, Ann (Inventor); Agan, Martin (Inventor); Jedrey, Thomas (Inventor)

2006-01-01

The system of the present invention is a highly integrated radio communication system with a multimedia co-processor which allows true two-way multimedia (video, audio, data) access as well as real-time biomedical monitoring in a pager-sized portable access unit. The system is integrated in a network structure including one or more general purpose nodes for providing a wireless-to-wired interface. The network architecture allows video, audio and data (including biomedical data) streams to be connected directly to external users and devices. The portable access units may also be mated to various non-personal devices such as cameras or environmental sensors for providing a method for setting up wireless sensor nets from which reported data may be accessed through the portable access unit. The reported data may alternatively be automatically logged at a remote computer for access and viewing through a portable access unit, including the user's own.

Wireless Augmented Reality Communication System

NASA Technical Reports Server (NTRS)

Jedrey, Thomas (Inventor); Agan, Martin (Inventor); Devereaux, Ann (Inventor)

2014-01-01

The system of the present invention is a highly integrated radio communication system with a multimedia co-processor which allows true two-way multimedia (video, audio, data) access as well as real-time biomedical monitoring in a pager-sized portable access unit. The system is integrated in a network structure including one or more general purpose nodes for providing a wireless-to-wired interface. The network architecture allows video, audio and data (including biomedical data) streams to be connected directly to external users and devices. The portable access units may also be mated to various non-personal devices such as cameras or environmental sensors for providing a method for setting up wireless sensor nets from which reported data may be accessed through the portable access unit. The reported data may alternatively be automatically logged at a remote computer for access and viewing through a portable access unit, including the user's own.

Wireless Augmented Reality Communication System

NASA Technical Reports Server (NTRS)

Agan, Martin (Inventor); Devereaux, Ann (Inventor); Jedrey, Thomas (Inventor)

2016-01-01

The system of the present invention is a highly integrated radio communication system with a multimedia co-processor which allows true two-way multimedia (video, audio, data) access as well as real-time biomedical monitoring in a pager-sized portable access unit. The system is integrated in a network structure including one or more general purpose nodes for providing a wireless-to-wired interface. The network architecture allows video, audio and data (including biomedical data) streams to be connected directly to external users and devices. The portable access units may also be mated to various non-personal devices such as cameras or environmental sensors for providing a method for setting up wireless sensor nets from which reported data may be accessed through the portable access unit. The reported data may alternatively be automatically logged at a remote computer for access and viewing through a portable access unit, including the user's own.

Approaches in highly parameterized inversion-PESTCommander, a graphical user interface for file and run management across networks

USGS Publications Warehouse

Karanovic, Marinko; Muffels, Christopher T.; Tonkin, Matthew J.; Hunt, Randall J.

2012-01-01

Models of environmental systems have become increasingly complex, incorporating increasingly large numbers of parameters in an effort to represent physical processes on a scale approaching that at which they occur in nature. Consequently, the inverse problem of parameter estimation (specifically, model calibration) and subsequent uncertainty analysis have become increasingly computation-intensive endeavors. Fortunately, advances in computing have made computational power equivalent to that of dozens to hundreds of desktop computers accessible through a variety of alternate means: modelers have various possibilities, ranging from traditional Local Area Networks (LANs) to cloud computing. Commonly used parameter estimation software is well suited to take advantage of the availability of such increased computing power. Unfortunately, logistical issues become increasingly important as an increasing number and variety of computers are brought to bear on the inverse problem. To facilitate efficient access to disparate computer resources, the PESTCommander program documented herein has been developed to provide a Graphical User Interface (GUI) that facilitates the management of model files ("file management") and remote launching and termination of "slave" computers across a distributed network of computers ("run management"). In version 1.0 described here, PESTCommander can access and ascertain resources across traditional Windows LANs: however, the architecture of PESTCommander has been developed with the intent that future releases will be able to access computing resources (1) via trusted domains established in Wide Area Networks (WANs) in multiple remote locations and (2) via heterogeneous networks of Windows- and Unix-based operating systems. The design of PESTCommander also makes it suitable for extension to other computational resources, such as those that are available via cloud computing. Version 1.0 of PESTCommander was developed primarily to work with the parameter estimation software PEST; the discussion presented in this report focuses on the use of the PESTCommander together with Parallel PEST. However, PESTCommander can be used with a wide variety of programs and models that require management, distribution, and cleanup of files before or after model execution. In addition to its use with the Parallel PEST program suite, discussion is also included in this report regarding the use of PESTCommander with the Global Run Manager GENIE, which was developed simultaneously with PESTCommander.

[The transformation of the healthcare model in Catalonia to improve the quality of care].

PubMed

Padrosa, Josep Maria; Guarga, Àlex; Brosa, Francesc; Jiménez, Josep; Robert, Roger

2015-11-01

The changes taking place in western countries require health systems to adapt to the public's evolving needs and expectations. The healthcare model in Catalonia is undergoing significant transformation in order to provide an adequate response to this new situation while ensuring the system's sustainability in the current climate of economic crisis. This transformation is based on converting the current disease-centred model which is fragmented into different levels, to a more patient-centred integrated and territorial care model that promotes the use of a shared network of the different specialities, the professionals, resources and levels of care, entering into territorial agreements and pacts which stipulate joint goals or objectives. The changes the Catalan Health Service (CatSalut) has undergone are principally focused on increasing resolution capacity of the primary level of care, eliminating differences in clinical practice, evolving towards more surgery-centred hospitals, promoting alternatives to conventional hospitalization, developing remote care models, concentrating and organizing highly complex care into different sectors at a territorial level and designing specific health codes in response to health emergencies. The purpose of these initiatives is to improve the effectiveness, quality, safety and efficiency of the system, ensuring equal access for the public to these services and ensuring a territorial balance. These changes should be facilitated and promoted using several different approaches, including implementing shared access to clinical history case files, the new model of results-based contracting and payment, territorial agreements, alliances between centres, harnessing the potential of information and communications technology and evaluation of results. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

Final priority; Rehabilitation Services Administration--Assistive Technology Alternative Financing Program. Final priority.

PubMed

2014-08-14

The Assistant Secretary for Special Education and Rehabilitative Services announces a priority under the Assistive Technology Alternative Financing Program administered by the Rehabilitation Services Administration (RSA). The Assistant Secretary may use this priority for competitions in fiscal year (FY) 2014 and later years. This priority is designed to ensure that the Department funds high-quality assistive technology (AT) alternative financing programs (AFPs) that meet rigorous standards in order to enable individuals with disabilities to access and acquire assistive technology devices and services necessary to achieve education, community living, and employment goals.

Characterizing monoclonal antibody structure by carbodiimide/GEE footprinting

PubMed Central

Kaur, Parminder; Tomechko, Sara; Kiselar, Janna; Shi, Wuxian; Deperalta, Galahad; Wecksler, Aaron T; Gokulrangan, Giridharan; Ling, Victor; Chance, Mark R

2014-01-01

Amino acid-specific covalent labeling is well suited to probe protein structure and macromolecular interactions, especially for macromolecules and their complexes that are difficult to examine by alternative means, due to size, complexity, or instability. Here we present a detailed account of carbodiimide-based covalent labeling (with GEE tagging) applied to a glycosylated monoclonal antibody therapeutic, which represents an important class of biologic drugs. Characterization of such proteins and their antigen complexes is essential to development of new biologic-based medicines. In this study, the experiments were optimized to preserve the structural integrity of the protein, and experimental conditions were varied and replicated to establish the reproducibility and precision of the technique. Homology-based models were generated and used to compare the solvent accessibility of the labeled residues, which include D, E, and the C-terminus, against the experimental surface accessibility data in order to understand the accuracy of the approach in providing an unbiased assessment of structure. Data from the protein were also compared to reactivity measures of several model peptides to explain sequence or structure-based variations in reactivity. The results highlight several advantages of this approach. These include: the ease of use at the bench top, the linearity of the dose response plots at high levels of labeling (indicating that the label does not significantly perturb the structure of the protein), the high reproducibility of replicate experiments (<2 % variation in modification extent), the similar reactivity of the 3 target probe residues (as suggested by analysis of model peptides), and the overall positive and significant correlation of reactivity and solvent accessible surface area (the latter values predicted by the homology modeling). Attenuation of reactivity, in otherwise solvent accessible probes, is documented as arising from the effects of positive charge or bond formation between adjacent amine and carboxyl groups, the latter accompanied by observed water loss. The results are also compared with data from hydroxyl radical-mediated oxidative footprinting on the same protein, showing that complementary information is gained from the 2 approaches, although the number of target residues in carbodiimide/GEE labeling is fewer. Overall, this approach is an accurate and precise method for assessing protein structure of biologic drugs. PMID:25484052

Constraints Imposed by the Membrane Selectively Guide the Alternating Access Dynamics of the Glutamate Transporter GltPh

PubMed Central

Lezon, Timothy R.; Bahar, Ivet

2012-01-01

Substrate transport in sodium-coupled amino acid symporters involves a large-scale conformational change that shifts the access to the substrate-binding site from one side of the membrane to the other. The structural change is particularly substantial and entails a unique piston-like quaternary rearrangement in glutamate transporters, as evidenced by the difference between the outward-facing and inward-facing structures resolved for the archaeal aspartate transporter GltPh. These structural changes occur over time and length scales that extend beyond the reach of current fully atomic models, but are regularly explored with the use of elastic network models (ENMs). Despite their success with other membrane proteins, ENM-based approaches for exploring the collective dynamics of GltPh have fallen short of providing a plausible mechanism. This deficiency is attributed here to the anisotropic constraints imposed by the membrane, which are not incorporated into conventional ENMs. Here we employ two novel (to our knowledge) ENMs to demonstrate that one can largely capture the experimentally observed structural change using only the few lowest-energy modes of motion that are intrinsically accessible to the transporter, provided that the surrounding lipid molecules are incorporated into the ENM. The presence of the membrane reduces the overall energy of the transition compared with conventional models, showing that the membrane not only guides the selected mechanism but also acts as a facilitator. Finally, we show that the dynamics of GltPh is biased toward transitions of individual subunits of the trimer rather than cooperative transitions of all three subunits simultaneously, suggesting a mechanism of transport that exploits the intrinsic dynamics of individual subunits. Our software is available online at http://www.membranm.csb.pitt.edu. PMID:22455916

Constraints imposed by the membrane selectively guide the alternating access dynamics of the glutamate transporter GltPh.

PubMed

Lezon, Timothy R; Bahar, Ivet

2012-03-21

Substrate transport in sodium-coupled amino acid symporters involves a large-scale conformational change that shifts the access to the substrate-binding site from one side of the membrane to the other. The structural change is particularly substantial and entails a unique piston-like quaternary rearrangement in glutamate transporters, as evidenced by the difference between the outward-facing and inward-facing structures resolved for the archaeal aspartate transporter Glt(Ph). These structural changes occur over time and length scales that extend beyond the reach of current fully atomic models, but are regularly explored with the use of elastic network models (ENMs). Despite their success with other membrane proteins, ENM-based approaches for exploring the collective dynamics of Glt(Ph) have fallen short of providing a plausible mechanism. This deficiency is attributed here to the anisotropic constraints imposed by the membrane, which are not incorporated into conventional ENMs. Here we employ two novel (to our knowledge) ENMs to demonstrate that one can largely capture the experimentally observed structural change using only the few lowest-energy modes of motion that are intrinsically accessible to the transporter, provided that the surrounding lipid molecules are incorporated into the ENM. The presence of the membrane reduces the overall energy of the transition compared with conventional models, showing that the membrane not only guides the selected mechanism but also acts as a facilitator. Finally, we show that the dynamics of Glt(Ph) is biased toward transitions of individual subunits of the trimer rather than cooperative transitions of all three subunits simultaneously, suggesting a mechanism of transport that exploits the intrinsic dynamics of individual subunits. Our software is available online at http://www.membranm.csb.pitt.edu. Copyright © 2012 Biophysical Society. Published by Elsevier Inc. All rights reserved.

Educational Benefits Analysis. An Examination of the Effects of G.I. Bill Educational Benefits on Service Accessions.

ERIC Educational Resources Information Center

Eisenman, Richard L.; And Others

A study was done to (1) examine the impact of terminating the G.I. Bill in respect to the number, quality, and representativeness of Service accessions (supply of volunteers for military services), and (2) provide a means for measuring the relative costs and benefits of alternative educational programs which might be needed to sustain military…

Making Higher Education More Affordable, One Course Reading at a Time: Academic Libraries as Key Advocates for Open Access Textbooks and Educational Resources

ERIC Educational Resources Information Center

Okamoto, Karen

2013-01-01

Open access textbooks (OATs) and educational resources (OERs) are being lauded as a viable alternative to costly print textbooks. Some academic libraries are joining the OER movement by creating guides to open repositories. Others are promoting OATs and OERs, reviewing them, and even helping to create them. This article analyzes how academic…

Access to Educational Opportunity in Rural Communities: Alternative Patterns of Delivering Vocational Education in Sparsely Populated Areas. Volume 4: The Interdistrict Cooperative Center: A Centralized Center.

ERIC Educational Resources Information Center

Peterson, Roland L.; And Others

The centralized secondary center pattern of inter-school district cooperation is examined in this third of four case studies addressing access of rural students to vocational education. The report identifies essential features of this form of cooperation, details factors facilitating/impeding the operation/maintenance of the cooperative…

Access to Educational Opportunity in Rural Communities: Alternative Patterns of Delivering Vocational Education in Sparsely Populated Areas. Volume 3: The Northwest Multi-District: A Mobile Facilities Center.

ERIC Educational Resources Information Center

Peterson, Roland L.; And Others

Representing the mobile facilities pattern of inter-district cooperation, the Northwest Multi-District case is one of four studies addressing access of rural students to vocational education through inter-school district cooperation. The report identifies essential features of this form of cooperation, details factors facilitating/impeding the…

Multinational Experiment 7: Protecting Access to Space

DTIC Science & Technology

2013-07-08

access to space cost to the design, engineering , production and operation of the spacecraft. They also have an impact on spacecraft mass, thermal...station and provide engineering support to receive data in the agreed format. Step 5 – Implementing interoperability. Once a framework has been...procedures or using alternative means (for example, high-altitude airships ). A7. The results support the view that better mitigation approaches need to

Squeezing the funding you need from today's capital sources.

PubMed

Gordon, Deborah C

2010-04-01

Healthcare providers need to understand traditional and nontraditional financing options and other potential strategies for accessing capital. Common financing options include bonds, commercial lending, acquisition financing, and financing through the Department of Housing and Urban Development's Section 232 program. Alternative strategies for accessing capital include joint ventures, equity, sale of assets, fund-raising, capital leases, internal capital, public grants, and grants from foundations.

The (Re)Construction of a Philosophical and Pedagogical Position for the Foundation Programme at UKZN with Particular Reference to the Biology Module

ERIC Educational Resources Information Center

Kirby, N. F.; Dempster, E. R.

2011-01-01

The Centre for Science Access Foundation Programme at the University of KwaZulu-Natal provides alternative access to tertiary science studies to educationally disadvantaged students. The philosophical basis for this Programme is that of constructivism, as adopted by the original Science Foundation Programme (SFP) which was initiated in 1991 on the…

17 CFR 240.15c3-5 - Risk management controls for brokers or dealers with market access.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 17 Commodity and Securities Exchanges 3 2013-04-01 2013-04-01 false Risk management controls for... Markets § 240.15c3-5 Risk management controls for brokers or dealers with market access. (a) For the... system provided by a broker-dealer operator of an alternative trading system to a non-broker-dealer. (2...

17 CFR 240.15c3-5 - Risk management controls for brokers or dealers with market access.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 17 Commodity and Securities Exchanges 4 2014-04-01 2014-04-01 false Risk management controls for... Markets § 240.15c3-5 Risk management controls for brokers or dealers with market access. (a) For the... system provided by a broker-dealer operator of an alternative trading system to a non-broker-dealer. (2...

Emissions Control in Swirl Stabilized Spray Combusters, an Experimental and Computational Study

DTIC Science & Technology

2007-02-01

dynamics and thus provide an attractive alternative for application in aircraft gas turbine engines. Triple Annular Research Swirler, which has been...octagonal combustor because it provided optical access for flame imaging while avoiding difficulty of drilling thermocouple access holes on the...indicated by the temperature distribution. c. OH* chemiluminescence image It is commonly accepted that CH* and OH* chemiluminescence represents reaction or

The Impact of Preoperative α-Adrenergic Antagonists on Ureteral Access Sheath Insertion Force and the Upper Limit of Force Required to Avoid Ureteral Mucosal Injury: A Randomized Controlled Study.

PubMed

Koo, Kyo Chul; Yoon, Jun-Ho; Park, No-Cheol; Lee, Hye Sun; Ahn, Hyun Kyu; Lee, Kwang Suk; Kim, Do Kyung; Cho, Kang Su; Chung, Byung Ha; Hong, Chang Hee

2018-06-01

Excessive bulking force during primary access of the ureteral access sheath may induce ureteral injury. We investigated the efficacy of preoperative α-blockade to reduce ureteral access sheath insertion force and determine the upper limit required to avoid ureteral injury. In this randomized controlled trial 135 patients from a single institution who had ureteropelvic junction or renal pelvis stones and were scheduled to undergo retrograde intrarenal surgery were prospectively enrolled from December 2015 to January 2017. Of the patients 41 and 42 were randomly assigned to the control and experimental groups, respectively. The experimental group received α-blockade preoperatively. The 21 patients who were pre-stented were assessed separately. We developed a homemade device to measure maximal ureteral access sheath insertion force. Our ureteral access sheath insertion force measurement device showed excellent reproducibility. Higher insertion velocity resulted in greater maximal sheath insertion force. Maximal insertion force in the α-blockade group was significantly lower than in the control group at the ureterovesical junction (p = 0.008) and the proximal ureter (p = 0.036). Maximal insertion force in the α-blockade group was comparable to that in pre-stented patients. Female patients and patients 70 years old or older showed a lower maximal ureteral access sheath insertion force than their counterparts. The rate of grade 2 or greater ureteral injury was lower in the α-blockade group than in controls (p = 0.038). No injury occurred in any case in which ureteral access sheath insertion force did not exceed 600 G. Preoperative α-blockade and slow sheath placement may reduce maximal ureteral access sheath insertion force. If the force exceeds 600 G, a smaller diameter sheath may be an alternative. Alternatively the procedure can be terminated and followed later by pre-stented retrograde intrarenal surgery. Copyright © 2018 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Lessons From Recruitment to an Internet-Based Survey for Degenerative Cervical Myelopathy: Comparison of Free and Fee-Based Methods.

PubMed

Davies, Benjamin; Kotter, Mark

2018-02-05

Degenerative Cervical Myelopathy (DCM) is a syndrome of subacute cervical spinal cord compression due to spinal degeneration. Although DCM is thought to be common, many fundamental questions such as the natural history and epidemiology of DCM remain unknown. In order to answer these, access to a large cohort of patients with DCM is required. With its unrivalled and efficient reach, the Internet has become an attractive tool for medical research and may overcome these limitations in DCM. The most effective recruitment strategy, however, is unknown. To compare the efficacy of fee-based advertisement with alternative free recruitment strategies to a DCM Internet health survey. An Internet health survey (SurveyMonkey) accessed by a new DCM Internet platform (myelopathy.org) was created. Using multiple survey collectors and the website's Google Analytics, the efficacy of fee-based recruitment strategies (Google AdWords) and free alternatives (including Facebook, Twitter, and myelopathy.org) were compared. Overall, 760 surveys (513 [68%] fully completed) were accessed, 305 (40%) from fee-based strategies and 455 (60%) from free alternatives. Accounting for researcher time, fee-based strategies were more expensive ($7.8 per response compared to $3.8 per response for free alternatives) and identified a less motivated audience (Click-Through-Rate of 5% compared to 57% using free alternatives) but were more time efficient for the researcher (2 minutes per response compared to 16 minutes per response for free methods). Facebook was the most effective free strategy, providing 239 (31%) responses, where a single message to 4 existing communities yielded 133 (18%) responses within 7 days. The Internet can efficiently reach large numbers of patients. Free and fee-based recruitment strategies both have merits. Facebook communities are a rich resource for Internet researchers. ©Benjamin Davies, Mark Kotter. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 05.02.2018.

Lessons From Recruitment to an Internet-Based Survey for Degenerative Cervical Myelopathy: Comparison of Free and Fee-Based Methods

PubMed Central

2018-01-01

Background Degenerative Cervical Myelopathy (DCM) is a syndrome of subacute cervical spinal cord compression due to spinal degeneration. Although DCM is thought to be common, many fundamental questions such as the natural history and epidemiology of DCM remain unknown. In order to answer these, access to a large cohort of patients with DCM is required. With its unrivalled and efficient reach, the Internet has become an attractive tool for medical research and may overcome these limitations in DCM. The most effective recruitment strategy, however, is unknown. Objective To compare the efficacy of fee-based advertisement with alternative free recruitment strategies to a DCM Internet health survey. Methods An Internet health survey (SurveyMonkey) accessed by a new DCM Internet platform (myelopathy.org) was created. Using multiple survey collectors and the website’s Google Analytics, the efficacy of fee-based recruitment strategies (Google AdWords) and free alternatives (including Facebook, Twitter, and myelopathy.org) were compared. Results Overall, 760 surveys (513 [68%] fully completed) were accessed, 305 (40%) from fee-based strategies and 455 (60%) from free alternatives. Accounting for researcher time, fee-based strategies were more expensive ($7.8 per response compared to $3.8 per response for free alternatives) and identified a less motivated audience (Click-Through-Rate of 5% compared to 57% using free alternatives) but were more time efficient for the researcher (2 minutes per response compared to 16 minutes per response for free methods). Facebook was the most effective free strategy, providing 239 (31%) responses, where a single message to 4 existing communities yielded 133 (18%) responses within 7 days. Conclusions The Internet can efficiently reach large numbers of patients. Free and fee-based recruitment strategies both have merits. Facebook communities are a rich resource for Internet researchers. PMID:29402760

Distinct modes of DNA accessibility in plant chromatin.

PubMed

Shu, Huan; Wildhaber, Thomas; Siretskiy, Alexey; Gruissem, Wilhelm; Hennig, Lars

2012-01-01

The accessibility of DNA to regulatory proteins is a major property of the chromatin environment that favours or hinders transcription. Recent studies in flies reported that H3K9me2-marked heterochromatin is accessible while H3K27me3-marked chromatin forms extensive domains of low accessibility. Here we show that plants regulate DNA accessibility differently. H3K9me2-marked heterochromatin is the least accessible in the Arabidopsis thaliana genome, and H3K27me3-marked chromatin also has low accessibility. We see that very long genes without H3K9me2 or H3K27me3 are often inaccessible and generated significantly lower amounts of antisense transcripts than other genes, suggesting that reduced accessibility is associated with reduced recognition of alternative promoters. Low accessibility of H3K9me2-marked heterochromatin and long genes depend on cytosine methylation, explaining why chromatin accessibility differs between plants and flies. Together, we conclude that restriction of DNA accessibility is a local property of chromatin and not necessarily a consequence of microscopically visible compaction.

Disruption of the cytochrome c gene in xylose-utilizing yeast Pichia stipitis leads to higher ethanol production

Treesearch

Nian-Qing Shi; Brian Davis; Fred Sherman; Jose Cruz; Thomas W. Jeffries

1999-01-01

The xylose-utilizing yeast, Pichia stipitis, has a complex respiratory system that contains cytochrome and non-cytochrome alternative electron transport chains in its mitochondria. To gain primary insights into the alternative respiratory pathway, a cytochrome c gene (PsCYC1, Accession No. AF030426) was cloned from wild-type P. stipitis CBS 6054 by cross-hybridization...

ARTI refrigerant database

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

Calm, J.M.

1996-07-01

The Refrigerant Database is an information system on alternative refrigerants, associated lubricants, and their use in air conditioning and refrigeration. It consolidates and facilitates access to property, compatibility, environmental, safety, application and other information. It provides corresponding information on older refrigerants, to assist manufacturers and those using alternative refrigerants, to make comparisons and determine differences. The underlying purpose is to accelerate phase out of chemical compounds of environmental concern.

Parent-Child Relationships and Family Functioning of Children and Youth Discharged from Residential Mental Health Treatment or a Home-Based Alternative

ERIC Educational Resources Information Center

Preyde, Michele; Cameron, Gary; Frensch, Karen; Adams, Gerald

2011-01-01

This report stems from a larger study on the outcomes of children and youth who accessed residential treatment or a home-based alternative. In this report an analysis of family descriptive information, the nature of family relationships, and indicators of family functioning for children and youth who have participated in children's mental health…

An Analysis of Alternatives for Gaining Capacity So as to Maintain Access to the University of California. Research & Occasional Paper Series: CSHE.5.06

ERIC Educational Resources Information Center

King, C. Judson

2006-01-01

This paper analyzes the need for providing additional undergraduate enrollment capacity at the University of California (UC) and of alternatives for gaining such capacity at UC and, by extension, other public research universities. In addition to the creation of new campuses, other approaches are capable of giving significant additional capacity…

ARTI refrigerant database

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

Calm, J.M.

1996-11-15

The Refrigerant Database is an information system on alternative refrigerants, associated lubricants, and their use in air conditioning and refrigeration. It consolidates and facilitates access to property, compatibility, environmental, safety, application and other information. It provides corresponding information on older refrigerants, to assist manufacturers and those using alternative refrigerants, to make comparisons and determine differences. The underlying purpose is to accelerate phase out of chemical compounds of environmental concern.

ComputerTown: A Do-It-Yourself Community Computer Project. [Computer Town, USA and Other Microcomputer Based Alternatives to Traditional Learning Environments].

ERIC Educational Resources Information Center

Zamora, Ramon M.

Alternative learning environments offering computer-related instruction are developing around the world. Storefront learning centers, museum-based computer facilities, and special theme parks are some of the new concepts. ComputerTown, USA! is a public access computer literacy project begun in 1979 to serve both adults and children in Menlo Park…

Green Peace: Can Biofuels Accelerate Energy Security

DTIC Science & Technology

2013-02-14

http://www.navy.mil/features/Navy_EnergySecurity.pdf 6 James T. Bartis and Lawrence Van Bibber. Alternative Fuels for Military Applications, (Santa...2013) 28 James T. Bartis and Lawrence Van Bibber, Alternative Fuels for Military Applications, (Santa Monica, CA: RAND Corporation, 2011), http...research/algae-based-biofuels (accessed 18 November 2012). 55 John Laitner, Karen Ehrhardt-Martinez, and Vanessa McKinney, Examining the Scale of

Alternative Assessments in Practice Data Base. Project 1.2: Technical Assistance on Assessment Issues. Annual Report of Communication, Training and Dissemination Activities.

ERIC Educational Resources Information Center

Center for Research on Evaluation, Standards, and Student Testing, Los Angeles, CA.

The Center for Research on Evaluation, Standards, and Student Testing (CRESST) has developed an Alternative Assessments in Practice Data Base to support technical assistance needs and to promote the exchange of new assessment ideas. The database is designed to provide easy access and retrieval of information about ongoing and newly developed…

The Retrieval of Information in an Elementary School Library Media Center: An Alternative Method of Classification in the Common School Library, Amherst, Massachusetts.

ERIC Educational Resources Information Center

Cooper, Linda

1997-01-01

Discusses the problems encountered by elementary school children in retrieving information from a library catalog, either the traditional card catalog or an OPAC (online public access catalog). An alternative system of classification using colors and symbols is described that was developed in the Common School (Amherst, Massachusetts). (Author/LRW)

Trans-Splenic Portal Vein Embolization: A Technique to Avoid Damage to the Future Liver Remnant

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

Sarwar, Ammar, E-mail: asarwar@bidmc.harvard.edu; Brook, Olga R.; Weinstein, Jeffrey L.

2016-10-15

Portal vein embolization (PVE) induces hypertrophy of the future liver remnant (FLR) in patients undergoing extensive hepatic resection. Portal vein access for PVE via the ipsilateral hepatic lobe (designated for resection) places veins targeted for embolization at acute angles to the access site requiring reverse curve catheters for access. This approach also involves access close to tumors in the ipsilateral lobe and requires care to avoid traversing tumor. Alternatively, a contralateral approach (through the FLR) risks damage to the FLR due to iatrogenic trauma or non-target embolization. Two patients successfully underwent PVE via trans-splenic portal vein access, allowing easy accessmore » to the ipsilateral portal veins and eliminating risk of damage to FLR. Technique and advantages of trans-splenic portal vein access to perform PVE are described.« less

Some Good Practices for Integration and Outreach and their Implementation in the Community Integrated Assessment System (CIAS) and its associated web portal CLIMASCOPE

NASA Astrophysics Data System (ADS)

Warren, R. F.; Price, J. T.; Goswami, S.

2010-12-01

Successful communication of knowledge to climate change policy makers requires the careful integration of scientific knowledge in an integrated assessment that can be clearly communicated to stakeholders, and which encapsulates the uncertainties in the analysis and conveys the need for using a risk assessment approach. It is important that (i) the system is co-designed with the users (ii) relevant disciplines are included (iii) assumptions made are clear (iv) the robustness of outputs to uncertainties is demonstrated (v) the system is flexible so that it can keep up with changing stakeholder needs and (vi) the results are communicated clearly and are readily accessible. The “Community Integrated Assessment System” (CIAS) is a unique multi-institutional, modular, and flexible integrated assessment system for modeling climate change which fulfils the above six criteria. It differs from other integrated models in being a flexible system allowing various combinations of component modules, to be connected together into alternative integrated assessment models. These modules may be written at different institutions in different computer languages and/or based on different operating systems. Scientists are able determine which particular CIAS coupled model they wish to use through a web portal. This includes the facility to implement Latin hypercube experimental design facilitating formal uncertainty analysis. Further exploration of robustness is possible through the ability to select, for example, alternative hyrdrological or climate models to address the same questions. It has been applied to study future scenarios of climate change mitigation, through for example the AVOIDing dangerous climate change project for DEFRA, in which the avoided impacts (benefits) of alternative climate policies were compared to no-policy baselines. These highlight the potential for mitigation to remove a substantial fraction of the climate change impacts that would otherwise occur; but also show that is not possible to avoid all the impacts, and hence that adaptation will still be required. For example, this has been shown for projections of future European drought. CIAS has also been used for analyses used in the IPCC 4AR and the Stern review. Recent applications include a study of the role of avoided deforestation in climate mitigation, and a study of the impacts of climate change on biodiversity. A second web portal, CLIMASCOPE, is being developed for use by stakeholders, currently focusing on the needs of adaptation planners. This will benefit communication by allowing a wide range of users free access to regional climate change projections in simple manner, yet one which encourages risk assessment through encapsulation of the uncertainties in climate change projection. Examples of CLIMASCOPE output that is being made available to stakeholders will be shown.

A service-oriented data access control model

NASA Astrophysics Data System (ADS)

Meng, Wei; Li, Fengmin; Pan, Juchen; Song, Song; Bian, Jiali

2017-01-01

The development of mobile computing, cloud computing and distributed computing meets the growing individual service needs. Facing with complex application system, it's an urgent problem to ensure real-time, dynamic, and fine-grained data access control. By analyzing common data access control models, on the basis of mandatory access control model, the paper proposes a service-oriented access control model. By regarding system services as subject and data of databases as object, the model defines access levels and access identification of subject and object, and ensures system services securely to access databases.

Formatting modifications in GRADE evidence profiles improved guideline panelists comprehension and accessibility to information. A randomized trial.

PubMed

Vandvik, Per Olav; Santesso, Nancy; Akl, Elie A; You, John; Mulla, Sohail; Spencer, Frederick A; Johnston, Bradley C; Brozek, Jan; Kreis, Julia; Brandt, Linn; Zhou, Qi; Schünemann, Holger J; Guyatt, Gordon

2012-07-01

To determine the effects of formatting alternatives in Grading of Recommendations Assessment, Development, and Evaluation (GRADE) evidence profiles on guideline panelists' preferences, comprehension, and accessibility. We randomized 116 antithrombotic therapy guideline panelists to review one of two table formats with four formatting alternatives. After answering relevant questions, panelists reviewed the other format and reported their preferences for specific formatting alternatives. Panelists (88 of 116 invited [76%]) preferred presentation of study event rates over no study event rates (median 1 [interquartile range (IQR) 1] on 1-7 scale), absolute risk differences over absolute risks (median 2 [IQR 3]), and additional information in table cells over footnotes (median 1 [IQR 2]). Panelists presented with time frame information in the tables, and not only in footnotes, were more likely to correctly answer questions regarding time frame (58% vs. 11%, P<0.0001), and those presented with risk differences and not absolute risks were more likely to correctly interpret confidence intervals for absolute effects (95% vs. 54%, P<0.0001). Information was considered easy to find, easy to comprehend, and helpful in making recommendations regardless of table format (median 6, IQR 0-1). Panelists found information in GRADE evidence profiles accessible. Correct comprehension of some key information was improved by providing additional information in table and presenting risk differences. Copyright © 2012 Elsevier Inc. All rights reserved.

Efficacy of the EZ-IO needle driver for out-of-hospital intraosseous access--a preliminary, observational, multicenter study.

PubMed

Schalk, Richard; Schweigkofler, Uwe; Lotz, Gösta; Zacharowski, Kai; Latasch, Leo; Byhahn, Christian

2011-10-26

Intraosseous (IO) access represents a reliable alternative to intravenous vascular access and is explicitly recommended in the current guidelines of the European Resuscitation Council when intravenous access is difficult or impossible. We therefore aimed to study the efficacy of the intraosseous needle driver EZ-IO in the prehospital setting. During a 24-month period, all cases of prehospital IO access using the EZ-IO needle driver within three operational areas of emergency medical services were prospectively recorded by a standardized questionnaire that needed to be filled out by the rescuer immediately after the mission and sent to the primary investigator. We determined the rate of successful insertion of the IO needle, the time required, immediate procedure-related complications, the level of previous experience with IO access, and operator's subjective satisfaction with the device. 77 IO needle insertions were performed in 69 adults and five infants and children by emergency physicians (n = 72 applications) and paramedics (n = 5 applications). Needle placement was successful at the first attempt in all but 2 adults (one patient with unrecognized total knee arthroplasty, one case of needle obstruction after placement). The majority of users (92%) were relative novices with less than five previous IO needle placements. Of 22 responsive patients, 18 reported pain upon fluid administration via the needle. The rescuers' subjective rating regarding handling of the device and ease of needle insertion, as described by means of an analogue scale (0 = entirely unsatisfied, 10 = most satisfied), provided a median score of 10 (range 1-10). The EZ-IO needle driver was an efficient alternative to establish immediate out-of-hospital vascular access. However, significant pain upon intramedullary infusion was observed in the majority of responsive patients.

Full duplex fiber link for alternative wired and wireless access based on SSB optical millimeter-wave with 4-PAM signal

NASA Astrophysics Data System (ADS)

Ma, Jianxin; Zhang, Junjie

2015-03-01

A novel full-duplex fiber-wireless link based on single sideband (SSB) optical millimeter (mm)-wave with 10 Gbit/s 4-pulse amplitude modulation (PAM) signal is proposed to provide alternative wired and 40 GHz wireless accesses for the user terminals. The SSB optical mm-wave with 4-PAM signal consists of two tones: one bears the 4-PAM signal and the other is unmodulated with high power. After transmission over the fiber to the hybrid optical network unit (HONU), the SSB optical mm-wave signal can be decomposed by fiber Bragg gratings (FBGs) as the SSB optical mm-wave signal with reduced carrier-to-sideband ratio (the baseband 4-PAM optical signal) and the uplink optical carrier for the wireless (wired) access. This makes the HONU free from the laser source. For the uplink, since the wireless access signal is converted to the baseband by power detection, both the transmitter in the HONU and the receiver in optical line terminal (OLT) are co-shared for both wireless and wired accesses, which makes the full duplex link much simpler. In our scheme, the optical electrical field of the square-root increment level 4-PAM signal assures an equal level spacing receiving for both the downlink wired and wireless accesses. Since the downlink wireless signal is down-converted to the baseband by power detection, RF local oscillator is unnecessary. To confirm the feasibility of our proposed scheme, a simulation full duplex link with 40 GHz SSB optical mm-wave with 10 Gbit/s 4-PAM signal is built. The simulation results show that both down- and up-links for either wired or wireless access can keep good performance even if the link length of the SSMF is extended to 40 km.

ARTI Refrigerant Database

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

Calm, J.M.

The Refrigerant Database consolidates and facilitates access to information to assist industry in developing equipment using alternative refrigerants. The underlying purpose is to accelerate phase out of chemical compounds of environmental concern.

Investigating the over‐representation of older persons in do‐it‐yourself home maintenance injury and barriers to prevention

PubMed Central

Ashby, K; Ozanne‐Smith, J; Fox, B

2007-01-01

Objective To examine why older persons undertake high‐risk do‐it‐yourself (DIY) home maintenance and under what circumstances, what constitutes acceptable low‐risk alternatives to DIY, and to assess if alternatives are feasible in the current context. Design Exploratory qualitative study using focus‐group methodology. Setting and subjects Fifteen focus groups were conducted, involving 118 persons aged 60 years and older, in two Melbourne communities. Participants resided locally, participated in local seniors groups, or received treatment for a DIY injury at one of two public hospitals serving these communities. Results Older persons' involvement in DIY ranged from necessity to choice. A number chose DIY for general fitness enhancement, satisfaction and pride in a job well done, and giving meaning and enjoyment to daily tasks. However, some older, frailer seniors were forced into DIY because of difficulties in choosing appropriate alternatives; lack of knowledge of some available resources and services; the challenge of accessing cost‐effective and reliable private service providers; and fear of vulnerability to overcharging, overservicing or their personal security. Preferred DIY alternatives were local government providers, local paper advertised services, recommendations to private service providers and family, friends or neighbors. Lack of knowledge of other existing alternatives was an impediment to preventing DIY injury, or accessing DIY alternatives. A number of potentially feasible alternatives to DIY were identified from our review. Conclusions This research is an important first step in understanding issues facing community‐dwelling seniors remaining at home, and provides a basis on which government agencies and other providers can develop services to meet increasing needs. PMID:17916890

Rationally engineered flavin-dependent oxidase reveals steric control of dioxygen reduction.

PubMed

Zafred, Domen; Steiner, Barbara; Teufelberger, Andrea R; Hromic, Altijana; Karplus, P Andrew; Schofield, Christopher J; Wallner, Silvia; Macheroux, Peter

2015-08-01

The ability of flavoenzymes to reduce dioxygen varies greatly, and is controlled by the protein environment, which may cause either a rapid reaction (oxidases) or a sluggish reaction (dehydrogenases). Previously, a 'gatekeeper' amino acid residue was identified that controls the reactivity to dioxygen in proteins from the vanillyl alcohol oxidase superfamily of flavoenzymes. We have identified an alternative gatekeeper residue that similarly controls dioxygen reactivity in the grass pollen allergen Phl p 4, a member of this superfamily that has glucose dehydrogenase activity and the highest redox potential measured in a flavoenzyme. A substitution at the alternative gatekeeper site (I153V) transformed the enzyme into an efficient oxidase by increasing dioxygen reactivity by a factor of 60,000. An inverse exchange (V169I) in the structurally related berberine bridge enzyme (BBE) decreased its dioxygen reactivity by a factor of 500. Structural and biochemical characterization of these and additional variants showed that our model enzymes possess a cavity that binds an anion and resembles the 'oxyanion hole' in the proximity of the flavin ring. We showed also that steric control of access to this site is the most important parameter affecting dioxygen reactivity in BBE-like enzymes. Analysis of flavin-dependent oxidases from other superfamilies revealed similar structural features, suggesting that dioxygen reactivity may be governed by a common mechanistic principle. Structural data are available in PDB database under the accession numbers 4PVE, 4PVH, 4PVJ, 4PVK, 4PWB, 4PWC and 4PZF. © 2015 FEBS.

An alternative to the TEM (Transformed Eulerian Mean) equations

NASA Astrophysics Data System (ADS)

Gaßmann, Almut

2013-04-01

The TEM equations constitute a powerful means to get access to the residual circulation. However, due to their foundation on the wave perspective, they deliver only a zonally averaged picture without access to the three-dimensional structure or the local origins of the residual circulation. Therefore it is worth to investigate whether there are alternatives. The pathway followed here is to perform a transformation of the momentum and the potential temperature equation before taking the zonal mean. This is done by removing the steady state ideal wind solution vid = ?×?B-(?±P) from the equations (? - potential temperature, B - Bernoulli function, P - Ertel's potential vorticity EPV, ?± - density). The advantage of that approach is that the total EPV-flux does no longer contain an explicitly visible 'do-nothing-flux'. This flux, ?? ×?B, does only vanish when averaging on isentropic surfaces, but not on other isosurfaces. Here we find the reason why the conventional zonal mean on isentropes delivers a direct overturning cell on each hemisphere, whereas on other isosurfaces we obtain the typical three-cell structure with Headley, Ferrel, and polar cells. It will be demonstrated and made visible through idealized climate experiments with the ICON-IAP model that the zonal averages of the nonideal wind components vnid = v - vid and wnid = w - wid constitute similar direct overturning cells on non-isentropic surfaces as obtained with the TEM-generated v* and w*. It is also interesting to inspect fields of local nonideal wind components, the very origin of the residual circulation.

The motivation to self-administer is increased after a history of spiking brain levels of cocaine.

PubMed

Zimmer, Benjamin A; Oleson, Erik B; Roberts, David Cs

2012-07-01

Recent attempts to model the addiction process in rodents have focused on cocaine self-administration procedures that provide extended daily access. Such procedures produce a characteristic loading phase during which blood levels rapidly rise and then are maintained within an elevated range for the duration of the session. The present experiments tested the hypothesis that multiple fast-rising spikes in cocaine levels contribute to the addiction process more robustly than constant, maintained drug levels. Here, we compared the effects of various cocaine self-administration procedures that produced very different patterns of drug intake and drug dynamics on Pmax, a behavioral economic measure of the motivation to self-administer drug. Two groups received intermittent access (IntA) to cocaine during daily 6-h sessions. Access was limited to twelve 5-min trials that alternated with 25-min timeout periods, using either a hold-down procedure or a fixed ratio 1 (FR1). Cocaine levels could not be maintained with this procedure; instead the animals experienced 12 fast-rising spikes in cocaine levels each day. The IntA groups were compared with groups given 6-h FR1 long access and 2-h short access sessions and two other control groups. Here, we report that cocaine self-administration procedures resulting in repeatedly spiking drug levels produce more robust increases in Pmax than procedures resulting in maintained high levels of cocaine. These results suggest that rapid spiking of brain-cocaine levels is sufficient to increase the motivation to self-administer cocaine.

Three-dimensional printed ultrasound and photoacoustic training phantoms for vasculature access (Conference Presentation)

NASA Astrophysics Data System (ADS)

Nikitichev, Daniil I.; Xia, Wenfeng; West, Simeon J.; Desjardins, Adrien E.; Ourselin, Sebastien; Vercauteren, Tom

2017-03-01

Ultrasound (US) imaging is widely used to guide vascular access procedures such as arterial and venous cannulation. As needle visualisation with US imaging can be very challenging, it is easy to misplace the needle in the patient and it can be life threating. Photoacoustic (PA) imaging is well suited to image medical needles and catheters that are commonly used for vascular access. To improve the success rate, a certain level of proficiency is required that can be gained through extensive practice on phantoms. Unfortunately, commercial training phantoms are expensive and custom-made phantoms usually do not replicate the anatomy very well. Thus, there is a great demand for more realistic and affordable ultrasound and photoacoustic imaging phantoms for vasculature access procedures training. Three-dimensional (3D) printing can help create models that replicate complex anatomical geometries. However, the available 3D printed materials do not possess realistic tissue properties. Alternatively, tissue-mimicking materials can be employed using casting and 3D printed moulds but this approach is limited to the creation of realistic outer shapes with no replication of complex internal structures. In this study, we developed a realistic vasculature access phantom using a combination of mineral oil based materials as background tissue and a non-toxic, water dissolvable filament material to create complex vascular structure using 3D printing. US and PA images of the phantoms comprising the complex vasculature network were acquired. The results show that 3D printing can facilitate the fabrication of anatomically realistic training phantoms, with designs that can be customized and shared electronically.

Alternative treatment technology information center computer database system

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

Sullivan, D.

1995-10-01

The Alternative Treatment Technology Information Center (ATTIC) computer database system was developed pursuant to the 1986 Superfund law amendments. It provides up-to-date information on innovative treatment technologies to clean up hazardous waste sites. ATTIC v2.0 provides access to several independent databases as well as a mechanism for retrieving full-text documents of key literature. It can be accessed with a personal computer and modem 24 hours a day, and there are no user fees. ATTIC provides {open_quotes}one-stop shopping{close_quotes} for information on alternative treatment options by accessing several databases: (1) treatment technology database; this contains abstracts from the literature on all typesmore » of treatment technologies, including biological, chemical, physical, and thermal methods. The best literature as viewed by experts is highlighted. (2) treatability study database; this provides performance information on technologies to remove contaminants from wastewaters and soils. It is derived from treatability studies. This database is available through ATTIC or separately as a disk that can be mailed to you. (3) underground storage tank database; this presents information on underground storage tank corrective actions, surface spills, emergency response, and remedial actions. (4) oil/chemical spill database; this provides abstracts on treatment and disposal of spilled oil and chemicals. In addition to these separate databases, ATTIC allows immediate access to other disk-based systems such as the Vendor Information System for Innovative Treatment Technologies (VISITT) and the Bioremediation in the Field Search System (BFSS). The user may download these programs to their own PC via a high-speed modem. Also via modem, users are able to download entire documents through the ATTIC system. Currently, about fifty publications are available, including Superfund Innovative Technology Evaluation (SITE) program documents.« less

An exploratory study of the perceived impact of raising the age of cigarette purchase on young smokers in Scotland.

PubMed

Borland, T; Amos, A

2009-10-01

To explore the perceived impact among a group of Scottish 16- and 17-year-old school leavers of the recent increase in age of sale of cigarettes (1 October 2007) from 16 to 18 years on their ability to purchase and access cigarettes. Qualitative interviews with friendship pairs. Twelve paired qualitative interviews conducted in June 2008. Participants were 16- and 17-year-old early school leavers undertaking a work skills programme in Lothian who smoked at least one cigarette per week. Data were analysed thematically. The increase in the age of sale affected participants' perceived ability to purchase cigarettes to differing extents. Three groups were identified: those who were unable to purchase cigarettes either before or after the change in the law, those who could purchase cigarettes before the change in the law but who found it very difficult to do so afterwards, and those who were relatively unaffected as they could purchase cigarettes both before and after the age was raised to 18 years, mostly from small corner shops. Smoking was embedded in participants' social lives and networks. Thus, there was only a limited impact upon their reported ability to access cigarettes due to the availability of alternative social sources of cigarettes from family, friends and others. This exploratory study raises questions about the nature and extent of the impact of raising the age of sale on young smokers' ability to purchase and access cigarettes. The importance of alternative social sources of cigarettes highlights the need for further research to investigate whether the change in legislation had less of an impact on more disadvantaged adolescent smokers, as they are likely to have greater access to alternative sources from their family, friends and community.

Recognition-induced forgetting is not due to category-based set size.

PubMed

Maxcey, Ashleigh M

2016-01-01

What are the consequences of accessing a visual long-term memory representation? Previous work has shown that accessing a long-term memory representation via retrieval improves memory for the targeted item and hurts memory for related items, a phenomenon called retrieval-induced forgetting. Recently we found a similar forgetting phenomenon with recognition of visual objects. Recognition-induced forgetting occurs when practice recognizing an object during a two-alternative forced-choice task, from a group of objects learned at the same time, leads to worse memory for objects from that group that were not practiced. An alternative explanation of this effect is that category-based set size is inducing forgetting, not recognition practice as claimed by some researchers. This alternative explanation is possible because during recognition practice subjects make old-new judgments in a two-alternative forced-choice task, and are thus exposed to more objects from practiced categories, potentially inducing forgetting due to set-size. Herein I pitted the category-based set size hypothesis against the recognition-induced forgetting hypothesis. To this end, I parametrically manipulated the amount of practice objects received in the recognition-induced forgetting paradigm. If forgetting is due to category-based set size, then the magnitude of forgetting of related objects will increase as the number of practice trials increases. If forgetting is recognition induced, the set size of exemplars from any given category should not be predictive of memory for practiced objects. Consistent with this latter hypothesis, additional practice systematically improved memory for practiced objects, but did not systematically affect forgetting of related objects. These results firmly establish that recognition practice induces forgetting of related memories. Future directions and important real-world applications of using recognition to access our visual memories of previously encountered objects are discussed.

Visualization of scoliotic spine using ultrasound-accessible skeletal landmarks

NASA Astrophysics Data System (ADS)

Church, Ben; Lasso, Andras; Schlenger, Christopher; Borschneck, Daniel P.; Mousavi, Parvin; Fichtinger, Gabor; Ungi, Tamas

2017-03-01

PURPOSE: Ultrasound imaging is an attractive alternative to X-ray for scoliosis diagnosis and monitoring due to its safety and inexpensiveness. The transverse processes as skeletal landmarks are accessible by means of ultrasound and are sufficient for quantifying scoliosis, but do not provide an informative visualization of the spine. METHODS: We created a method for visualization of the scoliotic spine using a 3D transform field, resulting from thin-spline interpolation of a landmark-based registration between the transverse processes that we localized in both the patient's ultrasound and an average healthy spine model. Additional anchor points were computationally generated to control the thin-spline interpolation, in order to gain a transform field that accurately represents the deformation of the patient's spine. The transform field is applied to the average spine model, resulting in a 3D surface model depicting the patient's spine. We applied ground truth CT from pediatric scoliosis patients in which we reconstructed the bone surface and localized the transverse processes. We warped the average spine model and analyzed the match between the patient's bone surface and the warped spine. RESULTS: Visual inspection revealed accurate rendering of the scoliotic spine. Notable misalignments occurred mainly in the anterior-posterior direction, and at the first and last vertebrae, which is immaterial for scoliosis quantification. The average Hausdorff distance computed for 4 patients was 2.6 mm. CONCLUSIONS: We achieved qualitatively accurate and intuitive visualization to depict the 3D deformation of the patient's spine when compared to ground truth CT.

KENNEDY SPACE CENTER, FLA. - Daniel L. Tweed, with the Facilities Division, NASA Spaceport Services, addresses attendees at the ribbon cutting for the KSC Security gates. Tweed was project manager. The two new Security gates on Kennedy Parkway (Gate 2) and NASA Parkway (Gate 3) were activated Aug. 1, allowing the general public to have access to the new Space Commerce Way, which will provide access to the Research Park and KSC Visitor Complex, and providing an alternate route for the general public between Titusville and Merritt Island that is accessible 24 hours a day. The gates are staffed 24 hours daily. Others taking part in the ribbon cutting were Center Director Jim Kennedy; Chief, Protective & Safe Guards Office, Calvin L. Burch; SGS Deputy Program Manager William A. Sample; and Bobby Porter, with Oneida Construction.

NASA Image and Video Library

2003-08-27

KENNEDY SPACE CENTER, FLA. - Daniel L. Tweed, with the Facilities Division, NASA Spaceport Services, addresses attendees at the ribbon cutting for the KSC Security gates. Tweed was project manager. The two new Security gates on Kennedy Parkway (Gate 2) and NASA Parkway (Gate 3) were activated Aug. 1, allowing the general public to have access to the new Space Commerce Way, which will provide access to the Research Park and KSC Visitor Complex, and providing an alternate route for the general public between Titusville and Merritt Island that is accessible 24 hours a day. The gates are staffed 24 hours daily. Others taking part in the ribbon cutting were Center Director Jim Kennedy; Chief, Protective & Safe Guards Office, Calvin L. Burch; SGS Deputy Program Manager William A. Sample; and Bobby Porter, with Oneida Construction.

Role of the plurality rule in multiple choices

NASA Astrophysics Data System (ADS)

Calvão, A. M.; Ramos, M.; Anteneodo, C.

2016-02-01

People are often challenged to select one among several alternatives. This situation is present not only in decisions about complex issues, e.g. political or academic choices, but also about trivial ones, such as in daily purchases at a supermarket. We tackle this scenario by means of the tools of statistical mechanics. Following this approach, we introduce and analyse a model of opinion dynamics, using a Potts-like state variable to represent the multiple choices, including the ‘undecided state’, which represents the individuals who do not make a choice. We investigate the dynamics over Erdös-Rényi and Barabási-Albert networks, two paradigmatic classes with the small-world property, and we show the impact of the type of network on the opinion dynamics. Depending on the number of available options q and on the degree distribution of the network of contacts, different final steady states are accessible: from a wide distribution of choices to a state where a given option largely dominates. The abrupt transition between them is consistent with the sudden viral dominance of a given option over many similar ones. Moreover, the probability distributions produced by the model are validated by real data. Finally, we show that the model also contemplates the real situation of overchoice, where a large number of similar alternatives makes the choice process harder and indecision prevail.

Medical waste tissues - breathing life back into respiratory research.

PubMed

BéruBé, Kelly A

2013-12-01

With the advent of biobanks to store human lung cells and tissues from patient donations and from the procurement of medical waste tissues, it is now possible to integrate (both spatially and temporally) cells into anatomically-correct and physiologically-functional tissues. Modern inhalation toxicology relies on human data on exposure and adverse effects, to determine the most appropriate risk assessments and mitigations for beneficial respiratory health. A point in case is the recapitulation of airway tissue, such as the bronchial epithelium, to investigate the impact of air pollution on human respiratory health. The bronchi are the first point of contact for inhaled substances that bypass defences in the upper respiratory tract. Animal models have been used to resolve such inhalation toxicology hazards. However, the access to medical waste tissues has enabled the Lung Particle Research Group to tissue-engineer the Micro-Lung (TM) and Metabo-Lung(TM) cell culture models, as alternatives to animals in basic research and in the safety testing of aerosolised consumer goods. The former model favours investigations focused on lung injury and repair mechanisms, and the latter model provides the element of metabolism, through the co-culturing of lung and liver (hepatocyte) cells. These innovations represent examples of the animal-free alternatives advocated by the 21st century toxicology paradigm, whereby human-derived cell/tissue data will lead to more-accurate and more-reliable public health risk assessments and therapeutic mitigations (e.g. exposure to ambient air pollutants and adverse drug reactions) for lung disease. 2013 FRAME.