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Sample records for ambulant kontinuerlig registrering

  1. Feasibility, Reliability and Predictive Value Of In-Ambulance Heart Rate Variability Registration

    PubMed Central

    van Hooff, Robbert-Jan; De Smedt, Ann; Nagels, Guy; Hubloue, Ives; De Keyser, Jacques; Brouns, Raf

    2016-01-01

    Background Heart rate variability (HRV) is a parameter of autonomic nervous system function. A decrease of HRV has been associated with disease severity, risk of complications and prognosis in several conditions. Objective We aim to investigate the feasibility and the reliability of in-ambulance HRV registration during emergency interventions, and to evaluate the association between prehospital HRV parameters, patient characteristics, vital parameters and short-term outcome. Methods We conducted a prospective study using a non-invasive 2-lead ECG registration device in 55 patients transported by the paramedic intervention team of the Universitair Ziekenhuis Brussel. HRV assessment included time domain parameters, frequency domain parameters, nonlinear analysis, and time-frequency analysis. The correlation between HRV parameters and patient and outcome characteristics was analyzed and compared to controls. Results Artifact and ectopic detection rates were higher in patients during ambulance transportation compared to controls in resting conditions, yet technical reasons precluding in-ambulance HRV analysis occurred in only 9.6% of cases. HRV acquisition was possible without safety issues or interference with routine emergency care. Reliability of the results was considered sufficient for Sample entropy (SampEn), good for the ratio of low frequency and high frequency components (LF/HF ratio) in the frequency and the time frequency domain, and excellent for the triangular interpolation of the NN interval histogram (TINN), and for the short-term scaling exponent of the detrended fluctuation analysis (DFA α1). HRV indices were significantly reduced inpatients with unfavorable outcome compared to patients with favorable outcome and controls. Multivariate analysis identified lower DFA α1 as an independent predictor of unfavorable outcome (OR, 0.155; 95% CI 0.024–0.966; p = 0.049). Conclusion In-ambulance HRV registration is technically and operationally feasible and

  2. Board Certification. Registered EMT-Paramedic. Registered EMT-Intermediate. Registered EMT-Ambulance. Registered EMT-Non-Ambulance.

    ERIC Educational Resources Information Center

    National Registry of Emergency Medical Technicians, Columbus, OH.

    These three brochures outline entry requirements and certification information for: (1) emergency medical technician (EMT)-ambulance and EMT-non-ambulance; (2) EMT-intermediate; and (3) EMT-paramedic. Each brochure provides information on entry requirements, including provisional registration and expiration date; lapsed registration; examination…

  3. Ambulance 3G.

    PubMed

    Banitsas, Konstantinos; Perakis, Konstantinos; Koutsouris, Dimitrios; Konis, Georgios; Tachakra, Sapal

    2005-01-01

    Minimising the time required for a patient to receive primary care has always been the concern of the Accidents and Emergency units. Ambulances are usually the first to arrive on the scene and to administer first aid. However, as the time that it takes to transfer the patient to the hospital increases, so does the fatality rate. In this paper, a mobile teleconsultation system is presented, based primarily on third generation mobile links and on Wi-Fi hotspots around a city. This system can be installed inside an ambulance and will permit high-resolution videoconferencing between the moving vehicle and a doctor or a consultant within a base station (usually a hospital). In addition to video and voice, high quality still images and screenshots from medical equipment can also be sent. The test was carried out in Athens, Greece where a 3G system was recently deployed by Vodafone. The results show that the system can perform satisfactory in most conditions and can effectively increase the patient's quality of service, while having a modest cost.

  4. Physical workload of ambulance assistants.

    PubMed

    Doormaal, M T; Driessen, A P; Landeweerd, J A; Drost, M R

    1995-02-01

    The physical workload of ambulance assistants was assessed by means of the Ovako Working posture Analysis System (OWAS) observation method and a Work and Health Questionnaire (WHQ) for measuring perceived workload. In addition, a biomechanical model was applied to several specifically strenuous conditions that were simulated in a laboratory situation. Bad postures were identified for a number of activities: 16% to 29% of a work shift was spent in harmful positions. Strenuous situations occur particularly during rides in emergency situations. The results of observed and perceived workload are generally in agreement. A number of practical recommendations are made. They concern, for example, the equipment in ambulance cars, training of ambulance assistants and adaptations in working procedures.

  5. [Design of a mechanical system for the balanceable system of ambulance].

    PubMed

    Zheng, Yi; Luo, Yibin; Zhang, Guangpeng; Zhang, Zhide; Chen, Chaomin

    2010-08-01

    This is the design of a mechanical systems for use in the balanceable system of ambulance, which can keep the medical service bed at the ambulance level, whatever the terrain is. A level detector will detect the level state of the bed and turn it to a signal. The central processing unit will use this signal to analyse and control the movement of the motor. By this design (which uses the rolling rail as a drive transmission and makes three supports of the bed go up and down), the bed will keep level. With the use of this design, the balanceable system of ambulance can counteract 35 degrees. The error is controlled within +/- 1 degree. And the response time is within 0.3 s. The method of registration can be effective for keeping the bed at the ambulance level, and for reducing the chance of making the patient get hurt on the way to hospital.

  6. Quantification of NSW Ambulance Record Linkages with Multiple External Datasets.

    PubMed

    Carroll, Therese; Muecke, Sandy; Simpson, Judy; Irvine, Katie; Jenkins, André

    2015-01-01

    This study has two aims: 1) to describe linkage rates between ambulance data and external datasets for "episodes of care" and "patient only" linkages in New South Wales (NSW), Australia; and 2) to detect and report any systematic issues with linkage that relate to patients, and operational or clinical variables that may introduce bias in subsequent studies if not adequately addressed. During 2010-11, the Centre for Health Record Linkage (CHeReL) in NSW, linked the records for patients attended by NSW Ambulance paramedics for the period July 2006 to June 2009, with four external datasets: Emergency Department Data Collection; Admitted Patient Data Collection; NSW Registry of Births, Deaths and Marriages death registration data; and the Australian Bureau of Statistics mortality data. This study reports linkage rates in terms of those "expected" to link and those who were "not expected" to link with external databases within 24 hours of paramedic attendance. Following thorough data preparation processes, 2,041,728 NSW Ambulance care episodes for 1,116,509 patients fulfilled the inclusion criteria. The overall episode-specific hospital linkage rate was 97.2%. Where a patient was not transported to hospital following paramedic care, 8.6% of these episodes resulted in an emergency department attendance within 24 hours. For all care episodes, 5.2% linked to a death record at some time within the 3-year period, with 2.4% of all death episodes occurring within 7 days of a paramedic encounter. For NSW Ambulance episodes of care that were expected to link to an external dataset but did not, nonlinkage to hospital admission records tended to decrease with age. For all other variables, issues relating to rates of linkage and nonlinkage were more indiscriminate. This quantification of the limitations of this large linked dataset will underpin the interpretation and results of ensuing studies that will inform future clinical and operational policies and practices at NSW Ambulance.

  7. Riding Third: Social Work in Ambulance Work

    ERIC Educational Resources Information Center

    Campbell, Hilary; Rasmussen, Brian

    2012-01-01

    This research explored the possible role of social work alongside emergency ambulance services. An ethnographic study included semistructured interviews and direct observations collected over 300 hours while riding in ambulances in an urban setting. The data suggest that social work could play a role by providing needed psychosocial care during…

  8. Air ambulance medical transport advertising and marketing.

    PubMed

    2011-01-01

    The National Association of EMS Physicians (NAEMSP), the American College of Emergency Physicians (ACEP), the Air Medical Physician Association (AMPA), the Association of Air Medical Services (AAMS), and the National Association of State EMS Officials (NASEMSO) believe that patient care and outcomes are optimized by using air medical transport services that are licensed air ambulance providers with robust physician medical director oversight and ongoing quality assessment and review. Only air ambulance medical transport services with these credentials should advertise/market themselves as air ambulance services. PMID:21226561

  9. Ambulance Design Survey 2011: A Summary Report

    PubMed Central

    Lee, Y Tina; Kibira, Deogratias; Feeney, Allison Barnard; Marshall, Jennifer

    2013-01-01

    Current ambulance designs are ergonomically inefficient and often times unsafe for practical treatment response to medical emergencies. Thus, the patient compartment of a moving ambulance is a hazardous working environment. As a consequence, emergency medical services (EMS) workers suffer fatalities and injuries that far exceed those of the average work place in the United States. To reduce injury and mortality rates in ambulances, the Department of Homeland Security Science and Technology Directorate has teamed with the National Institute of Standards and Technology, the National Institute for Occupational Safety and Health, and BMT Designers & Planners in a joint project to produce science-based ambulance patient compartment design standards. This project will develop new crash-safety design standards and improved user-design interface guidance for patient compartments that are safer for EMS personnel and patients, and facilitate improved patient care. The project team has been working with practitioners, EMS workers’ organizations, and manufacturers to solicit needs and requirements to address related issues. This paper presents an analysis of practitioners’ concerns, needs, and requirements for improved designs elicited through the web-based survey of ambulance design, held by the National Institute of Standards and Technology. This paper also introduces the survey, analyzes the survey results, and discusses recommendations for future ambulance patient compartments design. PMID:26401439

  10. Ambulance officers' use of online clinical evidence

    PubMed Central

    Westbrook, Johanna I; Westbrook, Mary T; Gosling, A Sophie

    2006-01-01

    Background Hospital-based clinicians have been shown to use and attain benefits from online evidence systems. To our knowledge there have been no studies investigating whether and how ambulance officers use online evidence systems if provided. We surveyed ambulance officers to examine their knowledge and use of the Clinical Information Access Program (CIAP), an online evidence system providing 24-hour access to information to support evidence-based practice. Methods A questionnaire was completed by 278 ambulance officers in New South Wales, Australia. Comparisons were made between those who used CIAP and officers who had heard of, but not used CIAP. Results Half the sample (48.6%) knew of, and 28.8% had used CIAP. Users were more likely to have heard of CIAP from a CIAP representative/presentation, non-users from written information. Compared to ambulance officers who had heard of but had not used CIAP, users were more likely to report better computer skills and that their supervisors regarded use of CIAP as a legitimate part of ambulance officers' clinical role. The main reasons for non-use were lack of access(49.0%) and training(31.4%). Of users, 51.3% rated their skills at finding information as good/very good, 67.5% found the information sought all/most of the time, 87.3% believed CIAP had the potential to improve patient care and 28.2% had directly experienced this. Most access to CIAP occurred at home. The databases frequently accessed were MIMS (A medicines information database) (73.8%) and MEDLINE(67.5%). The major journals accessed were Journal of Emergency Nursing(37.5%), American Journal of Medicine(30.0%) and JAMA(27.5%). Conclusion Over half of ambulance officers had not heard of CIAP. The proportion who knew about and used CIAP was also low. Reasons for this appear to be a work culture not convinced of CIAP's relevance to pre-hospital patient care and lack of access to CIAP at work. Ambulance officers who used CIAP accessed it primarily from home and

  11. Assisted ambulation and activities for persons with profound multiple disabilities: assessing different ambulation levels.

    PubMed

    Lancioni, G E; Mantini, M; Groeneweg, J

    2001-06-01

    Two participants with profound multiple disabilities were exposed to two occupational situations, which included 1-min. and 3-min. robot-assisted ambulation prior to each activity, respectively. Analysis showed participants' mean percentages of engagement time (session time they spent ambulating or manipulating objects) were well above 90 in both situations. The amount of deviant behavior was somewhat higher in the latter occupational situation for one participant. Implications of the findings were discussed.

  12. Energy cost of ambulation in healthy and disabled Filipino children.

    PubMed

    Luna-Reyes, O B; Reyes, T M; So, F Y; Matti, B M; Lardizabal, A A

    1988-11-01

    The energy expenditures (Ee) for locomotion by nondisabled and disabled Filipino children aged 7 to 13 were determined and compared using indirect calorimetry. Forty-one controls (20 boys and 21 girls) ambulated at a comfortable pace; 16 children (eight boys and eight girls) with lower extremity poliomyelitis of varying severity ambulated by (1) wheelchair propulsion, (2) bilateral axillary crutches, (3) unilateral lower extremity ankle-foot orthoses or knee-ankle-foot orthoses, and (4) unassisted. Disabled children, regardless of their mode of ambulation, had to expend significantly more energy to ambulate than normal children (p less than 0.05). Wheelchair propulsion cost 16% more energy than the normal gait; crutch ambulation cost 41% more than the control. Children using unilateral braces sacrificed speed to attain near-normal Ee. When they ambulated without orthoses, their Ee increased by 109% over the control. In ascending order, the least energy was expanded by normal ambulation followed by disabled ambulation with unilateral brace, disabled propelling a wheelchair, disabled ambulation with bilateral axillary crutches, and disabled ambulation without brace. Efficiency of locomotion was reflected in the values obtained for Ee in terms of kcal x 10(-3)/kg/m, as demonstrated by the lower Ee but slower ambulation of children with braces, as compared to the nondisabled children.

  13. Crash protection for children in ambulances.

    PubMed

    Bull, M J; Weber, K; Talty, J; Manary, M

    2001-01-01

    The objectives of the study were to determine the most effective and reliable means of restraining children on an ambulance cot and to develop recommended field procedures for emergency medical service providers. A series of crash tests at 48 km/h were conducted using convertible child restraints, car beds, and harness systems tested with 3-year, infant, and 6-year size dummies. Belt configuration and backrest position were varied. A new cot and fastener system significantly improved restraint performance over older systems previously tested. A two-belt attachment with elevated cot backrest was found to be the method with the least performance variability for securing either a convertible child restraint or a car bed. It was concluded that children who weight up to 18 kg, fit in a convertible child restraint, and can tolerate a semi-upright seated position can be restrained in a convertible child restraint secured with two belts to an ambulance cot. Infants who must lie flat can be restrained in a car bed modified for two seatbelt paths and secured to a cot. In each case, the cot backrest must be elevated, and the cot and anchor system must be crashworthy. None of the harness configurations tested proved to be satisfactory, but an effective system could be developed by following accepted restraint design principles. PMID:12214360

  14. Ambulation Increases Decompression Sickness in Spacewalk Simulations

    NASA Technical Reports Server (NTRS)

    Pollock, N. W.; Natoli, M. J.; Conkin, J.; Wessel, J. H., III; Gernhardt, M. L.

    2014-01-01

    Musculoskeletal activity has the potential to both improve and compromise decompression safety. Exercise enhances inert gas elimination during oxygen breathing prior to decompression (prebreathe), but it may also promote bubble nuclei formation (nucleation), which can lead to gas phase separation and bubble growth and increase the risk of decompression sickness (DCS). The timing, pattern and intensity of musculoskeletal activity and the level of tissue supersaturation may be critical to the net effect. Understanding the relationships is important to evaluate exercise prebreathe protocols and quantify decompression risk in gravity and microgravity environments. Data gathered during NASA's Prebreathe Reduction Program (PRP) studies combined oxygen prebreathe and exercise followed by low pressure (4.3 psi; altitude equivalent of 30,300 ft [9,235 m]) microgravity simulation to produce two protocols used by astronauts preparing for extravehicular activity. Both the Phase II/CEVIS (cycle ergometer vibration isolation system) and ISLE (in-suit light exercise) trials eliminated ambulation to more closely simulate the microgravity environment. The CEVIS results (35 male, 10 female) serve as control data for this NASA/Duke study to investigate the influence of ambulation exercise on bubble formation and the subsequent risk of DCS. METHODS Four experiments will replicate the CEVIS exercise-enhanced oxygen prebreathe protocol, each with a different exception. The first of these is currently underway. Experiment 1 - Subjects complete controlled ambulation (walking in place with fixed cadence and step height) during both preflight and at 4.3 psi instead of remaining nonambulatory throughout. Experiment 2 - Subjects remain non-ambulatory during the preflight period and ambulatory at 4.3 psi. Experiment 3 - Subjects ambulate during the preflight period and remain non-ambulatory at 4.3 psi. Experiment 4 - The order of heavy and light exercise employed in the CEVIS protocol is

  15. Medical Requirements for Ambulance Design and Equipment. Emergency Health Series.

    ERIC Educational Resources Information Center

    National Academy of Sciences - National Research Council, Washington, DC. Div. of Medical Sciences.

    A vehicle must meet certain specific requirements to be classified as an ambulance if it is to satisfy the demands of the physician in terms of emergency care for which properly trained ambulance attendants can be held responsible. Developed by professional and lay experts for use by automotive designers and manufacturing, this publication would…

  16. Energy expenditure during ambulation with ortho crutches and axillary crutches.

    PubMed

    Hinton, C A; Cullen, K E

    1982-06-01

    Thirteen normal male college students were studied during unassisted ambulation and nonweight-bearing ambulation with Ortho crutches and axillary crutches to determine energy expenditure. Subjects walked at self-selected velocities. Energy expenditure was determined by analyzing expired air collected by a calorimeter. Heart rate was monitored by telemetry. During the first 2.5 minutes of walking, heart rate and energy expenditure were significantly greater for ambulation with axillary crutches than with Ortho crutches. After 11.5 minutes of walking, no difference in energy cost was found between crutch types; however, heart rate increased significantly (p less than .01) during ambulation with axillary crutches. Differences in energy cost and heart rate were attributed to increased upper extremity work performed when using axillary crutches. We concluded that during nonweight-bearing ambulation for short periods of time or over a short distance, the Ortho crutch is less taxing in terms of energy cost and heart rate demands.

  17. Older people's use of ambulance services: a population based analysis.

    PubMed Central

    Clark, M J; FitzGerald, G

    1999-01-01

    OBJECTIVE: To investigate the use of emergency and non-urgent ambulance transport services by people aged 65 years and over. SETTING: The study was undertaken in Queensland where the Queensland Ambulance Services (QAS) is the sole provider of emergency pre-hospital and non-urgent ambulance services for the entire state. METHODS: The age and sex of 351,000 emergency and non-urgent cases treated and transported by the QAS from July 1995 to June 1996 were analysed. RESULTS: People aged 65 years and over who comprise 12% of the population utilise approximately one third of the emergency and two thirds of the non-urgent ambulance resources provided in Queensland. While the absolute number of occasions of service for females for emergency services is higher than for males, when the data are stratified for age and sex, males have higher rates of emergency ambulance service utilisation than females across every age group, and particularly in older age groups. Gender differences are also found for non-urgent ambulance usage. The absolute number of occasions of service for older females aged 65 and over using non-urgent ambulance transport is high, but utilisation patterns on stratified data reveal similar gender usage patterns across most age groupings, except at the older age groupings where male usage greatly exceeds female usage. CONCLUSIONS: As the aged are disproportionately high users of ambulance services, it will become increasingly important for ambulance services to plan for the projected increase in the aged population. Emergency pre-hospital care is one of the few health services along the continuum of care where male usage patterns are higher than those of females. More information needs to be obtained on the age and presenting characteristics of those people who are multiple users of the ambulance service. Such information will assist service planners. PMID:10191443

  18. Pacemaker assessment in the ambulant patient.

    PubMed Central

    Murray, A; Jordan, R S; Gold, R G

    1981-01-01

    A new technique for assessing implanted cardiac pacemaker function in the ambulant patient has been introduced and assessed. A modified portable electrocardiograph recorder is used to store 24 hours of electrocardiograms along with marker pulses indicating the timing of pacemaker impulses. The recorder detects this narrow impulse and records a wider marker pulse on a second channel. The false positive detection rate was estimated from recordings, each of 24 hours, taken from 10 patients. All of these patients were ambulant and none had a cardiac pacemaker. There was on average less than one false positive per 24 hours. When similar recordings were taken from a group of 15 patients with pacemakers, the average false positive rate in 13 of these patients was also less than on per 24 hours. In the two other recordings artefacts resulted in false positive rates of 28 and 960 per 24 hours. Failure to detect pacemaker pulses was confirmed in only one patient. In addition to determining the accuracy of pacemaker pulse detection, the clinical usefulness of this technique was assessed. Two patients had fixed-rate pacemakers and 13 had demand pacemakers. Of the latter, two patients had a total of three episodes of failure to sense, one patient frequently failed to capture, and six patients had episodes of inappropriate inhibition of the pacemaker, the number of episodes ranging from one to 21 in 24 hours. Paced complexes were easily identified even when they occurred as fusion complexes. The frequency of paced complexes was quantified in each patient and varied from 21 to over 100 000 impulses in the 24 hour period. PMID:7317218

  19. Emergency Department Overcrowding and Ambulance Turnaround Time

    PubMed Central

    Lee, Yu Jin; Shin, Sang Do; Lee, Eui Jung; Cho, Jin Seong; Cha, Won Chul

    2015-01-01

    Objective The aims of this study were to describe overcrowding in regional emergency departments in Seoul, Korea and evaluate the effect of crowdedness on ambulance turnaround time. Methods This study was conducted between January 2010 and December 2010. Patients who were transported by 119-responding ambulances to 28 emergency centers within Seoul were eligible for enrollment. Overcrowding was defined as the average occupancy rate, which was equal to the average number of patients staying in an emergency department (ED) for 4 hours divided by the number of beds in the ED. After selecting groups for final analysis, multi-level regression modeling (MLM) was performed with random-effects for EDs, to evaluate associations between occupancy rate and turnaround time. Results Between January 2010 and December 2010, 163,659 patients transported to 28 EDs were enrolled. The median occupancy rate was 0.42 (range: 0.10-1.94; interquartile range (IQR): 0.20-0.76). Overcrowded EDs were more likely to have older patients, those with normal mentality, and non-trauma patients. Overcrowded EDs were more likely to have longer turnaround intervals and traveling distances. The MLM analysis showed that an increase of 1% in occupancy rate was associated with 0.02-minute decrease in turnaround interval (95% CI: 0.01 to 0.03). In subgroup analyses limited to EDs with occupancy rates over 100%, we also observed a 0.03 minute decrease in turnaround interval per 1% increase in occupancy rate (95% CI: 0.01 to 0.05). Conclusions In this study, we found wide variation in emergency department crowding in a metropolitan Korean city. Our data indicate that ED overcrowding is negatively associated with turnaround interval with very small practical significance. PMID:26115183

  20. Understanding the factors that influence patient satisfaction with ambulance services.

    PubMed

    Bogomolova, Svetlana; Tan, P J; Dunn, S P; Bizjak-Mikic, M

    2016-01-01

    The quality of ambulance services has an immense impact on patients' future well-being and quality of life. Patient satisfaction is one of the key metrics for evaluating the quality of this service. Yet, the patient satisfaction measurement may be limited in its ability to accurately reflect this service quality, and even reflect factors beyond the patient experiences. We analyze 10 years of survey data to reveal a number of factors that systematically bias ambulance satisfaction ratings. Taking into account these biases provides more robust comparison of ambulance performance over time or across different jurisdictions. PMID:27295008

  1. Ambulation Increases Decompression Sickness in Altitude Exposure

    NASA Technical Reports Server (NTRS)

    Conkin, Johnny; Pollock, N. W.; Natoli, M. J.; Wessel, J. H., III; Gernhardt, M. L.

    2014-01-01

    INTRODUCTION - Exercise accelerates inert gas elimination during oxygen breathing prior to decompression (prebreathe), but may also promote bubble formation and increase the risk of decompression sickness (DCS). The timing, pattern and intensity of exercise are likely critical to the net effect. The NASA Prebreathe Reduction Program (PRP) combined oxygen prebreathe and exercise preceding a 4.3 psi exposure in non-ambulatory subjects (a microgravity analog) to produce two protocols now used by astronauts preparing for extravehicular activity (CEVIS and ISLE). Additional work is required to investigate whether exercise normal to 1 G environments increases the risk of DCS over microgravity simulation. METHODS - The CEVIS protocol was replicated with one exception. Our subjects completed controlled ambulation (walking in place with fixed cadence and step height) during both preflight and at 4.3 psi instead of remaining non-ambulatory throughout. Decompression stress was graded with aural Doppler (Spencer 0-IV scale). Two-dimensional echocardiographic imaging was used to look for left heart gas emboli (the presence of which prompted test termination). Venous blood was collected at three points to correlate Doppler measures of decompression stress with microparticle (cell fragment) accumulation. Fisher Exact Tests compared test and control groups. Trial suspension would occur when DCS risk >15% or grade IV venous gas emboli (VGE) risk >20% (at 70% confidence). RESULTS - Eleven person-trials were completed (9 male, 2 female) when DCS prompted suspension. DCS was greater than in CEVIS trials (3/11 [27%] vs. 0/45 [0%], respectively, p=0.03). Statistical significance was not reached for peak grade IV VGE (2/11 [18%] vs. 3/45 [7%], p=0.149) or cumulative grade IV VGE observations per subject-trial (8/128 [6%] vs. 26/630 [4%], p=0.151). Microparticle data were collected for 5/11 trials (3 with DCS outcomes), with widely varying patterns that could not be resolved statistically

  2. Superior Ambulance Call Out Rate Forecasting Using Meteorological Data

    NASA Astrophysics Data System (ADS)

    Mahmood, M. A.; Thornes, J. E.; Bloss, W.; Pope, F.

    2015-12-01

    Ambulances are an integral part of a country's infrastructure ensuring its citizens and visitors are kept healthy. The impact of weather, climate and climate change on ambulance services around the world has received increasing attention in recent years but most studies have been area specific and there is a need to establish basic relationships between ambulance data (both response and illness data) and meteorological parameters. In this presentation, the effects of temperature and relative humidity on ambulance call out rates for different medical categories will be investigated. We use call out data obtained from the London Ambulance Service (LAS) and meteorological data from a central London meteorological station. A time-series analysis was utilized to understand the relation between temperature, relative humidity, air pollutants and different call out categories. There are statistically significant relationships between mean temperature and ambulance callout rate for most of the categories investigated. Most categories show a negative dependence on temperature, i.e. call outs increase with decreasing temperature but some categories showed a positive dependence such as alcohol related call outs. Relative humidity is significant for some categories but in general is much less important than temperature. Significant time lag effects were observed for most of the categories related to infectious illnesses, which are transferrable through human contact. These findings support the opinion that ambulance attendance callouts records are an effective and well-timed source of data and can be used for health early warning systems. Furthermore the presented results can much improve our understanding of the relationships between meteorological conditions and human health thereby allowing for better prediction of ambulance use through the application of long and short-term weather forecasts.

  3. Ambulation after Deep Vein Thrombosis: A Systematic Review

    PubMed Central

    Overend, Tom J.; Godwin, Julie; Sealy, Christina; Sunderji, Aisha

    2009-01-01

    ABSTRACT Purpose: To systematically review the effects of early ambulation on development of pulmonary embolism (PE) and progression or development of a new thrombus in patients with acute deep vein thrombosis (DVT). Methods: Medline, PubMed, CINAHL, EMBASE, PEDro, and Cochrane Library databases were searched from inception to June 2008. Study quality was appraised using the Jadad and PEDro scales. Meta-analyses were reported as relative risks (RR) and 95% confidence intervals (CI). Results: Four randomized trials were accepted. For development of a PE, the pooled relative risks for ambulation and compression versus bed rest and compression (RR = 0.63, 95% CI: 0.34–1.19) and for ambulation and compression versus bed rest alone (RR = 1.36, 95% CI: 0.57–3.29) were not significant. For progression of an existing thrombus or development of a new thrombus, the independent relative risks for ambulation and compression versus bed rest and compression (RR = 0.39, 95% CI: 0.13–1.14) and for ambulation and compression versus bed rest alone (RR = 0.56, 95% CI: 0.20–1.57) were also not significant. Conclusions: Given the clinical benefits of mobility, and because there was no significant difference between ambulation and bed rest for risk of developing a PE or development and progression of a new DVT in any of the studies, clinicians should be confident in prescribing ambulation in this population. PMID:20514175

  4. Non-motor Factors Associated with the Attainment of Community Ambulation after Stroke

    PubMed Central

    Ferreira, Milene Silva; Chamlian, Therezinha Rosane; França, Carolina Nunes; Massaro, Ayrton Roberto

    2015-01-01

    Objective Detect the main predictive non-motor factors related to independent community ambulation after stroke. Furthermore, we propose a scale to estimate the probability of a stroke patient achieving independent community ambulation after 6 months of rehabilitation. Design and Settings Prospective cohort. Subjects treated in a rehabilitation center in a large metropolitan area. Independent community ambulation was evaluated after rehabilitation according to the Hoffer classification. Functional ambulation was assessed at four levels: nonambulatory, nonfunctional ambulation, household ambulation, and community ambulation. Participants Patients (n=201) with a moderate disability after stroke. Results The average time of hospitalization was 19.3 days. However, only 32.8% of the patients started the rehabilitation program during the first 6 months after stroke. We found that 121 patients achieved community ambulation (60.2%), 40 achieved household ambulation (19.9%), 12 achieved therapeutic ambulation (5.9%), and 28 were non-ambulatory after 6 months of treatment. Based on our final model, a scoring scale was created in order to evaluate the probability of stroke patients achieving independent community ambulation after 6 months of rehabilitation. Higher scores were associated with better chances of community ambulation within 6 months. Conclusions The scale that evaluated these factors proved to have acceptable sensitivity and specificity to establish the prognosis of community ambulation after 6 months of rehabilitation. PMID:25380611

  5. Early ambulation after acute deep vein thrombosis: is it safe?

    PubMed

    Blumenstein, Marilyn Slavin

    2007-01-01

    The number of thrombotic events in children, although significantly less than that in adults, is increasing as a result of therapeutic advances in primary illnesses that were previously fatal. When a patient, adult or pediatric, develops a deep vein thrombosis and anticoagulation therapy is initiated, many health professionals ask, "When should this patient have physical therapy and/or ambulate?" Fear of causing a pulmonary embolism with increased activity drives this question. Often, an order for bed rest is prescribed based more on tradition than on evidence-based medicine. A review of the literature has provided an evidence-based answer to the question, and although the studies are all of adult populations, the results have been extrapolated for use with comparable pediatric populations. The majority of studies agree that early ambulation does not increase an anticoagulated patient's risk for pulmonary embolism. Moreover, most studies report that early ambulation carries benefits such as decreased pain and swelling and fewer postthrombotic syndrome symptoms.

  6. A framework for the design of ambulance sirens.

    PubMed

    Catchpole, K; McKeown, D

    2007-08-01

    Ambulance sirens are essential for assisting the safe and rapid arrival of an ambulance at the scene of an emergency. In this study, the parameters upon which sirens may be designed were examined and a framework for emergency vehicle siren design was proposed. Validity for the framework was supported through acoustic measurements and the evaluation of ambulance transit times over 240 emergency runs using two different siren systems. Modifying existing siren sounds to add high frequency content would improve vehicle penetration, detectability and sound localization cues, and mounting the siren behind the radiator grill, rather than on the light bar or under the wheel arch, would provide less unwanted noise while maintaining or improving the effective distance in front of the vehicle. Ultimately, these considerations will benefit any new attempt to design auditory warnings for the emergency services. PMID:17558670

  7. Profile of Ambulance Runs at the Kennedy Space Center

    NASA Technical Reports Server (NTRS)

    Scarpa, Philip J.

    1999-01-01

    The Kennedy Space Center (KSC) has four onsite ambulances staffed with Paramedics at two fire stations that respond to 911 Emergency Medical System (EMS) medical dispatches. These ambulances serve over 22,000 NASA, military, government, and contractor employees in an area of approximately 520 square miles. Included in this coverage are several public areas such as beaches, a wildlife refuge and a popular Visitor Center. Reports are filled out on each patient encountered. However. the only element tracked has been the ambulance response time. Now that reports are filed electronically, it is possible to enter them into an electronic database for analysis. Data analyses reveal trends and assist in better allocation of resources.

  8. Muscle coordination of support, progression and balance during stair ambulation.

    PubMed

    Lin, Yi-Chung; Fok, Laurence A; Schache, Anthony G; Pandy, Marcus G

    2015-01-21

    Stair ambulation is more physically demanding than level walking because it requires the lower-limb muscles to generate greater net joint moments. Although lower-limb joint kinematics and kinetics during stair ambulation have been extensively studied, relatively little is known about how the lower-limb muscles accelerate the whole-body center of mass (COM) during stair ascent and descent. The aim of the current study was to evaluate differences in muscle contributions to COM accelerations between level walking and stair ambulation in 15 healthy adults. Three-dimensional quantitative gait analysis and musculoskeletal modeling were used to calculate the contributions of the individual lower-limb muscles to the vertical, fore-aft and mediolateral accelerations of the COM (support, progression, and balance, respectively) during level walking, stair ascent and stair descent. Muscles that contribute most significantly to the acceleration of the COM during level walking (hip, knee, and ankle extensors) also dominate during stair ambulation, but with noticeable differences in coordination. In stair ascent, gluteus maximus accelerates the body forward during the first half of stance and soleus accelerates the body backward during the second half of stance, opposite to the functions displayed by these muscles in level walking. In stair descent, vasti generates backward and medial accelerations of the COM during the second half of stance, whereas it contributes minimally during this period in level walking. Gluteus medius performs similarly in controlling mediolateral balance during level walking and stair ambulation. Differences in lower-limb muscular coordination exist between stair ambulation and level walking, and our results have implications for interventions aimed at preventing stair-related falls. PMID:25498364

  9. Occupational stress in the ambulance service: a diagnostic study.

    PubMed

    Young, K M; Cooper, C L

    1997-01-01

    The Occupational Stress Indicator (OSI) was used to investigate job stress in an ambulance service in the northwest of England. Seven different aspects of the stress-strain relationship were assessed and the findings compared with those from the fire service. Ambulance service employees were found to be experiencing major stress outcomes of low job satisfaction and poor mental and physical health. Fire service employees revealed significantly poorer physical health. Assesses the sources of job stress, type A behaviour, locus of control and coping styles and discusses them in the light of change in the public services.

  10. Post-traumatic stress among Swedish ambulance personnel

    PubMed Central

    Jonsson, A; Segesten, K; Mattsson, B

    2003-01-01

    Objective: Emergency workers, including ambulance personnel, must cope with a variety of duty related stressors including traumatic incident exposures. Little is known about the variables that might be associated with post-traumatic stress symptom in high risk occupational groups such as ambulance personnel. This study investigated the prevalence of post-traumatic stress disorder among Swedish ambulance personnel. Methods: To estimate the prevalence of trauma related disorders, a representative group of 362 ambulance personal from the county of Västra Götaland in Sweden was surveyed through use of a Swedish version of Antonovsky's 13-item short version of Sense of Coherence Scale, to measure reactions to traumatic events two instruments were used, Impact of Event Scale (IES-15) and the Post Traumatic Symptom Scale (PTSS-10). A total of 223 of the ambulance personnel reported that they had had experience of what they described as traumatic situations. Results: Of those who reported a traumatic situation 15.2% scored 31 or more on the IES-15 sub scale. Scores over 31 indicate a stress reaction with certain likelihood of post-traumatic disorder. On the PTSS-10 subscale 12.1% scored 5 or more, which indicates a relative strong reaction. The study indicates that lower sense of coherence predicts post-traumatic stress. Other predictors for the extent of traumatic stress were longer job experience, age, physical and psychological workload. Conclusions: The high prevalence of post-traumatic stress disorder symptoms in ambulance personnel indicates an inability to cope with stress in daily work. The strong relation between post-traumatic stress and Sense of Coherence Scale may be useful in predicting vulnerability for post-traumatic symptoms among recently employed ambulance service personnel. To prevent or reduce the upcoming of post-traumatic stress disorder symptoms it must be possible to take leave of absence, or for a longer or shorter time be transferred to non

  11. STEP-UP: Study of the Effectiveness of a Patient Ambulation Protocol.

    PubMed

    Teodoro, Catherine R; Breault, Katheleen; Garvey, Carolee; Klick, Cheryl; O'Brien, Jennifer; Purdue, Tracy; Stolaronek, Anthony; Wilbur, Heather W; Matney, Laurie

    2016-01-01

    Immobility in hospitalized patients, particularly the elderly, can lead to serious untoward events. A pragmatic ambulation program that could be incorporated easily into clinicians' practice routines significantly improved ambulation in hospitalized patients compared to usual care with no organized emphasis on ambulation. PMID:27323470

  12. 42 CFR 414.615 - Transition to the ambulance fee schedule.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... inflation factor for ambulance services. (b) 2003 Payment. For services furnished in CY 2003, payment is... inflation factor for ambulance services. (c) 2004 Payment. For services furnished in CY 2004, payment is... inflation factor for ambulance services. (d) 2005 Payment. For services furnished in CY 2005, payment...

  13. 42 CFR 414.615 - Transition to the ambulance fee schedule.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... inflation factor for ambulance services. (b) 2003 Payment. For services furnished in CY 2003, payment is... inflation factor for ambulance services. (c) 2004 Payment. For services furnished in CY 2004, payment is... inflation factor for ambulance services. (d) 2005 Payment. For services furnished in CY 2005, payment...

  14. 42 CFR 414.615 - Transition to the ambulance fee schedule.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... the statutory inflation factor for ambulance services. (b) 2003 Payment. For services furnished in CY..., multiplied by the statutory inflation factor for ambulance services. (c) 2004 Payment. For services furnished..., multiplied by the statutory inflation factor for ambulance services. (d) 2005 Payment. For services...

  15. Upper Limb Strength and Function Changes during a One-Year Follow-Up in Non-Ambulant Patients with Duchenne Muscular Dystrophy: An Observational Multicenter Trial

    PubMed Central

    Seferian, Andreea Mihaela; Moraux, Amélie; Annoussamy, Mélanie; Canal, Aurélie; Decostre, Valérie; Diebate, Oumar; Le Moing, Anne-Gaëlle; Gidaro, Teresa; Deconinck, Nicolas; Van Parys, Frauke; Vereecke, Wendy; Wittevrongel, Sylvia; Mayer, Michèle; Maincent, Kim; Desguerre, Isabelle; Thémar-Noël, Christine; Cuisset, Jean-Marie; Tiffreau, Vincent; Denis, Severine; Jousten, Virginie; Quijano-Roy, Susana; Voit, Thomas; Hogrel, Jean-Yves; Servais, Laurent

    2015-01-01

    Introduction Upper limb evaluation of patients with Duchenne Muscular Dystrophy is crucially important to evaluations of efficacy of new treatments in non-ambulant patients. In patients who have lost ambulation, there are few validated and informative outcome measures. In addition, longitudinal data demonstrating sensitivity to clinical evolution of outcome measures over short-term periods are lacking. Patients and Methods We report here the results of a one-year multicenter study using specifically designed tools to assess grip, pinch strength, and hand function in wheelchair-bound patients. Our study assessed 53 non-ambulant patients with Duchenne muscular dystrophy aged 17.1 ± 4.8 years (range: 9 – 28.1 years). The average Brooke functional score of these patients was 4.6 ± 1.1. The average forced vital capacity was 44.5% predicted and 19 patients used non-invasive ventilation. Patients were assessed at baseline, 6 months, and one year using the Motor Function Measure and innovative devices (namely the MyoSet composed of MyoGrip, MyoPinch, and MoviPlate). Results Our study confirmed preliminary data previously reported regarding feasibility of use and of reliability of the MyoSet and the correlation at baseline between distal strength and clinical outcomes such as FVC, Brooke score, age, and duration since loss of ambulation. A significant correlation was observed between the distal upper limb strength and clinical variables. The sensitive dynamometers (MyoGrip and MyoPinch) and MoviPlate captured a 12-month change in non-ambulant Duchenne muscular dystrophy patients of all ages. Trial Registration ClinicalTrials.gov NCT00993161 NCT00993161 PMID:25643053

  16. 4. OVERALL VIEW TO NORTH SHOWING (LEFT TO RIGHT) AMBULANT ...

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

    4. OVERALL VIEW TO NORTH SHOWING (LEFT TO RIGHT) AMBULANT QUARTERS, STOREHOUSE, BOILER HOUSE (LARGELY OBSCURED), SMOKESTACK, STATION GARAGE, ANIMAL HOUSE, AND WATER SOFTENER BUILDING - VA Medical Center, Aspinwall Division, 5103 Delafield Avenue (O'Hara Township), Aspinwall, Allegheny County, PA

  17. Mathematical model of ambulance resources in Saint-Petersburg

    NASA Astrophysics Data System (ADS)

    Shavidze, G. G.; Balykina, Y. E.; Lejnina, E. A.; Svirkin, M. V.

    2016-06-01

    Emergency medical system is one of the main elements in city infrastructure. The article contains analysis of existing system of ambulance resource distribution. Paper considers the idea of using multiperiodicity as a tool to increase the efficiency of the Emergency Medical Services. The program developed in programming environment Matlab helps to evaluate the changes in the functioning of the system of emergency medical service.

  18. 42 CFR 410.41 - Requirements for ambulance suppliers.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Requirements for ambulance suppliers. 410.41 Section 410.41 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... origin and destination and indicate on claims form that the physician certification is on file. (2)...

  19. 42 CFR 410.41 - Requirements for ambulance suppliers.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 2 2014-10-01 2014-10-01 false Requirements for ambulance suppliers. 410.41 Section 410.41 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... origin and destination and indicate on claims form that the physician certification is on file. (2)...

  20. Entry overload, emergency department overcrowding, and ambulance bypass

    PubMed Central

    Fatovich, D; Hirsch, R

    2003-01-01

    Objectives: To describe an experience of emergency department (ED) overcrowding and ambulance bypass. Methods: A prospective observational study at Royal Perth Hospital, a major teaching hospital. Episodes of ambulance bypass and their characteristics were recorded. Results: From 1 July 1999 to 30 June 2001, there were 141 episodes of ambulance bypass (mean duration 187 min, range 35–995). Monday was the most common day with 39 (28%) episodes. Entry block alone was the most common reason bypass was activated (n=38, 30.4%). The mean number of patients in ED at these times was 40 (occupancy 174%), including nine in the corridor, seven awaiting admission, and 14 waiting to be seen. Episodes attributable to entry block were typically preceded by a presentation rate of ⩾10 patients per hour for ⩾2 hours (OR 6.2, 95% CI 4.3 to 8.5). Mid-afternoon to early evening was the most common time for activation. Ambulance bypass is increasing in frequency and duration. Conclusions: Entry overload resulting in entry block results from overwhelming numbers of patients presenting to the ED in a short space of time. Entry block impairs access to emergency care. Unless something is done in the near future, the general public may no longer be able to rely on EDs for quality and timely emergency care. A "whole of system" approach is necessary to tackle the problem. PMID:12954675

  1. 42 CFR 410.41 - Requirements for ambulance suppliers.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... laws. (3) Be equipped with telecommunications equipment as required by State or local law to include... by State or local laws. (b) Vehicle staff—(1) BLS vehicles. A vehicle furnishing ambulance services... certification requirements in accordance with State and local laws. (3) Upon a carrier's request,...

  2. Emergency ambulance dispatch: is there a case for triage?

    PubMed

    Thakore, S; McGugan, E A; Morrison, W

    2002-03-01

    Emergency telephone calls for an ambulance (999 calls) are usually dealt with first-come first-served. We have devised and assessed criteria that ambulance dispatch might use to prioritize responses. Data were collected retrospectively on consecutive patients presenting to an accident and emergency (A&E) department after a 999 call. An unblinded researcher abstracted data including age, date, time, caller, location, reason for call and A&E diagnosis and each case was examined for ten predetermined criteria necessitating an immediate ambulance response--namely, cardiac arrest; chest pain; shortness of breath; altered mental status/seizure; abdominal/loin pain >65 years old; fresh haematemesis; fall >2m; stabbing; major burns. 471 patients were recruited, 55% male, median age 50 years. 406 calls came from bystanders or the patients themselves, 36 from general practitioners, 8 from other hospitals and 21 from the police. 52% of patients were admitted. 44% met at least one of the above criteria. Most patients did not meet the criteria for an immediate ambulance response but might nonetheless be suitable for an urgent response. The criteria used in this study have the advantage of being based on the history provided by the caller. The introduction of a priority-based dispatch system could reduce response times to those who are seriously ill, and also improve road safety.

  3. Ambulance clinical placements – A pilot study of students' experience

    PubMed Central

    Boyle, Malcolm J; Williams, Brett; Cooper, Jennifer; Adams, Bridget; Alford, Kassie

    2008-01-01

    Background Undergraduate paramedic students undertake clinical placements in a variety of locations. These placements are considered an essential element for paramedic pre-employment education. However, anecdotal evidence suggests some students have not had positive experiences on their emergency ambulance placements. The objective of this study was to identify the type of experiences had by students during ambulance clinical placements and to provide feedback to the ambulance services. Methods In this pilot study we employed a cross-sectional study methodology, using a convenience sample of undergraduate paramedic students available in semester one of 2007 to ascertain the students' views on their reception by on-road paramedics and their overall experience on emergency ambulance clinical placements. Ethics approval was granted. Results There were 77 students who participated in the survey, 64% were females, with 92% of students < 25 years of age and 55% < 65 Kg in weight. There was a statistically significant difference in average height between the genders (Male 179 cm vs Female 168 cm, p < 0.001). Clinical instructors were available to 44% of students with 30% of students excluded from patient management. Thirty percent of students felt there was a lot of unproductive down time during the placement. Paramedics remarked to 40% of students that they doubted their ability to perform the physical role of a paramedic, of this group 36% were advised this more than once. Conclusion This study demonstrates that for a small group of students, emergency ambulance clinical placements were not a positive experience clinically or educationally. Some qualified paramedics doubt if a number of female students can perform the physical role of a paramedic. PMID:18400111

  4. Feasibility of AmbulanCe-Based Telemedicine (FACT) Study: Safety, Feasibility and Reliability of Third Generation In-Ambulance Telemedicine

    PubMed Central

    Yperzeele, Laetitia; Van Hooff, Robbert-Jan; De Smedt, Ann; Valenzuela Espinoza, Alexis; Van Dyck, Rita; Van de Casseye, Rohny; Convents, Andre; Hubloue, Ives; Lauwaert, Door; De Keyser, Jacques; Brouns, Raf

    2014-01-01

    Background Telemedicine is currently mainly applied as an in-hospital service, but this technology also holds potential to improve emergency care in the prehospital arena. We report on the safety, feasibility and reliability of in-ambulance teleconsultation using a telemedicine system of the third generation. Methods A routine ambulance was equipped with a system for real-time bidirectional audio-video communication, automated transmission of vital parameters, glycemia and electronic patient identification. All patients ( ≥18 years) transported during emergency missions by a Prehospital Intervention Team of the Universitair Ziekenhuis Brussel were eligible for inclusion. To guarantee mobility and to facilitate 24/7 availability, the teleconsultants used lightweight laptop computers to access a dedicated telemedicine platform, which also provided functionalities for neurological assessment, electronic reporting and prehospital notification of the in-hospital team. Key registrations included any safety issue, mobile connectivity, communication of patient information, audiovisual quality, user-friendliness and accuracy of the prehospital diagnosis. Results Prehospital teleconsultation was obtained in 41 out of 43 cases (95.3%). The success rates for communication of blood pressure, heart rate, blood oxygen saturation, glycemia, and electronic patient identification were 78.7%, 84.8%, 80.6%, 64.0%, and 84.2%. A preliminary prehospital diagnosis was formulated in 90.2%, with satisfactory agreement with final in-hospital diagnoses. Communication of a prehospital report to the in-hospital team was successful in 94.7% and prenotification of the in-hospital team via SMS in 90.2%. Failures resulted mainly from limited mobile connectivity and to a lesser extent from software, hardware or human error. The user acceptance was high. Conclusions Ambulance-based telemedicine of the third generation is safe, feasible and reliable but further research and development, especially

  5. Is the Ability to Ambulate Associated with Better Employment Outcomes in Participants with Traumatic Spinal Cord Injury?

    ERIC Educational Resources Information Center

    Krause, James S.

    2010-01-01

    The author compares current employment status after spinal cord injury between participants who were independent in ambulation (required no assistance from others) and those who were dependent in ambulation (required assistance from at least one other person to ambulate). Those who were independent of assistance from others in ambulation were…

  6. Measuring Returns to Hospital Care: Evidence from Ambulance Referral Patterns

    PubMed Central

    Doyle, Joseph; Graves, John; Gruber, Jonathan

    2014-01-01

    Medicare spending exceeds 4% of GDP in the US each year, and there are concerns that moral hazard problems have led to overspending. This paper considers whether hospitals that treat patients more aggressively and receive higher payments from Medicare improve health outcomes for their patients. An innovation is a new lens to compare hospital performance for emergency patients: plausibly exogenous variation in ambulance-company assignment among patients who live near one another. Using Medicare data from 2002–2010, we show that ambulance company assignment importantly affects hospital choice for patients in the same ZIP code. Using data for New York State from 2000–2006 that matches exact patient addresses to hospital discharge records, we show that patients who live very near each other but on either side of ambulance service area boundaries go to different types of hospitals. Both identification strategies show that higher-cost hospitals achieve better patient outcomes for a variety of emergency conditions. Using our Medicare sample, the estimates imply that a one standard deviation increase in Medicare reimbursement leads to a 4 percentage point reduction in mortality (10% compared to the mean). Taking into account one-year spending after the health shock, the implied cost per at least one year of life saved is approximately $80,000. These results are found across different types of hospitals and patients, as well across both identification strategies. PMID:25750459

  7. [Plea for forensic aftercare--results from an evaluation of forensic ambulances in Germany (area: "Rheinland")].

    PubMed

    Seifert, Dieter; Schiffer, Boris; Leygraf, Norbert

    2003-07-01

    The reintegration of patients from forensic hospitals into society is as difficult as important. At present only a few specialized forensic ambulances can be found in Germany although experts have been demanding an extension of these institutions for years. In the following we will present results from an evaluation study of forensic ambulances in Germany (area: "Rheinland"). Our target is to develop minimum standards or essential pillars for successful ambulance work by taking all participants of the reintegration process into account.

  8. Energy expenditure of trans-tibial amputees during ambulation at self-selected pace.

    PubMed

    Gailey, R S; Wenger, M A; Raya, M; Kirk, N; Erbs, K; Spyropoulos, P; Nash, M S

    1994-08-01

    The purpose of this investigation was two-fold: 1) to compare the metabolic cost (VO2), heart rate (HR), and self-selected speed of ambulation of trans-tibial amputees (TTAs) with those of non-amputee subjects; and 2) to determine whether a correlation exists between either stump length or prosthesis mass and the energy cost of ambulation at the self-selected ambulation pace of TTAs. Subjects were thirty-nine healthy male non-vascular TTAs between the ages of 22 and 75 years (mean +/- sd = 47 +/- 16). All had regularly used their prosthesis for longer than six months and were independent of assistive ambulation devices. Twenty-one healthy non-amputee males aged 27-47 years (31 +/- 6) served as controls. Subjects ambulated at a self-selected pace over an indoor course, with steady-state VO2, HR, and ambulation speed averaged across minutes seven, eight and nine of walking. Results showed that HR and VO2 for TTAs were 16% greater, and the ambulation pace 11% slower than the non-amputee controls. Significant correlations were not observed between stump length or prosthesis mass, and the energy cost of ambulation. However, when the TTA subject pool was stratified on the basis of long and short stump length, the former sustained significantly lower steady-state VO2 and HR than the latter while walking at comparable pace. These data indicate that stump length may influence the metabolic cost of ambulation in TTAs. PMID:7991365

  9. Ambulation without wheelchairs for paraplegics with complete lesions.

    PubMed

    Natvig, H; McAdam, R

    1978-08-01

    Some salient features of the physical training programme for paraplegics at the State Rehabilitation Institute in Oslo are mentioned. A ten-year follow-up study of 42 clients with complete lesions (TI-L3) is presented. After an intensive physical training programme of some 10--15 weeks 74 per cent were able to climb and go down 20 standard stairs and 71 per cent were able to walk 100 metres indoors with crutches. The authors stress the importance of ambulations independent of wheelchairs whenever this is possible. PMID:733293

  10. Pursuing performance. New specs for ambulances and fleet managers.

    PubMed

    Reeder, L

    1994-07-01

    It seems so easy. A call comes in, you get in the ambulance, strap on the seatbelt and turn the key. But there's much more that goes into building the hunk of metal you're sitting in. Each part must meet a design or performance specification. But who sets up these specifications and why? Is it all geared to help you get your patient to the hospital quickly but safely? And what challenges await the maintenance person who must keep that hunk of metal running--and running well? This article will answer some of those questions, but we hope it prompts you to ask even more. PMID:10135485

  11. Determining the Feasibility of Ambulance-Based Randomised Controlled Trials in Patients with Ultra-Acute Stroke: Study Protocol for the "Rapid Intervention with GTN in Hypertensive Stroke Trial" (RIGHT, ISRCTN66434824).

    PubMed

    Ankolekar, Sandeep; Sare, Gillian; Geeganage, Chamila; Fuller, Michael; Stokes, Lynn; Sprigg, Nikola; Parry, Ruth; Siriwardena, A Niroshan; Bath, Philip M W

    2012-01-01

    Background. Time from acute stroke to enrolment in clinical trials needs to be reduced to improve the chances of finding effective treatments. No completed randomised controlled trials of ambulance-based treatment for acute stroke have been reported in the UK, and the practicalities of recruiting, consenting, and treating patients are unknown. Methods. RIGHT is an ambulance based, single-blind, randomised controlled trial with blinded-outcome assessment. The trial will assess feasibility of using ambulance services to deliver ultra-acute stroke treatments; a secondary aim is to assess the effect of glyceryl trinitrate (GTN) on haemodynamic variables and functional outcomes. Initial consent, randomisation, and treatment are performed by paramedics prior to hospitalisation. Patients with ultra-acute stroke (≤4 hours of onset) are randomised to transdermal GTN (5 mg/24 hours) or gauze dressing daily for 7 days. The primary outcome is systolic blood pressure at 2 hours. Secondary outcomes include feasibility, haemodynamics, dependency, and other functional outcomes. A nested qualitative study is included. Trial Status. The trial has all relevant ethics and regulatory approvals and recruitment started on February 15, 2010. The trial stopped recruitment in December 2011 after 41 patients were recruited. Trial Registration. The trial registration number is ISRCTN66434824 and EudraCT number is 2007-004766-40.

  12. Undergraduate Cross Registration.

    ERIC Educational Resources Information Center

    Grupe, Fritz H.

    This report discusses various aspects of undergraduate cross-registration procedures, including the dimensions, values, roles and functions, basic assumptions, and facilitating and encouragment of cross-registration. Dimensions of cross-registration encompass financial exchange, eligibility, program limitations, type of grade and credit; extent of…

  13. Rig safety 9-1-1: what you need to know about ambulance safety & standards.

    PubMed

    Levick, Nadine

    2008-10-01

    What is it that we need to know about ambulance safety? How do we digest the information that's put forward by manufacturers? Does KKK-A-1822 compliance mean the ambulance can endure a crash? What's safe and what isn't? What works and what doesn't? And where do we go to find out?

  14. Impacts of temperature change on ambulance dispatches and seasonal effect modification

    NASA Astrophysics Data System (ADS)

    Cheng, Jian; Xu, Zhiwei; Zhao, Desheng; Xie, Mingyu; Yang, Huihui; Wen, Liying; Li, Kesheng; Su, Hong

    2016-05-01

    Ambulance dispatch is a proxy of acute health outcomes, and growing epidemiological evidence documented its relation to extreme temperature events. Research, however, on short-term temperature change and ambulance dispatches is scarce. We aimed to investigate the effect of short-term temperature change on ambulance dispatches and potential modification by season. Daily data on ambulance dispatch and weather factors were collected in Huainan, a Chinese inland city from December 2011 through December 2013. A Poison generalized linear regression model combined with distributed lag nonlinear model was constructed to examine the association of temperature change between neighboring days (TCN) with ambulance dispatches. The effect modification by season was also examined. There were 48,700 ambulance attendances during the study period. A statistically significant association of TCN with ambulance dispatches was observed. Temperature rise between neighboring days (TCN > 0) was associated with elevated adverse risk of ambulance dispatches, and the effects appeared to be acute (lag0, on the current day) and could last for at least a week, while temperature drop between neighboring days (TCN < 0) had a protective effect. For a 1 °C increase of TCN at lag0 and lag06 (on the 7-day moving average), the risk of ambulance dispatches increased by 2 % (95 % CI 1-3 %) and 7 (95 % CI 1-13 %), respectively. Extreme TCN increase (95th percentile, 3.3 °C vs. 0 °C) at lag0 and lag05 was accompanied by 6 (95 % CI 3-8 %) and 27 % (95 % CI 12-44 %) increase in ambulance dispatches. Ambulance dispatches were more vulnerable to extremely great temperature rise in summer and autumn. TCN was adopted for the first time to quantify the impact of short-term temperature change on ambulance dispatches. Temperature drop between neighboring days (TCN < 0) had a protective effect on ambulance dispatches, while temperature rise between neighboring days (TCN > 0) could acutely trigger the increase in

  15. Prognostic Predictors for Ambulation in Thai Children With Cerebral Palsy Aged 2 to 18 Years.

    PubMed

    Keeratisiroj, Orawan; Thawinchai, Nuanlaor; Siritaratiwat, Wantana; Buntragulpoontawee, Montana

    2015-11-01

    The objectives of this study were to determine prognostic predictors for ambulation among Thai children with cerebral palsy and identify their ambulatory status. A retrospective cohort study was performed at 6 special schools or hospitals for children with physical disabilities. The prognostic predictors for ambulation were analyzed by multivariable ordinal continuation ratio logistic regression. The 533 participants aged 2 to 18 years were divided into 3 groups: 186 with independent ambulation (Gross Motor Function Classification System [GMFCS I-II]), 71 with assisted ambulation (Gross Motor Function Classification System III), and 276 with nonambulation (Gross Motor Function Classification System IV-V). The significant positive predictors for ambulation were type of cerebral palsy (spastic diplegia, spastic hemiplegia, dyskinesia, ataxia, hypotonia, and mixed type), sitting independently at age 2 years, and eating independently. These predictors were used to develop clinical scoring for predicting the future ability to walk among Thai children with cerebral palsy.

  16. Medicare program; coverage and payment of ambulance services; inflation update for CY 2004. Final rule with comment period.

    PubMed

    2003-12-01

    This final rule provides the sunset date for the interim bonus payment for rural ambulance mileage of 18 through 50 miles as required by the Medicare, Medicaid and State Child Health Insurance Program Benefits Improvement and Protection Act of 2000 (BIPA) and provides notice of the annual Ambulance Inflation Factor (AIF) for ambulance services for calendar year (CY) 2004. The statute requires that this inflation factor be applied in determining the fee schedule amounts and payment limits for ambulance services.

  17. Conus medullaris stroke. Does F wave predict return of ambulation?

    PubMed

    Alanazy, Mohammed H

    2016-07-01

    Absent F wave in the stage of spinal shock has been described in cases of traumatic spinal cord injury. The role of F wave in predicting prognosis after conus medullaris infarct has not been described. We describe herein a middle aged-man with a conus medullaris infarct. Both tibial and peroneal F waves were absent on day 4. The left tibial F wave reappeared in the following study on day 18. All F waves reappeared on day 56 at which time the patient was still wheelchair bound. He regained walking on day 105. We hypothesize that reappearance of initially absent F waves post conus medullaris infarct is a good prognostic sign for the return of ambulation. The applicability of this observation requires further research. We also discuss clinical and diagnostic caveats in this case.

  18. Conus medullaris stroke. Does F wave predict return of ambulation?

    PubMed

    Alanazy, Mohammed H

    2016-07-01

    Absent F wave in the stage of spinal shock has been described in cases of traumatic spinal cord injury. The role of F wave in predicting prognosis after conus medullaris infarct has not been described. We describe herein a middle aged-man with a conus medullaris infarct. Both tibial and peroneal F waves were absent on day 4. The left tibial F wave reappeared in the following study on day 18. All F waves reappeared on day 56 at which time the patient was still wheelchair bound. He regained walking on day 105. We hypothesize that reappearance of initially absent F waves post conus medullaris infarct is a good prognostic sign for the return of ambulation. The applicability of this observation requires further research. We also discuss clinical and diagnostic caveats in this case. PMID:27356660

  19. Pendular model of paraplegic swing-through crutch ambulation.

    PubMed

    Rovick, J S; Childress, D S

    1988-01-01

    Kinematics of swing-through crutch ambulation for an individual with complete T11-T12 spinal cord injury was examined and quantitative aspects of the body-swing phase used to formulate and evaluate a 3-link pendular model. Model simulation parallels measured kinematics when shoulder motion is forced to follow the measured motion while hips and crutch tips are free pivots. Shoulder control contributes to increased ground clearance, influences timing and stride length, and gives flowing gait. Results indicate that mechanical work requirements during the body-swing phase are low. Metabolic energy demands exceed mechanical work requirements, due particularly to support of the body by the arms and shoulders. Exploiting low mechanical work requirements of the body-swing phase might be achieved through alternative mechanisms to assist ground clearance and to stabilize the wrists, arms, and shoulders while weight bearing.

  20. Development of Training Programs to Optimize Planetary Ambulation

    NASA Technical Reports Server (NTRS)

    Bloomberg, J. J.; Mulavara, A. P.; Peters, B. T.; Cohen, H. S.; Miller, C. A.; Brady, R.; Warren, L. E.; Rutley, T. M.; Kozlovskaya, I. B.

    2007-01-01

    Astronauts experience disturbances in functional mobility following their return to Earth due to adaptive responses that occur during exposure to the microgravity conditions of space flight. Despite significant time spent performing in-flight exercise routines, these training programs have not been able to mitigate postflight alterations in postural and locomotor function. Therefore, the goal of our two inter-related projects (NSBRI-ground based and ISS flight study, "Mobility") is to develop and test gait training programs that will serve to optimize functional mobility during the adaptation period immediately following space flight, thereby improving the safety and efficiency of planetary ambulation. The gait training program entails manipulating the sensory conditions of treadmill exercise to systematically challenge the balance and gait control system. This enhances the overall adaptability of locomotor function enabling rapid reorganization of gait control to respond to ambulation in different gravitational environments. To develop the training program, we are conducting a series of ground-based studies evaluating the training efficacy associated with variation in visual flow, body loading, and support surface stability during treadmill walking. We will also determine the optimal method to present training stimuli within and across training sessions to maximize both the efficacy and efficiency of the training procedure. Results indicate that variations in both visual flow and body unloading during treadmill walking leads to modification in locomotor control and can be used as effective training modalities. Additionally, the composition and timing of sensory challenges experienced during each training session has significant impact on the ability to rapidly reorganize locomotor function when exposed to a novel sensory environment. We have developed the capability of producing support surface variation during gait training by mounting a treadmill on a six

  1. Improved outcomes for emergency department patients whose ambulance off-stretcher time is not delayed

    PubMed Central

    Crilly, Julia; Keijzers, Gerben; Tippett, Vivienne; O’Dwyer, John; Lind, James; Bost, Nerolie; O’Dwyer, Marilla; Shiels, Sue; Wallis, Marianne

    2015-01-01

    Objective To describe and compare characteristics and outcomes of patients who arrive by ambulance to the ED. We aimed to (i) compare patients with a delayed ambulance offload time (AOT) >30 min with those who were not delayed; and (ii) identify predictors of an ED length of stay (LOS) of >4 h for ambulance-arriving patients. Methods A retrospective, multi-site cohort study was undertaken in Australia using 12 months of linked health data (September 2007–2008). Outcomes of AOT delayed and non-delayed presentations were compared. Logistic regression analysis was undertaken to identify predictors of an ED LOS of >4 h. Results Of the 40 783 linked, analysable ambulance presentations, AOT delay of >30 min was experienced by 15%, and 63% had an ED LOS of >4 h. Patients with an AOT <30 min had better outcomes for: time to triage; ambulance time at hospital; time to see healthcare professional; proportion seen within recommended triage time frame; and ED LOS for both admitted and non-admitted patients. In-hospital mortality did not differ. Strong predictors of an ED LOS >4 h included: hospital admission, older age, triage category, and offload delay >30 min. Conclusion Patients arriving to the ED via ambulance and offloaded within 30 min experience better outcomes than those delayed. Given that offload delay is a modifiable predictor of an ED LOS of >4 h, targeted improvements in the ED arrival process for ambulance patients might be useful. PMID:25940975

  2. [The civil ambulances during the Franc-Prussion war (July 19, 1870 to January 28, 1871)].

    PubMed

    Guivarc'h, Marcel

    2007-01-01

    The civil ambulances joined together under the emblem of the Red Cross: the Company of Help to the Wounded Soldiers, directed from the Palate of Industry by Chenu and Le Fort; the Ambulance of the Press, directed by Ricord and Mgr Bailer; and multiple ambulances disseminated in Paris. They brought a decisive help to the French medical military Corps. On the ground, eigtheen civil Ambulances from Countryside formed in Paris looked after the casualties of the two camps: around Sedan, then in the battles of the Loire and the East, where 13 ambulances formed secondarily in province joined them. During the siege of Paris, flying Ambulances went out the ramparts and brought back the wounded to the Palate of Industry or to Longchamp 'street Press ambulancy. They were integrated in November in a great Coordination of 10 hospitals distributors, directed by Hippolyte Larrey. The surgical care, limited to the members, to the head and the neck, were simple, rapids and conservatives, and the number of amputations was limited. But secondary infectious complications were frequent, had a raised mortality, worsened by the associated diseases, infectious (smallpox, typhoid, pneumonia, and by the cold, hunger, denutrition. The war of 1870-1871 brought: a large humane progress due to the neutralization of the casualties, places and actors of care; a better approach of the infection and shown the need for an autonomy of the French Military Corps.

  3. Energy expenditure of ambulation using the Sure-Gait crutch and the standard axillary crutch.

    PubMed

    Annesley, A L; Almada-Norfleet, M; Arnall, D A; Cornwall, M W

    1990-01-01

    Energy expenditure is increased for ambulation with various assistive devices such as canes, walkers, and crutches compared with unassisted ambulation. The purpose of the present investigation was to determine whether a significant difference in oxygen consumption and heart rate existed during ambulation with two different types of crutches. Ten healthy male subjects between the ages of 40 and 60 years participated in this study. Each subject ambulated at 1.5 mph on a treadmill using two different types of crutches--the standard axillary crutch and the Sure-Gait crutch. After walking on the treadmill without an assistive device, subjects ambulated using a three-point, swing-to gait pattern with one of the two types of crutches. This procedure was repeated using the other type of crutch. Oxygen consumption and heart rate were analyzed using an analysis of variance for repeated measures design. The results of the study showed a significant difference (p less than .01) between ambulation with crutches and unassisted ambulation for oxygen consumption and heart rate. No difference, however, was found between the two crutch types.

  4. Image Registration Workshop Proceedings

    NASA Technical Reports Server (NTRS)

    LeMoigne, Jacqueline (Editor)

    1997-01-01

    Automatic image registration has often been considered as a preliminary step for higher-level processing, such as object recognition or data fusion. But with the unprecedented amounts of data which are being and will continue to be generated by newly developed sensors, the very topic of automatic image registration has become and important research topic. This workshop presents a collection of very high quality work which has been grouped in four main areas: (1) theoretical aspects of image registration; (2) applications to satellite imagery; (3) applications to medical imagery; and (4) image registration for computer vision research.

  5. Occupant accelerations and injury potential during an ambulance-to-curb impact.

    PubMed

    Lee, Ellen L; Hayes, Wilson C

    2014-04-01

    This paper presents real world acceleration data for an ambulance driving up and over a curb. A full scale reenactment was performed for a litigated case in which a patient on a gurney in an ambulance claimed a variety of bodily injuries after the ambulance struck a curb. A height and weight matched surrogate rode on the gurney during the tests. Results demonstrated that peak vehicle and occupant accelerations never exceeded 1.1g's. To address the claimed injuries, the accelerations likely sustained by the patient were compared to those experienced during daily life. Since ambulances are wide vehicles that travel fast on potentially narrow arterial, collector or local roadways, curb or median impacts may occur during the normal course of driving. Thus, these results may be useful for forensic experts in dealing with similar cases involving claimed injuries following curb impacts.

  6. 42 CFR 414.620 - Publication of the ambulance fee schedule.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... from incorporation of the annual inflation factor described in § 414.610(f) will be announced by CMS by... to the fee schedule for ambulance services that result from any factors other than the...

  7. Weather factors in the short-term forecasting of daily ambulance calls.

    PubMed

    Wong, Ho-Ting; Lai, Poh-Chin

    2014-07-01

    The daily ambulance demand for Hong Kong is rising, and it has been shown that weather factors (temperature and humidity) play a role in the demand for ambulance services. This study aimed at developing short-term forecasting models of daily ambulance calls using the 7-day weather forecast data as predictors. We employed the autoregressive integrated moving average (ARIMA) method to analyze over 1.3 million cases of emergency attendance in May 2006 through April 2009 and the 7-day weather forecast data for the same period. Our results showed that the ARIMA model could offer reasonably accurate forecasts of daily ambulance calls at 1-7 days ahead of time and with improved accuracy by including weather factors. Specifically, the inclusion of average temperature alone in our ARIMA model improved the predictability of the 1-day forecast when compared to that of a simple ARIMA model (8.8% decrease in the root mean square error, RMSE=53 vs 58). The improvement in the 7-day forecast with average temperature as a predictor was more pronounced, with a 10% drop in prediction error (RMSE=62 vs 69). These findings suggested that weather forecast data can improve the 1- to 7-day forecasts of daily ambulance demand. As weather forecast data are readily accessible from Hong Kong Observatory's official website, there is virtually no cost to including them in the ARIMA models, which yield better prediction for forward planning and deployment of ambulance manpower.

  8. Weather factors in the short-term forecasting of daily ambulance calls

    NASA Astrophysics Data System (ADS)

    Wong, Ho-Ting; Lai, Poh-Chin

    2013-03-01

    The daily ambulance demand for Hong Kong is rising, and it has been shown that weather factors (temperature and humidity) play a role in the demand for ambulance services. This study aimed at developing short-term forecasting models of daily ambulance calls using the 7-day weather forecast data as predictors. We employed the autoregressive integrated moving average (ARIMA) method to analyze over 1.3 million cases of emergency attendance in May 2006 through April 2009 and the 7-day weather forecast data for the same period. Our results showed that the ARIMA model could offer reasonably accurate forecasts of daily ambulance calls at 1-7 days ahead of time and with improved accuracy by including weather factors. Specifically, the inclusion of average temperature alone in our ARIMA model improved the predictability of the 1-day forecast when compared to that of a simple ARIMA model (8.8 % decrease in the root mean square error, RMSE = 53 vs 58). The improvement in the 7-day forecast with average temperature as a predictor was more pronounced, with a 10 % drop in prediction error (RMSE = 62 vs 69). These findings suggested that weather forecast data can improve the 1- to 7-day forecasts of daily ambulance demand. As weather forecast data are readily accessible from Hong Kong Observatory's official website, there is virtually no cost to including them in the ARIMA models, which yield better prediction for forward planning and deployment of ambulance manpower.

  9. Weather factors in the short-term forecasting of daily ambulance calls.

    PubMed

    Wong, Ho-Ting; Lai, Poh-Chin

    2014-07-01

    The daily ambulance demand for Hong Kong is rising, and it has been shown that weather factors (temperature and humidity) play a role in the demand for ambulance services. This study aimed at developing short-term forecasting models of daily ambulance calls using the 7-day weather forecast data as predictors. We employed the autoregressive integrated moving average (ARIMA) method to analyze over 1.3 million cases of emergency attendance in May 2006 through April 2009 and the 7-day weather forecast data for the same period. Our results showed that the ARIMA model could offer reasonably accurate forecasts of daily ambulance calls at 1-7 days ahead of time and with improved accuracy by including weather factors. Specifically, the inclusion of average temperature alone in our ARIMA model improved the predictability of the 1-day forecast when compared to that of a simple ARIMA model (8.8% decrease in the root mean square error, RMSE=53 vs 58). The improvement in the 7-day forecast with average temperature as a predictor was more pronounced, with a 10% drop in prediction error (RMSE=62 vs 69). These findings suggested that weather forecast data can improve the 1- to 7-day forecasts of daily ambulance demand. As weather forecast data are readily accessible from Hong Kong Observatory's official website, there is virtually no cost to including them in the ARIMA models, which yield better prediction for forward planning and deployment of ambulance manpower. PMID:23456448

  10. Weather factors in the short-term forecasting of daily ambulance calls

    NASA Astrophysics Data System (ADS)

    Wong, Ho-Ting; Lai, Poh-Chin

    2014-07-01

    The daily ambulance demand for Hong Kong is rising, and it has been shown that weather factors (temperature and humidity) play a role in the demand for ambulance services. This study aimed at developing short-term forecasting models of daily ambulance calls using the 7-day weather forecast data as predictors. We employed the autoregressive integrated moving average (ARIMA) method to analyze over 1.3 million cases of emergency attendance in May 2006 through April 2009 and the 7-day weather forecast data for the same period. Our results showed that the ARIMA model could offer reasonably accurate forecasts of daily ambulance calls at 1-7 days ahead of time and with improved accuracy by including weather factors. Specifically, the inclusion of average temperature alone in our ARIMA model improved the predictability of the 1-day forecast when compared to that of a simple ARIMA model (8.8 % decrease in the root mean square error, RMSE = 53 vs 58). The improvement in the 7-day forecast with average temperature as a predictor was more pronounced, with a 10 % drop in prediction error (RMSE = 62 vs 69). These findings suggested that weather forecast data can improve the 1- to 7-day forecasts of daily ambulance demand. As weather forecast data are readily accessible from Hong Kong Observatory's official website, there is virtually no cost to including them in the ARIMA models, which yield better prediction for forward planning and deployment of ambulance manpower.

  11. Demand Forecast Using Data Analytics for the Preallocation of Ambulances.

    PubMed

    Chen, Albert Y; Lu, Tsung-Yu; Ma, Matthew Huei-Ming; Sun, Wei-Zen

    2016-07-01

    The objective of prehospital emergency medical services (EMSs) is to have a short response time. By increasing the operational efficiency, the survival rate of patients could potentially be increased. The geographic information system (GIS) is introduced in this study to manage and visualize the spatial distribution of demand data and forecasting results. A flexible model is implemented in GIS, through which training data are prepared with user-desired sizes for the spatial grid and discretized temporal steps. We applied moving average, artificial neural network, sinusoidal regression, and support vector regression for the forecasting of prehospital emergency medical demand. The results from these approaches, as a reference, could be used for the preallocation of ambulances. A case study is conducted for the EMS in New Taipei City, where prehospital EMS data have been collected for three years. The model selection process has chosen different models with different input features for the forecast of different areas. The best daily mean absolute percentage error during testing of the EMS demand forecast is 23.01%, which is a reasonable forecast based on Lewis' definition. With the acceptable prediction performance, the proposed approach has its potential to be applied to the current practice. PMID:26087507

  12. Demand Forecast Using Data Analytics for the Preallocation of Ambulances.

    PubMed

    Chen, Albert Y; Lu, Tsung-Yu; Ma, Matthew Huei-Ming; Sun, Wei-Zen

    2016-07-01

    The objective of prehospital emergency medical services (EMSs) is to have a short response time. By increasing the operational efficiency, the survival rate of patients could potentially be increased. The geographic information system (GIS) is introduced in this study to manage and visualize the spatial distribution of demand data and forecasting results. A flexible model is implemented in GIS, through which training data are prepared with user-desired sizes for the spatial grid and discretized temporal steps. We applied moving average, artificial neural network, sinusoidal regression, and support vector regression for the forecasting of prehospital emergency medical demand. The results from these approaches, as a reference, could be used for the preallocation of ambulances. A case study is conducted for the EMS in New Taipei City, where prehospital EMS data have been collected for three years. The model selection process has chosen different models with different input features for the forecast of different areas. The best daily mean absolute percentage error during testing of the EMS demand forecast is 23.01%, which is a reasonable forecast based on Lewis' definition. With the acceptable prediction performance, the proposed approach has its potential to be applied to the current practice.

  13. Amputation and ambulation in diabetic patients: function is the goal.

    PubMed

    Attinger, Christopher E; Brown, Benjamin J

    2012-02-01

    The role of amputation in limb salvage is often poorly defined because the surgeon and the patient often attempt to save all limbs at all costs. The difficulty lies in selecting limb salvage versus early amputation. For the sedentary patient, a poorly functional salvaged limb can provide him/her with a higher quality of life than he/she would have with an amputation. For the active patient, early major amputation may offer the best functional outcome. Our experience with diabetic limb salvage over the last 20 years was retrospectively reviewed and compared with the existing literature in an attempt to better understand the role of amputation versus limb salvage in patients with diabetes. In the process, surgical techniques that we believe optimize foot and leg amputations were reviewed. Utilizing a team approach, limb salvage can yield a 64% ambulation rate and an 80% 2-year survival rate. Below-knee amputation led to a similar ambulatory rate, but the 2-year survival in these patients was 52%. With more severe rear-foot ulcers and osteomyelitis, the ambulatory rate declined with each comorbidity. However, those whose foot was saved had a higher chance of walking than those who underwent amputation. Function and quality of life are the outcomes of interest and may be maximized through either limb salvage or amputation. Our job as physicians is to match the correct solution to the patients' lifestyle and their medical, physical and psychological conditions so they can achieve their desired level of activity as quickly as possible.

  14. A Movement Monitor Based on Magneto-Inertial Sensors for Non-Ambulant Patients with Duchenne Muscular Dystrophy: A Pilot Study in Controlled Environment

    PubMed Central

    Moraux, Amélie; Annoussamy, Mélanie; Dorveaux, Eric; Gasnier, Erwan; Hogrel, Jean-Yves; Voit, Thomas; Vissière, David; Servais, Laurent

    2016-01-01

    Measurement of muscle strength and activity of upper limbs of non-ambulant patients with neuromuscular diseases is a major challenge. ActiMyo® is an innovative device that uses magneto-inertial sensors to record angular velocities and linear accelerations that can be used over long periods of time in the home environment. The device was designed to insure long-term stability and good signal to noise ratio, even for very weak movements. In order to determine relevant and pertinent clinical variables with potential for use as outcome measures in clinical trials or to guide therapy decisions, we performed a pilot study in non-ambulant neuromuscular patients. We report here data from seven Duchenne Muscular Dystrophy (DMD) patients (mean age 18.5 ± 5.5 years) collected in a clinical setting. Patients were assessed while wearing the device during performance of validated tasks (MoviPlate, Box and Block test and Minnesota test) and tasks mimicking daily living. The ActiMyo® sensors were placed on the wrists during all the tests. Software designed for use with the device computed several variables to qualify and quantify muscular activity in the non-ambulant subjects. Four variables representative of upper limb activity were studied: the rotation rate, the ratio of the vertical component in the overall acceleration, the hand elevation rate, and an estimate of the power of the upper limb. The correlations between clinical data and physical activity and the ActiMyo® movement parameters were analyzed. The mean of the rotation rate and mean of the elevation rate appeared promising since these variables had the best reliability scores and correlations with task scores. Parameters could be computed even in a patient with a Brooke functional score of 6. The variables chosen are good candidates as potential outcome measures in non-ambulant patients with Duchenne Muscular Dystrophy and use of the ActiMyo® is currently being explored in home environment. Trial Registration

  15. Microbial Air Quality and Bacterial Surface Contamination in Ambulances During Patient Services

    PubMed Central

    Luksamijarulkul, Pipat; Pipitsangjan, Sirikun

    2015-01-01

    Objectives We sought to assess microbial air quality and bacterial surface contamination on medical instruments and the surrounding areas among 30 ambulance runs during service. Methods We performed a cross-sectional study of 106 air samples collected from 30 ambulances before patient services and 212 air samples collected during patient services to assess the bacterial and fungal counts at the two time points. Additionally, 226 surface swab samples were collected from medical instrument surfaces and the surrounding areas before and after ambulance runs. Groups or genus of isolated bacteria and fungi were preliminarily identified by Gram’s stain and lactophenol cotton blue. Data were analyzed using descriptive statistics, t-test, and Pearson’s correlation coefficient with a p-value of less than 0.050 considered significant. Results The mean and standard deviation of bacterial and fungal counts at the start of ambulance runs were 318±485cfu/m3 and 522±581cfu/m3, respectively. Bacterial counts during patient services were 468±607cfu/m3 and fungal counts were 656±612cfu/m3. Mean bacterial and fungal counts during patient services were significantly higher than those at the start of ambulance runs, p=0.005 and p=0.030, respectively. For surface contamination, the overall bacterial counts before and after patient services were 0.8±0.7cfu/cm2 and 1.3±1.1cfu/cm2, respectively (p<0.001). The predominant isolated bacteria and fungi were Staphylococcus spp. and Aspergillus spp., respectively. Additionally, there was a significantly positive correlation between bacterial (r=0.3, p<0.010) and fungal counts (r=0.2, p=0.020) in air samples and bacterial counts on medical instruments and allocated areas. Conclusions This study revealed high microbial contamination (bacterial and fungal) in ambulance air during services and higher bacterial contamination on medical instrument surfaces and allocated areas after ambulance services compared to the start of ambulance runs

  16. 21 CFR 710.8 - Misbranding by reference to registration or to registration number.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... HUMAN SERVICES (CONTINUED) COSMETICS VOLUNTARY REGISTRATION OF COSMETIC PRODUCT ESTABLISHMENTS § 710.8 Misbranding by reference to registration or to registration number. Registration of a cosmetic...

  17. 21 CFR 710.8 - Misbranding by reference to registration or to registration number.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... HUMAN SERVICES (CONTINUED) COSMETICS VOLUNTARY REGISTRATION OF COSMETIC PRODUCT ESTABLISHMENTS § 710.8 Misbranding by reference to registration or to registration number. Registration of a cosmetic...

  18. 21 CFR 710.8 - Misbranding by reference to registration or to registration number.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... HUMAN SERVICES (CONTINUED) COSMETICS VOLUNTARY REGISTRATION OF COSMETIC PRODUCT ESTABLISHMENTS § 710.8 Misbranding by reference to registration or to registration number. Registration of a cosmetic...

  19. 21 CFR 710.8 - Misbranding by reference to registration or to registration number.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... HUMAN SERVICES (CONTINUED) COSMETICS VOLUNTARY REGISTRATION OF COSMETIC PRODUCT ESTABLISHMENTS § 710.8 Misbranding by reference to registration or to registration number. Registration of a cosmetic...

  20. 21 CFR 710.8 - Misbranding by reference to registration or to registration number.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... HUMAN SERVICES (CONTINUED) COSMETICS VOLUNTARY REGISTRATION OF COSMETIC PRODUCT ESTABLISHMENTS § 710.8 Misbranding by reference to registration or to registration number. Registration of a cosmetic...

  1. Using genetic algorithms to optimise current and future health planning - the example of ambulance locations

    PubMed Central

    2010-01-01

    Background Ambulance response time is a crucial factor in patient survival. The number of emergency cases (EMS cases) requiring an ambulance is increasing due to changes in population demographics. This is decreasing ambulance response times to the emergency scene. This paper predicts EMS cases for 5-year intervals from 2020, to 2050 by correlating current EMS cases with demographic factors at the level of the census area and predicted population changes. It then applies a modified grouping genetic algorithm to compare current and future optimal locations and numbers of ambulances. Sets of potential locations were evaluated in terms of the (current and predicted) EMS case distances to those locations. Results Future EMS demands were predicted to increase by 2030 using the model (R2 = 0.71). The optimal locations of ambulances based on future EMS cases were compared with current locations and with optimal locations modelled on current EMS case data. Optimising the location of ambulance stations locations reduced the average response times by 57 seconds. Current and predicted future EMS demand at modelled locations were calculated and compared. Conclusions The reallocation of ambulances to optimal locations improved response times and could contribute to higher survival rates from life-threatening medical events. Modelling EMS case 'demand' over census areas allows the data to be correlated to population characteristics and optimal 'supply' locations to be identified. Comparing current and future optimal scenarios allows more nuanced planning decisions to be made. This is a generic methodology that could be used to provide evidence in support of public health planning and decision making. PMID:20109172

  2. Can innovative ambulance transport avert pregnancy–related deaths? One–year operational assessment in Ethiopia

    PubMed Central

    Godefay, Hagos; Kinsman, John; Admasu, Kesetebirhan; Byass, Peter

    2016-01-01

    Background To maximise the potential benefits of maternity care services, pregnant women need to be able to physically get to health facilities in a timely manner. In most of sub–Saharan Africa, transport represents a major practical barrier. Here we evaluate the extent to which an innovative national ambulance service in Ethiopia, together with mobile phones, may have been successful in averting pregnancy–related deaths. Methods An operational assessment of pregnancy–related deaths in relation to utilisation of the new national ambulance service was undertaken in six randomly selected Districts in northern Ethiopia. All 183 286 households in the six randomly selected Districts were visited to identify live–births and deaths among women of reproductive age that occurred over a one–year period. The uptake of the new ambulance transport service for women’s deliveries in the same six randomly selected Districts over the same period was determined retrospectively from ambulance log books. Pregnancy–related deaths as determined by the World Health Organization (WHO 2012) verbal autopsy tool [13] and the InterVA–4 model [14] were analysed against ambulance utilisation by District, month, local area, distance from health facility and mobile network coverage. Findings A total of 51 pregnancy–related deaths and 19 179 live–births were documented. Pregnancy–related mortality for Districts with above average ambulance utilisation was 149 per 100 000 live–births (95% confidence interval CI 77–260), compared with 350 per 100 000 (95% CI 249–479) for below average utilisation (P = 0.01). Distance to a health facility, mobile network availability and ambulance utilisation were all significantly associated with pregnancy–related mortality on a bivariable basis. On a multivariable basis, ambulance non–utilisation uniquely persisted as a significant determinant of mortality (mortality rate ratio 1.97, 95% CI 1.05–3.69; P = 0

  3. A national census of ambulance response times to emergency calls in Ireland

    PubMed Central

    Breen, N.; Woods, J.; Bury, G.; Murphy, A.; Brazier, H.

    2000-01-01

    Background—Equity of access to appropriate pre-hospital emergency care is a core principle underlying an effective ambulance service. Care must be provided within a timeframe in which it is likely to be effective. A national census of response times to emergency and urgent calls in statutory ambulance services in Ireland was undertaken to assess current service provision. Methods—A prospective census of response times to all emergency and urgent calls was carried out in the nine ambulance services in the country over a period of one week. The times for call receipt, activation, arrival at and departure from scene and arrival at hospital were analysed. Crew type, location of call and distance from ambulance base were detailed. The type of incident leading to the call was recorded but no further clinical information was gathered. Results—2426 emergency calls were received by the services during the week. Fourteen per cent took five minutes or longer to activate (range 5–33%). Thirty eight per cent of emergencies received a response within nine minutes (range 10–47%). Only 4.5% of emergency calls originating greater than five miles from an ambulance station were responded to within nine minutes (range 0–10%). Median patient care times for "on call" crews were three times longer than "on duty" crews. Conclusion—Without prioritised use of available resources, inappropriately delayed responses to critical incidents will continue. Recommendations are made to improve the effectiveness of emergency medical service utilisation. PMID:11104237

  4. Recovery of ambulation activity across the first six months post-stroke.

    PubMed

    Mahendran, Niruthikha; Kuys, Suzanne S; Brauer, Sandra G

    2016-09-01

    Stroke survivors commonly adopt sedentary activity behaviours by the chronic phase of recovery. However, the change in activity behaviours from the subacute to chronic phase of stroke is variable. This study explored the recovery of ambulation activity (volume and bouts) at one, three and six months after hospital discharge post-stroke. A total of 42 stroke survivors were recruited at hospital discharge and followed up one, three and six months later. At follow-up, ambulation activity was measured over four days using the ActivPAL™ accelerometer. Measures included volume of activity and frequency and intensity of ambulation activity bouts per day. Linear mixed effects modelling was used to determine changes over time. There was wide variation in activity. Total step counts across all time points were below required levels for health benefits (mean 4592 SD 3411). Most activity was spread across short bouts. While most number of bouts was of low intensity, most time was spent in moderate intensity ambulation across all time points. Daily step count and time spent walking and sitting/lying increased from one month to three and six months. The number of and time spent in short and medium duration bouts increased from one to six months. Time in long duration bouts increased at three months only. Time spent in moderate intensity ambulation increased over time. No change was observed for any other measures. In future, it would be valuable to identify strategies to increase engagement in activity behaviours to improve health outcomes after stroke.

  5. The impact of postoperative pain on early ambulation after hip fracture.

    PubMed

    Dubljanin-Raspopović, E; Marković-Denić, L; Ivković, K; Nedeljković, U; Tomanović, S; Kadija, M; Tulić, G; Bumbasirević, M

    2013-01-01

    Hip fractures are the most serious consequence of falling in older people with osteoporosis. Early ambulation is one of the main goals of inpatient rehabilitation aimed at reducing negative effects of immobilization, and promoting functional recovery. Recognizing the role of different factors that are associated with time to ambulation time after hip fracture surgery may help decrease morbidity and mortality rates. The aim of this study was to examine the impact of postoperative pain time to ambulation following hip fracture surgery. A total of 96 patients who consecutively presented at the Clinic for Orthopaedic Surgery and Traumatology, Clinical Center Serbia during a 6 month period were included in the study. Subjects were assessed regarding socioedemographic characteristics, prefracture functional status, cognitive status, general health status, fracture type, type of anaesthesia, and waiting time for surgery. The VAS scale (0-100) was used to measure pain intensity on the first postoperative day. Our results revealed that patients, whose time to ambulation was = 48 h postoperatively were of worse physical health, and had significantly higher VAS score on the first postoperative day. Unrelieved pain in geriatric hip fracture patients is associated with delayed ambulation. Future research should confirm the posi-tive effects of aggressive pain management programs on early functional outcome in elderly patients who sustain hip fractures.

  6. Ambulation speed and corresponding mechanics are associated with changes in serum cartilage oligomeric matrix protein.

    PubMed

    Denning, W Matt; Becker Pardo, Michael; Winward, Jason G; Hunter, Iain; Ridge, Sarah; Hopkins, J Ty; Reese, C Shane; Parcell, Allen C; Seeley, Matthew K

    2016-02-01

    Because serum cartilage oligomeric matrix protein (COMP) has been used to reflect articular cartilage condition, we aimed to identify walking and running mechanics that are associated with changes in serum COMP. Eighteen subjects (9 male, 9 female; age=23 ± 2 yrs.; mass=68.3 ± 9.6 kg; height=1.70 ± 0.08 m) completed 4000 steps on an instrumented treadmill on three separate days. Each day corresponded to a different ambulation speed: slow (preferred walking speed), medium (+50% of slow), and fast (+100% of slow). Synchronized ground reaction force and video data were collected to evaluate walking mechanics. Blood samples were collected pre-, post-, 30-minute post-, and 60-minute post-ambulation to determine serum COMP concentration at these times. Serum COMP increased 29%, 18%, and 5% immediately post ambulation for the fast, medium, and slow sessions (p<0.01). When the speeds were pooled, peak ankle inversion, knee extension, knee abduction, hip flexion, hip extension, and hip abduction moment, and knee flexion angle at impact explained 61.4% of total variance in COMP concentration change (p<0.001). These results indicate that (1) certain joint mechanics are associated with acute change in serum COMP due to ambulation, and (2) increased ambulation speed increases serum COMP concentration. PMID:27004646

  7. 14 CFR 47.15 - Registration number.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Registration number. 47.15 Section 47.15... REGISTRATION General § 47.15 Registration number. (a) Number required. An applicant for aircraft registration must place a U.S. registration number (registration mark) on the Aircraft Registration Application,...

  8. User Registration in EOSDIS

    NASA Astrophysics Data System (ADS)

    Murphy, K. J.; Mitchell, A. E.

    2009-12-01

    Throughout the lifetime of EOSDIS the topic of user registration has received varied attention. Initially, for example, users ordering data from the Earth Science Data Gateway were required to register for delivery of media orders, to check order status and save profile information for future interactions. As EOSDIS embraced evolution of its data systems, the mostly centralized search and order system was replaced with a more diverse set of interfaces allowing (mostly) anonymous online access to data, tools and services. The changes to EOSDIS were embraced by users but the anonymous nature of the interaction made it more difficult to characterize users, capture metrics and provide customized services that benefit users. Additionally, new tools and interfaces have been developed without a centralized registration system. Currently a patchwork of independent registration systems exists throughout EOSDIS for ordering data and interacting with online tools and services. Each requires a separate username and password that must be managed by users. A consolidation of registration systems presents an opportunity to improve not only the user experience through tool customization and simplification of password management, but the understanding of users. This work discusses the options for implementing a common user registration for the EOSDIS, anticipated benefits and pitfalls.

  9. Availability of ambulance patient care reports in the emergency department.

    PubMed

    Shelton, Dominick; Sinclair, Paul

    2016-01-01

    Clinical handovers of patient care among healthcare professionals is vulnerable to the loss of important clinical information. A verbal report is typically provided by paramedics and documented by emergency department (ED) triage nurses. Paramedics subsequently complete a patient care report which is submitted electronically. This emergency medical system (EMS) patient care report often contains details of paramedic assessment and management that is not all captured in the nursing triage note. EMS patient care reports are often unavailable for review by emergency physicians and nurses. Two processes occur in the distribution of EMS patient care reports. The first is an external process to the ED that is influenced by the prehospital emergency medical system and results in the report being faxed to the ED. The second process is internal to the ED that requires clerical staff to distribute the fax report to accompany patient charts. A baseline audit measured the percentage of EMS patient care reports that were available to emergency physicians at the time of initial patient assessments and showed a wide variation in the availability of EMS reports. Also measured were the time intervals from patient transfer from EMS to ED stretcher until the EMS report was received by fax (external process measure) and the time from receiving the EMS fax report until distribution to patient chart (internal process measure). These baseline measures showed a wide variation in the time it takes to receive the EMS reports by fax and to distribute reports. Improvement strategies consisted of: 1. Educating ED clerical staff about the importance of EMS reports 2. Implementing a new process to minimize ED clerical staff handling of EMS reports for nonactive ED patients 3. Elimination of the automatic retrieval of old hospital charts and their distribution for ED patients 4. Introduction of an electronic dashboard for patients arriving by ambulance to facilitate more efficient distribution of

  10. Availability of ambulance patient care reports in the emergency department

    PubMed Central

    Shelton, Dominick; Sinclair, Paul

    2016-01-01

    Clinical handovers of patient care among healthcare professionals is vulnerable to the loss of important clinical information. A verbal report is typically provided by paramedics and documented by emergency department (ED) triage nurses. Paramedics subsequently complete a patient care report which is submitted electronically. This emergency medical system (EMS) patient care report often contains details of paramedic assessment and management that is not all captured in the nursing triage note. EMS patient care reports are often unavailable for review by emergency physicians and nurses. Two processes occur in the distribution of EMS patient care reports. The first is an external process to the ED that is influenced by the prehospital emergency medical system and results in the report being faxed to the ED. The second process is internal to the ED that requires clerical staff to distribute the fax report to accompany patient charts. A baseline audit measured the percentage of EMS patient care reports that were available to emergency physicians at the time of initial patient assessments and showed a wide variation in the availability of EMS reports. Also measured were the time intervals from patient transfer from EMS to ED stretcher until the EMS report was received by fax (external process measure) and the time from receiving the EMS fax report until distribution to patient chart (internal process measure). These baseline measures showed a wide variation in the time it takes to receive the EMS reports by fax and to distribute reports. Improvement strategies consisted of: 1. Educating ED clerical staff about the importance of EMS reports 2. Implementing a new process to minimize ED clerical staff handling of EMS reports for nonactive ED patients 3. Elimination of the automatic retrieval of old hospital charts and their distribution for ED patients 4. Introduction of an electronic dashboard for patients arriving by ambulance to facilitate more efficient distribution of

  11. The effects of assistive devices on the oxygen cost, cardiovascular stress, and perception of nonweight-bearing ambulation.

    PubMed

    Holder, C G; Haskvitz, E M; Weltman, A

    1993-10-01

    Nonweight-bearing ambulation with the aid of an assistive device is often prescribed in the clinical setting. Little is known about the oxygen cost, cardiovascular stress, and perception of effort of these devices when applied to the same sample of subjects. Therefore, the present study compared the oxygen cost, cardiovascular stress [measured by heart rate (HR), blood pressure (BP) responses, and rate pressure product (RPP)], and perception of effort [measured by ratings of perceived exertion (RPE)] of unassisted ambulation (UA), nonweight-bearing ambulation using axillary crutches (AC), a standard walker (SW), and a wheeled walker (WW). Nine female subjects ambulated at self-selected velocities for 7 minutes during each ambulation mode. Oxygen consumption, HR, BP, and RPEs were obtained. As expected, UA resulted in the lowest VO2 (11.2 +/- 1.4 ml/kg.min-1) and greatest velocity (1.24 +/- 0.27 m/sec). Results also indicated that AC ambulation resulted in lower oxygen consumption per meter (0.4 +/- 0.1 ml/kg.m-1) and greater velocity (0.74 +/- 0.18 m/sec) than either SW ambulation (0.6 +/- .1 ml/kg.-1, 0.39 +/- 0.09 m/sec) or WW ambulation (0.6 +/- .1 ml/kg.m-1, 0.40 +/- 0.12 m/sec) (p < .05). No differences were observed among assisted ambulation modes for HR, BP responses, RPP, or RPE values. Because patients typically ambulate for a set distance (rather than a set time) and because the oxygen cost per unit distance was lowest for AC, it is suggested that, when possible, AC should be prescribed for non-weight-bearing ambulation.

  12. Suicidal ideation and suicide attempts in a nationwide sample of operational Norwegian ambulance personnel.

    PubMed

    Sterud, Tom; Hem, Erlend; Lau, Bjørn; Ekeberg, Oivind

    2008-01-01

    This is the first paper on suicidal ideation and attempts among ambulance personnel. This study aimed to investigate levels of suicidal ideation and suicide attempts among ambulance personnel, and to identify important correlates and the factors to which ambulance personnel attribute their serious suicidal ideation. A comprehensive nationwide questionnaire survey of 1,180 operational ambulance personnel was conducted. Measurements included: Paykel's Suicidal Feelings in the General Population questionnaire, the Hospital Anxiety and Depression scale, the Subjective Health Complaints Questionnaire, the Maslach Burnout Inventory, the Job Satisfaction Scale, the Basic Character Inventory, and the Rosenberg Self-Esteem Scale. Lifetime prevalence ranged from 28% for feelings that life was not worth living to 10.4% for seriously considered suicide and 3.1% for a suicide attempt. Serious suicidal ideation was independently associated with job-related emotional exhaustion (feelings of being overextended and depleted of resources) (OR 1.5, 95% CI 1.1-2.0) and bullying at work (OR 1.7, 95% CI 1.02-2.7), younger age, not married/cohabitant, depression symptoms, low self-esteem and the personality trait reality weakness. In general, suicidal thoughts were hardly attributable to working conditions, since only 1.8% of ambulance personnel attributed suicidal ideation to work problems alone. In conclusion, ambulance personnel reported a moderate level of suicidal ideation and suicide attempts. Although serious suicidal ideation was rarely attributed to working conditions in general, this study suggests that job-related factors like emotional exhaustion and bullying may be of importance.

  13. Management and the creation of occupational stressors in an Australian and a UK ambulance service.

    PubMed

    Mahony, K L

    2001-01-01

    Qualitative methods were used to explore the aetiology of occupational stress experienced by on-road ambulance officers. The researcher found that the way in which a service is organised and its officers valued can create and reproduce workplace stressors that are as causative of occupational stress as the often acknowledged occupational specific stressors like night shifts, irregular work hours and witnessing human trauma and tragedy. These stressors thought to be intrinsic to the work of ambulance officers were found to have an organisational dimension.

  14. On an ambulance stretcher suspension concerned with the reduction of patient's blood pressure variation.

    PubMed

    Sagawa, K; Inooka, H; Ino-oka, E; Takahashi, T

    1997-01-01

    The design process and control of an ambulance stretcher suspension to reduce patient's blood pressure variation (BPV) is discussed. The BPV caused by applying the vehicle brakes may lead to deterioration of a patient's condition. The proposed method can reduce BPV by tilting the stretcher and counterbalancing back-to-front acceleration of the ambulance with gravity. The experimental results obtained when using a manually controlled stretcher confirm that BPV is reduced by tilting the stretcher. A continuous control method that varies the tilting angle is investigated through simulation analysis. The results show that this control method reduces the BPV effectively and achieves safe transport of the patient.

  15. Ambulance and aeromedical accident rates during emergency retrieval in Great Britain.

    PubMed

    Lutman, D; Montgomery, M; Ramnarayan, P; Petros, A

    2008-05-01

    The retrieval of critically ill patients is frequently done in difficult circumstances and often under considerable time pressures. These adverse conditions have a finite risk of serious injury or death. The level of risk is poorly described in the literature and reliable data on accident rates are hard to find. Most of the information comes from North America. There are no clear published statistics for the UK. We report for the first time data on accidents and casualties involving vehicles classified as having an ambulance body type and air ambulances within Great Britain between 1999 and 2004. PMID:18434473

  16. Work-related psychosocial factors, worry about work conditions and health complaints among female and male ambulance personnel.

    PubMed

    Aasa, Ulrika; Brulin, Christine; Angquist, Karl-Axel; Barnekow-Bergkvist, Margareta

    2005-09-01

    This study aimed at investigating the relationships between work-related psychosocial factors, worry about work conditions and health complaints (sleeping problems, headache and stomach symptoms) among female and male ambulance personnel. Out of 4000 ambulance personnel in Sweden, 1500 (300 female and 1200 male personnel) were randomly selected. They answered a questionnaire including items on self-reported health complaints, individual characteristics, work-related psychological demands, decision latitude, social support and worry about work conditions. Twenty-five per cent of the female and 20% of the male ambulance personnel reported two or more health complaints sometimes or often. According to the demand-control-support questionnaire, ambulance personnel reported a generally positive psychosocial work environment, although psychological demands were associated with sleeping problems, headache and stomach symptoms among both female and male ambulance personnel. Another factor that was significantly associated with health complaints among both genders was worry about work conditions. When worry about work conditions was added to the regression models, this variable took over the role from psychological demands as a predictor for health complaints among the female ambulance personnel. The prevalence of sleeping problems, headache and stomach symptoms were significantly associated with psychological demands among both female and male ambulance personnel. Notably, worry about work conditions seems to be an important risk factor for health complaints. This suggests that worry about work conditions should not be neglected when considering risk factors among ambulance personnel.

  17. Assessing Pesticide Impact on Human Health in Nebraska: A Survey of Ambulance Services and Rescue Squads. Department Report No. 7.

    ERIC Educational Resources Information Center

    Vitzthum, Edward F.; And Others

    A study examined the employment qualifications, job content, training, and training needs of ambulance service and rescue squad workers in Nebraska. Based on the 268 mail questionnaires that were completed and returned out of a total of 338 sent out, it was concluded that the strengths of the various ambulance and rescue services vary widely. The…

  18. Work-related psychosocial factors, worry about work conditions and health complaints among female and male ambulance personnel.

    PubMed

    Aasa, Ulrika; Brulin, Christine; Angquist, Karl-Axel; Barnekow-Bergkvist, Margareta

    2005-09-01

    This study aimed at investigating the relationships between work-related psychosocial factors, worry about work conditions and health complaints (sleeping problems, headache and stomach symptoms) among female and male ambulance personnel. Out of 4000 ambulance personnel in Sweden, 1500 (300 female and 1200 male personnel) were randomly selected. They answered a questionnaire including items on self-reported health complaints, individual characteristics, work-related psychological demands, decision latitude, social support and worry about work conditions. Twenty-five per cent of the female and 20% of the male ambulance personnel reported two or more health complaints sometimes or often. According to the demand-control-support questionnaire, ambulance personnel reported a generally positive psychosocial work environment, although psychological demands were associated with sleeping problems, headache and stomach symptoms among both female and male ambulance personnel. Another factor that was significantly associated with health complaints among both genders was worry about work conditions. When worry about work conditions was added to the regression models, this variable took over the role from psychological demands as a predictor for health complaints among the female ambulance personnel. The prevalence of sleeping problems, headache and stomach symptoms were significantly associated with psychological demands among both female and male ambulance personnel. Notably, worry about work conditions seems to be an important risk factor for health complaints. This suggests that worry about work conditions should not be neglected when considering risk factors among ambulance personnel. PMID:16101853

  19. Earth Science Imagery Registration

    NASA Technical Reports Server (NTRS)

    LeMoigne, Jacqueline; Morisette, Jeffrey; Cole-Rhodes, Arlene; Johnson, Kisha; Netanyahu, Nathan S.; Eastman, Roger; Stone, Harold; Zavorin, Ilya

    2003-01-01

    The study of global environmental changes involves the comparison, fusion, and integration of multiple types of remotely-sensed data at various temporal, radiometric, and spatial resolutions. Results of this integration may be utilized for global change analysis, as well as for the validation of new instruments or for new data analysis. Furthermore, future multiple satellite missions will include many different sensors carried on separate platforms, and the amount of remote sensing data to be combined is increasing tremendously. For all of these applications, the first required step is fast and automatic image registration, and as this need for automating registration techniques is being recognized, it becomes necessary to survey all the registration methods which may be applicable to Earth and space science problems and to evaluate their performances on a large variety of existing remote sensing data as well as on simulated data of soon-to-be-flown instruments. In this paper we present one of the first steps toward such an exhaustive quantitative evaluation. First, the different components of image registration algorithms are reviewed, and different choices for each of these components are described. Then, the results of the evaluation of the corresponding algorithms combining these components are presented o n several datasets. The algorithms are based on gray levels or wavelet features and compute rigid transformations (including scale, rotation, and shifts). Test datasets include synthetic data as well as data acquired over several EOS Land Validation Core Sites with the IKONOS and the Landsat-7 sensors.

  20. Registration Study. Research Note.

    ERIC Educational Resources Information Center

    Baratta, Mary Kathryne

    During spring 1977 registration, 3,255 or 45% of Moraine Valley Community College (MVCC) registering students responded to a scheduling preferences and problems questionnaire covering enrollment status, curriculum load, program preference, ability to obtain courses, schedule conflicts, preferred times for class offerings, actual scheduling of…

  1. CUNY's Voter Registration System.

    ERIC Educational Resources Information Center

    Hershenson, Jay; And Others

    This collection of items including public testimony by the Vice Chancellor, Jay Hershenson, a formal resolution, a press release, and brochures, documents the City University of New York's (CUNY) unique voter registration system, "CUNY Project Vote". As the press release describes it, Project Vote is the nation's largest student voter registration…

  2. Registrations and vehicle miles of travel of light duty vehicles, 1985--1995

    SciTech Connect

    Hu, P.S.; Davis, S.C.; Schmoyer, R.L.

    1998-02-01

    To obtain vehicle registration data that consistently and accurately reflect the distinction between automobiles and light-duty trucks, Oak Ridge National Laboratory (ORNL) was asked by FHWA to estimate the current and historical vehicle registration numbers of automobiles and of other two-axle four-tire vehicles (i.e., light-duty trucks), and their associated travel. The term automobile is synonymous with passenger car. Passenger cars are defined as all sedans, coupes, and station wagons manufactured primarily for the purpose of carrying passengers. This includes taxicabs, rental cars, and ambulances and hearses on an automobile chassis. Light-duty trucks refer to all two-axle four-tire vehicles other than passenger cars. They include pickup trucks, panel trucks, delivery and passenger vans, and other vehicles such as campers, motor homes, ambulances on a truck chassis, hearses on a truck chassis, and carryalls. In this study, light-duty trucks include four major types: (1) pickup truck, (2) van, (3) sport utility vehicle, and (4) other 2-axle 4-tire truck. Specifically, this project re-estimates statistics that appeared in Tables MV-1 and MV-9 of the 1995 Highway Statistics. Given the complexity of the approach developed in this effort and the incompleteness and inconsistency of the state-submitted data, it is recommended that alternatives be considered by FHWA to obtain vehicle registration data. One alternative is the Polk`s NVPP data (via the US Department of Transportation`s annual subscription to Polk). The second alternative is to obtain raw registration files from individual states` Departments of Motor Vehicles and to decode individual VINs.

  3. Upper Limb Evaluation and One-Year Follow Up of Non-Ambulant Patients with Spinal Muscular Atrophy: An Observational Multicenter Trial

    PubMed Central

    Canal, Aurélie; Decostre, Valérie; Diebate, Oumar; Le Moing, Anne Gaëlle; Gidaro, Teresa; Deconinck, Nicolas; Van Parys, Frauke; Vereecke, Wendy; Wittevrongel, Sylvia; Annoussamy, Mélanie; Mayer, Michèle; Maincent, Kim; Cuisset, Jean-Marie; Tiffreau, Vincent; Denis, Severine; Jousten, Virginie; Quijano-Roy, Susana; Voit, Thomas; Hogrel, Jean-Yves; Servais, Laurent

    2015-01-01

    Assessment of the upper limb strength in non-ambulant neuromuscular patients remains challenging. Although potential outcome measures have been reported, longitudinal data demonstrating sensitivity to clinical evolution in spinal muscular atrophy patients are critically lacking. Our study recruited 23 non-ambulant patients, 16 patients (males/females = 6/10; median age 15.4 years with a range from 10.7 to 31.1 years) with spinal muscular atrophy type II and 7 patients (males/females = 2/5; median age 19.9 years with a range from 8.3 to 29.9 years) with type III. The Brooke functional score was on median 3 with a range from 2 to 6. The average total vital capacity was 46%, and seven patients required non-invasive ventilation at night. Patients were assessed at baseline, 6 months, and 1 year using the Motor Function Measure and innovative devices MyoGrip, MyoPinch, and MoviPlate, which assess handgrip strength, key pinch strength, and hand/finger extension-flexion function, respectively. The study demonstrated the feasibility and reliability of these measures for all patients, and sensitivity to negative changes after the age of 14 years. The younger patients showed an increase of the distal force in the follow-up period. The distal force measurements and function were correlated to different functional scales. These data represent an important step in the process of validating these devices as potential outcome measures for future clinical trials. Trial Registration ClinicalTrials.gov NCT00993161 PMID:25861036

  4. The effect of active warming in prehospital trauma care during road and air ambulance transportation - a clinical randomized trial

    PubMed Central

    2011-01-01

    Background Prevention and treatment of hypothermia by active warming in prehospital trauma care is recommended but scientifical evidence of its effectiveness in a clinical setting is scarce. The objective of this study was to evaluate the effect of additional active warming during road or air ambulance transportation of trauma patients. Methods Patients were assigned to either passive warming with blankets or passive warming with blankets with the addition of an active warming intervention using a large chemical heat pad applied to the upper torso. Ear canal temperature, subjective sensation of cold discomfort and vital signs were monitored. Results Mean core temperatures increased from 35.1°C (95% CI; 34.7-35.5°C) to 36.0°C (95% CI; 35.7-36.3°C) (p < 0.05) in patients assigned to passive warming only (n = 22) and from 35.6°C (95% CI; 35.2-36.0°C) to 36.4°C (95% CI; 36.1-36.7°C) (p < 0.05) in patients assigned to additional active warming (n = 26) with no significant differences between the groups. Cold discomfort decreased in 2/3 of patients assigned to passive warming only and in all patients assigned to additional active warming, the difference in cold discomfort change being statistically significant (p < 0.05). Patients assigned to additional active warming also presented a statistically significant decrease in heart rate and respiratory frequency (p < 0.05). Conclusions In mildly hypothermic trauma patients, with preserved shivering capacity, adequate passive warming is an effective treatment to establish a slow rewarming rate and to reduce cold discomfort during prehospital transportation. However, the addition of active warming using a chemical heat pad applied to the torso will significantly improve thermal comfort even further and might also reduce the cold induced stress response. Trial Registration ClinicalTrials.gov: NCT01400152 PMID:22017799

  5. Basic Training Program for Emergency Medical Technician: Ambulance Concepts and Recommendations.

    ERIC Educational Resources Information Center

    Fucigna, Joseph T.; And Others

    The main objective was to develop and pilot test a basic course for ambulance personnel with emphasis on the medical aspect of training. This included the identification of a medically acceptable text or manual, and determining the prerequisites for selecting students and instructors. Secondary objectives were to outline the requirements for…

  6. Emergency Medical Technician-Ambulance: National Standard Curriculum. Course Guide (Third Edition).

    ERIC Educational Resources Information Center

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

    This course guide is intended to assist course coordinators in planning and managing a course to train emergency medical technicians to work with ambulance or other specialized rescue services. Materials are presented to enable students to perform the following functions: recognize the nature and seriousness of the patient's condition or extent of…

  7. Functional ambulation velocity and distance requirements in rural and urban communities. A clinical report.

    PubMed

    Robinett, C S; Vondran, M A

    1988-09-01

    The purposes of this clinical report are 1) to document the distances and velocities that individuals must ambulate to function independently in their community and 2) to demonstrate the differences in travel distances and velocities among communities of various sizes. In seven communities of different sizes, we measured distances from a designated parking space to commonly frequented sites (eg, stores, post offices, banks, and medical buildings). We also measured street widths and the time allowed by crossing signals to cross streets safely. From these data, we calculated the velocities needed to safely cross streets in each community. The study results showed that ambulation distances and velocities vary depending on the size of the community and that for individuals to function independently within their community, they must ambulate at velocities and distances much greater than the ambulation objectives that may be set at most rehabilitation settings. Based on the results of this study, we suggest that they receive the majority of their patients to more accurately prepare patients for functional independence after rehabilitation discharge.

  8. Promoting Ambulation Responses among Children with Multiple Disabilities through Walkers and Microswitches with Contingent Stimuli

    ERIC Educational Resources Information Center

    Lancioni, Giulio E.; Singh, Nirbhay N.; O'Reilly, Mark F.; Sigafoos, Jeff; Oliva, Doretta; Smaldone, Angela; La Martire, Maria L.; Stasolla, Fabrizio; Castagnaro, Francesca; Groeneweg, Jop

    2010-01-01

    Children with severe or profound intellectual and motor disabilities often present problems of balance and ambulation and spend much of their time sitting or lying, with negative consequences for their development and social status. Recent research has shown the possibility of using a walker (support) device and microswitches with preferred…

  9. A new vibration isolation bed stage with magnetorheological dampers for ambulance vehicles

    NASA Astrophysics Data System (ADS)

    Chae, Hee Dong; Choi, Seung-Bok

    2015-01-01

    The vibration experienced in an ambulance can lead to secondary injury to a patient and discourage a paramedic from providing emergency care. In this study, with the goal of resolving this problem, a new vibration isolation bed stage associated with magnetorheological (MR) dampers is proposed to ensure ride quality as well as better care for the patient while he/she is being transported. The bed stage proposed in this work can isolate vibrations in the vertical, rolling and pitching directions to reflect the reality that occurs in the ambulance. Firstly, an appropriate-sized MR damper is designed based on the field-dependent rheological properties of MR fluid, and the damping force characteristics of a MR damper are evaluated as a function of the current. A mechanical model of the proposed vibration isolation bed stage is then established to derive the governing equations of motion. Subsequently, a sliding mode controller is formulated to control the vibrations caused from the imposed excitation signals; those signals are directly measured using a real ambulance subjected to bump-and-curve road conditions. Using the controller based on the dynamic motion of the bed stage, the vibration control performance is evaluated in both the vertical and pitch directions. It is demonstrated that the magnitude of the vibration in the patient compartment of the ambulance can be significantly reduced by applying an input current to the MR dampers installed for the new bed stage.

  10. Functional ability and muscle force in healthy children and ambulant Duchenne muscular dystrophy patients.

    PubMed

    Beenakker, Ernesto A C; Maurits, Natalia M; Fock, Johanna M; Brouwer, Oebele F; van der Hoeven, Johannes H

    2005-01-01

    Neuromuscular disorders are characterised by progressive muscle weakness, which in time causes functional impairment. To quantify the extent of disease progression, muscle force and functional ability can be measured. Which of these parameters changes most depends on the disease stage. In a previous study, we reported normal values for muscle force obtained by hand-held dynamometry in healthy children aged 4-16 years. In the present study, we report normal values for timed functional tests in healthy children aged 4-11 years. These normal values were compared with values obtained in 16 ambulant patients with Duchenne muscular dystrophy (DMD) aged 5-8 years to study the extent of functional impairment. In ambulant patients with DMD, we found that muscle function assessed by timed functional tests (running 9 m and rising up from the floor) and muscle force assessed by hand-held dynamometry were severely impaired. However, a small reduction of muscle force was accompanied by a large reduction in functional ability. Therefore, in our group of ambulant patients with DMD, timed functional testing was the most sensitive parameter to determine the extent of disease progression. Timed functional testing may therefore be considered as an additional outcome measure in drug trials to evaluate the effects of therapy in ambulant patients with DMD and possibly in other neuromuscular disorders.

  11. A non-contact vital sign monitoring system for ambulances using dual-frequency microwave radars.

    PubMed

    Suzuki, Satoshi; Matsui, Takemi; Kawahara, Hiroshi; Ichiki, Hiroto; Shimizu, Jun; Kondo, Yoko; Gotoh, Shinji; Yura, Hirofumi; Takase, Bonpei; Ishihara, Masayuki

    2009-01-01

    We developed a novel non-contact monitoring system to measure the vital signs of casualties inside a moving ambulance. This system was designed to prevent exposure of patients to infectious organisms under biochemical hazard conditions. The system consists of two microwave radars: a 10-GHz respiratory-monitoring radar is positioned 20 cm away from the surface of the isolator. The 24-GHz cardiac-monitoring radar is positioned below the stretcher underneath the isolator. The subject (22.13 +/- 0.99 years) was placed inside the isolator on a stretcher in the simulated ambulance. While the ambulance was in motion at a speed of approximately 10 km/h, the heart rates determined by the cardiac-monitoring radar correlated significantly with those measured by ECG (r = 0.69, p < 0.01), and the respiratory rates derived from the respiratory-monitoring radar correlated with those measured by the respiration curves (r = 0.97, p < 0.0001). The proposed system appears promising for future on-ambulance monitoring of the vital sign of casualties exposed to toxins. PMID:18946695

  12. A Prevalence and Management Study of Acute Pain in Children Attending Emergency Departments by Ambulance.

    PubMed

    Murphy, Adrian; McCoy, Siobhan; O'Reilly, Kay; Fogarty, Eoin; Dietz, Jason; Crispino, Gloria; Wakai, Abel; O'Sullivan, Ronan

    2016-01-01

    Pain is the most common symptom in the emergency setting and remains one of the most challenging problems for emergency care providers, particularly in the pediatric population. The primary objective of this study was to determine the prevalence of acute pain in children attending emergency departments (EDs) in Ireland by ambulance. In addition, this study sought to describe the prehospital and initial ED management of pain in this population, with specific reference to etiology of pain, frequency of pain assessment, pain severity, and pharmacological analgesic interventions. A prospective cross-sectional study was undertaken over a 12-month period of all pediatric patients transported by emergency ambulance to four tertiary referral hospitals in Ireland. All children (<16 years) who had pain as a symptom (regardless of cause) at any stage during the prehospital phase of care were included in this study. Over the study period, 6,371 children attended the four EDs by emergency ambulance, of which 2,635 (41.4%, 95% confidence interval 40.2-42.3%) had pain as a documented symptom on the ambulance patient care report (PCR) form. Overall 32% (n = 856) of children who complained of pain were subject to a formal pain assessment during the prehospital phase of care. Younger age, short transfer time to the ED, and emergency calls between midnight and 6 am were independently associated with decreased likelihood of having a documented assessment of pain intensity during the prehospital phase of care. Of the 2,635 children who had documented pain on the ambulance PCR, 26% (n = 689) received some form of analgesic agent prior to ED arrival. Upon ED arrival 54% (n = 1,422) of children had a documented pain assessment and some form of analgesic agent was administered to 50% (n = 1,324). Approximately 41% of children who attend EDs in Ireland by ambulance have pain documented as their primary symptom. This study suggests that the management of acute pain in children transferred by

  13. PROFESSIONAL REGISTRATION OF GOVERNMENT ENGINEERS.

    USGS Publications Warehouse

    Buchanan, Thomas J.

    1985-01-01

    The American Society of Civil Engineers views professional registration as an appropriate requirement for engineers, including those in government. The National Society of Professional Engineers makes registration a requirement for the grade of member and full privileges in the society. Some Federal agencies require engineering registration for certain positions in their agencies. Engineers in government service should consider the value of engineering registration to themselves and to their agencies and take pride in their professions and in their own capabilities by becoming registered engineers. They should also take steps to encourage their agencies to give more attention to engineering registration.

  14. Image registration with uncertainty analysis

    DOEpatents

    Simonson, Katherine M.

    2011-03-22

    In an image registration method, edges are detected in a first image and a second image. A percentage of edge pixels in a subset of the second image that are also edges in the first image shifted by a translation is calculated. A best registration point is calculated based on a maximum percentage of edges matched. In a predefined search region, all registration points other than the best registration point are identified that are not significantly worse than the best registration point according to a predetermined statistical criterion.

  15. Ambulance Services at Hospital Universiti Sains Malaysia and Hospital Kota Bharu: A Retrospective Study of Calls

    PubMed Central

    Shah Che Hamzah, Mohd Shaharudin; Ahmad, Rashidi; Nik Abdul Rahman, Nik Hisamuddin; Pardi, Kasmah Wati; Jaafar, Naimah; Wan Adnan, Wan Aasim; Jaalam, Kamaruddin; Sahil Jamalullail, Syed Mohsin

    2005-01-01

    This retrospective study attempted to identify the pattern of ambulance calls for the past two years at the Hospital Universiti Sains Malaysia (HUSM) and Hospital Kota Bharu (HKB). This study will provide a simple method of acquiring information related to ambulance response time (ART) and to test whether it met the international standards and needs of the client. Additionally, this paper takes into account the management of emergency calls. This included ambulance response time, which was part of Emergency Medical Services (EMS) episode: onset of ART, which started when details like phone number of the caller, exact location of the incident and the nature of the main complaint had been noted. ART ended when the emergency team arrived at the scene of incident. Information regarding ambulance calls from the record offices of HUSM and HKB was recorded for the year 2001 and 2002, tabulated and analyzed. There was a significant difference in the total number of calls managed by HUSM and HKB in the year 2001. It was noted that 645 calls were managed by HUSM while 1069 calls were recorded at HKB. In the year 2002, however, HUSM led with 613 extra numbers of calls as compare to HKB with 1193 numbers of calls. The pattern of ambulance calls observed is thought to possibly be influenced by social activities like local festivities, school holidays and the seasons. Further, it is observed that no studies were previously undertaken to compare the ART at both the HUSM and HKB to that of the international standards. In fact, a literature review undertaken so far showed no similar studies have been done for the whole Malaysia. PMID:22605956

  16. Access block causes emergency department overcrowding and ambulance diversion in Perth, Western Australia

    PubMed Central

    Fatovich, D; Nagree, Y; Sprivulis, P

    2005-01-01

    Objective: Access block refers to the situation where patients in the emergency department (ED) requiring inpatient care are unable to gain access to appropriate hospital beds within a reasonable time frame. We systematically evaluated the relationship between access block, ED overcrowding, ambulance diversion, and ED activity. Methods: This was a retrospective analysis of data from the Emergency Department Information System for the three major central metropolitan EDs in Perth, Western Australia, for the calendar years 2001–2. Bivariate analyses were performed in order to study the relationship between a range of emergency department workload variables, including access block (>8 hour total ED stay for admitted patients), ambulance diversion, ED overcrowding, and ED waiting times. Results: We studied 259 580 ED attendances. Total diversion hours increased 74% from 3.39 hours/day in 2001 to 5.90 hours/day in 2002. ED overcrowding (r = 0.96; 95% confidence interval (CI) 0.91 to 0.98), ambulance diversion (r = 0.75; 95% CI 0.49 to 0.88), and ED waiting times for care (r = 0.83; 95% CI 0.65 to 0.93) were strongly correlated with high levels of ED occupancy by access blocked patients. Total attendances, admissions, discharges, and low acuity patient attendances were not associated with ambulance diversion. Conclusion: Reducing access block should be the highest priority in allocating resources to reduce ED overcrowding. This would result in reduced overcrowding, reduced ambulance diversion, and improved ED waiting times. Improving hospital inpatient flow, which would directly reduce access block, is most likely to achieve this. PMID:15843704

  17. Self-paced brain-computer interface control of ambulation in a virtual reality environment

    NASA Astrophysics Data System (ADS)

    Wang, Po T.; King, Christine E.; Chui, Luis A.; Do, An H.; Nenadic, Zoran

    2012-10-01

    Objective. Spinal cord injury (SCI) often leaves affected individuals unable to ambulate. Electroencephalogram (EEG) based brain-computer interface (BCI) controlled lower extremity prostheses may restore intuitive and able-body-like ambulation after SCI. To test its feasibility, the authors developed and tested a novel EEG-based, data-driven BCI system for intuitive and self-paced control of the ambulation of an avatar within a virtual reality environment (VRE). Approach. Eight able-bodied subjects and one with SCI underwent the following 10-min training session: subjects alternated between idling and walking kinaesthetic motor imageries (KMI) while their EEG were recorded and analysed to generate subject-specific decoding models. Subjects then performed a goal-oriented online task, repeated over five sessions, in which they utilized the KMI to control the linear ambulation of an avatar and make ten sequential stops at designated points within the VRE. Main results. The average offline training performance across subjects was 77.2±11.0%, ranging from 64.3% (p = 0.001 76) to 94.5% (p = 6.26×10-23), with chance performance being 50%. The average online performance was 8.5±1.1 (out of 10) successful stops and 303±53 s completion time (perfect = 211 s). All subjects achieved performances significantly different than those of random walk (p < 0.05) in 44 of the 45 online sessions. Significance. By using a data-driven machine learning approach to decode users’ KMI, this BCI-VRE system enabled intuitive and purposeful self-paced control of ambulation after only 10 minutes training. The ability to achieve such BCI control with minimal training indicates that the implementation of future BCI-lower extremity prosthesis systems may be feasible.

  18. Weather and age-gender effects on the projection of future emergency ambulance demand in Hong Kong.

    PubMed

    Lai, Poh-Chin; Wong, Ho-Ting

    2015-03-01

    An accurate projection for ambulance demand is essential to enable better resource planning for the future that strives to either maintain current levels of services or reconsider future standards and expectations. More than 2 million cases of emergency room attendance in 2008 were obtained from the Hong Kong Hospital Authority to project the demand for its ambulance services in 2036. The projection of ambulance demand in 2036 was computed in consideration of changes in the age-gender structure between 2008 and 2036. The quadratic relation between average daily temperature and daily ambulance demand in 2036 was further explored by including and excluding age-gender demographic changes. Without accounting for changes in the age-gender structure, the 2036 ambulance demand for age groups of 65 and above were consistently underestimated (by 38%-65%), whereas those of younger age groups were overestimated (by 6%-37%). Moreover, changes in the 2008 to 2036 age-gender structure also shift upward and emphasize relationships between average daily temperature and daily ambulance demand at both ends of the quadratic U-shaped curve. Our study reveals a potential societal implication of ageing population on the demand for ambulance services.

  19. Weather and age-gender effects on the projection of future emergency ambulance demand in Hong Kong.

    PubMed

    Lai, Poh-Chin; Wong, Ho-Ting

    2015-03-01

    An accurate projection for ambulance demand is essential to enable better resource planning for the future that strives to either maintain current levels of services or reconsider future standards and expectations. More than 2 million cases of emergency room attendance in 2008 were obtained from the Hong Kong Hospital Authority to project the demand for its ambulance services in 2036. The projection of ambulance demand in 2036 was computed in consideration of changes in the age-gender structure between 2008 and 2036. The quadratic relation between average daily temperature and daily ambulance demand in 2036 was further explored by including and excluding age-gender demographic changes. Without accounting for changes in the age-gender structure, the 2036 ambulance demand for age groups of 65 and above were consistently underestimated (by 38%-65%), whereas those of younger age groups were overestimated (by 6%-37%). Moreover, changes in the 2008 to 2036 age-gender structure also shift upward and emphasize relationships between average daily temperature and daily ambulance demand at both ends of the quadratic U-shaped curve. Our study reveals a potential societal implication of ageing population on the demand for ambulance services. PMID:23070758

  20. Ambulance call-outs and response times in Birmingham and the impact of extreme weather and climate change.

    PubMed

    Thornes, John Edward; Fisher, Paul Anthony; Rayment-Bishop, Tracy; Smith, Christopher

    2014-03-01

    Although there has been some research on the impact of extreme weather on the number of ambulance call-out incidents, especially heat waves, there has been very little research on the impact of cold weather on ambulance call-outs and response times. In the UK, there is a target response rate of 75% of life threatening incidents (Category A) that must be responded to within 8 min. This paper compares daily air temperature data with ambulance call-out data for Birmingham over a 5-year period (2007-2011). A significant relationship between extreme weather and increased ambulance call-out and response times can clearly be shown. Both hot and cold weather have a negative impact on response times. During the heat wave of August 2003, the number of ambulance call-outs increased by up to a third. In December 2010 (the coldest December for more than 100 years), the response rate fell below 50% for 3 days in a row (18 December-20 December 2010) with a mean response time of 15 min. For every reduction of air temperature by 1°C there was a reduction of 1.3% in performance. Improved weather forecasting and the take up of adaptation measures, such as the use of winter tyres, are suggested for consideration as management tools to improve ambulance response resilience during extreme weather. Also it is suggested that ambulance response times could be used as part of the syndromic surveillance system at the Health Protection Agency.

  1. Articulated registration: elastic registration based on a wire-model

    NASA Astrophysics Data System (ADS)

    Martin-Fernandez, Miguel A.; Munyoz-Moreno, Emma; Martin-Fernandez, Marcos; Alberola-Lopez, Carlos

    2005-04-01

    In this paper we propose a new method of elastic registration of anatomical structures that bears an inner skeleton, such as the knee, hand or spine. Such a method has to deal with great degrees of variability, specially for the case of inter-subject registration; but even for the intra-subject case the degree of variability of images will be large since the structures we bear in mind are articulated. Rigid registration methods are clearly inappropriate for this problem, and well-known elastic methods do not usually incorporate the restriction of maintaining long skeletal structures straight. A new method is therefore needed to deal with such a situation; we call this new method "articulated registration". The inner bone skeleton is modeled with a wire model, where wires are drawn by connecting landmarks located in the main joints of the skeletal structure to be registered (long bones). The main feature of our registration method is that within the bone axis (specifically, where the wires are) an exact registration is guaranteed, while for the remaining image points an elastic registration is carried out based on a distance transform (with respect to the model wires); this causes the registration on long bones to be affine to all practical purposes, while the registration of soft tissue -- far from the bones -- is elastic. As a proof-of-concept of this method we describe the registration of hands on radiographs.

  2. An overview of the state of the art of noninvasive FES for independent ambulation by thoracic level paraplegics.

    PubMed

    Graupe, Daniel

    2002-07-01

    This paper is an overview of the status of transcutaneous noninvasive (unbraced) functional electrical stimulation (FES) for independent standing and for independent ambulation by traumatic spinal-cord injured (SCI) paraplegics with complete spinal cord lesions at the thoracic level. The paper discusses aspects of patient selection, patient training, system performance, ambulation range, medical benefits and psychological benefits. It also considers problems relating to system adoption and long term system use. Furthermore, the paper discusses the various aspects of transcutaneous noninvasive FES as compared with implanted FES systems for ambulation by thoracic level SCI patients.

  3. Medicare program; Medicare ambulance MMA temporary rate increases beginning July 1, 2004. Interim final rule with comment period.

    PubMed

    2004-07-01

    This interim final rule codifies the four payment provisions for Medicare covered ambulance services contained in section 414 of the Medicare Prescription Drug, Improvement and Modernization Act of 2003 (MMA).

  4. 10-year experience of CO2-laser application in ambulance gynecology

    NASA Astrophysics Data System (ADS)

    Stachanov, Michael L.; Masychev, Victor I.; Velsher, Leonid Z.; Kirkin, Vladimir V.; Zhashkov, Roman V.; Kocharian, Emilia A.

    2000-10-01

    CO2-laser surgical systems have come to stay in everyday practice of modern physicians and are successfully used in colposcopic and laparoscopic surgery. Results, obtained in ambulance gynecology are especially impressing. CO2- laser provides high medical- and cost-effective treatment. Presented work describes many-years experience of CO2- laser application. 439 patients with various vulvaric and cervix diseases were operated within this period. Laser beam parameters were selected according to requirements ((tau) =4 J/cm2) treatment without carbonization. Analyses of the results showed that the laser successfully destructs uterine cervix erosion, endocervicosis, dysplasia, leukoplakia, eritoplakia of uterine cervix, various benignant pathologies and focus degenerative process in ambulate conditions.

  5. [Ambulant compression therapy for crural ulcers; an effective treatment when applied skilfully].

    PubMed

    de Boer, Edith M; Geerkens, Maud; Mooij, Michael C

    2015-01-01

    The incidence of crural ulcers is high. They reduce quality of life considerably and create a burden on the healthcare budget. The key treatment is ambulant compression therapy (ACT). We describe two patients with crural ulcers whose ambulant compression treatment was suboptimal and did not result in healing. When the bandages were applied correctly healing was achieved. If correctly applied ACT should provide sufficient pressure to eliminate oedema, whilst taking local circumstances such as bony structures and arterial qualities into consideration. To provide pressure-to-measure regular practical training, skills and regular quality checks are needed. Knowledge of the properties of bandages and the proper use of materials for padding under the bandage enables good personalised ACT. In trained hands adequate compression and making use of simple bandages and dressings provides good care for patients suffering from crural ulcers in contrast to inadequate ACT using the same materials. PMID:26374726

  6. Venous Gas Emboli and Ambulation at 4.3 PSIA (Preliminary)

    NASA Technical Reports Server (NTRS)

    Conkin, J.; Pollock, N. W.; Natoli, M. J.; Martina, S. D.; Wessel, J. H., III; Gernhardt, M. L.

    2016-01-01

    Introduction: Ambulation imparts compressive and decompressive forces into the lower body[1], potentially creating quasi-stable micronuclei that influence the outcome of hypobaric depressurizations[2-4]. Hypotheses: ambulation before the conclusion of a denitrogenation (prebreathe) protocol at 14.7 pounds per square inch absolute is not sufficient to increase the incidence of venous gas emboli (VGE) at 4.3 pounds per square inch absolute but is sufficient if performed after tissues become supersaturated with nitrogen at 4.3 pounds per square inch absolute. Methods: VGE results from 45 subjects that performed exercise prebreathe without ambulation before or during a 4-hr exposure to 4.3 pounds per square inch absolute (Phase II control) are compared to 21 subjects that performed the same prebreathe but ambulated before and during the hypobaric exposure (Phase II-1) and to 30 subjects that only ambulated before the hypobaric exposure (Phase II-3). VGE in the pulmonary artery were detected at about 16 min intervals using precordial Doppler ultrasound (2.5 megahertz) and assigned a Spencer 0-IV grade. The highest grade assigned during the exposure is one metric, and Grade III or IV were combined as "high VGE grade". We used Fisher's exact directional chi squared for VGE count data. We evaluated survival curves for onset of high VGE grade using non-parametric Kaplan-Meier. Finally, we used logistic regression (LR) to describe the binary response of high VGE grade during an exposure across the three protocols with the three categorical ambulatory states (k) transformed into k-1 dummy variables, plus the following explanatory variables: gender (74 men and 22 women), age (19-57 years), height (155-191 cm), weight (44-115 kg), body mass index (17.5-35.5, as weight in kg/height as square meters), and aerobic fitness through peak oxygen (O (sub 2)) consumption as the volume of oxygen peak (26.1-64.9 milliliters (O (sub 2 (STPD - standard temperature and pressure, dry)) per

  7. 32 CFR 1615.1 - Registration.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Defense Other Regulations Relating to National Defense SELECTIVE SERVICE SYSTEM ADMINISTRATION OF REGISTRATION § 1615.1 Registration. (a) Registration under selective service law consists of: (1) Completing a registration card or other method of registration prescribed by the Director of Selective Service by a...

  8. 32 CFR 1615.1 - Registration.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Defense Other Regulations Relating to National Defense SELECTIVE SERVICE SYSTEM ADMINISTRATION OF REGISTRATION § 1615.1 Registration. (a) Registration under selective service law consists of: (1) Completing a registration card or other method of registration prescribed by the Director of Selective Service by a...

  9. 32 CFR 1615.1 - Registration.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Defense Other Regulations Relating to National Defense SELECTIVE SERVICE SYSTEM ADMINISTRATION OF REGISTRATION § 1615.1 Registration. (a) Registration under selective service law consists of: (1) Completing a registration card or other method of registration prescribed by the Director of Selective Service by a...

  10. 32 CFR 1615.1 - Registration.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Defense Other Regulations Relating to National Defense SELECTIVE SERVICE SYSTEM ADMINISTRATION OF REGISTRATION § 1615.1 Registration. (a) Registration under selective service law consists of: (1) Completing a registration card or other method of registration prescribed by the Director of Selective Service by a...

  11. Regional intensive care transports: a prospective analysis of distance, time and cost for road, helicopter and fixed-wing ambulances

    PubMed Central

    2014-01-01

    Background There are three different types of ambulance systems, all of which can manage the same secondary intensive care patient transport mission: road ambulance, rotor-wing ambulance, and fixed-wing ambulance. We hypothesized that costs for specific transport distances would differ between systems. We aimed to analyze distances and observed times for ambulance intensive care secondary transport missions together with system costs to assess this. Methods We prospectively collected data for consecutive urgent intensive care transports into the regional tertiary care hospital in the northern region of Sweden. Distances and transport times were gathered, and a cost model was generated based on these together with fixed and operating costs from the three different ambulance systems. Distance-cost and time–cost estimations were then generated for each transport system. Results Road ambulance cost relatively less for shorter distances (within 250 kilometers/155 miles) but were relatively time ineffective. The rotor-wing systems were most expensive regardless of distance; but were most time-effective up to 400–500 km (248–310 miles). Fixed-wing systems were more cost-effective for longer distance (300 km/186 miles), and time effective for transports over 500 km (310 miles). Conclusions In summary, based on an economic model developed from observed regional ICU patient transports, and cost estimations, different ambulance system cost-distances could be compared. Distance-cost and time results show that helicopters can be effective up to moderate ICU transport distances (400–500), though are expensive to operate. For longer ICU patient transports, fixed-wing transport systems are both cost and time effective compared to helicopter-based systems. PMID:24902480

  12. Upper limb module in non-ambulant patients with spinal muscular atrophy: 12 month changes.

    PubMed

    Sivo, Serena; Mazzone, Elena; Antonaci, Laura; De Sanctis, Roberto; Fanelli, Lavinia; Palermo, Concetta; Montes, Jacqueline; Pane, Marika; Mercuri, Eugenio

    2015-03-01

    Recent studies have suggested that in non-ambulant patients affected by spinal muscular atrophy the Upper Limb Module can increase the range of activities assessed by the Hammersmith Functional Motor Scale Expanded. The aim of this study was to establish 12-month changes in the Upper Limb Module in a cohort of non-ambulant spinal muscular atrophy patients and their correlation with changes on the Hammersmith Functional Motor Scale Expanded. The Upper Limb Module scores ranged between 0 and 17 (mean 10.23, SD 4.81) at baseline and between 1 and 17 at 12 months (mean 10.27, SD 4.74). The Hammersmith Functional Motor Scale Expanded scores ranged between 0 and 34 (mean 12.43, SD 9.13) at baseline and between 0 and 34 at 12 months (mean 12.08, SD 9.21). The correlation betweeen the two scales was 0.65 at baseline and 0.72 on the 12 month changes. Our results confirm that the Upper Limb Module can capture functional changes in non-ambulant spinal muscular atrophy patients not otherwise captured by the other scale and that the combination of the two measures allows to capture changes in different subgroups of patients in whom baseline scores and functional changes may be influenced by several variables such as age.

  13. Experience of critical incident stress among ambulance service staff and relationship to psychological symptoms.

    PubMed

    Gallagher, Sharon; McGilloway, Sinéad

    2009-01-01

    This two-stage study was undertaken to assess the extent and nature of Critical Incident Stress (CIS) amongst frontline staff in a large ambulance service in Ireland. In Stage One, 63% (112/180) of participants completed a Screening Questionnaire and the GHQ-12. In Stage Two, 27 participants, who had experienced a critical incident (CI) during the previous year completed several measures to assess PTSD symptomatology, burnout, health-related Quality of Life, and dispositional optimism. Eighty-one per cent (80/94) of the Stage One group reported that their health had been affected by a CI; 42% (44/106) were identified as 'cases' on the GHQ-12. Stage Two results indicated that 12 participants had PTSD symptoms while this entire group showed moderate levels of emotional exhaustion and depersonalization, despite experiencing high levels of personal accomplishment and optimism. The findings suggest a high prevalence of CIS among ambulance personnel in Ireland and a significant impact on overall health and wellbeing. This has important implications for the effective management of CIS and suggests an important role for occupational health and organizational psychologists in providing routine support to ambulance service staff andpossibly other emergency services personnel.

  14. Attachment insecurity, responses to critical incident distress, and current emotional symptoms in ambulance workers.

    PubMed

    Halpern, Janice; Maunder, Robert G; Schwartz, Brian; Gurevich, Maria

    2012-02-01

    Ambulance workers are exposed to critical incidents that may evoke intense distress and can result in long-term impairment. Individuals who can regulate distress may experience briefer post-incident distress and fewer long-term emotional difficulties. Attachment research has contributed to our understanding of individual differences in stress regulation, suggesting that secure attachment is associated with effective support-seeking and coping strategies, and fewer long-term difficulties. We tested the effect of attachment insecurity on emotional distress in ambulance workers, hypothesizing that (1) insecure attachment is associated with symptoms of current distress and (2) prolonged recovery from acute post-critical incident distress, coping strategies and supportive contact mediate this relationship. We measured (1) attachment insecurity, (2) acute distress, coping and social contact following an index critical incident and (3) current symptoms of post-traumatic stress, depression, somatization and burnout and tested the hypothesized associations. Fearful-avoidant insecure attachment was associated with all current symptoms, most strongly with depression (R=0.38, p<0.001). Fearful-avoidant attachment insecurity was also associated with maladaptive coping, reduced social support and slower recovery from social withdrawal and physical arousal following the critical incident, but these processes did not mediate the relationship between attachment insecurity and current symptoms. These findings are relevant for optimizing post-incident support for ambulance workers.

  15. Reducing Time to First on Scene: An Ambulance-Community First Responder Scheme.

    PubMed

    Campbell, Alan; Ellington, Matt

    2016-01-01

    The importance of early access to prehospital care has been demonstrated in many medical emergencies. This work aims to describe the potential time benefit of implementing a student Community First Responder scheme to support ambulance services in an inner-city setting in the United Kingdom. Twenty final and penultimate year medical students in the UK were trained in the "First Person on Scene" Business and Technology Education Council (BTEC) qualification. Over 12 months, they attended 89 emergency calls in an inner-city setting as Community First Responders (CFRs), alongside the West Midlands Ambulance Service, UK. At the end of this period, a qualitative survey investigated the perceived educational value of the scheme. The mean CFR response time across all calls was an average of 3 minutes and 8 seconds less than ambulance crew response times. The largest difference was to calls relating to falls (12 min). The difference varied throughout the day, peaking between 16:00 and 18:00. All questionnaire respondents stated that they felt more prepared in assessing and treating acutely unwell patients. In this paper, the authors present a symbiotic solution which has both reduced time to first on scene and provided training and experience in medical emergencies for senior medical students. PMID:27119024

  16. Manager-employee interaction in ambulance services: an exploratory study of employee perspectives on management communication.

    PubMed

    Nordby, Halvor

    2015-01-01

    Managers of ambulance stations face many communicative challenges in their interaction with employees working in prehospital first-line services. The article presents an exploratory study of how paramedics experience these challenges in communication with station leaders. On the basis of a dialogue perspective in qualitative method, 24 paramedics were interviewed in one-to-one and focus group settings. Naturalistic and phenomenological approaches were used to analyze the interviews. All the paramedics said that they wished to be more involved in decision processes and that station managers should provide better explanations of information "from above." The paramedics understood that it was difficult for the managers to find time for extensive dialogue, but many thought that the managers should give more priority to communication. The paramedics' views correspond to theoretical assumptions in human resource management. According to this model, employees should be involved in decision processes on management levels, as long as it is realistically possible to do so. Furthermore, expressing emotional support and positive attitudes does not take much time, and the study suggests that many ambulance managers should focus more on interpersonal relations to employees. It has been extensively documented that management communication affects organizational performance. The study indicates that managers of ambulance stations should be more aware of how their leadership style affects professional commitment and motivation in the first-line services.

  17. Hammersmith Functional Motor Scale and Motor Function Measure-20 in non ambulant SMA patients.

    PubMed

    Mazzone, E; De Sanctis, R; Fanelli, L; Bianco, F; Main, M; van den Hauwe, M; Ash, M; de Vries, R; Fagoaga Mata, J; Schaefer, K; D'Amico, A; Colia, G; Palermo, C; Scoto, M; Mayhew, A; Eagle, M; Servais, L; Vigo, M; Febrer, A; Korinthenberg, R; Jeukens, M; de Viesser, M; Totoescu, A; Voit, T; Bushby, K; Muntoni, F; Goemans, N; Bertini, E; Pane, M; Mercuri, E

    2014-04-01

    The aim of this prospective longitudinal multi centric study was to evaluate the correlation between the Hammersmith Functional Motor Scale and the 20 item version of the Motor Function Measure in non ambulant SMA children and adults at baseline and over a 12 month period. Seventy-four non-ambulant patients performed both measures at baseline and 49 also had an assessment 12 month later. At baseline the scores ranged between 0 and 40 on the Hammersmith Motor function Scale and between 3 and 45 on the Motor Function Measure 20. The correlation between the two scales was 0.733. The 12 month changes ranged between -11 and 4 for the Hammersmith and between -11 and 7 for the Motor Function Measure 20. The correlation between changes was 0.48. Our results suggest that both scales provide useful information although they appeared to work differently at the two extremes of the spectrum of abilities. The Hammersmith Motor Function Scale appeared to be more suitable in strong non ambulant patients, while the Motor Function Measures appeared to be more sensitive to capture activities and possible changes in the very weak patients, including more items capturing axial and upper limb activities. The choice of these measures in clinical trials should therefore depend on inclusion criteria and magnitude of expected changes.

  18. Emergency call work-load, deprivation and population density: an investigation into ambulance services across England.

    PubMed

    Peacock, Philip J; Peacock, Janet L

    2006-06-01

    Demand for emergency ambulance services has risen steeply over the recent years. This study examined differences in work-load of ambulance services across England and investigated factors linked to high demand. The number of emergency calls received by each ambulance service in 1997 and 2002 and population and area data were used to calculate call rates and population density for each of 27 service areas. Deprivation score and proportion of the population under age 15 and over age 65 were calculated for each service area. There was wide variation in emergency call rates across England, with London having the highest rate both in 1997 (125.6 calls per 1000 persons) and in 2002 (140.1 per 1000). Statistically significant positive associations were observed between call rates and deprivation (1997, r = 0.49; 2002, r = 0.53) and between call rates and population density (1997, r = 0.70; 2002, r = 0.68). Following multivariable regression, the effect of deprivation score was consistently weaker, but the effect of population density was virtually unchanged. We conclude that areas with higher population density have higher call rates, which is not explained by deprivation. Deprivation is associated with higher usage, but its effect is partly due to population density. There is no evidence that these relationships are confounded by age.

  19. Manager-employee interaction in ambulance services: an exploratory study of employee perspectives on management communication.

    PubMed

    Nordby, Halvor

    2015-01-01

    Managers of ambulance stations face many communicative challenges in their interaction with employees working in prehospital first-line services. The article presents an exploratory study of how paramedics experience these challenges in communication with station leaders. On the basis of a dialogue perspective in qualitative method, 24 paramedics were interviewed in one-to-one and focus group settings. Naturalistic and phenomenological approaches were used to analyze the interviews. All the paramedics said that they wished to be more involved in decision processes and that station managers should provide better explanations of information "from above." The paramedics understood that it was difficult for the managers to find time for extensive dialogue, but many thought that the managers should give more priority to communication. The paramedics' views correspond to theoretical assumptions in human resource management. According to this model, employees should be involved in decision processes on management levels, as long as it is realistically possible to do so. Furthermore, expressing emotional support and positive attitudes does not take much time, and the study suggests that many ambulance managers should focus more on interpersonal relations to employees. It has been extensively documented that management communication affects organizational performance. The study indicates that managers of ambulance stations should be more aware of how their leadership style affects professional commitment and motivation in the first-line services. PMID:25909398

  20. An overhead harness and trolly system for balance and ambulation assessment and training.

    PubMed

    Harburn, K L; Hill, K M; Kramer, J F; Noh, S; Vandervoort, A A; Matheson, J E

    1993-02-01

    Safe assessment of standing balance and gait is often jeopardized by the potential for falls, which may have major physical and legal consequences. This article describes the design and use of a system that enhances the safety of the patient and clinician during balance and gait assessment and training. The system consists of an overhead track and moveable trolly that allows the patient, while secured in a simple body harness, the freedom to ambulate, perform functional types of activities, and fall with minimal risk of injury. As a result, a single therapist can more readily assess balance and ambulation, as well as provide training for these skills. In addition, the therapist is free to observe the patient's movements from any position, without direct physical contact. Practically, the system described may allow ambulation training sooner after injury or surgery, permit training in weight-bearing or partial weight-bearing activities with or without assistive devices, and allow the clinician to focus on assessment and training, rather than on patient safety.

  1. Design and validation of a platform robot for determination of ankle impedance during ambulation.

    PubMed

    Rouse, Elliott J; Hargrove, Levi J; Peshkin, Michael A; Kuiken, Todd A

    2011-01-01

    In order to provide natural, biomimetic control to recently developed powered ankle prostheses, we must characterize the impedance of the ankle during ambulation tasks. To this end, a platform robot was developed that can apply an angular perturbation to the ankle during ambulation and simultaneously acquire ground reaction force data. In this study, we detail the design of the platform robot and characterize the impedance of the ankle during quiet standing. Subjects were perturbed by a 3° dorsiflexive ramp perturbation with a length of 150 ms. The impedance was defined parametrically, using a second order model to map joint angle to the torque response. The torque was determined using the inverted pendulum assumption, and impedance was identified by the least squares best estimate, yielding an average damping coefficient of 0.03 ± 0.01 Nms/° and an average stiffness coefficient of 3.1 ± 1.2 Nm/°. The estimates obtained by the proposed platform robot compare favorably to those published in the literature. Future work will investigate the impedance of the ankle during ambulation for powered prosthesis controller development.

  2. 22 CFR 122.3 - Registration fees.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... reviewed, adjudicated or issued a response. The additional fee will be determined by multiplying $250 times...) Lapse in registration. A registrant who fails to renew a registration and, after an intervening...

  3. 22 CFR 122.3 - Registration fees.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... reviewed, adjudicated or issued a response. The additional fee will be determined by multiplying $250 times...) Lapse in registration. A registrant who fails to renew a registration and, after an intervening...

  4. Computer Assisted Operations: Registration Records, Schedules

    ERIC Educational Resources Information Center

    College and University, 1977

    1977-01-01

    Proceedings of AACRAO's 63rd annual meeting cover: computer networking in small colleges; continuous registration; computer logic; computerized academic record overview; on-line registration systems; and analysis of registration and records systems. (LBH)

  5. INTERSECTING SELF-REPORTED MOBILITY AND GAIT SPEED TO CREATEA MULTI-DIMENSIONAL MEASURE OF AMBULATION: THE “AMBULATION SPEED-ENDURANCE” (ASE) TYPOLOGY

    PubMed Central

    SIORDIA, C.

    2015-01-01

    Background Assessing mobility through readily available and affordable protocols may help advance public health by providing early detection and implementing intervention therapies aimed at mitigating the progression from physiological vitality to disability at older ages. Until now, little attention has been given to how self-reported mobility (SRM) and gait speed can be combined in a categorization scheme. Objectives The specific aim of this report is to introduce the Ambulation Speed-Endurance (ASE) Typology to the literature—a classification system that intersects SRM and gait speed to create a multi-dimensional measure of ambulation. Design Cross-sectional. Setting: Community-dwelling older adults in the United States. Participants Evidence is provided from the National Health and Aging Trends Study (NHATS) that community-dwelling older adults (n=5,403) may be found in each of the ASE Typologies. The discussion is complimented by investigating the cross-sectional predictors of a “Discrepancy Score” (measure of gap between speed and endurance) amongst those with gait speeds < 0.99 m/sec (n=4,521). Results Multivariable linear regression results indicate level of severity in speed-endurance discrepancy is higher amongst: non-Latino-Blacks (β=0.48); Latinos (β=0.42); older ages; and lower educated. Models also show that severity in speed-endurance discrepancy is lower amongst: females (β=−0.38); those with higher body mass index; with more chronic health conditions; and poorer self-rated health. Conclusion Research should continue to investigate how to optimize SRM. PMID:26258113

  6. [Study of the quality of interhospital transport of sick neonates by selected ambulances in the Witwatersrand area].

    PubMed

    Roux, J C; Nolte, A G; Muller, M E

    1989-12-01

    The quality of the inter hospital transport of ill neonates, by selected ambulances in the Witwatersrand area, was investigated by means of the case study method. Of the fifteen case studies investigated, eleven neonates were transported by a private ambulance and four by provincial ambulances. Data regarding the maternal- and neonatal history, the optimal maintenance of the neonate's condition, the communication system, as well as aspects relating to the transport personnel, were collected by means of a structured instrument. Retrospective auditing of records, structured interviewing and direct observation/inspection were utilised as the research techniques. The quality of the inter hospital transport of ill neonates, especially by the private ambulance, is not up to standard. Deterioration of the neonate's body temperature, heart and respiration rates, as well as the serum glucose values after transport, were of the more important findings. The lack of equipment, especially in the private ambulance, increases the risk of transport. Staff development and formal control by a local committee, as well as a national control body, are recommended.

  7. Automated personnel-assets-consumables-drug tracking in ambulance services for more effective and efficient medical emergency interventions.

    PubMed

    Utku, Semih; Özcanhan, Mehmet Hilal; Unluturk, Mehmet Suleyman

    2016-04-01

    Patient delivery time is no longer considered as the only critical factor, in ambulatory services. Presently, five clinical performance indicators are used to decide patient satisfaction. Unfortunately, the emergency ambulance services in rapidly growing metropolitan areas do not meet current satisfaction expectations; because of human errors in the management of the objects onboard the ambulances. But, human involvement in the information management of emergency interventions can be reduced by electronic tracking of personnel, assets, consumables and drugs (PACD) carried in the ambulances. Electronic tracking needs the support of automation software, which should be integrated to the overall hospital information system. Our work presents a complete solution based on a centralized database supported by radio frequency identification (RFID) and bluetooth low energy (BLE) identification and tracking technologies. Each object in an ambulance is identified and tracked by the best suited technology. The automated identification and tracking reduces manual paper documentation and frees the personnel to better focus on medical activities. The presence and amounts of the PACD are automatically monitored, warning about their depletion, non-presence or maintenance dates. The computerized two way hospital-ambulance communication link provides information sharing and instantaneous feedback for better and faster diagnosis decisions. A fully implemented system is presented, with detailed hardware and software descriptions. The benefits and the clinical outcomes of the proposed system are discussed, which lead to improved personnel efficiency and more effective interventions.

  8. Automated personnel-assets-consumables-drug tracking in ambulance services for more effective and efficient medical emergency interventions.

    PubMed

    Utku, Semih; Özcanhan, Mehmet Hilal; Unluturk, Mehmet Suleyman

    2016-04-01

    Patient delivery time is no longer considered as the only critical factor, in ambulatory services. Presently, five clinical performance indicators are used to decide patient satisfaction. Unfortunately, the emergency ambulance services in rapidly growing metropolitan areas do not meet current satisfaction expectations; because of human errors in the management of the objects onboard the ambulances. But, human involvement in the information management of emergency interventions can be reduced by electronic tracking of personnel, assets, consumables and drugs (PACD) carried in the ambulances. Electronic tracking needs the support of automation software, which should be integrated to the overall hospital information system. Our work presents a complete solution based on a centralized database supported by radio frequency identification (RFID) and bluetooth low energy (BLE) identification and tracking technologies. Each object in an ambulance is identified and tracked by the best suited technology. The automated identification and tracking reduces manual paper documentation and frees the personnel to better focus on medical activities. The presence and amounts of the PACD are automatically monitored, warning about their depletion, non-presence or maintenance dates. The computerized two way hospital-ambulance communication link provides information sharing and instantaneous feedback for better and faster diagnosis decisions. A fully implemented system is presented, with detailed hardware and software descriptions. The benefits and the clinical outcomes of the proposed system are discussed, which lead to improved personnel efficiency and more effective interventions. PMID:26777434

  9. Effects of weather conditions on emergency ambulance calls for acute coronary syndromes

    NASA Astrophysics Data System (ADS)

    Vencloviene, Jone; Babarskiene, Ruta; Dobozinskas, Paulius; Siurkaite, Viktorija

    2015-08-01

    The aim of this study was to evaluate the relationship between weather conditions and daily emergency ambulance calls for acute coronary syndromes (ACS). The study included data on 3631 patients who called the ambulance for chest pain and were admitted to the department of cardiology as patients with ACS. We investigated the effect of daily air temperature ( T), barometric pressure (BP), relative humidity, and wind speed (WS) to detect the risk areas for low and high daily volume (DV) of emergency calls. We used the classification and regression tree method as well as cluster analysis. The clusters were created by applying the k-means cluster algorithm using the standardized daily weather variables. The analysis was performed separately during cold (October-April) and warm (May-September) seasons. During the cold period, the greatest DV was observed on days of low T during the 3-day sequence, on cold and windy days, and on days of low BP and high WS during the 3-day sequence; low DV was associated with high BP and decreased WS on the previous day. During June-September, a lower DV was associated with low BP, windless days, and high BP and low WS during the 3-day sequence. During the warm period, the greatest DV was associated with increased BP and changing WS during the 3-day sequence. These results suggest that daily T, BP, and WS on the day of the ambulance call and on the two previous days may be prognostic variables for the risk of ACS.

  10. Configuring a Powered Knee and Ankle Prosthesis for Transfemoral Amputees within Five Specific Ambulation Modes

    PubMed Central

    Simon, Ann M.; Ingraham, Kimberly A.; Fey, Nicholas P.; Finucane, Suzanne B.; Lipschutz, Robert D.; Young, Aaron J.; Hargrove, Levi J.

    2014-01-01

    Lower limb prostheses that can generate net positive mechanical work may restore more ambulation modes to amputees. However, configuration of these devices imposes an additional burden on clinicians relative to conventional prostheses; devices for transfemoral amputees that require configuration of both a knee and an ankle joint are especially challenging. In this paper, we present an approach to configuring such powered devices. We developed modified intrinsic control strategies—which mimic the behavior of biological joints, depend on instantaneous loads within the prosthesis, or set impedance based on values from previous states, as well as a set of starting configuration parameters. We developed tables that include a list of desired clinical gait kinematics and the parameter modifications necessary to alter them. Our approach was implemented for a powered knee and ankle prosthesis in five ambulation modes (level-ground walking, ramp ascent/descent, and stair ascent/descent). The strategies and set of starting configuration parameters were developed using data from three individuals with unilateral transfemoral amputations who had previous experience using the device; this approach was then tested on three novice unilateral transfemoral amputees. Only 17% of the total number of parameters (i.e., 24 of the 140) had to be independently adjusted for each novice user to achieve all five ambulation modes and the initial accommodation period (i.e., time to configure the device for all modes) was reduced by 56%, to 5 hours or less. This approach and subsequent reduction in configuration time may help translate powered prostheses into a viable clinical option where amputees can more quickly appreciate the benefits such devices can provide. PMID:24914674

  11. Configuring a powered knee and ankle prosthesis for transfemoral amputees within five specific ambulation modes.

    PubMed

    Simon, Ann M; Ingraham, Kimberly A; Fey, Nicholas P; Finucane, Suzanne B; Lipschutz, Robert D; Young, Aaron J; Hargrove, Levi J

    2014-01-01

    Lower limb prostheses that can generate net positive mechanical work may restore more ambulation modes to amputees. However, configuration of these devices imposes an additional burden on clinicians relative to conventional prostheses; devices for transfemoral amputees that require configuration of both a knee and an ankle joint are especially challenging. In this paper, we present an approach to configuring such powered devices. We developed modified intrinsic control strategies--which mimic the behavior of biological joints, depend on instantaneous loads within the prosthesis, or set impedance based on values from previous states, as well as a set of starting configuration parameters. We developed tables that include a list of desired clinical gait kinematics and the parameter modifications necessary to alter them. Our approach was implemented for a powered knee and ankle prosthesis in five ambulation modes (level-ground walking, ramp ascent/descent, and stair ascent/descent). The strategies and set of starting configuration parameters were developed using data from three individuals with unilateral transfemoral amputations who had previous experience using the device; this approach was then tested on three novice unilateral transfemoral amputees. Only 17% of the total number of parameters (i.e., 24 of the 140) had to be independently adjusted for each novice user to achieve all five ambulation modes and the initial accommodation period (i.e., time to configure the device for all modes) was reduced by 56%, to 5 hours or less. This approach and subsequent reduction in configuration time may help translate powered prostheses into a viable clinical option where amputees can more quickly appreciate the benefits such devices can provide.

  12. Operational implementation and lessons learned from Haiti's first helicopter air ambulance.

    PubMed

    DeGennaro, Vincent; Owen, Jordan; Chandler, Jerry; McDaniel, Ralph

    2016-05-01

    Critical-care helicopter transport has demonstrated improvements in morbidity and mortality to those patients who utilise the service, but this has largely excluded developing country populations due to set up costs. Haiti Air Ambulance is the first completely publicly-available helicopter ambulance service in a developing country. US standards were adopted for both aviation and aeromedical care in Haiti due to proximity and relationships. In order to implement properly, standards for aviation, critical care, and insurance reimbursement had to be put in place with local authorities. Haiti Air Ambulance worked with the Ministry of Health to author standards for medical procedures, medication usage, and staff training for aeromedical programs in the country. Utilisation criteria for the helicopter were drafted, edited, and constantly updated to ensure the program adapted to the clinical situation while maintaining US standard of care. During the first year, 76 patients were transferred; 13 of whom were children and 3 pregnant women. Three patients were intubated and two required bi-level mask ventilation. Traumatic injury and non-emergency interfacility transfers were the two most common indications for service. More than half of the transfers (54%) originated at one of six hospitals, mostly as a result of highly-involved staff. The program was limited by weather and the lack of weather reporting, radar, visual flight recognition, thus also causing an inability to fly at night. In partnership with the government and other non-governmental organisations, we seek to implement a more robust pre-hospital system in Haiti over the next 12-24 months, including more scene call capabilities.

  13. Training Persons with Spinal Cord Injury to Ambulate Using a Powered Exoskeleton.

    PubMed

    Asselin, Pierre K; Avedissian, Manuel; Knezevic, Steven; Kornfeld, Stephen; Spungen, Ann M

    2016-01-01

    Powered exoskeletons have become available for overground ambulation in persons with paralyses due to spinal cord injury (SCI) who have intact upper extremity function and are able to maintain upright balance using forearm crutches. To ambulate in an exoskeleton, the user must acquire the ability to maintain balance while standing, sitting and appropriate weight shifting with each step. This can be a challenging task for those with deficits in sensation and proprioception in their lower extremities. This manuscript describes screening criteria and a training program developed at the James J. Peters VA Medical Center, Bronx, NY to teach users the skills needed to utilize these devices in institutional, home or community environments. Before training can begin, potential users are screened for appropriate range of motion of the hip, knee and ankle joints. Persons with SCI are at an increased risk of sustaining lower extremity fractures, even with minimal strain or trauma, therefore a bone mineral density assessment is performed to reduce the risk of fracture. Also, as part of screening, a physical examination is performed in order to identify additional health-related contraindications. Once the person has successfully passed all screening requirements, they are cleared to begin the training program. The device is properly adjusted to fit the user. A series of static and dynamic balance tasks are taught and performed by the user before learning to walk. The person is taught to ambulate in various environments ranging from indoor level surfaces to outdoors over uneven or changing surfaces. Once skilled enough to be a candidate for home use with the exoskeleton, the user is then required to designate a companion-walker who will train alongside them. Together, the pair must demonstrate the ability to perform various advanced tasks in order to be permitted to use the exoskeleton in their home/community environment. PMID:27340808

  14. The Impact of Ambulance and Patient Diversion on Crowdedness of Multiple Emergency Departments in a Region.

    PubMed

    Kao, Chung-Yao; Yang, Jhen-Ci; Lin, Chih-Hao

    2015-01-01

    Emergency department (ED) overcrowding threatens healthcare quality. Ambulance diversion (AD) may relieve ED overcrowding; however, diverting patients from an overcrowded ED will load neighboring EDs with more patients and may result in regional overcrowding. The purpose of this study was to evaluate the impact of different diversion strategies on the crowdedness of multiple EDs in a region. The importance of regional coordination was also explored. A queuing model for patient flow was utilized to develop a computer program for simulating AD among EDs in a region. Key parameters, including patient arrival rates, percentages of patients of different acuity levels, percentage of patients transported by ambulance, and total resources of EDs, were assigned based on real data. The crowdedness indices of each ED and the regional crowdedness index were assessed to evaluate the effectiveness of various AD strategies. Diverting patients equally to all other EDs in a region is better than diverting patients only to EDs with more resources. The effect of diverting all ambulance-transported patients is similar to that of diverting only low-acuity patients. To minimize regional crowdedness, ambulatory patients should be sent to proper EDs when AD is initiated. Based on a queuing model with parameters calibrated by real data, patient flows of EDs in a region were simulated by a computer program. From a regional point of view, randomly diverting ambulatory patients provides almost no benefit. With regards to minimizing the crowdedness of the whole region, the most promising strategy is to divert all patients equally to all other EDs that are not already crowded. This result implies that communication and coordination among regional hospitals are crucial to relieve overall crowdedness. A regional coordination center may prioritize AD strategies to optimize ED utility. PMID:26659589

  15. Training Persons with Spinal Cord Injury to Ambulate Using a Powered Exoskeleton

    PubMed Central

    Asselin, Pierre K.; Avedissian, Manuel; Knezevic, Steven; Kornfeld, Stephen; Spungen, Ann M.

    2016-01-01

    Powered exoskeletons have become available for overground ambulation in persons with paralyses due to spinal cord injury (SCI) who have intact upper extremity function and are able to maintain upright balance using forearm crutches. To ambulate in an exoskeleton, the user must acquire the ability to maintain balance while standing, sitting and appropriate weight shifting with each step. This can be a challenging task for those with deficits in sensation and proprioception in their lower extremities. This manuscript describes screening criteria and a training program developed at the James J. Peters VA Medical Center, Bronx, NY to teach users the skills needed to utilize these devices in institutional, home or community environments. Before training can begin, potential users are screened for appropriate range of motion of the hip, knee and ankle joints. Persons with SCI are at an increased risk of sustaining lower extremity fractures, even with minimal strain or trauma, therefore a bone mineral density assessment is performed to reduce the risk of fracture. Also, as part of screening, a physical examination is performed in order to identify additional health-related contraindications. Once the person has successfully passed all screening requirements, they are cleared to begin the training program. The device is properly adjusted to fit the user. A series of static and dynamic balance tasks are taught and performed by the user before learning to walk. The person is taught to ambulate in various environments ranging from indoor level surfaces to outdoors over uneven or changing surfaces. Once skilled enough to be a candidate for home use with the exoskeleton, the user is then required to designate a companion-walker who will train alongside them. Together, the pair must demonstrate the ability to perform various advanced tasks in order to be permitted to use the exoskeleton in their home/community environment. PMID:27340808

  16. Operational implementation and lessons learned from Haiti's first helicopter air ambulance.

    PubMed

    DeGennaro, Vincent; Owen, Jordan; Chandler, Jerry; McDaniel, Ralph

    2016-05-01

    Critical-care helicopter transport has demonstrated improvements in morbidity and mortality to those patients who utilise the service, but this has largely excluded developing country populations due to set up costs. Haiti Air Ambulance is the first completely publicly-available helicopter ambulance service in a developing country. US standards were adopted for both aviation and aeromedical care in Haiti due to proximity and relationships. In order to implement properly, standards for aviation, critical care, and insurance reimbursement had to be put in place with local authorities. Haiti Air Ambulance worked with the Ministry of Health to author standards for medical procedures, medication usage, and staff training for aeromedical programs in the country. Utilisation criteria for the helicopter were drafted, edited, and constantly updated to ensure the program adapted to the clinical situation while maintaining US standard of care. During the first year, 76 patients were transferred; 13 of whom were children and 3 pregnant women. Three patients were intubated and two required bi-level mask ventilation. Traumatic injury and non-emergency interfacility transfers were the two most common indications for service. More than half of the transfers (54%) originated at one of six hospitals, mostly as a result of highly-involved staff. The program was limited by weather and the lack of weather reporting, radar, visual flight recognition, thus also causing an inability to fly at night. In partnership with the government and other non-governmental organisations, we seek to implement a more robust pre-hospital system in Haiti over the next 12-24 months, including more scene call capabilities. PMID:26739767

  17. Training Persons with Spinal Cord Injury to Ambulate Using a Powered Exoskeleton.

    PubMed

    Asselin, Pierre K; Avedissian, Manuel; Knezevic, Steven; Kornfeld, Stephen; Spungen, Ann M

    2016-01-01

    Powered exoskeletons have become available for overground ambulation in persons with paralyses due to spinal cord injury (SCI) who have intact upper extremity function and are able to maintain upright balance using forearm crutches. To ambulate in an exoskeleton, the user must acquire the ability to maintain balance while standing, sitting and appropriate weight shifting with each step. This can be a challenging task for those with deficits in sensation and proprioception in their lower extremities. This manuscript describes screening criteria and a training program developed at the James J. Peters VA Medical Center, Bronx, NY to teach users the skills needed to utilize these devices in institutional, home or community environments. Before training can begin, potential users are screened for appropriate range of motion of the hip, knee and ankle joints. Persons with SCI are at an increased risk of sustaining lower extremity fractures, even with minimal strain or trauma, therefore a bone mineral density assessment is performed to reduce the risk of fracture. Also, as part of screening, a physical examination is performed in order to identify additional health-related contraindications. Once the person has successfully passed all screening requirements, they are cleared to begin the training program. The device is properly adjusted to fit the user. A series of static and dynamic balance tasks are taught and performed by the user before learning to walk. The person is taught to ambulate in various environments ranging from indoor level surfaces to outdoors over uneven or changing surfaces. Once skilled enough to be a candidate for home use with the exoskeleton, the user is then required to designate a companion-walker who will train alongside them. Together, the pair must demonstrate the ability to perform various advanced tasks in order to be permitted to use the exoskeleton in their home/community environment.

  18. Emerging organizational structures in the ambulance industry in the United States.

    PubMed

    Narad, R A

    2000-01-01

    This analysis seeks to identify emerging forms of organizations in emergency medical services (EMS) in the United States, to provide examples of them, to relate them to changes in healthcare generally, and to apply a classification scheme. Public policy issues related to these new forms of organizations and lessons from other areas of the healthcare system are identified. Recent changes in the healthcare system in the United States have been marked by modifications in the structure of organizations that provide and pay for health services. New forms of organizations and alliances among existing organizations have emerged in an effort to improve the efficiency of the services provided and to improve organizations' market positions. Reflecting increased competition within EMS and the demands of the changing health-care delivery system, several types of organizations have begun to emerge in EMS that resemble those occurring in health care generally. These include forms of horizontal integration, such as consolidated ambulance services and various models of ambulance service networks; and forms of vertical integration, such as demand management programs and public-private joint ventures. The ultimate end might be complete integration with a carve-out of all non-scheduled care. Although changes in EMS organizations result largely from marketplace decisions by sellers and purchasers, this does not mean that there is no public policy role. While new organizational forms may increase the ambulance industry's efficiency, public policy makers must be concerned about quality and access as well. Some policy responses will promote marketplace changes, others will accept them generally, but will seek to correct problems, and a third group will attempt to restrain the market.

  19. Lightweight physiologic sensor performance during pre-hospital care delivered by ambulance clinicians.

    PubMed

    Mort, Alasdair J; Fitzpatrick, David; Wilson, Philip M J; Mellish, Chris; Schneider, Anne

    2016-02-01

    The aim of this study was to explore the impact of motion generated by ambulance patient management on the performance of two lightweight physiologic sensors. Two physiologic sensors were applied to pre-hospital patients. The first was the Contec Medical Systems CMS50FW finger pulse oximeter, monitoring heart rate (HR) and blood oxygen saturation (SpO2). The second was the RESpeck respiratory rate (RR) sensor, which was wireless-enabled with a Bluetooth(®) Low Energy protocol. Sensor data were recorded from 16 pre-hospital patients, who were monitored for 21.2 ± 9.8 min, on average. Some form of error was identified on almost every HR and SpO2 trace. However, the mean proportion of each trace exhibiting error was <10 % (range <1-50 % for individual patients). There appeared to be no overt impact of the gross motion associated with road ambulance transit on the incidence of HR or SpO2 error. The RESpeck RR sensor delivered an average of 4.2 (±2.2) validated breaths per minute, but did not produce any validated breaths during the gross motion of ambulance transit as its pre-defined motion threshold was exceeded. However, this was many more data points than could be achieved using traditional manual assessment of RR. Error was identified on a majority of pre-hospital physiologic signals, which emphasised the need to ensure consistent sensor attachment in this unstable and unpredictable environment, and in developing intelligent methods of screening out such error.

  20. The Impact of Ambulance and Patient Diversion on Crowdedness of Multiple Emergency Departments in a Region

    PubMed Central

    Kao, Chung-Yao; Yang, Jhen-Ci; Lin, Chih-Hao

    2015-01-01

    Emergency department (ED) overcrowding threatens healthcare quality. Ambulance diversion (AD) may relieve ED overcrowding; however, diverting patients from an overcrowded ED will load neighboring EDs with more patients and may result in regional overcrowding. The purpose of this study was to evaluate the impact of different diversion strategies on the crowdedness of multiple EDs in a region. The importance of regional coordination was also explored. A queuing model for patient flow was utilized to develop a computer program for simulating AD among EDs in a region. Key parameters, including patient arrival rates, percentages of patients of different acuity levels, percentage of patients transported by ambulance, and total resources of EDs, were assigned based on real data. The crowdedness indices of each ED and the regional crowdedness index were assessed to evaluate the effectiveness of various AD strategies. Diverting patients equally to all other EDs in a region is better than diverting patients only to EDs with more resources. The effect of diverting all ambulance-transported patients is similar to that of diverting only low-acuity patients. To minimize regional crowdedness, ambulatory patients should be sent to proper EDs when AD is initiated. Based on a queuing model with parameters calibrated by real data, patient flows of EDs in a region were simulated by a computer program. From a regional point of view, randomly diverting ambulatory patients provides almost no benefit. With regards to minimizing the crowdedness of the whole region, the most promising strategy is to divert all patients equally to all other EDs that are not already crowded. This result implies that communication and coordination among regional hospitals are crucial to relieve overall crowdedness. A regional coordination center may prioritize AD strategies to optimize ED utility. PMID:26659589

  1. The use of intraluminal strain gauges for recording ambulant small bowel motility.

    PubMed

    Gill, R C; Kellow, J E; Browning, C; Wingate, D L

    1990-04-01

    Perfused-tube manometry has hitherto been the standard technique for recording intraluminal intestinal pressure in humans, but it is unsuitable for ambulant use. The aim of our study was to evaluate the ability of resistive strain gauge transducers attached to a fine catheter to detect pressure change. Simultaneous strain gauge and perfused-tube manometry was performed on six fasting subjects; in four, strain gauge activation was continuous and in two, the transducers were activated in a pulsed mode with data encoded as a pulse train with an approximate frequency of 20 Hz. Eight thousand eight hundred eighty-eight pressure waves were recorded by strain gauge, of which 96% were detected by perfused-tube manometry. There was good agreement in both phases II and III of the migrating motor complex. The amplitude of pressure waves recorded by strain gauge was slightly but significantly greater. A proportion (14-17%) of pressure waves recorded by strain gauge were bifid; this was not seen with the perfused tube. These differences are best explained by the greater sensitivity and more rapid rise time of the strain gauges. There was no loss of fidelity in the pulse-interval recording mode. A seventh subject underwent a continuous 72-h recording with the strain gauge catheter attached to a battery-operated encoder and magnetic tape cassette recorder and was freely ambulant during this period. The procedure was well tolerated and motility patterns could be clearly identified. We conclude that intraluminal strain gauge catheters are suitable for prolonged use in ambulant subjects and produce data that are closely comparable to the data acquired from perfused-tube manometry under laboratory conditions. PMID:2333973

  2. Effects of weather conditions on emergency ambulance calls for acute coronary syndromes.

    PubMed

    Vencloviene, Jone; Babarskiene, Ruta; Dobozinskas, Paulius; Siurkaite, Viktorija

    2015-08-01

    The aim of this study was to evaluate the relationship between weather conditions and daily emergency ambulance calls for acute coronary syndromes (ACS). The study included data on 3631 patients who called the ambulance for chest pain and were admitted to the department of cardiology as patients with ACS. We investigated the effect of daily air temperature (T), barometric pressure (BP), relative humidity, and wind speed (WS) to detect the risk areas for low and high daily volume (DV) of emergency calls. We used the classification and regression tree method as well as cluster analysis. The clusters were created by applying the k-means cluster algorithm using the standardized daily weather variables. The analysis was performed separately during cold (October-April) and warm (May-September) seasons. During the cold period, the greatest DV was observed on days of low T during the 3-day sequence, on cold and windy days, and on days of low BP and high WS during the 3-day sequence; low DV was associated with high BP and decreased WS on the previous day. During June-September, a lower DV was associated with low BP, windless days, and high BP and low WS during the 3-day sequence. During the warm period, the greatest DV was associated with increased BP and changing WS during the 3-day sequence. These results suggest that daily T, BP, and WS on the day of the ambulance call and on the two previous days may be prognostic variables for the risk of ACS. PMID:25344902

  3. Emergency department overcrowding and ambulance transport delays for patients with chest pain

    PubMed Central

    Schull, Michael J.; Morrison, Laurie J.; Vermeulen, Marian; Redelmeier, Donald A.

    2003-01-01

    Objective Emergency department overcrowding sometimes results in diversion of ambulances to other locations. We sought to determine the resulting prehospital delays for cardiac patients. Methods Data on consecutive patients with chest pain who were transported to Toronto hospitals by ambulance were obtained for a 4-month period in 1997 and a 4-month period in 1999, which represented periods of low and high emergency department overcrowding respectively. Multivariate analyses were used to model 90th percentile system response (initiation of 9-1-1 call to arrival on scene), on-scene (arrival on scene to departure from scene) and transport (departure from scene to arrival at hospital) intervals. Predictor variables were study period (1997 or 1999), day of the week, time of day, geographic location of the patient, dispatch priority, case severity, return priority and number of other patients with chest pain transported within 2 hours of the index transport. Results A total of 3609 patients (mean age 66.3 years, 50.3% female) who met the study criteria were transported by ambulance during the 2 study periods. There were no significant differences in patient characteristics between the 2 periods, despite the fact that more patients were transported during the second period (p < 0.001). The 90th percentile system response interval increased by 11.3% from the first to the second period (9.7 v. 10.8 min, p < 0.001), whereas the on-scene interval decreased by 8.2% (28.0 v. 25.7 min, p < 0.001). The longest delay was in the transport interval, which increased by 28.4% from 1997 to 1999 (13.4 v. 17.2 min, p < 0.001). In multivariate analyses, the study period (1997 v. 1999) remained a significant predictor of longer transport interval (p < 0.001) and total prehospital interval (p = 0.004). Interpretation An increase in overcrowding in emergency departments was associated with a substantial increase in the system response interval and the ambulance transport interval for

  4. Validation of histology image registration

    NASA Astrophysics Data System (ADS)

    Shojaii, Rushin; Karavardanyan, Tigran; Yaffe, Martin; Martel, Anne L.

    2011-03-01

    The aim of this paper is to validate an image registration pipeline used for histology image alignment. In this work a set of histology images are registered to their correspondent optical blockface images to make a histology volume. Then multi-modality fiducial markers are used to validate the alignment of histology images. The fiducial markers are catheters perfused with a mixture of cuttlefish ink and flour. Based on our previous investigations this fiducial marker is visible in medical images, optical blockface images and it can also be localized in histology images. The properties of this fiducial marker make it suitable for validation of the registration techniques used for histology image alignment. This paper reports on the accuracy of a histology image registration approach by calculation of target registration error using these fiducial markers.

  5. 32 CFR 1615.1 - Registration.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... registration card or other method of registration prescribed by the Director of Selective Service by a person... the records (master computer file) of the Selective Service System. Registration is completed when... Director include completing a Selective Service Registration Card at a classified Post Office,...

  6. Open-field temporal pattern of ambulation in Japanese quail genetically selected for contrasting adrenocortical responsiveness to brief manual restraint.

    PubMed

    Kembro, J M; Satterlee, D G; Schmidt, J B; Perillo, M A; Marin, R H

    2008-11-01

    Japanese quail selected for a low-stress (LS), rather than a high-stress (HS), plasma corticosterone response to brief restraint have been shown to possess lower fearfulness and a nonspecific reduction in stress responsiveness. Detrended fluctuation analysis provides information on the organization and complexity of temporal patterns of behavior. The present study evaluated the temporal pattern of ambulation of LS and HS quail in an open field that represented a novel environment. Time series of 4,200 data points were collected for each bird by registering the distance ambulated every 0.5 s during a 35-min test period. Consistent with their known reduced fearfulness, the LS quail initiated ambulation significantly sooner (P < 0.02) and tended to ambulate more (P < 0.09) than did their HS counterparts. Detrended fluctuation analyses showed a monofractal series (i.e., a series with similar complexity at different temporal scales) in 72% of the birds. These birds initiated their ambulatory activity in less than 600 s. Among these birds, a lower (P < 0.03) autosimilarity coefficient (alpha) was found in the LS quail than in their HS counterparts (alpha = 0.76 +/- 0.03 and 0.87 +/- 0.03, respectively), suggesting a more complex (less regular) ambulatory pattern in the LS quail. However, when the patterns of ambulation were reexamined by considering only the active period of the time series (i.e., after the birds had initiated their ambulatory activity), monofractal patterns were observed in 97% of the birds, and no differences were found between the lines. Collectively, the results suggest that during the active period of open-field testing, during which fear responses are likely less strong and other motivations are the driving forces of ambulation, the LS and HS lines have similar ambulatory organization.

  7. Clinical measures as valid predictors and discriminators of the level of community ambulation of hemiparetic stroke survivors

    PubMed Central

    Lee, GyuChang; An, SeungHeon; Lee, YunBok; Park, Dong-Sik

    2016-01-01

    [Purpose] To investigate clinical measures as valid predictors and discriminators of the level of community ambulation of hemiparetic stroke survivors. [Subjects and Methods] Seventy-five hemiparetic stroke patients were separated into a community ambulation group (>0.8 m/s) and a limited community ambulation group (0.4–0.8 m/s). The dorsiflexor strength of the affected side, Sit to Stand (STS) test, Timed Up & Go (TUG) test, Berg Balance Scale (BBS), Fugl-Meyer Assessment (FMA), Falls Efficacy Scale (FES), 2-min step test (2mST), and 6-min walk test (6mWT) were used for evaluation. The discriminative powers of the tests and measures were investigated using the receiver-operating characteristic (ROC) curve, and odd ratios were calculated to predict the level of community ambulation. [Results] The cutoff values for predicting the level of community ambulation (>0.8 m/s) were <14.77 s for TUG, <12.6 s for STS, a score >46.5 for BBS, a score >25.5 for FMA, a score <13.5 for FES, >7.5 kg for dorsiflexor strength, >30 times for 2mST, and >318 m for 6mWT. All clinical measures except FES had moderate accuracy according to the area under the curve of 0.76–0.88 (70–93%). [Conclusion] Clinical measures (except FES) have moderate validity in predicting the level of community ambulation of stroke survivors. PMID:27630394

  8. Clinical measures as valid predictors and discriminators of the level of community ambulation of hemiparetic stroke survivors.

    PubMed

    Lee, GyuChang; An, SeungHeon; Lee, YunBok; Park, Dong-Sik

    2016-08-01

    [Purpose] To investigate clinical measures as valid predictors and discriminators of the level of community ambulation of hemiparetic stroke survivors. [Subjects and Methods] Seventy-five hemiparetic stroke patients were separated into a community ambulation group (>0.8 m/s) and a limited community ambulation group (0.4-0.8 m/s). The dorsiflexor strength of the affected side, Sit to Stand (STS) test, Timed Up & Go (TUG) test, Berg Balance Scale (BBS), Fugl-Meyer Assessment (FMA), Falls Efficacy Scale (FES), 2-min step test (2mST), and 6-min walk test (6mWT) were used for evaluation. The discriminative powers of the tests and measures were investigated using the receiver-operating characteristic (ROC) curve, and odd ratios were calculated to predict the level of community ambulation. [Results] The cutoff values for predicting the level of community ambulation (>0.8 m/s) were <14.77 s for TUG, <12.6 s for STS, a score >46.5 for BBS, a score >25.5 for FMA, a score <13.5 for FES, >7.5 kg for dorsiflexor strength, >30 times for 2mST, and >318 m for 6mWT. All clinical measures except FES had moderate accuracy according to the area under the curve of 0.76-0.88 (70-93%). [Conclusion] Clinical measures (except FES) have moderate validity in predicting the level of community ambulation of stroke survivors. PMID:27630394

  9. Clinical measures as valid predictors and discriminators of the level of community ambulation of hemiparetic stroke survivors

    PubMed Central

    Lee, GyuChang; An, SeungHeon; Lee, YunBok; Park, Dong-Sik

    2016-01-01

    [Purpose] To investigate clinical measures as valid predictors and discriminators of the level of community ambulation of hemiparetic stroke survivors. [Subjects and Methods] Seventy-five hemiparetic stroke patients were separated into a community ambulation group (>0.8 m/s) and a limited community ambulation group (0.4–0.8 m/s). The dorsiflexor strength of the affected side, Sit to Stand (STS) test, Timed Up & Go (TUG) test, Berg Balance Scale (BBS), Fugl-Meyer Assessment (FMA), Falls Efficacy Scale (FES), 2-min step test (2mST), and 6-min walk test (6mWT) were used for evaluation. The discriminative powers of the tests and measures were investigated using the receiver-operating characteristic (ROC) curve, and odd ratios were calculated to predict the level of community ambulation. [Results] The cutoff values for predicting the level of community ambulation (>0.8 m/s) were <14.77 s for TUG, <12.6 s for STS, a score >46.5 for BBS, a score >25.5 for FMA, a score <13.5 for FES, >7.5 kg for dorsiflexor strength, >30 times for 2mST, and >318 m for 6mWT. All clinical measures except FES had moderate accuracy according to the area under the curve of 0.76–0.88 (70–93%). [Conclusion] Clinical measures (except FES) have moderate validity in predicting the level of community ambulation of stroke survivors.

  10. Frontal plane standing balance with an ambulation aid: Upper limb biomechanics.

    PubMed

    Tung, James Y; Gage, William H; Zabjek, Karl F; Maki, Brian E; McIlroy, William E

    2011-05-17

    Despite widespread acceptance of clinical benefits, empirical evidence to evaluate the advantages and limitations of ambulation aids for balance control is limited. The current study investigates the upper limb biomechanical contributions to the control of frontal plane stability while using a 4-wheeled walker in quiet standing. We hypothesized that: (1) upper limb stabilizing moments would be significant, and (2) would increase under conditions of increased stability demand. Factors influencing upper limb moment generation were also examined. Specifically, the contributions of upper limb center-of-pressure (COP(hands)), vertical and horizontal loads applied to the assistive device were assessed. The results support a significant mechanical role for the upper limbs, generating 27.1% and 58.8% of overall stabilizing moments under baseline and challenged stability demand conditions, respectively. The increased moment was achieved primarily through the preferential use of phasic upper limb control, reflected by increased COP(hands) (baseline vs. challenged conditions: 0.29 vs. 0.72cm). Vertical, but not horizontal, was the primary force direction contributing to stabilizing moments in quiet standing. The key finding that the upper limbs play an important role in effecting frontal plane balance control has important implications for ambulation aid users (e.g., elderly, stroke, and traumatic brain injury).

  11. Benefits of microprocessor-controlled prosthetic knees to limited community ambulators: systematic review.

    PubMed

    Kannenberg, Andreas; Zacharias, Britta; Pröbsting, Eva

    2014-01-01

    The benefits of microprocessor-controlled prosthetic knees (MPKs) have been well established in community ambulators (Medicare Functional Classification Level [MFCL]-3) with a transfemoral amputation (TFA). A systematic review of the literature was performed to analyze whether limited community ambulators (MFCL-2) may also benefit from using an MPK in safety, performance-based function and mobility, and perceived function and satisfaction. We searched 10 scientific databases for clinical trials with MPKs and identified six publications with 57 subjects with TFA and MFCL-2 mobility grade. Using the criteria of a Cochrane Review on prosthetic components, we rated methodological quality moderate in four publications and low in two publications. MPK use may significantly reduce uncontrolled falls by up to 80% as well as significantly improve indicators of fall risk. Performance-based outcome measures suggest that persons with MFCL-2 mobility grade may be able to walk about 14% to 25% faster on level ground, be around 20% quicker on uneven surfaces, and descend a slope almost 30% faster when using an MPK. The results of this systematic review suggest that trial fittings may be used to determine whether or not individuals with TFA and MFCL-2 mobility grade benefit from MPK use. Criteria for patient selection and assessment of trial fitting success or failure are proposed.

  12. Assessing post-anterior cruciate ligament reconstruction ambulation using wireless wearable integrated sensors.

    PubMed

    Arosha Senanayake, S M N; Ahmed Malik, Owais; Mohammad Iskandar, Pg; Zaheer, Dansih

    2013-11-01

    Abstract A hardware/software co-design for assessing post-Anterior Cruciate Ligament (ACL) reconstruction ambulation is presented. The knee kinematics and neuromuscular data during walking (2-6 km h(-1)) have been acquired using wireless wearable motion and electromyography (EMG) sensors, respectively. These signals were integrated by superimposition and mixed signals processing techniques in order to provide visual analyses of bio-signals and identification of the recovery progress of subjects. Monitoring overlapped signals simultaneously helps in detecting variability and correlation of knee joint dynamics and muscles activities for an individual subject as well as for a group. The recovery stages of subjects have been identified based on combined features (knee flexion/extension and EMG signals) using an adaptive neuro-fuzzy inference system (ANFIS). The proposed system has been validated for 28 test subjects (healthy and ACL-reconstructed). Results of ANFIS showed that the ambulation data can be used to distinguish subjects at different levels of recuperation after ACL reconstruction. PMID:24117351

  13. Regionalization of trauma services in western Sydney: predicted effect on ambulance and hospital utilization rates.

    PubMed

    Lyle, D M; Thomson, P C; Deane, S A; Coulon, L A

    1991-08-01

    A previous study has demonstrated the effectiveness of ambulance staff in identifying the majority of trauma victims who warrant admission to a Level 3 Hospital. This paper applied the results of that study in order to estimate the likely effect of a system of bypass whereby these identified patients are transported to a Level 3 hospital rather than the nearest Level 1 or 2 Hospital. Under the proposed plan whereby both Westmead and Liverpool Hospitals would be granted Level 3 status, the effect of Westmead would be negligible. However, Liverpool's caseload would increase (25% for total admissions, 136% for serious admissions) and, consequently, its level of resources would need to be upgraded before this plan can be put into action. Meanwhile, Level 1 and 2 hospitals would see little change to total patient admissions, although there would be a substantial drop in serious admissions (-63%). Under the proposed system, the effects on the Ambulance Service would also be negligible in terms of both the number of transports and total transport hours. However, the nature of these transports would change. More time would be required in bypass cases, although this would be compensated for by a corresponding fall off in interhospital transfers (28% decline in time spent on transfers). Ultimately, this means that patients would be getting to the hospital of definitive care much sooner. These results have implications for the development of trauma services in other sectors.

  14. Ambulation and independence among Veterans with nontraumatic bilateral lower-limb loss.

    PubMed

    Sharath, Sherene; Henson, Helene; Flynn, Stacy; Pisimisis, George; Kougias, Panos; Barshes, Neal R

    2015-01-01

    In describing functional outcomes and independent living in a cohort of bilateral major amputees, we sought to provide current estimates of function and independence after a second major amputation in an elderly Veteran population with peripheral arterial disease and/or diabetes. After retrospectively reviewing and excluding the electronic health records of those failing to meet the inclusion criteria, we identified 40 patients with a history of unilateral major amputation who underwent a second major amputation during the defined study period. Of these, 43% (17) were bilateral transfemoral amputations (TFAs); bilateral transtibial amputations (TTAs) and TFA-TTA accounted for the rest (33% and 25%, respectively). Of the 19 (48%) patients who were ambulatory prior to bilateral amputation, only 2 (11%) remained ambulatory after the second amputation, while 17 (89%) patients lost ambulatory capabilities. Compared with those who were ambulate precontralateral amputation (p = 0.03). All patients with bilateral TFA were nonambulatory. Independence postcontralateral amputation decreased from 88% (35) to 53% (21). When data were available (58%), pre and post Functional Independence Measure scores showed a decrease in 74% of patients, while 22% showed an increase. In conclusion, bilateral lower-limb amputation among dysvascular Veterans is highly associated with a loss of ambulation. PMID:26745753

  15. Neurotherapeutic and neuroprosthetic effects of implanted functional electrical stimulation for ambulation after incomplete spinal cord injury.

    PubMed

    Bailey, Stephanie Nogan; Hardin, Elizabeth C; Kobetic, Rudi; Boggs, Lisa M; Pinault, Gilles; Triolo, Ronald J

    2010-01-01

    The purpose of this single-subject study was to determine the neurotherapeutic and neuroprosthetic effects of an implanted functional electrical stimulation (FES) system designed to facilitate walking in an individual with a longstanding motor and sensory incomplete spinal cord injury. An implanted pulse generator and eight intramuscular stimulating electrodes were installed unilaterally, activating weak or paralyzed hip flexors, hip and knee extensors, and ankle dorsiflexors during 36 sessions of gait training with FES. The neurotherapeutic effects were assessed by a comparison of pre- and posttraining volitional walking. The neuroprosthetic effects were assessed by a comparison of posttraining volitional and FES-assisted walking. Treatment resulted in significant (p < 0.005) volitional improvements in 6-minute walking distance and speed, speed during maximum walk, double support time, and 10 m walking speed. Posttraining FES-assisted walking resulted in significant additional improvements in all these measures, except 10 m walking speed. When the subject was using FES-assisted gait, maximum walking distance, peak knee flexion in swing, peak ankle dorsiflexion in swing, and knee extension moment also significantly increased. Neuroprosthetic gains were sufficient to enable the subject to advance from household ambulation to limited community ambulation. Additionally, the subject could perform multiple walks per day when using FES-assisted gait, which was impossible with volitional effort alone.

  16. Using HSPA to improve the telemedical links on a moving ambulance.

    PubMed

    Banitsas, Konstantinos; Tachakra, Sapal; Stefanidis, Euclid; Boletis, Konstantinos

    2008-01-01

    As the demand for faster and more effective health care increases, there is a growing need to establish mobile, high-speed communications between a moving ambulance and a consultation point (usually a hospital). The recent addition of HSPA (HSDPA and HSUPA) into the UMTS suite provides higher bandwidth and reduced delays, making this choice ideal for real-time telemedical applications. In this paper, we will describe a set of scenarios that took place in a typical large city area, along with their equivalent results: a moving ambulance was linked with a consultation station using HSPA and several videoconferencing sessions were initiated. Best-case, worst-case and average scenarios were recorded. Furthermore, in areas where the UMTS reception was marginal, a repeater was placed on top of the vehicle to boost up the signal power and thus maintain the higher bandwidth. Finally, treating doctors were asked to evaluate the effectiveness of this system's outputs, based on a variety of objective and subjective criteria.

  17. Transcranial Magnetic Stimulation and Diffusion Tensor Tractography for Evaluating Ambulation after Stroke

    PubMed Central

    Kim, Bo-Ram; Moon, Won-Jin; Kim, Hyuntae; Jung, Eunhwa; Lee, Jongmin

    2016-01-01

    Background and Purpose We aimed to investigate the usefulness of combining transcranial magnetic stimulation (TMS) and diffusion tensor tractography (DTT) to evaluate corticospinal tract (CST) integrity and subsequently predict ambulatory function after middle cerebral artery (MCA) stroke. Methods Forty-three patients with first MCA stroke underwent TMS and DTT to evaluate CST integrity. Patients were classified into four groups according to the presence of motor-evoked potentials (MEPs) obtained from the tibialis anterior muscle and CST integrity. Motor impairment and functional status were assessed using the Fugl-Meyer Assessment, Functional Ambulation Category, and Korean modified Barthel Index, both at the time of admission and after 4 weeks of rehabilitation. Results Patients with the presence of both measurable MEPs and a preserved CST showed better motor recovery and ambulatory function than other groups at the 4-week follow-up. Intact CSTs were not visualized in patients without detectable MEPs. Among the patients displaying MEPs, those with preserved CSTs showed better recovery of paretic lower extremities. Conclusions Combined assessment using TMS and DTT to evaluate CST integrity confers advantages in predicting motor and ambulation recovery in patients with MCA stroke. PMID:27283282

  18. Local image registration a comparison for bilateral registration mammography

    NASA Astrophysics Data System (ADS)

    Celaya-Padilaa, José M.; Rodriguez-Rojas, Juan; Trevino, Victor; Tamez-Pena, José G.

    2013-11-01

    Early tumor detection is key in reducing the number of breast cancer death and screening mammography is one of the most widely available and reliable method for early detection. However, it is difficult for the radiologist to process with the same attention each case, due the large amount of images to be read. Computer aided detection (CADe) systems improve tumor detection rate; but the current efficiency of these systems is not yet adequate and the correct interpretation of CADe outputs requires expert human intervention. Computer aided diagnosis systems (CADx) are being designed to improve cancer diagnosis accuracy, but they have not been efficiently applied in breast cancer. CADx efficiency can be enhanced by considering the natural mirror symmetry between the right and left breast. The objective of this work is to evaluate co-registration algorithms for the accurate alignment of the left to right breast for CADx enhancement. A set of mammograms were artificially altered to create a ground truth set to evaluate the registration efficiency of DEMONs , and SPLINE deformable registration algorithms. The registration accuracy was evaluated using mean square errors, mutual information and correlation. The results on the 132 images proved that the SPLINE deformable registration over-perform the DEMONS on mammography images.

  19. Lower Extremity Passive Range of Motion in Community-Ambulating Stroke Survivors

    PubMed Central

    Schindler-Ivens, Sheila; Desimone, Davalyn; Grubich, Sarah; Kelley, Carolyn; Sanghvi, Namita; Brown, David A.

    2014-01-01

    Background Physical therapists may prescribe stretching exercises for individuals with stroke to improve joint integrity and to reduce the risk of secondary musculoskeletal impairment. While deficits in passive range of motion (PROM) exist in stroke survivors with severe hemiparesis and spasticity, the extent to which impaired lower extremity PROM occurs in community-ambulating stroke survivors remains unclear. This study compared lower extremity PROM in able-bodied individuals and independent community-ambulatory stroke survivors with residual stroke-related neuromuscular impairments. Our hypothesis was that the stroke group would show decreased lower extremity PROM in the paretic but not the nonparetic side and that decreased PROM would be associated with increased muscle stiffness and decreased muscle length. Methods Individuals with chronic poststroke hemiparesis who reported the ability to ambulate independently in the community (n = 17) and age-matched control subjects (n = 15) participated. PROM during slow (5 degrees/sec) hip extension, hip flexion, and ankle dorsiflexion was examined bilaterally using a dynamometer that measured joint position and torque. The maximum angular position of the joint (ANGmax), torque required to achieve ANGmax (Tmax), and mean joint stiffness (K) were measured. Comparisons were made between able-bodied and paretic and able-bodied and nonparetic limbs. Results Contrary to our expectations, between-group differences in ANGmax were observed only during hip extension in which ANGmax was greater bilaterally in people post-stroke compared to control subjects (P ≤ 0.05; stroke = 13 degrees, able-bodied = −1 degree). Tmax, but not K, was also significantly higher during passive hip extension in paretic and nonparetic limbs compared to control limbs (P ≤ 0.05; stroke = 40 Nm, able-bodied = 29 Nm). Compared to the control group, Tmax was increased during hip flexion in the paretic and nonparetic limbs of post-stroke subjects (P

  20. The Medical Duty Officer: An Attempt to Mitigate the Ambulance At-Hospital Interval

    PubMed Central

    Halliday, Megan H.; Bouland, Andrew J.; Lawner, Benjamin J.; Comer, Angela C.; Ramos, Daniel C.; Fletcher, Mark

    2016-01-01

    Introduction A lack of coordination between emergency medical services (EMS), emergency departments (ED) and systemwide management has contributed to extended ambulance at-hospital times at local EDs. In an effort to improve communication within the local EMS system, the Baltimore City Fire Department (BCFD) placed a medical duty officer (MDO) in the fire communications bureau. It was hypothesized that any real-time intervention suggested by the MDO would be manifested in a decrease in the EMS at-hospital time. Methods The MDO was implemented on November 11, 2013. A senior EMS paramedic was assigned to the position and was placed in the fire communication bureau from 9 a.m. to 9 p.m., seven days a week. We defined the pre-intervention period as August 2013 – October 2013 and the post-intervention period as December 2013 – February 2014. We also compared the post-intervention period to the “seasonal match control” one year earlier to adjust for seasonal variation in EMS volume. The MDO was tasked with the prospective management of city EMS resources through intensive monitoring of unit availability and hospital ED traffic. The MDO could suggest alternative transport destinations in the event of ED crowding. We collected and analyzed data from BCFD computer-aided dispatch (CAD) system for the following: ambulance response times, ambulance at-hospital interval, hospital diversion and alert status, and “suppression wait time” (defined as the total time suppression units remained on scene until ambulance arrival). The data analysis used a pre/post intervention design to examine the MDO impact on the BCFD EMS system. Results There were a total of 15,567 EMS calls during the pre-intervention period, 13,921 in the post-intervention period and 14,699 in the seasonal match control period one year earlier. The average at-hospital time decreased by 1.35 minutes from pre- to post-intervention periods and 4.53 minutes from the pre- to seasonal match control

  1. The Medical Duty Officer: An Attempt to Mitigate the Ambulance At-Hospital Interval

    PubMed Central

    Halliday, Megan H.; Bouland, Andrew J.; Lawner, Benjamin J.; Comer, Angela C.; Ramos, Daniel C.; Fletcher, Mark

    2016-01-01

    Introduction A lack of coordination between emergency medical services (EMS), emergency departments (ED) and systemwide management has contributed to extended ambulance at-hospital times at local EDs. In an effort to improve communication within the local EMS system, the Baltimore City Fire Department (BCFD) placed a medical duty officer (MDO) in the fire communications bureau. It was hypothesized that any real-time intervention suggested by the MDO would be manifested in a decrease in the EMS at-hospital time. Methods The MDO was implemented on November 11, 2013. A senior EMS paramedic was assigned to the position and was placed in the fire communication bureau from 9 a.m. to 9 p.m., seven days a week. We defined the pre-intervention period as August 2013 – October 2013 and the post-intervention period as December 2013 – February 2014. We also compared the post-intervention period to the “seasonal match control” one year earlier to adjust for seasonal variation in EMS volume. The MDO was tasked with the prospective management of city EMS resources through intensive monitoring of unit availability and hospital ED traffic. The MDO could suggest alternative transport destinations in the event of ED crowding. We collected and analyzed data from BCFD computer-aided dispatch (CAD) system for the following: ambulance response times, ambulance at-hospital interval, hospital diversion and alert status, and “suppression wait time” (defined as the total time suppression units remained on scene until ambulance arrival). The data analysis used a pre/post intervention design to examine the MDO impact on the BCFD EMS system. Results There were a total of 15,567 EMS calls during the pre-intervention period, 13,921 in the post-intervention period and 14,699 in the seasonal match control period one year earlier. The average at-hospital time decreased by 1.35 minutes from pre- to post-intervention periods and 4.53 minutes from the pre- to seasonal match control

  2. 21 CFR 1301.35 - Certificate of registration; denial of registration.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... registration. (a) The Administrator shall issue a Certificate of Registration (DEA Form 223) to an applicant if... Federal Register. (c) The Certificate of Registration (DEA Form 223) shall contain the name, address,...

  3. 21 CFR 1309.42 - Certificate of registration; denial of registration.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...; denial of registration. (a) The Administrator shall issue a Certificate of Registration (DEA Form 511) to..., shall hold a hearing on the application pursuant to § 1309.51. (b) The Certificate of Registration...

  4. 21 CFR 1309.42 - Certificate of registration; denial of registration.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...; denial of registration. (a) The Administrator shall issue a Certificate of Registration (DEA Form 511) to..., shall hold a hearing on the application pursuant to § 1309.51. (b) The Certificate of Registration...

  5. 21 CFR 1301.35 - Certificate of registration; denial of registration.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... registration. (a) The Administrator shall issue a Certificate of Registration (DEA Form 223) to an applicant if... Federal Register. (c) The Certificate of Registration (DEA Form 223) shall contain the name, address,...

  6. 21 CFR 1301.35 - Certificate of registration; denial of registration.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... registration. (a) The Administrator shall issue a Certificate of Registration (DEA Form 223) to an applicant if... Federal Register. (c) The Certificate of Registration (DEA Form 223) shall contain the name, address,...

  7. 21 CFR 1309.42 - Certificate of registration; denial of registration.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...; denial of registration. (a) The Administrator shall issue a Certificate of Registration (DEA Form 511) to..., shall hold a hearing on the application pursuant to § 1309.51. (b) The Certificate of Registration...

  8. 21 CFR 1301.35 - Certificate of registration; denial of registration.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... registration. (a) The Administrator shall issue a Certificate of Registration (DEA Form 223) to an applicant if... Federal Register. (c) The Certificate of Registration (DEA Form 223) shall contain the name, address,...

  9. 21 CFR 1301.35 - Certificate of registration; denial of registration.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... registration. (a) The Administrator shall issue a Certificate of Registration (DEA Form 223) to an applicant if... Federal Register. (c) The Certificate of Registration (DEA Form 223) shall contain the name, address,...

  10. 21 CFR 1309.42 - Certificate of registration; denial of registration.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...; denial of registration. (a) The Administrator shall issue a Certificate of Registration (DEA Form 511) to..., shall hold a hearing on the application pursuant to § 1309.51. (b) The Certificate of Registration...

  11. Mask registration and wafer overlay

    NASA Astrophysics Data System (ADS)

    Lee, Chulseung; Bang, Changjin; Kim, Myoungsoo; Kang, Hyosang; Lee, Dohwa; Jeong, Woonjae; Lim, Ok-Sung; Yoon, Seunghoon; Jung, Jaekang; Laske, Frank; Parisoli, Lidia; Roeth, Klaus-Dieter; Robinson, John C.; Jug, Sven; Izikson, Pavel; Dinu, Berta; Widmann, Amir; Choi, DongSub

    2010-03-01

    Overlay continues to be one of the key challenges for lithography in advanced semiconductor manufacturing. It becomes even more challenging due to the continued shrinking of the device node. Some low k1 techniques, such as Double Exposure and Double Patterning also add additional loss of the overlay margin due to the fact that the single layer pattern is created based on more than 1 exposure. Therefore, the overlay between 2 exposures requires very tight overlay specification. Mask registration is one of the major contributors to wafer overlay, especially field related overlay. We investigated mask registration and wafer overlay by co-analyzing the mask data and the wafer overlay data. To achieve the accurate cohesive results, we introduced the combined metrology mark which can be used for both mask registration measurement as well as for wafer overlay measurement. Coincidence of both metrology marks make it possible to subtract mask signature from wafer overlay without compromising the accuracy due to the physical distance between measurement marks, if we use 2 different marks for both metrologies. Therefore, it is possible to extract pure scanner related signatures, and to analyze the scanner related signatures in details to in order to enable root cause analysis and ultimately drive higher wafer yield. We determined the exact mask registration error in order to decompose wafer overlay into mask, scanner, process and metrology. We also studied the impact of pellicle mounting by comparison of mask registration measurement pre-pellicle mounting and post-pellicle mounting in this investigation.

  12. Radar image registration and rectification

    NASA Technical Reports Server (NTRS)

    Naraghi, M.; Stromberg, W. D.

    1983-01-01

    Two techniques for radar image registration and rectification are presented. In the registration method, a general 2-D polynomial transform is defined to accomplish the geometric mapping from one image into the other. The degree and coefficients of the polynomial are obtained using an a priori found tiepoint data set. In the second part of the paper, a rectification procedure is developed that models the distortion present in the radar image in terms of the radar sensor's platform parameters and the topographic variations of the imaged scene. This model, the ephemeris data and the digital topographic data are then used in rectifying the radar image. The two techniques are then used in registering and rectifying two examples of radar imagery. Each method is discussed as to its benefits, shortcomings and registration accuracy.

  13. Language proficiency and nursing registration.

    PubMed

    Müller, Amanda

    2016-02-01

    This discussion paper focuses on English proficiency standards for nursing registration in Australia, how Australia has dealt with the issue of language proficiency, and the factors which have led to the establishment of the current language standards. Also, this paper will provide a comparison of the two language tests that are currently accepted in Australia (OET and IELTS), including the appropriateness of these tests and the minimum standards used. The paper will also examine the use of educational background as an indicator of language proficiency. Finally, communication-based complaints in the post-registration environment will be explored, and some discussion will be provided about why pre-registration measures might have failed to prevent such problematic situations from occurring.

  14. Language proficiency and nursing registration.

    PubMed

    Müller, Amanda

    2016-02-01

    This discussion paper focuses on English proficiency standards for nursing registration in Australia, how Australia has dealt with the issue of language proficiency, and the factors which have led to the establishment of the current language standards. Also, this paper will provide a comparison of the two language tests that are currently accepted in Australia (OET and IELTS), including the appropriateness of these tests and the minimum standards used. The paper will also examine the use of educational background as an indicator of language proficiency. Finally, communication-based complaints in the post-registration environment will be explored, and some discussion will be provided about why pre-registration measures might have failed to prevent such problematic situations from occurring. PMID:25704372

  15. Registration of interferometric SAR images

    NASA Technical Reports Server (NTRS)

    Lin, Qian; Vesecky, John F.; Zebker, Howard A.

    1992-01-01

    Interferometric synthetic aperture radar (INSAR) is a new way of performing topography mapping. Among the factors critical to mapping accuracy is the registration of the complex SAR images from repeated orbits. A new algorithm for registering interferometric SAR images is presented. A new figure of merit, the average fluctuation function of the phase difference image, is proposed to evaluate the fringe pattern quality. The process of adjusting the registration parameters according to the fringe pattern quality is optimized through a downhill simplex minimization algorithm. The results of applying the proposed algorithm to register two pairs of Seasat SAR images with a short baseline (75 m) and a long baseline (500 m) are shown. It is found that the average fluctuation function is a very stable measure of fringe pattern quality allowing very accurate registration.

  16. Emergency obstetric referral in rural Sierra Leone: what can motorbike ambulances contribute? A mixed-methods study.

    PubMed

    Bhopal, Sunil S; Halpin, Stephen J; Gerein, Nancy

    2013-08-01

    Giving birth remains a dangerous endeavour for many of the world's women. Progress to improve this has been slow in sub-Saharan Africa. The second delay, where transport infrastructure is key in allowing a woman to reach care, has been a relatively neglected field of study. Six eRanger motorbike ambulances, specifically engineered for use on poor roads in resource-poor situations were provided in 2006 as part of an emergency referral system in rural Sierra Leone. The aim of this study was to evaluate the implementation of this referral system in terms of its use, acceptability and accessibility. Data were collected from usage records, and a series of semi-structured interviews and focus groups conducted to provide deeper understanding of the service. A total of 130 records of patients being transported to a health facility were found, 1/3 of which were for obstetric cases. The ambulance is being used regularly to transport patients to a health care facility. It is well known to the communities, is acceptable and accessible, and is valued by those it serves. District-wide traditional birth attendant training and the sensitisation activities provided a foundation for the introduction of the ambulance service, creating a high level of awareness of the service and its importance, particularly for women in labour. Motorbike ambulances are suited to remote areas and can function on poor roads inaccessible to other vehicles.

  17. 42 CFR 422.113 - Special rules for ambulance services, emergency and urgently needed services, and maintenance and...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... on charges to enrollees for emergency department services that CMS will determine annually, or what... 42 Public Health 3 2011-10-01 2011-10-01 false Special rules for ambulance services, emergency and... Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN...

  18. 42 CFR 422.113 - Special rules for ambulance services, emergency and urgently needed services, and maintenance and...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... on charges to enrollees for emergency department services that CMS will determine annually, or what... 42 Public Health 3 2012-10-01 2012-10-01 false Special rules for ambulance services, emergency and... Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN...

  19. 42 CFR 422.113 - Special rules for ambulance services, emergency and urgently needed services, and maintenance and...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... on charges to enrollees for emergency department services that CMS will determine annually, or what... 42 Public Health 3 2013-10-01 2013-10-01 false Special rules for ambulance services, emergency and... Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN...

  20. 42 CFR 422.113 - Special rules for ambulance services, emergency and urgently needed services, and maintenance and...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... on charges to enrollees for emergency department services that CMS will determine annually, or what... 42 Public Health 3 2014-10-01 2014-10-01 false Special rules for ambulance services, emergency and... Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN...

  1. Development of Key-Pecking, Pause, and Ambulation during Extended Exposure to a Fixed-Interval Schedule of Reinforcement

    ERIC Educational Resources Information Center

    Berry, Meredith S.; Kangas, Brian D.; Branch, Marc N.

    2012-01-01

    Six pigeons key-pecked under a fixed-interval (FI) 3-min schedule of food presentation. Each pigeon was studied for 200 daily sessions with 15 intervals per session (3,000 total food presentations). Analyses included the examination of latency to first peck (pause), mean rate of key pecking, and ambulation. Characterizations of stable performance…

  2. Evaluation of the effects of botulinum toxin A injections when used to improve ease of care and comfort in children with cerebral palsy whom are non-ambulant: a double blind randomized controlled trial

    PubMed Central

    2012-01-01

    with Disabilities Questionnaire (CPCHILD©) (health status) and the Paediatric Pain Profile (PPP) (pain). Adverse events will be carefully monitored by a clinician masked to group allocation. Discussion This paper outlines the theoretical basis, study hypotheses and outcome measures for a trial of BoNT-A injections and therapy for children with non-ambulant CP. Trial registration Australia New Zealand Clinical Trials Registry:N12609000360213 PMID:22873758

  3. Fasten their seatbelts: legal restraint of children in car seats and road ambulances.

    PubMed

    Wilson, Phil

    2007-09-01

    Registered nurses transport sick children in ambulances and other road vehicles every day in the United Kingdom (U.K.). Safely restraining the child, the equipment and the accompanying adults is a matter which should be addressed by all departments who transport children. A motor vehicle collision may cause an unrestrained child to be seriously injured. An unrestrained child is likely to inflict serious injury on the accompanying nurse or parent. Recent changes in child seat law require that appropriate measures must be put in place to ensure sick children receive the safest possible care. The use of a Regulation 44 compliant child-seat or an appropriately sized five-point stretcher harness should be the default standard when transporting a child in a road vehicle under any circumstances. Recent research also indicates that young infants must never be allowed to sleep in car seats on the ward because of the increased risk of obstructive sleep apnoea. PMID:17926766

  4. [The evaluation of health of medical personnel of ambulance care and impacting factors].

    PubMed

    2012-01-01

    The analysis of self-assessment of medical personnel of ambulance care revealed that 13.2% of respondents consider themselves as healthy persons, 35.1%--as practically healthy, 39.2%--as rarely being ill, 12%--as often being ill According to the poll data, deterioration of health is promoted by such personal factors as disregard of one's health (35%) and chronic diseases (25.3%). Its own role play such external factors as professional characteristics (34%). ecological conditions (23%), poor conditions of work (22.2%). The amelioration of health is supported mainly by sport exercises (42.8%). The significant role in this process play the improvement of work conditions, the enhancement of quality of medical examninations and the introduction of professional dispanserization.

  5. Outpatient or short-stay skin grafting with early ambulation for lower-extremity burns.

    PubMed

    Dean, S; Press, B

    1990-08-01

    Lower-extremity burns and skin grafts to these wounds have traditionally required extended hospitalization. We have used early tangential excision of the burn wounds and application of an Unna boot to fresh skin grafts in an attempt to shorten the hospitalization for such patients. Over a six-month period, 9 patients were treated with Unna boots to fresh skin grafts on the lower extremity. The average hospital stay was 0.9 days (range, 0 to 3 days). Graft take was 85% to 100%; no regrafting was required. Ambulation was begun 24 hours postoperatively. The technique described is a safe, effective, and inexpensive alternative to prolonged immobilization and hospitalization in patients with lower-extremity skin grafts.

  6. Occupational risk towards blood-borne infections among ambulance personnel in a provincial hospital network in Thailand.

    PubMed

    Luksamijarulkul, Pipat; Pipitsangjan, Sirikun; Vatanasomboon, Pisit

    2014-07-01

    Health-care personnel working in an ambulance may be at risk for work-related infections, especially blood-borne infections. This cross-sectional study was conducted to assess occupational risks and their preventive practices for blood-borne infections among ambulance personnel working in a provincial hospital network. One hundred sixty-one personnel who voluntarily participated were interviewed using a structured questionnaire. The one-month history of risk exposures to blood-borne infections was collected. In order to cover the real situation of patient care practices among ambulance personnel during working, 30 ambulance runs were observed. Data from the questionnaire and field observation were analyzed and presented by descriptive statistics. The results indicated that 82% had a history of contact with jaundiced patients, and 95% had a history of contact with AIDS patients. Approximately, 63.4% had a history of contact with patients' blood through injuries; of these, 64.7% had needle stick injuries, and 24.5% had sharp injuries. Data for blood-borne preventive practices from interviews reported 82.6% wore disposaiole gloves when doing a blood puncture or giving intravenous fluid/blood. Only 54% broke off drug vials with a clean cloth or cotton wool to protect from an injury, in contradiction to recommended procedure. The mean score of preventive practices was 7.6±2.2; a score classified at a moderate level. However, data from field observations demonstrated only 30.3% of observed personnel (3/9) used aprons and goggles when contacting a large amount of blood, and only 11.1% (1/9) broke off drug vials with a clean cloths to protect from an injury. Continuous education and training, as well as the improvement of safety equipment are needed to better protect ambulance personnel from occupational risks. PMID:25427363

  7. Can bedside patient-reported numbness predict postoperative ambulation ability for total knee arthroplasty patients with nerve block catheters?

    PubMed Central

    Mudumbai, Seshadri C.; Ganaway, Toni; Kim, T. Edward; Howard, Steven K.; Giori, Nicholas J.; Shum, Cynthia

    2016-01-01

    Background Adductor canal catheters offer advantages over femoral nerve catheters for knee replacement patients because they produce less quadriceps muscle weakness; however, applying adductor canal catheters in bedside clinical practice remains challenging. There is currently no patient-reported outcome that accurately predicts patients' physical function after knee replacement. The present study evaluates the validity of a relatively new patient-reported outcome, i.e., a numbness score obtained using a numeric rating scale, and assesses its predictive value on postoperative ambulation. Methods We conducted a retrospective cohort study pooling data from two previously-published clinical trials using identical research methodologies. Both studies recruited patients undergoing knee replacement; one studied adductor canal catheters while the other studied femoral nerve catheters. Our primary outcome was patient-reported numbness scores on postoperative day 1. We also examined postoperative day 1 ambulation distance and its association with postoperative numbness using linear regression, adjusting for age, body mass index, and physical status. Results Data from 94 subjects were included (femoral subjects, n = 46; adductor canal subjects, n = 48). Adductor canal patients reported decreased numbness (median [10th–90th percentiles]) compared to femoral patients (0 [0–5] vs. 4 [0–10], P = 0.001). Adductor canal patients also ambulated seven times further on postoperative day 1 relative to femoral patients. There was a significant association between postoperative day 1 total ambulation distance and numbness (Beta = –2.6; 95% CI: –4.5, –0.8, P = 0.01) with R2 = 0.1. Conclusions Adductor canal catheters facilitate improved early ambulation and produce less patient-reported numbness after knee replacement, but the correlation between these two variables is weak. PMID:26885299

  8. 32 CFR 1615.3 - Registration procedures.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... National Defense Other Regulations Relating to National Defense SELECTIVE SERVICE SYSTEM ADMINISTRATION OF REGISTRATION § 1615.3 Registration procedures. Persons required by selective service law and the Proclamation... of Selective Service....

  9. 32 CFR 1615.3 - Registration procedures.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... National Defense Other Regulations Relating to National Defense SELECTIVE SERVICE SYSTEM ADMINISTRATION OF REGISTRATION § 1615.3 Registration procedures. Persons required by selective service law and the Proclamation... of Selective Service....

  10. 32 CFR 1615.3 - Registration procedures.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... National Defense Other Regulations Relating to National Defense SELECTIVE SERVICE SYSTEM ADMINISTRATION OF REGISTRATION § 1615.3 Registration procedures. Persons required by selective service law and the Proclamation... of Selective Service....

  11. 32 CFR 1615.3 - Registration procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... National Defense Other Regulations Relating to National Defense SELECTIVE SERVICE SYSTEM ADMINISTRATION OF REGISTRATION § 1615.3 Registration procedures. Persons required by selective service law and the Proclamation... of Selective Service....

  12. 32 CFR 1615.3 - Registration procedures.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... National Defense Other Regulations Relating to National Defense SELECTIVE SERVICE SYSTEM ADMINISTRATION OF REGISTRATION § 1615.3 Registration procedures. Persons required by selective service law and the Proclamation... of Selective Service....

  13. Spinal Cord Injury Functional Ambulation Profile: A Preliminary Look at Responsiveness

    PubMed Central

    Musselman, Kristin E.

    2014-01-01

    Background The Spinal Cord Injury Functional Ambulation Profile (SCI-FAP) is a valid, reliable measure of walking skill (eg, walking while negotiating obstacles, doors, and stairs). Objective The responsiveness of the SCI-FAP was assessed at least 7 months after spinal cord injury (SCI) and compared with that of the 10-Meter Walk Test (10MWT) and the Six-Minute Walk Test (6MWT). Design A secondary analysis of data collected during a randomized, single-blind, crossover trial was performed. Methods Participants had incomplete SCI and could walk at least 5 m without manual assistance. After 3 or 4 baseline assessments, participants completed 2 months of precision training (stepping over obstacles and onto targets on the ground) and 2 months of endurance training (treadmill training with body weight support, if needed). Walking function was assessed with the SCI-FAP, 10MWT, and 6MWT. Internal responsiveness was evaluated through change scores and standardized response means (SRMs). External responsiveness was gauged by correlating change scores on the SCI-FAP, 10MWT, and 6MWT. The minimal detectable change was calculated from the standard error of measurement from the baseline assessments. Results The SCI-FAP scores improved with both interventions. The magnitude of change was greater for participants whose pretraining self-selected speed was less than 0.5 m/s. The SCI-FAP had moderate SRMs. The 10MWT (fastest speed) and 6MWT had the largest SRMs after precision training and endurance training, respectively. The minimal detectable change in the SCI-FAP was 96 points. Limitations The convenience sample was small and all participants could ambulate independently (with devices); therefore, the generalizability of the findings is limited. Conclusions The SCI-FAP was responsive to changes in walking ability in participants who had incomplete SCI and walked at slow speeds, but overall the 10MWT and 6MWT were more responsive. PMID:24114437

  14. Effects of weather and heliophysical conditions on emergency ambulance calls for elevated arterial blood pressure.

    PubMed

    Vencloviene, Jone; Babarskiene, Ruta M; Dobozinskas, Paulius; Sakalyte, Gintare; Lopatiene, Kristina; Mikelionis, Nerijus

    2015-03-01

    We hypothesized that weather and space weather conditions were associated with the exacerbation of essential hypertension. The study was conducted during 2009-2010 in the city of Kaunas, Lithuania. We analyzed 13,475 cards from emergency ambulance calls (EACs), in which the conditions for the emergency calls were made coded I.10-I.15. The Kaunas Weather Station provided daily records of air temperature (T), wind speed (WS), relative humidity, and barometric pressure (BP). We evaluated the associations between daily weather variables and daily number of EACs by applying a multivariate Poisson regression. Unfavorable heliophysical conditions (two days after the active-stormy geomagnetic field or the days with solar WS>600 km/s) increased the daily number of elevated arterial blood pressure (EABP) by 12% (RR=1.12; 95% confidence interval (CI) 1.04-1.21); and WS≥3.5 knots during days of T<1.5 °C and T≥12.5 °C by 8% (RR=1.08; CI 1.04-1.12). An increase of T by 10 °C and an elevation of BP two days after by 10 hPa were associated with a decrease in RR by 3%. An additional effect of T was detected during days of T≥17.5 °C only in females. Women and patients with grade III arterial hypertension at the time of the ambulance call were more sensitive to weather conditions. These results may help in the understanding of the population's sensitivity to different weather conditions. PMID:25734792

  15. On-Premise Alcohol Establishments and Ambulance Calls for Trauma, Assault, and Intoxication.

    PubMed

    Ray, Joel G; Turner, Linda; Gozdyra, Piotr; Matheson, Flora I; Robert, Burgess; Bartsch, Emily; Park, Alison L

    2016-05-01

    Alcohol contributes to intentional and unintentional injury. We explored on-premise licensed alcohol establishments (LAEs) and emergency medical service (EMS) ambulance calls.We completed a retrospective population-based study in the Region of Peel, Ontario, 2005 to 2014, where alcohol sales are tightly regulated and healthcare is universally available. We included participants age ≥ 19 years. Longitude-latitude coordinates of all 696 LAEs and all 267,477 EMS ambulance calls were ascertained, and then assigned to 1 of 1568 dissemination areas (DA) in Peel. Relative risks (RRs) described the association between density of on-premise LAEs (by DA deciles) and the rate of EMS calls, adjusted for material deprivation, and density of beer/liquor stores in each DA.There was a curvilinear relation between LAE density and EMS calls for trauma, rising from 45.3 per 1000 in DAs with no LAEs to 381.0 per 1000 in decile-10 (adjusted RR 7.83, 95% confidence interval [CI] 6.15-9.97). This relation was more pronounced for alcohol-focused LAEs, and highest among younger males. Calls for assault (RR 2.67, 95% CI 1.26-5.65) and intoxication (RR 4.00, 95% CI 1.41-11.38) were more likely on the last day of the month and the day thereafter, compared to 1 week prior. At 02:00 hours, when LAEs must stop selling alcohol, there was a considerable rise in assault-related calls in DAs with LAE but not in DAs without LAEs.On-premise LAEs contribute to EMS calls for trauma and assault, especially among young males, around last call, and when monthly pay cheques are cashed. PMID:27175699

  16. On-Premise Alcohol Establishments and Ambulance Calls for Trauma, Assault, and Intoxication

    PubMed Central

    Ray, Joel G.; Turner, Linda; Gozdyra, Piotr; Matheson, Flora I.; Robert, Burgess; Bartsch, Emily; Park, Alison L.

    2016-01-01

    Abstract Alcohol contributes to intentional and unintentional injury. We explored on-premise licensed alcohol establishments (LAEs) and emergency medical service (EMS) ambulance calls. We completed a retrospective population-based study in the Region of Peel, Ontario, 2005 to 2014, where alcohol sales are tightly regulated and healthcare is universally available. We included participants age ≥ 19 years. Longitude–latitude coordinates of all 696 LAEs and all 267,477 EMS ambulance calls were ascertained, and then assigned to 1 of 1568 dissemination areas (DA) in Peel. Relative risks (RRs) described the association between density of on-premise LAEs (by DA deciles) and the rate of EMS calls, adjusted for material deprivation, and density of beer/liquor stores in each DA. There was a curvilinear relation between LAE density and EMS calls for trauma, rising from 45.3 per 1000 in DAs with no LAEs to 381.0 per 1000 in decile-10 (adjusted RR 7.83, 95% confidence interval [CI] 6.15–9.97). This relation was more pronounced for alcohol-focused LAEs, and highest among younger males. Calls for assault (RR 2.67, 95% CI 1.26–5.65) and intoxication (RR 4.00, 95% CI 1.41–11.38) were more likely on the last day of the month and the day thereafter, compared to 1 week prior. At 02:00 hours, when LAEs must stop selling alcohol, there was a considerable rise in assault-related calls in DAs with LAE but not in DAs without LAEs. On-premise LAEs contribute to EMS calls for trauma and assault, especially among young males, around last call, and when monthly pay cheques are cashed. PMID:27175699

  17. Longitudinal effect of eteplirsen versus historical control on ambulation in Duchenne muscular dystrophy

    PubMed Central

    Goemans, Nathalie; Lowes, Linda P.; Alfano, Lindsay N.; Berry, Katherine; Shao, James; Kaye, Edward M.; Mercuri, Eugenio; Hamid, Hoda Abdel; Byrne, Barry J.; Connolly, Anne M.; Dracker, Robert A.; Matthew Frank, L.; Heydemann, Peter T.; O'Brien, Kevin C.; Sparks, Susan E.; Specht, Linda A.; Rodino‐Klapac, Louise; Sahenk, Zarife; Al‐Zaidy, Samiah; Cripe, Linda H.; Lewis, Sarah; M, Pane; E, Mazzone; S, Messina; GL, Vita; Bertini, D Amico A; Casimiro, Berardinelli A; Y, Torrente; F, Magri; GP, Comi; G, Baranello; T, Mongini; A, Pini; R, Battini; E, Pegoraro; C, Bruno; L, Politano; S, Previtali

    2016-01-01

    Objective To continue evaluation of the long‐term efficacy and safety of eteplirsen, a phosphorodiamidate morpholino oligomer designed to skip DMD exon 51 in patients with Duchenne muscular dystrophy (DMD). Three‐year progression of eteplirsen‐treated patients was compared to matched historical controls (HC). Methods Ambulatory DMD patients who were ≥7 years old and amenable to exon 51 skipping were randomized to eteplirsen (30/50mg/kg) or placebo for 24 weeks. Thereafter, all received eteplirsen on an open‐label basis. The primary functional assessment in this study was the 6‐Minute Walk Test (6MWT). Respiratory muscle function was assessed by pulmonary function testing (PFT). Longitudinal natural history data were used for comparative analysis of 6MWT performance at baseline and months 12, 24, and 36. Patients were matched to the eteplirsen group based on age, corticosteroid use, and genotype. Results At 36 months, eteplirsen‐treated patients (n = 12) demonstrated a statistically significant advantage of 151m (p < 0.01) on 6MWT and experienced a lower incidence of loss of ambulation in comparison to matched HC (n = 13) amenable to exon 51 skipping. PFT results remained relatively stable in eteplirsen‐treated patients. Eteplirsen was well tolerated. Analysis of HC confirmed the previously observed change in disease trajectory at age 7 years, and more severe progression was observed in patients with mutations amenable to exon skipping than in those not amenable. The subset of patients amenable to exon 51 skipping showed a more severe disease course than those amenable to any exon skipping. Interpretation Over 3 years of follow‐up, eteplirsen‐treated patients showed a slower rate of decline in ambulation assessed by 6MWT compared to untreated matched HC. Ann Neurol 2016;79:257–271 PMID:26573217

  18. Effects of weather and heliophysical conditions on emergency ambulance calls for elevated arterial blood pressure.

    PubMed

    Vencloviene, Jone; Babarskiene, Ruta M; Dobozinskas, Paulius; Sakalyte, Gintare; Lopatiene, Kristina; Mikelionis, Nerijus

    2015-02-27

    We hypothesized that weather and space weather conditions were associated with the exacerbation of essential hypertension. The study was conducted during 2009-2010 in the city of Kaunas, Lithuania. We analyzed 13,475 cards from emergency ambulance calls (EACs), in which the conditions for the emergency calls were made coded I.10-I.15. The Kaunas Weather Station provided daily records of air temperature (T), wind speed (WS), relative humidity, and barometric pressure (BP). We evaluated the associations between daily weather variables and daily number of EACs by applying a multivariate Poisson regression. Unfavorable heliophysical conditions (two days after the active-stormy geomagnetic field or the days with solar WS>600 km/s) increased the daily number of elevated arterial blood pressure (EABP) by 12% (RR=1.12; 95% confidence interval (CI) 1.04-1.21); and WS≥3.5 knots during days of T<1.5 °C and T≥12.5 °C by 8% (RR=1.08; CI 1.04-1.12). An increase of T by 10 °C and an elevation of BP two days after by 10 hPa were associated with a decrease in RR by 3%. An additional effect of T was detected during days of T≥17.5 °C only in females. Women and patients with grade III arterial hypertension at the time of the ambulance call were more sensitive to weather conditions. These results may help in the understanding of the population's sensitivity to different weather conditions.

  19. On-Premise Alcohol Establishments and Ambulance Calls for Trauma, Assault, and Intoxication.

    PubMed

    Ray, Joel G; Turner, Linda; Gozdyra, Piotr; Matheson, Flora I; Robert, Burgess; Bartsch, Emily; Park, Alison L

    2016-05-01

    Alcohol contributes to intentional and unintentional injury. We explored on-premise licensed alcohol establishments (LAEs) and emergency medical service (EMS) ambulance calls.We completed a retrospective population-based study in the Region of Peel, Ontario, 2005 to 2014, where alcohol sales are tightly regulated and healthcare is universally available. We included participants age ≥ 19 years. Longitude-latitude coordinates of all 696 LAEs and all 267,477 EMS ambulance calls were ascertained, and then assigned to 1 of 1568 dissemination areas (DA) in Peel. Relative risks (RRs) described the association between density of on-premise LAEs (by DA deciles) and the rate of EMS calls, adjusted for material deprivation, and density of beer/liquor stores in each DA.There was a curvilinear relation between LAE density and EMS calls for trauma, rising from 45.3 per 1000 in DAs with no LAEs to 381.0 per 1000 in decile-10 (adjusted RR 7.83, 95% confidence interval [CI] 6.15-9.97). This relation was more pronounced for alcohol-focused LAEs, and highest among younger males. Calls for assault (RR 2.67, 95% CI 1.26-5.65) and intoxication (RR 4.00, 95% CI 1.41-11.38) were more likely on the last day of the month and the day thereafter, compared to 1 week prior. At 02:00 hours, when LAEs must stop selling alcohol, there was a considerable rise in assault-related calls in DAs with LAE but not in DAs without LAEs.On-premise LAEs contribute to EMS calls for trauma and assault, especially among young males, around last call, and when monthly pay cheques are cashed.

  20. USDA registration and rectification requirements

    NASA Technical Reports Server (NTRS)

    Allen, R.

    1982-01-01

    Some of the requirements of the United States Department of Agriculture for accuracy of aerospace acquired data, and specifically, requirements for registration and rectification of remotely sensed data are discussed. Particular attention is given to foreign and domestic crop estimation and forecasting, forestry information applications, and rangeland condition evaluations.

  1. Benefits of glucocorticoids in non-ambulant boys/men with Duchenne muscular dystrophy: A multicentric longitudinal study using the Performance of Upper Limb test.

    PubMed

    Pane, Marika; Fanelli, Lavinia; Mazzone, Elena Stacy; Olivieri, Giorgia; D'Amico, Adele; Messina, Sonia; Scutifero, Marianna; Battini, Roberta; Petillo, Roberta; Frosini, Silvia; Sivo, Serena; Vita, Gian Luca; Bruno, Claudio; Mongini, Tiziana; Pegoraro, Elena; De Sanctis, Roberto; Gardani, Alice; Berardinelli, Angela; Lanzillotta, Valentina; Carlesi, Adelina; Viggiano, Emanuela; Cavallaro, Filippo; Sframeli, Maria; Bello, Luca; Barp, Andrea; Bianco, Flaviana; Bonfiglio, Serena; Rolle, Enrica; Palermo, Concetta; D'Angelo, Grazia; Pini, Antonella; Iotti, Elena; Gorni, Ksenija; Baranello, Giovanni; Bertini, Enrico; Politano, Luisa; Sormani, Maria Pia; Mercuri, Eugenio

    2015-10-01

    The aim of this study was to establish the possible effect of glucocorticoid treatment on upper limb function in a cohort of 91 non-ambulant DMD boys and adults of age between 11 and 26 years. All 91 were assessed using the Performance of Upper Limb test. Forty-eight were still on glucocorticoid after loss of ambulation, 25 stopped steroids at the time they lost ambulation and 18 were GC naïve or had steroids while ambulant for less than a year. At baseline the total scores ranged between 0 and 74 (mean 41.20). The mean total scores were 47.92 in the glucocorticoid group, 36 in those who stopped at loss of ambulation and 30.5 in the naïve group (p < 0.001). The 12-month changes ranged between -20 and 4 (mean -4.4). The mean changes were -3.79 in the glucocorticoid group, -5.52 in those who stopped at loss of ambulation and -4.44 in the naïve group. This was more obvious in the patients between 12 and 18 years and at shoulder and elbow levels. Our findings suggest that continuing glucocorticoids throughout teenage years and adulthood after loss of ambulation appears to have a beneficial effect on upper limb function. PMID:26248957

  2. Benefits of glucocorticoids in non-ambulant boys/men with Duchenne muscular dystrophy: A multicentric longitudinal study using the Performance of Upper Limb test

    PubMed Central

    Pane, Marika; Fanelli, Lavinia; Mazzone, Elena Stacy; Olivieri, Giorgia; D'Amico, Adele; Messina, Sonia; Scutifero, Marianna; Battini, Roberta; Petillo, Roberta; Frosini, Silvia; Sivo, Serena; Vita, Gian Luca; Bruno, Claudio; Mongini, Tiziana; Pegoraro, Elena; De Sanctis, Roberto; Gardani, Alice; Berardinelli, Angela; Lanzillotta, Valentina; Carlesi, Adelina; Viggiano, Emanuela; Cavallaro, Filippo; Sframeli, Maria; Bello, Luca; Barp, Andrea; Bianco, Flaviana; Bonfiglio, Serena; Rolle, Enrica; Palermo, Concetta; D'Angelo, Grazia; Pini, Antonella; Iotti, Elena; Gorni, Ksenija; Baranello, Giovanni; Bertini, Enrico; Politano, Luisa; Sormani, Maria Pia; Mercuri, Eugenio

    2015-01-01

    The aim of this study was to establish the possible effect of glucocorticoid treatment on upper limb function in a cohort of 91 non-ambulant DMD boys and adults of age between 11 and 26 years. All 91 were assessed using the Performance of Upper Limb test. Forty-eight were still on glucocorticoid after loss of ambulation, 25 stopped steroids at the time they lost ambulation and 18 were GC naïve or had steroids while ambulant for less than a year. At baseline the total scores ranged between 0 and 74 (mean 41.20). The mean total scores were 47.92 in the glucocorticoid group, 36 in those who stopped at loss of ambulation and 30.5 in the naïve group (p < 0.001). The 12-month changes ranged between −20 and 4 (mean −4.4). The mean changes were −3.79 in the glucocorticoid group, −5.52 in those who stopped at loss of ambulation and −4.44 in the naïve group. This was more obvious in the patients between 12 and 18 years and at shoulder and elbow levels. Our findings suggest that continuing glucocorticoids throughout teenage years and adulthood after loss of ambulation appears to have a beneficial effect on upper limb function. PMID:26248957

  3. 21 CFR 710.6 - Notification of registrant; cosmetic product establishment registration number.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 7 2010-04-01 2010-04-01 false Notification of registrant; cosmetic product... OF HEALTH AND HUMAN SERVICES (CONTINUED) COSMETICS VOLUNTARY REGISTRATION OF COSMETIC PRODUCT ESTABLISHMENTS § 710.6 Notification of registrant; cosmetic product establishment registration number....

  4. 21 CFR 710.6 - Notification of registrant; cosmetic product establishment registration number.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 7 2013-04-01 2013-04-01 false Notification of registrant; cosmetic product... OF HEALTH AND HUMAN SERVICES (CONTINUED) COSMETICS VOLUNTARY REGISTRATION OF COSMETIC PRODUCT ESTABLISHMENTS § 710.6 Notification of registrant; cosmetic product establishment registration number....

  5. 21 CFR 710.6 - Notification of registrant; cosmetic product establishment registration number.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 7 2014-04-01 2014-04-01 false Notification of registrant; cosmetic product... OF HEALTH AND HUMAN SERVICES (CONTINUED) COSMETICS VOLUNTARY REGISTRATION OF COSMETIC PRODUCT ESTABLISHMENTS § 710.6 Notification of registrant; cosmetic product establishment registration number....

  6. 21 CFR 710.6 - Notification of registrant; cosmetic product establishment registration number.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 7 2011-04-01 2010-04-01 true Notification of registrant; cosmetic product... OF HEALTH AND HUMAN SERVICES (CONTINUED) COSMETICS VOLUNTARY REGISTRATION OF COSMETIC PRODUCT ESTABLISHMENTS § 710.6 Notification of registrant; cosmetic product establishment registration number....

  7. 21 CFR 710.6 - Notification of registrant; cosmetic product establishment registration number.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 7 2012-04-01 2012-04-01 false Notification of registrant; cosmetic product... OF HEALTH AND HUMAN SERVICES (CONTINUED) COSMETICS VOLUNTARY REGISTRATION OF COSMETIC PRODUCT ESTABLISHMENTS § 710.6 Notification of registrant; cosmetic product establishment registration number....

  8. 16 CFR 1130.8 - Requirements for Web site registration or alternative e-mail registration.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... alternative e-mail registration. 1130.8 Section 1130.8 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION... PRODUCTS § 1130.8 Requirements for Web site registration or alternative e-mail registration. (a) Link to... site registration page shall request only the consumer's name, address, telephone number,...

  9. 21 CFR 1301.13 - Application for registration; time for application; expiration date; registration for independent...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...; expiration date; registration for independent activities; application forms, fees, contents and signature... § 1301.13 Application for registration; time for application; expiration date; registration for... days before the expiration date of his/her registration, except that a bulk manufacturer of Schedule...

  10. 12 CFR 583.18 - Registrant.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE TREASURY DEFINITIONS FOR REGULATIONS AFFECTING SAVINGS AND LOAN HOLDING COMPANIES § 583.18 Registrant. The term registrant means a savings and loan holding company filing a registration statement with the Office pursuant to § 584.1 of this chapter....

  11. 14 CFR 47.15 - Registration number.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false Registration number. 47.15 Section 47.15 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRCRAFT REGISTRATION General § 47.15 Registration number. (a) Number required. An applicant for aircraft...

  12. 14 CFR 47.3 - Registration required.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false Registration required. 47.3 Section 47.3 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRCRAFT REGISTRATION General § 47.3 Registration required. (a) An aircraft may be registered under 49 U.S.C. 44103...

  13. 75 FR 47729 - National Voter Registration Act

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-09

    ... COMMISSION 11 CFR Part 9428 National Voter Registration Act AGENCY: Election Assistance Commission. ACTION... proposed changes to its regulations pertaining to the National Voter Registration Act of 1993 (NVRA... mail voter registration form and for submitting a biennial report to Congress on the impact of the...

  14. 32 CFR 1602.20 - Registrant.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 6 2010-07-01 2010-07-01 false Registrant. 1602.20 Section 1602.20 National Defense Other Regulations Relating to National Defense SELECTIVE SERVICE SYSTEM DEFINITIONS § 1602.20 Registrant. A registrant is a person registered under the Selective Service Law....

  15. 32 CFR 1602.20 - Registrant.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 6 2011-07-01 2011-07-01 false Registrant. 1602.20 Section 1602.20 National Defense Other Regulations Relating to National Defense SELECTIVE SERVICE SYSTEM DEFINITIONS § 1602.20 Registrant. A registrant is a person registered under the Selective Service Law....

  16. 32 CFR 1602.20 - Registrant.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 6 2014-07-01 2014-07-01 false Registrant. 1602.20 Section 1602.20 National Defense Other Regulations Relating to National Defense SELECTIVE SERVICE SYSTEM DEFINITIONS § 1602.20 Registrant. A registrant is a person registered under the Selective Service Law....

  17. 32 CFR 1602.20 - Registrant.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 6 2012-07-01 2012-07-01 false Registrant. 1602.20 Section 1602.20 National Defense Other Regulations Relating to National Defense SELECTIVE SERVICE SYSTEM DEFINITIONS § 1602.20 Registrant. A registrant is a person registered under the Selective Service Law....

  18. 32 CFR 1602.20 - Registrant.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 6 2013-07-01 2013-07-01 false Registrant. 1602.20 Section 1602.20 National Defense Other Regulations Relating to National Defense SELECTIVE SERVICE SYSTEM DEFINITIONS § 1602.20 Registrant. A registrant is a person registered under the Selective Service Law....

  19. Clinical trial registration in oral health journals.

    PubMed

    Smaïl-Faugeron, V; Fron-Chabouis, H; Durieux, P

    2015-03-01

    Prospective registration of randomized controlled trials (RCTs) represents the best solution to reporting bias. The extent to which oral health journals have endorsed and complied with RCT registration is unknown. We identified journals publishing RCTs in dentistry, oral surgery, and medicine in the Journal Citation Reports. We classified journals into 3 groups: journals requiring or recommending trial registration, journals referring indirectly to registration, and journals providing no reference to registration. For the 5 journals with the highest 2012 impact factors in each group, we assessed whether RCTs with results published in 2013 had been registered. Of 78 journals examined, 32 (41%) required or recommended trial registration, 19 (24%) referred indirectly to registration, and 27 (35%) provided no reference to registration. We identified 317 RCTs with results published in the 15 selected journals in 2013. Overall, 73 (23%) were registered in a trial registry. Among those, 91% were registered retrospectively and 32% did not report trial registration in the published article. The proportion of trials registered was not significantly associated with editorial policies: 29% with results in journals that required or recommended registration, 15% in those that referred indirectly to registration, and 21% in those providing no reference to registration (P = 0.05). Less than one-quarter of RCTs with results published in a sample of oral health journals were registered with a public registry. Improvements are needed with respect to how journals inform and require their authors to register their trials.

  20. 21 CFR 1301.51 - Modification in registration.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 9 2012-04-01 2012-04-01 false Modification in registration. 1301.51 Section 1301.51 Food and Drugs DRUG ENFORCEMENT ADMINISTRATION, DEPARTMENT OF JUSTICE REGISTRATION OF... Registration § 1301.51 Modification in registration. Any registrant may apply to modify his/her registration...

  1. 40 CFR 155.50 - Initiate a pesticide's registration review.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 23 2010-07-01 2010-07-01 false Initiate a pesticide's registration...) PESTICIDE PROGRAMS REGISTRATION STANDARDS AND REGISTRATION REVIEW Registration Review Procedures § 155.50 Initiate a pesticide's registration review. The Agency will initiate a pesticide's registration review...

  2. 40 CFR 155.50 - Initiate a pesticide's registration review.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 24 2011-07-01 2011-07-01 false Initiate a pesticide's registration...) PESTICIDE PROGRAMS REGISTRATION STANDARDS AND REGISTRATION REVIEW Registration Review Procedures § 155.50 Initiate a pesticide's registration review. The Agency will initiate a pesticide's registration review...

  3. 40 CFR 155.50 - Initiate a pesticide's registration review.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 25 2013-07-01 2013-07-01 false Initiate a pesticide's registration...) PESTICIDE PROGRAMS REGISTRATION STANDARDS AND REGISTRATION REVIEW Registration Review Procedures § 155.50 Initiate a pesticide's registration review. The Agency will initiate a pesticide's registration review...

  4. 40 CFR 155.50 - Initiate a pesticide's registration review.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 24 2014-07-01 2014-07-01 false Initiate a pesticide's registration...) PESTICIDE PROGRAMS REGISTRATION STANDARDS AND REGISTRATION REVIEW Registration Review Procedures § 155.50 Initiate a pesticide's registration review. The Agency will initiate a pesticide's registration review...

  5. 40 CFR 155.50 - Initiate a pesticide's registration review.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 25 2012-07-01 2012-07-01 false Initiate a pesticide's registration...) PESTICIDE PROGRAMS REGISTRATION STANDARDS AND REGISTRATION REVIEW Registration Review Procedures § 155.50 Initiate a pesticide's registration review. The Agency will initiate a pesticide's registration review...

  6. Predicting Ambulance Time of Arrival to the Emergency Department Using Global Positioning System and Google Maps

    PubMed Central

    Fleischman, Ross J.; Lundquist, Mark; Jui, Jonathan; Newgard, Craig D.; Warden, Craig

    2014-01-01

    Objective To derive and validate a model that accurately predicts ambulance arrival time that could be implemented as a Google Maps web application. Methods This was a retrospective study of all scene transports in Multnomah County, Oregon, from January 1 through December 31, 2008. Scene and destination hospital addresses were converted to coordinates. ArcGIS Network Analyst was used to estimate transport times based on street network speed limits. We then created a linear regression model to improve the accuracy of these street network estimates using weather, patient characteristics, use of lights and sirens, daylight, and rush-hour intervals. The model was derived from a 50% sample and validated on the remainder. Significance of the covariates was determined by p < 0.05 for a t-test of the model coefficients. Accuracy was quantified by the proportion of estimates that were within 5 minutes of the actual transport times recorded by computer-aided dispatch. We then built a Google Maps-based web application to demonstrate application in real-world EMS operations. Results There were 48,308 included transports. Street network estimates of transport time were accurate within 5 minutes of actual transport time less than 16% of the time. Actual transport times were longer during daylight and rush-hour intervals and shorter with use of lights and sirens. Age under 18 years, gender, wet weather, and trauma system entry were not significant predictors of transport time. Our model predicted arrival time within 5 minutes 73% of the time. For lights and sirens transports, accuracy was within 5 minutes 77% of the time. Accuracy was identical in the validation dataset. Lights and sirens saved an average of 3.1 minutes for transports under 8.8 minutes, and 5.3 minutes for longer transports. Conclusions An estimate of transport time based only on a street network significantly underestimated transport times. A simple model incorporating few variables can predict ambulance time of

  7. Genetic modifiers of ambulation in the cooperative international Neuromuscular research group Duchenne natural history study

    PubMed Central

    Bello, Luca; Kesari, Akanchha; Gordish-Dressman, Heather; Cnaan, Avital; Morgenroth, Lauren P; Punetha, Jaya; Duong, Tina; Henricson, Erik K; Pegoraro, Elena; McDonald, Craig M; Hoffman, Eric P

    2015-01-01

    Objective We studied the effects of LTBP4 and SPP1 polymorphisms on age at loss of ambulation (LoA) in a multiethnic Duchenne muscular dystrophy (DMD) cohort. Methods We genotyped SPP1 rs28357094 and LTBP4 haplotype in 283 of 340 participants in the Cooperative International Neuromuscular Research Group Duchenne Natural History Study (CINRG-DNHS). Median ages at LoA were compared by Kaplan–Meier analysis and log-rank test. We controlled polymorphism analyses for concurrent effects of glucocorticoid corticosteroid (GC) treatment (time-varying Cox regression) and for population stratification (multidimensional scaling of genome-wide markers). Results Hispanic and South Asian participants (n = 18, 41) lost ambulation 2.7 and 2 years earlier than Caucasian subjects (p = 0.003, <0.001). The TG/GG genotype at SPP1 rs28357094 was associated to 1.2-year-earlier median LoA (p = 0.048). This difference was greater (1.9 years, p = 0.038) in GC-treated participants, whereas no difference was observed in untreated subjects. Cox regression confirmed a significant effect of SPP1 genotype in GC-treated participants (hazard ratio = 1.61, p = 0.016). LTBP4 genotype showed a direction of association with age at LoA as previously reported, but it was not statistically significant. After controlling for population stratification, we confirmed a strong effect of LTBP4 genotype in Caucasians (2.4 years, p = 0.024). Median age at LoA with the protective LTBP4 genotype in this cohort was 15.0 years, 16.0 for those who were treated with GC. Interpretation SPP1 rs28357094 acts as a pharmacodynamic biomarker of GC response, and LTBP4 haplotype modifies age at LoA in the CINRG-DNHS cohort. Adjustment for GC treatment and population stratification appears crucial in assessing genetic modifiers in DMD. PMID:25641372

  8. Guilt, shame and need for a container: a study of post-traumatic stress among ambulance personnel.

    PubMed

    Jonsson, Anders; Segesten, Kerstin

    2004-10-01

    Post-traumatic stress symptoms among ambulance personnel are regarded as a natural behaviour and reaction to working with the severely injured, suicides, injured children and dead people. The findings show that post-traumatic stress symptoms, guilt, shame and self-reproach are common after duty-related traumatic events. To handle these overwhelming feelings it is necessary to talk about them with fellow workers, friends or family members. By using another person as a container it is possible to internalise the traumatic experience. Poor and un-emphatic behaviour towards a patient and their relatives can have its origin in untreated traumatic experiences. Personnel in ambulance organisations who perform defusing, debriefing and counselling have to be informed of the importance that the roll of guilt and shame may play in the developing of post-traumatic stress symptoms.

  9. Physical and psychosocial work environment factors and their association with health outcomes in Danish ambulance personnel – a cross-sectional study

    PubMed Central

    2012-01-01

    Background Reviews of the literature on the health and work environment of ambulance personnel have indicated an increased risk of work-related health problems in this occupation. The aim of this study was to compare health status and exposure to different work environmental factors among ambulance personnel and the core work force in Denmark. In addition, to examine the association between physical and psychosocial work environment factors and different measures of health among ambulance personnel. Methods Data were taken from a nationwide sample of ambulance personnel and fire fighters (n = 1,691) and was compared to reference samples of the Danish work force. The questionnaire contained measures of physical and psychosocial work environment as well as measures of musculoskeletal pain, mental health, self-rated health and sleep quality. Results Ambulance personnel have half the prevalence of poor self-rated health compared to the core work force (5% vs. 10%). Levels of mental health were the same across the two samples whereas a substantially higher proportion of the ambulance personnel reported musculoskeletal pain (42% vs. 29%). The ambulance personnel had higher levels of emotional demands and meaningfulness of and commitment to work, and substantially lower levels of quantitative demands and influence at work. Only one out of ten aspects of physical work environment was consistently associated with higher levels of musculoskeletal pain. Emotional demands was the only psychosocial work factor that was associated with both poorer mental health and worse sleep quality. Conclusions Ambulance personnel have similar levels of mental health but substantially higher levels of musculoskeletal pain than the work force in general. They are more exposed to emotional demands and these demands are associated with higher levels of poor mental health and poor sleep quality. To improve work environment, attention should be paid to musculoskeletal problems and the presence

  10. Effect evaluation of a heated ambulance mattress-prototype on thermal comfort and patients’ temperatures in prehospital emergency care – an intervention study

    PubMed Central

    Aléx, Jonas; Karlsson, Stig; Björnstig, Ulf; Saveman, Britt-Inger

    2015-01-01

    Background The ambulance milieu does not offer good thermal comfort to patients during the cold Swedish winters. Patients’ exposure to cold temperatures combined with a cold ambulance mattress seems to be the major factor leading to an overall sensation of discomfort. There is little research on the effect of active heat delivered from underneath in ambulance care. Therefore, the aim of this study was to evaluate the effect of an electrically heated ambulance mattress-prototype on thermal comfort and patients’ temperatures in the prehospital emergency care. Methods A quantitative intervention study on ambulance care was conducted in the north of Sweden. The ambulance used for the intervention group (n=30) was equipped with an electrically heated mattress on the regular ambulance stretcher whereas for the control group (n=30) no active heat was provided on the stretcher. Outcome variables were measured as thermal comfort on the Cold Discomfort Scale (CDS), subjective comments on cold experiences, and finger, ear and air temperatures. Results Thermal comfort, measured by CDS, improved during the ambulance transport to the emergency department in the intervention group (p=0.001) but decreased in the control group (p=0.014). A significant higher proportion (57%) of the control group rated the stretcher as cold to lie down compared to the intervention group (3%, p<0.001). At arrival, finger, ear and compartment air temperature showed no statistical significant difference between groups. Mean transport time was approximately 15 minutes. Conclusions The use of active heat from underneath increases the patients’ thermal comfort and may prevent the negative consequences of cold stress. PMID:26374468

  11. North Star Ambulatory Assessment, 6-minute walk test and timed items in ambulant boys with Duchenne muscular dystrophy.

    PubMed

    Mazzone, Elena; Martinelli, Diego; Berardinelli, Angela; Messina, Sonia; D'Amico, Adele; Vasco, Gessica; Main, Marion; Doglio, Luca; Politano, Luisa; Cavallaro, Filippo; Frosini, Silvia; Bello, Luca; Carlesi, Adelina; Bonetti, Anna Maria; Zucchini, Elisabetta; De Sanctis, Roberto; Scutifero, Marianna; Bianco, Flaviana; Rossi, Francesca; Motta, Maria Chiara; Sacco, Annalisa; Donati, Maria Alice; Mongini, Tiziana; Pini, Antonella; Battini, Roberta; Pegoraro, Elena; Pane, Marika; Pasquini, Elisabetta; Bruno, Claudio; Vita, Giuseppe; de Waure, Chiara; Bertini, Enrico; Mercuri, Eugenio

    2010-11-01

    The North Star Ambulatory Assessment is a functional scale specifically designed for ambulant boys affected by Duchenne muscular dystrophy (DMD). Recently the 6-minute walk test has also been used as an outcome measure in trials in DMD. The aim of our study was to assess a large cohort of ambulant boys affected by DMD using both North Star Assessment and 6-minute walk test. More specifically, we wished to establish the spectrum of findings for each measure and their correlation. This is a prospective multicentric study involving 10 centers. The cohort included 112 ambulant DMD boys of age ranging between 4.10 and 17 years (mean 8.18±2.3 DS). Ninety-one of the 112 were on steroids: 37/91 on intermittent and 54/91 on daily regimen. The scores on the North Star assessment ranged from 6/34 to 34/34. The distance on the 6-minute walk test ranged from 127 to 560.6 m. The time to walk 10 m was between 3 and 15 s. The time to rise from the floor ranged from 1 to 27.5 s. Some patients were unable to rise from the floor. As expected the results changed with age and were overall better in children treated with daily steroids. The North Star assessment had a moderate to good correlation with 6-minute walk test and with timed rising from floor but less with 10 m timed walk/run test. The 6-minute walk test in contrast had better correlation with 10 m timed walk/run test than with timed rising from floor. These findings suggest that a combination of these outcome measures can be effectively used in ambulant DMD boys and will provide information on different aspects of motor function, that may not be captured using a single measure. PMID:20634072

  12. North Star Ambulatory Assessment, 6-minute walk test and timed items in ambulant boys with Duchenne muscular dystrophy.

    PubMed

    Mazzone, Elena; Martinelli, Diego; Berardinelli, Angela; Messina, Sonia; D'Amico, Adele; Vasco, Gessica; Main, Marion; Doglio, Luca; Politano, Luisa; Cavallaro, Filippo; Frosini, Silvia; Bello, Luca; Carlesi, Adelina; Bonetti, Anna Maria; Zucchini, Elisabetta; De Sanctis, Roberto; Scutifero, Marianna; Bianco, Flaviana; Rossi, Francesca; Motta, Maria Chiara; Sacco, Annalisa; Donati, Maria Alice; Mongini, Tiziana; Pini, Antonella; Battini, Roberta; Pegoraro, Elena; Pane, Marika; Pasquini, Elisabetta; Bruno, Claudio; Vita, Giuseppe; de Waure, Chiara; Bertini, Enrico; Mercuri, Eugenio

    2010-11-01

    The North Star Ambulatory Assessment is a functional scale specifically designed for ambulant boys affected by Duchenne muscular dystrophy (DMD). Recently the 6-minute walk test has also been used as an outcome measure in trials in DMD. The aim of our study was to assess a large cohort of ambulant boys affected by DMD using both North Star Assessment and 6-minute walk test. More specifically, we wished to establish the spectrum of findings for each measure and their correlation. This is a prospective multicentric study involving 10 centers. The cohort included 112 ambulant DMD boys of age ranging between 4.10 and 17 years (mean 8.18±2.3 DS). Ninety-one of the 112 were on steroids: 37/91 on intermittent and 54/91 on daily regimen. The scores on the North Star assessment ranged from 6/34 to 34/34. The distance on the 6-minute walk test ranged from 127 to 560.6 m. The time to walk 10 m was between 3 and 15 s. The time to rise from the floor ranged from 1 to 27.5 s. Some patients were unable to rise from the floor. As expected the results changed with age and were overall better in children treated with daily steroids. The North Star assessment had a moderate to good correlation with 6-minute walk test and with timed rising from floor but less with 10 m timed walk/run test. The 6-minute walk test in contrast had better correlation with 10 m timed walk/run test than with timed rising from floor. These findings suggest that a combination of these outcome measures can be effectively used in ambulant DMD boys and will provide information on different aspects of motor function, that may not be captured using a single measure.

  13. Diffusion tensor image registration using polynomial expansion

    NASA Astrophysics Data System (ADS)

    Wang, Yuanjun; Chen, Zengai; Nie, Shengdong; Westin, Carl-Fredrik

    2013-09-01

    In this paper, we present a deformable registration framework for the diffusion tensor image (DTI) using polynomial expansion. The use of polynomial expansion in image registration has previously been shown to be beneficial due to fast convergence and high accuracy. However, earlier work was developed only for 3D scalar medical image registration. In this work, it is shown how polynomial expansion can be applied to DTI registration. A new measurement is proposed for DTI registration evaluation, which seems to be robust and sensitive in evaluating the result of DTI registration. We present the algorithms for DTI registration using polynomial expansion by the fractional anisotropy image, and an explicit tensor reorientation strategy is inherent to the registration process. Analytic transforms with high accuracy are derived from polynomial expansion and used for transforming the tensor's orientation. Three measurements for DTI registration evaluation are presented and compared in experimental results. The experiments for algorithm validation are designed from simple affine deformation to nonlinear deformation cases, and the algorithms using polynomial expansion give a good performance in both cases. Inter-subject DTI registration results are presented showing the utility of the proposed method.

  14. Consistency-based rectification of nonrigid registrations

    PubMed Central

    Gass, Tobias; Székely, Gábor; Goksel, Orcun

    2015-01-01

    Abstract. We present a technique to rectify nonrigid registrations by improving their group-wise consistency, which is a widely used unsupervised measure to assess pair-wise registration quality. While pair-wise registration methods cannot guarantee any group-wise consistency, group-wise approaches typically enforce perfect consistency by registering all images to a common reference. However, errors in individual registrations to the reference then propagate, distorting the mean and accumulating in the pair-wise registrations inferred via the reference. Furthermore, the assumption that perfect correspondences exist is not always true, e.g., for interpatient registration. The proposed consistency-based registration rectification (CBRR) method addresses these issues by minimizing the group-wise inconsistency of all pair-wise registrations using a regularized least-squares algorithm. The regularization controls the adherence to the original registration, which is additionally weighted by the local postregistration similarity. This allows CBRR to adaptively improve consistency while locally preserving accurate pair-wise registrations. We show that the resulting registrations are not only more consistent, but also have lower average transformation error when compared to known transformations in simulated data. On clinical data, we show improvements of up to 50% target registration error in breathing motion estimation from four-dimensional MRI and improvements in atlas-based segmentation quality of up to 65% in terms of mean surface distance in three-dimensional (3-D) CT. Such improvement was observed consistently using different registration algorithms, dimensionality (two-dimensional/3-D), and modalities (MRI/CT). PMID:26158083

  15. Helicopter Emergency Ambulance Service (HEAS) Transfer: An Analysis of Trauma Patient Case-Mix, Injury Severity and Outcome

    PubMed Central

    Melton, JTK; Jain, S; Kendrick, B; Deo, SD

    2007-01-01

    INTRODUCTION A retrospective review of all patients transferred by helicopter ambulance to the Great Western Hospital over a 20-month period between January 2003 and September 2004 was undertaken to establish the case-mix of patients (trauma and non-trauma) transferred and the outcome. PATIENTS AND METHODS Details of all Helicopter Emergency Ambulance Service (HEAS) transfers to this unit in the study time period were obtained from the three HEAS providers in the area and case notes were reviewed. RESULTS There were 156 trauma patients transferred (total 193) in the study period with 111 cases identified for analysis with a mean age of 33 years (range, 1–92 years). Average Injury Severity Score on admission was 12 (range, 1–36). Forty-five patients were discharged home from the emergency department, 24 cases had operation, 10 patients required ICU care and 2 were pronounced dead in the emergency department. Average hospital stay following HEAS transfer was 2.97 days (range, 0–18 days). DISCUSSION Helicopter ambulance transfer in the acute setting is of debated value. Triage criteria are at fault if as many as 41% of patients transferred are being discharged home from casualty having incurred the financial cost of helicopter transfer. We suggest that the triage criteria for helicopter emergency transfer should be reviewed. PMID:17688727

  16. Strategies to reduce the configuration time for a powered knee and ankle prosthesis across multiple ambulation modes.

    PubMed

    Simon, Ann M; Fey, Nicholas P; Finucane, Suzanne B; Lipschutz, Robert D; Hargrove, Levi J

    2013-06-01

    Recently developed powered lower limb prostheses allow users to more closely mimic the kinematics and kinetics of non-amputee gait. However, configuring such a device, in particular a combined powered knee and ankle, for individuals with a transfemoral amputation is challenging. Previous attempts have relied on empirical tuning of all control parameters. This paper describes modified stance phase control strategies - which mimic the behavior of biological joints or depend on the instantaneous loads within the prosthesis - developed to reduce the number of control parameters that require individual tuning. Three individuals with unilateral transfemoral amputations walked with a powered knee and ankle prosthesis across five ambulation modes (level ground walking, ramp ascent/descent, and stair ascent/descent). Starting with a nominal set of impedance parameters, the modified control strategies were applied and the devices were individually tuned such that all subjects achieved comfortable and safe ambulation. The control strategies drastically reduced the number of independent parameters that needed to be tuned for each subject (i.e., to 21 parameters instead of a possible 140 or approximately 4 parameters per mode) while relative amplitudes and timing of kinematic and kinetic data remained similar to those previously reported and to those of non-amputee subjects. Reducing the time necessary to configure a powered device across multiple ambulation modes may allow users to more quickly realize the benefits such powered devices can provide.

  17. Use of 3G mobile phone links for teleconsultation between a moving ambulance and a hospital base station.

    PubMed

    Banitsas, Konstantinos A; Perakis, Konstantinos; Tachakra, Sapal; Koutsouris, Dimitrios

    2006-01-01

    We developed a mobile teleconsultation system based on third-generation mobile phone links. The system comprised a laptop computer and a digital camcorder. It was installed inside an ambulance to allow video-conferencing between the moving vehicle and a doctor at a base station. In addition to video and voice, high-quality still images could also be transmitted. A series of 17 trial runs with real ambulance patients was conducted in the city of Athens. In general, the videoconferencing sessions produced relatively clear video. The bandwidth was high enough for a satisfactory video of 10-15 frames/s. During a total testing period of 23 h and in an area of about 180 km2, there were nine instances of signal loss, amounting to a total of 17 min. The general opinion formed by the doctors was that the system produced good results. All initial diagnoses made using the system agreed with the final diagnoses of the patients. The study showed that the mobile system could reduce the time before an ambulance patient is seen by a doctor. PMID:16438775

  18. Transcranial Motor Evoked Potentials of Lower Limbs Can Prognosticate Ambulation in Hemiplegic Stroke Patients

    PubMed Central

    2016-01-01

    Objective To examine the association between motor evoked potentials (MEPs) in lower limbs and ambulatory outcomes of hemiplegic stroke patients. Methods Medical records of hemiplegic patients with the first ever stroke who received inpatient rehabilitation from January 2013 to May 2014 were reviewed. Patient who had diabetes, quadriplegia, bilateral lesion, brainstem lesion, severe musculoskeletal problem, and old age over 80 years were excluded. MEPs in lower limbs were measured when they were transferred to the Department of Rehabilitation Medicine. Subjects were categorized into three groups (normal, abnormal, and absent response) according to MEPs findings. Berg Balance Scale (BBS) and Functional Ambulation Category (FAC) at initial and discharge were compared among the three groups by one-way analysis of variance (ANOVA). Correlation was determined using a linear regression model. Results Fifty-eight hemiplegic patients were included. BBS and FAC at discharge were significantly (ANOVA, p<0.001) different according to MEPs findings. In linear regression model of BBS and FAC using stepwise selection, patients' age (p<0.01), BBS at admission (p<0.01), and MEPs (p<0.01) remained significant covariates. In regression assumption model of BBS and FAC at admission, MEPs and gender were significant covariates. Conclusion Initial MEPs of lower limbs can prognosticate the ambulatory outcomes of hemiplegic patients. PMID:27446774

  19. Reliability and validity of the modified functional ambulation category scale in patients with hemiparalysis.

    PubMed

    Park, Chang Sik; An, Seung Heon

    2016-08-01

    [Purpose] This study aimed to examine the inter- and intra-rater reliability and validity of the modified functional ambulation category (mFAC) scale. [Subjects and Methods] The participants were 66 stroke patients with hemiparalysis. The inter- and intra-rater validity of the mFAC was calculated using the Spearman correlation coefficient. A score comparison of the stable or maximum gait speed with regard to mFAC and modified Rivermead Mobility Index (mRMI) performances was performed as a univariate linear regression analysis to determine how the Kruskal-Wallis test affects the mRMI and stable/maximum gait speed with regard to mFAC. [Results] The inter-rater reliability of the mFAC (intraclass coefficient [ICC]) was 0.982 (0.971-0.989), with a kappa coefficient of 0.923 and a consistency ratio of 94%. In contrast, the intra-rater reliability of the mFAC (ICC) was 0.991 (0.986-0.995), with a kappa coefficient of 0.961 and a consistency ratio of 96%, showing higher reliability. Moreover, there was a significant difference in stable/maximum gait speed between the mFAC and the mRMI. [Conclusion] Since the mFAC has sufficient inter- and intra-reliability and high validity, it can be used as an assessment tool that reflects the gait performance and mobility of stroke patients. PMID:27630410

  20. Leg Lengthening as a Means of Improving Ambulation Following an Internal Hemipelvectomy

    PubMed Central

    Okazaki, Hiroshi; Goto, Takahiro

    2016-01-01

    Reconstructive surgery following an internal hemipelvectomy for a malignant pelvic tumor is difficult due to the structural complexity of the pelvis and the massive extension of the tumor. While high complication rates have been encountered in various types of reconstructive surgery, resection without reconstruction reportedly involved fewer complications. However, this method often results in limb shortening with resultant instability during walking. We reported herein leg lengthening performed to correct lower limb shortening after an internal hemipelvectomy, which improved ambulatory stability and overall QOL. An 18-year-old male patient came to our hospital to correct a lower limb discrepancy resulting from a left internal hemipelvectomy. His left pelvis and proximal femur had been resected, and the femur remained without an acetabular roof. His left lower limb was about 8 centimeters shorter. The left tibia was lengthened 8 centimeters with an external fixator. After the lengthening, the patient was able to walk without support and his gait remarkably improved. Additionally he no longer required placing a wallet in his back pocket as a pad as a means of raising the left side of his torso while sitting. Leg lengthening was a useful method of improving ambulation after an internal hemipelvectomy. PMID:27800202

  1. Reliability and validity of the modified functional ambulation category scale in patients with hemiparalysis

    PubMed Central

    Park, Chang Sik; An, Seung Heon

    2016-01-01

    [Purpose] This study aimed to examine the inter- and intra-rater reliability and validity of the modified functional ambulation category (mFAC) scale. [Subjects and Methods] The participants were 66 stroke patients with hemiparalysis. The inter- and intra-rater validity of the mFAC was calculated using the Spearman correlation coefficient. A score comparison of the stable or maximum gait speed with regard to mFAC and modified Rivermead Mobility Index (mRMI) performances was performed as a univariate linear regression analysis to determine how the Kruskal-Wallis test affects the mRMI and stable/maximum gait speed with regard to mFAC. [Results] The inter-rater reliability of the mFAC (intraclass coefficient [ICC]) was 0.982 (0.971–0.989), with a kappa coefficient of 0.923 and a consistency ratio of 94%. In contrast, the intra-rater reliability of the mFAC (ICC) was 0.991 (0.986–0.995), with a kappa coefficient of 0.961 and a consistency ratio of 96%, showing higher reliability. Moreover, there was a significant difference in stable/maximum gait speed between the mFAC and the mRMI. [Conclusion] Since the mFAC has sufficient inter- and intra-reliability and high validity, it can be used as an assessment tool that reflects the gait performance and mobility of stroke patients. PMID:27630410

  2. Ambulation During Periods of Supersaturation Increase Decompression Stress in Spacewalk Simulations

    NASA Technical Reports Server (NTRS)

    Pollock, N. W.; Natoli, M. J.; Martina, S. D.; Conkin, J.; Wessel, J. H., III; Gernhardt, M. L.

    2016-01-01

    Musculoskeletal activity accelerates inert gas elimination during oxygen breathing prior to decompression (prebreathe), but may also promote bubble formation (nucleation) and increase the risk of decompression sickness (DCS). The timing, pattern and intensity of musculoskeletal activity and the level of tissue supersaturation are likely critical to the net effect. Understanding the relationships is important to evaluate exercise prebreathe protocols and quantify decompression risk in gravity and microgravity environments. The NASA Prebreathe Reduction Program (PRP) combined oxygen prebreathe and exercise preceding a low pressure (4.3 psia; altitude equivalent of 30,300 ft [9,235 m]) simulation exposure of non-ambulatory subjects (a microgravity analog) to produce two protocols now used by astronauts preparing for extravehicular activity. One protocol included both upright cycling and non-cycling exercise (CEVIS: 'cycle ergometer vibration isolation system') and one protocol relied on non-cycling exercise only (ISLE: 'in-suit light exercise'). CEVIS trial data serve as control data for the current study to investigate the influence of ambulation exercise in 1G environments on bubble formation and the subsequent risk of DCS.

  3. Ambulance 12-lead electrocardiography transmission via cell phone technology to cardiologists.

    PubMed

    Hsieh, Jui-Chien; Lin, Bo-Xuan; Wu, Feng-Ren; Chang, Pei-Chann; Tsuei, Yi-Wei; Yang, Chung-Chi

    2010-10-01

    This study demonstrates transmission of 12-lead electrocardiography (ECG) in an ambulance to the cell phone of the attendant emergency medical technician and then to the hospital and to cell phones of off-site cardiologists. The emergency medical technician cell phone receives Extensible Markup Language files generated by a Phillips Extensible Markup Language ECG instrument via Wi-Fi-based wireless network and then sends them to an ECG-processing server at the hospital over the mobile telephone network. After reducing ECG noises and artifacts, the server converts files to Digital Imaging and Communications in Medicine-based ECG reports stored in Picture Archiving and Communication System. These reports are sent to the cell phones of off-site cardiologists. Consequently, on-site Emergency Department physicians and off-site cardiologists can discuss ECG reports via Picture Archiving and Communication System on their computers or cell phones to prepare for the most appropriate treatment while the patient is on the way to the hospital. In conclusion, this 12-lead ECG transmission e-technology expands the functions of a 12-lead ECG instrument and facilitates more efficient prehospital cardiac care.

  4. Reliability and validity of the modified functional ambulation category scale in patients with hemiparalysis

    PubMed Central

    Park, Chang Sik; An, Seung Heon

    2016-01-01

    [Purpose] This study aimed to examine the inter- and intra-rater reliability and validity of the modified functional ambulation category (mFAC) scale. [Subjects and Methods] The participants were 66 stroke patients with hemiparalysis. The inter- and intra-rater validity of the mFAC was calculated using the Spearman correlation coefficient. A score comparison of the stable or maximum gait speed with regard to mFAC and modified Rivermead Mobility Index (mRMI) performances was performed as a univariate linear regression analysis to determine how the Kruskal-Wallis test affects the mRMI and stable/maximum gait speed with regard to mFAC. [Results] The inter-rater reliability of the mFAC (intraclass coefficient [ICC]) was 0.982 (0.971–0.989), with a kappa coefficient of 0.923 and a consistency ratio of 94%. In contrast, the intra-rater reliability of the mFAC (ICC) was 0.991 (0.986–0.995), with a kappa coefficient of 0.961 and a consistency ratio of 96%, showing higher reliability. Moreover, there was a significant difference in stable/maximum gait speed between the mFAC and the mRMI. [Conclusion] Since the mFAC has sufficient inter- and intra-reliability and high validity, it can be used as an assessment tool that reflects the gait performance and mobility of stroke patients.

  5. [Progress of research in retinal image registration].

    PubMed

    Yu, Lun; Wei, Lifang; Pan, Lin

    2011-10-01

    The retinal image registration has important applications in the processes of auxiliary diagnosis and treatment for a variety of diseases. The retinal image registration can be used to measure the disease process and the therapeutic effect. A variety of retinal image registration techniques have been studied extensively in recent years. However, there are still many problems existing and there are numerous research possibilities. Based on extensive investigation of existing literatures, the present paper analyzes the feature of retinal image and current challenges of retinal image registration, and reviews the transformation models of the retinal image registration technology and the main research algorithms in current retinal image registration, and analyzes the advantages and disadvantages of various types of algorithms. Some research challenges and future developing trends are also discussed.

  6. Evaluating Similarity Measures for Brain Image Registration

    PubMed Central

    Razlighi, Q. R.; Kehtarnavaz, N.; Yousefi, S.

    2013-01-01

    Evaluation of similarity measures for image registration is a challenging problem due to its complex interaction with the underlying optimization, regularization, image type and modality. We propose a single performance metric, named robustness, as part of a new evaluation method which quantifies the effectiveness of similarity measures for brain image registration while eliminating the effects of the other parts of the registration process. We show empirically that similarity measures with higher robustness are more effective in registering degraded images and are also more successful in performing intermodal image registration. Further, we introduce a new similarity measure, called normalized spatial mutual information, for 3D brain image registration whose robustness is shown to be much higher than the existing ones. Consequently, it tolerates greater image degradation and provides more consistent outcomes for intermodal brain image registration. PMID:24039378

  7. Non-accidental non-fatal poisonings attended by emergency ambulance crews: an observational study of data sources and epidemiology

    PubMed Central

    John, Ann; Porter, Alison; Moore, Chris; Thomas, Gareth; Whitfield, Richard; Oretti, Rossana

    2016-01-01

    Background Non-accidental non-fatal poisoning (NANFP) is associated with high risk of repeat episodes and fatality. This cross-sectional study aims to describe the data sources and epidemiology of non-fatal poisonings (NFPs) presenting to the emergency ambulance service. Methods We assessed incidents of NFP across Wales from electronic ambulance call centre records and paper records completed by attending ambulance crews, December 2007 to February 2008. We descriptively analysed data completed by attending crews. Results 92 331 calls were made to the ambulance call centre, of which 3923 (4.2%) were coded as ‘overdose’ or ‘poisoning’. During the same period, ambulance crews recorded 1827 attended NANFP incidents in those categories, of which 1287 (70.4%) had been identified in the call centre. 76.1% (1356/1782) were aged 15–44 years and 54.2% (991/1827) were female. 75.0% (1302/1753) of incidents occurred in areas from the lower 2 quintiles of deprivation in Wales. Substance taken was reported in 90% of cases (n=1639). Multiple ingestion was common (n=886, 54.1%). Psychotropic was the most frequently taken group of substances (n=585, 32.0%) and paracetamol (n=484, 26.5%) was the most frequently taken substance prehospital. Almost half of patients had taken alcohol alongside other substances (n=844, 46.2%). Naloxone was the most frequently administered treatment (n=137, 7.5%). Only 142/1827 (7.8%) patients were not transported to hospital, of whom 4 were recorded to have been given naloxone. Conclusions We report new data on the epidemiology of NFP across substance types at national level, highlighting deficiencies in information systems and high levels of multiple ingestion. In order to develop policy and practice for this patient group prehospital and further along the care pathway, information systems need to be developed to allow accurate routine monitoring of volume, presentation and outcomes. PMID:27540098

  8. Effect of Registration on Cyclical Kinematic Data

    PubMed Central

    Crane, Elizabeth A.; Cassidy, Ruth B.; Rothman, Edward D.; Gerstner, Geoffrey E.

    2010-01-01

    Given growing interest in Functional Data Analysis (FDA) as a useful method for analyzing human movement data, it is critical to understand the effects of standard FDA procedures, including registration, on biomechanical analyses. Registration is used to reduce phase variability between curves while preserving the individual curves shape and amplitude. The application of three methods available to assess registration could benefit those in the biomechanics community using FDA techniques: comparison of mean curves, comparison of average RMS values, and assessment of time-warping functions. Therefore, the present study has two purposes. First, the necessity of registration applied to cyclical data after time normalization is assessed. Second, we illustrate the three methods for evaluating registration effects. Masticatory jaw movements of 22 healthy adults (2 males, 21 females) were tracked while subjects chewed a gum-based pellet for 20 seconds. Motion data were captured at 60 Hz with two gen-locked video cameras. Individual chewing cycles were time normalized and then transformed into functional observations. Registration did not affect mean curves and warping functions were linear. Although registration decreased the RMS, indicating a decrease in inter-subject variability, the difference was not statistically significant. Together these results indicate that registration may not always be necessary for cyclical chewing data. An important contribution of this paper is the illustration of three methods for evaluating registration that are easy to apply and useful for judging whether the extra data manipulation is necessary. PMID:20537335

  9. Unbiased rigid registration using transfer functions

    NASA Astrophysics Data System (ADS)

    Hahn, Dieter A.; Hornegger, Joachim; Bautz, Werner; Kuwert, Torsten; Roemer, Wolfgang

    2005-04-01

    The evaluation of tumor growth as regression under therapy is an important clinical issue. Rigid registration of sequentially acquired 3D-images has proven its value for this purpose. Existing approaches to rigid image registration use the whole volume for the estimation of the rigid transform. Non-rigid soft tissue deformation, however, will imply a bias to the registration result, because local deformations cannot be modeled by rigid transforms. Anatomical substructures, like bones or teeth, are not affected by these deformations, but follow a rigid transform. This important observation is incorporated in the proposed registration algorithm. The selection of anatomical substructure is done by manual interaction of medical experts adjusting the transfer function of the volume rendering software. The parameters of the transfer function are used to identify the voxels that are considered for registration. A rigid transform is estimated by a quaternion gradient descent algorithm based on the intensity values of the specified tissue classes. Commonly used voxel intensity measures are adjusted to the modified registration algorithm. The contribution describes the mathematical framework of the proposed registration method and its implementation in a commercial software package. The experimental evaluation includes the discussion of different similarity measures, the comparison of the proposed method to established rigid registration techniques and the evaluation of the efficiency of the new method. We conclude with the discussion of potential medical applications of the proposed registration algorithm.

  10. Effect of registration on cyclical kinematic data.

    PubMed

    Crane, Elizabeth A; Cassidy, Ruth B; Rothman, Edward D; Gerstner, Geoffrey E

    2010-08-26

    Given growing interest in functional data analysis (FDA) as a useful method for analyzing human movement data, it is critical to understand the effects of standard FDA procedures, including registration, on biomechanical analyses. Registration is used to reduce phase variability between curves while preserving the individual curve's shape and amplitude. The application of three methods available to assess registration could benefit those in the biomechanics community using FDA techniques: comparison of mean curves, comparison of average RMS values, and assessment of time-warping functions. Therefore, the present study has two purposes. First, the necessity of registration applied to cyclical data after time normalization is assessed. Second, we illustrate the three methods for evaluating registration effects. Masticatory jaw movements of 22 healthy adults (2 males, 21 females) were tracked while subjects chewed a gum-based pellet for 20s. Motion data were captured at 60 Hz with two gen-locked video cameras. Individual chewing cycles were time normalized and then transformed into functional observations. Registration did not affect mean curves and warping functions were linear. Although registration decreased the RMS, indicating a decrease in inter-subject variability, the difference was not statistically significant. Together these results indicate that registration may not always be necessary for cyclical chewing data. An important contribution of this paper is the illustration of three methods for evaluating registration that are easy to apply and useful for judging whether the extra data manipulation is necessary.

  11. Error correction in image registration using POCS

    NASA Astrophysics Data System (ADS)

    Duraisamy, Prakash; Alam, Mohammad S.; Jackson, Stephen C.

    2011-04-01

    Image registration plays a vital role in many real time imaging applications. Registering the images in a precise manner is a challenging problem. In this paper, we focus on improving image registration error computation using the projection onto convex sets (POCS) techniques which improves the sub-pixel accuracy in the images leading to better estimates for the registration error. This can be used in turn to improve the registration itself. The results obtained from the proposed technique match well with the ground truth which validates the accuracy of this technique. Furthermore, the proposed technique shows better performance compared to existing methods.

  12. 37 CFR 2.173 - Amendment of registration.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... change in the mark: a new specimen showing the mark as used on or in connection with the goods or...) Registration must still contain registrable matter. The registration as amended must still contain registrable matter, and the mark as amended must be registrable as a whole. (d) Amendment may not materially...

  13. 27 CFR 31.111 - Date registration form is due.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2014-04-01 2014-04-01 false Date registration form is....111 Date registration form is due. (a) General. Dealers must register by filing the registration form... form was filed, no additional registration is required. If the registration form is received in...

  14. 14 CFR 47.61 - Dealer's Aircraft Registration Certificates.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 1 2013-01-01 2013-01-01 false Dealer's Aircraft Registration Certificates... TRANSPORTATION AIRCRAFT AIRCRAFT REGISTRATION Dealers' Aircraft Registration Certificate § 47.61 Dealer's Aircraft Registration Certificates. (a) The FAA issues a Dealer's Aircraft Registration Certificate,...

  15. 14 CFR 47.61 - Dealers' Aircraft Registration Certificates.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Dealers' Aircraft Registration Certificates... TRANSPORTATION AIRCRAFT AIRCRAFT REGISTRATION Dealers' Aircraft Registration Certificate § 47.61 Dealers' Aircraft Registration Certificates. (a) The FAA issues a Dealers' Aircraft Registration Certificate,...

  16. 14 CFR 47.61 - Dealer's Aircraft Registration Certificates.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false Dealer's Aircraft Registration Certificates... TRANSPORTATION AIRCRAFT AIRCRAFT REGISTRATION Dealers' Aircraft Registration Certificate § 47.61 Dealer's Aircraft Registration Certificates. (a) The FAA issues a Dealer's Aircraft Registration Certificate,...

  17. 21 CFR 1301.52 - Termination of registration; transfer of registration; distribution upon discontinuance of business.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Termination of registration; transfer of registration; distribution upon discontinuance of business. 1301.52 Section 1301.52 Food and Drugs DRUG... person seeking authority to transfer a registration shall submit a written request, providing...

  18. 16 CFR 1130.8 - Requirements for Web site registration or alternative e-mail registration.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... alternative e-mail registration. 1130.8 Section 1130.8 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION... PRODUCTS § 1130.8 Requirements for Web site registration or alternative e-mail registration. (a) Link to... a link to the manufacturer's home page, a field to confirm submission, and a prompt to indicate...

  19. 28 CFR 12.3 - Prior registration with the Foreign Agents Registration Unit.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Prior registration with the Foreign Agents Registration Unit. 12.3 Section 12.3 Judicial Administration DEPARTMENT OF JUSTICE REGISTRATION OF CERTAIN PERSONS HAVING KNOWLEDGE OF FOREIGN ESPIONAGE, COUNTERESPIONAGE, OR SABOTAGE MATTERS UNDER THE...

  20. 75 FR 37790 - Lauryl Sulfate Salts; Antimicrobial Registration Review Final Work Plan and Proposed Registration...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-30

    ... AGENCY Lauryl Sulfate Salts; Antimicrobial Registration Review Final Work Plan and Proposed Registration... decision for the pesticide lauryl sulfate salts, case number 4061 and opens a public comment period on the... availability of EPA's proposed registration review decision for the pesticide lauryl sulfate salts, case...

  1. 21 CFR 1301.52 - Termination of registration; transfer of registration; distribution upon discontinuance of business.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 9 2011-04-01 2011-04-01 false Termination of registration; transfer of registration; distribution upon discontinuance of business. 1301.52 Section 1301.52 Food and Drugs DRUG... OF CONTROLLED SUBSTANCES Modification, Transfer and Termination of Registration § 1301.52...

  2. 21 CFR 1301.52 - Termination of registration; transfer of registration; distribution upon discontinuance of business.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 9 2012-04-01 2012-04-01 false Termination of registration; transfer of registration; distribution upon discontinuance of business. 1301.52 Section 1301.52 Food and Drugs DRUG... OF CONTROLLED SUBSTANCES Modification, Transfer and Termination of Registration § 1301.52...

  3. 21 CFR 1301.52 - Termination of registration; transfer of registration; distribution upon discontinuance of business.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 9 2013-04-01 2013-04-01 false Termination of registration; transfer of registration; distribution upon discontinuance of business. 1301.52 Section 1301.52 Food and Drugs DRUG... OF CONTROLLED SUBSTANCES Modification, Transfer and Termination of Registration § 1301.52...

  4. 21 CFR 1301.52 - Termination of registration; transfer of registration; distribution upon discontinuance of business.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 9 2014-04-01 2014-04-01 false Termination of registration; transfer of registration; distribution upon discontinuance of business. 1301.52 Section 1301.52 Food and Drugs DRUG... OF CONTROLLED SUBSTANCES Modification, Transfer and Termination of Registration § 1301.52...

  5. REGISTRATION OF ORTHODONTIC DIGITAL MODELS

    PubMed Central

    Grauer, Dan; Cevidanes, Lucia H.; Tyndall, Donald; Styner, Martin A.; Flood, Patrick M.; Proffit, William R.

    2011-01-01

    Current methods to assess outcomes and change in orthodontics are comparison of photographs, cephalometric measurements and superimpositions, and comparisons/measurements on dental casts. Digital models are a relatively new records modality in orthodontics. They offer numerous advantages in terms of storage space, spatial registration and superimposition. The purpose of this chapter is to determine the reproducibility of: 1) establishing occlusion of independently scanned digital models; and 2) registering digital models obtained after treatment on their homologous digital model setups produced before treatment. Reliability of both procedures was assessed with two random samples of five patient’s models. In both experiments, three replicate positionings of the models per patient were created and variability in position was evaluated by the maximum surface difference between replicates, and the standard deviation of the surface distances between replicates respectively. Based on the data obtained, we concluded that it is reliable to register independently scanned models to a scanned surface of the models in occlusion. Surface-to-surface registration of final orthodontic digital models to planned setup models also is reproducible. PMID:26549917

  6. Calls Forecast for the Moscow Ambulance Service. The Impact of Weather Forecast

    NASA Astrophysics Data System (ADS)

    Gordin, Vladimir; Bykov, Philipp

    2015-04-01

    We use the known statistics of the calls for the current and previous days to predict them for tomorrow and for the following days. We assume that this algorithm will work operatively, will cyclically update the available information and will move the horizon of the forecast. Sure, the accuracy of such forecasts depends on their lead time, and from a choice of some group of diagnoses. For comparison we used the error of the inertial forecast (tomorrow there will be the same number of calls as today). Our technology has demonstrated accuracy that is approximately two times better compared to the inertial forecast. We obtained the following result: the number of calls depends on the actual weather in the city as well as on its rate of change. We were interested in the accuracy of the forecast for 12-hour sum of the calls in real situations. We evaluate the impact of the meteorological errors [1] on the forecast errors of the number of Ambulance calls. The weather and the Ambulance calls number both have seasonal tendencies. Therefore, if we have medical information from one city only, we should separate the impacts of such predictors as "annual variations in the number of calls" and "weather". We need to consider the seasonal tendencies (associated, e. g. with the seasonal migration of the population) and the impact of the air temperature simultaneously, rather than sequentially. We forecasted separately the number of calls with diagnoses of cardiovascular group, where it was demonstrated the advantage of the forecasting method, when we use the maximum daily air temperature as a predictor. We have a chance to evaluate statistically the influence of meteorological factors on the dynamics of medical problems. In some cases it may be useful for understanding of the physiology of disease and possible treatment options. We can assimilate some personal archives of medical parameters for the individuals with concrete diseases and the relative meteorological archive. As a

  7. Energy expenditure and fatiguability in paraplegic ambulation using reciprocating gait orthosis and electric stimulation.

    PubMed

    Hirokawa, S; Solomonow, M; Baratta, R; D'Ambrosia, R

    1996-03-01

    To clarify the relationship between metabolic energy expenditure and fatiguability in paraplegic persons fitted with orthoses, we measured energy consumption in six thoracic paraplegic patients ambulating by means of reciprocating gait orthosis (RGO) used with and without functional electrical stimulation (FES). The data obtained from persons using both RGO and FES were adjusted to allow for the effects of fatiguability so as to obtain an approximate value for upper-body consumption. The data obtained from persons using RGO only were not adjusted, because no energy consumption occurred in the lower portion of the body. The data, expressed in kcal/kg-min and kcal/kg-m, were plotted against walking speed attained using RGO, and RGO with FES. The results were compared with those from persons fitted with long leg braces (LLB), hip guidance orthoses (HGO) and an FES walking aid (data obtained from available literature). We found that the lowest energy expenditure in kcal/kg-m across the full range of walking speeds occurred when both RGO and FES were used together, followed by RGO only, HGO, LLB, and FES only, respectively. The lowest energy expenditure in kcal/kg-min, for walking speeds, below 0-28 m/s, also occurred when both RGO and FES were used together, followed by RGO only, HGO, LLB, and FES only. The results suggest that, although the use of FES with RGO may increase oxygen uptake, it decreases energy expenditure in the upper extremities, thereby reducing patient fatigue. They also suggest that mechanical orthosis giving passive support to the hip, knee and ankle in combination with FES may provide the most efficient walking aid for paraplegic persons.

  8. Long Term Natural History Data in Ambulant Boys with Duchenne Muscular Dystrophy: 36-Month Changes

    PubMed Central

    Sormani, Maria Pia; Messina, Sonia; D′Amico, Adele; Carlesi, Adelina; Vita, Gianluca; Fanelli, Lavinia; Berardinelli, Angela; Torrente, Yvan; Lanzillotta, Valentina; Viggiano, Emanuela; D′Ambrosio, Paola; Cavallaro, Filippo; Frosini, Silvia; Barp, Andrea; Bonfiglio, Serena; Scalise, Roberta; De Sanctis, Roberto; Rolle, Enrica; Graziano, Alessandra; Magri, Francesca; Palermo, Concetta; Rossi, Francesca; Donati, Maria Alice; Sacchini, Michele; Arnoldi, Maria Teresa; Baranello, Giovanni; Mongini, Tiziana; Pini, Antonella; Battini, Roberta; Pegoraro, Elena; Previtali, Stefano; Bruno, Claudio; Politano, Luisa; Comi, Giacomo P.; Bertini, Enrico; Mercuri, Eugenio

    2014-01-01

    The 6 minute walk test has been recently chosen as the primary outcome measure in international multicenter clinical trials in Duchenne muscular dystrophy ambulant patients. The aim of the study was to assess the spectrum of changes at 3 years in the individual measures, their correlation with steroid treatment, age and 6 minute walk test values at baseline. Ninety-six patients from 11 centers were assessed at baseline and 12, 24 and 36 months after baseline using the 6 minute walk test and the North Star Ambulatory Assessment. Three boys (3%) lost the ability to perform the 6 minute walk test within 12 months, another 13 between 12 and 24 months (14%) and 11 between 24 and 36 months (12%). The 6 minute walk test showed an average overall decline of −15.8 (SD 77.3) m at 12 months, of −58.9 (SD 125.7) m at 24 months and −104.22 (SD 146.2) m at 36 months. The changes were significantly different in the two baseline age groups and according to the baseline 6 minute walk test values (below and above 350 m) (p<0.001). The changes were also significantly different according to steroid treatment (p = 0.01). Similar findings were found for the North Star Ambulatory Assessment. These are the first 36 month longitudinal data using the 6 minute walk test and North Star Ambulatory Assessment in Duchenne muscular dystrophy. Our findings will help not only to have a better idea of the progression of the disorder but also provide reference data that can be used to compare with the results of the long term extension studies that are becoming available. PMID:25271887

  9. Long term natural history data in ambulant boys with Duchenne muscular dystrophy: 36-month changes.

    PubMed

    Pane, Marika; Mazzone, Elena Stacy; Sivo, Serena; Sormani, Maria Pia; Messina, Sonia; D'Amico, Adele; Carlesi, Adelina; Vita, Gianluca; Fanelli, Lavinia; Berardinelli, Angela; Torrente, Yvan; Lanzillotta, Valentina; Viggiano, Emanuela; D Ambrosio, Paola; Cavallaro, Filippo; Frosini, Silvia; Barp, Andrea; Bonfiglio, Serena; Scalise, Roberta; De Sanctis, Roberto; Rolle, Enrica; Graziano, Alessandra; Magri, Francesca; Palermo, Concetta; Rossi, Francesca; Donati, Maria Alice; Sacchini, Michele; Arnoldi, Maria Teresa; Baranello, Giovanni; Mongini, Tiziana; Pini, Antonella; Battini, Roberta; Pegoraro, Elena; Previtali, Stefano; Bruno, Claudio; Politano, Luisa; Comi, Giacomo P; Bertini, Enrico; Mercuri, Eugenio

    2014-01-01

    The 6 minute walk test has been recently chosen as the primary outcome measure in international multicenter clinical trials in Duchenne muscular dystrophy ambulant patients. The aim of the study was to assess the spectrum of changes at 3 years in the individual measures, their correlation with steroid treatment, age and 6 minute walk test values at baseline. Ninety-six patients from 11 centers were assessed at baseline and 12, 24 and 36 months after baseline using the 6 minute walk test and the North Star Ambulatory Assessment. Three boys (3%) lost the ability to perform the 6 minute walk test within 12 months, another 13 between 12 and 24 months (14%) and 11 between 24 and 36 months (12%). The 6 minute walk test showed an average overall decline of -15.8 (SD 77.3) m at 12 months, of -58.9 (SD 125.7) m at 24 months and -104.22 (SD 146.2) m at 36 months. The changes were significantly different in the two baseline age groups and according to the baseline 6 minute walk test values (below and above 350 m) (p<0.001). The changes were also significantly different according to steroid treatment (p = 0.01). Similar findings were found for the North Star Ambulatory Assessment. These are the first 36 month longitudinal data using the 6 minute walk test and North Star Ambulatory Assessment in Duchenne muscular dystrophy. Our findings will help not only to have a better idea of the progression of the disorder but also provide reference data that can be used to compare with the results of the long term extension studies that are becoming available. PMID:25271887

  10. 40 CFR 68.160 - Registration.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 16 2014-07-01 2014-07-01 false Registration. 68.160 Section 68.160 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CHEMICAL ACCIDENT PREVENTION PROVISIONS Risk Management Plan § 68.160 Registration. (a) The owner or operator...

  11. 77 FR 73558 - Sex Offender Registration Amendments

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-11

    ... SUPERVISION AGENCY FOR THE DISTRICT OF COLUMBIA 28 CFR Part 811 RIN 3225-AA10 Sex Offender Registration... requirements relating to periodic verification of registration information for sex offenders. The proposed rule, if finalized, would permit CSOSA to verify addresses of sex offenders by conducting home visits...

  12. 78 FR 23835 - Sex Offender Registration Amendments

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-23

    ... it can be found at 77 FR 73558. The proposed rule was published to allow CSOSA to better meet the... SUPERVISION AGENCY FOR THE DISTRICT OF COLUMBIA 28 CFR Part 811 RIN 3225-AA10 Sex Offender Registration... verification of registration information for sex offenders. Furthermore, the rule permits CSOSA to...

  13. 5 CFR 330.207 - Registration area.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 1 2013-01-01 2013-01-01 false Registration area. 330.207 Section 330..., SELECTION, AND PLACEMENT (GENERAL) Reemployment Priority List (RPL) § 330.207 Registration area. (a) Except... commuting area in which the eligible was, or will be, separated. (b) If the agency has, or will have,...

  14. 5 CFR 330.207 - Registration area.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 5 Administrative Personnel 1 2012-01-01 2012-01-01 false Registration area. 330.207 Section 330..., SELECTION, AND PLACEMENT (GENERAL) Reemployment Priority List (RPL) § 330.207 Registration area. (a) Except... commuting area in which the eligible was, or will be, separated. (b) If the agency has, or will have,...

  15. 77 FR 16544 - Pesticide Product Registration Approvals

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-21

    ... of receipt published on April 14, 2010 (75 FR 19388; FRL- 8808-5). One comment was received during... AGENCY Pesticide Product Registration Approvals AGENCY: Environmental Protection Agency (EPA). ACTION... pesticide products and amended registrations for currently existing pesticide products. FOR...

  16. 9 CFR 2.30 - Registration.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... and filing a properly executed form which will be furnished, upon request, by the AC Regional Director. The registration form shall be filed with the AC Regional Director for the State in which the research... filing of a new registration form which will be provided by the AC Regional Director. Except as...

  17. 19 CFR 360.102 - Online registration.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 19 Customs Duties 3 2010-04-01 2010-04-01 false Online registration. 360.102 Section 360.102... ANALYSIS SYSTEM § 360.102 Online registration. (a) In general. (1) Any importer, importing company, customs.... boxes will not be accepted. A user identification number will be issued within two business...

  18. 78 FR 48667 - Revised Company Registration System

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-09

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Revised Company Registration System AGENCY: Federal Energy Regulatory... Registration System. The Commission issued a previous notice in the Federal Register, 78 FR 44559 (July...

  19. 31 CFR 316.4 - Registration.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ....4 Registration. Series E bonds were permitted to be registered as set forth in subpart B of 31 CFR... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Registration. 316.4 Section 316.4 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL...

  20. 40 CFR 80.1650 - Registration.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... the first date that such person will blend oxygenate into RBOB, whichever is earlier. (4) Any ethanol... advance of the first date that such person will produce or import ethanol denaturant, whichever is earlier... inaccurate. (h) Certified ethanol denaturant producer registration. (1) Registration shall be on forms...

  1. 18 CFR 390.1 - Electronic registration.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    .... 390.1 Section 390.1 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY PROCEDURAL RULES ELECTRONIC REGISTRATION § 390.1 Electronic registration. Any person who... Commission's web site, in compliance with instructions located on the Web site, at...

  2. 18 CFR 390.1 - Electronic registration.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    .... 390.1 Section 390.1 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY PROCEDURAL RULES ELECTRONIC REGISTRATION § 390.1 Electronic registration. Any person who... Commission's web site, in compliance with instructions located on the Web site, at...

  3. 18 CFR 390.1 - Electronic registration.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    .... 390.1 Section 390.1 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY PROCEDURAL RULES ELECTRONIC REGISTRATION § 390.1 Electronic registration. Any person who... Commission's web site, in compliance with instructions located on the Web site, at...

  4. 76 FR 42684 - Statutory Invention Registration

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-19

    ... Patent and Trademark Office Statutory Invention Registration ACTION: Proposed collection; comment request... drawings be published as a statutory invention registration (SIR). A published SIR is not a patent. It has... obtaining patents on the inventions claimed in the applications. However, given that 37 CFR 1.211...

  5. 32 CFR 636.9 - Registration requirement.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 4 2013-07-01 2013-07-01 false Registration requirement. 636.9 Section 636.9 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) LAW ENFORCEMENT AND CRIMINAL INVESTIGATIONS MOTOR VEHICLE TRAFFIC SUPERVISION (SPECIFIC INSTALLATIONS) Fort Stewart, Georgia § 636.9 Registration requirement....

  6. 7 CFR 915.120 - Handler registration.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Agreements and Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF AGRICULTURE AVOCADOS GROWN IN SOUTH FLORIDA Rules and Regulations § 915.120 Handler registration. (a) Each handler who desires to handle avocados... shall be by application for registration filed with the Avocado Administrative Committee on a...

  7. 9 CFR 2.30 - Registration.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 9 Animals and Animal Products 1 2014-01-01 2014-01-01 false Registration. 2.30 Section 2.30 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE ANIMAL WELFARE REGULATIONS Research Facilities § 2.30 Registration. (a) Requirements and procedures. (1)...

  8. 9 CFR 2.30 - Registration.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 9 Animals and Animal Products 1 2011-01-01 2011-01-01 false Registration. 2.30 Section 2.30 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE ANIMAL WELFARE REGULATIONS Research Facilities § 2.30 Registration. (a) Requirements and procedures. (1)...

  9. 15 CFR 295.24 - Registration.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Registration. 295.24 Section 295.24 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade NATIONAL INSTITUTE OF... Assistance to United States Industry-Led Joint Research and Development Ventures § 295.24 Registration....

  10. 19 CFR 360.102 - Online registration.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 19 Customs Duties 3 2012-04-01 2012-04-01 false Online registration. 360.102 Section 360.102 Customs Duties INTERNATIONAL TRADE ADMINISTRATION, DEPARTMENT OF COMMERCE STEEL IMPORT MONITORING AND ANALYSIS SYSTEM § 360.102 Online registration. (a) In general. (1) Any importer, importing company,...

  11. 19 CFR 360.102 - Online registration.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 19 Customs Duties 3 2013-04-01 2013-04-01 false Online registration. 360.102 Section 360.102 Customs Duties INTERNATIONAL TRADE ADMINISTRATION, DEPARTMENT OF COMMERCE STEEL IMPORT MONITORING AND ANALYSIS SYSTEM § 360.102 Online registration. (a) In general. (1) Any importer, importing company,...

  12. 19 CFR 360.102 - Online registration.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 19 Customs Duties 3 2011-04-01 2011-04-01 false Online registration. 360.102 Section 360.102 Customs Duties INTERNATIONAL TRADE ADMINISTRATION, DEPARTMENT OF COMMERCE STEEL IMPORT MONITORING AND ANALYSIS SYSTEM § 360.102 Online registration. (a) In general. (1) Any importer, importing company,...

  13. 19 CFR 360.102 - Online registration.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 19 Customs Duties 3 2014-04-01 2014-04-01 false Online registration. 360.102 Section 360.102 Customs Duties INTERNATIONAL TRADE ADMINISTRATION, DEPARTMENT OF COMMERCE STEEL IMPORT MONITORING AND ANALYSIS SYSTEM § 360.102 Online registration. (a) In general. (1) Any importer, importing company,...

  14. Image Registration for Stability Testing of MEMS

    NASA Technical Reports Server (NTRS)

    Memarsadeghi, Nargess; LeMoigne, Jacqueline; Blake, Peter N.; Morey, Peter A.; Landsman, Wayne B.; Chambers, Victor J.; Moseley, Samuel H.

    2011-01-01

    Image registration, or alignment of two or more images covering the same scenes or objects, is of great interest in many disciplines such as remote sensing, medical imaging. astronomy, and computer vision. In this paper, we introduce a new application of image registration algorithms. We demonstrate how through a wavelet based image registration algorithm, engineers can evaluate stability of Micro-Electro-Mechanical Systems (MEMS). In particular, we applied image registration algorithms to assess alignment stability of the MicroShutters Subsystem (MSS) of the Near Infrared Spectrograph (NIRSpec) instrument of the James Webb Space Telescope (JWST). This work introduces a new methodology for evaluating stability of MEMS devices to engineers as well as a new application of image registration algorithms to computer scientists.

  15. Medicare, Medicaid, and Children's Health Insurance Programs: Announcement of the Implementation and Extension of Temporary Moratoria on Enrollment of Part B Non-Emergency Ground Ambulance Suppliers and Home Health Agencies in Designated Geographic Locations and Lifting of the Temporary Moratoria on Enrollment of Part B Emergency Ground Ambulance Suppliers in All Geographic Locations. Extension, implementation, and lifting of temporary moratoria.

    PubMed

    2016-08-01

    This document announces the extension of temporary moratoria on the enrollment of new Medicare Part B non-emergency ground ambulance suppliers and Medicare home health agencies (HHAs), subunits, and branch locations in specific locations within designated metropolitan areas in Florida, Illinois, Michigan, Texas, Pennsylvania, and New Jersey to prevent and combat fraud, waste, and abuse. It also announces the implementation of temporary moratoria on the enrollment of new Medicare Part B non-emergency ground ambulance suppliers and Medicare HHAs, subunits, and branch locations in Florida, Illinois, Michigan, Texas, Pennsylvania, and New Jersey on a statewide basis. In addition, it announces the lifting of the moratoria on all Part B emergency ground ambulance suppliers. These moratoria, and the changes described in this document, also apply to the enrollment of HHAs and non-emergency ground ambulance suppliers in Medicaid and the Children's Health Insurance Program. PMID:27487581

  16. Medicare, Medicaid, and Children's Health Insurance Programs: Announcement of the Implementation and Extension of Temporary Moratoria on Enrollment of Part B Non-Emergency Ground Ambulance Suppliers and Home Health Agencies in Designated Geographic Locations and Lifting of the Temporary Moratoria on Enrollment of Part B Emergency Ground Ambulance Suppliers in All Geographic Locations. Extension, implementation, and lifting of temporary moratoria.

    PubMed

    2016-08-01

    This document announces the extension of temporary moratoria on the enrollment of new Medicare Part B non-emergency ground ambulance suppliers and Medicare home health agencies (HHAs), subunits, and branch locations in specific locations within designated metropolitan areas in Florida, Illinois, Michigan, Texas, Pennsylvania, and New Jersey to prevent and combat fraud, waste, and abuse. It also announces the implementation of temporary moratoria on the enrollment of new Medicare Part B non-emergency ground ambulance suppliers and Medicare HHAs, subunits, and branch locations in Florida, Illinois, Michigan, Texas, Pennsylvania, and New Jersey on a statewide basis. In addition, it announces the lifting of the moratoria on all Part B emergency ground ambulance suppliers. These moratoria, and the changes described in this document, also apply to the enrollment of HHAs and non-emergency ground ambulance suppliers in Medicaid and the Children's Health Insurance Program.

  17. Characterization of Artifacts Produced by Gel Displacement on Non-invasive Brain-Machine Interfaces during Ambulation.

    PubMed

    Costa, Álvaro; Salazar-Varas, Rocio; Úbeda, Andrés; Azorín, José M

    2016-01-01

    So far, Brain-Machine Interfaces (BMIs) have been mainly used to study brain potentials during movement-free conditions. Recently, due to the emerging concern of improving rehabilitation therapies, these systems are also being used during gait experiments. Under this new condition, the evaluation of motion artifacts has become a critical point to assure the validity of the results obtained. Due to the high signal to noise ratio provided, the use of wet electrodes is a widely accepted technic to acquire electroencephalographic (EEG signals). To perform these recordings it is necessary to apply a conductive gel between the scalp and the electrodes. This work is focused on the study of gel displacements produced during ambulation and how they affect the amplitude of EEG signals. Data recorded during three ambulation conditions (gait training) and one movement-free condition (BMI motor imagery task) are compared to perform this study. Two phenomenons, manifested as unusual increases of the signals' amplitude, have been identified and characterized during this work. Results suggest that they are caused by abrupt changes on the conductivity between the electrode and the scalp due to gel displacement produced during ambulation and head movements. These artifacts significantly increase the Power Spectral Density (PSD) of EEG recordings at all frequencies from 5 to 90 Hz, corresponding to the main bandwidth of electrocortical potentials. They should be taken into consideration before performing EEG recordings in order to asses the correct gel allocation and to avoid the use of electrodes on certain scalp areas depending on the experimental conditions. PMID:26941601

  18. Effects of robot-assisted gait training on the balance and gait of chronic stroke patients: focus on dependent ambulators.

    PubMed

    Cho, Duk Youn; Park, Si-Woon; Lee, Min Jin; Park, Dae Sung; Kim, Eun Joo

    2015-10-01

    [Purpose] The purpose of this study was to confirm the effect of robot-assisted gait training on the balance and gait ability of stroke patients who were dependent ambulators. [Subjects and Methods] Twenty stroke patients participated in this study. The participants were allocated to either group 1, which received robot-assisted gait training for 4 weeks followed by conventional physical therapy for 4 weeks, or group 2, which received the same treatments in the reverse order. Robot-assisted gait training was conducted for 30 min, 3 times a week for 4 weeks. The Berg Balance Scale, Modified Functional Reach Test, Functional Ambulation Category, Modified Ashworth Scale, Fugl-Meyer Assessment, Motricity Index, and Modified Barthel Index were assessed before and after treatment. To confirm the characteristics of patients who showed a significant increase in Berg Balance Scale after robot-assisted gait training as compared with physical therapy, subgroup analysis was conducted. [Results] Only lateral reaching and the Functional Ambulation Category were significantly increased following robot-assisted gait training. Subscale analyses identified 3 patient subgroups that responded well to robot-assisted gait training: a subgroup with hemiplegia, a subgroup in which the guidance force needed to be decreased to needed to be decreased to ≤45%, and a subgroup in which weight bearing was decreased to ≤21%. [Conclusion] The present study showed that robot-assisted gait training is not only effective in improving balance and gait performance but also improves trunk balance and motor skills required by high-severity stroke patients to perform activities daily living. Moreover, subscale analyses identified subgroups that responded well to robot-assisted gait training.

  19. Characterization of Artifacts Produced by Gel Displacement on Non-invasive Brain-Machine Interfaces during Ambulation

    PubMed Central

    Costa, Álvaro; Salazar-Varas, Rocio; Úbeda, Andrés; Azorín, José M.

    2016-01-01

    So far, Brain-Machine Interfaces (BMIs) have been mainly used to study brain potentials during movement-free conditions. Recently, due to the emerging concern of improving rehabilitation therapies, these systems are also being used during gait experiments. Under this new condition, the evaluation of motion artifacts has become a critical point to assure the validity of the results obtained. Due to the high signal to noise ratio provided, the use of wet electrodes is a widely accepted technic to acquire electroencephalographic (EEG signals). To perform these recordings it is necessary to apply a conductive gel between the scalp and the electrodes. This work is focused on the study of gel displacements produced during ambulation and how they affect the amplitude of EEG signals. Data recorded during three ambulation conditions (gait training) and one movement-free condition (BMI motor imagery task) are compared to perform this study. Two phenomenons, manifested as unusual increases of the signals' amplitude, have been identified and characterized during this work. Results suggest that they are caused by abrupt changes on the conductivity between the electrode and the scalp due to gel displacement produced during ambulation and head movements. These artifacts significantly increase the Power Spectral Density (PSD) of EEG recordings at all frequencies from 5 to 90 Hz, corresponding to the main bandwidth of electrocortical potentials. They should be taken into consideration before performing EEG recordings in order to asses the correct gel allocation and to avoid the use of electrodes on certain scalp areas depending on the experimental conditions. PMID:26941601

  20. Effects of robot-assisted gait training on the balance and gait of chronic stroke patients: focus on dependent ambulators

    PubMed Central

    Cho, Duk Youn; Park, Si-Woon; Lee, Min Jin; Park, Dae Sung; Kim, Eun Joo

    2015-01-01

    [Purpose] The purpose of this study was to confirm the effect of robot-assisted gait training on the balance and gait ability of stroke patients who were dependent ambulators. [Subjects and Methods] Twenty stroke patients participated in this study. The participants were allocated to either group 1, which received robot-assisted gait training for 4 weeks followed by conventional physical therapy for 4 weeks, or group 2, which received the same treatments in the reverse order. Robot-assisted gait training was conducted for 30 min, 3 times a week for 4 weeks. The Berg Balance Scale, Modified Functional Reach Test, Functional Ambulation Category, Modified Ashworth Scale, Fugl-Meyer Assessment, Motricity Index, and Modified Barthel Index were assessed before and after treatment. To confirm the characteristics of patients who showed a significant increase in Berg Balance Scale after robot-assisted gait training as compared with physical therapy, subgroup analysis was conducted. [Results] Only lateral reaching and the Functional Ambulation Category were significantly increased following robot-assisted gait training. Subscale analyses identified 3 patient subgroups that responded well to robot-assisted gait training: a subgroup with hemiplegia, a subgroup in which the guidance force needed to be decreased to needed to be decreased to ≤45%, and a subgroup in which weight bearing was decreased to ≤21%. [Conclusion] The present study showed that robot-assisted gait training is not only effective in improving balance and gait performance but also improves trunk balance and motor skills required by high-severity stroke patients to perform activities daily living. Moreover, subscale analyses identified subgroups that responded well to robot-assisted gait training. PMID:26644642

  1. Model application for rapid detection of the exact location when calling an ambulance using OGC Open GeoSMS Standards

    NASA Astrophysics Data System (ADS)

    Sukic, Enes; Stoimenov, Leonid

    2016-02-01

    The web has penetrated just about every sphere of human interest and using information from the web has become ubiquitous among different categories of users. Medicine has long being using the benefits of modern technologies and without them it cannot function. This paper offers a proposal of use and mutual collaboration of several modern technologies within facilitating the location and communication between persons in need of emergency medical assistance and the emergency head offices, i.e., the ambulance. The main advantage of the proposed model is the technical possibility of implementation and use of these technologies in developing countries and low implementation cost.

  2. Development and evaluation of an articulated registration algorithm for human skeleton registration

    NASA Astrophysics Data System (ADS)

    Yip, Stephen; Perk, Timothy; Jeraj, Robert

    2014-03-01

    Accurate registration over multiple scans is necessary to assess treatment response of bone diseases (e.g. metastatic bone lesions). This study aimed to develop and evaluate an articulated registration algorithm for the whole-body skeleton registration in human patients. In articulated registration, whole-body skeletons are registered by auto-segmenting into individual bones using atlas-based segmentation, and then rigidly aligning them. Sixteen patients (weight = 80-117 kg, height = 168-191 cm) with advanced prostate cancer underwent the pre- and mid-treatment PET/CT scans over a course of cancer therapy. Skeletons were extracted from the CT images by thresholding (HU>150). Skeletons were registered using the articulated, rigid, and deformable registration algorithms to account for position and postural variability between scans. The inter-observers agreement in the atlas creation, the agreement between the manually and atlas-based segmented bones, and the registration performances of all three registration algorithms were all assessed using the Dice similarity index—DSIobserved, DSIatlas, and DSIregister. Hausdorff distance (dHausdorff) of the registered skeletons was also used for registration evaluation. Nearly negligible inter-observers variability was found in the bone atlases creation as the DSIobserver was 96 ± 2%. Atlas-based and manual segmented bones were in excellent agreement with DSIatlas of 90 ± 3%. Articulated (DSIregsiter = 75 ± 2%, dHausdorff = 0.37 ± 0.08 cm) and deformable registration algorithms (DSIregister = 77 ± 3%, dHausdorff = 0.34 ± 0.08 cm) considerably outperformed the rigid registration algorithm (DSIregsiter = 59 ± 9%, dHausdorff = 0.69 ± 0.20 cm) in the skeleton registration as the rigid registration algorithm failed to capture the skeleton flexibility in the joints. Despite superior skeleton registration performance, deformable registration algorithm failed to preserve the local rigidity of bones as over 60% of the

  3. Development and evaluation of an articulated registration algorithm for human skeleton registration.

    PubMed

    Yip, Stephen; Perk, Timothy; Jeraj, Robert

    2014-03-21

    Accurate registration over multiple scans is necessary to assess treatment response of bone diseases (e.g. metastatic bone lesions). This study aimed to develop and evaluate an articulated registration algorithm for the whole-body skeleton registration in human patients. In articulated registration, whole-body skeletons are registered by auto-segmenting into individual bones using atlas-based segmentation, and then rigidly aligning them. Sixteen patients (weight = 80-117 kg, height = 168-191 cm) with advanced prostate cancer underwent the pre- and mid-treatment PET/CT scans over a course of cancer therapy. Skeletons were extracted from the CT images by thresholding (HU>150). Skeletons were registered using the articulated, rigid, and deformable registration algorithms to account for position and postural variability between scans. The inter-observers agreement in the atlas creation, the agreement between the manually and atlas-based segmented bones, and the registration performances of all three registration algorithms were all assessed using the Dice similarity index-DSIobserved, DSIatlas, and DSIregister. Hausdorff distance (dHausdorff) of the registered skeletons was also used for registration evaluation. Nearly negligible inter-observers variability was found in the bone atlases creation as the DSIobserver was 96 ± 2%. Atlas-based and manual segmented bones were in excellent agreement with DSIatlas of 90 ± 3%. Articulated (DSIregsiter = 75 ± 2%, dHausdorff = 0.37 ± 0.08 cm) and deformable registration algorithms (DSIregister = 77 ± 3%, dHausdorff = 0.34 ± 0.08 cm) considerably outperformed the rigid registration algorithm (DSIregsiter = 59 ± 9%, dHausdorff = 0.69 ± 0.20 cm) in the skeleton registration as the rigid registration algorithm failed to capture the skeleton flexibility in the joints. Despite superior skeleton registration performance, deformable registration algorithm failed to preserve the local rigidity of bones as over 60% of the skeletons

  4. Masked object registration in the Fourier domain.

    PubMed

    Padfield, Dirk

    2012-05-01

    Registration is one of the most common tasks of image analysis and computer vision applications. The requirements of most registration algorithms include large capture range and fast computation so that the algorithms are robust to different scenarios and can be computed in a reasonable amount of time. For these purposes, registration in the Fourier domain using normalized cross-correlation is well suited and has been extensively studied in the literature. Another common requirement is masking, which is necessary for applications where certain regions of the image that would adversely affect the registration result should be ignored. To address these requirements, we have derived a mathematical model that describes an exact form for embedding the masking step fully into the Fourier domain so that all steps of translation registration can be computed efficiently using Fast Fourier Transforms. We provide algorithms and implementation details that demonstrate the correctness of our derivations. We also demonstrate how this masked FFT registration approach can be applied to improve the Fourier-Mellin algorithm that calculates translation, rotation, and scale in the Fourier domain. We demonstrate the computational efficiency, advantages, and correctness of our algorithm on a number of images from real-world applications. Our framework enables fast, global, parameter-free registration of images with masked regions.

  5. Cellular recurrent deep network for image registration

    NASA Astrophysics Data System (ADS)

    Alam, M.; Vidyaratne, L.; Iftekharuddin, Khan M.

    2015-09-01

    Image registration using Artificial Neural Network (ANN) remains a challenging learning task. Registration can be posed as a two-step problem: parameter estimation and actual alignment/transformation using the estimated parameters. To date ANN based image registration techniques only perform the parameter estimation, while affine equations are used to perform the actual transformation. In this paper, we propose a novel deep ANN based image rigid registration that combines parameter estimation and transformation as a simultaneous learning task. Our previous work shows that a complex universal approximator known as Cellular Simultaneous Recurrent Network (CSRN) can successfully approximate affine transformations with known transformation parameters. This study introduces a deep ANN that combines a feed forward network with a CSRN to perform full rigid registration. Layer wise training is used to pre-train feed forward network for parameter estimation and followed by a CSRN for image transformation respectively. The deep network is then fine-tuned to perform the final registration task. Our result shows that the proposed deep ANN architecture achieves comparable registration accuracy to that of image affine transformation using CSRN with known parameters. We also demonstrate the efficacy of our novel deep architecture by a performance comparison with a deep clustered MLP.

  6. Tensor scale-based image registration

    NASA Astrophysics Data System (ADS)

    Saha, Punam K.; Zhang, Hui; Udupa, Jayaram K.; Gee, James C.

    2003-05-01

    Tangible solutions to image registration are paramount in longitudinal as well as multi-modal medical imaging studies. In this paper, we introduce tensor scale - a recently developed local morphometric parameter - in rigid image registration. A tensor scale-based registration method incorporates local structure size, orientation and anisotropy into the matching criterion, and therefore, allows efficient multi-modal image registration and holds potential to overcome the effects of intensity inhomogeneity in MRI. Two classes of two-dimensional image registration methods are proposed - (1) that computes angular shift between two images by correlating their tensor scale orientation histogram, and (2) that registers two images by maximizing the similarity of tensor scale features. Results of applications of the proposed methods on proton density and T2-weighted MR brain images of (1) the same slice of the same subject, and (2) different slices of the same subject are presented. The basic superiority of tensor scale-based registration over intensity-based registration is that it may allow the use of local Gestalts formed by the intensity patterns over the image instead of simply considering intensities as isolated events at the pixel level. This would be helpful in dealing with the effects of intensity inhomogeneity and noise in MRI.

  7. Case Studies of Technology-aided Interventions to Promote Hand Reaching and Standing or Basic Ambulation in Persons with Multiple Disabilities.

    PubMed

    Lancioni, Giulio E; Singh, Nirbhay N; O'Reilly, Mark F; Sigafoos, Jeff; Alberti, Gloria; Campodonico, Francesca

    2016-02-01

    Motor impairments such as lack of standing and/or independent ambulation are common among persons with multiple disabilities. These two studies assessed technology-aided programs for persons with those impairments. Specifically, Study I assessed a program to teach two non-ambulatory adults to hand reach a stimulation-linked object by standing up. Study II assessed a program to teach a child and a man to ambulate while holding a rail or following a corridor wall. Standing increased from below 15% to about or over 80% of the session duration in Study I. The participants of Study II managed to complete brief ambulation trials independent of guidance. These performance achievements were discussed in relation to the technology-aided programs employed in the studies and the programs' applicability in daily contexts. PMID:27420316

  8. Interferometric SAR to EO image registration problem

    NASA Astrophysics Data System (ADS)

    Rogers, George W.; Mansfield, Arthur W.; Rais, Houra

    2000-08-01

    Historically, SAR to EO registration accuracy has been at the multiple pixel level compared to sub-pixel EO to EO registration accuracies. This is due to a variety of factors including the different scattering characteristics of the ground for EO and SAR, SAR speckle, and terrain induced geometric distortion. One approach to improving the SAR to EO registration accuracy is to utilize the full information from multiple SAR surveys using interferometric techniques. In this paper we will examine this problem in detail with an example using ERS SAR imagery. Estimates of the resulting accuracy based on ERS are included.

  9. Hitting and missing targets by ambulance services for emergency calls: effects of different systems of performance measurement within the UK

    PubMed Central

    Bevan, Gwyn; Hamblin, Richard

    2009-01-01

    Following devolution, differences developed between UK countries in systems of measuring performance against a common target that ambulance services ought to respond to 75% of calls for what may be immediately life threatening emergencies (category A calls) within 8 minutes. Only in England was this target integral to a ranking system of ‘star rating’, which inflicted reputational damage on services that failed to hit targets, and only in England has this target been met. In other countries, the target has been missed by such large margins that services would have been publicly reported as failing, if they had been covered by the English system of star ratings. The paper argues that this case-study adds to evidence from comparisons of different systems of hospital performance measurement that, to have an effect, these systems need to be designed to inflict reputational damage on those that have performed poorly; and it explores implications of this hypothesis. The paper also asks questions about the adequacy of systems of performance measurement of ambulance services in UK countries. PMID:19381327

  10. Pre-hospital assessment by a single responder: The Swedish ambulance nurse in a new role: A pilot study.

    PubMed

    Magnusson, Carl; Källenius, Christofer; Knutsson, Susanne; Herlitz, Johan; Axelsson, Christer

    2016-05-01

    When a person with vague symptoms calls 112, the dispatchers often have difficulty prioritising the severity of the call. Their only alternative has been to send an ambulance. In Gothenburg, Sweden, a nurse-manned single responder (SR) was initiated to assess this patient group. The study aims to describe patient characteristics and assessment level made by the SR nurse among patients assessed by the dispatcher as low priority and/or vague symptoms. A consecutive journal review was conducted. During six months, 529 patients were assessed; 329 (62%) attended the emergency department (ED) or inpatient care (IC). Of these, 85 patients (26%) were assessed as high priority. Only 108 were assessed as being in need of ambulance transport. ED/IC patients were significantly older. Two hundred (38%) stayed at the scene (SS) (n = 142) or were referred to primary care (PC) (n = 58). Of the 200 SS/PC patients, 38 (19%) attended the ED within 72 hrs with residual symptoms, 20 of whom were admitted to a ward. Nine patients (4% of 200 SS/PC patients) required inpatient treatment and 11 patients stayed overnight for observation. These results suggest a relatively high level of patient safety and the usefulness of an SR among patients assessed by the dispatcher as low priority. PMID:26472522

  11. Reduction in Fatalities, Ambulance Calls, and Hospital Admissions for Road Trauma After Implementation of New Traffic Laws

    PubMed Central

    Chan, Herbert; Brasher, Penelope; Erdelyi, Shannon; Desapriya, Edi; Asbridge, Mark; Purssell, Roy; Macdonald, Scott; Schuurman, Nadine; Pike, Ian

    2014-01-01

    Objectives. We evaluated the public health benefits of traffic laws targeting speeding and drunk drivers (British Columbia, Canada, September 2010). Methods. We studied fatal crashes and ambulance dispatches and hospital admissions for road trauma, using interrupted time series with multiple nonequivalent comparison series. We determined estimates of effect using linear regression models incorporating an autoregressive integrated moving average error term. We used neighboring jurisdictions (Alberta, Saskatchewan, Washington State) as external controls. Results. In the 2 years after implementation of the new laws, significant decreases occurred in fatal crashes (21.0%; 95% confidence interval [CI] = 15.3, 26.4) and in hospital admissions (8.0%; 95% CI = 0.6, 14.9) and ambulance calls (7.2%; 95% CI = 1.1, 13.0) for road trauma. We found a very large reduction in alcohol-related fatal crashes (52.0%; 95% CI = 34.5, 69.5), and the benefits of the new laws are likely primarily the result of a reduction in drinking and driving. Conclusions. These findings suggest that laws calling for immediate sanctions for dangerous drivers can reduce road trauma and should be supported. PMID:25121822

  12. [Ambulance helicopters in the mountains. An evaluation of the 1-year activity at the Dombås base].

    PubMed

    Karper, S; Stokstad, I; Hjort, P F; Indrebø, T

    1991-01-20

    On 1 January 1988 the Norwegian Air Ambulance Plan was put into effect. The operational base for the regional counties Oppland, parts of South Trøndelag, Møre and Romsdal and Hedmark was established in the township of Dombås. The base had a helicopter staffed with a specialist in emergency medicine. The operation of this base was evaluated for the period 1 February 1988 to 1 February 1989. 242 missions were undertaken. In 27 of 184 primary missions (15%) and in 11 of 32 secondary missions (33%) the service was judged to have given health benefit. It may have prevented the death of 13 patients. The service costs during the year were approximately NOK 10 million. The cost-benefit ratio is judged to be too high. In inland-Norway, with a widely scattered population, it is probably better to improve the quality of the emergency services offered by general practitioners and ordinary road ambulances than to use a helicopter staffed with a specialist in emergency medicine.

  13. Burn Functional Outcomes - Ventilator Usage and Discharge Ambulation Status of Patients in a Burn Wound in-Patient Centre.

    PubMed

    Harmon, R L; Mian, M A H; Alam, B; Hassan, Z; Mullins, R F

    2009-12-31

    Anticipating functional outcomes of patients managed in an in-patient burn wound centre can help in advising patients and their families of prognosis as well as assist case managers in discharge planning. The records of 37 burn patients were reviewed; one patient expired and was removed from further analysis. Data were obtained regarding patient characteristics, types and locations of burns and other wounds, ventilator use, level of mobility at hospital discharge, and disposition; three patients lacked discharge ambulation status and were removed from the outcome comparison analysis. Of the 36 patients, 17 had thermal burns and nine (25%) had associated inhalation injuries. Thermal burn patients (p = 0.02), patients requiring ventilator support during their hospital stay (p = 0.04), and those with inhalation injuries (p = 0.04) were less likely to be ambulating independently or with assistance at discharge from the burn wound centre than other patients. This preliminary study suggests that patients with thermal burns and inhalation injuries and those requiring ventilator support were less likely to be ambulatory at hospital discharge. Further studies appear indicated. PMID:21991182

  14. [A statistical analysis of factors influencing standing balance, activity of daily living and ambulation in hemiplegic patients].

    PubMed

    Nogaki, H

    1992-04-01

    This study was undertaken to investigate several factors influencing standing balance, activity of daily living and ambulation in hemiplegic patients after cerebro-vascular diseases. A statistical analysis of 121 hemiplegic patients with unilateral supratentorial lesions showed that age, severity of muscle weakness of involved or uninvolved extremities, unilateral spatial neglect and the sense of toe position had influence on standing balance, activity of daily living or ambulation. The patients were divided into five groups based on the degree of unilateral spatial neglect, evaluated by their copies of two daisies who omitted more than three quarters, three quarters, half, one quarter and none of the figures were defined as the USN-4, USN-3, USN-2, USN-1 and no involvement groups, respectively. Those who belonged to the USN-2 group had significantly lower scores for activity of daily living than those who belonged to the no involvement group. In the USN-2 group, 7 of the 8 patients could not keep standing for 50 seconds, while in the no involvement group, this was the case in only 1 of the 15 patients. Activity of daily living scores or sway area during standing showed no statistically significant differences between the USN-1 and no involvement groups. These results suggested that severe or moderate unilateral spatial neglect is one of the most important factors influencing standing balance and activity of daily living. PMID:1614008

  15. Semiautomated Multimodal Breast Image Registration

    PubMed Central

    Curtis, Charlotte; Frayne, Richard; Fear, Elise

    2012-01-01

    Consideration of information from multiple modalities has been shown to have increased diagnostic power in breast imaging. As a result, new techniques such as microwave imaging continue to be developed. Interpreting these novel image modalities is a challenge, requiring comparison to established techniques such as the gold standard X-ray mammography. However, due to the highly deformable nature of breast tissues, comparison of 3D and 2D modalities is a challenge. To enable this comparison, a registration technique was developed to map features from 2D mammograms to locations in the 3D image space. This technique was developed and tested using magnetic resonance (MR) images as a reference 3D modality, as MR breast imaging is an established technique in clinical practice. The algorithm was validated using a numerical phantom then successfully tested on twenty-four image pairs. Dice's coefficient was used to measure the external goodness of fit, resulting in an excellent overall average of 0.94. Internal agreement was evaluated by examining internal features in consultation with a radiologist, and subjective assessment concludes that reasonable alignment was achieved. PMID:22481910

  16. 28 CFR 811.7 - Initial registration.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... marks or characteristics; (iv) Social security, PDID, DCDC and FBI numbers; (v) Driver's license number... section for initial registration; (ii) Periodically verify the address(es) at which the sex offender...

  17. 40 CFR 68.160 - Registration.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... ACCIDENT PREVENTION PROVISIONS Risk Management Plan § 68.160 Registration. (a) The owner or operator shall... source is subject to 29 CFR 1910.119; (11) Whether the stationary source is subject to 40 CFR part...

  18. 40 CFR 68.160 - Registration.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... ACCIDENT PREVENTION PROVISIONS Risk Management Plan § 68.160 Registration. (a) The owner or operator shall... source is subject to 29 CFR 1910.119; (11) Whether the stationary source is subject to 40 CFR part...

  19. 75 FR 4383 - Pesticide Products: Registration Applications

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-27

    ... AGENCY Pesticide Products: Registration Applications AGENCY: Environmental Protection Agency (EPA). ACTION: Notice. SUMMARY: This notice announces receipt of applications to register pesticide products... comments. Mail: Office of Pesticide Programs (OPP) Regulatory Public Docket (7502P),...

  20. Deformable Medical Image Registration: A Survey

    PubMed Central

    Sotiras, Aristeidis; Davatzikos, Christos; Paragios, Nikos

    2013-01-01

    Deformable image registration is a fundamental task in medical image processing. Among its most important applications, one may cite: i) multi-modality fusion, where information acquired by different imaging devices or protocols is fused to facilitate diagnosis and treatment planning; ii) longitudinal studies, where temporal structural or anatomical changes are investigated; and iii) population modeling and statistical atlases used to study normal anatomical variability. In this paper, we attempt to give an overview of deformable registration methods, putting emphasis on the most recent advances in the domain. Additional emphasis has been given to techniques applied to medical images. In order to study image registration methods in depth, their main components are identified and studied independently. The most recent techniques are presented in a systematic fashion. The contribution of this paper is to provide an extensive account of registration techniques in a systematic manner. PMID:23739795

  1. 76 FR 38160 - Pesticide Products; Registration Applications

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-29

    ... AGENCY Pesticide Products; Registration Applications AGENCY: Environmental Protection Agency (EPA). ACTION: Notice. SUMMARY: EPA has received applications to register pesticide products containing an active ingredient not included in any previously registered pesticide products. Pursuant to...

  2. 75 FR 80490 - Pesticide Products; Registration Applications

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-22

    ... AGENCY Pesticide Products; Registration Applications AGENCY: Environmental Protection Agency (EPA). ACTION: Notice. SUMMARY: EPA has received applications to register pesticide products containing active ingredients not included in any previously registered pesticide products. Pursuant to the provisions...

  3. 75 FR 24694 - Pesticide Products; Registration Applications

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-05

    ... AGENCY Pesticide Products; Registration Applications AGENCY: Environmental Protection Agency (EPA). ACTION: Notice. SUMMARY: EPA has received applications to register pesticide products containing an active ingredient not included in any previously registered pesticide product. Pursuant to the...

  4. 75 FR 32767 - Pesticide Products; Registration Applications

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-09

    ... AGENCY Pesticide Products; Registration Applications AGENCY: Environmental Protection Agency (EPA). ACTION: Notice. SUMMARY: This notice announces receipt of applications to register new uses for pesticide...: Office of Pesticide Programs (OPP) Regulatory Public Docket (7502P), Environmental Protection...

  5. 75 FR 71695 - Pesticide Products; Registration Applications

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-24

    ... AGENCY Pesticide Products; Registration Applications AGENCY: Environmental Protection Agency ACTION: Notice. SUMMARY: EPA has received applications to register new uses for pesticide products containing... Pesticide Programs (OPP) Regulatory Public Docket (7502P), Environmental Protection Agency,...

  6. 77 FR 38285 - Pesticide Products; Registration Applications

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-27

    ... AGENCY Pesticide Products; Registration Applications AGENCY: Environmental Protection Agency (EPA). ACTION: Notice. SUMMARY: This notice announces receipt of applications to register pesticide products...), Office of Pesticide Programs, Environmental Protection Agency, 1200 Pennsylvania Ave. NW., Washington,...

  7. Iterative most likely oriented point registration.

    PubMed

    Billings, Seth; Taylor, Russell

    2014-01-01

    A new algorithm for model based registration is presented that optimizes both position and surface normal information of the shapes being registered. This algorithm extends the popular Iterative Closest Point (ICP) algorithm by incorporating the surface orientation at each point into both the correspondence and registration phases of the algorithm. For the correspondence phase an efficient search strategy is derived which computes the most probable correspondences considering both position and orientation differences in the match. For the registration phase an efficient, closed-form solution provides the maximum likelihood rigid body alignment between the oriented point matches. Experiments by simulation using human femur data demonstrate that the proposed Iterative Most Likely Oriented Point (IMLOP) algorithm has a strong accuracy advantage over ICP and has increased ability to robustly identify a successful registration result.

  8. 21 CFR 56.106 - Registration.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... registration information, in writing, to the Good Clinical Practice Program (HF-34), Office of Science and... to FDA either electronically or in writing in accordance with paragraph (d) of this section....

  9. 27 CFR 25.112 - Dealer registration.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... appropriate TTB officer, will constitute the brewer's registration as a dealer at the brewery. Every brewer... business as a dealer at a location other than the brewery must register and keep records in accordance...

  10. 27 CFR 25.112 - Dealer registration.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... appropriate TTB officer, will constitute the brewer's registration as a dealer at the brewery. Every brewer... business as a dealer at a location other than the brewery must register and keep records in accordance...

  11. 27 CFR 25.112 - Dealer registration.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... appropriate TTB officer, will constitute the brewer's registration as a dealer at the brewery. Every brewer... business as a dealer at a location other than the brewery must register and keep records in accordance...

  12. 27 CFR 25.112 - Dealer registration.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... appropriate TTB officer, will constitute the brewer's registration as a dealer at the brewery. Every brewer... business as a dealer at a location other than the brewery must register and keep records in accordance...

  13. 27 CFR 25.112 - Dealer registration.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... appropriate TTB officer, will constitute the brewer's registration as a dealer at the brewery. Every brewer... business as a dealer at a location other than the brewery must register and keep records in accordance...

  14. BYU's Touch-Tone Telephone Registration System.

    ERIC Educational Resources Information Center

    Rasband, H. Garth; And Others

    1986-01-01

    A voice recognition, voice response registration system used at Brigham Young University is described. System design and implementation, system impact, staff adjustment, student responsibility, freedom and flexibility, system acceptance, and the future outlook are discussed. (MLW)

  15. 27 CFR 53.140 - Registration.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... of selling or purchasing articles tax free as provided in this section. In the case of a nonprofit....141. (e) Cross references. (1) For exceptions to the requirement for registration, see section...

  16. 32 CFR 634.19 - Registration policy.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... solely off the road, are usually not registered as motor vehicles. Installation commanders may require registration of off-road vehicles and bicycles under a separate local system. (c) Commanders can grant...

  17. Automated Registration of MDIM with MOLA Tracks

    NASA Astrophysics Data System (ADS)

    Kim, J. R.; Muller, J.-P.; Morley, J. G.; Mitchell, K. L.

    2001-03-01

    We have developed a method for the automatic registration of MOLA tracks and optical images by means of a crater detection algorithm and a specialised matching function for the photogrammetric DEM creation with MOLA reference using stereo photogrammetric methods.

  18. [A review of international clinical trial registration].

    PubMed

    Yu, He; Liu, Jian-ping

    2007-05-01

    Clinical trials play a critical role in medical research. However, only a few clinical trials conducted at present have been registered at various clinical trial registries. Clinical trial registration can prevent bias in these registered trials effectively and avoid unnecessary waste of resources due to meaningless repeats. Moreover, it will benefit the development of evidence-based medicine, and promote human welfare. Great attention has been paid to the importance and necessity of clinical trial registration. This review briefly introduced the definition, justification, contents, history, current status of clinical trial registration, and introduced the information regarding important international clinical trial registries in detail. Clinical trial registration should be developed toward a transparent, compulsory and comprehensive stage. PMID:17498477

  19. Research relative to automated multisensor image registration

    NASA Technical Reports Server (NTRS)

    Kanal, L. N.

    1983-01-01

    The basic aproaches to image registration are surveyed. Three image models are presented as models of the subpixel problem. A variety of approaches to the analysis of subpixel analysis are presented using these models.

  20. 75 FR 19388 - Pesticide Product; Registration Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-14

    ... AGENCY Pesticide Product; Registration Application AGENCY: Environmental Protection Agency (EPA). ACTION: Notice. SUMMARY: EPA has received an application to register a pesticide product containing an active ingredient not included in any previously registered pesticide products. Pursuant to the provisions...

  1. 40 CFR 68.160 - Registration.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... ACCIDENT PREVENTION PROVISIONS Risk Management Plan § 68.160 Registration. (a) The owner or operator shall... source is subject to 29 CFR 1910.119; (11) Whether the stationary source is subject to 40 CFR part...

  2. Automated Image Registration for the Future (Invited)

    NASA Astrophysics Data System (ADS)

    Hack, W. J.

    2008-08-01

    A primary problem facing all surveys or archives of astronomical images remains the automated registration of the images. Images often have pointing errors not accounted for in their headers or metadata, errors which need to be removed in order to successfully combine them into a single, deeper, more scientifically valuable product. The primary techniques rely on either matching catalogs of positions or performing cross-correlation on images. Each of these techniques can only be applied successfully to limited sets of astronomical data. This talk will review the primary techniques currently used for image registration and identify their most obvious limitations for use in automated registration. A new algorithm merging the best of these techniques with a proven technique developed outside of astronomy will be explored as an example of a new paradigm for solving the problem of automated and robust image registration.

  3. 40 CFR 152.42 - Application for new registration.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 23 2010-07-01 2010-07-01 false Application for new registration. 152... for new registration. Any person seeking to obtain a registration for a new pesticide product must... for new registration must be approved by the Agency before the product may legally be distributed...

  4. 14 CFR 47.16 - Temporary registration numbers.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false Temporary registration numbers. 47.16 Section 47.16 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRCRAFT REGISTRATION General § 47.16 Temporary registration numbers. (a) Temporary registration...

  5. 32 CFR 1615.7 - Evidence of registration.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... National Defense Other Regulations Relating to National Defense SELECTIVE SERVICE SYSTEM ADMINISTRATION OF REGISTRATION § 1615.7 Evidence of registration. The Director of Selective Service Shall issue to each registrant written evidence of his registration. The Director of Selective Service will replace that...

  6. 32 CFR 1615.7 - Evidence of registration.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... National Defense Other Regulations Relating to National Defense SELECTIVE SERVICE SYSTEM ADMINISTRATION OF REGISTRATION § 1615.7 Evidence of registration. The Director of Selective Service Shall issue to each registrant written evidence of his registration. The Director of Selective Service will replace that...

  7. 32 CFR 1615.7 - Evidence of registration.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... National Defense Other Regulations Relating to National Defense SELECTIVE SERVICE SYSTEM ADMINISTRATION OF REGISTRATION § 1615.7 Evidence of registration. The Director of Selective Service Shall issue to each registrant written evidence of his registration. The Director of Selective Service will replace that...

  8. 32 CFR 1615.7 - Evidence of registration.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... National Defense Other Regulations Relating to National Defense SELECTIVE SERVICE SYSTEM ADMINISTRATION OF REGISTRATION § 1615.7 Evidence of registration. The Director of Selective Service Shall issue to each registrant written evidence of his registration. The Director of Selective Service will replace that...

  9. 32 CFR 1615.7 - Evidence of registration.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... National Defense Other Regulations Relating to National Defense SELECTIVE SERVICE SYSTEM ADMINISTRATION OF REGISTRATION § 1615.7 Evidence of registration. The Director of Selective Service Shall issue to each registrant written evidence of his registration. The Director of Selective Service will replace that...

  10. 40 CFR 155.42 - Registration review cases.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... existing registration review case or to a new registration review case. (3) A pesticide product that... Agency will close a registration review case if all products in the case are canceled. (d) Establishing a... 40 Protection of Environment 23 2010-07-01 2010-07-01 false Registration review cases....

  11. 22 CFR 203.9 - Denial of registration.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Denial of registration. 203.9 Section 203.9 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT REGISTRATION OF PRIVATE VOLUNTARY ORGANIZATIONS (PVOs) § 203.9 Denial of registration. (a) Notification of denial of registration. Denial...

  12. 22 CFR 203.6 - IPVO conditions of registration.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 1 2011-04-01 2011-04-01 false IPVO conditions of registration. 203.6 Section 203.6 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT REGISTRATION OF PRIVATE VOLUNTARY ORGANIZATIONS (PVOs) § 203.6 IPVO conditions of registration. There are eight Conditions of Registration...

  13. 22 CFR 203.9 - Denial of registration.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Denial of registration. 203.9 Section 203.9 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT REGISTRATION OF PRIVATE VOLUNTARY ORGANIZATIONS (PVOs) § 203.9 Denial of registration. (a) Notification of denial of registration. Denial...

  14. 22 CFR 203.10 - Termination of registration.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Termination of registration. 203.10 Section 203.10 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT REGISTRATION OF PRIVATE VOLUNTARY ORGANIZATIONS (PVOs) § 203.10 Termination of registration. (a) Reasons. USAID may terminate registration for...

  15. 22 CFR 203.10 - Termination of registration.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Termination of registration. 203.10 Section 203.10 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT REGISTRATION OF PRIVATE VOLUNTARY ORGANIZATIONS (PVOs) § 203.10 Termination of registration. (a) Reasons. USAID may terminate registration for...

  16. 47 CFR 1.8001 - FCC Registration Number (FRN).

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 1 2010-10-01 2010-10-01 false FCC Registration Number (FRN). 1.8001 Section 1.8001 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE FCC Registration Number § 1.8001 FCC Registration Number (FRN). (a) The FCC Registration Number (FRN) is a...

  17. 17 CFR 49.6 - Registration of successor entities.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... registration on Form SDR, and the predecessor files a request for vacation of registration on Form SDR provided... after the application for registration on Form SDR is filed by the successor swap data repository. (b... succession, amend the registration of the predecessor swap data repository on Form SDR to reflect...

  18. 17 CFR 49.6 - Registration of successor entities.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... registration on Form SDR, and the predecessor files a request for vacation of registration on Form SDR provided... after the application for registration on Form SDR is filed by the successor swap data repository. (b... succession, amend the registration of the predecessor swap data repository on Form SDR to reflect...

  19. 18 CFR 390.2 - Activities requiring registration.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 18 Conservation of Power and Water Resources 1 2014-04-01 2014-04-01 false Activities requiring registration. 390.2 Section 390.2 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY PROCEDURAL RULES ELECTRONIC REGISTRATION § 390.2 Activities requiring registration. (a) Electronic registration is...

  20. 37 CFR 7.22 - Recording changes to international registration.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... international registration. 7.22 Section 7.22 Patents, Trademarks, and Copyrights UNITED STATES PATENT AND... THE MADRID AGREEMENT CONCERNING THE INTERNATIONAL REGISTRATION OF MARKS Recording Changes to International Registration § 7.22 Recording changes to international registration. Except as provided in §§...

  1. 37 CFR 7.22 - Recording changes to international registration.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... international registration. 7.22 Section 7.22 Patents, Trademarks, and Copyrights UNITED STATES PATENT AND... THE MADRID AGREEMENT CONCERNING THE INTERNATIONAL REGISTRATION OF MARKS Recording Changes to International Registration § 7.22 Recording changes to international registration. Except as provided in §§...

  2. 37 CFR 7.22 - Recording changes to international registration.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... international registration. 7.22 Section 7.22 Patents, Trademarks, and Copyrights UNITED STATES PATENT AND... THE MADRID AGREEMENT CONCERNING THE INTERNATIONAL REGISTRATION OF MARKS Recording Changes to International Registration § 7.22 Recording changes to international registration. Except as provided in §§...

  3. 22 CFR 122.2 - Submission of registration statement.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Submission of registration statement. 122.2 Section 122.2 Foreign Relations DEPARTMENT OF STATE INTERNATIONAL TRAFFIC IN ARMS REGULATIONS REGISTRATION...) who has been empowered by the intended registrant to sign such documents. The intended registrant...

  4. 28 CFR 10.2 - Language of registration statement.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... ON ACTIVITIES WITHIN THE UNITED STATES Registration Statement § 10.2 Language of registration statement. Registration statements must be in English if possible. If in a foreign language they must be... 28 Judicial Administration 1 2014-07-01 2014-07-01 false Language of registration statement....

  5. 28 CFR 10.2 - Language of registration statement.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... ON ACTIVITIES WITHIN THE UNITED STATES Registration Statement § 10.2 Language of registration statement. Registration statements must be in English if possible. If in a foreign language they must be... 28 Judicial Administration 1 2012-07-01 2012-07-01 false Language of registration statement....

  6. 28 CFR 10.2 - Language of registration statement.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 28 Judicial Administration 1 2011-07-01 2011-07-01 false Language of registration statement. 10.2... ON ACTIVITIES WITHIN THE UNITED STATES Registration Statement § 10.2 Language of registration statement. Registration statements must be in English if possible. If in a foreign language they must...

  7. 28 CFR 10.2 - Language of registration statement.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Language of registration statement. 10.2... ON ACTIVITIES WITHIN THE UNITED STATES Registration Statement § 10.2 Language of registration statement. Registration statements must be in English if possible. If in a foreign language they must...

  8. Registration and Marking Requirements for UAS. Unmanned Aircraft System (UAS) Registration

    NASA Technical Reports Server (NTRS)

    2005-01-01

    The registration of an aircraft is a prerequisite for issuance of a U.S. certificate of airworthiness by the FAA. The procedures and requirements for aircraft registration, and the subsequent issuance of registration numbers, are contained in FAR Part 47. However, the process/method(s) for applying the requirements of Parts 45 & 47 to Unmanned Aircraft Systems (UAS) has not been defined. This task resolved the application of 14 CFR Parts 45 and 47 to UAS. Key Findings: UAS are aircraft systems and as such the recommended approach to registration is to follow the same process for registration as manned aircraft. This will require manufacturers to comply with the requirements for 14 CFR 47, Aircraft Registration and 14 CFR 45, Identification and Registration Marking. In addition, only the UA should be identified with the N number registration markings. There should also be a documentation link showing the applicability of the control station and communication link to the UA. The documentation link can be in the form of a Type Certificate Data Sheet (TCDS) entry or a UAS logbook entry. The recommended process for the registration of UAS is similar to the manned aircraft process and is outlined in a 6-step process in the paper.

  9. 21 CFR 1309.25 - Temporary exemption from registration for chemical registration applicants.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... distribute, import, or export a combination ephedrine product is temporarily exempted from the registration... or import prescription drug products containing ephedrine, pseudoephedrine, or phenylpropanolamine...

  10. 21 CFR 1309.25 - Temporary exemption from registration for chemical registration applicants.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... distribute, import, or export a combination ephedrine product is temporarily exempted from the registration... or import prescription drug products containing ephedrine, pseudoephedrine, or phenylpropanolamine...

  11. 21 CFR 1309.25 - Temporary exemption from registration for chemical registration applicants.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... distribute, import, or export a combination ephedrine product is temporarily exempted from the registration... or import prescription drug products containing ephedrine, pseudoephedrine, or phenylpropanolamine...

  12. 21 CFR 1309.25 - Temporary exemption from registration for chemical registration applicants.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... distribute, import, or export a combination ephedrine product is temporarily exempted from the registration... or import prescription drug products containing ephedrine, pseudoephedrine, or phenylpropanolamine...

  13. 21 CFR 1309.25 - Temporary exemption from registration for chemical registration applicants.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... distribute, import, or export a combination ephedrine product is temporarily exempted from the registration... or import prescription drug products containing ephedrine, pseudoephedrine, or phenylpropanolamine...

  14. A survey of medical image registration - under review.

    PubMed

    Viergever, Max A; Maintz, J B Antoine; Klein, Stefan; Murphy, Keelin; Staring, Marius; Pluim, Josien P W

    2016-10-01

    A retrospective view on the past two decades of the field of medical image registration is presented, guided by the article "A survey of medical image registration" (Maintz and Viergever, 1998). It shows that the classification of the field introduced in that article is still usable, although some modifications to do justice to advances in the field would be due. The main changes over the last twenty years are the shift from extrinsic to intrinsic registration, the primacy of intensity-based registration, the breakthrough of nonlinear registration, the progress of inter-subject registration, and the availability of generic image registration software packages. Two problems that were called urgent already 20 years ago, are even more urgent nowadays: Validation of registration methods, and translation of results of image registration research to clinical practice. It may be concluded that the field of medical image registration has evolved, but still is in need of further development in various aspects.

  15. RRS: Replica Registration Service for Data Grids

    SciTech Connect

    Shoshani, Arie; Sim, Alex; Stockinger, Kurt

    2005-07-15

    Over the last few years various scientific experiments and Grid projects have developed different catalogs for keeping track of their data files. Some projects use specialized file catalogs, others use distributed replica catalogs to reference files at different locations. Due to this diversity of catalogs, it is very hard to manage files across Grid projects, or to replace one catalog with another. In this paper we introduce a new Grid service called the Replica Registration Service (RRS). It can be thought of as an abstraction of the concepts for registering files and their replicas. In addition to traditional single file registration operations, the RRS supports collective file registration requests and keeps persistent registration queues. This approach is of particular importance for large-scale usage where thousands of files are copied and registered. Moreover, the RRS supports a set of error directives that are triggered in case of registration failures. Our goal is to provide a single uniform interface for various file catalogs to support the registration of files across multiple Grid projects, and to make Grid clients oblivious to the specific catalog used.

  16. THE ESTABLISHMENT OF CIVIL REGISTRATION IN SCOTLAND*

    PubMed Central

    CAMERON, ANNE

    2008-01-01

    An act for registering births, deaths, and marriages was passed for England and Wales in 1836. Scotland, despite evident support for the principle of civil registration there, did not obtain equivalent legislation until 1854 – a paradox that has yet to be fully explained. Eight unsuccessful bills preceded the Scottish act, and this article explores the reasons for their failure. Although the Scottish churches and municipal authorities broadly favoured vital registration, their objections to particular clauses concerning the nomination and payment of registrars, the imposition of fees for registration and penalties for non-registration, and the provision of new administrative facilities, repeatedly impeded the bills’ progress through parliament. More importantly, four of the bills were linked to measures for reforming the marriage law, which were so offensive to Scottish sensibilities that the registration bills were damned by association. Only by altering these contentious clauses and eschewing any interference with the law of marriage did Lord Elcho’s bill of 1854 succeed. The lengthy gestational period preceding the Scottish legislation did, however, result in the compulsory registration of births and deaths, unlike in England, and secured a greater breadth of detail in the Scottish registers. PMID:18978952

  17. Automatic initialization for 3D bone registration

    NASA Astrophysics Data System (ADS)

    Foroughi, Pezhman; Taylor, Russell H.; Fichtinger, Gabor

    2008-03-01

    In image-guided bone surgery, sample points collected from the surface of the bone are registered to the preoperative CT model using well-known registration methods such as Iterative Closest Point (ICP). These techniques are generally very sensitive to the initial alignment of the datasets. Poor initialization significantly increases the chances of getting trapped local minima. In order to reduce the risk of local minima, the registration is manually initialized by locating the sample points close to the corresponding points on the CT model. In this paper, we present an automatic initialization method that aligns the sample points collected from the surface of pelvis with CT model of the pelvis. The main idea is to exploit a mean shape of pelvis created from a large number of CT scans as the prior knowledge to guide the initial alignment. The mean shape is constant for all registrations and facilitates the inclusion of application-specific information into the registration process. The CT model is first aligned with the mean shape using the bilateral symmetry of the pelvis and the similarity of multiple projections. The surface points collected using ultrasound are then aligned with the pelvis mean shape. This will, in turn, lead to initial alignment of the sample points with the CT model. The experiments using a dry pelvis and two cadavers show that the method can align the randomly dislocated datasets close enough for successful registration. The standard ICP has been used for final registration of datasets.

  18. Deformable registration using scale space keypoints

    NASA Astrophysics Data System (ADS)

    Moradi, Mehdi; Abolmaesoumi, Purang; Mousavi, Parvin

    2006-03-01

    In this paper, we describe a new methodology for keypoint-based affine and deformable medical image registration. This fast and computationally efficient method is automatic and does not rely on segmentation of images. The keypoint pixels used in this technique are extreme points in the scale space and are characterized by descriptor vectors which summarize the intensity gradient profile of the surrounding pixels. For each of the keypoints in the scene image, a corresponding keypoint is identified in the model image using the feature space nearest neighbor criteria. For deformable registration, B-splines are used to extrapolate a regular deformation grid for all of the pixels in the scene image based on the relative displacement vectors of the corresponding pairs. This approach results in a fast and accurate registration in the brain MRI images (an average target registration error of less than 2mm was acquired). We have also studied the affine registration problem in the liver ultrasound and brain MRI images and have acquired acceptable registrations using a mean square solution for affine parameters based on only around 30 corresponding keypoint pairs.

  19. Wearable seismocardiography: towards a beat-by-beat assessment of cardiac mechanics in ambulant subjects.

    PubMed

    Di Rienzo, M; Vaini, E; Castiglioni, P; Merati, G; Meriggi, P; Parati, G; Faini, A; Rizzo, F

    2013-11-01

    Seismocardiogram (SCG) is the measure of the micro-vibrations produced by the heart contraction and blood ejection into the vascular tree. Over time, a large body of evidence has been collected on the ability of SCG to reflect cardiac mechanical events such as opening and closure of mitral and aortic valves, atrial filling and point of maximal aortic blood ejection. We recently developed a smart garment, named MagIC-SCG, that allows the monitoring of SCG, electrocardiogram (ECG) and respiration out of the laboratory setting in ambulant subjects. The present pilot study illustrates the results of two different experiments performed to obtain a first evaluation on whether a dynamical assessment of indexes of cardiac mechanics can be obtained from SCG recordings obtained by MagIC-SCG. In the first experiment, we evaluated the consistency of the estimates of two indexes of cardiac contractility, the pre-ejection period, PEP, and the left ventricular ejection time, LVET. This was done in the lab, by reproducing an experimental protocol well known in literature, so that our measures derived from SCG could have been compared with PEP and LVET reference values obtained by traditional techniques. Six healthy subjects worn MagIC-SCG while assuming two different postures (supine and standing); PEP was estimated as the time interval between the Q wave in ECG and the SCG wave corresponding to the opening of aortic valve; LVET was the time interval between the SCG waves corresponding to the opening and closure of the aortic valve. The shift from supine to standing posture produced a significant increase in PEP and PEP/LVET ratio, a reduction in LVET and a concomitant rise in the LF/HF ratio in the RR interval (RRI) power spectrum. These results are in line with data available in literature thus providing a first support to the validity of our estimates. In the second experiment, we evaluated in one subject the feasibility of the beat-by-beat assessment of LVET during spontaneous

  20. 17 CFR 240.6a-1 - Application for registration as a national securities exchange or exemption from registration...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... as a national securities exchange or exemption from registration based on limited volume. 240.6a-1... national securities exchange or exemption from registration based on limited volume. (a) An application for registration as a national securities exchange, or for exemption from such registration based on limited...

  1. 17 CFR 240.6a-1 - Application for registration as a national securities exchange or exemption from registration...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... as a national securities exchange or exemption from registration based on limited volume. 240.6a-1... national securities exchange or exemption from registration based on limited volume. (a) An application for registration as a national securities exchange, or for exemption from such registration based on limited...

  2. 17 CFR 240.6a-1 - Application for registration as a national securities exchange or exemption from registration...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... as a national securities exchange or exemption from registration based on limited volume. 240.6a-1... national securities exchange or exemption from registration based on limited volume. (a) An application for registration as a national securities exchange, or for exemption from such registration based on limited...

  3. 17 CFR 240.6a-1 - Application for registration as a national securities exchange or exemption from registration...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... as a national securities exchange or exemption from registration based on limited volume. 240.6a-1... national securities exchange or exemption from registration based on limited volume. (a) An application for registration as a national securities exchange, or for exemption from such registration based on limited...

  4. 17 CFR 240.6a-1 - Application for registration as a national securities exchange or exemption from registration...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... as a national securities exchange or exemption from registration based on limited volume. 240.6a-1... national securities exchange or exemption from registration based on limited volume. (a) An application for registration as a national securities exchange, or for exemption from such registration based on limited...

  5. TU-B-19A-01: Image Registration II: TG132-Quality Assurance for Image Registration

    SciTech Connect

    Brock, K; Mutic, S

    2014-06-15

    AAPM Task Group 132 was charged with a review of the current approaches and solutions for image registration in radiotherapy and to provide recommendations for quality assurance and quality control of these clinical processes. As the results of image registration are always used as the input of another process for planning or delivery, it is important for the user to understand and document the uncertainty associate with the algorithm in general and the Result of a specific registration. The recommendations of this task group, which at the time of abstract submission are currently being reviewed by the AAPM, include the following components. The user should understand the basic image registration techniques and methods of visualizing image fusion. The disclosure of basic components of the image registration by commercial vendors is critical in this respect. The physicists should perform end-to-end tests of imaging, registration, and planning/treatment systems if image registration is performed on a stand-alone system. A comprehensive commissioning process should be performed and documented by the physicist prior to clinical use of the system. As documentation is important to the safe implementation of this process, a request and report system should be integrated into the clinical workflow. Finally, a patient specific QA practice should be established for efficient evaluation of image registration results. The implementation of these recommendations will be described and illustrated during this educational session. Learning Objectives: Highlight the importance of understanding the image registration techniques used in their clinic. Describe the end-to-end tests needed for stand-alone registration systems. Illustrate a comprehensive commissioning program using both phantom data and clinical images. Describe a request and report system to ensure communication and documentation. Demonstrate an clinically-efficient patient QA practice for efficient evaluation of image

  6. Factors Associated With Incidence of "?Inappropriate"? Ambulance Transport in Rural Areas in Cases of Moderate to Severe Head Injury in Children

    ERIC Educational Resources Information Center

    Poltavski, Dmitri; Muus, Kyle

    2005-01-01

    Context: Ambulance transport of pediatric trauma patients to designated trauma centers in cases of moderate and severe injury is not always performed, which has been shown to result in poor treatment outcomes. Determination of factors involved in inappropriate patient transport, especially in rural areas, remains an important avenue of research.…

  7. Factors Associated with Incidence of "Inappropriate" Ambulance Transport in Rural Areas in Cases of Moderate to Severe Head Injury in Children

    ERIC Educational Resources Information Center

    Poltavski, Dmitri; Muus, Kyle

    2005-01-01

    Context: Ambulance transport of pediatric trauma patients to designated trauma centers in cases of moderate and severe injury is not always performed, which has been shown to result in poor treatment outcomes. Determination of factors involved in inappropriate patient transport, especially in rural areas, remains an important avenue of research.…

  8. 21 CFR 1301.36 - Suspension or revocation of registration; suspension of registration pending final order...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... international treaties, conventions, or protocols in effect on October 12, 1984. (c) The Administrator may limit... shall immediately deliver his/her Certificate of Registration, any order forms, and any import or export... the registrant pursuant to part 1303 of this chapter and any import or export permits issued to...

  9. 16 CFR 1130.8 - Requirements for Web site registration or alternative e-mail registration.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... not need to fill out the card that came with your product.” (c) Content of registration page. The Web... information shall appear on the electronic registration form, except for identification of the manufacturer or... when scanned would provide a direct link for the consumer to register the product. (2) Such a link...

  10. 21 CFR 1309.42 - Certificate of registration; denial of registration.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 9 2013-04-01 2013-04-01 false Certificate of registration; denial of registration. 1309.42 Section 1309.42 Food and Drugs DRUG ENFORCEMENT ADMINISTRATION, DEPARTMENT OF JUSTICE... Administration or of any Federal, State, or local agency engaged in enforcement of laws relating to List...

  11. 16 CFR 1130.8 - Requirements for Web site registration or alternative e-mail registration.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... alternative e-mail registration. 1130.8 Section 1130.8 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION... PRODUCTS (Eff. June 28, 2010) § 1130.8 Requirements for Web site registration or alternative e-mail... number, e-mail address, product model name and number, and the date of manufacture. The...

  12. 40 CFR 154.21 - Preliminary notification to registrants and applicants for registration.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 23 2010-07-01 2010-07-01 false Preliminary notification to registrants and applicants for registration. 154.21 Section 154.21 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) PESTICIDE PROGRAMS SPECIAL REVIEW PROCEDURES Procedures § 154.21...

  13. 40 CFR 154.21 - Preliminary notification to registrants and applicants for registration.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 25 2012-07-01 2012-07-01 false Preliminary notification to registrants and applicants for registration. 154.21 Section 154.21 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) PESTICIDE PROGRAMS SPECIAL REVIEW PROCEDURES Procedures § 154.21...

  14. 40 CFR 154.21 - Preliminary notification to registrants and applicants for registration.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 24 2011-07-01 2011-07-01 false Preliminary notification to registrants and applicants for registration. 154.21 Section 154.21 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) PESTICIDE PROGRAMS SPECIAL REVIEW PROCEDURES Procedures § 154.21...

  15. Real-Time Human Ambulation, Activity, and Physiological Monitoring: Taxonomy of Issues, Techniques, Applications, Challenges and Limitations

    PubMed Central

    Khusainov, Rinat; Azzi, Djamel; Achumba, Ifeyinwa E.; Bersch, Sebastian D.

    2013-01-01

    Automated methods of real-time, unobtrusive, human ambulation, activity, and wellness monitoring and data analysis using various algorithmic techniques have been subjects of intense research. The general aim is to devise effective means of addressing the demands of assisted living, rehabilitation, and clinical observation and assessment through sensor-based monitoring. The research studies have resulted in a large amount of literature. This paper presents a holistic articulation of the research studies and offers comprehensive insights along four main axes: distribution of existing studies; monitoring device framework and sensor types; data collection, processing and analysis; and applications, limitations and challenges. The aim is to present a systematic and most complete study of literature in the area in order to identify research gaps and prioritize future research directions. PMID:24072027

  16. Phylogenetic position of Rhynchopus sp. and Diplonema ambulator as indicated by analyses of euglenozoan small subunit ribosomal DNA.

    PubMed

    Busse, I; Preisfeld, Angelika

    2002-02-01

    The taxa Rhynchopus Skuja and Diplonema Griessmann were first described as remarkable protists with euglenid affinities. Later on, the placement of Diplonema within the Euglenozoa was confirmed by molecular data. For this study two new sequences were added to the euglenozoan data set. The uncertainly placed Rhynchopus can be identified as a close relative to Diplonema by small subunit ribosomal DNA (SSU rDNA) analysis. The new sequence of Diplonema ambulator is in close relationship to two other Diplonema species. Our molecular analyses clearly support the monophyly of the diplonemids comprising Rhynchopus and Diplonema. Yet the topology at the base of the euglenozoan tree remains unresolved, and especially the monophyly of the euglenids is arguable. SSU rDNA sequence analyses suggest that significantly different GC contents, high mutational saturation in the euglenids, and different evolutionary rates in the euglenozoan clades make it difficult to identify any sister group to the diplonemids.

  17. Out-of-hospital cardiac arrest due to coronary heart disease: a comparison of survival before and after the introduction of defribrillators in ambulances.

    PubMed Central

    Leslie, W. S.; Fitzpatrick, B.; Morrison, C. E.; Watt, G. C.; Tunstall-Pedoe, H.

    1996-01-01

    OBJECTIVE: To assess the actual impact on coronary mortality of equipping ambulances with defibrillators. DESIGN: Retrospective analysis of routine medical and legal records of all those who had a cardiac arrest attributed to coronary heart disease occurring outside hospital in a defined population before and after the introduction of Heartstart. SETTING: City of Glasgow, North of the River Clyde, 1984 and 1990. PATIENTS: 296 and 267 men and women aged 25-64 inclusive in 1984 and 1990 respectively who had a cardiac arrest outside hospital which was attributed to coronary heart disease (International Classification of Diseases codes 410-414, ninth revision). RESULTS: The impact on coronary mortality in 1990 of equipping ambulances with defibrillators concurred with the earlier prediction of less than 1% of all coronary deaths. The circumstances of cardiac arrest were largely unchanged; most occurred outside hospital in the victim's home and the principal witnesses were members of the victim's family. A call for help before cardiac arrest was made in very few cases and cardiopulmonary resuscitation was attempted by laypersons in less than a third of the deaths they witnessed. There was a significant increase in the number of cardiopulmonary resuscitation attempts made by ambulance crews (16% v 32%, P < 0.01). Ambulance crews, however, still attended less than half of all cases (44% and 47%). CONCLUSION: The impact of equipping ambulances with defibrillators will remain small unless strategies are introduced that focus on improving the public's response to coronary emergencies by calling for help promptly and initiating cardiopulmonary resuscitation before the arrival of the emergency services. PMID:8673761

  18. Effect evaluation of a heated ambulance mattress-prototype on body temperatures and thermal comfort - an experimental study

    PubMed Central

    2014-01-01

    Background Exposure to cold temperatures is, often, a neglected problem in prehospital care. One of the leading influences of the overall sensation of cold discomfort is the cooling of the back. The aim of this study was to evaluate the effect of a heated ambulance mattress-prototype on body temperatures and thermal comfort in an experimental study. Method Data were collected during four days in November, 2011 inside and outside of a cold chamber. All participants (n = 23) participated in two trials each. In one trial, they were lying on a stretcher with a supplied heated mattress and in the other trial without a heated mattress. Outcomes were back temperature, finger temperature, core body temperature, Cold Discomfort Scale (CDS), four statements from the state-trait anxiety – inventory (STAI), and short notes of their experiences of the two mattresses. Data were analysed both quantitatively and qualitatively. A repeated measure design was used to evaluate the effect of the two mattresses. Results A statistical difference between the regular mattress and the heated mattress was found in the back temperature. In the heated mattress trial, the statement “I am tense” was fewer whereas the statements “I feel comfortable”, “I am relaxed” and “I feel content” were higher in the heated mattress trial. The qualitative analyses of the short notes showed that the heated mattress, when compared to the unheated mattress, was experienced as warm, comfortable, providing security and was easier to relax on. Conclusions Heat supply from underneath the body results in increased comfort and may prevent hypothermia which is important for injured and sick patients in ambulance care. PMID:25103366

  19. Effects of a novel cholinergic M1 agonist, AF102B, on ambulation and water drinking behavior in rats.

    PubMed

    Togashi, H; Matsumoto, M; Yoshioka, M; Saito, Y; Saito, H

    1991-01-01

    Effects of a novel M1 agonist, AF102B (cis-2-methylspiro(1,3-oxathiolane-5,3')quinuclidine HCl), on ambulation and water drinking behavior were examined using an Ambulo-Drinkometer. AF64A-treated rats, an animal model for senile dementia of the Alzheimer type (SDAT), and non-treated control rats were used. AF102B was administered orally via tap water at a concentration of 0.01% and 0.1% for an experimental therapeutic dose and a supramaximal dose, respectively. Four-week administration of 0.01% AF102B did not affect either ambulatory activity or water drinking activity in non-treated rats. Successive 0.1% AF102B administration for 4 weeks produced a significant decrease in drinking activity as compared with non-treated control rats. In AF64A-treated rats, AF102B did not change the cholinotoxin AF64A-induced high activity in ambulation. However, a decrease in water drinking activity was observed after 0.1% AF102B administration, as in non-treated rats. These results suggest that therapeutic dose of AF102B do not produce any changes in the spontaneous moter activity and water drinking behavior in normal rats or the animal model for SDAT. Several investigators reported that AF102B (FSK-508; cis-2-methylspiro (1,3-oxathiolane-5,3') quinuclidine HCl) had the property of a relatively specific muscarinic agonist of the M1-type This novel M1 agonist, AF102B, also exerted and ameliorating effect on experimental amnesia; in a T-maze, radial-arm maze task and passive avoidance tasks. AF102B improves the cognitive impairment in various animal models for memory disorders including senile dementia of the Alzheimer type (SDAT). Based on these observations, AF102B has been proposed for the treatment of SDAT.(ABSTRACT TRUNCATED AT 250 WORDS)

  20. Mass preserving registration for lung CT

    NASA Astrophysics Data System (ADS)

    Gorbunova, Vladlena; Lo, Pechin; Loeve, Martine; Tiddens, Harm A.; Sporring, Jon; Nielsen, Mads; de Bruijne, Marleen

    2009-02-01

    In this paper, we evaluate a novel image registration method on a set of expiratory-inspiratory pairs of computed tomography (CT) lung scans. A free-form multi resolution image registration technique is used to match two scans of the same subject. To account for the differences in the lung intensities due to differences in inspiration level, we propose to adjust the intensity of lung tissue according to the local expansion or compression. An image registration method without intensity adjustment is compared to the proposed method. Both approaches are evaluated on a set of 10 pairs of expiration and inspiration CT scans of children with cystic fibrosis lung disease. The proposed method with mass preserving adjustment results in significantly better alignment of the vessel trees. Analysis of local volume change for regions with trapped air compared to normally ventilated regions revealed larger differences between these regions in the case of mass preserving image registration, indicating that mass preserving registration is better at capturing localized differences in lung deformation.

  1. Onboard Image Registration from Invariant Features

    NASA Technical Reports Server (NTRS)

    Wang, Yi; Ng, Justin; Garay, Michael J.; Burl, Michael C

    2008-01-01

    This paper describes a feature-based image registration technique that is potentially well-suited for onboard deployment. The overall goal is to provide a fast, robust method for dynamically combining observations from multiple platforms into sensors webs that respond quickly to short-lived events and provide rich observations of objects that evolve in space and time. The approach, which has enjoyed considerable success in mainstream computer vision applications, uses invariant SIFT descriptors extracted at image interest points together with the RANSAC algorithm to robustly estimate transformation parameters that relate one image to another. Experimental results for two satellite image registration tasks are presented: (1) automatic registration of images from the MODIS instrument on Terra to the MODIS instrument on Aqua and (2) automatic stabilization of a multi-day sequence of GOES-West images collected during the October 2007 Southern California wildfires.

  2. A multicore based parallel image registration method.

    PubMed

    Yang, Lin; Gong, Leiguang; Zhang, Hong; Nosher, John L; Foran, David J

    2009-01-01

    Image registration is a crucial step for many image-assisted clinical applications such as surgery planning and treatment evaluation. In this paper we proposed a landmark based nonlinear image registration algorithm for matching 2D image pairs. The algorithm was shown to be effective and robust under conditions of large deformations. In landmark based registration, the most important step is establishing the correspondence among the selected landmark points. This usually requires an extensive search which is often computationally expensive. We introduced a nonregular data partition algorithm using the K-means clustering algorithm to group the landmarks based on the number of available processing cores. The step optimizes the memory usage and data transfer. We have tested our method using IBM Cell Broadband Engine (Cell/B.E.) platform. PMID:19964921

  3. Effects of a Public Education Campaign on the Association Between Knowledge of Early Stroke Symptoms and Intention to Call an Ambulance at Stroke Onset: The Acquisition of Stroke Knowledge (ASK) Study

    PubMed Central

    Nishikawa, Tomofumi; Okamura, Tomonori; Nakayama, Hirofumi; Miyamatsu, Naomi; Morimoto, Akiko; Toyoda, Kazunori; Suzuki, Kazuo; Toyota, Akihiro; Hata, Takashi; Yamaguchi, Takenori

    2016-01-01

    Background An immediate ambulance call offers the greatest opportunity for acute stroke therapy. Effectively using ambulance services requires strengthening the association between knowledge of early stroke symptoms and intention to call an ambulance at stroke onset, and encouraging the public to use ambulance services. Methods The present study utilized data from the Acquisition of Stroke Knowledge (ASK) study, which administered multiple-choice, mail-in surveys regarding awareness of early stroke symptoms and response to a stroke attack before and after a 2-year stroke education campaign in two areas subject to intensive and moderate intervention, as well as in a control area, in Japan. In these three areas, 3833 individuals (1680, 1088 and 1065 participants in intensive intervention, moderate intervention, and control areas, respectively), aged 40 to 74 years, who responded appropriately to each survey were included in the present study. Results After the intervention, the number of correctly identified symptoms significantly associated with intention to call an ambulance (P < 0.05) increased (eg, from 4 to 5 correctly identified symptoms), without increasing choice of decoy symptoms in the intensive intervention area. Meanwhile, in other areas, rate of identification of not only correct symptoms but also decoy symptoms associated with intention to call an ambulance increased. Furthermore, the association between improvement in the knowledge of stroke symptoms and intention to call an ambulance was observed only in the intensive intervention area (P = 0.009). Conclusions Our results indicate that intensive interventions are useful for strengthening the association between correct knowledge of early stroke symptoms and intention to call an ambulance, without strengthening the association between incorrect knowledge and intention to call an ambulance. PMID:26441211

  4. Laser interrogation of latent vehicle registration number

    SciTech Connect

    Russo, R.E. |; Pelkey, G.E.; Grant, P.; Whipple, R.E.; Andresen, B.D.

    1994-09-01

    A recent investigation involved automobile registration numbers as important evidentiary specimens. In California, as in most states, small, thin metallic decals are issued to owners of vehicles each year as the registration is renewed. The decals are applied directly to the license plate of the vehicle and typically on top of the previous year`s expired decal. To afford some degree of security, the individual registration decals have been designed to tear easily; they cannot be separated from each other, but can be carefully removed intact from the metal license plate by using a razor blade. In September 1993, the City of Livermore Police Department obtained a blue 1993 California decal that had been placed over an orange 1992 decal. The two decals were being investigated as possible evidence in a case involving vehicle registration fraud. To confirm the suspicion and implicate a suspect, the department needed to known the registration number on the bottom (completely covered) 1992 decal. The authors attempted to use intense and directed light to interrogate the colored stickers. Optical illumination using a filtered white-light source partially identified the latent number. However, the most successful technique used a tunable dye laser pumped by a pulsed Nd:YAG laser. By selectively tuning the wavelength and intensity of the dye laser, backlit illumination of the decals permitted visualization of the underlying registration number through the surface of the top sticker. With optimally-tuned wavelength and intensity, 100% accuracy was obtained in identifying the sequence of latent characters. The advantage of optical techniques is their completely nondestructive nature, thus preserving the evidence for further interrogation or courtroom presentation.

  5. Automatic parameter selection for multimodal image registration.

    PubMed

    Hahn, Dieter A; Daum, Volker; Hornegger, Joachim

    2010-05-01

    Over the past ten years similarity measures based on intensity distributions have become state-of-the-art in automatic multimodal image registration. An implementation for clinical usage has to support a plurality of images. However, a generally applicable parameter configuration for the number and sizes of histogram bins, optimal Parzen-window kernel widths or background thresholds cannot be found. This explains why various research groups present partly contradictory empirical proposals for these parameters. This paper proposes a set of data-driven estimation schemes for a parameter-free implementation that eliminates major caveats of heuristic trial and error. We present the following novel approaches: a new coincidence weighting scheme to reduce the influence of background noise on the similarity measure in combination with Max-Lloyd requantization, and a tradeoff for the automatic estimation of the number of histogram bins. These methods have been integrated into a state-of-the-art rigid registration that is based on normalized mutual information and applied to CT-MR, PET-MR, and MR-MR image pairs of the RIRE 2.0 database. We compare combinations of the proposed techniques to a standard implementation using default parameters, which can be found in the literature, and to a manual registration by a medical expert. Additionally, we analyze the effects of various histogram sizes, sampling rates, and error thresholds for the number of histogram bins. The comparison of the parameter selection techniques yields 25 approaches in total, with 114 registrations each. The number of bins has no significant influence on the proposed implementation that performs better than both the manual and the standard method in terms of acceptance rates and target registration error (TRE). The overall mean TRE is 2.34 mm compared to 2.54 mm for the manual registration and 6.48 mm for a standard implementation. Our results show a significant TRE reduction for distortion

  6. 3D-2D registration for surgical guidance: effect of projection view angles on registration accuracy

    NASA Astrophysics Data System (ADS)

    Uneri, A.; Otake, Y.; Wang, A. S.; Kleinszig, G.; Vogt, S.; Khanna, A. J.; Siewerdsen, J. H.

    2014-01-01

    An algorithm for intensity-based 3D-2D registration of CT and x-ray projections is evaluated, specifically using single- or dual-projection views to provide 3D localization. The registration framework employs the gradient information similarity metric and covariance matrix adaptation evolution strategy to solve for the patient pose in six degrees of freedom. Registration performance was evaluated in an anthropomorphic phantom and cadaver, using C-arm projection views acquired at angular separation, Δθ, ranging from ˜0°-180° at variable C-arm magnification. Registration accuracy was assessed in terms of 2D projection distance error and 3D target registration error (TRE) and compared to that of an electromagnetic (EM) tracker. The results indicate that angular separation as small as Δθ ˜10°-20° achieved TRE <2 mm with 95% confidence, comparable or superior to that of the EM tracker. The method allows direct registration of preoperative CT and planning data to intraoperative fluoroscopy, providing 3D localization free from conventional limitations associated with external fiducial markers, stereotactic frames, trackers and manual registration.

  7. Effects of spatial resolution on image registration

    NASA Astrophysics Data System (ADS)

    Zhao, Can; Carass, Aaron; Jog, Amod; Prince, Jerry L.

    2016-03-01

    This paper presents a theoretical analysis of the effect of spatial resolution on image registration. Based on the assumption of additive Gaussian noise on the images, the mean and variance of the distribution of the sum of squared differences (SSD) were estimated. Using these estimates, we evaluate a distance between the SSD distributions of aligned images and non-aligned images. The experimental results show that by matching the resolutions of the moving and fixed images one can get a better image registration result. The results agree with our theoretical analysis of SSD, but also suggest that it may be valid for mutual information as well.

  8. 14 CFR 47.16 - Temporary registration numbers.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... temporary registration number may not be used on more than one aircraft in flight at the same time. (3... importation. (d) The assignment of any temporary registration number to any person lapses upon the...

  9. 40 CFR 155.56 - Interim registration review decision.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... required data, conducting the new risk assessment and completing the registration review. A FIFRA 3(c)(2)(B... registration review decision may require new risk mitigation measures, impose interim risk mitigation...

  10. 49 CFR 107.608 - General registration requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... MATERIALS PROGRAM PROCEDURES Registration of Persons Who Offer or Transport Hazardous Materials § 107.608... Internet at http://hazmat.dot.gov. (e) If the registrant is not a resident of the United States,...

  11. 76 FR 44587 - Product Cancellation Order for Certain Pesticide Registrations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-26

    ... Maintenance Fees--Continued, column number one, ``EPA Registration No.,'' last row, ``WA080009'' should read...--Continued, in the first column, ``EPA Registration No.,'' and third row, ``WA080011'' should read...

  12. 78 FR 63100 - Unified Registration System; Correction

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-23

    .... SUPPLEMENTARY INFORMATION: In FR Doc. 2013-20446, beginning on page 78 FR 52608 in the Federal Register of... System; Correction AGENCY: Federal Motor Carrier Safety Administration (FMCSA), DOT. ACTION: Final rule... Registration System. This document makes four minor revisions to the URS final rule to be consistent with...

  13. 76 FR 27898 - Registration and Recordation Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-13

    ... From the Federal Register Online via the Government Publishing Office ] LIBRARY OF CONGRESS Copyright Office 37 CFR Parts 202, 203, and 211 Registration and Recordation Program AGENCY: Copyright Office, Library of Congress. ACTION: Final rule; technical amendments. SUMMARY: The Copyright Office...

  14. 44 CFR 206.112 - Registration period.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Registration period. 206.112 Section 206.112 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF... days following the date that the President declares an incident a major disaster or an emergency....

  15. How accurate are Scottish cancer registration data?

    PubMed Central

    Brewster, D.; Crichton, J.; Muir, C.

    1994-01-01

    In order to assess the accuracy of Scottish cancer registration data, a random sample of 2,200 registrations, attributed to the year 1990, was generated. Relevant medical records were available for review in 2,021 (92%) cases. Registration details were reabstracted from available records and compared with data in the registry. Discrepancies in identifying items of data (surname, forename, sex and date of birth) were found in 3.5% of cases. Most were trivial and would not disturb record linkage. Discrepancy rates of 7.1% in post code of residence at the time of diagnosis (excluding differences arising through boundary changes), 11.0% in anniversary date (excluding differences of 6 weeks or less), 7.7% in histological verification status, 5.4% in ICD-9 site codes (the first three digits) and 14.5% in ICD-O morphology codes (excluding 'inferred' morphology codes) were recorded. Overall, serious discrepancies were judged to have occurred in 2.8% of cases. In many respects, therefore, Scottish cancer registration data show a high level of accuracy that compares favourably to the reported accuracy of the few other cancer registries undertaking such analyses. PMID:7947104

  16. Reflectance and fluorescence hyperspectral elastic image registration

    NASA Astrophysics Data System (ADS)

    Lange, Holger; Baker, Ross; Hakansson, Johan; Gustafsson, Ulf P.

    2004-05-01

    Science and Technology International (STI) presents a novel multi-modal elastic image registration approach for a new hyperspectral medical imaging modality. STI's HyperSpectral Diagnostic Imaging (HSDI) cervical instrument is used for the early detection of uterine cervical cancer. A Computer-Aided-Diagnostic (CAD) system is being developed to aid the physician with the diagnosis of pre-cancerous and cancerous tissue regions. The CAD system uses the fusion of multiple data sources to optimize its performance. The key enabling technology for the data fusion is image registration. The difficulty lies in the image registration of fluorescence and reflectance hyperspectral data due to the occurrence of soft tissue movement and the limited resemblance of these types of imagery. The presented approach is based on embedding a reflectance image in the fluorescence hyperspectral imagery. Having a reflectance image in both data sets resolves the resemblance problem and thereby enables the use of elastic image registration algorithms required to compensate for soft tissue movements. Several methods of embedding the reflectance image in the fluorescence hyperspectral imagery are described. Initial experiments with human subject data are presented where a reflectance image is embedded in the fluorescence hyperspectral imagery.

  17. A new combined surface and volume registration

    NASA Astrophysics Data System (ADS)

    Lepore, Natasha; Joshi, Anand A.; Leahy, Richard M.; Brun, Caroline; Chou, Yi-Yu; Pennec, Xavier; Lee, Agatha D.; Barysheva, Marina; De Zubicaray, Greig I.; Wright, Margaret J.; McMahon, Katie L.; Toga, Arthur W.; Thompson, Paul M.

    2010-03-01

    3D registration of brain MRI data is vital for many medical imaging applications. However, purely intensitybased approaches for inter-subject matching of brain structure are generally inaccurate in cortical regions, due to the highly complex network of sulci and gyri, which vary widely across subjects. Here we combine a surfacebased cortical registration with a 3D fluid one for the first time, enabling precise matching of cortical folds, but allowing large deformations in the enclosed brain volume, which guarantee diffeomorphisms. This greatly improves the matching of anatomy in cortical areas. The cortices are segmented and registered with the software Freesurfer. The deformation field is initially extended to the full 3D brain volume using a 3D harmonic mapping that preserves the matching between cortical surfaces. Finally, these deformation fields are used to initialize a 3D Riemannian fluid registration algorithm, that improves the alignment of subcortical brain regions. We validate this method on an MRI dataset from 92 healthy adult twins. Results are compared to those based on volumetric registration without surface constraints; the resulting mean templates resolve consistent anatomical features both subcortically and at the cortex, suggesting that the approach is well-suited for cross-subject integration of functional and anatomic data.

  18. 75 FR 24695 - Pesticide Products; Registration Applications

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-05

    ... AGENCY Pesticide Products; Registration Applications AGENCY: Environmental Protection Agency (EPA). ACTION: Notice. SUMMARY: This notice announces receipt of applications to register new uses for pesticide....regulations.gov . Follow the on-line instructions for submitting comments. Mail: Office of Pesticide...

  19. 75 FR 71697 - Pesticide Products; Registration Applications

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-24

    ...-RR) was published in a separate notice (see 75 FR 11175; March 10, 2010; FRL-8811-6). File symbol... AGENCY Pesticide Products; Registration Applications AGENCY: Environmental Protection Agency (EPA). ACTION: Notice. SUMMARY: EPA has received applications to register pesticide products containing...

  20. FIFRA-88, GLP, and QA: pesticide registration.

    PubMed

    Sterner, R T; Fagerstone, K A

    1997-01-01

    The 1988 amendment to the Federal Insecticide, Fungicide, and Rodenticide Act (FIFRA-88) has decreased the number of pesticide registrations in the United States. Subsequent implementation of the U.S. Environmental Protection Agency (EPA) Good Laboratory Practice (GLP) and quality assurance (QA) standards has increased costs of maintaining these registrations. The U.S. Department of Agriculture (USDA) Animal and Plant Health Inspection Service (APHIS) maintains approximately 30 Section 3 (federal) or Section 24c (state) vertebrate pesticide registrations for the Wildlife Services (WS) program to control wild mammals and birds that damage crops, impact endangered species, or pose human health risks. Under FIFRA-88, APHIS summarized, performed, and submitted or gained waivers for > 500 studies requested by the U.S. EPA to assess potential hazards/effects of these pesticides. A summary of FIFRA-88 milestones for registration of 3-chloro-p-toluidine hydrochloride (CPTH), the active ingredient (AI) in a "low-volume, minor-use" avicide (DRC-1339, Starlicide), is used to illustrate GLP/QA/animal welfare issues involved in this process. Trends in the development of new pesticides and veterinary drugs are compared to provide some perspectives on future career paths for QA professionals.

  1. 47 CFR 76.1801 - Registration statement.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... information on FCC Form 322. (1) The legal name of the operator, entity identification or social security... attorney shall in that event separately set forth the reasons why the registration statement was not signed... (rather than the attorney's knowledge), the attorney shall separately set forth the reasons for...

  2. A Teacher's Guide to Selective Service Registration.

    ERIC Educational Resources Information Center

    Selective Service System, Washington, DC.

    This guide is designed to assist high school teachers in their preparation of lessons covering the Selective Service System. The guide is organized into seven chapters. Chapter 1 describes Selective Service as it exists today, explains the registration process and its role in the national defense system, details who must register, and emphasizes…

  3. 31 CFR 357.21 - Registration.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Black and Jane Brown, without right of survivorship. Any registration which purports, by its terms, to.... In the name of one individual followed by the words “Payable on death to” (or “P.O.D.”) another individual. Example: Jack S. Jones, payable on death to Marie Jones. If a minor or an incompetent is named...

  4. 31 CFR 357.21 - Registration.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Black and Jane Brown, without right of survivorship. Any registration which purports, by its terms, to.... In the name of one individual followed by the words “Payable on death to” (or “P.O.D.”) another individual. Example: Jack S. Jones, payable on death to Marie Jones. If a minor or an incompetent is named...

  5. 27 CFR 53.140 - Registration.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 2 2011-04-01 2011-04-01 false Registration. 53.140 Section 53.140 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT... organization described in section 170(b)(1)(A)(ii) of the Code that is exempt from income tax under section...

  6. 27 CFR 53.140 - Registration.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 2 2012-04-01 2011-04-01 true Registration. 53.140 Section 53.140 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT... organization described in section 170(b)(1)(A)(ii) of the Code that is exempt from income tax under section...

  7. 27 CFR 53.140 - Registration.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 2 2013-04-01 2013-04-01 false Registration. 53.140 Section 53.140 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT... organization described in section 170(b)(1)(A)(ii) of the Code that is exempt from income tax under section...

  8. 27 CFR 53.140 - Registration.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 2 2014-04-01 2014-04-01 false Registration. 53.140 Section 53.140 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT... organization described in section 170(b)(1)(A)(ii) of the Code that is exempt from income tax under section...

  9. 75 FR 20841 - Pesticide Products; Registration Applications

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-21

    ..., papaya, star apple, black sapote, mango, sapodilla, canistel, mamey sapote. Contact: Autumn Metzger, (703) 305- 5314; metzger.autumn@epa.gov . 8. Registration Number: 59639-151. Docket Number: EPA-HQ-OPP-2010...; leaves of legume vegetables (subgroup 7A; excluding cowpea and lentils); and sweet corn....

  10. 76 FR 66505 - Unified Registration System

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-26

    ... in the Federal Register on January 17, 2008 (73 FR 3316), or you may visit http://edocket.access.gpo... Federal Register on May 12, 2006 (71 FR 27777). The Board's duties include issuing rules and regulations... structure for the Unified Carrier Registration Agreement in the Federal Register (72 FR 48585). The...

  11. Automated Registration Of Images From Multiple Sensors

    NASA Technical Reports Server (NTRS)

    Rignot, Eric J. M.; Kwok, Ronald; Curlander, John C.; Pang, Shirley S. N.

    1994-01-01

    Images of terrain scanned in common by multiple Earth-orbiting remote sensors registered automatically with each other and, where possible, on geographic coordinate grid. Simulated image of terrain viewed by sensor computed from ancillary data, viewing geometry, and mathematical model of physics of imaging. In proposed registration algorithm, simulated and actual sensor images matched by area-correlation technique.

  12. Highly accurate fast lung CT registration

    NASA Astrophysics Data System (ADS)

    Rühaak, Jan; Heldmann, Stefan; Kipshagen, Till; Fischer, Bernd

    2013-03-01

    Lung registration in thoracic CT scans has received much attention in the medical imaging community. Possible applications range from follow-up analysis, motion correction for radiation therapy, monitoring of air flow and pulmonary function to lung elasticity analysis. In a clinical environment, runtime is always a critical issue, ruling out quite a few excellent registration approaches. In this paper, a highly efficient variational lung registration method based on minimizing the normalized gradient fields distance measure with curvature regularization is presented. The method ensures diffeomorphic deformations by an additional volume regularization. Supplemental user knowledge, like a segmentation of the lungs, may be incorporated as well. The accuracy of our method was evaluated on 40 test cases from clinical routine. In the EMPIRE10 lung registration challenge, our scheme ranks third, with respect to various validation criteria, out of 28 algorithms with an average landmark distance of 0.72 mm. The average runtime is about 1:50 min on a standard PC, making it by far the fastest approach of the top-ranking algorithms. Additionally, the ten publicly available DIR-Lab inhale-exhale scan pairs were registered to subvoxel accuracy at computation times of only 20 seconds. Our method thus combines very attractive runtimes with state-of-the-art accuracy in a unique way.

  13. 76 FR 823 - Registration of Municipal Advisors

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-06

    ... Act Release No. IA-2910 (August 3, 2009), 74 FR 39840, 39840-41 (August 7, 2009) (``Political...\\ See Investment Advisers Act Release No. IA-3043 (July 1, 2010), 75 FR 41018, 41019 (July 14, 2010... FR 54465 (September 8, 2010) (``Temporary Registration Rule Release''). \\64\\ 17 CFR 249.1300T....

  14. 28 CFR 811.7 - Initial registration.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Initial registration. 811.7 Section 811.7 Judicial Administration COURT SERVICES AND OFFENDER SUPERVISION AGENCY FOR THE DISTRICT OF COLUMBIA SEX... offender of the penalties for failure to comply with the sex offender's duties. (5) If the Superior...

  15. 32 CFR 636.8 - Registration policy.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 4 2010-07-01 2010-07-01 true Registration policy. 636.8 Section 636.8 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) LAW ENFORCEMENT AND CRIMINAL INVESTIGATIONS MOTOR VEHICLE TRAFFIC SUPERVISION (SPECIFIC INSTALLATIONS) Fort Stewart, Georgia §...

  16. Programs and Registrations, 1970-1971.

    ERIC Educational Resources Information Center

    Childs, Gayle B., Ed.

    This report provides, in tabular form, Association of University Evening Colleges (AUEC)-National University Extension Association (NUEA) programs and registrations for 1970-1971. Academic subjects are grouped under the following basic headings: Agriculture, Behavioral Sciences, Biological Sciences, Business, Education, Engineering, Health…

  17. 15 CFR 295.24 - Registration.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 15 Commerce and Foreign Trade 1 2011-01-01 2011-01-01 false Registration. 295.24 Section 295.24 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade NATIONAL INSTITUTE OF STANDARDS AND TECHNOLOGY, DEPARTMENT OF COMMERCE NIST EXTRAMURAL PROGRAMS ADVANCED TECHNOLOGY...

  18. 15 CFR 295.24 - Registration.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 15 Commerce and Foreign Trade 1 2013-01-01 2013-01-01 false Registration. 295.24 Section 295.24 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade NATIONAL INSTITUTE OF STANDARDS AND TECHNOLOGY, DEPARTMENT OF COMMERCE NIST EXTRAMURAL PROGRAMS ADVANCED TECHNOLOGY...

  19. 15 CFR 295.24 - Registration.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 15 Commerce and Foreign Trade 1 2014-01-01 2014-01-01 false Registration. 295.24 Section 295.24 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade NATIONAL INSTITUTE OF STANDARDS AND TECHNOLOGY, DEPARTMENT OF COMMERCE NIST EXTRAMURAL PROGRAMS ADVANCED TECHNOLOGY...

  20. 15 CFR 295.24 - Registration.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 15 Commerce and Foreign Trade 1 2012-01-01 2012-01-01 false Registration. 295.24 Section 295.24 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade NATIONAL INSTITUTE OF STANDARDS AND TECHNOLOGY, DEPARTMENT OF COMMERCE NIST EXTRAMURAL PROGRAMS ADVANCED TECHNOLOGY...

  1. The design of LBT's telemetry source registration

    NASA Astrophysics Data System (ADS)

    Edgin, Tony; Cushing, Norman

    2010-07-01

    In the current report, we describe the structure of the telemetry logging system of the Large Binocular Telescope (LBT) and its approach to telemeter registration. The telemetry logging system, called Telemetry, has three functions. It will provide system data to LBT Observatory (LBTO) personnel in order to facilitate engineering activities such as commissioning, failure diagnosis and system repair. In order to detect failures as soon as possible after they occur, telemetry will allow for live monitoring of the functional status of key telescope systems. Finally, in order to help personnel understand how the LBT operating characteristics evolve with time, telemetry will provide access to historical telescope system data. Given this range of functions, a key requirement of Telemetry is that it must easily adapt to new sources of data. To minimize the changes required to Telemetry, it has no pre-existing knowledge about the structure of the data it will collect. Instead, it engages in a telemeter registration process, in which the data source must describe its own structure. This registration process requires no external data files to be maintained since the description is built up by a sequence of function calls to a C++ library. So far, this strategy has proven successful, as only minor modifications have been made to accommodate the nearly 400 sources of data introduced to the system in the past year. The current report describes the design of the LBT telemetry system and its source registration process.

  2. 77 FR 51898 - Registration of Intermediaries

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-28

    ... errors. \\3\\ 76 FR 12888, Mar. 9, 2011. \\4\\ The comments the Commission received on the Proposal are... amended version of the effective date order at 77 FR 41260, July 13, 2012. \\7\\ NFA requested that the... compliance officer is listed as an example of a principal of a registrant. See 77 FR 20200, Apr. 3, 2012....

  3. Cross-Registration and Joint Academic Programs.

    ERIC Educational Resources Information Center

    Strandness, Jean T.

    1999-01-01

    The development of a cross-registration system and formation of joint academic programs between colleges create a variety of educational opportunities for students and provide both direct and indirect benefits to a consortium's member institutions and their faculty. The Tri-College University Consortium in North Dakota illustrates the advantages…

  4. 32 CFR 636.9 - Registration requirement.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 4 2014-07-01 2013-07-01 true Registration requirement. 636.9 Section 636.9 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) LAW ENFORCEMENT AND.... On a periodic basis, Military Police will conduct vehicle safety inspection operations using...

  5. 32 CFR 636.9 - Registration requirement.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 4 2012-07-01 2011-07-01 true Registration requirement. 636.9 Section 636.9 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) LAW ENFORCEMENT AND.... On a periodic basis, Military Police will conduct vehicle safety inspection operations using...

  6. 31 CFR 316.4 - Registration.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL SERVICE, DEPARTMENT OF THE TREASURY BUREAU OF THE FISCAL SERVICE OFFERING OF UNITED STATES SAVINGS BONDS, SERIES E § 316.4 Registration. Series E bonds were permitted to be registered as set forth in subpart B of 31...

  7. SELECTING PLANT SPECIES FOR PESTICIDE REGISTRATION TESTS

    EPA Science Inventory

    Current test protocols used by the US EPA for the registration of pesticides examines plant responses of 10 crop species but may not examine regionally important native plants or crops. In order to test the efficiency of current test protocols we selected six native plant species...

  8. Registration of heat capacity mapping mission day and night images

    NASA Technical Reports Server (NTRS)

    Watson, K.; Hummer-Miller, S.; Sawatzky, D. L.

    1982-01-01

    Registration of thermal images is complicated by distinctive differences in the appearance of day and night features needed as control in the registration process. These changes are unlike those that occur between Landsat scenes and pose unique constraints. Experimentation with several potentially promising techniques has led to selection of a fairly simple scheme for registration of data from the experimental thermal satellite HCMM using an affine transformation. Two registration examples are provided.

  9. 75 FR 56101 - Lauryl Sulfate Salts Registration Review Final Decision; Notice of Availability

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-15

    ... AGENCY Lauryl Sulfate Salts Registration Review Final Decision; Notice of Availability AGENCY... final registration review decision for the pesticide, lauryl sulfate salts (also known as sodium lauryl salts), case 4061. Registration review is EPA's periodic review of pesticide registrations to...

  10. Highway Safety Program Manual: Volume 2: Motor Vehicle Registration.

    ERIC Educational Resources Information Center

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

    Volume 2 of the 19-volume Highway Safety Program Manual (which provides guidance to State and local governments on preferred highway safety practices) describes the purposes and specific objectives of motor vehicle registration. Federal authority for vehicle registration and general policies regarding vehicle registration systems are outlined.…

  11. 7 CFR 1230.627 - Registration form and ballot.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Registration form and ballot. (a) Producers. (1) A ballot (Form LS-72) and combined registration and certification form (Form LS-72-2) will be used for voting in-person. The information required on the registration form includes name, address, and telephone number. Form LS-72-2 also contains the...

  12. 17 CFR 3.51 - Withdrawal of application for registration.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 17 Commodity and Securities Exchanges 1 2012-04-01 2012-04-01 false Withdrawal of application for registration. 3.51 Section 3.51 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION REGISTRATION Denial, Suspension or Revocation of Registration § 3.51 Withdrawal of application for...

  13. 32 CFR 1615.8 - Cancellation of registration.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 6 2013-07-01 2013-07-01 false Cancellation of registration. 1615.8 Section 1615.8 National Defense Other Regulations Relating to National Defense SELECTIVE SERVICE SYSTEM ADMINISTRATION OF REGISTRATION § 1615.8 Cancellation of registration. The Director of Selective Service...

  14. 32 CFR 1615.9 - Registration card or form.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 6 2012-07-01 2012-07-01 false Registration card or form. 1615.9 Section 1615.9 National Defense Other Regulations Relating to National Defense SELECTIVE SERVICE SYSTEM ADMINISTRATION OF REGISTRATION § 1615.9 Registration card or form. For the purposes of these regulations, the terms...

  15. 32 CFR 1615.9 - Registration card or form.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 6 2010-07-01 2010-07-01 false Registration card or form. 1615.9 Section 1615.9 National Defense Other Regulations Relating to National Defense SELECTIVE SERVICE SYSTEM ADMINISTRATION OF REGISTRATION § 1615.9 Registration card or form. For the purposes of these regulations, the terms...

  16. 34 CFR 668.37 - Selective Service registration.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 34 Education 3 2013-07-01 2013-07-01 false Selective Service registration. 668.37 Section 668.37... Selective Service registration. (a)(1) To be eligible to receive title IV, HEA program funds, a male student who is subject to registration with the Selective Service must register with the Selective Service....

  17. 32 CFR 1615.9 - Registration card or form.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 6 2014-07-01 2014-07-01 false Registration card or form. 1615.9 Section 1615.9 National Defense Other Regulations Relating to National Defense SELECTIVE SERVICE SYSTEM ADMINISTRATION OF REGISTRATION § 1615.9 Registration card or form. For the purposes of these regulations, the terms...

  18. 34 CFR 668.37 - Selective Service registration.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 3 2011-07-01 2011-07-01 false Selective Service registration. 668.37 Section 668.37... Selective Service registration. (a)(1) To be eligible to receive title IV, HEA program funds, a male student who is subject to registration with the Selective Service must register with the Selective Service....

  19. 32 CFR 1615.9 - Registration card or form.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 6 2013-07-01 2013-07-01 false Registration card or form. 1615.9 Section 1615.9 National Defense Other Regulations Relating to National Defense SELECTIVE SERVICE SYSTEM ADMINISTRATION OF REGISTRATION § 1615.9 Registration card or form. For the purposes of these regulations, the terms...

  20. 32 CFR 1615.9 - Registration card or form.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 6 2011-07-01 2011-07-01 false Registration card or form. 1615.9 Section 1615.9 National Defense Other Regulations Relating to National Defense SELECTIVE SERVICE SYSTEM ADMINISTRATION OF REGISTRATION § 1615.9 Registration card or form. For the purposes of these regulations, the terms...

  1. 34 CFR 668.37 - Selective Service registration.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 34 Education 3 2014-07-01 2014-07-01 false Selective Service registration. 668.37 Section 668.37... Selective Service registration. (a)(1) To be eligible to receive title IV, HEA program funds, a male student who is subject to registration with the Selective Service must register with the Selective Service....

  2. 32 CFR 1615.8 - Cancellation of registration.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 6 2012-07-01 2012-07-01 false Cancellation of registration. 1615.8 Section 1615.8 National Defense Other Regulations Relating to National Defense SELECTIVE SERVICE SYSTEM ADMINISTRATION OF REGISTRATION § 1615.8 Cancellation of registration. The Director of Selective Service...

  3. 34 CFR 668.37 - Selective Service registration.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 34 Education 3 2012-07-01 2012-07-01 false Selective Service registration. 668.37 Section 668.37... Selective Service registration. (a)(1) To be eligible to receive title IV, HEA program funds, a male student who is subject to registration with the Selective Service must register with the Selective Service....

  4. 34 CFR 668.37 - Selective Service registration.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 3 2010-07-01 2010-07-01 false Selective Service registration. 668.37 Section 668.37... Selective Service registration. (a)(1) To be eligible to receive title IV, HEA program funds, a male student who is subject to registration with the Selective Service must register with the Selective Service....

  5. 32 CFR 1615.8 - Cancellation of registration.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 6 2011-07-01 2011-07-01 false Cancellation of registration. 1615.8 Section 1615.8 National Defense Other Regulations Relating to National Defense SELECTIVE SERVICE SYSTEM ADMINISTRATION OF REGISTRATION § 1615.8 Cancellation of registration. The Director of Selective Service...

  6. 32 CFR 1615.8 - Cancellation of registration.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 6 2014-07-01 2014-07-01 false Cancellation of registration. 1615.8 Section 1615.8 National Defense Other Regulations Relating to National Defense SELECTIVE SERVICE SYSTEM ADMINISTRATION OF REGISTRATION § 1615.8 Cancellation of registration. The Director of Selective Service...

  7. 32 CFR 1615.8 - Cancellation of registration.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 6 2010-07-01 2010-07-01 false Cancellation of registration. 1615.8 Section 1615.8 National Defense Other Regulations Relating to National Defense SELECTIVE SERVICE SYSTEM ADMINISTRATION OF REGISTRATION § 1615.8 Cancellation of registration. The Director of Selective Service...

  8. 28 CFR 811.9 - Periodic verification of registration information.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Periodic verification of registration... THE DISTRICT OF COLUMBIA SEX OFFENDER REGISTRATION § 811.9 Periodic verification of registration... photograph that is five or more years old. (e) CSOSA, either on its own accord or with its law...

  9. 46 CFR 401.220 - Registration of pilots.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... affecting § 401.220, see the List of CFR Sections Affected, which appears in the Finding Aids section of the... 46 Shipping 8 2011-10-01 2011-10-01 false Registration of pilots. 401.220 Section 401.220 Shipping... Registration of Pilots § 401.220 Registration of pilots. (a) The Director shall determine the number of...

  10. 75 FR 32140 - Voluntary Surrender of Certificate of Registration

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-07

    ... Certificate of Registration for cause. The effect of these proposed changes would make it clear that a voluntary surrender of a registration for cause by a registrant has the legal effect of immediately... order to show cause, a hearing, or any other proceedings * * *.'' Thus the forms have led...

  11. 32 CFR 635.27 - Vehicle Registration System.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 4 2011-07-01 2011-07-01 false Vehicle Registration System. 635.27 Section 635... ENFORCEMENT AND CRIMINAL INVESTIGATIONS LAW ENFORCEMENT REPORTING Offense Reporting § 635.27 Vehicle Registration System. The Vehicle Registration System (VRS) is a module within COPS. Use of VRS to...

  12. 32 CFR 635.27 - Vehicle Registration System.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 4 2010-07-01 2010-07-01 true Vehicle Registration System. 635.27 Section 635... ENFORCEMENT AND CRIMINAL INVESTIGATIONS LAW ENFORCEMENT REPORTING Offense Reporting § 635.27 Vehicle Registration System. The Vehicle Registration System (VRS) is a module within COPS. Use of VRS to...

  13. 40 CFR 162.153 - State registration procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... STATE REGISTRATION OF PESTICIDE PRODUCTS Regulations Pertaining to State Registration of Pesticides To... for use. (2) The name of the pesticide product, and, if the application is for an amendment to a federally registered product, the EPA registration number of that product. (3) A copy of proposed...

  14. 27 CFR 19.155 - Maintenance of registration file.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... registration file. 19.155 Section 19.155 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND... Spirits Plants § 19.155 Maintenance of registration file. The proprietor shall maintain the registration file in looseleaf form in complete and current condition, readily available at the plant for...

  15. 46 CFR 401.200 - Application for registration.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 8 2010-10-01 2010-10-01 false Application for registration. 401.200 Section 401.200 Shipping COAST GUARD (GREAT LAKES PILOTAGE), DEPARTMENT OF HOMELAND SECURITY GREAT LAKES PILOTAGE REGULATIONS Registration of Pilots § 401.200 Application for registration. (a) An application for...

  16. 46 CFR 401.240 - Renewal of Certificates of Registration.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 8 2010-10-01 2010-10-01 false Renewal of Certificates of Registration. 401.240 Section 401.240 Shipping COAST GUARD (GREAT LAKES PILOTAGE), DEPARTMENT OF HOMELAND SECURITY GREAT LAKES PILOTAGE REGULATIONS Registration of Pilots § 401.240 Renewal of Certificates of Registration. (a)...

  17. 76 FR 4072 - Registration of Claims of Copyright

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-24

    ... of Claims to Copyright, Group Registration Options, 73 FR 23390, 23392 (Apr. 30, 2008), that proposal... 1989. See Registration of Claims to Copyright Registration and Deposit of Databases, 54 FR 13177 (March... reveal the work for which copyright protection is claimed.' 65 FR at 26164. Deposit of the work...

  18. 21 CFR 710.7 - Inspection of registrations.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 7 2014-04-01 2014-04-01 false Inspection of registrations. 710.7 Section 710.7 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) COSMETICS VOLUNTARY REGISTRATION OF COSMETIC PRODUCT ESTABLISHMENTS § 710.7 Inspection of registrations....

  19. 21 CFR 710.7 - Inspection of registrations.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 7 2012-04-01 2012-04-01 false Inspection of registrations. 710.7 Section 710.7 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) COSMETICS VOLUNTARY REGISTRATION OF COSMETIC PRODUCT ESTABLISHMENTS § 710.7 Inspection of registrations....

  20. 21 CFR 710.7 - Inspection of registrations.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 7 2011-04-01 2010-04-01 true Inspection of registrations. 710.7 Section 710.7 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) COSMETICS VOLUNTARY REGISTRATION OF COSMETIC PRODUCT ESTABLISHMENTS § 710.7 Inspection of registrations....