Affinity monolith chromatography: A review of principles and recent analytical applications

PubMed Central

Pfaunmiller, Erika L.; Paulemond, Marie Laura; Dupper, Courtney M.; Hage, David S.

2012-01-01

Affinity monolith chromatography (AMC) is a type of liquid chromatography that uses a monolithic support and a biologically-related binding agent as a stationary phase. AMC is a powerful method for the selective separation, analysis or studies of specific target compounds in a sample. This review discusses the basic principles of AMC and recent developments or applications of this method, with particular emphasis being given to work that has appeared in the last five years. Various materials that have been used to prepare columns for AMC are examined, including organic monoliths, silica monoliths, agarose monoliths and cryogels. These supports have been used in AMC for formats that have ranged from traditional columns to disks, microcolumns and capillaries. Many binding agents have also been employed in AMC, such as antibodies, enzymes, proteins, lectins, immobilized metal-ions and dyes. Some applications that have been reported with these binding agents in AMC are bioaffinity chromatography, immunoaffinity chromatography or immunoextraction, immobilized metal-ion affinity chromatography, dye-ligand affinity chromatography, chiral separations and biointeraction studies. Examples are presented from fields that include analytical chemistry, pharmaceutical analysis, clinical testing and biotechnology. Current trends and possible future directions in AMC are also discussed. PMID:23187827

Dietary intake and cardiometabolic biomarkers in relation to insulin resistance and hypertension in a middle-aged and elderly population in Beijing, China.

PubMed

Wang, Jia; Hong, Zhongxin; Wu, Li; Ding, Bingjie; Bi, Yanxia; Gu, Zhongyi; Li, Wei

2017-08-01

This study investigated the relationships of dietary intake and cardiometabolic biomarkers with insulin resistance and hypertension in rural middle-aged and elderly people in China. One hundred and eight middle-aged and elderly adults were recruited in Zhangfang village in May 2014. We measured blood pressure, anthropometric parameters, and biochemical indexes, including high-sensitivity C-reactive protein (hsCRP), soluble intercellular adhesion molecule-1 (sICAM-1), glucose, insulin, and blood lipids. Homeostasis model assessment of insulin resistance index (HOMA-IR) was assessed on the basis of fasting glucose and insulin. We recorded participant demographic characteristics, dietary intake, and lifestyle using questionnaires. Hypertensive participants had higher levels of triglycerides (TG), hsCRP, sICAM-1, body fat percentage (BF%), arm muscle circumference (AMC) and HOMA-IR than nonhypertensive individuals. Hypertensive participants had higher carbohydrate intake but lower intakes of protein and fat. Carbohydrate intake was positively correlated with hsCRP, sICAM-1, TG, BF%, and HOMA-IR, and was negatively correlated with AMC. Protein and fat intakes were negatively correlated with hsCRP and sICAM-1. Protein intake was also significantly negatively correlated with TG and HOMA-IR, and positively correlated with AMC. HOMA-IR was positively correlated with hsCRP, sICAM-1, TG and BF%, and negatively correlated with AMC. Multivariable linear regression indicated that TG, sICAM-1, and hsCRP were significantly associated with HOMA-IR. In conclusion, in a rural Chinese population, high intake of carbohydrate and low intake of fat and protein were associated with insulin resistance and hypertension, possibly by increasing inflammatory factors such as sICAM-1 and hsCRP, increasing BF% and increasing the level of plasma TG.

Xenografted human amniotic membrane-derived mesenchymal stem cells are immunologically tolerated and transdifferentiated into cardiomyocytes.

PubMed

Tsuji, Hiroko; Miyoshi, Shunichiro; Ikegami, Yukinori; Hida, Naoko; Asada, Hironori; Togashi, Ikuko; Suzuki, Junshi; Satake, Masaki; Nakamizo, Hikaru; Tanaka, Mamoru; Mori, Taisuke; Segawa, Kaoru; Nishiyama, Nobuhiro; Inoue, Junko; Makino, Hatsune; Miyado, Kenji; Ogawa, Satoshi; Yoshimura, Yasunori; Umezawa, Akihiro

2010-05-28

Amniotic membrane is known to have the ability to transdifferentiate into multiple organs and is expected to stimulate a reduced immunologic reaction. Determine whether human amniotic membrane-derived mesenchymal cells (hAMCs) can be an ideal allograftable stem cell source for cardiac regenerative medicine. We established hAMCs. After cardiomyogenic induction in vitro, hAMCs beat spontaneously, and the calculated cardiomyogenic transdifferentiation efficiency was 33%. Transplantation of hAMCs 2 weeks after myocardial infarction improved impaired left ventricular fractional shortening measured by echocardiogram (34+/-2% [n=8] to 39+/-2% [n=11]; P<0.05) and decreased myocardial fibrosis area (18+/-1% [n=9] to 13+/-1% [n=10]; P<0.05), significantly. Furthermore hAMCs transplanted into the infarcted myocardium of Wistar rats were transdifferentiated into cardiomyocytes in situ and survived for more than 4 weeks after the transplantation without using any immunosuppressant. Immunologic tolerance was caused by the hAMC-derived HLA-G expression, lack of MHC expression of hAMCs, and activation of FOXP3-positive regulatory T cells. Administration of IL-10 or progesterone, which is known to play an important role in feto-maternal tolerance during pregnancy, markedly increased HLA-G expression in hAMCs in vitro and, surprisingly, also increased cardiomyogenic transdifferentiation efficiency in vitro and in vivo. Because hAMCs have a high ability to transdifferentiate into cardiomyocytes and to acquire immunologic tolerance in vivo, they can be a promising cellular source for allograftable stem cells for cardiac regenerative medicine.

Physician leadership is essential to the survival of teaching hospitals.

PubMed

Schwartz, R W; Pogge, C

2000-06-01

Academic medical centers (AMCs) face severe financial constraints because they must now compete directly with private providers that focus exclusively on cost-effective healthcare delivery. Educational and research capacities developed at AMCs have been supported by government and third party payers, but government support is diminishing. Physicians are ill-equipped to respond to market pressures. Analyses of cultural change and restructuring in corporate giants such as Greyhound, IBM and FedEx are relevant to teaching hospitals. To succeed, organizations must flatten hierarchy, empower staff, train leaders, and mobilize intellectual capital. Effective leadership is essential. Physicians must educate themselves on forces impacting the AMC, understand changes needed in the structure and processes of AMC governance and acquire competencies for leadership and management if AMCs are to survive and thrive. Surgeons should acquire competencies that will enable them to become leaders in the process of AMC transformation.

Concept Study for the Establishment of the Harry Diamond Development Center - An AMC Electronic Development Center - An AMC Electronic Development Center.

DTIC Science & Technology

Acquisition Review Committee (AMARC). The proposed Harry Diamond Development Center (HDDC), reporting directly to Headquarters, AMC, is to be primarily...This report summarizes three alternatives which have been formulated to provide the Department of the Army and the Army Materiel Command (AMC) with...concerned with electronics. It would consolidate and integrate the present Harry Diamond Laboratories (HDL); selected portions of the U.S. Army Security

Inhibitor-resistant TEM- and OXA-1-producing Escherichia coli isolates resistant to amoxicillin-clavulanate are more clonal and possess lower virulence gene content than susceptible clinical isolates.

PubMed

Oteo, Jesús; González-López, Juan José; Ortega, Adriana; Quintero-Zárate, J Natalia; Bou, Germán; Cercenado, Emilia; Conejo, María Carmen; Martínez-Martínez, Luis; Navarro, Ferran; Oliver, Antonio; Bartolomé, Rosa M; Campos, José

2014-07-01

In a previous prospective multicenter study in Spain, we found that OXA-1 and inhibitor-resistant TEM (IRT) β-lactamases constitute the most common plasmid-borne mechanisms of genuine amoxicillin-clavulanate (AMC) resistance in Escherichia coli. In the present study, we investigated the population structure and virulence traits of clinical AMC-resistant E. coli strains expressing OXA-1 or IRT and compared these traits to those in a control group of clinical AMC-susceptible E. coli isolates. All OXA-1-producing (n = 67) and IRT-producing (n = 45) isolates were matched by geographical and temporal origin to the AMC-susceptible control set (n = 56). We performed multilocus sequence typing and phylogenetic group characterization for each isolate and then studied the isolates for the presence of 49 virulence factors (VFs) by PCR and sequencing. The most prevalent clone detected was distinct for each group: group C isolates of sequence type (ST) 88 (C/ST88) were the most common in OXA-1 producers, B2/ST131 isolates were the most common in IRT producers, and B2/ST73 isolates were the most common in AMC-susceptible isolates. The median numbers of isolates per ST were 3.72 in OXA-1 producers, 2.04 in IRT producers, and 1.69 in AMC-susceptible isolates; the proportions of STs represented by one unique isolate in each group were 19.4%, 31.1%, and 48.2%, respectively. The sum of all VFs detected, calculated as a virulence score, was significantly higher in AMC-susceptible isolates than OXA-1 and IRT producers (means, 12.5 versus 8.3 and 8.2, respectively). Our findings suggest that IRT- and OXA-1-producing E. coli isolates resistant to AMC have a different and less diverse population structure than AMC-susceptible clinical E. coli isolates. The AMC-susceptible population also contains more VFs than AMC-resistant isolates. Copyright © 2014, American Society for Microbiology. All Rights Reserved.

Semiparametric Modeling of Daily Ammonia Levels in Naturally Ventilated Caged-Egg Facilities

PubMed Central

Gutiérrez-Zapata, Diana María; Galeano-Vasco, Luis Fernando; Cerón-Muñoz, Mario Fernando

2016-01-01

Ammonia concentration (AMC) in poultry facilities varies depending on different environmental conditions and management; however, this is a relatively unexplored subject in Colombia (South America). The objective of this study was to model daily AMC variations in a naturally ventilated caged-egg facility using generalized additive models. Four sensor nodes were used to record AMC, temperature, relative humidity and wind speed on a daily basis, with 10 minute intervals for 12 weeks. The following variables were included in the model: Heat index, Wind, Hour, Location, Height of the sensor to the ground level, and Period of manure accumulation. All effects included in the model were highly significant (p<0.001). The AMC was higher during the night and early morning when the wind was not blowing (0.0 m/s) and the heat index was extreme. The average and maximum AMC were 5.94±3.83 and 31.70 ppm, respectively. Temperatures above 25°C and humidity greater than 80% increased AMC levels. In naturally ventilated caged-egg facilities the daily variations observed in AMC primarily depend on cyclic variations of the environmental conditions and are also affected by litter handling (i.e., removal of the bedding material). PMID:26812150

A theoretical flaw in the advance market commitment idea.

PubMed

Sonderholm, Jorn

2010-06-01

Infectious and parasitic diseases cause massive health problems in the developing world. Research and development of drugs for diseases that mainly affect poor people in developing countries is limited. The advance market commitment (AMC) idea is an incentivising mechanism for research and development of drugs for neglected diseases. Discussion of the AMC idea is of renewed interest given the launch in June 2009 of the first AMC. This pilot AMC is designed to, among other things, test the idea for potential future applications. This paper is a critique of the AMC idea. It seeks to show that the idea has a hitherto unrecognised theoretical flaw that should make policy-makers and donors hesitant to embrace future applications of the idea.

Citations in Life Science Patents to Publicly Funded Research at Academic Medical Centers.

PubMed

Sampat, Bhaven N; Pincus, Harold Alan

2015-12-01

The contributions of Academic Medical Centers (AMCs) to biomedical innovation have been difficult to measure because of the challenges involved in tracing knowledge flows from their origin to their uses. The authors examined patent citation linkages between AMC research funded by the National Institutes of Health (NIH) and patents. In prospective analyses, they examine the extent to which articles resulting from NIH grants to AMCs awarded between 1990 and 1995 were cited in drug and medical patents. The authors then examine the extent to which these patents are associated with marketed drugs. In retrospective analyses, they examine the share of drugs approved between 2000 and 2009 that have citation links to NIH-funded AMC research. The prospective analyses show over a third of AMC grants resulted in publications that were cited in patents. Most the patents are drug and biotechnology patents, and are assigned to private firms. Patents citing NIH-funded AMC publications were associated with 106 new FDA approved drugs, half of which are new molecular entities and a quarter of which are priority NMEs. The retrospective analyses showed that about half of the new molecular entities approved over the 2000-2009 period had citations links to NIH-funded AMC research. There are strong links between articles from NIH-funded AMC research and private sector medical patenting, including drugs. More research is needed to better understand the types of links the citations represent and their implications for public policy. © 2015 Wiley Periodicals, Inc.

Randomized Double-Blind Study Comparing 3- and 6-Day Regimens of Azithromycin with a 10-Day Amoxicillin-Clavulanate Regimen for Treatment of Acute Bacterial Sinusitis

PubMed Central

Henry, Dan C.; Riffer, Ernie; Sokol, William N.; Chaudry, Naumann I.; Swanson, Robert N.

2003-01-01

A randomized, double-blind, multicenter study of adults with acute bacterial sinusitis (ABS) compared the efficacy and safety of two azithromycin (AZM) regimens, 500 mg/day once daily for 3 days (AZM-3) or 6 days (AZM-6) to the efficacy and safety of an amoxicillin-clavulanate (AMC) regimen of 500-125 mg three times daily for 10 days. A total of 936 subjects with clinically and radiologically documented ABS were treated (AZM-3, 312; AZM-6, 311; AMC, 313). Clinical success rates were equivalent among per-protocol subjects at the end of therapy (AZM-3, 88.8%; AZM-6, 89.3%; AMC, 84.9%) and at the end of the study (AZM-3, 71.7%; AZM-6, 73.4%; AMC, 71.3%). Subjects treated with AMC reported a higher incidence of treatment-related adverse events (AE) (51.1%) than AZM-3 (31.1%, P < 0.001) or AZM-6 (37.6%, P < 0.001). More AMC subjects discontinued the study (n = 28) than AZM-3 (n = 7) and AZM-6 (n = 11) subjects. Diarrhea was the most frequent treatment-related AE. AZM-3 and AZM-6 were each equivalent in efficacy and better tolerated than AMC for ABS. PMID:12936972

ACETYLMETHYLCARBINOL PRODUCTION AND THE CLASSIFICATION OF AEROMONADS ASSOCIATED WITH ULCERATIVE DISEASES OF ECTOTHERMIC VERTEBRATES

PubMed Central

Page, L. A.

1962-01-01

Page, L. A. (Biological Research Institute, San Diego, and University of California, Davis). Acetylmethylcarbinol production and the classification of aeromonads associated with ulcerative diseases of ectothermic vertebrates. J. Bacteriol. 84:772–777. 1962.—Quantitative colorimetric tests were made for acetylmethylcarbinol (AMC) production by 14 Aeromonas isolates from ulcerous lesions of snakes, lizards, frogs, and other animals, and by 27 cultures of “identified” aeromonads. The tests revealed that: (i) some strains failed to produce AMC, while the other strains produced AMC in amounts of 5 to > 100 μg/ml of culture; (ii) the reagents employed in the standard method of Barritt failed to detect AMC in concentrations below 35 μg/ml; and (iii) certain strains reported as producing AMC at 23 C and not at 37 C (or vice versa) produced AMC at both temperatures, but at one temperature produced AMC at a level below the sensitivity of the qualitative test. The strains representing the two biotypes could not be distinguished on the basis of their morphology, habitat, pathogenicity for mice or snakes, or serological specificity. Therefore, the Aeromonas classification proposed by Ewing, Hugh, and Johnson, who incorporated the two biotypes into one species, was followed, and the new isolates were designated A. hydrophila. Images PMID:13941061

Tempus Pro Patient Monitoring System

DTIC Science & Technology

2015-04-03

AFMSA SG5T, (AFMESA) Mr. John Ingram, AFMSA SG5T, AFMESA Mr. John Plaga , 711 HPW/HP Human Factors Engineering Mr. Paul Bailey, AMC SG/SGR Ms. Lynn...John Plaga , 711 HPW/HP Human Factors Engineering Mr. Paul Bailey, AMC SG/SGR Lt Col Cheryl Hale, AMC SG/SGK Mr. Graham Murphy, RDT Mr. Nigel

Laser pattern generator challenges in airborne molecular contamination protection

NASA Astrophysics Data System (ADS)

Ekberg, Mats; Skotte, Per-Uno; Utterback, Tomas; Paul, Swaraj; Kishkovich, Oleg P.; Hudzik, James S.

2003-08-01

The introduction of photomask laser pattern generators presents new challenges to system designers and manufacturers. One of the laser pattern generator's environmental operating challenges is Airborne Molecular Contamination (AMC), which affects both chemically amplified resists (CAResist) and laser optics. Similar challenges in CAResist protection have already been addressed in semiconductor wafer lithography with reasonable solutions and experience gained by all those involved. However, photomask and photomask equipment manufacturers have not previously had a comparable experience, and some photomask AMC issues differ from those seen in semiconductor wafer lithography. Culminating years of AMC experience, the authors discuss specific requirements of Photomask AMC. Air sampling and material of construction analysis were performed to understand these particular AMC challenges and used to develop an appropriate filtration specification for different classes of contaminates. The authors portray the importance of cooperation between tool designers and AMC experts early in the design stage to assure goal attainment to maximize both process stability and machine productivity in advanced mask making. In conclusion, the authors provide valuable recommendations to both laser tool users and other equipment manufacturers.

The Effects of Long-term Abacus Training on Topological Properties of Brain Functional Networks.

PubMed

Weng, Jian; Xie, Ye; Wang, Chunjie; Chen, Feiyan

2017-08-18

Previous studies in the field of abacus-based mental calculation (AMC) training have shown that this training has the potential to enhance a wide variety of cognitive abilities. It can also generate specific changes in brain structure and function. However, there is lack of studies investigating the impact of AMC training on the characteristics of brain networks. In this study, utilizing graph-based network analysis, we compared topological properties of brain functional networks between an AMC group and a matched control group. Relative to the control group, the AMC group exhibited higher nodal degrees in bilateral calcarine sulcus and increased local efficiency in bilateral superior occipital gyrus and right cuneus. The AMC group also showed higher nodal local efficiency in right fusiform gyrus, which was associated with better math ability. However, no relationship was significant in the control group. These findings provide evidence that long-term AMC training may improve information processing efficiency in visual-spatial related regions, which extend our understanding of training plasticity at the brain network level.

Comparative Effectiveness of Low-Volume Time-Efficient Resistance Training Versus Endurance Training in Patients With Heart Failure.

PubMed

Munch, Gregers Winding; Rosenmeier, Jaya Birgitte; Petersen, Morten; Rinnov, Anders Rasmussen; Iepsen, Ulrik Winning; Pedersen, Bente Klarlund; Mortensen, Stefan Peter

2018-05-01

Cardiorespiratory fitness is positively related to heart failure (HF) prognosis, but lack of time and low energy are barriers for adherence to exercise. We, therefore, compared the effect of low-volume time-based resistance exercise training (TRE) with aerobic moderate-intensity cycling (AMC) on maximal and submaximal exercise capacity, health-related quality of life, and vascular function. Twenty-eight HF patients (New York Heart Association class I-II) performed AMC (n = 14) or TRE (n = 14). Maximal and submaximal exercise capacity, health-related quality of life, and vascular function were evaluated before and after a 6-wk training intervention with 3 training sessions per week. The AMC group and the TRE group trained for 45 and 25 min per training session, respectively. During the training sessions, the TRE and AMC groups trained at 60 ± 4% and 59 ± 2% (mean ± standard deviation) of (Equation is included in full-text article.)O2peak, respectively. The energy expenditure was significantly greater in AMC than in TRE (P < .05). The (Equation is included in full-text article.)O2peak and Wattpeak increased in AMC group (P < .001) and TRE group (P = .001), with no differences between groups. Six-minute walk distance also increased in both groups (AMC, P = .006 and TRE, P = .036), with no difference between groups. Health-related quality of life improved equally in the 2 groups, whereas vascular function did not change in either group. These results demonstrate that AMC and TRE equally improved exercise capacity and health-related quality of life in lower New York Heart Association-stage HF patients, despite less time required as well as lower energy expenditure during TRE than during AMC. Therefore, TRE might represent a time-efficient exercise modality for improving adherence to exercise in patients with class I-II HF.

Rectal pre-treatment with ozonized oxygen (O3) aggravates clinic status in septic rats treated with amoxicillin/clavulanate.

PubMed

Martín-Barrasa, José L; Méndez Cordovez, Charlín; Espinosa de los Monteros y Zayas, Antonio; Juste de Santa Ana, M Candelaria; Clavo Varas, Bernardino; Herráez Thomas, Pedro; Bordes Benitez, Ana; Montoya-Alonso, José Alberto; García-Bello, Miguel; Artiles Campelo, Fernando; Tejedor-Junco, M Teresa

2015-01-01

Despite the advanced antibiotic therapies, sepsis continues being a clinical entity with high morbidity and mortality. The ozone/oxygen mixture (O3/O2) has been reported to exhibit positive effects on immunity. The aim of our study was to analyze whether (O3/O2) combined with amoxicillin/clavulanate has any influence on the morbidity and mortality of septic rats. We used 48 Sprague-Dawley rats randomly allocated to 6 groups (n=8): healthy (C), septic (I), healthy+ozone therapy (O3), septic+amoxicillin/clavulanate (AMC), septic+amoxicillin/clavulanate+ozone therapy (AMC/O3) and septic+ozone therapy (I/O3). O3/O2 was administered rectally at increasing O3 concentrations during 10 days prior to the onset of sepsis model (intraperitoneally injection of fecal material) or saline administration in healthy control rats. Later (post-inoculation), 3 days per week, O3 was also administered. Vital signs were recorded, and microbiological, hematological and histopathological studies were performed. The number of surviving animal/total was higher in AMC (8/8) than in AMC/O3 (4/8) p=0.077. The percentage of surviving animals with pneumonia was higher in AMC/O3 than in AMC (100% vs 37.5%). In dead animals, AMC/O3 rats had a significantly higher percentage of lesions: Cardiac lesions, pulmonary hemorrhages and pleuritis (100%) and serositis/peritonitis (75%). Only Escherichia coli (2 different biotypes) was isolated from blood and/or peritoneal fluid from all infected groups. A significant decrease in the percentage of band neutrophils from the surviviors belonging to AMC/O3vs AMC was observed (p<0.05). Rectal pre-treatment with O3/O2 aggravates clinic status in septic rats treated with amoxicillin/clavulanate. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

End-of-life care at academic medical centers: implications for future workforce requirements.

PubMed

Goodman, David C; Stukel, Thérèse A; Chang, Chiang-hua; Wennberg, John E

2006-01-01

The expansion of U.S. physician workforce training has been justified on the basis of population growth, technological innovation, and economic expansion. Our analyses found threefold differences in physician full-time-equivalent (FTE) inputs for Medicare cohorts cared for at academic medical centers (AMCs); AMC inputs were highly correlated with the number of physician FTEs per Medicare beneficiary in AMC regions. Given the apparent inefficiency of current physician practices, the supply pipeline is sufficient to meet future needs through 2020, with adoption of the workforce deployment patterns now seen among AMCs and regions dominated by large group practices.

Prognostic significance of peripheral monocyte count in patients with extranodal natural killer/T-cell lymphoma.

PubMed

Huang, Jia-Jia; Li, Ya-Jun; Xia, Yi; Wang, Yu; Wei, Wen-Xiao; Zhu, Ying-Jie; Lin, Tong-Yu; Huang, Hui-Qiang; Jiang, Wen-Qi; Li, Zhi-Ming

2013-05-03

Extranodal natural killer/T-cell lymphoma (ENKL) has heterogeneous clinical manifestations and prognosis. This study aims to evaluate the prognostic impact of absolute monocyte count (AMC) in ENKL, and provide some immunologically relevant information for better risk stratification in patients with ENKL. Retrospective data from 163 patients newly diagnosed with ENKL were analyzed. The absolute monocyte count (AMC) at diagnosis was analyzed as continuous and dichotomized variables. Independent prognostic factors of survival were determined by Cox regression analysis. The AMC at diagnosis were related to overall survival (OS) and progression-free survival (PFS) in patients with ENKL. Multivariate analysis identified AMC as independent prognostic factors of survival, independent of International Prognostic Index (IPI) and Korean prognostic index (KPI). The prognostic index incorporating AMC and absolute lymphocyte count (ALC), another surrogate factor of immune status, could be used to stratify all 163 patients with ENKL into different prognostic groups. For patients who received chemotherapy followed by radiotherapy (102 cases), the three AMC/ALC index categories identified patients with significantly different survivals. When superimposed on IPI or KPI categories, the AMC/ALC index was better able to identify high-risk patients in the low-risk IPI or KPI category. The baseline peripheral monocyte count is shown to be an effective prognostic indicator of survival in ENKL patients. The prognostic index related to tumor microenvironment might be helpful to identify high-risk patients with ENKL.

Cost Analysis of Integrative Inpatient Treatment Based on DRG Data: The Example of Anthroposophic Medicine

PubMed Central

Heinz, Jürgen; Fiori, Wolfgang; Heusser, Peter

2013-01-01

Background. Much work has been done to evaluate the outcome of integrative inpatient treatment but scarcely the costs. This paper evaluates the costs for inpatient treatment in three anthroposophic hospitals (AHs). Material and Methods. Cost and performance data from a total of 23,180 cases were analyzed and compared to national reference data. Subgroup analysis was performed between the cases with and without anthroposophic medical complex (AMC) treatment. Results. Costs and length of stay in the cases without AMC displayed no relevant differences compared to the national reference data. In contrast the inlier cases with AMC caused an average of € 1,394 more costs. However costs per diem were not higher than those in the national reference data. Hence, the delivery of AMC was associated with a prolonged length of stay. 46.6% of the cases with AMC were high outliers. Only 10.6% of the inlier cases with AMC were discharged before reaching the mean length of stay of each DRG. Discussion. Treatment in an AH is not generally associated with an increased use of resources. However, the provision of AMC leads to a prolonged length of stay and cannot be adequately reimbursed by the current G-DRG system. Due to the heterogeneity of the patient population, an additional payment should be negotiated individually. PMID:23431346

Advance market commitment for pneumococcal vaccines: putting theory into practice.

PubMed

Cernuschi, Tania; Furrer, Eliane; Schwalbe, Nina; Jones, Andrew; Berndt, Ernst R; McAdams, Susan

2011-12-01

Markets for life-saving vaccines do not often generate the most desired outcomes from a public health perspective in terms of product quantity, quality, affordability, programmatic suitability and/or sustainability for use in the lowest income countries. The perceived risks and uncertainties about sustainably funded demand from developing countries often leads to underinvestment in development and manufacturing of appropriate products. The pilot initiative Advance Market Commitment (AMC) for pneumococcal vaccines, launched in 2009, aims to remove some of these market risks by providing a legally binding forward commitment to purchase vaccines according to predetermined terms. To date, 14 countries have already introduced pneumococcal vaccines through the AMC with a further 39 countries expected to introduce before the end of 2013.This paper describes early lessons learnt on the selection of a target disease and the core design choices for the pilot AMC. It highlights the challenges faced with tailoring the AMC design to the specific supply situation of pneumococcal vaccines. It points to the difficulty - and the AMC's apparent early success - in establishing a long-term, credible commitment in a constantly changing unpredictable environment. It highlights one of the inherent challenges of the AMC: its dependence on continuous donor funding to ensure long-term purchases of products. The paper examines alternative design choices and aims to provide a starting point to inform discussions and encourage debate about the potential application of the AMC concept to other fields.

Rejecting conventional wisdom: how academic medical centers can regain their leadership positions.

PubMed

Krauss, K; Smith, J

1997-07-01

Academic medical centers (i.e., medical schools and their principal hospitals) are following very similar strategies in attempts to secure their futures. It is likely that these undifferentiated strategies will fail, since most of them have been copied from the lower-cost, geographically better-positioned hospitals and health systems. Despite a wealth of innovative, entrepreneurial talent and the potential to reshape the world that AMCs live in, most AMCs are in reactive modes. Future directions and strategies are almost always shaped, forced, and justified by external pressures. The major problem with the strategic plans of most AMCs is that they are based on conventional industry wisdom. Strategic plans tend not to be analytically driven. The insight and understanding of those factors that drive the demand for AMCs' services and determine the performances of AMCs are lacking. The authors note some questions that are critical to the formulation of strategies for AMCs. For example, how can the research mission be changed from a cost-based to a value-based endeavor? Most AMCs cannot answer these questions, and if they do address them in the planning process, they do so superficially. Several examples of the factors that need to be understood are also given, such as patients' purposes and needs in seeking specialty care. Alternative strategies are listed, such as maintaining and exploiting the economic irrationality of the market rather than acting as if it were economically rational or forcing it to become so. Last, the authors outline the scope of the changes that are required and urge AMCs to reject conventional wisdom, determine their own unique situations, and work from there.

"Mr Smith's been our problem child today…": anticipatory management communication (AMC) in VA end-of-shift medicine and nursing handoffs.

PubMed

Bergman, Alicia A; Flanagan, Mindy E; Ebright, Patricia R; O'Brien, Colleen M; Frankel, Richard M

2016-02-01

Tools and procedures designed to improve end-of-shift handoffs through standardisation of processes and reliance on technology may miss contextually sensitive information about anticipated events that emerges during face-to-face handoff interactions. Such information, what we refer to as anticipatory management communication (AMC), is necessary to ensure timely and safe patient care, but has been little studied and understood. To investigate AMC and the role it plays in nursing and medicine handoffs. Qualitative thematic analysis based on audio recordings of nurse-to-nurse, medical resident-to-resident and surgical intern-to-intern handoffs. 27 nurse handoff dyads and 18 medical resident and surgical intern handoff dyads at one VA Medical Center. Heads-up information was the most frequent type of AMC across all handoff dyads (N=257; 108 resident and 149 nursing). Indirect instructions AMC was used in a little over half the resident handoff dyads, but occurred in all nursing dyads (292 instances). Direct instructions AMC occurred in roughly equal proportion across all dyads but at a modest frequency (N=45; 28 resident and 17 nursing). Direct (if/then) contingency AMC occurred in resident handoffs more frequently than in nursing handoffs (N=32; 30 resident and 2 nursing). The different frequencies for types of AMC likely reflect differences in how residents and nurses work and disparate professional cultures. But, verbal communication in both groups included important information unlikely to be captured in written handoff tools or the electronic medical record, underscoring the importance of direct communication to ensure safe handoffs. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Characteristics of Planar Monopole Antenna on High Impedance Electromagnetic Surface

NASA Technical Reports Server (NTRS)

Scardelletti, Maximilian C.; Jastram, Nathan; Ponchak, George E.; Franklin, Rhonda R.

2011-01-01

This paper presents for the first time measured characteristics of a planar monopole antenna placed directly on a high impedance electromagnetic surface or artificial magnetic conductor (AMC). The return loss and radiation patterns are compared between the antenna in free space, and when placed directly on a perfect electrical conductor (PEC), and on the AMC. The antenna measured in free space has a wide pass band from 3 to 10 GHz. The return loss for the antenna on the PEC is nearly all reflected back and the return loss for the antenna on the AMC has a 10 dB bandwidth from 7.5 to 9.5 GHz. The gain of the antenna in free space, on PEC and on AMC is 1, -12 and 10 dBi, respectively. This indicates that the AMC is working properly, sending all the radiation outward with little loss.

Impact of Air Filter Material on Metal Oxide Semiconductor (MOS) Device Characteristics in HF Vapor Environment

NASA Astrophysics Data System (ADS)

Hsiao, Chih-Wen; Lou, Jen-Chung; Yeh, Ching-Fa; Hsieh, Chih-Ming; Lin, Shiuan-Jeng; Kusumi, Toshio

2004-05-01

Airborne molecular contamination (AMC) is becoming increasingly important as devices are scaled down to the nanometer generation. Optimum ultra low penetration air (ULPA) filter technology can eliminate AMC. In a cleanroom, however, the acid vapor generated from the cleaning process may degrade the ULPA filter, releasing AMC to the air and the surface of wafers, degrading the electrical characteristics of devices. This work proposes the new PTFE ULPA filter, which is resistant to acid vapor corrosion, to solve this problem. Experimental results demonstrate that the PTFE ULPA filter can effectively eliminate the AMC and provide a very clean cleanroom environment.

Magnetic nanoparticles modified with DTPA-AMC-rare earth for fluorescent and magnetic resonance dual mode imaging.

PubMed

Liu, Zengchen; Li, Bo; Wang, Baodui; Yang, Zhengyin; Wang, Qin; Li, Tianrong; Qin, Dongdong; Li, Yong; Wang, Mingfang; Yan, Mihui

2012-07-28

In the present study, we report new water-soluble cell fluorescence imaging and contrast agents that are based on DTPA-AMC(7-amino-4-methyl coumarin)-Eu(3+) and DTPA-AMC(7-amino-4-methyl coumarin)-Gd(3+) compounds conjugated to Fe(3)O(4) NPs via a PEG-NH(2) linker. The novel Fe(3)O(4) NP-conjugates present two main advantages for cell fluorescence labelling: water solubility and targeting ability. The in vitro experiments demonstrate that water-soluble Fe(3)O(4) NPs-DBI-PEG-NH-DTPA-AMC(7-amino-4-methyl coumarin)-Eu(3+) has excellent cell permeating activity. Moreover, the relaxation rate test of Fe(3)O(4) NPs-DBI-PEG-NH-DTPA-AMC(7-amino-4-methyl coumarin)-Gd(3+) shows a higher T1 relaxation effect than traditional DTPA-Gd(3+) MRI agents. According to in vivo liver MRI experiments, better contrast of the liver was achieved after addition of Fe(3)O(4) NPs-DBI-PEG-NH-DTPA-AMC(7-amino-4-methyl coumarin)-Gd(3+). The results will provide a significant guide for researchers exploring the biomedical applications of superparamagnetic Fe(3)O(4) NPs.

Establishing the pharmaceutical quality of Chinese herbal medicine: a provisional BCS classification.

PubMed

Fong, Sophia Y K; Liu, Mary; Wei, Hai; Löbenberg, Raimar; Kanfer, Isadore; Lee, Vincent H L; Amidon, Gordon L; Zuo, Zhong

2013-05-06

The Biopharmaceutical Classification System (BCS), which is a scientific approach to categorize active drug ingredient based on its solubility and intestinal permeability into one of the four classes, has been used to set the pharmaceutical quality standards for drug products in western society. However, it has received little attention in the area of Chinese herbal medicine (CHM). This is likely, in part, due to the presence of multiple active components as well as lack of standardization of CHM. In this report, we apply BCS classification to CHMs provisionally as a basis for establishing improved in vitro quality standards. Based on a top-200 drugs selling list in China, a total of 31 CHM products comprising 50 official active marker compounds (AMCs) were provisionally classified according to BCS. Information on AMC content and doses of these CHM products were retrieved from the Chinese Pharmacopoeia. BCS parameters including solubility and permeability of the AMCs were predicted in silico (ACD/Laboratories). A BCS classification of CHMs according to biopharmaceutical properties of their AMCs is demonstrated to be feasible in the current study and can be used to provide a minimum set of quality standards. Our provisional results showed that 44% of the included AMCs were classified as Class III (high solubility, low permeability), followed by Class II (26%), Class I (18%), and Class IV (12%). A similar trend was observed when CHMs were classified in accordance with the BCS class of AMCs. Most (45%) of the included CHMs were classified as Class III, followed by Class II (16%), Class I (10%), and Class IV (6%); whereas 23% of the CHMs were of mixed class due to the presence of multiple individual AMCs with different BCS classifications. Moreover, about 60% of the AMCs were classified as high-solubility compounds (Class I and Class III), suggesting an important role for an in vitro dissolution test in setting quality control standards ensuring consistent biopharmaceutical quality for the commercially available CHM products. That is, provisionally, more than half of the AMCs of the top-selling CHMs included in this study would be candidates for a bioequivalence (BE) biowaiver, based on WHO recommendations and EMEA guidelines. Thus a dissolution requirement on these AMCs would represent a significant advance in the pharmaceutical quality of CHM today.

Prognostic significance of peripheral monocyte count in patients with extranodal natural killer/T-cell lymphoma

PubMed Central

2013-01-01

Background Extranodal natural killer/T-cell lymphoma (ENKL) has heterogeneous clinical manifestations and prognosis. This study aims to evaluate the prognostic impact of absolute monocyte count (AMC) in ENKL, and provide some immunologically relevant information for better risk stratification in patients with ENKL. Methods Retrospective data from 163 patients newly diagnosed with ENKL were analyzed. The absolute monocyte count (AMC) at diagnosis was analyzed as continuous and dichotomized variables. Independent prognostic factors of survival were determined by Cox regression analysis. Results The AMC at diagnosis were related to overall survival (OS) and progression-free survival (PFS) in patients with ENKL. Multivariate analysis identified AMC as independent prognostic factors of survival, independent of International Prognostic Index (IPI) and Korean prognostic index (KPI). The prognostic index incorporating AMC and absolute lymphocyte count (ALC), another surrogate factor of immune status, could be used to stratify all 163 patients with ENKL into different prognostic groups. For patients who received chemotherapy followed by radiotherapy (102 cases), the three AMC/ALC index categories identified patients with significantly different survivals. When superimposed on IPI or KPI categories, the AMC/ALC index was better able to identify high-risk patients in the low-risk IPI or KPI category. Conclusion The baseline peripheral monocyte count is shown to be an effective prognostic indicator of survival in ENKL patients. The prognostic index related to tumor microenvironment might be helpful to identify high-risk patients with ENKL. PMID:23638998

Political strategy, business strategy, and the academic medical center: linking theory and practice.

PubMed

Souba, W W; Weitekamp, M R; Mahon, J F

2001-09-01

The purpose of this paper is to link external political strategy theory to a specific health care setting-that of the academic medical center (AMC). Political strategy encompasses those activities undertaken by AMCs to acquire, develop, and use power (clout, influence, and credibility) to gain an advantage in situations of conflict. It should be differentiated from internal politics, a topic that will not be dealt with in this review. Political strategy should also be distinguished from but not divorced from competitive strategy. As political and social action can change the competitive landscape and the rules of competition, AMCs must become adept in issues management and stakeholder management. The focus on political strategy is a reflection of the enormous changes in the external environment that have impacted AMCs in recent years. These changes have often emerged out of political and social action and they impact significantly on the organization's more traditional business strategies. We suggest that a tighter alignment between political and business strategies in the future will help ensure organizational survival and success. This article reviews the literature and theory in corporate political strategy and illustrates the application of political strategy with examples of issues and problems faced by AMCs. Models of political strategy are well crafted, and this article concludes with succinct observations on the use of political strategies to enhance the business-based strategies of AMCs. Although the focus is on AMCs, the use of political strategies is applicable to any health care institution. Copyright 2001 Academic Press.

Using information technology to improve the quality and efficiency of clinical trial research in academic medical centers.

PubMed

Hardison, C D; Schnetzer, T

1999-01-01

In the area of clinical trial research, academic medical centers (AMCs) need to create additional capacity and improve performance on vital indicators to attract more studies, as they are currently losing their share to stand-alone research sites. Through the utilization of information technology, AMCs will be in a better position to fend off the competitive threats to their clinical research dollars. Most AMCs are in an enviable position to leverage the value of information technology because of the existing people, processes, and technologies that probably already exist throughout the AMC. The challenge, then, is to deploy these resources in a different manner to support clinical trial research.

Corrosion of Continuous Fiber Reinforced Aluminum Metal Matrix Composites (CF-AMCs)

NASA Astrophysics Data System (ADS)

Tiwari, Shruti

The first objective of this research is to study the atmospheric corrosion behavior of continuous reinforced aluminum matrix composites (CF-AMCs). The materials used for this research were alumina (Al2O3) and nickel (Ni) coated carbon (C) fibers reinforced AMCs. The major focus is to identify the correlation between atmospheric parameters and the corrosion rates of CF-AMCs in the multitude of microclimates and environments in Hawai'i. The micro-structures of CF-AMCs were obtained to correlate the microstructures with their corrosion performances. Also electrochemical polarization experiments were conducted in the laboratory to explain the corrosion mechanism of CF-AMCs. In addition, CF-AMCs were exposed to seven different test sites for three exposure periods. The various climatic conditions like temperature (T), relative humidity (RH), rainfall (RF), time of wetness (TOW), chloride (Cl- ) and sulfate (SO42-) deposition rate, and pH were monitored for three exposure period. Likewise, mass losses of CF-AMCs at each test site for three exposure periods were determined. The microstructure of the CF-AMCS showed that Al/C/50f MMCs contained a Ni-rich phase in the matrix, indicating that the Ni coating on the C fiber dissolved in the matrix. The intermetallic phases obtained in Al-2wt% Cu/Al 2O3/50f-T6 MMC and Al-2wt%-T6 monolith were rich in Cu and Fe. The intermetallic phases obtained in Al 7075/Al2O3/50f-T6 MMC and Al 7075-T6 monolith also contained traces of Mg, Zn, Ni, and Si. Electrochemical polarization experiment indicated that the Al/Al 2O3/50f Al-2wt% Cu/Al2O3/50f-T6 and Al 7075/Al2O3/50f-T6 MMC showed similar corrosion trends as their respective monoliths pure Al, Al-2wt%-T6 and Al 7075-T6 in both aerated and deaerated condition. Al2O3 fiber, being an insulator, did not have a great effect on the polarization behavior of the composites. Al/C/50f MMCs corroded at a much faster rate as compared to pure Al monolith due to the galvanic effect between C and Al. According to the mass loss data of Al/C/50f MMCs, corrosion rate was high at marine environments (high Cl-) when compared to a tropical rainforest microclimate and low in a test site with a high SO2 and acid rain. Due to presence of conductive C fiber, the galvanic corrosion was a dominating corrosion mechanism. Due to high volume fraction of C, the corrosion phenomenon was cathodically controlled. The galvanic corrosion between C fiber and Al matrix showed a strong positive correlation with Cl - deposition rate. Lower corrosion rate at volcanic test site was attributed to dissolution of Ni rich phase, a potential cathodic site that promotes corrosion of Al/C/50f MMCs. Based on the mass loss data of Al2O3 based CF-AMCs and the monoliths showed maximum corrosion at volcanic test site when compared to any other test site. Due to the small volume fraction of intermetallic phases, the corrosion was anodically controlled. And hence the maximum anodic dissolution was found at volcanic test site (high SO2 and acid rain). The second objective of this thesis is to study the effect localized deformation on the corrosion of CF-AMCs. Corrosion initiation on Al (2 wt% Cu)/Al2O3/60f (60% fiber), Al 6061/Al2O 3/60f, and Al/Al2O3/60f CF-AMCs was studied in an aqueous environment The CF-AMCs and their monolithic alloys were deformed locally using a 1/16" diameter silicon nitride ball and 15-60 Kg load in a Rockwell hardness testing machine. Corrosion initiated at the deformed sites, and after longer exposures, spread over the entire region. Localized mechanical deformation resulted in micro-crevice formations at the fiber matrix interface. When deformed material is exposed to a corrosive solution, the crevices at the fiber matrix interface likely increased the hydrogen ion concentration lowering the pH at those regions, a process that leads to premature corrosion. The copper (Cu) rich CF-AMCs in aqueous solution resulted in dissolution of Cu rich phase and their subsequent deposition and redistribution as Cu over the deformed CF-AMCs surface. The corrosion rates of deformed CF-AMCs were higher than the non-deformed CF-AMCs.

A new survey to evaluate conflict of interest policies at academic medical centers

PubMed Central

Hams, Marcia; Zentner, Lynn; Schmidt, Cory; Dweik, Raed A.; Karafa, Matthew; Rose, Susannah L.

2017-01-01

Background A majority of academic medical centers (AMCs) have now adopted conflict of interest policies (COI) to address relationships with pharmaceutical and device industries that can increase the risk of bias in patient care, education and research. However, AMCs may have little information on the impact of their policies. This paper provides a new method, which is a free, publicly-available survey, to fill this information gap and improve COI programs at AMCs. Methods & findings The survey, piloted in three AMCs and designed in collaboration with national conflicts of interest policy experts, covers a range of universal compliance-related concerns, which allows institutions to tailor questions to align with their own policies and culture. The survey was low-burden, and provided important data for these AMCs to evaluate their policies. A descriptive analysis of the pooled pilot site data (n = 1578) was performed, which found that a majority of respondents did not have financial ties with industry and a majority was satisfied with specific COI policies at their institutions. The analysis also showed that the survey is sensitive to differences that AMCs will find meaningful. For instance, individuals with industry ties were significantly more likely than individuals without ties to think that COI policies unnecessarily hindered interactions with industry (p = .004), were ineffective at reducing harm to patients (p < .001), and were ineffective in reducing bias in medical education (p>.001). Conclusion The survey is now free and publicly available for use by any institution. AMCs can use the results to update and refine policies, and to provide ongoing education regarding existing policies. PMID:28296898

A new survey to evaluate conflict of interest policies at academic medical centers.

PubMed

Hams, Marcia; Wilkinson, Wells G; Zentner, Lynn; Schmidt, Cory; Dweik, Raed A; Karafa, Matthew; Rose, Susannah L

2017-01-01

A majority of academic medical centers (AMCs) have now adopted conflict of interest policies (COI) to address relationships with pharmaceutical and device industries that can increase the risk of bias in patient care, education and research. However, AMCs may have little information on the impact of their policies. This paper provides a new method, which is a free, publicly-available survey, to fill this information gap and improve COI programs at AMCs. The survey, piloted in three AMCs and designed in collaboration with national conflicts of interest policy experts, covers a range of universal compliance-related concerns, which allows institutions to tailor questions to align with their own policies and culture. The survey was low-burden, and provided important data for these AMCs to evaluate their policies. A descriptive analysis of the pooled pilot site data (n = 1578) was performed, which found that a majority of respondents did not have financial ties with industry and a majority was satisfied with specific COI policies at their institutions. The analysis also showed that the survey is sensitive to differences that AMCs will find meaningful. For instance, individuals with industry ties were significantly more likely than individuals without ties to think that COI policies unnecessarily hindered interactions with industry (p = .004), were ineffective at reducing harm to patients (p < .001), and were ineffective in reducing bias in medical education (p>.001). The survey is now free and publicly available for use by any institution. AMCs can use the results to update and refine policies, and to provide ongoing education regarding existing policies.

Runx2 Expression in Smooth Muscle Cells Is Required for Arterial Medial Calcification in Mice

PubMed Central

Lin, Mu-En; Chen, Theodore; Leaf, Elizabeth M.; Speer, Mei Y.; Giachelli, Cecilia M.

2016-01-01

Arterial medial calcification (AMC) is a hallmark of aging, diabetes, and chronic kidney disease. Smooth muscle cell (SMC) transition to an osteogenic phenotype is a common feature of AMC, and is preceded by expression of runt-related transcription factor 2 (Runx2), a master regulator of bone development. Whether SMC-specific Runx2 expression is required for osteogenic phenotype change and AMC remains unknown. We therefore created an improved targeting construct to generate mice with floxed Runx2 alleles (Runx2f/f) that do not produce truncated Runx2 proteins after Cre recombination, thereby preventing potential off-target effects. SMC-specific deletion using SM22–recombinase transgenic allele mice (Runx2ΔSM) led to viable mice with normal bone and arterial morphology. After vitamin D overload, arterial SMCs in Runx2f/f mice expressed Runx2, underwent osteogenic phenotype change, and developed severe AMC. In contrast, vitamin D–treated Runx2ΔSM mice had no Runx2 in blood vessels, maintained SMC phenotype, and did not develop AMC. Runx2 deletion did not affect serum calcium, phosphate, fibroblast growth factor-23, or alkaline phosphatase levels. In vitro, Runx2f/f SMCs calcified to a much greater extent than those derived from Runx2ΔSM mice. These data indicate a critical role of Runx2 in SMC osteogenic phenotype change and mineral deposition in a mouse model of AMC, suggesting that Runx2 and downstream osteogenic pathways in SMCs may be useful therapeutic targets for treating or preventing AMC in high-risk patients. PMID:25987250

Numerical processing efficiency improved in children using mental abacus: ERP evidence utilizing a numerical Stroop task

PubMed Central

Yao, Yuan; Du, Fenglei; Wang, Chunjie; Liu, Yuqiu; Weng, Jian; Chen, Feiyan

2015-01-01

This study examined whether long-term abacus-based mental calculation (AMC) training improved numerical processing efficiency and at what stage of information processing the effect appeard. Thirty-three children participated in the study and were randomly assigned to two groups at primary school entry, matched for age, gender and IQ. All children went through the same curriculum except that the abacus group received a 2-h/per week AMC training, while the control group did traditional numerical practice for a similar amount of time. After a 2-year training, they were tested with a numerical Stroop task. Electroencephalographic (EEG) and event related potential (ERP) recording techniques were used to monitor the temporal dynamics during the task. Children were required to determine the numerical magnitude (NC) (NC task) or the physical size (PC task) of two numbers presented simultaneously. In the NC task, the AMC group showed faster response times but similar accuracy compared to the control group. In the PC task, the two groups exhibited the same speed and accuracy. The saliency of numerical information relative to physical information was greater in AMC group. With regards to ERP results, the AMC group displayed congruity effects both in the earlier (N1) and later (N2 and LPC (late positive component) time domain, while the control group only displayed congruity effects for LPC. In the left parietal region, LPC amplitudes were larger for the AMC than the control group. Individual differences for LPC amplitudes over left parietal area showed a positive correlation with RTs in the NC task in both congruent and neutral conditions. After controlling for the N2 amplitude, this correlation also became significant in the incongruent condition. Our results suggest that AMC training can strengthen the relationship between symbolic representation and numerical magnitude so that numerical information processing becomes quicker and automatic in AMC children. PMID:26042012

Patients transferred to academic medical centers and other hospitals: characteristics, resource use, and outcomes.

PubMed

Wyatt, S M; Moy, E; Levin, R J; Lawton, K B; Witter, D M; Valente, E; Lala, R; Griner, P F

1997-10-01

As purchasers of health care increasingly rely on hospital resource use and outcomes profiles to guide quality improvement efforts and contract decisions, a better understanding of the contribution of the most severely ill patients to aggregate resource use and outcomes is needed to develop measures that make fair comparisons between hospitals. In this article, the authors examine the distribution, resource utilization, and outcomes of transferred patients ("transfers"), a group known to be highly complex. The study examines the contributions to resource use and outcomes of these patients at academic medical centers (AMCs) and non-teaching hospitals. The authors go beyond previous work by comparing AMCs with non-teaching hospitals, and by using a nationally representative sample for the year 1992. The detailed findings demonstrated that AMCs provided a disproportionate share of care to transfers in 1992, and that transfers to AMCs are more complex and require more specialized care than do transfers to non-teaching hospitals. The study also determined that, during the time studied, AMCs received a disproportionate share of Medicaid and indigentcare transfers. Finally, the findings demonstrated that transfers increased in absolute numbers and as a percentage of total patient volumes for all hospitals from 1988 to 1994. The rate of increase was greatest for AMCs. The authors explain why they believe that their findings are applicable today, although they caution that study of more recent data should be made. The authors comment that purchasers of health care may find the study useful in better understanding benchmarking tools used to evaluate hospitals. This study may also help those involved in health policy to more fully understand the magnitude of the contribution to transfer patient care provided by AMCs. Finally, health policymakers and planners may find this work useful as they prepare for increasing numbers of transfers in the future, particularly at AMCs.

Paleomagnetism of Neoproterozoic cap carbonates of the Sao Francisco and Amazonian cratons, Brazil

NASA Astrophysics Data System (ADS)

Trindade, R. I. F.; Dagrella-Filho, M. S.; Figueiredo, F. T.; Font, E.; Babinski, M.; Nogueira, A. C. R.; Riccomini, C.

2003-04-01

The low-latitude paleomagnetic record of some Neoproterozoic glacial successions has long been used as an evidence for dramatic changes in Earth climate (Snowball Earth events). But the test for such events demands a global-scale paleomagnetic database in the Neoproterozoic glacial/carbonate successions. In order to better constrain these extreme climatic events, an extensive paleomagnetic survey has been conducted in carbonates that cap the Neoproterozoic glacial rocks of the Sao Francisco (SFC) and Amazonian (AMC) cratons, Brazil. In the SFC, sampling was performed at 104 sites (horizontal beds) distributed at two sectors (north and south), about 1.000 km apart, within the stable area of the craton. In the AMC, sampling included 15 sites in undeformed, sub-horizontal beds, and 25 sites along the limbs of regional folds in the margin of the craton. After paleomagnetic cleaning, most samples from both SFC and AMC yielded similar PGVs (mean SFC: 32°N, 322°E (A95=2.8, K=65.3); mean AMC: 31°N, 336°E (A95=6.8, K=46.2)). Pb-Pb ages around 520 Ma for SFC samples, a negative fold-test for AMC samples, and the coincidence of these poles with 520 Ma Gondwanan reference poles after rotation of South America to Africa, suggest a continental-scale remagnetization by this time. Some sites from both cratons, however, seem to have not been affected by the Cambrian remagnetization. Two mean poles were calculated for SFC and AMC for which consistent reversals could be recorded, suggesting a primary nature for the characteristic magnetization (mean SFC pole: 66°S, 198°E (A95=5.4, K=47.5); mean AMC pole: 77°S, 66°E (A95=8.8, K=47.7)). These results indicate a moderate latitude (51°) for the SFC Bebedouro (Sturtian) glaciation and a low latitude (24°) for the AMC Puga (Varanger) glaciation, and reinforces the hypothesis of Neoproterozoic global-scale ice-ages.

Finite difference time domain grid generation from AMC helicopter models

NASA Technical Reports Server (NTRS)

Cravey, Robin L.

1992-01-01

A simple technique is presented which forms a cubic grid model of a helicopter from an Aircraft Modeling Code (AMC) input file. The AMC input file defines the helicopter fuselage as a series of polygonal cross sections. The cubic grid model is used as an input to a Finite Difference Time Domain (FDTD) code to obtain predictions of antenna performance on a generic helicopter model. The predictions compare reasonably well with measured data.

Association Between Academic Medical Center Pharmaceutical Detailing Policies and Physician Prescribing.

PubMed

Larkin, Ian; Ang, Desmond; Steinhart, Jonathan; Chao, Matthew; Patterson, Mark; Sah, Sunita; Wu, Tina; Schoenbaum, Michael; Hutchins, David; Brennan, Troyen; Loewenstein, George

2017-05-02

In an effort to regulate physician conflicts of interest, some US academic medical centers (AMCs) enacted policies restricting pharmaceutical representative sales visits to physicians (known as detailing) between 2006 and 2012. Little is known about the effect of these policies on physician prescribing. To analyze the association between detailing policies enacted at AMCs and physician prescribing of actively detailed and not detailed drugs. The study used a difference-in-differences multivariable regression analysis to compare changes in prescribing by physicians before and after implementation of detailing policies at AMCs in 5 states (California, Illinois, Massachusetts, Pennsylvania, and New York) that made up the intervention group with changes in prescribing by a matched control group of similar physicians not subject to a detailing policy. Academic medical center implementation of policies regulating pharmaceutical salesperson visits to attending physicians. The monthly within-drug class market share of prescriptions written by an individual physician for detailed and nondetailed drugs in 8 drug classes (lipid-lowering drugs, gastroesophageal reflux disease drugs, diabetes drugs, antihypertensive drugs, hypnotic drugs approved for the treatment of insomnia [sleep aids], attention-deficit/hyperactivity disorder drugs, antidepressant drugs, and antipsychotic drugs) comparing the 10- to 36-month period before implementation of the detailing policies with the 12- to 36-month period after implementation, depending on data availability. The analysis included 16 121 483 prescriptions written between January 2006 and June 2012 by 2126 attending physicians at the 19 intervention group AMCs and by 24 593 matched control group physicians. The sample mean market share at the physician-drug-month level for detailed and nondetailed drugs prior to enactment of policies was 19.3% and 14.2%, respectively. Exposure to an AMC detailing policy was associated with a decrease in the market share of detailed drugs of 1.67 percentage points (95% CI, -2.18 to -1.18 percentage points; P < .001) and an increase in the market share of nondetailed drugs of 0.84 percentage points (95% CI, 0.54 to 1.14 percentage points; P < .001). Associations were statistically significant for 6 of 8 study drug classes for detailed drugs (lipid-lowering drugs, gastroesophageal reflux disease drugs, antihypertensive drugs, sleep aids, attention-deficit/hyperactivity disorder drugs, and antidepressant drugs) and for 9 of the 19 AMCs that implemented policies. Eleven of the 19 AMCs regulated salesperson gifts to physicians, restricted salesperson access to facilities, and incorporated explicit enforcement mechanisms. For 8 of these 11 AMCs, there was a significant change in prescribing. In contrast, there was a significant change at only 1 of 8 AMCs that did not enact policies in all 3 areas. Implementation of policies at AMCs that restricted pharmaceutical detailing between 2006 and 2012 was associated with modest but significant reductions in prescribing of detailed drugs across 6 of 8 major drug classes; however, changes were not seen in all of the AMCs that enacted policies.

The small molecule '1-(4-biphenylylcarbonyl)-4-(5-bromo-2-methoxybenzyl) piperazine oxalate' and its derivatives regulate global protein synthesis by inactivating eukaryotic translation initiation factor 2-alpha.

PubMed

Hong, Mi-Na; Nam, Ky-Youb; Kim, Kyung Kon; Kim, So-Young; Kim, InKi

2016-05-01

By environmental stresses, cells can initiate a signaling pathway in which eukaryotic translation initiation factor 2-alpha (eIF2-α) is involved to regulate the response. Phosphorylation of eIF2-α results in the reduction of overall protein neogenesis, which allows cells to conserve resources and to reprogram energy usage for effective stress control. To investigate the role of eIF2-α in cell stress responses, we conducted a viability-based compound screen under endoplasmic reticulum (ER) stress condition, and identified 1-(4-biphenylylcarbonyl)-4-(5-bromo-2-methoxybenzyl) piperazine oxalate (AMC-01) and its derivatives as eIF2-α-inactivating chemical. Molecular characterization of this signaling pathway revealed that AMC-01 induced inactivation of eIF2-α by phosphorylating serine residue 51 in a dose- and time-dependent manner, while the negative control compounds did not affect eIF2-α phosphorylation. In contrast with ER stress induction by thapsigargin, phosphorylation of eIF2-α persisted for the duration of incubation with AMC-01. By pathway analysis, AMC-01 clearly induced the activation of protein kinase RNA-activated (PKR) kinase and nuclear factor-κB (NF-κB), whereas it did not modulate the activity of PERK or heme-regulated inhibitor (HRI). Finally, we could detect a lower protein translation rate in cells incubated with AMC-01, establishing AMC-01 as a potent chemical probe that can regulate eIF2-α activity. We suggest from these data that AMC-01 and its derivative compounds can be used as chemical probes in future studies of the role of eIF2-α in protein synthesis-related cell physiology.

Impact of restricted amoxicillin/clavulanic acid use on Escherichia coli resistance--antibiotic DU90% profiles with bacterial resistance rates: a visual presentation.

PubMed

Mimica Matanovic, Suzana; Bergman, Ulf; Vukovic, Dubravka; Wettermark, Björn; Vlahovic-Palcevski, Vera

2010-10-01

High use of amoxicillin/clavulanic acid (AMC) at the University Hospital Osijek (Croatia) contributed to high rates of resistance in Enterobacteriaceae, in particular Escherichia coli (50%). Thus, in order to decrease bacterial resistance, AMC use was restricted. We present results of the restriction on resistance amongst antibiotics accounting for 90% of antibiotic use [drug utilisation 90% (DU90%)]. Data were analysed on antibiotic use and microbiological susceptibility of E. coli during two 9-month periods, before and after the restriction of AMC use. Drug use was presented as numbers of defined daily doses (DDDs) and DDDs/100 bed-days. Resistance of E. coli to antibiotics was presented as percentages of isolated strains in the DU90% segment. Use of AMC was 16 DDDs/100 bed-days or 30% of all antibiotics before the intervention. Use of AMC fell to 2 DDDs/100 bed-days or 4% after the intervention, and resistance of E. coli fell from 37% to 11%. In conclusion, restricted use of AMC resulted in a significant decrease of E. coli resistance. DU90% resistance profiles are simple and useful tools in highlighting problems in antibiotic use and resistance but may also be useful in long-term follow-up of antibiotic policy. Copyright 2010 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

Mitogenic and chondrogenic effects of fibroblast growth factor-2 in adipose-derived mesenchymal cells

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

Chiou, Michael; Xu Yue; Longaker, Michael T.

2006-05-05

Adipose-derived mesenchymal cells (AMCs) have demonstrated a great capacity for differentiating into bone, cartilage, and fat. Studies using bone marrow-derived mesenchymal cells (BMSCs) have shown that fibroblast growth factor (FGF)-2, a potent mitogenic factor, plays an important role in tissue engineering due to its effects in proliferation and differentiation for mesenchymal cells. The aim of this study was to investigate the function of FGF-2 in AMC chondrogenic differentiation and its possible contributions to cell-based therapeutics in skeletal tissue regeneration. Data demonstrated that FGF-2 significantly promoted the proliferation of AMCs and enhanced chondrogenesis in three-dimensional micromass culture. Moreover, priming AMCs withmore » treatment of FGF-2 at 10 ng/ml demonstrated that cells underwent chondrogenic phenotypic differentiation, possibly by inducing N-Cadherin, FGF-receptor 2, and transcription factor Sox9. Our results indicated that FGF-2 potentiates chondrogenesis in AMCs, similar to its functions in BMSCs, suggesting the versatile potential applications of FGF-2 in skeletal regeneration and cartilage repair.« less

Association Between Academic Medical Center Pharmaceutical Detailing Policies and Physician Prescribing

PubMed Central

Ang, Desmond; Steinhart, Jonathan; Chao, Matthew; Patterson, Mark; Sah, Sunita; Wu, Tina; Schoenbaum, Michael; Hutchins, David; Brennan, Troyen; Loewenstein, George

2017-01-01

Importance In an effort to regulate physician conflicts of interest, some US academic medical centers (AMCs) enacted policies restricting pharmaceutical representative sales visits to physicians (known as detailing) between 2006 and 2012. Little is known about the effect of these policies on physician prescribing. Objective To analyze the association between detailing policies enacted at AMCs and physician prescribing of actively detailed and not detailed drugs. Design, Setting, and Participants The study used a difference-in-differences multivariable regression analysis to compare changes in prescribing by physicians before and after implementation of detailing policies at AMCs in 5 states (California, Illinois, Massachusetts, Pennsylvania, and New York) that made up the intervention group with changes in prescribing by a matched control group of similar physicians not subject to a detailing policy. Exposures Academic medical center implementation of policies regulating pharmaceutical salesperson visits to attending physicians. Main Outcomes and Measures The monthly within-drug class market share of prescriptions written by an individual physician for detailed and nondetailed drugs in 8 drug classes (lipid-lowering drugs, gastroesophageal reflux disease drugs, diabetes drugs, antihypertensive drugs, hypnotic drugs approved for the treatment of insomnia [sleep aids], attention-deficit/hyperactivity disorder drugs, antidepressant drugs, and antipsychotic drugs) comparing the 10- to 36-month period before implementation of the detailing policies with the 12- to 36-month period after implementation, depending on data availability. Results The analysis included 16 121 483 prescriptions written between January 2006 and June 2012 by 2126 attending physicians at the 19 intervention group AMCs and by 24 593 matched control group physicians. The sample mean market share at the physician-drug-month level for detailed and nondetailed drugs prior to enactment of policies was 19.3% and 14.2%, respectively. Exposure to an AMC detailing policy was associated with a decrease in the market share of detailed drugs of 1.67 percentage points (95% CI, −2.18 to −1.18 percentage points; P < .001) and an increase in the market share of nondetailed drugs of 0.84 percentage points (95% CI, 0.54 to 1.14 percentage points; P < .001). Associations were statistically significant for 6 of 8 study drug classes for detailed drugs (lipid-lowering drugs, gastroesophageal reflux disease drugs, antihypertensive drugs, sleep aids, attention-deficit/hyperactivity disorder drugs, and antidepressant drugs) and for 9 of the 19 AMCs that implemented policies. Eleven of the 19 AMCs regulated salesperson gifts to physicians, restricted salesperson access to facilities, and incorporated explicit enforcement mechanisms. For 8 of these 11 AMCs, there was a significant change in prescribing. In contrast, there was a significant change at only 1 of 8 AMCs that did not enact policies in all 3 areas. Conclusions and Relevance Implementation of policies at AMCs that restricted pharmaceutical detailing between 2006 and 2012 was associated with modest but significant reductions in prescribing of detailed drugs across 6 of 8 major drug classes; however, changes were not seen in all of the AMCs that enacted policies. PMID:28464141

Advance market commitment for pneumococcal vaccines: putting theory into practice

PubMed Central

Cernuschi, Tania; Schwalbe, Nina; Jones, Andrew; Berndt, Ernst R; McAdams, Susan

2011-01-01

Abstract Markets for life-saving vaccines do not often generate the most desired outcomes from a public health perspective in terms of product quantity, quality, affordability, programmatic suitability and/or sustainability for use in the lowest income countries. The perceived risks and uncertainties about sustainably funded demand from developing countries often leads to underinvestment in development and manufacturing of appropriate products. The pilot initiative Advance Market Commitment (AMC) for pneumococcal vaccines, launched in 2009, aims to remove some of these market risks by providing a legally binding forward commitment to purchase vaccines according to predetermined terms. To date, 14 countries have already introduced pneumococcal vaccines through the AMC with a further 39 countries expected to introduce before the end of 2013. This paper describes early lessons learnt on the selection of a target disease and the core design choices for the pilot AMC. It highlights the challenges faced with tailoring the AMC design to the specific supply situation of pneumococcal vaccines. It points to the difficulty – and the AMC’s apparent early success – in establishing a long-term, credible commitment in a constantly changing unpredictable environment. It highlights one of the inherent challenges of the AMC: its dependence on continuous donor funding to ensure long-term purchases of products. The paper examines alternative design choices and aims to provide a starting point to inform discussions and encourage debate about the potential application of the AMC concept to other fields. PMID:22271949

Microstructure and wear characterization of aluminum matrix composites reinforced with industrial waste fly ash particulates synthesized by friction stir processing

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

Dinaharan, I., E-mail: dinaweld2009@gmail.com

Fly ash (FA) is a waste product of coal combustion in thermal power plants which is available in massive quantities all over the world causing land pollution. This paper reports the characterization of AA6061 aluminum matrix composites (AMCs) reinforced with FA particles synthesized using friction stir processing (FSP). The volume fraction of FA particles was varied from 0 to 18 in steps of 6. The prepared AMCs were characterized using optical microscopy (OM), scanning electron microscopy (SEM) and electron backscattered diagram (EBSD). The wear rate was estimated using a pin-on-disc wear apparatus. FA particles were observed to be distributed homogeneouslymore » in the AMC irrespective of the location within the stir zone. The EBSD micrographs revealed remarkable grain refinement in the AMC. The incorporation of FA particles enhanced the microhardness and wear resistance of the AMC. The strengthening mechanisms of the AMC were discussed and correlated to the observed microstructures. The wear mechanisms were identified by characterizing the wear debris and worn surfaces. - Highlights: •Industrial waste fly ash was used to produce aluminum matrix composites. •Friction stir processing was used to produce AA6061/Fly Ash composite. •Fly ash particles refined the grains of aluminum matrix. •Fly ash particles enhanced the hardness and wear resistance. •Successful utilization of fly ash to make aluminum composites reduces land pollution.« less

Developing a consensus framework and risk profile for agents of opportunity in academic medical centers: implications for public health preparedness.

PubMed

Farmer, Brenna M; Nelson, Lewis S; Graham, Margaret E; Bendzans, Carly; McCrillis, Aileen M; Portelli, Ian; Zhang, Meng; Goldberg, Judith; Rosenberg, Sheldon D; Goldfrank, Lewis R; Tunik, Michael

2010-12-01

Agents of opportunity (AO) in academic medical centers (AMC) are defined as unregulated or lightly regulated substances used for medical research or patient care that can be used as "dual purpose" substances by terrorists to inflict damage upon populations. Most of these agents are used routinely throughout AMC either during research or for general clinical practice. To date, the lack of careful regulations for AOs creates uncertain security conditions and increased malicious potential. Using a consensus-based approach, we collected information and opinions from staff working in an AMC and 4 AMC-affiliated hospitals concerning identification of AO, AO attributes, and AMC risk and preparedness, focusing on AO security and dissemination mechanisms and likely hospital response. The goal was to develop a risk profile and framework for AO in the institution. Agents of opportunity in 4 classes were identified and an AO profile was developed, comprising 16 attributes denoting information critical to preparedness for AO misuse. Agents of opportunity found in AMC present a unique and vital gap in public health preparedness. Findings of this project may provide a foundation for a discussion and consensus efforts to determine a nationally accepted risk profile framework for AO. This foundation may further lead to the implementation of appropriate regulatory policies to improve public health preparedness. Agents of opportunity modeling of dissemination properties should be developed to better predict AO risk.

Utilization of human amniotic mesenchymal cells as feeder layers to sustain propagation of human embryonic stem cells in the undifferentiated state.

PubMed

Zhang, Kehua; Cai, Zhe; Li, Yang; Shu, Jun; Pan, Lin; Wan, Fang; Li, Hong; Huang, Xiaojie; He, Chun; Liu, Yanqiu; Cui, Xiaohui; Xu, Yang; Gao, Yan; Wu, Liqun; Cao, Shanxia; Li, Lingsong

2011-08-01

Human embryonic stem (ES) cells are usually maintained in the undifferentiated state by culturing on feeder cells layers of mouse embryonic fibroblasts (MEFs). However, MEFs are not suitable to support human ES cells used for clinical purpose because of risk of zoonosis from animal cells. Therefore, human tissue-based feeder layers need to be developed for human ES cells for clinical purpose. Hereof we report that human amniotic mesenchymal cells (hAMCs) could act as feeder cells for human ES cells, because they are easily obtained and relatively exempt from ethical problem. Like MEFs, hAMCs could act as feeder cells for human ES cells to grow well on. The self-renewal rate of human ES cells cultured on hAMCs feeders was higher than that on MEFs and human amniotic epithelial cells determined by measurement of colonial diameters and growth curve as well as cell cycle analysis. Both immunofluorescence staining and immunoblotting showed that human ES cells cultured on hAMCs expressed stem cell markers such as Oct-3/4, Sox2, and NANOG. Verified by embryoid body formation in vitro and teratoma formation in vivo, we found out that after 20 passages of culture, human ES cells grown on hAMCs feeders could still retain the potency of differentiating into three germ layers. Taken together, our data suggested hAMCs may be safe feeder cells to sustain the propagation of human ES cells in undifferentiated state for future therapeutic use.

Effects of amoxicillin/clavulanic acid on the pharmacokinetics of valproic acid

PubMed Central

Lee, Soo-Yun; Huh, Wooseong; Jung, Jin Ah; Yoo, Hye Min; Ko, Jae-Wook; Kim, Jung-Ryul

2015-01-01

Valproic acid (VPA) is mainly metabolized via glucuronide, which is hydrolyzed by β-glucuronidase and undergoes enterohepatic circulation. Amoxicillin/clavulanic acid (AMC) administration leads to decreased levels of β-glucuronidase-producing bacteria, suggesting that these antibiotics could interrupt enterohepatic circulation and thereby alter the pharmacokinetics of VPA. This study aimed to evaluate the effects of AMC on the pharmacokinetics of VPA. This was an open-label, two-treatment, one-sequence study in 16 healthy volunteers. Two treatments were evaluated; treatment VPA, in which a single dose of VPA 500 mg was administered, and treatment AMC + VPA, in which multiple doses of AMC 500/125 mg were administered three times daily for 7 days and then a single dose of VPA was administered. Blood samples were collected up to 48 hours. Pharmacokinetic parameters were calculated using noncompartmental methods. Fifteen subjects completed the study. Systemic exposures and peak concentrations of VPA were slightly lower with treatment AMC + VPA than with treatment VPA (AUClast, 851.0 h·mg/L vs 889.6 h·mg/L; Cmax, 52.1 mg/L vs 53.0 mg/L). There were no significant between-treatment effects on pharmacokinetics (95% confidence interval [CI]) of AUClast and Cmax (95.7 [85.9–106.5] and 98.3 [91.6–105.6], respectively). Multiple doses of AMC had no significant effects on the pharmacokinetics of VPA; thus, no dose adjustment is necessary. PMID:26309401

Agent of opportunity risk mitigation: people, engineering, and security efficacy.

PubMed

Graham, Margaret E; Tunik, Michael G; Farmer, Brenna M; Bendzans, Carly; McCrillis, Aileen M; Nelson, Lewis S; Portelli, Ian; Smith, Silas; Goldberg, Judith D; Zhang, Meng; Rosenberg, Sheldon D; Goldfrank, Lewis R

2010-12-01

Agents of opportunity (AO) are potentially harmful biological, chemical, radiological, and pharmaceutical substances commonly used for health care delivery and research. AOs are present in all academic medical centers (AMC), creating vulnerability in the health care sector; AO attributes and dissemination methods likely predict risk; and AMCs are inadequately secured against a purposeful AO dissemination, with limited budgets and competing priorities. We explored health care workers' perceptions of AMC security and the impact of those perceptions on AO risk. Qualitative methods (survey, interviews, and workshops) were used to collect opinions from staff working in a medical school and 4 AMC-affiliated hospitals concerning AOs and the risk to hospital infrastructure associated with their uncontrolled presence. Secondary to this goal, staff perception concerning security, or opinions about security behaviors of others, were extracted, analyzed, and grouped into themes. We provide a framework for depicting the interaction of staff behavior and access control engineering, including the tendency of staff to "defeat" inconvenient access controls. In addition, 8 security themes emerged: staff security behavior is a significant source of AO risk; the wide range of opinions about "open" front-door policies among AMC staff illustrates a disparity of perceptions about the need for security; interviewees expressed profound skepticism concerning the effectiveness of front-door access controls; an AO risk assessment requires reconsideration of the security levels historically assigned to areas such as the loading dock and central distribution sites, where many AOs are delivered and may remain unattended for substantial periods of time; researchers' view of AMC security is influenced by the ongoing debate within the scientific community about the wisdom of engaging in bioterrorism research; there was no agreement about which areas of the AMC should be subject to stronger access controls; security personnel play dual roles of security and customer service, creating the negative perception that neither role is done well; and budget was described as an important factor in explaining the state of security controls. We determined that AMCs seeking to reduce AO risk should assess their institutionally unique AO risks, understand staff security perceptions, and install access controls that are responsive to the staff's tendency to defeat them. The development of AO attribute fact sheets is desirable for AO risk assessment; new funding and administrative or legislative tools to improve AMC security are required; and security practices and methods that are convenient and effective should be engineered.

Resistance to amoxicillin-clavulanate and its relation to virulence-related factors in Yersinia enterocolitica biovar 1A.

PubMed

Singhal, N; Kumar, M; Virdi, J S

2016-01-01

Recent studies have reported that the virulence factors (VFs) were detected more frequently in amoxicillin-clavulanate (AMC) susceptible clinical isolates of Escherichia coli. Here, we have evaluated the relationship between VFs and AMC-resistance phenotype in clinical isolates of Y. enterocolitica biovar 1A. The presence/absence of VFs was compared with their minimum inhibitory concentrations for AMC in strains of two serovars. We observed that the strains of the serovar O: 6, 30-6, 31 showed a similar relationship between the number of VFs and resistance to clavulanic acid as in E. coli but not of serovar O: 6, 30. Variations in the promoters/complete coding sequences (CCDSs) of β-lactamase gene (bla A) or the serological characteristics could not account for unusual susceptibility to AMC displayed by the strains of the serovar O: 6, 30. Therefore, we speculate that since the clinical strains of serovar O: 6, 30-6, 31 originated from the environment they were less exposed to antibiotics compared to clinical strains of serovar O: 6, 30. Thus, AMC susceptibility seems to be influenced by factors other than serotypes or promoters/CCDS of β-lactamase genes.

Compact planar monopole antenna for wearable wireless applications

NASA Astrophysics Data System (ADS)

Andriamiharivolamena, Tsitoha; Lemaître-Auger, Pierre; Tedjini, Smail; Tirard, Franck

2015-11-01

We report in this paper the design and the realization of a compact wearable monopole antenna directly placed over an Artificial Magnetic Conductor (AMC), which is located directly on the body. The major contribution is that there is no space between the monopole and the AMC, or between the AMC and the body. Simulation results and measurements are in good agreement and show that the antenna's performances are as good as the best ones reported so far in the literature, while having a smaller volume. The antenna operates at 1.92 GHz with a bandwidth of 8%. The reflection coefficient of the antenna is - 35 dB. The measurement of the antenna gain provides a value of 4.3 dBi with a half-power beamwidth of 70° and a front-to-back radiation ratio of 15.8 dB. Measurement and simulation results also show that the AMC isolates well the monopole from the body: the localized Specific Absorption Rate (SAR) value calculated with 1 g of tissue is 0.34 W/kg with an injected power of 1 W. The antenna with the AMC is well adapted for wearable applications.

The future of hospital economic health.

PubMed

Gerber, David R; Bekes, Carolyn E; Parrillo, Joseph E

2006-03-01

To evaluate factors which may influence the economic future of academic medical centers (AMCs). A literature search was performed to identify publications which reviewed the areas of revenue sources for AMCs, costs and expenses incurred by these institutions, and mechanisms for optimizing institutional economic stability. Data were reviewed and evaluated in two primary contexts: hospital revenues and organizational and administrative factors influencing hospital economic health. Increasing economic stress will require AMCs to make efforts both to increase revenue through a variety of mechanisms and to minimize expenses without compromising their mission or impairing worker morale.

Detection of myocardial ischemia by automated, motion-corrected, color-encoded perfusion maps compared with visual analysis of adenosine stress cardiovascular magnetic resonance imaging at 3 T: a pilot study.

PubMed

Doesch, Christina; Papavassiliu, Theano; Michaely, Henrik J; Attenberger, Ulrike I; Glielmi, Christopher; Süselbeck, Tim; Fink, Christian; Borggrefe, Martin; Schoenberg, Stefan O

2013-09-01

The purpose of this study was to compare automated, motion-corrected, color-encoded (AMC) perfusion maps with qualitative visual analysis of adenosine stress cardiovascular magnetic resonance imaging for detection of flow-limiting stenoses. Myocardial perfusion measurements applying the standard adenosine stress imaging protocol and a saturation-recovery temporal generalized autocalibrating partially parallel acquisition (t-GRAPPA) turbo fast low angle shot (Turbo FLASH) magnetic resonance imaging sequence were performed in 25 patients using a 3.0-T MAGNETOM Skyra (Siemens Healthcare Sector, Erlangen, Germany). Perfusion studies were analyzed using AMC perfusion maps and qualitative visual analysis. Angiographically detected coronary artery (CA) stenoses greater than 75% or 50% or more with a myocardial perfusion reserve index less than 1.5 were considered as hemodynamically relevant. Diagnostic performance and time requirement for both methods were compared. Interobserver and intraobserver reliability were also assessed. A total of 29 CA stenoses were included in the analysis. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for detection of ischemia on a per-patient basis were comparable using the AMC perfusion maps compared to visual analysis. On a per-CA territory basis, the attribution of an ischemia to the respective vessel was facilitated using the AMC perfusion maps. Interobserver and intraobserver reliability were better for the AMC perfusion maps (concordance correlation coefficient, 0.94 and 0.93, respectively) compared to visual analysis (concordance correlation coefficient, 0.73 and 0.79, respectively). In addition, in comparison to visual analysis, the AMC perfusion maps were able to significantly reduce analysis time from 7.7 (3.1) to 3.2 (1.9) minutes (P < 0.0001). The AMC perfusion maps yielded a diagnostic performance on a per-patient and on a per-CA territory basis comparable with the visual analysis. Furthermore, this approach demonstrated higher interobserver and intraobserver reliability as well as a better time efficiency when compared to visual analysis.

A users manual for the method of moments Aircraft Modeling Code (AMC), version 2

NASA Technical Reports Server (NTRS)

Peters, M. E.; Newman, E. H.

1994-01-01

This report serves as a user's manual for Version 2 of the 'Aircraft Modeling Code' or AMC. AMC is a user-oriented computer code, based on the method of moments (MM), for the analysis of the radiation and/or scattering from geometries consisting of a main body or fuselage shape with attached wings and fins. The shape of the main body is described by defining its cross section at several stations along its length. Wings, fins, rotor blades, and radiating monopoles can then be attached to the main body. Although AMC was specifically designed for aircraft or helicopter shapes, it can also be applied to missiles, ships, submarines, jet inlets, automobiles, spacecraft, etc. The problem geometry and run control parameters are specified via a two character command language input format. This report describes the input command language and also includes several examples which illustrate typical code inputs and outputs.

Comparative biochemical methane potential of paragrass using an unacclimated and an acclimated microbial consortium.

PubMed

Nuchdang, Sasikarn; Khemkhao, Maneerat; Techkarnjanaruk, Somkiet; Phalakornkule, Chantaraporn

2015-05-01

The effect of inoculum sources on the anaerobic digestion of paragrass was investigated. Two types of sludge were used as the inoculums: an anaerobic sludge obtained from a domestic wastewater treatment plant (OS) and a sludge acclimated to fibrous substrates in raw palm oil mill effluent (AMC). Microbial activity assays showed that the AMC had hydrolytic and acetogenic activities two times greater than the activities of the OS. In addition, the production of methane from acetate by the AMC occurred without a lag phase, while it took 8 days for the OS to start producing methane from the same substrate. The biochemical methane potential after 80 days digestion was 316 ml STP/g VS(added) using the AMC, and 277 ml STP/g VS(added) using the OS. The methane potential of the paragrass was estimated to be 3337 Nm(3) CH4/ha a. Copyright © 2015 Elsevier Ltd. All rights reserved.

A user's manual for the method of moments Aircraft Modeling Code (AMC)

NASA Technical Reports Server (NTRS)

Peters, M. E.; Newman, E. H.

1989-01-01

This report serves as a user's manual for the Aircraft Modeling Code or AMC. AMC is a user-oriented computer code, based on the method of moments (MM), for the analysis of the radiation and/or scattering from geometries consisting of a main body or fuselage shape with attached wings and fins. The shape of the main body is described by defining its cross section at several stations along its length. Wings, fins, rotor blades, and radiating monopoles can then be attached to the main body. Although AMC was specifically designed for aircraft or helicopter shapes, it can also be applied to missiles, ships, submarines, jet inlets, automobiles, spacecraft, etc. The problem geometry and run control parameters are specified via a two character command language input format. The input command language is described and several examples which illustrate typical code inputs and outputs are also included.

The Harvard Medical School Academic Innovations Collaborative: transforming primary care practice and education.

PubMed

Bitton, Asaf; Ellner, Andrew; Pabo, Erika; Stout, Somava; Sugarman, Jonathan R; Sevin, Cory; Goodell, Kristen; Bassett, Jill S; Phillips, Russell S

2014-09-01

Academic medical centers (AMCs) need new approaches to delivering higher-quality care at lower costs, and engaging trainees in the work of high-functioning primary care practices. In 2012, the Harvard Medical School Center for Primary Care, in partnership with with local AMCs, established an Academic Innovations Collaborative (AIC) with the goal of transforming primary care education and practice. This novel two-year learning collaborative consisted of hospital- and community-based primary care teaching practices, committed to building highly functional teams, managing populations, and engaging patients. The AIC built on models developed by Qualis Health and the Institute for Healthcare Improvement, optimized for the local AMC context. Foundational elements included leadership engagement and development, application of rapid-cycle process improvement, and the creation of teams to care for defined patient populations. Nineteen practices across six AMCs participated, with nearly 260,000 patients and 450 resident learners. The collaborative offered three 1.5-day learning sessions each year featuring shared learning, practice coaches, and improvement measures, along with monthly data reporting, webinars, and site visits. Validated self-reports by transformation teams showed that practices made substantial improvement across all areas of change. Important factors for success included leadership development, practice-level resources, and engaging patients and trainees. The AIC model shows promise as a path for AMCs to catalyze health system transformation through primary care improvement. In addition to further evaluating the impact of practice transformation, expansion will require support from AMCs and payers, and the application of similar approaches on a broader scale.

Characterizing the In-Phase Reflection Bandwidth Theoretical Limit of Artificial Magnetic Conductors With a Transmission Line Model

NASA Technical Reports Server (NTRS)

Xie, Yunsong; Fan, Xin; Chen, Yunpeng; Wilson, Jeefrey D.; Simons, Rainee N.; Xiao, John Q.

2013-01-01

We validate through simulation and experiment that artificial magnetic conductors (AMC s) can be well characterized by a transmission line model. The theoretical bandwidth limit of the in-phase reflection can be expressed in terms of the effective RLC parameters from the surface patch and the properties of the substrate. It is found that the existence of effective inductive components will reduce the in-phase reflection bandwidth of the AMC. Furthermore, we propose design strategies to optimize AMC structures with an in-phase reflection bandwidth closer to the theoretical limit.

Techniques Analysis of the Interference Suppression Algorithm in Broadband Aeronautical Multi-carrier Communication System

NASA Astrophysics Data System (ADS)

Li, Dong-xia; Ye, Qian-wen

Out-of-band radiation suppression algorithm must be used efficiently for broadband aeronautical communication system in order not to interfere the operation of the existing systems in aviation L-Band. Based on the simple introduction of the broadband aeronautical multi-carrier communication (B-AMC) system model, several sidelobe suppression techniques in orthogonal frequency multiplexing (OFDM) system are presented and analyzed so as to find a suitable algorithm for B-AMC system in this paper. Simulation results show that raise-cosine function windowing can suppress the out-of-band radiation of B-AMC system effectively.

Retention performance of green roofs in three different climate regions

NASA Astrophysics Data System (ADS)

Sims, Andrew W.; Robinson, Clare E.; Smart, Charles C.; Voogt, James A.; Hay, Geoffrey J.; Lundholm, Jeremey T.; Powers, Brandon; O'Carroll, Denis M.

2016-11-01

Green roofs are becoming increasingly popular for moderating stormwater runoff in urban areas. This study investigated the impact different climates have on the retention performance of identical green roofs installed in London Ontario (humid continental), Calgary Alberta (semi-arid, continental), and Halifax Nova Scotia (humid, maritime). Drier climates were found to have greater percent cumulative stormwater retention with Calgary (67%) having significantly better percent retention than both London (48%) and Halifax (34%). However, over the same study period the green roof in London retained the greatest depth of stormwater (598 mm), followed by the green roof in Halifax (471 mm) and then Calgary (411 mm). The impact of climate was largest for medium sized storms where the antecedent moisture condition (AMC) at the beginning of a rainfall event governs retention performance. Importantly AMC was a very good predictor of stormwater retention, with similar retention at all three sites for a given AMC, emphasizing that AMC is a relevant indicator of retention performance in any climate. For large rainfall events (i.e., >45 mm) green roof average retention ranged between 16% and 29% in all cities. Overall, drier climates have superior retention due to lower AMC in the media. However, moderate and wet climates still provide substantial total volume reduction benefits.

Good Neighbors: Shared Challenges and Solutions Toward Increasing Value at Academic Medical Centers and Universities.

PubMed

Clancy, Gerard P

2015-12-01

Academic medical centers (AMCs) and universities are experiencing increasing pressure to enhance the value they offer at the same time that they are facing challenges related to outcomes, controlling costs, new competition, and government mandates. Yet, rarely do the leaders of these academic neighbors work cooperatively to enhance value. In this Perspective the author, a former university regional campus president with duties in an AMC as an academic physician, shares his insights into the shared challenges these academic neighbors face in improving the value of their services in complex environments. He describes the successes some AMCs have had in generating revenues from new clinical programs that reduce the overall cost of care for larger populations. He also describes how several universities have taken a comprehensive approach to reduce overhead and administrative costs. The author identifies six themes related to successful value improvement efforts and provides examples of successful strategies used by AMCs and their university neighbors to improve the overall value of their programs. He concludes by encouraging leaders of AMCs and universities to share information about their successes in value improvements with each other, to seek additional joint value enhancement efforts, and to market their value improvements to the public.

Influence of ECAP temperature on the formability of a particle reinforced 2017 aluminum alloy

NASA Astrophysics Data System (ADS)

Wagner, S.; Härtel, M.; Frint, P.; F-X Wagner, M.

2017-03-01

Severe plastic deformation methods are commonly used to increase the strength of materials by generating ultrafine-grained microstructures. The application of these methods to Al-Cu alloys is, however, difficult because of their poor formability at room temperature. An additional reduction of formability of such alloys occurs when ceramic particles are added as reinforcement: this often triggers shear localization and crack initiation during ECAP. This is the main reason why equal-channel angular pressing (ECAP) of aluminum matrix composites (AMCs) can generally only be performed at elevated temperatures and using ECAP dies with a channel angle larger than 90° (e.g. 120°). In this study we present a brief first report on an alternative approach for the improvement of the formability of an AMC (AA2017, 10 % SiC): ECAP at low temperatures. We show that, using a temperature of -60 °C and a channel angle of 90° (corresponding to an equivalent strain of 1.1), ECAP of the AMC can be successfully performed without material failure. The mechanical properties of the strongly deformed AMC are analyzed by tensile testing. Our results indicate that the increased formability of the AMC at low temperatures can be attributed to the suppression of unstable plastic flow that affects formability at room temperature.

Arbitrary waveform modulated pulse EPR at 200 GHz

NASA Astrophysics Data System (ADS)

Kaminker, Ilia; Barnes, Ryan; Han, Songi

2017-06-01

We report here on the implementation of arbitrary waveform generation (AWG) capabilities at ∼200 GHz into an Electron Paramagnetic Resonance (EPR) and Dynamic Nuclear Polarization (DNP) instrument platform operating at 7 T. This is achieved with the integration of a 1 GHz, 2 channel, digital to analog converter (DAC) board that enables the generation of coherent arbitrary waveforms at Ku-band frequencies with 1 ns resolution into an existing architecture of a solid state amplifier multiplier chain (AMC). This allows for the generation of arbitrary phase- and amplitude-modulated waveforms at 200 GHz with >150 mW power. We find that the non-linearity of the AMC poses significant difficulties in generating amplitude-modulated pulses at 200 GHz. We demonstrate that in the power-limited regime of ω1 < 1 MHz phase-modulated pulses were sufficient to achieve significant improvements in broadband (>10 MHz) spin manipulation in incoherent (inversion), as well as coherent (echo formation) experiments. Highlights include the improvement by one order of magnitude in inversion bandwidth compared to that of conventional rectangular pulses, as well as a factor of two in improvement in the refocused echo intensity at 200 GHz.

Life-science research within US academic medical centers.

PubMed

Zinner, Darren E; Campbell, Eric G

2009-09-02

Besides the generic "basic" vs "applied" labels, little information is known about the types of life-science research conducted within academic medical centers (AMCs). To determine the relative proportion, characteristics, funding, and productivity of AMC faculty by the type of research they conduct. Mailed survey conducted in 2007 of 3080 life-science faculty at the 50 universities with medical schools that received the most funding from the National Institutes of Health in 2004. Response rate was 74%. Research faculty affiliated with a medical school or teaching hospital, representing 77% of respondents (n = 1663). Type of research (basic, translational, clinical trials, health services research/clinical epidemiology, multimode, other), total funding, industry funding, publications, professional activities, patenting behavior, and industry relationships. Among AMC research faculty, 33.6% exclusively conducted basic science research as principal investigators compared with translational researchers (9.1%), clinical trial investigators (7.1%), and health services researchers/clinical epidemiologists (9.0%). While principal investigators garnered a mean of $410,755 in total annual research funding, 22.1% of all AMC research faculty were unsponsored, a proportion that ranged from 11.5% for basic science researchers to 46.8% for health services researchers (P < .001). The average AMC faculty member received $33,417 in industry-sponsored funding, with most of this money concentrated among clinical trial ($110,869) and multimode ($59,916) principal investigators. Translational (61.3%), clinical trial (67.3%), and multimode (70.9%) researchers were significantly more likely than basic science researchers (41.9%) to report a relationship with industry and that these relationships contributed to their most important scientific work (P < .05 for all comparisons). The research function of AMCs is active and diverse, incorporating a substantial proportion of faculty who are conducting research and publishing without sponsorship.

Engaging the Public Through a Joint Outreach Program with the Appalachian Mountain Club - A Successful First Year

NASA Astrophysics Data System (ADS)

Arion, Douglas N.; DeLucia, S.; Anderson, K.; Tatge, C.; Troyer, Z. D.

2013-01-01

Carthage College and the Appalachian Mountain Club (AMC) formed a partnership to deliver hands-on astronomy programs to the public, train mentors and docents, and provide experiential learning opportunities for astronomy students. In its first year of operation the program reached over 2000 visitors, and engaged them in daytime and nighttime observing, lectures and presentations, and workshops. The AMC serves more than 500,000 visitors each year at its lodges, centers, and high-mountain huts and delivers a wealth of experiences in nature and the environment. Through this project Carthage and the AMC have added astronomy to the education programming to provide a holistic, integrative picture of the workings of the universe to the lay public. The presentations given are atypical of astronomy outreach, as they emphasize the physical connections and linkages among many disciplines with astronomy. For example, the coincidence between eye color sensitivity and the solar spectrum; the evolutionary patterns that resulted from asteroid impacts; and the seasonal variation in animal coat colors are emphasized as much as the scale of the Universe and the typical stellar nucleosynthesis (the ‘we are stardust’ analogy) that are often covered. An extensive evaluation and assessment process has been implemented, and results of those studies show significant impact on participants. Participants ranged from older, more experienced AMC visitors to elementary and middle school students in the Mountain Classroom program, as well as a wide range of visitors from across the country. In addition to these programs, training workshops have been implemented for all AMC staff who work with the public, including those at the high mountain huts, the naturalists, and AMC volunteers. This work was supported in part by the National Science Foundation AST Division.

Academic medical centers as innovation ecosystems to address population -omics challenges in precision medicine.

PubMed

Silva, Patrick J; Schaibley, Valerie M; Ramos, Kenneth S

2018-02-15

While the promise of the Human Genome Project provided significant insights into the structure of the human genome, the complexities of disease at the individual level have made it difficult to utilize -omic information in clinical decision making. Some of the existing constraints have been minimized by technological advancements that have reduced the cost of sequencing to a rate far in excess of Moore's Law (a halving in cost per unit output every 18 months). The reduction in sequencing costs has made it economically feasible to create large data commons capturing the diversity of disease across populations. Until recently, these data have primarily been consumed in clinical research, but now increasingly being considered in clinical decision- making. Such advances are disrupting common diagnostic business models around which academic medical centers (AMCs) and molecular diagnostic companies have collaborated over the last decade. Proprietary biomarkers and patents on proprietary diagnostic content are no longer driving biomarker collaborations between industry and AMCs. Increasingly the scope of the data commons and biorepositories that AMCs can assemble through a nexus of academic and pharma collaborations is driving a virtuous cycle of precision medicine capabilities that make an AMC relevant and highly competitive. A rebalancing of proprietary strategies and open innovation strategies is warranted to enable institutional precision medicine asset portfolios. The scope of the AMC's clinical trial and research collaboration portfolios with industry are increasingly dependent on the currency of data, and less on patents. Intrapeneurial support of internal service offerings, clinical trials and clinical laboratory services for example, will be important new points of emphasis at the academic-industry interface. Streamlining these new models of industry collaboration for AMCs are a new area for technology transfer offices to offer partnerships and to add value beyond the traditional intellectual property offering.

Derivation of Aerosol Columnar Mass from MODIS Optical Depth

NASA Technical Reports Server (NTRS)

Gasso, Santiago; Hegg, Dean A.

2003-01-01

In order to verify performance, aerosol transport models (ATM) compare aerosol columnar mass (ACM) with those derived from satellite measurements. The comparison is inherently indirect since satellites derive optical depths and they use a proportionality constant to derive the ACM. Analogously, ATMs output a four dimensional ACM distribution and the optical depth is linearly derived. In both cases, the proportionality constant requires a direct intervention of the user by prescribing the aerosol composition and size distribution. This study introduces a method that minimizes the direct user intervention by making use of the new aerosol products of MODIS. A parameterization is introduced for the derivation of columnar aerosol mass (AMC) and CCN concentration (CCNC) and comparisons between sunphotometer, MODIS Airborne Simulator (MAS) and in-measurements are shown. The method still relies on the scaling between AMC and optical depth but the proportionality constant is dependent on the MODIS derived r$_{eff}$,\\eta (contribution of the accumulation mode radiance to the total radiance), ambient RH and an assumed constant aerosol composition. The CCNC is derived fkom a recent parameterization of CCNC as a function of the retrieved aerosol volume. By comparing with in-situ data (ACE-2 and TARFOX campaigns), it is shown that retrievals in dry ambient conditions (dust) are improved when using a proportionality constant dependent on r$ {eff}$ and \\eta derived in the same pixel. In high humidity environments, the improvement inthe new method is inconclusive because of the difficulty in accounting for the uneven vertical distribution of relative humidity. Additionally, two detailed comparisons of AMC and CCNC retrieved by the MAS algorithm and the new method are shown. The new method and MAS retrievals of AMC are within the same order of magnitude with respect to the in-situ measurements of aerosol mass. However, the proposed method is closer to the in-situ measurements than the MODIS retrievals. The retrievals of CCNC are also within the same order of magnitude for both methods. The new method is applied to an actual MODIS retrieval and although no in-situ data is available to compare, it is shown that the proposed method yields more credible values than the MODIS retrievals. In addition, recent data available from the PRIDE (Puerto Rico Dust Experiment, July 2000) will be shown by comparing sunphotometer, MODIS and in-situ data.

Practice management for academic dermatology departments.

PubMed

Eaglstein, W H

2000-09-01

Practice management in the academic medical center (AMC) is different than in other environments. Practice is only a part of the practitioner's mission within an AMC. Practice revenue will be subject to a tax or overhead by both the school and the department. Contract and practice guidelines cannot be tailored to the needs of the dermatology practice, because contracts and guidelines are negotiated globally for all of the practices within the AMC. Personnel, on which the practice depends, may report to hospitals and clinics rather than to the practice's management. Even control of the practice's manager may be diluted by a dual or "dotted line" reporting relationship between the department manager and the school practice manager. Although more constraints exist within the AMC, there are some strategic and operational choices that affect a practice's success. Among these are: (1) selection of services offered; (2) creation of satellites; (3) stimulation of faculty effort; (4) enhancement of faculty billing knowledge; and (5) creation of a "tie" between staff and the practice.

A randomized trial of the efficacy and safety of sequential intravenous/oral moxifloxacin monotherapy versus intravenous piperacillin/tazobactam followed by oral amoxicillin/clavulanate for complicated skin and skin structure infections.

PubMed

Gyssens, Inge C; Dryden, Matthew; Kujath, Peter; Nathwani, Dilip; Schaper, Nicolaas; Hampel, Barbara; Reimnitz, Peter; Alder, Jeff; Arvis, Pierre

2011-11-01

The primary aim of the RELIEF study was to evaluate the efficacy and safety of two sequential intravenous (iv)/oral regimens: moxifloxacin iv/oral versus piperacillin/tazobactam (TZP) iv followed by oral amoxicillin/clavulanate (AMC). The study had a prospective, randomized, double-dummy, double-blind, multicentre design. Patients ≥18 years were prospectively stratified according to complicated skin and skin structure infection (cSSSI) subtype/diagnosis (major abscess, diabetic foot infection, wound infection or infected ischaemic ulcer), surgical intervention and severity of illness. Diagnoses and disease severity were based on predetermined criteria, documented by repeated photographs, and confirmed by an independent data review committee. Patients were randomized to receive either 400 mg of moxifloxacin iv once daily followed by 400 mg of moxifloxacin orally once daily or 4.0/0.5 g of TZP iv thrice daily followed by 875/125 mg of AMC orally twice daily for 7-21 days. The primary efficacy variable was clinical response at test of cure (TOC) for the per-protocol (PP) population. Clinical efficacy was assessed by the data review committee based on repeated photographs and case descriptions. Clinical trials registry number: NCT 00402727. A total of 813 patients were randomized. Clinical success rates at TOC were similar for moxifloxacin and TZP-AMC in the PP [320/361 (88.6%) versus 275/307 (89.6%), respectively; P = 0.758] and intent-to-treat (ITT) [350/426 (82.2%) versus 305/377 (80.9%), respectively; P = 0.632] populations. Thus, moxifloxacin was non-inferior to TZP-AMC. Bacteriological success rates were high in both treatment arms [moxifloxacin: 432/497 (86.9%) versus TZP-AMC: 370/429 (86.2%), microbiologically valid (MBV) population]. Moxifloxacin was non-inferior to TZP-AMC at TOC in both the MBV and the ITT populations. Both treatments were well tolerated. Once-daily iv/oral moxifloxacin monotherapy was clinically and bacteriologically non-inferior to iv TZP thrice daily followed by oral AMC twice daily in patients with cSSSIs.

A randomized trial of the efficacy and safety of sequential intravenous/oral moxifloxacin monotherapy versus intravenous piperacillin/tazobactam followed by oral amoxicillin/clavulanate for complicated skin and skin structure infections

PubMed Central

Gyssens, Inge C.; Dryden, Matthew; Kujath, Peter; Nathwani, Dilip; Schaper, Nicolaas; Hampel, Barbara; Reimnitz, Peter; Alder, Jeff; Arvis, Pierre

2011-01-01

Objectives The primary aim of the RELIEF study was to evaluate the efficacy and safety of two sequential intravenous (iv)/oral regimens: moxifloxacin iv/oral versus piperacillin/tazobactam (TZP) iv followed by oral amoxicillin/clavulanate (AMC). Patients and methods The study had a prospective, randomized, double-dummy, double-blind, multicentre design. Patients ≥18 years were prospectively stratified according to complicated skin and skin structure infection (cSSSI) subtype/diagnosis (major abscess, diabetic foot infection, wound infection or infected ischaemic ulcer), surgical intervention and severity of illness. Diagnoses and disease severity were based on predetermined criteria, documented by repeated photographs, and confirmed by an independent data review committee. Patients were randomized to receive either 400 mg of moxifloxacin iv once daily followed by 400 mg of moxifloxacin orally once daily or 4.0/0.5 g of TZP iv thrice daily followed by 875/125 mg of AMC orally twice daily for 7–21 days. The primary efficacy variable was clinical response at test of cure (TOC) for the per-protocol (PP) population. Clinical efficacy was assessed by the data review committee based on repeated photographs and case descriptions. Clinical trials registry number: NCT 00402727. Results A total of 813 patients were randomized. Clinical success rates at TOC were similar for moxifloxacin and TZP–AMC in the PP [320/361 (88.6%) versus 275/307 (89.6%), respectively; P = 0.758] and intent-to-treat (ITT) [350/426 (82.2%) versus 305/377 (80.9%), respectively; P = 0.632] populations. Thus, moxifloxacin was non-inferior to TZP–AMC. Bacteriological success rates were high in both treatment arms [moxifloxacin: 432/497 (86.9%) versus TZP–AMC: 370/429 (86.2%), microbiologically valid (MBV) population]. Moxifloxacin was non-inferior to TZP–AMC at TOC in both the MBV and the ITT populations. Both treatments were well tolerated. Conclusions Once-daily iv/oral moxifloxacin monotherapy was clinically and bacteriologically non-inferior to iv TZP thrice daily followed by oral AMC twice daily in patients with cSSSIs. PMID:21896561

Evaluation of the microbiological quality of conventional and organic leafy greens at the time of purchase from retail markets in Alexandria, Egypt.

PubMed

Khalil, Rowaida; Gomaa, Mohamed

2014-01-01

This is a pioneer study in Egypt that provides some assessment of the microbiological quality of conventional and organic leafy green vegetables that constitute an essential component of the Egyptians' daily diet. A total of 380 samples of unpackaged whole conventional and 84 packaged whole organic leafy greens were collected from retail markets in Alexandria, and analyzed for total aerobic mesophilic count (AMC) and total E. coli count (ECC) using the standard spread plate method. Mean AMC values for organic samples were statistically less (p < 0.05) than those of the corresponding conventional samples. Conventional radish and organic parsley samples had the highest AMC of 7.17 and 7.68 log CFU/g respectively, while conventional green cabbage and organic basil had the lowest AMC of 3.63 and 3.23 log CFU/g respectively. The presence of E. coli in 100% of the studied leafy greens was indicative of potential fecal contamination, in view of open and unhygienic environmental and unsanitary handling conditions, as leafy green items are available for sale by street-vendors. Unsatisfactory AMC and ECC levels encountered in the studied samples, warrant future investigations to determine the potential prevalence of foodborne pathogens, and to identify sources of dominating microorganisms, which could make a contribution to the field of food safety

Evaluating Community Engagement in an Academic Medical Center

PubMed Central

Shone, Laura P.; Dozier, Ann M.; Newton, Gail L.; Green, Theresa; Bennett, Nancy M.

2014-01-01

From the perspective of academic medical centers (AMCs), community engagement is a collaborative process of working toward mutually defined goals to improve the community’s health, and involves partnerships between AMCs, individuals, and entities representing the surrounding community. AMCs increasingly recognize the importance of community engagement, and recent programs such as Prevention Research Centers and Clinical and Translational Science Awards have highlighted community engagement activities. However, there is no standard or accepted metric for evaluating AMCs’ performance and impact of community engagement activities. In this article, the authors present a framework for evaluating AMCs’ community engagement activities. The framework includes broad goals and specific activities within each goal, wherein goals and activities are evaluated using a health services research framework consisting of structure, process, and outcome criteria. To illustrate how to use this community engagement evaluation framework, the authors present specific community engagement goals and activities of the University of Rochester Medical Center to (1) improve the health of the community served by the AMC; (2) increase the AMC’s capacity for community engagement; and (3) increase generalizable knowledge and practices in community engagement and public health. Using a structure-process-outcomes framework, a multidisciplinary team should regularly evaluate an AMC’s community engagement program with the purpose of measurably improving the performance of the AMC and the health of its surrounding community. PMID:24556768

Comparing non-invasive scapular tracking methods across elevation angles, planes of elevation and humeral axial rotations.

PubMed

Grewal, T-J; Cudlip, A C; Dickerson, C R

2017-12-01

Altered scapular motions premeditate shoulder impingement and other musculoskeletal disorders. Divergent experimental conditions in previous research precludes rigorous comparisons of non-invasive scapular tracking techniques. This study evaluated scapular orientation measurement methods across an expanded range of humeral postures. Scapular medial/lateral rotation, anterior/posterior tilt and protraction/retraction was measured using an acromion marker cluster (AMC), a scapular locator, and a reference stylus. Motion was captured using reflective markers on the upper body, as well as on the AMC, locator and stylus. A combination of 5 arm elevation angles, 3 arm elevation planes and 3 arm axial rotations was examined. Measurement method interacted with elevation angle and plane of elevation for all three scapular orientation directions (p < 0.01). Method of measurement interacted with axial rotation in anterior/posterior tilt and protraction/retraction (p < 0.01). The AMC had strong agreement with the reference stylus than the locator for the majority of humeral elevations, planes and axial rotations. The AMC underestimated lateral rotation, with the largest difference of ∼2° at 0° elevation. Both the locator and AMC overestimated posterior tilt at high arm elevation by up to 7.4°. Misestimations from using the locator could be enough to potentially obscure meaningful differences in scapular rotations. Copyright © 2017 Elsevier Ltd. All rights reserved.

Application of water-insoluble polymers to orally disintegrating tablets treated by high-pressure carbon dioxide gas.

PubMed

Ito, Yoshitaka; Maeda, Atsushi; Kondo, Hiromu; Iwao, Yasunori; Noguchi, Shuji; Itai, Shigeru

2016-09-10

The phase transition of pharmaceutical excipients that can be induced by humidifying or heating is well-known to increase the hardness of orally disintegrating tablets (ODTs). However, these conditions are not applicable to drug substances that are chemically unstable against such stressors. Here, we describe a system which enhances the hardness of tablets containing water-insoluble polymers by using high-pressure carbon dioxide (CO2). On screening of 26 polymeric excipients, aminoalkyl methacrylate copolymer E (AMCE) markedly increased tablet hardness (+155N) when maintained in a high-pressure CO2 environment. ODTs containing 10% AMCE were prepared and treatment with 4.0MPa CO2 gas at 25°C for 10min increased the hardness to +30N, whose level corresponded to heating at 70°C for 720min. In addition, we confirmed the effects of CO2 pressure, temperature, treatment time, and AMCE content on the physical properties of ODTs. Optimal pressure of CO2 gas was considered to be approximately 3.5MPa for an AMCE formula, as excessive pressure delayed the disintegration of ODTs. Combination of high-pressure CO2 gas and AMCE is a prospective approach for increasing the tablet hardness for ODTs, and can be conducted without additional heat or moisture stress using a simple apparatus. Copyright © 2016 Elsevier B.V. All rights reserved.

Marketing the academic medical center group practice.

PubMed

Eudes, J A; Divis, K L

1992-01-01

From a marketing perspective, there are many differences between private and academic medical center (AMC) group practices. Given the growing competition between the two, write John Eudes and Kathy Divis, it is important for the AMC group practice to understand and use these differences to develop a competitive market advantage.

The Effect of Computer Automation on Institutional Review Board (IRB) Office Efficiency

ERIC Educational Resources Information Center

Oder, Karl; Pittman, Stephanie

2015-01-01

Companies purchase computer systems to make their processes more efficient through automation. Some academic medical centers (AMC) have purchased computer systems for their institutional review boards (IRB) to increase efficiency and compliance with regulations. IRB computer systems are expensive to purchase, deploy, and maintain. An AMC should…

The house of gastrointestinal medicine: how academic medical centers can build a sustainable economic clinical model.

PubMed

Rustgi, Anil K; Allen, John I

2013-11-01

Academic Medical Centers (AMCs) have been given unique responsibilities to care for patients, educate future clinicians, and bring innovative research to the bedside. Over the last few decades, this tripartite mission has served the United States well, and payers (Federal, State, and commercial) have been willing to underwrite these missions with overt and covert financial subsidies. As cost containment efforts have escalated, the traditional business model of AMCs has been challenged. In this issue, Dr Anil Rustgi and I offer some insights into how AMCs must alter their business model to be sustainable in our new world of accountable care, cost containment, and clinical integration.

Applications of AMC-based impedance surfaces

NASA Astrophysics Data System (ADS)

Balanis, Constantine A.; Amiri, Mikal Askarian; Modi, Anuj Y.; Pandi, Sivaseetharaman; Birtcher, Craig R.

2018-03-01

The recent and major enhancements of artificial magnetic conductor (AMC) and their applications namely RCS reduction, low-profile antennas and holographic leaky wave antennas are reviewed. Full-wave simulations are compared to measurements of fabricated models, and a good agreement is attained. All of the measurement were conducted in the Arizona State University electromagnetic anechoic chamber (EMAC).

Performance Characteristics of Automotive Engines in the United States, Third Series, Report No. 3, 1978 AMC, 121 CID (2.0 Liters), 2V

DOT National Transportation Integrated Search

1979-02-01

Experimental data were obtained in dynamometer tests of a 1978 AMC 121 CID engine to determine fuel consumption and emissions (hydrocarbon, carbon monoxide, oxides of nitrogen) at steady-state engine operating modes. The objective of the program is t...

77 FR 61583 - Privacy Act of 1974; System of Records; Correction

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-10

... A0351 AMC, Student/Faculty Records: AMC Schools Systems, as the records had been transferred to the... discovered that the records had not yet been transferred to TRADOC. Therefore, the DOA systems of records notice cannot be deleted at this time. DATES: This correction is effective October 10, 2012. FOR FURTHER...

Study on microstructure and tensile properties of fly ash AMCs welded by FSW

NASA Astrophysics Data System (ADS)

Sachinkumar, Narendranath, S.; Chakradhar, D.

2018-04-01

Aluminum matrix composite (AMCs) constitute a new class of light weight and high strength materials which have widespread applications in almost all engineering sectors. But the cost of AMCs is the only barrier to increase their applications still. Hence there is a huge demand for the composites containing low cost reinforcement with less weight, keeping this in mind, in the present work, Friction stir welding (FSW) of AA6061/SiC/fly ash was carried out successfully. Microstructural study on the welded specimens was performed using optical microscopy (OM) and scanning electron microscopy (SEM). Results indicate that fly ash particles were uniformly distributed in the weld nugget area because of the stirring action of the FSW tool also promoted the grain refinement of the matrix material with complete elimination of clusters present in matrix material which resulting in sound welds without any defects for AA6061/SiC/fly ash composites. 82% of joint efficiency is obtained for selected AMCs. Transverse tensile test results showed that all welds fractured in HAZ.

Accountable care organization readiness and academic medical centers.

PubMed

Berkowitz, Scott A; Pahira, Jennifer J

2014-09-01

As academic medical centers (AMCs) consider becoming accountable care organizations (ACOs) under Medicare, they must assess their readiness for this transition. Of the 253 Medicare ACOs prior to 2014, 51 (20%) are AMCs. Three critical components of ACO readiness are institutional and ACO structure, leadership, and governance; robust information technology and analytic systems; and care coordination and management to improve care delivery and health at the population level. All of these must be viewed through the lens of unique AMC mission-driven goals.There is clear benefit to developing and maintaining a centralized internal leadership when it comes to driving change within an ACO, yet there is also the need for broad stakeholder involvement. Other important structural features are an extensive primary care foundation; concomitant operation of a managed care plan or risk-bearing entity; or maintaining a close relationship with post-acute-care or skilled nursing facilities, which provide valuable expertise in coordinating care across the continuum. ACOs also require comprehensive and integrated data and analytic systems that provide meaningful population data to inform care teams in real time, promote quality improvement, and monitor spending trends. AMCs will require proven care coordination and management strategies within a population health framework and deployment of an innovative workforce.AMC core functions of providing high-quality subspecialty and primary care, generating new knowledge, and training future health care leaders can be well aligned with a transition to an ACO model. Further study of results from Medicare-related ACO programs and commercial ACOs will help define best practices.

Spanish multicenter study of the epidemiology and mechanisms of amoxicillin-clavulanate resistance in Escherichia coli.

PubMed

Ortega, Adriana; Oteo, Jesús; Aranzamendi-Zaldumbide, Maitane; Bartolomé, Rosa M; Bou, Germán; Cercenado, Emilia; Conejo, M Carmen; González-López, Juan José; Marín, Mercedes; Martínez-Martínez, Luis; Merino, María; Navarro, Ferran; Oliver, Antonio; Pascual, Alvaro; Rivera, Alba; Rodríguez-Baño, Jesús; Weber, Irene; Aracil, Belén; Campos, José

2012-07-01

We conducted a prospective multicenter study in Spain to characterize the mechanisms of resistance to amoxicillin-clavulanate (AMC) in Escherichia coli. Up to 44 AMC-resistant E. coli isolates (MIC ≥ 32/16 μg/ml) were collected at each of the seven participant hospitals. Resistance mechanisms were characterized by PCR and sequencing. Molecular epidemiology was studied by pulsed-field gel electrophoresis (PFGE) and by multilocus sequence typing. Overall AMC resistance was 9.3%. The resistance mechanisms detected in the 257 AMC-resistant isolates were OXA-1 production (26.1%), hyperproduction of penicillinase (22.6%), production of plasmidic AmpC (19.5%), hyperproduction of chromosomic AmpC (18.3%), and production of inhibitor-resistant TEM (IRT) (17.5%). The IRTs identified were TEM-40 (33.3%), TEM-30 (28.9%), TEM-33 (11.1%), TEM-32 (4.4%), TEM-34 (4.4%), TEM-35 (2.2%), TEM-54 (2.2%), TEM-76 (2.2%), TEM-79 (2.2%), and the new TEM-185 (8.8%). By PFGE, a high degree of genetic diversity was observed although two well-defined clusters were detected in the OXA-1-producing isolates: the C1 cluster consisting of 19 phylogroup A/sequence type 88 [ST88] isolates and the C2 cluster consisting of 19 phylogroup B2/ST131 isolates (16 of them producing CTX-M-15). Each of the clusters was detected in six different hospitals. In total, 21.8% of the isolates were serotype O25b/phylogroup B2 (O25b/B2). AMC resistance in E. coli is widespread in Spain at the hospital and community levels. A high prevalence of OXA-1 was found. Although resistant isolates were genetically diverse, clonality was linked to OXA-1-producing isolates of the STs 88 and 131. Dissemination of IRTs was frequent, and the epidemic O25b/B2/ST131 clone carried many different mechanisms of AMC resistance.

Optimization of a novel wax matrix system using aminoalkyl methacrylate copolymer E and ethylcellulose to suppress the bitter taste of acetaminophen.

PubMed

Shiino, Kai; Iwao, Yasunori; Miyagishima, Atsuo; Itai, Shigeru

2010-08-16

The purpose of the present study was to design and evaluate a novel wax matrix system containing various ratios of aminoalkyl methacrylate copolymer E (AMCE) and ethylcellulose (EC) as functional polymers in order to achieve the optimal acetaminophen (APAP) release rate for taste masking. A two factor, three level (3(2)) full factorial study design was used to optimize the ratios of AMCE and EC, and the release of APAP from the wax matrix was evaluated using a stationary disk in accordance with the paddle method. The disk was prepared by congealing glyceryl monostearate (GM), a wax with a low melting point, with various ratios of polymers and APAP. The criteria for release rate of APAP from the disk at pH 4.0 and pH 6.5 were calculated to be more than 0.5017 microg/(mlxmin) and less than 0.1414 microg/(mlxmin), respectively, under the assumption that the particle size of spherical matrix should be 100 microm. In multiple regression analysis, the release of APAP at pH 4.0 was found to increase markedly as the concentration of AMCE increased, whereas the release of APAP at pH 6.5 decreased as the EC concentration increased, even when a high level of AMCE was incorporated. Using principle component analysis, it was found that the viscosity of the matrix affects the pH-dependent release of APAP at pH 4.0 and pH 6.5. Furthermore, using multiple regression analysis, the optimum ratio of APAP:AMCE:EC:GM was found to be 30:7:10:53, and the release pattern of APAP from the optimum wax formulation nearly complied with the desired criteria. Therefore, the present study demonstrated that the incorporation of AMCE and EC into a wax matrix system enabled the appropriate release of APAP as a means of taste masking. Copyright (c) 2010 Elsevier B.V. All rights reserved.

The Cimmerian accretionary wedge of Anarak, Central Iran

NASA Astrophysics Data System (ADS)

Zanchi, Andrea; Malaspina, Nadia; Zanchetta, Stefano; Berra, Fabrizio; Benciolini, Luca; Bergomi, Maria; Cavallo, Alessandro; Javadi, Hamid Reza; Kouhpeyma, Meyssam

2015-04-01

The occurrence in Iran of several ophiolite belts dating between Late Palaeozoic to Triassic poses several questions on the possible existence of various sutures marking the closure of the Palaeotethys ocean between Eurasia and this Gondwana-derived microplate. In this scenario, the Anarak region in Central Iran still represents a conundrum. Contrasting geochronological, paleontological, paleomagnetic data and reported field evidence suggest different origins for the Anarak Metamorphic Complex (AMC). The AMC is either interpreted, as: (1) relict of an accretionary wedge developed at the Eurasia margin during the Palaeotethys subduction as part of the Cimmerian suture zone of NE Iran, displaced to Central Iran by a large counter-clockwise rotation of the central Iranian blocks; (2) autochthonous unit forming a secondary branch of the main suture zone. Our structural, petrographic and geochemical data indicate that the AMC consists of several metamorphic units also including dismembered "ophiolites" which display different tectono-metamorphic evolutions. Three main ductile deformational events can be distinguished in the AMC. The Morghab and Chah Gorbeh complexes preserve a different M1 metamorphism, characterized by blueschist relics in the S1 foliation of the former unit, and greenschist assemblages in the latter. They share a subsequent similar D2 deformational and M2 metamorphic history, showing a prograde metamorphism with syn- to post-deformation growth of blueschist facies mineral assemblages on pre-existing greenschist facies associations. High pressure, low temperature (HP/LT) metamorphism responsible for the growth of sodic amphibole has been recognized also within marble lenses at the contact between the Chah Gorbeh Complex and serpentinites. Evidence of HP/LT metamorphism also occurs in glaucophane-bearing meta-pillow lavas and serpentinites, which contain antigorite and form most of the "ophiolites" within the AMC. Structural relationships show that the Chah Gorbeh and Morghab units and the "ophiolites" were tectonically coupled within an accretionary wedge before the D2 folding stage. The other units of the AMC lack evidence of HP metamorphism in the area around Anarak, especially the Lakh Marble, a large thrust sheet that occupies the uppermost structural position in the AMC. Available radiometric ages of trondhjemite dikes and stocks that intruded the accretionary wedge, as well as our new data, constrain the subduction event at the end of the Carboniferous, before 290 Ma. These data suggest that the AMC is part of an allochthonous crustal fragment belonging to the Variscan belt developed along the southern Eurasian margin before the Cimmerian collision of Iran. Subsequent deformational events that occurred during the Mesozoic and the Cenozoic, up to the Miocene and possibly later, resulted in folding, thrusting and faulting that dismembered the original structure of the wedge accompanying its displacement to the present day position.

Structural Alteration of Gut Microbiota during the Amelioration of Human Type 2 Diabetes with Hyperlipidemia by Metformin and a Traditional Chinese Herbal Formula: a Multicenter, Randomized, Open Label Clinical Trial.

PubMed

Tong, Xiaolin; Xu, Jia; Lian, Fengmei; Yu, Xiaotong; Zhao, Yufeng; Xu, Lipeng; Zhang, Menghui; Zhao, Xiyan; Shen, Jian; Wu, Shengping; Pang, Xiaoyan; Tian, Jiaxing; Zhang, Chenhong; Zhou, Qiang; Wang, Linhua; Pang, Bing; Chen, Feng; Peng, Zhiping; Wang, Jing; Zhen, Zhong; Fang, Chao; Li, Min; Chen, Limei; Zhao, Liping

2018-05-22

Accumulating evidence implicates gut microbiota as promising targets for the treatment of type 2 diabetes mellitus (T2DM). With a randomized clinical trial, we tested the hypothesis that alteration of gut microbiota may be involved in the alleviation of T2DM with hyperlipidemia by metformin and a specifically designed herbal formula (AMC). Four hundred fifty patients with T2DM and hyperlipidemia were randomly assigned to either the metformin- or AMC-treated group. After 12 weeks of treatment, 100 patients were randomly selected from each group and assessed for clinical improvement. The effects of the two drugs on the intestinal microbiota were evaluated by analyzing the V3 and V4 regions of the 16S rRNA gene by Illumina sequencing and multivariate statistical methods. Both metformin and AMC significantly alleviated hyperglycemia and hyperlipidemia and shifted gut microbiota structure in diabetic patients. They significantly increased a coabundant group represented by Blautia spp., which significantly correlated with the improvements in glucose and lipid homeostasis. However, AMC showed better efficacies in improving homeostasis model assessment of insulin resistance (HOMA-IR) and plasma triglyceride and also exerted a larger effect on gut microbiota. Furthermore, only AMC increased the coabundant group represented by Faecalibacterium spp., which was previously reported to be associated with the alleviation of T2DM in a randomized clinical trial. Metformin and the Chinese herbal formula may ameliorate type 2 diabetes with hyperlipidemia via enriching beneficial bacteria, such as Blautia and Faecalibacterium spp. IMPORTANCE Metabolic diseases such as T2DM and obesity have become a worldwide public health threat. Accumulating evidence indicates that gut microbiota can causatively arouse metabolic diseases, and thus the gut microbiota serves as a promising target for disease control. In this study, we evaluated the role of gut microbiota during improvements in hyperglycemia and hyperlipidemia by two drugs: metformin and a specifically designed Chinese herbal formula (AMC) for diabetic patients with hyperlipidemia. Both drugs significantly ameliorated blood glucose and lipid levels and shifted the gut microbiota. Blautia spp. were identified as being associated with improvements in glucose and lipid homeostasis for both drugs. AMC exerted larger effects on the gut microbiota together with better efficacies in improving HOMA-IR and plasma triglyceride levels, which were associated with the enrichment of Faecalibacterium spp. In brief, these data suggest that gut microbiota might be involved in the alleviation of diabetes with hyperlipidemia by metformin and the AMC herbal formula. Copyright © 2018 Tong et al.

Prudentia: A Medical School's Solution to Curriculum Mapping and Curriculum Management

ERIC Educational Resources Information Center

Steketee, Carole

2015-01-01

During early accreditation visits by the Australian Medical Council (AMC), staff in the School of Medicine (SoM) were asked to demonstrate how and when AMC student outcome statements were being integrated into the MBBS course. As a result, the School Executive committed to developing a curriculum mapping system (CMS) that could systematically…

Active Duty C-17 Aircraft Commander Fuel Efficiency Metrics and Goal Evaluation

DTIC Science & Technology

2015-03-26

document/AFD-140304-043.pdf. AMC/A3F. “AMC Fuel Metrics,” Air Mobility Command, 2014. Bandura , A. “ Social Cognitive Theory of Self-Regulation...qualitative criteria analysis, picked the most effective metric, and utilized Goal Setting Theory (GST) to couple the metric with an attainable goal...9 Goal-Setting Theory

Use of a public-private partnership in malaria elimination efforts in Sri Lanka; a case study.

PubMed

Fernando, Deepika; Wijeyaratne, Pandu; Wickremasinghe, Rajitha; Abeyasinghe, Rabindra R; Galappaththy, Gawrie N L; Wickremasinghe, Renu; Hapugoda, M; Abeywickrema, W A; Rodrigo, Chaturaka

2018-03-23

In special circumstances, establishing public private partnerships for malaria elimination may achieve targets faster than the state sector acting by itself. Following the end of the separatist war in Sri Lanka in 2009, the Anti Malaria Campaign (AMC) of Sri Lanka intensified malaria surveillance jointly with a private sector partner, Tropical and Environmental Diseases and Health Associates Private Limited (TEDHA) with a view to achieving malaria elimination targets by 2014. This is a case study on how public private partnerships can be effectively utilized to achieve malaria elimination goals. TEDHA established 50 Malaria Diagnostic Laboratories and 17 entomology surveillance sentinel sites in consultation with the AMC in areas difficult to access by government officials (five districts in two provinces affected by war). TEDHA screened 994,448 individuals for malaria, of which 243,867 were screened at mobile malaria clinics as compared to 1,102,054 screened by the AMC. Nine malaria positives were diagnosed by TEDHA, while the AMC diagnosed 103 malaria cases in the same districts in parallel. Over 13,000 entomological activity days were completed. Relevant information was shared with AMC and the data recorded in the health information system. A successful public-private partnership model for malaria elimination was initiated at a time when the health system was in disarray in war ravaged areas of Sri Lanka. This ensured a high annual blood examination rate and screening of vulnerable people in receptive areas. These were important for certification of malaria-free status which Sri Lanka eventually received in 2016.

Differences in characteristics among new pediatric neurology patients: the effect of a newly established private pediatric neurology practice.

PubMed

Van Cleave, Jeanne; Woodruff, Brian; Freed, Gary L

2008-01-01

To investigate changes in volume and characteristics of new patients referred when a private pediatric neurology practice (PP) opened in 2004 in an area served primarily by an academic medical center's (AMC) pediatric neurology practice. Retrospective analysis of medical and billing records to examine changes in volume, diagnosis, and sociodemographic factors of new patients at the AMC from July 2004 to June 2005; the PP during the same period; and the AMC during the year before. One year after the PP opened, 40% more new pediatric neurology patients were seen in this area than the year before. Compared with the AMC, PP saw a greater proportion of seizures (34% vs 26%, P < .05) and headaches (32% vs 17%, P < .001), and a lesser proportion of developmental delay/musculoskeletal disorders (12% vs 19%, P < .001) and congenital/metabolic disorders (<1% vs 2%, P < .001). Fewer PP patients lived >20 miles from the practice (32% vs 64%, P < .001), and fewer had public insurance (4% vs 33%, P < .001). The establishment of the PP dramatically increased the volume of new pediatric neurology patients in this area. After the PP opened, the AMC continued to care for most patients with rare diseases and fewer financial resources. Future research should examine whether the increase in volume reflects relief of pent-up demand or increased referral rates due to eased access, and should elucidate how differences in patient populations at academic and private subspecialty practices relate to access to subspecialty care and financial well-being of academic practices.

What is the value and role of academic medicine in the life of its university?

PubMed

Azziz, Ricardo

2014-02-01

National and global events are rapidly and irrevocably driving transformation in both academia and health care. One result is an increase in the pace of institutional restructuring, consolidations, and mergers, including the melding of academic medical centers (AMCs; i.e., medical schools and their clinical enterprises) with nonmedical universities. Georgia Regents University (GRU) resulted from one such recent consolidation, and the experience at the institution has highlighted the need to answer the question "What is the value and role of academic medicine and an AMC in the life and transformation of its university?" In attempting to answer this question, the author first contrasts the cultural features of academic medicine and nonmedical faculty and leaders, as observed from the GRU experience, which might be useful for leaders of other institutions of higher education. His analysis suggests that academic medicine is currently significantly insulated from the larger university, and that this segregation or siloing represents a lost opportunity for both the AMC and the university at large. The author's experience suggests that fostering greater synergy between the university and its AMC adds significant value, and that such synergy better ensures the ability of those universities with an AMC to undertake and meet future transformative challenges. Strategies should be proactively developed both to enhance academic medicine leaders' engagement with, exposure to, and education regarding the operations and challenges of higher education and the broader university, and, likewise, to increase nonmedical faculty's understanding of and experience with the value and unique challenges of academic medicine.

Creating 21st-Century Laboratories and Classrooms for Improving Population Health: A Call to Action for Academic Medical Centers.

PubMed

DeVoe, Jennifer E; Likumahuwa-Ackman, Sonja; Shannon, Jackilen; Steiner Hayward, Elizabeth

2017-04-01

Academic medical centers (AMCs) in the United States built world-class infrastructure to successfully combat disease in the 20th century, which is inadequate for the complexity of sustaining and improving population health. AMCs must now build first-rate 21st-century infrastructure to connect combating disease and promoting health. This infrastructure must acknowledge the bio-psycho-social-environmental factors impacting health and will need to reach far beyond the AMC walls to foster community "laboratories" that support the "science of health," complementary to those supporting the "science of medicine"; cultivate community "classrooms" to stimulate learning and discovery in the places where people live, work, and play; and strengthen bridges between academic centers and these community laboratories and classrooms to facilitate bidirectional teaching, learning, innovation, and discovery.Private and public entities made deep financial investments that contributed to the AMC disease-centered approach to clinical care, education, and research in the 20th century. Many of these same funders now recognize the need to transform U.S. health care into a system that is accountable for population health and the need for a medical workforce equipped with the skills to measure and improve health. Innovative ideas about communities as centers of learning, the importance of social factors as major determinants of health, and the need for multidisciplinary perspectives to solve complex problems are not new; many are 20th-century ideas still waiting to be fully implemented. The window of opportunity is now. The authors articulate how AMCs must take bigger and bolder steps to become leaders in population health.

Joint Department of Defense, Advance Planning Briefing to Industry, Held at Kissimmee, Florida, on 30 April - 2 May 1996

DTIC Science & Technology

1996-05-01

Systems 17 Motion Bases Upgraded Aero Misc > Contact Info • AMC, Lt Col Letica , Phone (618) 256-5696 L8 Upgrade Flow Plan Advance Planning Briefing...Projected Schedule: FY 05 > Requirement Document: AMMP >• Projected Program Size: ? < $40M > Funding Status/Stability: > POCs: • AMC, Lt Col Letica

Epidemiological and clinical complexity of amoxicillin-clavulanate-resistant Escherichia coli.

PubMed

Rodríguez-Baño, Jesús; Oteo, Jesús; Ortega, Adriana; Villar, Macarena; Conejo, M Carmen; Bou, Germán; Aranzamendi-Zaldumbide, Maitane; Cercenado, Emilia; Gurguí, Mercè; Martínez-Martínez, Luis; Merino, María; Rivera, Alba; Oliver, Antonio; Weber, Irene; Pascual, Alvaro; Bartolomé, Rosa M; Gónzalez-López, Juan José; Campos, José

2013-07-01

Two hundred twelve patients with colonization/infection due to amoxicillin-clavulanate (AMC)-resistant Escherichia coli were studied. OXA-1- and inhibitor-resistant TEM (IRT)-producing strains were associated with urinary tract infections, while OXA-1 producers and chromosomal AmpC hyperproducers were associated with bacteremic infections. AMC resistance in E. coli is a complex phenomenon with heterogeneous clinical implications.

Developing future clinician scientists while supporting a research infrastructure.

PubMed

Holsti, Maija; Adelgais, Kathleen M; Willis, Leah; Jacobsen, Kammy; Clark, Edward B; Byington, Carrie L

2013-04-01

Supporting clinical research is a national priority. Clinician scientists are rare and clinical trials in academic medical centers (AMC) often fail to meet enrollment goals. Undergraduate students interested in biomedical careers often lack opportunities to perform clinical research. Describe an innovative undergraduate course that supports clinical research in an AMC. The course, Clinical Research Methods and Practice, offers undergraduate students the opportunity to learn clinical research through didactic and practical experiences. The students in turn support clinician scientists' conduct of clinical studies in an AMC. Clinician scientists receive research support and participate in mentoring sessions for students. Over seven semesters, 128 students have assisted in 21 clinical studies located in outpatient and inpatient units of two hospitals. Students identified and screened eligible patients, collected clinical data, assisted in obtaining informed consent, and transported specimens. Many of the clinician scientists have met their enrollment goals and several have been top-enrollers in multicenter clinical trials as a result of student support. The Clinical Research Methods and Practice class addresses barriers to clinical research in AMC. This may be a model for institutions committed to mentoring students early in their career and to developing infrastructures for clinical research. © 2013 Wiley Periodicals, Inc.

Efficacy of simulated cefditoren versus amoxicillin-clavulanate free concentrations in countering intrastrain ftsI gene diffusion in Haemophilus influenzae.

PubMed

González, Natalia; Aguilar, Lorenzo; Sevillano, David; Giménez, Maria-Jose; Alou, Luis; Cafini, Fabio; Torrico, Martha; López, Ana-Maria; Coronel, Pilar; Prieto, Jose

2011-06-01

This study explores the effects of cefditoren (CDN) versus amoxicillin-clavulanic acid (AMC) on the evolution (within a single strain) of total and recombined populations derived from intrastrain ftsI gene diffusion in β-lactamase-positive (BL⁺) and β-lactamase-negative (BL⁻) Haemophilus influenzae. DNA from β-lactamase-negative, ampicillin-resistant (BLNAR) isolates (DNA(BLNAR)) and from β-lactamase-positive, amoxicillin-clavulanate-resistant (BLPACR) (DNA(BLPACR)) isolates was extracted and added to a 10⁷-CFU/ml suspension of one BL⁺ strain (CDN MIC, 0.007 μg/ml; AMC MIC, 1 μg/ml) or one BL⁻ strain (CDN MIC, 0.015 μg/ml; AMC MIC, 0.5 μg/ml) in Haemophilus Test Medium (HTM). The mixture was incubated for 3 h and was then inoculated into a two-compartment computerized device simulating free concentrations of CDN (400 mg twice a day [b.i.d.]) or AMC (875 and 125 mg three times a day [t.i.d.]) in serum over 24 h. Controls were antibiotic-free simulations. Colony counts were performed; the total population and the recombined population were differentiated; and postsimulation MICs were determined. At time zero, the recombined population was 0.00095% of the total population. In controls, the BL⁻ and BL⁺ total populations and the BL⁻ recombined population increased (from ≈3 log₁₀ to 4.5 to 5 log₁₀), while the BL⁺ recombined population was maintained in simulations with DNA(BLPACR) and was decreased by ≈2 log₁₀ with DNA(BLNAR). CDN was bactericidal (percentage of the dosing interval for which experimental antibiotic concentrations exceeded the MIC [ft>MIC], >88%), and no recombined populations were detected from 4 h on. AMC was bactericidal against BL⁻ strains (ft>MIC, 74.0%) in DNA(BLNAR) and DNA(BLPACR) simulations, with a small final recombined population (MIC, 4 μg/ml; ft>MIC, 30.7%) in DNA(BLPACR) simulations. When AMC was used against the BL⁺ strain (in DNA(BLNAR) or DNA(BLPACR) simulations), the bacterial load was reduced ≈2 log₁₀ (ft>MIC, 44.3%), but 6.3% and 32% of the total population corresponded to a recombined population (MIC, 16 μg/ml; ft>MIC, 0%) in DNA(BLNAR) and DNA(BLPACR) simulations, respectively. AMC, but not CDN, unmasked BL⁺ recombined populations obtained by transformation. ft>MIC values higher than those classically considered for bacteriological response are needed to counter intrastrain ftsI gene diffusion by covering recombined populations.

Near elimination of ventricular pacing in SafeR mode compared to DDD modes: a randomized study of 422 patients.

PubMed

Davy, Jean-Marc; Hoffmann, Ellen; Frey, Axel; Jocham, Kurt; Rossi, Stefano; Dupuis, Jean-Marc; Frabetti, Lorenzo; Ducloux, Pascale; Prades, Emmanuel; Jauvert, Gaël

2012-04-01

SafeR performance versus DDD/automatic mode conversion (DDD/AMC) and DDD with a 250-ms atrioventricular (AV) delay (DDD/LD) modes was assessed toward ventricular pacing (Vp) reduction. After a 1-month run-in phase, recipients of dual-chamber pacemakers without persistent AV block and persistent atrial fibrillation (AF) were randomly assigned to SafeR, DDD/AMC, or DDD/LD in a 1:1:1 design. The main endpoint was the percentage of Vp (%Vp) at 2 months and 1 year after randomization, ascertained from device memories. Secondary endpoints include %Vp at 1 year according to pacing indication and 1-year AF incidence based on automatic mode switch device stored episodes. Among 422 randomized patients (73.2±10.6 years, 50% men, sinus node dysfunction 47.4%, paroxysmal AV block 30.3%, bradycardia-tachycardia syndrome 21.8%), 141 were assigned to SafeR versus 146 to DDD/AMC and 135 to DDD/LD modes. Mean %Vp at 2 months was 3.4±12.6% in SafeR versus 33.6±34.7% and 14.0±26.0% in DDD/AMC and DDD/LD modes, respectively (P<0.0001 for both). At 1 year, mean %Vp in SafeR was 4.5±15.3% versus 37.9±34.4% and 16.7±28.0% in DDD/AMC and DDD/LD modes, respectively (P<0.0001 for both). The proportion of patients in whom Vp was completely eliminated was significantly higher in SafeR (69%) versus DDD/AMC (15%) and DDD/LD (45%) modes (P<0.0001 for both), regardless of pacing indication. The absolute risk of developing permanent AF or of remaining in AF for >30% of the time was 5.4% lower in SafeR than in the DDD pacing group (ns). In this selected patient population, SafeR markedly suppressed unnecessary Vp compared with DDD modes. ©2012, The Authors. Journal compilation ©2012 Wiley Periodicals, Inc.

Global collaborative healthcare: assessing the resource requirements at a leading Academic Medical Center.

PubMed

Rosson, Nicole J; Hassoun, Heitham T

2017-09-20

Academic Medical Centers ("AMCs") have served as a hub of the United States ("US") health system and represented the state-of-the art in American health care for well over a century. Currently, the global healthcare market is both massive and expanding and is being altered by the unprecedented impact of technological advances and globalization. This provides AMCs a platform to enter into trans-national collaborative partnerships with healthcare organizations around the world, thus providing a means to deliver on its promise globally while also expanding and diversifying its resources. A number of leading US AMCs have engaged in global collaborative healthcare, employing different models based on services offered, global distribution, and inclination to assume risk. Engaging in these collaborations requires significant effort from across the health system, and an understanding of the resources required is paramount for effective delivery and to avoid overextension and diversion from the primary mission of these organizations. The goal of this paper is to discuss the role of US AMCs in this current global healthcare landscape and to also investigate our institutional faculty and staff resource requirements to support the operating model. We extracted and retrospectively analyzed data from the JHI Global Services database for a 3-year period (Jan, 2013-Dec, 2015) to determine total utilization (hours and full time equivalent (FTE)), utilization by profession, and clinical and non-clinical areas of expertise. JHI utilized on average 21,940 h annually, or 10.55 FTEs of faculty and staff subject matter experts. The majority of the hours are for work performed by physician faculty members from 23 departments within the School of Medicine, representing 77% percent or on average 16,894 h annually. Clinical and allied health departments had an average annual utilization of 17,642 h or 7.8 FTEs, while non-clinical departments, schools and institutes averaged 4298 h or 1.9 FTEs, representing 80.4% and 19.6% respectively. We found that significant human resources are required within a broad range of AMC subject matter expertise across multiple disciplines, and that with adequate forecasting AMCs can successfully engage in these collaborations while continuing to fulfill their core mission.

About my Child: measuring 'Complexity' in neurodisability. Evidence of reliability and validity.

PubMed

Ritzema, A M; Lach, L M; Rosenbaum, P; Nicholas, D

2016-05-01

About my Child, 26-item version (AMC-26) was developed as a measure of child health 'complexity' and has been proposed as a tool for understanding the functional needs of children and the priorities of families. The current study investigated the reliability and validity of AMC-26 with a sample of caregivers of children with neurodevelopmental disorders (NDD; n = 258) who completed AMC-26 as part of a larger study on parenting children with NDD. A subsample of children from the larger study (n = 49) were assessed using standardized measures of cognitive and adaptive functioning. Factor analysis revealed that a four-component model explained 51.12% of the variance. Cronbach's alpha was calculated for each of the four factors and for the scale as a whole, and ranged from 0.75 to 0.85, suggesting a high level of internal consistency. Construct validity was tested through comparisons with the results of standardized measures of child functioning. Predicted relationships for factors one, two and three were statistically significant and in the expected directions. Predictions for factor four were partially supported. AMC-26 was also expected to serve as an indicator of caregiver distress. Drawing on a sample of caregivers from the larger study (n = 251) the model was found to be significant and explained 23% of the variance in caregiver depressive symptoms (R(2)  = .053, F (1, 249) = 14.06, P < .001). Based on these observations, the authors contend that AMC-26 may be used by clinicians and researchers as a tool to capture child function and child health complexity. Such a measure may help elucidate the relationships between child complexity and family well-being. This is an important avenue for further investigation. © 2016 John Wiley & Sons Ltd.

Structural Alteration of Gut Microbiota during the Amelioration of Human Type 2 Diabetes with Hyperlipidemia by Metformin and a Traditional Chinese Herbal Formula: a Multicenter, Randomized, Open Label Clinical Trial

PubMed Central

2018-01-01

ABSTRACT Accumulating evidence implicates gut microbiota as promising targets for the treatment of type 2 diabetes mellitus (T2DM). With a randomized clinical trial, we tested the hypothesis that alteration of gut microbiota may be involved in the alleviation of T2DM with hyperlipidemia by metformin and a specifically designed herbal formula (AMC). Four hundred fifty patients with T2DM and hyperlipidemia were randomly assigned to either the metformin- or AMC-treated group. After 12 weeks of treatment, 100 patients were randomly selected from each group and assessed for clinical improvement. The effects of the two drugs on the intestinal microbiota were evaluated by analyzing the V3 and V4 regions of the 16S rRNA gene by Illumina sequencing and multivariate statistical methods. Both metformin and AMC significantly alleviated hyperglycemia and hyperlipidemia and shifted gut microbiota structure in diabetic patients. They significantly increased a coabundant group represented by Blautia spp., which significantly correlated with the improvements in glucose and lipid homeostasis. However, AMC showed better efficacies in improving homeostasis model assessment of insulin resistance (HOMA-IR) and plasma triglyceride and also exerted a larger effect on gut microbiota. Furthermore, only AMC increased the coabundant group represented by Faecalibacterium spp., which was previously reported to be associated with the alleviation of T2DM in a randomized clinical trial. Metformin and the Chinese herbal formula may ameliorate type 2 diabetes with hyperlipidemia via enriching beneficial bacteria, such as Blautia and Faecalibacterium spp. PMID:29789365

Standardized Solution for Management Controller for MTCA.4

NASA Astrophysics Data System (ADS)

Makowski, D.; Fenner, M.; Ludwig, F.; Mavrič, U.; Mielczarek, A.; Napieralski, A.; Perek, P.; Schlarb, H.

2015-06-01

The Micro Telecommunications Computing Architecture (MTCA) standard is a modern platform that is gaining popularity in the area of High Energy Physics (HEP) experiments. The standard provides extensive management, monitoring and diagnostics functionalities. The hardware control and monitoring is based on the Intelligent Platform Management Interface (IPMI), that was initially developed for supervision of complex computers operation. The original IPMI specification was extended to support functions required by the MTCA specification. The Module Management Controller (MMC) is required on each Advanced Mezzanine Card (AMC) installed in MTCA chassis. The Rear Transition Modules (RTMs) have to be equipped with RTM Management Controllers (RMCs) which is required by the MTCA.4 subsidiary specification. The commercially available implementations of MMC and RMC are expensive and do not provide the complete functionality that is required by specific HEP applications. Therefore, many research centers and commercial companies work on their own implementation of AMC and RTM controllers. The available implementations suffer because of lack of common approach and interoperability problems. Since both Lodz University of Technology (TUL) and Deutsches Elektronen-Synchrotron (DESY) have long-term experience in developing ATCA and MTCA hardware, the authors decided to develop a unified solution of management controller fully compliant with AMC and MTCA.4 standards. The MMC v1.00 solution is dedicated for management of AMC and RTM modules. The MMC v1.00 is based on Atmel ATxmega MCUs and can be fully customized by the user or used as a drop-in-module without any modifications. The paper discusses the functionality of the MMC v1.00 solution. The implementation was verified with developed evaluation kits for AMC and RTM cards.

Susceptibility Testing of Extensively Drug-Resistant and Pre-Extensively Drug-Resistant Mycobacterium tuberculosis against Levofloxacin, Linezolid, and Amoxicillin-Clavulanate

PubMed Central

Ahmed, Imran; Jabeen, Kauser; Inayat, Raunaq

2013-01-01

Pakistan is a high-burden country for tuberculosis (TB). The emergence and increasing incidence of extensively drug-resistant (XDR) TB has been reported in Pakistan. Similarly, the prevalence of multidrug-resistant TB infections with fluoroquinolone resistance (pre-XDR) is also increasing. To treat these infections, local drug susceptibility patterns of alternate antituberculosis agents, including levofloxacin (LVX), linezolid (LZD), and amoxicillin-clavulanate (AMC), is urgently needed. The aim of this study was to determine the susceptibility frequencies of drug-resistant (DR) Mycobacterium tuberculosis against LVX, LZD, and AMC. All susceptibilities were determined on Middlebrook 7H10 agar. A critical concentration was used for LVX (1 μg/ml), whereas MICs were determined for LZD and AMC. M. tuberculosis H37Rv was used as a control strain. A total of 102 M. tuberculosis isolates (XDR, n = 59; pre-XDR, n = 43) were tested. Resistance to LVX was observed in 91.2% (93/102). Using an MIC value of 0.5 μg/ml as a cutoff, resistance to LZD (MIC ≥ 1 μg/ml) was noted in 5.9% (6/102). Although the sensitivity breakpoints are not established for AMC, the MIC values were high (>16 μg/ml) in 97.1% (99/102). Our results demonstrate that LZD may be effective for the treatment of XDR and pre-XDR cases from Pakistan. High resistance rates against LVX in our study suggest the use of this drug with caution for DR-TB cases from this area. Drug susceptibility testing against LVX and AMC may be helpful in complicated and difficult-to-manage cases. PMID:23507286

Susceptibility testing of extensively drug-resistant and pre-extensively drug-resistant Mycobacterium tuberculosis against levofloxacin, linezolid, and amoxicillin-clavulanate.

PubMed

Ahmed, Imran; Jabeen, Kauser; Inayat, Raunaq; Hasan, Rumina

2013-06-01

Pakistan is a high-burden country for tuberculosis (TB). The emergence and increasing incidence of extensively drug-resistant (XDR) TB has been reported in Pakistan. Similarly, the prevalence of multidrug-resistant TB infections with fluoroquinolone resistance (pre-XDR) is also increasing. To treat these infections, local drug susceptibility patterns of alternate antituberculosis agents, including levofloxacin (LVX), linezolid (LZD), and amoxicillin-clavulanate (AMC), is urgently needed. The aim of this study was to determine the susceptibility frequencies of drug-resistant (DR) Mycobacterium tuberculosis against LVX, LZD, and AMC. All susceptibilities were determined on Middlebrook 7H10 agar. A critical concentration was used for LVX (1 μg/ml), whereas MICs were determined for LZD and AMC. M. tuberculosis H37Rv was used as a control strain. A total of 102 M. tuberculosis isolates (XDR, n = 59; pre-XDR, n = 43) were tested. Resistance to LVX was observed in 91.2% (93/102). Using an MIC value of 0.5 μg/ml as a cutoff, resistance to LZD (MIC ≥ 1 μg/ml) was noted in 5.9% (6/102). Although the sensitivity breakpoints are not established for AMC, the MIC values were high (>16 μg/ml) in 97.1% (99/102). Our results demonstrate that LZD may be effective for the treatment of XDR and pre-XDR cases from Pakistan. High resistance rates against LVX in our study suggest the use of this drug with caution for DR-TB cases from this area. Drug susceptibility testing against LVX and AMC may be helpful in complicated and difficult-to-manage cases.

AmeriFlux Measurement Component (AMC) Instrument Handbook

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

Reichl, Ken; Biraud, Sebastien C.

2016-04-01

An AMC system was installed at the U.S. Department of Energy (DOE)’s Atmospheric Radiation Measurement (ARM) Climate Research Facility North Slope of Alaska (NSA) Barrow site, also known as NSA C1 at the ARM Data Archive, in August 2012. A second AMC system was installed at the third ARM Mobile Facility deployment at Oliktok Point, also known as NSA M1. This in situ system consists of 12 combination soil temperature and volumetric water content (VWC) reflectometers and one set of upwelling and downwelling photosynthetically active radiation (PAR) sensors, all deployed within the fetch of the Eddy Correlation Flux Measurement System.more » Soil temperature and VWC sensors placed at two depths (10 and 30 cm below the vegetation layer) at six locations (or microsites) allow soil property inhomogeneity to be monitored across a landscape.« less

Toxicological assessment of Anionic Methacrylate Copolymer: I. Characterization, bioavailability and genotoxicity.

PubMed

Eisele, Johanna; Haynes, Geoff; Kreuzer, Knut; Hall, Caroline

2016-12-01

Anionic Methacrylate Copolymer (AMC) is a fully polymerized copolymer used in the pharmaceutical industry as an enteric/delayed-release coating to permit the pH-dependent release of active ingredients in the gastrointestinal tract from oral dosage forms. This function is of potential use for food supplements. Oral administration of radiolabeled copolymer to rats resulted in the detection of chemically unchanged copolymer in the feces, with negligible absorption (<0.1%). AMC is therefore determined not to be bioavailable. Within a genotoxicity test battery AMC did not show any evidence of genotoxicity in bacteria and mammalian cells. Furthermore, no genotoxic effects occurred in vivo within a micronucleus test. There would therefore appear to be no safety concerns under intended conditions of oral use for the discussed toxicological endpoints. Copyright © 2016 Elsevier Inc. All rights reserved.

Airlift Cargo Hub Port Hold Times: Controlling Variations in Defense Supply Chain Delivery

DTIC Science & Technology

2010-06-01

AIR UNIVERSITY AIR FORCE INSTITUTE OF TECHNOLOGY Wright-Patterson Air Force Base, Ohio APPROVED FOR PUBLIC RELEASE; DISTRIBUTION UNLIMITED...Department of Operational Sciences Graduate School of Engineering and Management Air Force Institute of Technology Air University Air...process for a seamless flow of cargo onto the aircraft segment (AMC and DDC , 24 Sep 08). Figure 6 AMC Velocity Efforts (Anderson D. , 2009) While

Army Stock Positioning: How Can Distribution Performance Be Improved

DTIC Science & Technology

2017-01-01

Support RAND Make a tax -deductible charitable contribution at www.rand.org/giving/contribute www.rand.org Preface The...the source- preference logic that selects the warehouse for issuing an item to a cus- tomer. Below, we describe the LMP source-preference logic and...the AMC pilot to use it to tailor how warehouses are selected to issue items to customers. AMC Pilot Implementation of LMP Source-Preference

Involvement of Shewanella oneidensis MR-1 LuxS in Biofilm Development and Sulfur Metabolism

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

Learman, Deric R.; Yi, Haakrho; Brown, Steven D.

2009-01-05

The role of LuxS in Shewanella oneidensis MR-1 has been examined by transcriptomic profiling, biochemical, and physiological experiments. The results indicate that a mutation in luxS alters biofilm development, not by altering quorum-sensing abilities but by disrupting the activated methyl cycle (AMC). The S. oneidensis wild type can produce a luminescence response in the AI-2 reporter strain Vibrio harveyi MM32. This luminescence response is abolished upon the deletion of luxS. The deletion of luxS also alters biofilm formations in static and flowthrough conditions. Genetic complementation restores the mutant biofilm defect, but the addition of synthetic AI-2 has no effect. Thesemore » results suggest that AI-2 is not used as a quorum-sensing signal to regulate biofilm development in S. oneidensis. Growth on various sulfur sources was examined because of the involvement of LuxS in the AMC. A mutation in luxS produced a reduced ability to grow with methionine as the sole sulfur source. Methionine is a key metabolite used in the AMC to produce a methyl source in the cell and to recycle homocysteine. These data suggest that LuxS is important to metabolizing methionine and the AMC in S. oneidensis.« less

Hospitalist time usage and cyclicality: opportunities to improve efficiency.

PubMed

Kim, Christopher S; Lovejoy, William; Paulsen, Michael; Chang, Robert; Flanders, Scott A

2010-01-01

Academic medical centers (AMCs) have a constrained resident work force. Many AMCs have increased the use of nonresident service hospitalists to manage continued growth in clinical volume. To optimize their time in the hospital, it is important to understand hospitalists' work flow. We performed a time-motion study of hospitalists carrying the admission pager throughout the 3 types of shifts we have at our hospital (day shift, swing shift, and night shift). Tertiary academic medical center in the Midwest. Hospitalists spend about 15% of their time on direct patient care, and two-thirds of their time on indirect patient care. Of the indirect activities, communication and documentation dominate. Travel demands make up over 7% of a hospitalists' time. There are spikes in indirect patient care, followed closely by spikes in direct patient care, at shift changes. At our AMC, indirect patient care activities accounted for the majority of the admitting hospitalists' time spent in the hospital, with documentation and communication dominating this time. Travel takes a significant fraction of hospitalists' time. There is also a cyclical nature to activities performed throughout the day, which can cause patient delays and impose variability on support services. There is a need for both service-specific and systemic improvements for AMCs to efficiently manage further growth in their inpatient volume. (c) 2010 Society of Hospital Medicine.

Ten trends transforming cancer care and their effects on space planning for academic medical centers.

PubMed

Bloom, Mara; Markovitz, Sarah; Silverman, Susan; Yost, Carl

2015-01-01

This article aims to define the major trends currently affecting space needs for academic medical center (AMC) cancer centers. It will distinguish between the trends that promote the concentration of services with those that promote decentralization as well as identify opportunities for achieving greater effectiveness in cancer care space planning. Changes in cancer care-higher survival rates, increased clinical trials, new technology, and changing practice models-increasingly fill hospitals' and clinicians' schedules and strain clinical space resources. Conflicts among these trends are concentrating some services and dispersing others. As a result, AMCs must expand and renovate intelligently to continue providing state-of-the-art, compassionate care. Although the typical AMC cancer center can expect to utilize more space than it would have 10 years ago, a deeper understanding of the cancer center enterprise can lead to opportunities for more effectively using available facility resources. Each AMC must determine for itself the appropriate balance of patient volume, clinical activity, and services between its main hospital campus and satellite branches. As well, space allocation should be flexible, as care trends, medical technology, and the provider's own priorities shift over time. The goal isn't necessarily more space-it's better space. © The Author(s) 2015.

Academic Medical Support to the Ebola Virus Disease Outbreak in Liberia.

PubMed

McQuilkin, Patricia A; Niescierenko, Michelle; Beddoe, Ann Marie; Goentzel, Jarrod; Graham, Elinor A; Henwood, Patricia C; Rehwaldt, Lise; Teklu, Sisay; Tupesis, Janis; Marshall, Roseda

2017-12-01

During the Ebola Virus Disease (EVD) epidemic in West Africa (2014-2016), many faculty, staff, and trainees from U.S. academic medical centers (i.e., teaching hospitals and their affiliated medical schools; AMCs) wished to contribute to the response to the outbreak, but many barriers prevented their participation. Here, the authors describe a successful long-term academic collaboration in Liberia that facilitated participation in the EVD response. This Perspective outlines the role the authors played in the response (providing equipment and training, supporting the return of medical education), the barriers they faced (logistical and financial), and elements that contributed to their success (partnering and coordinating their response with both U.S. and African institutions). There is a paucity of literature discussing the role of AMCs in disaster response, so the authors discuss the lessons learned and offer suggestions about the responsibilities that AMCs have and the roles they can play in responding to disaster situations.

Ball catching in children with developmental coordination disorder: control of degrees of freedom.

PubMed

Utley, Andrea; Steenbergen, Bert; Astill, Sarah Louise

2007-01-01

This study investigated two-handed catching in eight children (four males, four females) aged 7 to 8 years (mean 7y 4mo [SD 3mo]) with developmental coordination disorder (DCD) and their age-matched controls (AMCs). Kinematic data were collected to examine Bernstein's (1967) notion of freezing and releasing degrees of freedom (DF). Participants were asked to catch a ball 30 times, delivered in three blocks of 10 trials. Video analysis showed that children with DCD caught significantly fewer balls than their AMCs (p< or =0.001) counterparts. Kinematic analyses showed that children with DCD exhibited smaller ranges of motion and less variable angular excursions of the elbow joints than their AMCs, and that their elbows are more rigidly coupled (p< or =0.001). These data suggest that children with DCD rigidly fix and couple their limbs to reduce the number of DF actively involved in the task.

A relook at NEH-4 curve number data and antecedent moisture condition criteria

NASA Astrophysics Data System (ADS)

Mishra, Surendra Kumar; Singh, Vijay P.

2006-08-01

This paper investigates the variation of the popular curve number (CN) values given in the National Engineering Hand Book-Section 4 (NEH-4) of the Soil Conservation Service (SCS) with antecedent moisture condition (AMC) and soil type. Using the volumetric concept, involving soil, water, and air, a significant condensation of the NEH-4 tables is achieved. This leads to a procedure for determination of CN for gauged as well as ungauged watersheds. The rainfall-runoff events derived from daily data of four Indian watersheds exhibited a power relation between the potential maximum retention or CN and the 5-day antecedent rainfall amount. Including this power relation, the SCS-CN method was modified. This modification also eliminates the problem of sudden jumps from one AMC level to the other. The runoff values predicted using the modified method and the existing method utilizing the NEH-4 AMC criteria yielded similar results.

What Happens when Sea Ice Retreats, Peatlands Form, and a Landbridge Drowns? A Molecular View of the Last Deglacial from the Pacific-Arctic Gateway

NASA Astrophysics Data System (ADS)

Kocis, J. J.; Petsch, S.; Castañeda, I. S.; Brigham-Grette, J.

2014-12-01

Arctic peatlands and thermokarst lakes (TK) are thought to play a significant role in changing atmospheric methane concentration (AMC) during the last deglacial. However, there is debate concerning timing of their initiation and extent they drove variations in AMC. Models show sea ice cover (SIC) and sea surface temperatures (SSTs) can also play a significant role. Yet, changes in peatland/TK lake areal extent in response to those dynamics as continental shelves were submerged are often not considered. To examine such connections, we report on molecular proxies in marine records that reveal change in terrestrial organic matter (TOM) export, SIC, and SSTs as sea levels rose during the last 18 ka in the Pacific-Arctic Gateway. Here, TOM input to the ocean was tracked by measuring the flux of branched glycerol dialkyl glycerol tetraethers, n-alkyl lipids, and pentacyclic triterpenoids. SIC and SSTs were reconstructed using modern calibrations of highly branched isoprenoid alkene abundances in surface sediments from the Bering and Chukchi Seas. SSTs were also reconstructed based on the relative abundance of isoprenoid glycerol dialkyl glycerol tetraethers. Our sediment records reveal increased flux of TOM coincides with peatland/TK lake initiation, reduced SIC (~20%), and warmer SSTs (~4°C) as AMC increased during the Bølling-Allerød (BA). Terrestrial flux dramatically reduced as SIC increased (~50%) and SSTs cooled as AMC fell during the Younger Dryas. Most notably, TOM export rapidly rebounds as AMC abruptly rose throughout the Holocene Thermal Maximum (HTM), when SSTs warmed by ~3°C and SIC diminished and peatland areal extent increased. Using multi-proxy evidence in combination with a simple model that accounts for submergence of peatland/TK lake area, we estimate that the exposed Beringian shelf emitted an amount of CH4 comparable to previously reported peatland emissions in Alaska during the BA and HTM. The GDGT-based methane index (MI) was <0.3 throughout our sediment records, suggesting destabilized marine gas hydrates were not the principal source of methane. Results of our study provide novel marine-based evidence for the timing of peatland and TK lake initiation and the role sea ice played in contributing to variations in AMC during deglacial sea level rise in the Arctic.

Proceedings of the Digital/Electronic Terrain Board Symposium Held in Wichita, Kansas on 5-6 October 1989

DTIC Science & Technology

1990-02-01

Representative is Mr. H. C. Race, AMC Smart Weapons Management Office, ATTN: AMSMI-SW, Redstone Arsenal, Alabama 35898- 5222. Reproduction. Permission to...reproduce any material contained in this document must be requested and approved in writing by the AMC Smart Weapons Management Office, AMSMI-SW, Redstone...elevation points, necessitating a large geometric data base that requires heavy computation loads for rendering. The second innovative technique is the

Prognostic roles of absolute monocyte and absolute lymphocyte counts in patients with advanced-stage follicular lymphoma in the rituximab era: an analysis from the FOLL05 trial of the Fondazione Italiana Linfomi.

PubMed

Marcheselli, Luigi; Bari, Alessia; Anastasia, Antonella; Botto, Barbara; Puccini, Benedetta; Dondi, Alessandra; Carella, Angelo M; Alvarez, Isabel; Chiarenza, Annalisa; Arcari, Annalisa; Salvi, Flavia; Federico, Massimo

2015-05-01

Recently, in an attempt to improve the discrimination power of the international prognostic index (IPI), patients with diffuse large B-cell lymphoma were evaluated to determine the prognostic roles of peripheral blood absolute monocyte count (AMC) and absolute lymphocyte count (ALC). Here, we analysed data of 428 patients with follicular lymphoma (FL) enrolled in a prospective, randomized trial (FOLL05 study) conducted by Fondazione Italiana Linfomi, to assess the impact of AMC and ALC on progression-free survival (PFS). All patients had been treated with one of three treatment combinations: (i) rituximab (R) plus cyclophosphamide, vincristine and prednisone; (ii) R plus cyclophosphamide, doxorubicin, vincristine and prednisone or (iii) R plus mitoxantrone and fludarabine. We showed that only AMC was a powerful predictor of PFS, and possibly overall survival, in patients with FL treated with combination chemotherapy regimens that contained R. The AMC can be used alone as a novel, simple factor that can predict survival outcome in patients with FL, independent of the immunochemotherapy regimen. It may therefore be widely used by clinicians, due to its simplicity and broad applicability. Additionally, it can be combined with other factors that determine the IPI or FLIPI, to increase the discriminating ability of these indices. © 2015 John Wiley & Sons Ltd.

Bridging of a substrate between cyclodextrin and an enzyme’s active site pocket triggers a unique mode of inhibition

PubMed Central

Sule, Nitesh V; Ugrinov, Angel; Mallik, Sanku; Srivastava, D. K.

2014-01-01

Background Methionyl-7-amino-4-methylcoumarin (MetAMC) serves as a substrate for the E. coli Methionine aminopeptidase (MetAP) catalyzed reaction, and is routinely used for screening compounds to identify potential antibiotic agents. In pursuit of screening the enzyme’s inhibitors, we observed that 2-hydroxypropyl-β-cyclodextrin (HP-β-CD), utilized to solubilize hydrophobic inhibitors, inhibited the catalytic activity of the enzyme, and such inhibition was not solely due to sequestration of the substrate by HP-β-CD. Methods The mechanistic path for the HP-β-CD mediated inhibition of MetAP was probed by performing a detailed account of steady-state kinetics, ligand binding, X-ray crystallographic, and molecular modeling studies. Results X-ray crystallographic data of the β-cyclodextrin—substrate (β-CD—MetAMC) complex reveal that while the AMC moiety of the substrate is confined within the CD cavity, the methionine moiety protrudes outward. The steady-state kinetic data for inhibition of MetAP by HP-β-CD—MetAMC conform to a model mechanism in which the substrate is “bridged” between HP-β-CD and the enzyme’s active-site pocket, forming HP-β-CD—MetAMC—MetAP as the catalytically inactive ternary complex. Molecular modeling shows that the scissile bond of HP-β-CD-bound MetAMC substrate does not reach within the proximity of the enzyme’s catalytic metal center, and thus the substrate fails to undergo cleavage. Conclusions The data presented herein suggests that the bridging of the substrate between the enzyme and HP-β-CD cavities is facilitated by interaction of their surfaces, and the resulting complex inhibits the enzyme activity. General Significance Due to its potential interaction with physiological proteins via sequestered substrates, caution must be exercised in HP-β-CD mediated delivery of drugs under pathophysiological conditions. PMID:25450177

The Army Study Program Fiscal Year 1992 Report

DTIC Science & Technology

1991-11-25

Investigation Command (ATTN: CIRM-M-S) 2 US Army Military District of Washington (ATTN: ANRM-RE) 2 US Army Health Services Command (ATTN: HSCM-R) 2 US Army...0 QA AM40 SURVEILLANCE TASK COST ANALYSIS (TCA) 1 9003 9004 AMC MEA AMQEI01C 0 SUPPLY AND SERVICES TASK COST ANALYSIS (TCA) ( 1 9003 9004 AMC MEA 4...CONFLICT MODEL DEVELOPMENT 1 9110 9210 TRADOC T/OAC ATRCLMOC1 P COMBAT SERVICE SUPPORT FORCE DESIGN ANALYSIS 2 9110 9212 TRADOC T/LEE ATRCLMOC2 P

Regulatory impairments following selective 6-OHDA lesions of the neostriatum.

PubMed

Dunnett, S B; Iversen, S D

1982-02-01

6-Hydroxydopamine lesions of the ventrolateral (VLC) but not anteromedial (AMC) caudate-putamen in rats resulted in a greater post-operative reduction in body weight and water intake than seen in animals with sham lesions. Once animals had fully resumed spontaneous food and water intake, a series of regulatory challenges were administered, and the AMC rats showed a reduced enhancement of drinking following injection of hypertonic saline. The results are interpreted in terms of a heterogeneous striatal convergence of nigrostriatal and cortical regulatory mechanisms.

Army Needs to Improve the Reliability of the Spare Parts Forecasts It Submits to the Defense Logistics Agency

DTIC Science & Technology

2014-09-29

In response to this finding, AMC is initiating a Depot Material Requirements Planning ( MRP ) Integrated Process Team (IPT) from which one objective...methodologies for DOF reviews and corrective actions by AMC and its component organizations. The target completion date for the Depot MRP IPT is June...implemented a matrix for MRP SOW where the aviation programs were updated in Production LMP 1QFY14. Army Materiel Command (cont’d) Management

History of the TOW Missile System

DTIC Science & Technology

1977-10-01

pp. 1 .5 .4 & 1 .5 .5 . (2 ) L t r , DCG/LCS, I I C O M , t o CG, AMC, 29 Nar 65, s u b j : PEVA FY 65 APE P r o j AXMS 4220.X.32909...TOW). HDF. 3 8 ~ t r , C G , MICOM, t o CG, AMC, 23 J u l 65 , s u b j : PEVA FY 66 APE P r o j MCMS 4290.X.32947 (TOW). HDF. $1.7 m i l l

Air Mobility Command’s En Route Support Infrastructure: A Construct of Aircraft Type and Geographic Location Utilized to Assess En Route Aircraft Logistic Support

DTIC Science & Technology

2007-06-01

or JTF air mobility operations (AFDC, 2000). As stated in the following definition, the NAMS integrates the primary functions of airlift, air...control, and communications (C3), logistics support, and aerial port functions . The goal of the en route is to minimize delays for AMC mission...process. The resulting data was used to perform a statistical analysis of AMC off-station aircraft logistic support records for AMC’s six primary

Best practice in unbilled account management: one medical center's story.

PubMed

Menaker, Debra; Miller, Joshua

2016-02-01

After implementing its new electronic health record, a large metropolitan academic medical center (AMC) decided to optimize its supporting business systems, beginning with billing. By identifying problems and taking the following corrective actions immediately, the AMC significantly reduced the number and average age of its unbilled accounts: Realigning system automation to improve routing efficiency. Facilitating interdisciplinary collaboration to better identify and correct the root causes of issues. Ensuring transparent data reporting by setting up different ways of viewing the underlying information.

The effects of adding single-joint exercises to a multi-joint exercise resistance training program on upper body muscle strength and size in trained men.

PubMed

de França, Henrique Silvestre; Branco, Paulo Alexandre Nordeste; Guedes Junior, Dilmar Pinto; Gentil, Paulo; Steele, James; Teixeira, Cauê Vazquez La Scala

2015-08-01

The aim of this study was compare changes in upper body muscle strength and size in trained men performing resistance training (RT) programs involving multi-joint plus single-joint (MJ+SJ) or only multi-joint (MJ) exercises. Twenty young men with at least 2 years of experience in RT were randomized in 2 groups: MJ+SJ (n = 10; age, 27.7 ± 6.6 years) and MJ (n = 10; age, 29.4 ± 4.6 years). Both groups trained for 8 weeks following a linear periodization model. Measures of elbow flexors and extensors 1-repetition maximum (1RM), flexed arm circumference (FAC), and arm muscle circumference (AMC) were taken pre- and post-training period. Both groups significantly increased 1RM for elbow flexion (4.99% and 6.42% for MJ and MJ+SJ, respectively), extension (10.60% vs 9.79%, for MJ and MJ+SJ, respectively), FAC (1.72% vs 1.45%, for MJ and MJ+SJ, respectively), and AMC (1.33% vs 3.17% for MJ and MJ+SJ, respectively). Comparison between groups revealed no significant difference in any variable. In conclusion, 8 weeks of RT involving MJ or MJ+SJ resulted in similar alterations in muscle strength and size in trained participants. Therefore, the addition of SJ exercises to a RT program involving MJ exercises does not seem to promote additional benefits to trained men, suggesting MJ-only RT to be a time-efficient approach.

Funds Flow in the Era of Value-Based Health Care.

PubMed

Itri, Jason N; Mithqal, Ayman; Krishnaraj, Arun

2017-06-01

Health care reform is creating significant challenges for hospital systems and academic medical centers (AMCs), requiring a new operating model to adapt to declining reimbursement, diminishing research funding, market consolidation, payers' focus on higher quality and lower cost, and greater cost sharing by patients. Maintaining and promoting the triple mission of clinical care, research, and education will require AMCs to be system-based with strong alignment around governance, operations, clinical care, and finances. Funds flow is the primary mechanism whereby an AMC maintains the triple mission through alignment of the hospital, physician practices, school of medicine, undergraduate university, and other professional schools. The purpose of this article is to discuss challenges with current funds flow models, impact of funds flow on academic and private practice radiology groups, and strategies that can increase funds flow to support radiology practices achieving clinical, research, and teaching missions in the era of value-based health care. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

The AMCE (AIST Managed Cloud Environment)

NASA Astrophysics Data System (ADS)

Cook, S.

2017-12-01

ESTO has developed and implemented the AIST Managed Cloud Environment (AMCE) to offer cloud computing services to SMD-funded PIs to conduct their project research. AIST will provide projects access to a cloud computing framework that incorporates NASA security, technical, and financial standards, on which project can freely store, run, and process data. Currently, many projects led by research groups outside of NASA do not have the awareness of requirements or the resources to implement NASA standards into their research, which limits the likelihood of infusing the work into NASA applications. Offering this environment to PIs allows them to conduct their project research using the many benefits of cloud computing. In addition to the well-known cost and time savings that it allows, it also provides scalability and flexibility. The AMCE facilitates infusion and end user access by ensuring standardization and security. This approach will ultimately benefit ESTO, the science community, and the research, allowing the technology developments to have quicker and broader applications.

Developmental programming of O2 sensing by neonatal intermittent hypoxia via epigenetic mechanisms

PubMed Central

Nanduri, Jayasri; Prabhakar, Nanduri R.

2014-01-01

Recurrent apnea with intermittent hypoxia (IH) is a major clinical problem in infants born preterm. Carotid body chemo-reflex and catecholamine secretion from adrenal medullary chromaffin cells (AMC) are important for maintenance of cardio-respiratory homeostasis during hypoxia. This article highlights studies on the effects of IH on O2 sensing by the carotid body and AMC in neonatal rodents. Neonatal IH augments hypoxia-evoked carotid body sensory excitation and catecholamine secretion from AMC which are mediated by reactive oxygen species (ROS)-dependent recruitment of endothelin-1 and Ca2+ signaling, respectively. The effects of neonatal IH persist into adulthood. Evidence is emerging that neonatal IH initiates epigenetic mechanisms involving DNA hypermethylation contributing to long-lasting increase in ROS levels. Since adult human subjects born preterm exhibit higher incidence of sleep-disordered breathing and hypertension, DNA hypomethylating agents might offer a novel therapeutic intervention to decrease long-term cardio-respiratory morbidity caused by neonatal IH. PMID:22846496

The effect of process parameters in Aluminum Metal Matrix Composites with Powder Metallurgy

NASA Astrophysics Data System (ADS)

Vani, Vemula Vijaya; Chak, Sanjay Kumar

2018-06-01

Metal Matrix Composites are developed in recent years as an alternative over conventional engineering materials due to their improved properties. Among all, Aluminium Matrix Composites (AMCs) are increasing their demand due to low density, high strength-to-weight ratio, high toughness, corrosion resistance, higher stiffness, improved wear resistance, increased creep resistance, low co-efficient of thermal expansion, improved high temperature properties. Major applications of these materials have been in aerospace, automobile, military. There are different processing techniques for the fabrication of AMCs. Powder metallurgy is a one of the most promising and versatile routes for fabrication of particle reinforced AMCs as compared to other manufacturing methods. This method ensures the good wettability between matrix and reinforcement, homogeneous microstructure of the fabricated MMC, and prevents the formation of any undesirable phases. This article addresses mainly on the effect of process parameters like sintering time, temperature and particle size on the microstructure of aluminum metal matrix composites.

Textile antenna integrated with compact AMC and parasitic elements for WLAN/WBAN applications

NASA Astrophysics Data System (ADS)

Lago, Herwansyah; Soh, Ping Jack; Jamlos, Mohd Faizal; Shohaimi, Nursuriati; Yan, Sen; Vandenbosch, Guy A. E.

2016-12-01

A wearable antenna fully designed and fabricated using textile is presented. Both antenna and artificial magnetic conductor plane are designed for operation in the wireless local area network (WLAN)/wireless body area network (WBAN) band from 2.4 to 2.5 GHz. The AMC unit element is designed based on the rectangular patch structure, which is then integrated using slots and slits for bandwidth broadening. Meanwhile, the combination of the slits and L-shaped parasitic elements applied at four edges of the rectangular antenna structure enabled unidirectional radiation outwards from the body. The structure is coaxially fed using a rectangular ring slot centered on the radiating element. Simulated and measured reflection and radiation performance indicate a satisfactory agreement, fulfilling the requirements for WLAN/WBAN applications both in free space and on body. The shielding effectiveness provided by the AMC plane is also evaluated numerically in terms of specific absorption rate, indicating levels below the European regulatory limit of 2 W/kg.

Effect of Zn2+ on halohydrin dehalogenase expression and accumulation through multi-parameter correlation research with Escherichia coli P84A/MC1061

PubMed Central

Li, Xiao; Luo, Yu-Di; Pan, Dong-Rui; Shi, Xiao-Dan; Tan, Ya-Li; Li, Zhi-Hong

2017-01-01

ABSTRACT Using 5 Zn2+ supplementation strategies in a 50 L batch bioreactor named FUS-50L(A), possible correlations among Zn2+ content and addition timing, physiologic activity (PA), halohydrin dehalogenase (HheC) accumulation of Escherichia coli P84A/MC1061 were systematically investigated. First, Zn2+ was confirmed as the significant factor, and its optimal concentration for HheC expression was 3.87 mg/L through fermentation experiments in shaking flasks. Second, based on experimental results from the different strategies, it was found that PA, nutrient consumption rate (NCR) and specific growth rate (μ) for E. coli P84A/MC1061 were promoted in the log phase (4–8 h) under appropriate Zn2+ concentrations in the lag phase and late log phase. Furthermore cell biomass was also increased to a higher level and the maximum HheC activity (i.e. HheCmax) was increased by 9.80%, and the time to reach HheCmax was reduced from 16 to 12 hours. Furthermore, appropriate supplementation of Zn2+ caused higher μ for E. coli P84A/MC1061, which resulted in more rapid accumulation of increased acetic acid concentrations, leading to higher acetic acid consumption avoiding any negative effects on producing HheC because of carbon source being exhausted prematurely and acetic acid being consumed rapidly. PMID:28282255

Cardiovascular mortality in patients with prostate cancer exposed to androgen deprivation therapy.

PubMed

Monzó-Gardiner, J I; Herranz-Amo, F

2015-10-01

A relationship between the administration of GnRH agonists and the risk of acute myocardial infarction (AMC) in patients with prostate cancer has been showed in the third observational study published in April 2014. The association AMC-orchiectomy was not found in any of these studies. Define risk factors for cardiovascular disease in patients treated with GnRH agonist. Their probable underlying pathogenic mechanism in the myocardium and peripheral vascular tree was also analyzed. English articles cited in PubMed were reviewed. No time period is specified. The last search date was 11/30/14. In patients with coronary history of AMC or congestive heart failure, hormonal neoadjuvant therapy increased cardiovascular mortality rates (HR: 1.96, IC 95%: 1.04-3.71; P=.04) as well as cardiovascular-specific mortality rates (AHR: 3.28; IC 95%: 1.01-10.64; P=.048). Two possible mechanisms can be involved: a) direct mechanism through myocardial receptor for GnRH/PKA along with atherogenic plaques; and b) indirect mechanism related with metabolic disturbances. Patients with AMC or congestive heart failure history could present a higher risk of death related to the use of GnRH agonists. In these cases, should carefully consider appropriateness of such treatment. These effects can explained by a direct mechanism on myocardium and peripheral vascular tree and indirect ones related with modified metabolic syndrome. Copyright © 2014 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

The culture of academic medicine: faculty perceptions of the lack of alignment between individual and institutional values.

PubMed

Pololi, Linda; Kern, David E; Carr, Phyllis; Conrad, Peter; Knight, Sharon

2009-12-01

Energized, talented faculty are essential to achieving the missions of academic medical centers (AMCs) in education, research and health care. The alignment of individuals' values with workplace experiences are linked to meaningfulness of work and productivity. To determine faculty values and their alignment with institutional values. A qualitative hypothesis-generating interview study to understand the professional experiences of faculty and organizational approach in five AMCs that were nationally representative in regional and organizational characteristics. Analysis was inductive and data driven. Using stratified, purposeful sampling, we interviewed 96 male and female faculty at different career stages (early career, plateaued, senior faculty and those who had left academic medicine) and diverse specialties (generalists, medical and surgical subspecialists, and research scientists). Dominant themes that emerged from the data. Faculty described values relating to excellence in clinical care, community service (including care for the underserved and disadvantaged), teaching, intellectual rigor/freedom and discovery, all values that mirror the stated missions of AMCs. However, many faculty also described behaviors that led them to conclude that their AMCs, in practice, undervalued excellence in clinical care, and their social and educational missions. Themes were seen across gender, career stage, race and discipline, except that female leaders appeared more likely than male leaders to identify incongruence of individual values and organizational practices. In this study of five diverse medical schools, faculty values were well aligned with stated institutional missions; however, many perceived that institutional behaviors were not always aligned with individual faculty values.

Longitudinal mathematics development of students with learning disabilities and students without disabilities: a comparison of linear, quadratic, and piecewise linear mixed effects models.

PubMed

Kohli, Nidhi; Sullivan, Amanda L; Sadeh, Shanna; Zopluoglu, Cengiz

2015-04-01

Effective instructional planning and intervening rely heavily on accurate understanding of students' growth, but relatively few researchers have examined mathematics achievement trajectories, particularly for students with special needs. We applied linear, quadratic, and piecewise linear mixed-effects models to identify the best-fitting model for mathematics development over elementary and middle school and to ascertain differences in growth trajectories of children with learning disabilities relative to their typically developing peers. The analytic sample of 2150 students was drawn from the Early Childhood Longitudinal Study - Kindergarten Cohort, a nationally representative sample of United States children who entered kindergarten in 1998. We first modeled students' mathematics growth via multiple mixed-effects models to determine the best fitting model of 9-year growth and then compared the trajectories of students with and without learning disabilities. Results indicate that the piecewise linear mixed-effects model captured best the functional form of students' mathematics trajectories. In addition, there were substantial achievement gaps between students with learning disabilities and students with no disabilities, and their trajectories differed such that students without disabilities progressed at a higher rate than their peers who had learning disabilities. The results underscore the need for further research to understand how to appropriately model students' mathematics trajectories and the need for attention to mathematics achievement gaps in policy. Copyright © 2015 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

Using Advanced Tabu Search Approaches to Perform Enhanced Air Mobility Command Operational Airlift Analyses - Phases II and III

DTIC Science & Technology

2006-10-31

Ross USN, Javier Barreiro and Jason Porter AMC: Mr. David L. Merrill, Maj David Van Veldhuizen PhD Mitre Inc. (USTRANSOM) Mr. Stuart Draper, Mr. Mark...interface (GUI), at the request of Lt Col Van Veldhuizen (AMC), to facilitate the use of McKinzie’s TPFDD automated editor/error corrector that was part of...and Van Veldhuizen (2006). This research addressed both the channel and contingency instances of air fleet loading at’ an APOE. In this process, Capt

Mastitis prevention and control practices and mastitis treatment strategies associated with the consumption of (critically important) antimicrobials on dairy herds in Flanders, Belgium.

PubMed

Stevens, M; Piepers, S; De Vliegher, S

2016-04-01

The main objectives of this study were to evaluate to what extent variations in herd-level antimicrobial consumption (AMC) can be explained by differences in management practices that are consistently effective in the prevention of (sub)clinical mastitis, on the one hand, and by differences in mastitis treatment strategies, on the other hand. Antimicrobial consumption data were obtained during 2012 and 2013 by "garbage can audits" and expressed as antimicrobial treatment incidences (ATI) for all compounds combined (total ATI) and for the critically important antimicrobials for human health separately. Data on mastitis prevention and control practices were obtained via face-to-face interviews performed during herd visits in March 2013. Some management practices and treatment strategies related to udder health were associated with the total AMC. However, the results demonstrated that implementing effective udder health management practices does not necessarily imply a low AMC and vice versa. Herds participating in a veterinary herd health management program and herds selectively drying off cows used fewer antimicrobials compared with herds not participating in such a program or applying blanket dry-cow therapy. Moreover, herds treating (some) (sub)clinical mastitis cases with intramammary homeopathic substances consumed fewer antimicrobials than herds not applying such homeopathic treatments. Besides these factors, no other direct association was found between effective udder health management practices on the one hand and AMC on the other hand. Also, the use of critically important antimicrobials was only associated with the way in which subclinical mastitis cases were treated. The latter indicates that the AMC of critically important antimicrobials is potentially driven by factors other than those included in this study such as those related to the "mindset" of the veterinarians and their farmers. Future research should therefore aim to unravel the reasoning of vets and their farmers behind the use of those critically important antimicrobials for the treatment of mastitis and other diseases. Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

A homogeneous cellular histone deacetylase assay suitable for compound profiling and robotic screening.

PubMed

Ciossek, Thomas; Julius, Heiko; Wieland, Heike; Maier, Thomas; Beckers, Thomas

2008-01-01

Most cellular assays that quantify the efficacy of histone deacetylase (HDAC) inhibitors measure hyperacetylation of core histone proteins H3 and H4. Here we describe a new approach, directly measuring cellular HDAC enzymatic activity using the substrate Boc-K(Ac)-7-amino-4-methylcoumarin (AMC). After penetration into HeLa cervical carcinoma or K562 chronic myeloid leukemia cells, the deacetylated product Boc-K-AMC is formed which, after cell lysis, is cleaved by trypsin, finally releasing the fluorophor AMC. The cellular potency of suberoylanilide hydroxamic acid, LBH589, trichostatin A, and MS275 as well-known HDAC inhibitors was determined using this assay. IC(50) values derived from concentration-effect curves correlated well with EC(50) values derived from a cellomics array scan histone H3 hyperacetylation assay. The cellular HDAC activity assay was adapted to a homogeneous format, fully compatible with robotic screening. Concentration-effect curves generated on a Tecan Genesis Freedom workstation were highly reproducible with a signal-to-noise ratio of 5.7 and a Z' factor of 0.88, indicating a very robust assay. Finally, a HDAC-inhibitor focused library was profiled in a medium-throughput screening campaign. Inhibition of cellular HDAC activity correlated well with cytotoxicity and histone H3 hyperacetylation in HeLa cells and with inhibition of human recombinant HDAC1 in a biochemical assay. Thus, by using Boc-K(Ac)-AMC as a cell-permeable HDAC substrate, the activity of various protein lysine-specific deacetylases including HDAC1-containing complexes is measurable in intact cells in a simple and homogeneous manner.

Academic Medical Centers Forming Accountable Care Organizations and Partnering With Community Providers: The Experience of the Johns Hopkins Medicine Alliance for Patients.

PubMed

Berkowitz, Scott A; Ishii, Lisa; Schulz, John; Poffenroth, Matt

2016-03-01

Academic medical centers (AMCs)--which include teaching hospital(s) and additional care delivery entities--that form accountable care organizations (ACOs) must decide whether to partner with other provider entities, such as community practices. Indeed, 67% (33/49) of AMC ACOs through the Medicare Shared Savings Program through 2014 are believed to include an outside community practice. There are opportunities for both the AMC and the community partners in pursuing such relationships, including possible alignment around shared goals and adding ACO beneficiaries. To create the Johns Hopkins Medicine Alliance for Patients (JMAP), in January 2014, Johns Hopkins Medicine chose to partner with two community primary care groups and one cardiology practice to support clinical integration while adding approximately 60 providers and 5,000 Medicare beneficiaries. The principal initial interventions within JMAP included care coordination for high-risk beneficiaries and later, in 2014, generating dashboards of ACO quality measures to facilitate quality improvement and early efforts at incorporating clinical pathways and Choosing Wisely recommendations. Additional interventions began in 2015.The principal initial challenges JMAP faced were data integration, generation of quality measure reports among disparate electronic medical records, receiving and then analyzing claims data, and seeking to achieve provider engagement; all these affected timely deployment of the early interventions. JMAP also created three regional advisory councils as a forum promoting engagement of local leadership. Network strategies among AMCs, including adding community practices in a nonemployment model, will continue to require thoughtful strategic planning and a keen understanding of local context.

A Cognitive Machine Learning Algorithm for Cardiac Imaging: A Pilot Study for Differentiating Constrictive Pericarditis from Restrictive Cardiomyopathy

PubMed Central

Sengupta, Partho P.; Huang, Yen-Min; Bansal, Manish; Ashrafi, Ali; Fisher, Matt; Shameer, Khader; Gall, Walt; Dudley, Joel T

2016-01-01

Background Associating a patient’s profile with the memories of prototypical patients built through previous repeat clinical experience is a key process in clinical judgment. We hypothesized that a similar process using a cognitive computing tool would be well suited for learning and recalling multidimensional attributes of speckle tracking echocardiography (STE) data sets derived from patients with known constrictive pericarditis (CP) and restrictive cardiomyopathy (RCM). Methods and Results Clinical and echocardiographic data of 50 patients with CP and 44 with RCM were used for developing an associative memory classifier (AMC) based machine learning algorithm. The STE data was normalized in reference to 47 controls with no structural heart disease, and the diagnostic area under the receiver operating characteristic curve (AUC) of the AMC was evaluated for differentiating CP from RCM. Using only STE variables, AMC achieved a diagnostic AUC of 89·2%, which improved to 96·2% with addition of 4 echocardiographic variables. In comparison, the AUC of early diastolic mitral annular velocity and left ventricular longitudinal strain were 82.1% and 63·7%, respectively. Furthermore, AMC demonstrated greater accuracy and shorter learning curves than other machine learning approaches with accuracy asymptotically approaching 90% after a training fraction of 0·3 and remaining flat at higher training fractions. Conclusions This study demonstrates feasibility of a cognitive machine learning approach for learning and recalling patterns observed during echocardiographic evaluations. Incorporation of machine learning algorithms in cardiac imaging may aid standardized assessments and support the quality of interpretations, particularly for novice readers with limited experience. PMID:27266599

Soil conservation service curve number: How to take into account spatial and temporal variability

NASA Astrophysics Data System (ADS)

Rianna, M.; Orlando, D.; Montesarchio, V.; Russo, F.; Napolitano, F.

2012-09-01

The most commonly used method to evaluate rainfall excess, is the Soil Conservation Service (SCS) runoff curve number model. This method is based on the determination of the CN valuethat is linked with a hydrological soil group, cover type, treatment, hydrologic condition and antecedent runoff condition. To calculate the antecedent runoff condition the standard procedure needs to calculate the rainfall over the entire basin during the five days previous to the beginning of the event in order to simulate and then to use that volume of rainfall to calculate the antecedent moisture condition (AMC). This is necessary in order to obtain the correct curve number value. The value of the modified parameter is then kept constant throughout the whole event. The aim of this work is to evaluate the possibility of improving the curve number method. The various assumptions are focused on modifying those related to rainfall and the determination of an AMC condition and their role in the determination of the value of the curve number parameter. In order to consider the spatial variability we assumed that the rainfall which influences the AMC and the CN value does not account for the rainfall over the entire basin, but for the rainfall within a single cell where the basin domain is discretized. Furthermore, in order to consider the temporal variability of rainfall we assumed that the value of the CN of the single cell is not maintained constant during the whole event, but instead varies throughout it according to the time interval used to define the AMC conditions.

Academic Medical Centers as Innovation Ecosystems: Evolution of Industry Partnership Models Beyond the Bayh-Dole Act.

PubMed

Silva, Patrick J; Ramos, Kenneth S

2018-04-17

Innovation ecosystems tied to academic medical centers (AMCs) are inextricably linked to policy, practices, and infrastructure resulting from the passage of the Bayh-Dole Act in 1980. Bayh-Dole smoothed the way to patenting and licensing new drugs, and to some degree, medical devices and diagnostic reagents. Property rights under Bayh-Dole provided a significant incentive for industry investments in clinical trials, clinical validation, and industrial scale-up of products that advanced health care. Bayh-Dole amplified private investment in biotechnology drug development, and from the authors' perspective did not significantly interfere with the ability of AMCs to produce excellent peer-reviewed science. In today's policy environment, it is increasingly difficulty to patent and license products based on the laws of nature - as the scope of patentability has been narrowed by case law and development of a suitable clinical and business case for the technology is increasingly a gating consideration for licensees. Consequently, fewer academic patents are commercially valuable. The role of technology transfer organizations in engaging industry partners has thus become increasingly complex. The partnering toolbox and the organizational mandate for commercialization must evolve toward novel collaborative models that exploit opportunities for future patent creation (early drug discovery), data exchange (precision medicine using big data), cohort assembly (clinical trials), and decision rule validation (clinical trials). These inputs all contribute to intellectual property rights, and their clinical exploitation manifests the commercialization of translational science. New collaboration models between AMCs and industry must be established to leverage the assets within AMCs that industry partners deem valuable.

Recommendations to Sustain the Academic Mission Ecosystem at U.S. Medical Schools.

PubMed

Kerschner, Joseph E; Hedges, Jerris R; Antman, Karen; Abraham, Edward; Colón Negrón, Edgar; Jameson, J Larry

2018-07-01

Academic medical center (AMC) faculty, administrators, and leaders have the critical tasks of teaching and training the next generation of health care providers and biomedical researchers, as well as generating new knowledge that improves the health of all. In the United States, medical schools and their affiliated hospitals train remarkably high-quality physicians and scientists, and the research conducted at these institutions results in advances in health. To that end, AMCs have become essential engines for driving better health in the United States and the rest of the world; they also have become essential engines driving the economies of their respective communities and regions. The education and research missions, however, require subsidization because tuition and extramural grant funding do not cover the costs of these endeavors. This subsidization largely has come from revenues generated by AMCs' clinical endeavors. The viability of this cross-subsidization, however, is increasingly threatened in the current clinical environment. The authors of this Perspective discuss these issues in depth and provide some concrete recommendations to address these challenges. They hope to stimulate discussion and, ultimately, ensure the financial viability of U.S. AMCs-a national resource of utmost importance. Recommendations to sustain research include creating strategic biomedical research plans, developing a defined and sustained model to support National Institutes of Health funding that keeps pace with inflation, and evolving funding mechanisms. Recommendations to sustain medical education include limiting student debt, creating more cost-effective curricula, and ensuring that clinical training opportunities that meet national standards are available to students.

A flexible 70 MHz phase-controlled double waveguide system for hyperthermia treatment of superficial tumours with deep infiltration.

PubMed

van Stam, Gerard; Kok, H Petra; Hulshof, Maarten C C M; Kolff, M Willemijn; van Tienhoven, Geertjan; Sijbrands, Jan; Bakker, Akke; Zum Vörde Sive Vörding, Paul J; Oldenborg, Sabine; de Greef, Martijn; Rasch, Coen R N; Crezee, Hans

2017-11-01

Superficial tumours with deep infiltration in the upper 15 cm of the trunk cannot be treated adequately with existing hyperthermia systems. The aim of this study was to develop, characterise and evaluate a new flexible two-channel hyperthermia system (AMC-2) for tumours in this region. The two-channel AMC-2 system has two horizontally revolving and height adjustable 70 MHz waveguides. Three different interchangeable antennas with sizes 20 × 34, 15 × 34 and 8.5 × 34 cm were developed and their electrical properties were determined. The performance of the AMC-2 system was tested by measurements of the electric field distribution in a saline water filled elliptical phantom, using an electric field vector probe. Clinical feasibility was demonstrated by treatment of a melanoma in the axillary region. Phantom measurements showed a good performance for all waveguides. The large reflection of the smallest antenna has to be compensated by increased forward power. Field patterns become asymmetrical when using smaller top antennas, necessitating phase corrections. The clinical application showed that tumours deeper than 4 cm can be heated adequately. A median tumour temperature of 42 °C can be reached up to 12 cm depth with adequate antenna positioning and phase-amplitude steering. This 70 MHz AMC-2 waveguide system is a useful addition to existing loco-regional hyperthermia equipment as it is capable of heating axillary tumours and other tumours deeper than 4 cm.

Virucidal action of sore throat lozenges against respiratory viruses parainfluenza type 3 and cytomegalovirus.

PubMed

Shephard, Adrian; Zybeshari, Stela

2015-11-01

Most respiratory tract infections are self-limiting and caused by viruses, and do not warrant antibiotic treatment. Despite this, patients with respiratory tract infections often receive antibiotics, fuelling the rise of antibiotic resistance. Therefore, there is a need to encourage patients to try alternative non-antibiotic therapies, which ideally treat the symptoms and the cause. Lozenges containing amylmetacresol and 2,4-dichlorobenzyl alcohol (AMC/DCBA lozenges) as well as lozenges containing hexylresorcinol have been shown to provide effective symptomatic relief for sore throat. In this study, we investigated whether these lozenges also have virucidal effects in vitro against two viruses associated with respiratory tract infections, parainfluenza virus type 3 and cytomegalovirus. Both viruses were incubated with AMC/DCBA lozenge, placebo lozenge or the active ingredients (AMC/DCBA) as free substances, and parainfluenza virus type 3 was incubated with hexylresorcinol lozenge, placebo lozenge or hexylresorcinol as a free substance. Virucidal effects were observed with the active lozenges and the active ingredients as free substances against both parainfluenza virus type 3 and cytomegalovirus. Mean reductions in viral titre were significantly greater compared with placebo lozenge and peak effects were observed for the shortest incubation time, 1min. These findings suggest that AMC/DCBA lozenge and hexylresorcinol lozenge have the potential to have local antiviral effects in patients with sore throat due to viral respiratory tract infections. Use of such over-the-counter treatments for self-limiting respiratory tract infections may satisfy patients' desire for an anti-infective medication and reduce the demand for antibiotics. Copyright © 2015 Elsevier B.V. All rights reserved.

In Vitro Screening of Synthetic Fluorogenic Substrates for Detection of Cancer Procoagulant Activity.

PubMed

Krause, Jason; Frost, Carminita L

2018-04-01

Cancer procoagulant (CP), a direct activator of coagulation factor X, is among one of the tumour cell products or activities which may promote fibrin formation and has been suggested to be selectively associated with the malignant phenotype. At present, the most reliable assay for the quantification of CP activity is the three-stage chromogenic assay which utilises the ability of CP to activate factor X. In this assay, the activation of factor X leads to the formation of activated thrombin from prothrombin and the eventual hydrolyses of a thrombin chromogenic substrate which contains a p-nitroaniline leaving group. The complexity of the three-stage chromogenic assay suggests a need for a direct method of assaying CP activity. This study focuses on the design of a fluorogenic substrate that would enable the direct quantification of CP activity. The results of the study show two promising substrates for the determination of CP activity: Boc-PQVR-AMC and PQVR-AMC. Further analysis showed that Boc-PQVR-AMC could be excluded as a potential substrate for CP since it was also cleaved by collagenase.

Hierarchical activated mesoporous phenolic-resin-based carbons for supercapacitors.

PubMed

Wang, Zhao; Zhou, Min; Chen, Hao; Jiang, Jingui; Guan, Shiyou

2014-10-01

A series of hierarchical activated mesoporous carbons (AMCs) were prepared by the activation of highly ordered, body-centered cubic mesoporous phenolic-resin-based carbon with KOH. The effect of the KOH/carbon-weight ratio on the textural properties and capacitive performance of the AMCs was investigated in detail. An AMC prepared with a KOH/carbon-weight ratio of 6:1 possessed the largest specific surface area (1118 m(2) g(-1)), with retention of the ordered mesoporous structure, and exhibited the highest specific capacitance of 260 F g(-1) at a current density of 0.1 A g(-1) in 1 M H2 SO4 aqueous electrolyte. This material also showed excellent rate capability (163 F g(-1) retained at 20 A g(-1)) and good long-term electrochemical stability. This superior capacitive performance could be attributed to a large specific surface area and an optimized micro-mesopore structure, which not only increased the effective specific surface area for charge storage but also provided a favorable pathway for efficient ion transport. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

AmeriFlux Measurement Component (AMC) Handbook

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

Reichl, K.; Biraud, S. C.

An AMC system was installed at the Atmospheric Radiation Measurement (ARM) Climate Research Facility’s North Slope Alaska (NSA) Barrow site, also known as NSA C1 at the ARM Data Archive, in August 2012. A second AMC system was installed at the third ARM Mobile Facility deployment at Oliktok Point, also known as NSA M1. This in situ system consists of 12 combination soil temperature and volumetric water content (VWC) reflectometers and one set of upwelling and downwelling PAR sensors, all deployed within the fetch of the Eddy Correlation Flux Measurement System. Soil temperature and VWC sensors placed at two depthsmore » (10 and 30 cm below the vegetation layer) at six locations (or microsites) allow soil property inhomogeneity to be monitored across a landscape. The soil VWC and temperature sensors used at NSA C1 are the Campbell Scientific CS650L and the sensors at NSA M1 use the Campbell Scientific CS655. The two sensors are nearly identical in function, and vendor specifications are based on the CS650 unless otherwise stated.« less

A theoretical approach to evaluate the release rate of acetaminophen from erosive wax matrix dosage forms.

PubMed

Agata, Yasuyoshi; Iwao, Yasunori; Shiino, Kai; Miyagishima, Atsuo; Itai, Shigeru

2011-07-29

To predict drug dissolution and understand the mechanisms of drug release from wax matrix dosage forms containing glyceryl monostearate (GM; a wax base), aminoalkyl methacrylate copolymer E (AMCE; a pH-dependent functional polymer), and acetaminophen (APAP; a model drug), we tried to derive a novel mathematical model with respect to erosion and diffusion theory. Our model exhibited good agreement with the whole set of experimentally obtained values pertaining to APAP release at pH 4.0 and pH 6.5. In addition, this model revealed that the eroding speed of wax matrices was strongly influenced by the loading content of AMCE, but not that of APAP, and that the diffusion coefficient increased as APAP loading decreased and AMCE loading increased, thus directly defining the physicochemical properties of erosion and diffusion. Therefore, this model might prove a useful equation for the precise prediction of dissolution and for understanding the mechanisms of drug release from wax matrix dosage forms. Copyright © 2011 Elsevier B.V. All rights reserved.

Theoretical study of actinide monocarbides (ThC, UC, PuC, and AmC)

NASA Astrophysics Data System (ADS)

Pogány, Peter; Kovács, Attila; Visscher, Lucas; Konings, Rudy J. M.

2016-12-01

A study of four representative actinide monocarbides, ThC, UC, PuC, and AmC, has been performed with relativistic quantum chemical calculations. The two applied methods were multireference complete active space second-order perturbation theory (CASPT2) including the Douglas-Kroll-Hess Hamiltonian with all-electron basis sets and density functional theory with the B3LYP exchange-correlation functional in conjunction with relativistic pseudopotentials. Beside the ground electronic states, the excited states up to 17 000 cm-1 have been determined. The molecular properties explored included the ground-state geometries, bonding properties, and the electronic absorption spectra. According to the occupation of the bonding orbitals, the calculated electronic states were classified into three groups, each leading to a characteristic bond distance range for the equilibrium geometry. The ground states of ThC, UC, and PuC have two doubly occupied π orbitals resulting in short bond distances between 1.8 and 2.0 Å, whereas the ground state of AmC has significant occupation of the antibonding orbitals, causing a bond distance of 2.15 Å.

Experimental Evaluation of Adaptive Modulation and Coding in MIMO WiMAX with Limited Feedback

NASA Astrophysics Data System (ADS)

Mehlführer, Christian; Caban, Sebastian; Rupp, Markus

2007-12-01

We evaluate the throughput performance of an OFDM WiMAX (IEEE 802.16-2004, Section 8.3) transmission system with adaptive modulation and coding (AMC) by outdoor measurements. The standard compliant AMC utilizes a 3-bit feedback for SISO and Alamouti coded MIMO transmissions. By applying a 6-bit feedback and spatial multiplexing with individual AMC on the two transmit antennas, the data throughput can be increased significantly for large SNR values. Our measurements show that at small SNR values, a single antenna transmission often outperforms an Alamouti transmission. We found that this effect is caused by the asymmetric behavior of the wireless channel and by poor channel knowledge in the two-transmit-antenna case. Our performance evaluation is based on a measurement campaign employing the Vienna MIMO testbed. The measurement scenarios include typical outdoor-to-indoor NLOS, outdoor-to-outdoor NLOS, as well as outdoor-to-indoor LOS connections. We found that in all these scenarios, the measured throughput is far from its achievable maximum; the loss is mainly caused by a too simple convolutional coding.

Antecedent moisture content and soil texture effects on infiltration and erosion

NASA Astrophysics Data System (ADS)

Mamedov, A. I.; Huang, C.; Levy, G. J.

2006-12-01

Water infiltration, seal formation, runoff and erosion depend on the soil's inherent properties and surface conditions. Most erosion models consider only soil inherent properties (mainly texture) in assessing infiltration and erosion without consideration of spatial and temporary variation in the surface condition, particularly the antecedent moisture content. We studied the interaction of two different surface conditions, i.e. antecedent moisture content (AMC) and aging (timing after wetting) on infiltration (IR), seal formation (runoff generation) and erosion in four soils varying from loam to clay. Soil samples were packed in erosion box and wetted with different amounts of water (0, 1, 2, 3, 4, 6, 8, or 16 mm) to obtain a wide moisture range (i.e., pF 0-6.2, or from air dry to full saturation). The boxes were put in plastic bags and allowed to age for 0.01, 1, 3, or 7 days. Then the soil in the erosion box exposed to 60 mm of rain. At no aging final IR of soils did not change significantly, but runoff volume (a measure for seal development) and soil loss increased with an increase in AMC mainly because of aggregate breakdown. For any given aging, the highest IR and smallest runoff volume and soil loss were obtained at the intermediate AMC levels (pF 2.4-4.2, between wilting point and field capacity). For instance, in the clay soil to which 3 mm of water (pF~2.7) was added, as aging increased from one to seven days, final IR increased from 5.3 to 7.9 mm h-1, while runoff and soil loss decreased from 34 mm to 22 mm, and from 630 to 360 g m2 respectively. At this AMC range, increasing aging time resulted in up to 40% increase in IR and decrease in runoff or soil loss. This tendency significantly more pronounced for clay soils because water-filled pores in the clay fabric were considered active in the stabilization process and the development of cohesive bonds between and within particles during the aging period. The results of this study are important for soil erosion modeling. In order to improve the prediction capabilities of erosion models, temporal and spatial variation of soil moisture content (AMC, wetting and aging) prior to erosive rainstorms should be considered and or incorporated. In addition, management practices could be adapted to diminish the severe soil moisture variation, where ever possible, (minimum till or no-till with known residue) to maintain the soil surface at a desired AMC level prior to expected rainstorms in order to decrease soil susceptibility to seal formation, runoff and soil loss.

Prefrontal oscillations during recall of conditioned and extinguished fear in humans.

PubMed

Mueller, Erik M; Panitz, Christian; Hermann, Christiane; Pizzagalli, Diego A

2014-05-21

Human neuroimaging studies indicate that the anterior midcingulate cortex (AMC) and the ventromedial prefrontal cortex (vmPFC) play important roles in the expression and extinction of fear, respectively. Electrophysiological rodent studies further indicate that oscillatory neuronal activity in homolog regions (i.e., prelimbic and infralimbic cortices) changes during fear expression and fear extinction recall. Whether similar processes occur in humans remains largely unexplored. By assessing scalp surface EEG in conjunction with LORETA source estimation of CS-related theta and gamma activity, we tested whether a priori defined ROIs in the human AMC and vmPFC similarly modulate their oscillatory activity during fear expression and extinction recall, respectively. To this end, 42 healthy individuals underwent a differential conditioning/differential extinction protocol with a Recall Test on the next day. In the Recall Test, nonextinguished versus extinguished stimuli evoked an increased differential (CS(+) vs CS(-)) response with regard to skin conductance and AMC-localized theta power. Conversely, extinguished versus nonextinguished stimuli evoked an increased differential response with regard to vmPFC-localized gamma power. Finally, individuals who failed to show a suppressed skin conductance response to the extinguished versus nonextinguished CS(+) also failed to show the otherwise observed alterations in vmPFC gamma power to extinguished CS(+). These results indicate that fear expression is associated with AMC theta activity, whereas successful fear extinction recall relates to changes in vmPFC gamma activity. The present work thereby bridges findings from prior rodent electrophysiological research and human neuroimaging studies and indicates that EEG is a valuable tool for future fear extinction research. Copyright © 2014 the authors 0270-6474/14/347059-08$15.00/0.

Five-year Retrospective Review of Physician and Non-physician Performed Ultrasound in a Canadian Critical Care Helicopter Emergency Medical Service.

PubMed

O'Dochartaigh, Domhnall; Douma, Matthew; MacKenzie, Mark

2017-01-01

To describe the use of prehospital ultrasonography (PHUS) to support interventions, when used by physician and non-physician air medical crew (AMC), in a Canadian helicopter emergency medical service (HEMS). A retrospective review was conducted of consecutive patients who underwent ultrasound examination during HEMS care from January 1, 2009 through March 10, 2014. An a priori created data form was used to record patient demographics, type of ultrasound scan performed, ultrasound findings, location of scan, type of interventions supported by PHUS, factors that affected PHUS completion, and quality indicator(s). Data analysis was performed through descriptive statistics, Student's t-test for continuous variables, Z-test for proportions, and Mann-Whitney U Test for nonparametric data. Outcomes included interventions supported by PHUS, factors associated with incomplete scans, and quality indicators associated with PHUS use. Differences between physician and AMC groups were also assessed. PHUS was used in 455 missions, 318 by AMC and 137 by physicians. In combined trauma and medical patients, in the AMC group interventions were supported by PHUS in 26% of cases (95% CI 18-34). For transport physicians the percentage support was found to be significantly greater at 45% of cases (95% CI 34-56) p = < 0.006. Incomplete PHUS scans were common and reasons included patient obesity, lack of time, patient access, and clinical reasons. Quality indicators associated with PHUS were rarely identified. The use of PHUS by both physicians and non-physicians was found to support interventions in select trauma and medical patients. Key words: emergency medical services; aircraft; helicopter; air ambulance; ultrasonography; emergency care, prehospital; prehospital emergency care.

Numerical magnitude processing in abacus-trained children with superior mathematical ability: an EEG study*

PubMed Central

Huang, Jian; Du, Feng-lei; Yao, Yuan; Wan, Qun; Wang, Xiao-song; Chen, Fei-yan

2015-01-01

Distance effect has been regarded as the best established marker of basic numerical magnitude processes and is related to individual mathematical abilities. A larger behavioral distance effect is suggested to be concomitant with lower mathematical achievement in children. However, the relationship between distance effect and superior mathematical abilities is unclear. One could get superior mathematical abilities by acquiring the skill of abacus-based mental calculation (AMC), which can be used to solve calculation problems with exceptional speed and high accuracy. In the current study, we explore the relationship between distance effect and superior mathematical abilities by examining whether and how the AMC training modifies numerical magnitude processing. Thus, mathematical competencies were tested in 18 abacus-trained children (who accepted the AMC training) and 18 non-trained children. Electroencephalography (EEG) waveforms were recorded when these children executed numerical comparison tasks in both Arabic digit and dot array forms. We found that: (a) the abacus-trained group had superior mathematical abilities than their peers; (b) distance effects were found both in behavioral results and on EEG waveforms; (c) the distance effect size of the average amplitude on the late negative-going component was different between groups in the digit task, with a larger effect size for abacus-trained children; (d) both the behavioral and EEG distance effects were modulated by the notation. These results revealed that the neural substrates of magnitude processing were modified by AMC training, and suggested that the mechanism of the representation of numerical magnitude for children with superior mathematical abilities was different from their peers. In addition, the results provide evidence for a view of non-abstract numerical representation. PMID:26238541

Mathematical modelling of active safety system functions as tools for development of driverless vehicles

NASA Astrophysics Data System (ADS)

Ryazantsev, V.; Mezentsev, N.; Zakharov, A.

2018-02-01

This paper is dedicated to a solution of the issue of synthesis of the vehicle longitudinal dynamics control functions (acceleration and deceleration control) based on the element base of the vehicle active safety system (ESP) - driverless vehicle development tool. This strategy helps to reduce time and complexity of integration of autonomous motion control systems (AMCS) into the vehicle architecture and allows direct control of actuators ensuring the longitudinal dynamics control, as well as reduction of time for calibration works. The “vehicle+wheel+road” longitudinal dynamics control is complicated due to the absence of the required prior information about the control object. Therefore, the control loop becomes an adaptive system, i.e. a self-adjusting monitoring system. Another difficulty is the driver’s perception of the longitudinal dynamics control process in terms of comfort. Traditionally, one doesn’t pay a lot of attention to this issue within active safety systems, and retention of vehicle steerability, controllability and stability in emergency situations are considered to be the quality criteria. This is mainly connected to its operational limits, since it is activated only in critical situations. However, implementation of the longitudinal dynamics control in the AMCS poses another challenge for the developers - providing the driver with comfortable vehicle movement during acceleration and deceleration - while the possible highest safety level in terms of the road grip is provided by the active safety system (ESP). The results of this research are: universal active safety system - AMCS interaction interface; block diagram for the vehicle longitudinal acceleration and deceleration control as one of the active safety system’s integrated functions; ideology of adaptive longitudinal dynamics control, which enables to realize the deceleration and acceleration requested by the AMCS; algorithms synthesised; analytical experiments proving the efficiency and practicability of the chosen concept.

Symptoms of endocrine treatment and outcome in the BIG 1-98 study.

PubMed

Huober, J; Cole, B F; Rabaglio, M; Giobbie-Hurder, A; Wu, J; Ejlertsen, B; Bonnefoi, H; Forbes, J F; Neven, P; Láng, I; Smith, I; Wardley, A; Price, K N; Goldhirsch, A; Coates, A S; Colleoni, M; Gelber, R D; Thürlimann, B

2014-01-01

There may be a relationship between the incidence of vasomotor and arthralgia/myalgia symptoms and treatment outcomes for postmenopausal breast cancer patients with endocrine-responsive disease who received adjuvant letrozole or tamoxifen. Data on patients randomized into the monotherapy arms of the BIG 1-98 clinical trial who did not have either vasomotor or arthralgia/myalgia/carpal tunnel (AMC) symptoms reported at baseline, started protocol treatment and were alive and disease-free at the 3-month landmark (n = 4,798) and at the 12-month landmark (n = 4,682) were used for this report. Cohorts of patients with vasomotor symptoms, AMC symptoms, neither, or both were defined at both 3 and 12 months from randomization. Landmark analyses were performed for disease-free survival (DFS) and for breast cancer free interval (BCFI), using regression analysis to estimate hazard ratios (HR) and 95 % confidence intervals (CI). Median follow-up was 7.0 years. Reporting of AMC symptoms was associated with better outcome for both the 3- and 12-month landmark analyses [e.g., 12-month landmark, HR (95 % CI) for DFS = 0.65 (0.49-0.87), and for BCFI = 0.70 (0.49-0.99)]. By contrast, reporting of vasomotor symptoms was less clearly associated with DFS [12-month DFS HR (95 % CI) = 0.82 (0.70-0.96)] and BCFI (12-month DFS HR (95 % CI) = 0.97 (0.80-1.18). Interaction tests indicated no effect of treatment group on associations between symptoms and outcomes. While reporting of AMC symptoms was clearly associated with better DFS and BCFI, the association between vasomotor symptoms and outcome was less clear, especially with respect to breast cancer-related events.

Cyclic Thermal Stress-Induced Degradation of Cu Metallization on Si3N4 Substrate at -40°C to 300°C

NASA Astrophysics Data System (ADS)

Lang, Fengqun; Yamaguchi, Hiroshi; Nakagawa, Hiroshi; Sato, Hiroshi

2015-01-01

The high-temperature reliability of active metal brazed copper (AMC) on Si3N4 ceramic substrates used for fabricating SiC high-temperature power modules was investigated under harsh environments. The AMC substrate underwent isothermal storage at 300°C for up to 3000 h and a thermal cycling test at -40°C to 300°C for up to 3000 cycles. During isothermal storage at 300°C, the AMC substrate exhibited high reliability, characterized by very little deformation of the copper (Cu) layer, low crack growth, and low oxidation rate of the Cu layer. Under thermal cycling conditions at -40°C to 300°C, no detachment of the Cu layer was observed even after the maximum 3000 cycles of the experiment. However, serious deformation of the Cu layer occurred and progressed as the number of thermal cycles increased, thus significantly roughening the surface of the Cu metallized layer. The cyclic thermal stress led to a significant increase in the crack growth and oxidation of the Cu layer. The maximum depth of the copper oxides reached up to 5/6 of the Cu thickness. The deformation of the Cu layer was the main cause of the decrease of the bond strength under thermal cycling conditions. The shear strength of the SiC chips bonded on the AMC substrate with a Au-12 wt.%Ge solder decreased from the original 83 MPa to 14 MPa after 3000 cycles. Therefore, the cyclic thermal stress destroyed the Cu oxides and enhanced the oxidation of the Cu layer.

Impact of high-flux haemodialysis on the probability of target attainment for oral amoxicillin/clavulanic acid combination therapy.

PubMed

Hui, Katrina; Patel, Kashyap; Kong, David C M; Kirkpatrick, Carl M J

2017-07-01

Clearance of small molecules such as amoxicillin and clavulanic acid is expected to increase during high-flux haemodialysis, which may result in lower concentrations and thus reduced efficacy. To date, clearance of amoxicillin/clavulanic acid (AMC) during high-flux haemodialysis remains largely unexplored. Using published pharmacokinetic parameters, a two-compartment model with first-order input was simulated to investigate the impact of high-flux haemodialysis on the probability of target attainment (PTA) of orally administered AMC combination therapy. The following pharmacokinetic/pharmacodynamic targets were used to calculate the PTA. For amoxicillin, the time that the free concentration remains above the minimum inhibitory concentration (MIC) of ≥50% of the dosing period (≥50%ƒT >MIC ) was used. For clavulanic acid, the time that the free concentration was >0.1 mg/L of ≥45% of the dosing period (≥45%ƒT >0.1 mg/L ) was used. Dialysis clearance reported in low-flux haemodialysis for both compounds was doubled to represent the likely clearance during high-flux haemodialysis. Monte Carlo simulations were performed to produce concentration-time profiles over 10 days in 1000 virtual patients. Seven different regimens commonly seen in clinical practice were explored. When AMC was dosed twice daily, the PTA was mostly ≥90% for both compounds regardless of when haemodialysis commenced. When administered once daily, the PTA was 20-30% for clavulanic acid and ≥90% for amoxicillin. The simulations suggest that once-daily orally administered AMC in patients receiving high-flux haemodialysis may result in insufficient concentrations of clavulanic acid to effectively treat infections, especially on days when haemodialysis occurs. Copyright © 2017 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.

Integer-Linear-Programing Optimization in Scalable Video Multicast with Adaptive Modulation and Coding in Wireless Networks

PubMed Central

Lee, Chaewoo

2014-01-01

The advancement in wideband wireless network supports real time services such as IPTV and live video streaming. However, because of the sharing nature of the wireless medium, efficient resource allocation has been studied to achieve a high level of acceptability and proliferation of wireless multimedia. Scalable video coding (SVC) with adaptive modulation and coding (AMC) provides an excellent solution for wireless video streaming. By assigning different modulation and coding schemes (MCSs) to video layers, SVC can provide good video quality to users in good channel conditions and also basic video quality to users in bad channel conditions. For optimal resource allocation, a key issue in applying SVC in the wireless multicast service is how to assign MCSs and the time resources to each SVC layer in the heterogeneous channel condition. We formulate this problem with integer linear programming (ILP) and provide numerical results to show the performance under 802.16 m environment. The result shows that our methodology enhances the overall system throughput compared to an existing algorithm. PMID:25276862

Accelerating change: Fostering innovation in healthcare delivery at academic medical centers.

PubMed

Ostrovsky, Andrey; Barnett, Michael

2014-03-01

Academic medical centers (AMCs) have the potential to be leaders in the era of healthcare delivery reform, but most have yet to display a commitment to delivery innovation on par with their commitment to basic research. Several institutional factors impede delivery innovation including the paucity of adequate training in design and implementation of new delivery models and the lack of established pathways for academic career advancement outside of research. This paper proposes two initiatives to jumpstart disruptive innovation at AMCs: an institutional "innovation incubator" program and a clinician-innovator career track coupled with innovation training programs. Copyright © 2013 Elsevier Inc. All rights reserved.

Loss-of-Function Mutations in LGI4, a Secreted Ligand Involved in Schwann Cell Myelination, Are Responsible for Arthrogryposis Multiplex Congenita.

PubMed

Xue, Shifeng; Maluenda, Jérôme; Marguet, Florent; Shboul, Mohammad; Quevarec, Loïc; Bonnard, Carine; Ng, Alvin Yu Jin; Tohari, Sumanty; Tan, Thong Teck; Kong, Mung Kei; Monaghan, Kristin G; Cho, Megan T; Siskind, Carly E; Sampson, Jacinda B; Rocha, Carolina Tesi; Alkazaleh, Fawaz; Gonzales, Marie; Rigonnot, Luc; Whalen, Sandra; Gut, Marta; Gut, Ivo; Bucourt, Martine; Venkatesh, Byrappa; Laquerrière, Annie; Reversade, Bruno; Melki, Judith

2017-04-06

Arthrogryposis multiplex congenita (AMC) is a developmental condition characterized by multiple joint contractures resulting from reduced or absent fetal movements. Through genetic mapping of disease loci and whole-exome sequencing in four unrelated multiplex families presenting with severe AMC, we identified biallelic loss-of-function mutations in LGI4 (leucine-rich glioma-inactivated 4). LGI4 is a ligand secreted by Schwann cells that regulates peripheral nerve myelination via its cognate receptor ADAM22 expressed by neurons. Immunolabeling experiments and transmission electron microscopy of the sciatic nerve from one of the affected individuals revealed a lack of myelin. Functional tests using affected individual-derived iPSCs showed that these germline mutations caused aberrant splicing of the endogenous LGI4 transcript and in a cell-based assay impaired the secretion of truncated LGI4 protein. This is consistent with previous studies reporting arthrogryposis in Lgi4-deficient mice due to peripheral hypomyelination. This study adds to the recent reports implicating defective axoglial function as a key cause of AMC. Copyright © 2017 American Society of Human Genetics. Published by Elsevier Inc. All rights reserved.

Disruptive innovation in academic medical centers: balancing accountable and academic care.

PubMed

Stein, Daniel; Chen, Christopher; Ackerly, D Clay

2015-05-01

Numerous academic medicine leaders have argued that academic referral centers must prepare for the growing importance of accountability-driven payment models by adopting population health initiatives. Although this shift has merit, execution of this strategy will prove significantly more problematic than most observers have appreciated. The authors describe how successful implementation of an accountable care health strategy within a referral academic medical center (AMC) requires navigating a critical tension: The academic referral business model, driven by tertiary-level care, is fundamentally in conflict with population health. Referral AMCs that create successful value-driven population health systems within their organizations will in effect disrupt their own existing tertiary care businesses. The theory of disruptive innovation suggests that balancing the push and pull of academic and accountable care within a single organization is achievable. However, it will require significant shifts in resource allocation and changes in management structure to enable AMCs to make the inherent difficult choices and trade-offs that will ensue. On the basis of the theories of disruptive innovation, the authors present recommendations for how academic health systems can successfully navigate these issues as they transition toward accountability-driven care.

Effect of Intensive Plastic Deformation on Microstructure and Mechanical Properties of Aluminum Alloys

NASA Astrophysics Data System (ADS)

Rakhadilov, Bauyrzhan; Uazyrkhanova, Gulzhaz; Myakinin, Alexandr; Uazyrkhanova, Zhuldyz

2016-08-01

In work it was studied the influence of intensive plastic deformation on structure and mechanical properties of aluminum alloys. Intensive plastic deformation was carried out by using equal-channel angular extrusion. It is shown that the most efficient angle of intersection of the channels is the angle of Φ=120°, which ensures defect-free parts at the highest possible level of accumulated strain (e=8). It is established that the intensive milling grain structures in aluminum alloys AMG6 and AMC occurs at ECAE-12 passes, while the intersection angle of the channels of 120°. After ECAE-12 in aluminum alloys the grain refinement reaches to the size of ∼⃒1.0-1.5 gm. It is determined that as a result of equal channel angular pressing, the microhardness of alloy AMG6 increases almost 4 times in comparison with the initial state, the microhardness of alloy AMC increases by almost 4.5 times in comparison with the initial state. It is shown that ECAE-12 mass loss is reduced to 5.4 and 5.6 mg, which shows an increase in wear-resistance of aluminum alloys AMG6 and AMC 13-14 %.

Effect of petroleum hydrocarbons in copper phytoremediation by a salt marsh plant (Juncus maritimus) and the role of autochthonous bioaugmentation.

PubMed

Montenegro, I P F M; Mucha, A P; Reis, I; Rodrigues, P; Almeida, C M R

2016-10-01

This work aimed to investigate, under controlled but environmental relevant conditions, the effects of the presence of both inorganic and organic contaminants (copper and petroleum hydrocarbons) on phytoremediation potential of the salt marsh plant Juncus maritimus. Moreover, bioaugmentation, with an autochthonous microbial consortium (AMC) resistant to Cu, was tested, aiming an increase in the remediation potential of this plant in the presence of a co-contamination. Salt marsh plants with sediment attached to their roots were collected, placed in vessels, and kept in greenhouses, under tidal simulation. Sediments were contaminated with Cu and petroleum, and the AMC was added to half of the vessels. After 5 months, plants accumulated significant amounts of Cu but only in belowground structures. The amount of Cu was even higher in the presence of petroleum. AMC addition increased Cu accumulation in belowground tissues, despite decreasing Cu bioavailability, promoting J. maritimus phytostabilization potential. Therefore, J. maritimus has potential to phytoremediate co-contaminated sediments, and autochthonous bioaugmentation can be a valuable strategy for the recovery and management of moderately impacted estuaries. This approach can contribute for a sustainable use of the environmental resources. Graphical abstract ᅟ.

Trans-methylation reactions in plants: focus on the activated methyl cycle.

PubMed

Rahikainen, Moona; Alegre, Sara; Trotta, Andrea; Pascual, Jesús; Kangasjärvi, Saijaliisa

2018-02-01

Trans-methylation reactions are vital in basic metabolism, epigenetic regulation, RNA metabolism, and posttranslational control of protein function and therefore fundamental in determining the physiological processes in all living organisms. The plant kingdom is additionally characterized by the production of secondary metabolites that undergo specific hydroxylation, oxidation and methylation reactions to obtain a wide array of different chemical structures. Increasing research efforts have started to reveal the enzymatic pathways underlying the biosynthesis of complex metabolites in plants. Further engineering of these enzymatic machineries offers significant possibilities in the development of bio-based technologies, but necessitates deep understanding of their potential metabolic and regulatory interactions. Trans-methylation reactions are tightly coupled with the so-called activated methyl cycle (AMC), an essential metabolic circuit that maintains the trans-methylation capacity in all living cells. Tight regulation of the AMC is crucial in ensuring accurate trans-methylation reactions in different subcellular compartments, cell types, developmental stages and environmental conditions. This review addresses the organization and posttranslational regulation of the AMC and elaborates its critical role in determining metabolic regulation through modulation of methyl utilization in stress-exposed plants. © 2017 Scandinavian Plant Physiology Society.

Advancing Translational Research through Facility Design in Non-AMC Hospitals.

PubMed

Pati, Debajyoti; Pietrzak, Michael P; Harvey, Thomas E; Armstrong, Walter B; Clarke, Robert; Weissman, Neil J; Rapp, Paul E; Smith, Mark S; Fairbanks, Rollin J; Collins, Jeffreyg M

2013-01-01

This article aims to explore the future of translational research and its physical design implications for community hospitals and hospitals not attached to large centralized research platforms. With a shift in medical services delivery focus to community wellness, continuum of care, and comparative effectiveness research, healthcare research will witness increasing pressure to include community-based practitioners. The roundtable discussion group, comprising 14 invited experts from 10 institutions representing the fields of biomedical research, research administration, facility planning and design, facility management, finance, and environmental design research, examined the issue in a structured manner. The discussion was conducted at the Washington Hospital Center, MedStar Health, Washington, D.C. Institutions outside the AMCs will be increasingly targeted for future research. Three factors are crucial for successful research in non-AMC hospitals: operational culture, financial culture, and information culture. An operating culture geared towards creation, preservation, and protection of spaces needed for research; creative management of spaces for financial accountability; and a flexible information infrastructure at the system level that enables complete link of key programmatic areas to academic IT research infrastructure are critical to success of research endeavors. Hospital, interdisciplinary, leadership, planning, work environment.

Identifying Runoff Generation Mechanisms and Its Controlling Parameters in the Lesser Himalayan Hillslopes

NASA Astrophysics Data System (ADS)

Nanda, A.; Sen, S.

2017-12-01

The Himalayas, being one of the youngest and tectonically active mountains, are highly unstable and prone to natural disaster. Thus, a typical grassland (GS) of 14.42 % gradient and a mixture of fallow and forested (FF) hillslope of 23.73 % gradient are selected in an experimental watershed of the Lesser Himalayas to understand the hillslope hydrology. This work mainly focuses on analysing the influence of spatial and temporal dynamics of soil moisture on hillslope response and on identifying the dominant runoff generation mechanisms in different landuse conditions. Further, we characterize the different hydrologic conditions under which either the rainfall rate, antecedent moisture condition (AMC), or both have a significant impact on hillslope runoff. The rainfall, runoff and soil moisture data are being collected since monsoon June 2017 and five significant rainfall event results have been presented here. However, the paper will be presented with complete 2017 monsoon rainfall-runoff analyses. At FF hillslope, the rainfall of 18.47 mm and 133.14 mm occurred in 1 hr 9 min and 6 hr 24 min durations which resulted in runoff coefficient of 0.39 % and 6 %, respectively for an approximately AMC of 160 mm. Similarly, for GA hillslope, the observed runoff coefficients were 0.094 % and 1.2 % for 31.68 mm and 123.77 mm rainfall occurred in 1 hr and 6 hr 24 min duration, respectively with an AMC value of 230 mm. In an another event, the low AMC (182 mm) of GA hillslope resulted in runoff coefficient of 0.602 % for 64.68 mm rainfall occurred in 6 hr. For same AMC, the rainfall characteristics played a critical role to govern the hillslope runoff. Besides that, it was observed that the less surface resistance and higher gradient of FF hillslope generated more runoff than GA hillslope which indicates the role of topography and vegetation on hillslope runoff. During high and low rainfall magnitude, the soil moisture sensors located at lower parts of FF hillslope showed quick (3-5 min) and delayed (20-26 min) peak than the runoff hydrograph peak. Similarly, for GA hillslope the quick and delayed response were increased up to 43 min and 23 hr, respectively. It was concluded that the subsurface response of hillslope was governed by soil characteristics, topography and gradient of the hillslope.

The structure of 0- to 0.2-m.y.-old oceanic crust at 9°N on the East Pacific Rise from expanded spread profiles

NASA Astrophysics Data System (ADS)

Vera, E. E.; Mutter, J. C.; Buhl, P.; Orcutt, J. A.; Harding, A. J.; Kappus, M. E.; Detrick, R. S.; Brocher, T. M.

1990-09-01

We analyze four expanded spread profiles acquired at distances of 0, 2.1, 3.1, and 10 km (0-0.2 m.y.) from the axis of the East Pacific Rise between 9° and 10°N. Velocity-depth models for these profiles have been obtained by travel time inversion in the τ-p domain, and by x-t forward modeling using the WKBJ and the reflectivity methods. We observe refracted arrivals that allow us to determine directly the uppermost crustal velocity structure (layer 2A). At the seafloor we find very low Vp and VS/Vp values around 2.2 km/s and ≤ 0.43. In the topmost 100-200 m of the crust, Vp remains low (≤ 2.5 km/s) then rapidly increases to 5 km/s at ˜500 m below the seafloor. High attenuation values (Qp < 100) are suggested in the topmost ˜500 m of the crust. The layer 2-3 transition probably occurs within the dike unit, a few hundred meters above the dike-gabbro transition. This transition may mark the maximum depth of penetration by a cracking front and associated hydrothermal circulation in the axial region above the axial magma chamber (AMC). The on-axis profile shows arrivals that correspond to the bright AMC event seen in reflection lines within 2 km of the rise axis. The top of the AMC lies 1.6 km below the seafloor and consists of molten material where Vp ≈ 3 km/s and VS = 0. Immediately above the AMC, there is a zone of large negative velocity gradients where, on the average, Vp decreases from ˜6.3 to 3 km/s over a depth of approximately 250 m. Associated with the AMC there is a low velocity zone (LVZ) that extends to a distance no greater than 10 km away from the rise axis. At the top of the LVZ, sharp velocity contrasts are confined to within 2 km of the rise axis and are associated with molten material or material with a high percentage of melt which would be concentrated only in a thin zone at the apex of the LVZ, in the axial region where the AMC event is seen in reflection lines. Away from the axis, the transition to the LVZ is smoother, the top of the LVZ is deeper, and the LVZ is less pronounced. The bottom of the LVZ is probably located near the bottom of the crust and above the Moho. Moho arrivals are observed in the profiles at zero and at 10 km from the rise axis. Rather than a single discontinuity, these arrivals indicate an approximately 1-km-thick Moho transition zone.

White Matter Abnormalities Track Disease Progression in PSEN1 Autosomal Dominant Alzheimer's Disease.

PubMed

Sánchez-Valle, Raquel; Monté, Gemma C; Sala-Llonch, Roser; Bosch, Beatriz; Fortea, Juan; Lladó, Albert; Antonell, Anna; Balasa, Mircea; Bargalló, Nuria; Molinuevo, José Luis

2016-01-01

PSEN1 mutations are the most frequent cause of autosomal dominant Alzheimer's disease (ADAD), and show nearly full penetrance. There is presently increasing interest in the study of biomarkers that track disease progression in order to test therapeutic interventions in ADAD. We used white mater (WM) volumetric characteristics and diffusion tensor imaging (DTI) metrics to investigate correlations with the normalized time to expected symptoms onset (relative age ratio) and group differences in a cohort of 36 subjects from PSEN1 ADAD families: 22 mutation carriers, 10 symptomatic (SMC) and 12 asymptomatic (AMC), and 14 non-carriers (NC). Subjects underwent a 3T MRI. WM morphometric data and DTI metrics were analyzed. We found that PSEN1 MC showed significant negative correlation between fractional anisotropy (FA) and the relative age ratio in the genus and body of corpus callosum and corona radiate (p <  0.05 Family-wise error correction (FWE) at cluster level) and positive correlation with mean diffusivity (MD), axial diffusivity (AxD), and radial diffusivity (RD) in the splenium of corpus callosum. SMC presented WM volume loss, reduced FA and increased MD, AxD, and RD in the anterior and posterior corona radiate, corpus callosum (p <  0.05 FWE) compared with NC. No significant differences were observed between AMC and NC in WM volume or DTI measures. These findings suggest that the integrity of the WM deteriorates linearly in PSEN1 ADAD from the early phases of the disease; thus DTI metrics might be useful to monitor the disease progression. However, the lack of significant alterations at the preclinical stages suggests that these indexes might not be good candidates for early markers of the disease.

Monitor for status epilepticus seizures

NASA Technical Reports Server (NTRS)

Johnson, Mark; Simkins, Thomas

1994-01-01

This paper describes the sensor technology and associated electronics of a monitor designed to detect the onset of a seizure disorder called status epilepticus. It is a condition that affects approximately 3-5 percent of those individuals suffering from epilepsy. This form of epilepsy does not follow the typical cycle of start-peak-end. The convulsions continue until medically interrupted and are life threatening. The mortality rate is high without prompt medical treatment at a suitable facility. The paper describes the details of a monitor design that provides an inexpensive solution to the needs of those responsible for the care of individuals afflicted with this disorder. The monitor has been designed as a cooperative research and development effort involving the United States Army Armament Research, Development, and Engineering Center's Benet Laboratories (Benet) and the Cerebral Palsy Center for the Disabled (Center), in association with the Department of Neurology at Albany Medical College (AMC). Benet has delivered a working prototype of the device for field testing, in collaboration with Albany Medical College. The Center has identified several children in need of special monitoring and has agreed to pursue commercialization of the device.

Spontaneous myogenic differentiation of Flk-1-positive cells from adult pancreas and other nonmuscle tissues.

PubMed

Di Rocco, Giuliana; Tritarelli, Alessandra; Toietta, Gabriele; Gatto, Ilaria; Iachininoto, Maria Grazia; Pagani, Francesca; Mangoni, Antonella; Straino, Stefania; Capogrossi, Maurizio C

2008-02-01

At the embryonic or fetal stages, autonomously myogenic cells (AMCs), i.e., cells able to spontaneously differentiate into skeletal myotubes, have been identified from several different sites other than skeletal muscle, including the vascular compartment. However, in the adult animal, AMCs from skeletal muscle-devoid tissues have been described in only two cases. One is represented by thymic myoid cells, a restricted population of committed myogenic progenitors of unknown derivation present in the thymic medulla; the other is represented by a small subset of adipose tissue-associated cells, which we recently identified. In the present study we report, for the first time, the presence of spontaneously differentiating myogenic precursors in the pancreas and in other skeletal muscle-devoid organs such as spleen and stomach, as well as in the periaortic tissue of adult mice. Immunomagnetic selection procedures indicate that AMCs derive from Flk-1(+) progenitors. Individual clones of myogenic cells from nonmuscle organs are morphologically and functionally indistinguishable from skeletal muscle-derived primary myoblasts. Moreover, they can be induced to proliferate in vitro and are able to participate in muscle regeneration in vivo. Thus, we provide evidence that fully competent myogenic progenitors can be derived from the Flk-1(+) compartment of several adult tissues that are embryologically unrelated to skeletal muscle.

Automated analysis of food-borne pathogens using a novel microbial cell culture, sensing and classification system.

PubMed

Xiang, Kun; Li, Yinglei; Ford, William; Land, Walker; Schaffer, J David; Congdon, Robert; Zhang, Jing; Sadik, Omowunmi

2016-02-21

We hereby report the design and implementation of an Autonomous Microbial Cell Culture and Classification (AMC(3)) system for rapid detection of food pathogens. Traditional food testing methods require multistep procedures and long incubation period, and are thus prone to human error. AMC(3) introduces a "one click approach" to the detection and classification of pathogenic bacteria. Once the cultured materials are prepared, all operations are automatic. AMC(3) is an integrated sensor array platform in a microbial fuel cell system composed of a multi-potentiostat, an automated data collection system (Python program, Yocto Maxi-coupler electromechanical relay module) and a powerful classification program. The classification scheme consists of Probabilistic Neural Network (PNN), Support Vector Machines (SVM) and General Regression Neural Network (GRNN) oracle-based system. Differential Pulse Voltammetry (DPV) is performed on standard samples or unknown samples. Then, using preset feature extractions and quality control, accepted data are analyzed by the intelligent classification system. In a typical use, thirty-two extracted features were analyzed to correctly classify the following pathogens: Escherichia coli ATCC#25922, Escherichia coli ATCC#11775, and Staphylococcus epidermidis ATCC#12228. 85.4% accuracy range was recorded for unknown samples, and within a shorter time period than the industry standard of 24 hours.

Acetanilide and bromoacetyl-lysine derivatives as activators for human histone deacetylase 8.

PubMed

Mukhtar, Yusif M; Huang, Yajun; Liu, Jiajia; Chen, Di; Zheng, Weiping

2017-06-01

In the current study, seven compounds (i.e. 1-7) were found to be novel activators for the N ε -acetyl-lysine deacetylation reaction catalyzed by human histone deacetylase 8 (HDAC8). When assessed with the commercially available HDAC8 peptide substrate Fluor-de-Lys®-HDAC8 that harbors the unnatural 7-amino-4-methylcoumarin (AMC) residue immediately C-terminal to the N ε -acetyl-lysine residue to be deacetylated, our compounds exhibited comparable activation potency to that of TM-2-51, the strongest HDAC8 activator reported in the current literature. However, when assessed with an AMC-less peptide substrate derived from the native HDAC8 non-histone substrate protein Zinc finger protein ZNF318, while our compounds were all found to be able to activate HDAC8 deacetylation reaction, TM-2-51 was found not to be able to. Our compounds also seemed to be largely selective for HDAC8 over other classical HDACs. Moreover, treatment with the strongest activator among our compounds (i.e. 7) was found to decrease the K M of the above AMC-less HDAC8 substrate, while nearly maintaining the k cat of the HDAC8-catalyzed deacetylation on this substrate. Copyright © 2017 Elsevier Ltd. All rights reserved.

Nurse practitioners' role perception, stress, satisfaction, and intent to stay at a Midwestern academic medical center.

PubMed

Brom, Heather M; Melnyk, Bernadette M; Szalacha, Laura A; Graham, Margaret

2016-05-01

There is a growing demand for nurse practitioners (NPs) within academic medical centers (AMCs) because of physician shortages and increased need for access to care. In order to retain these NPs, it is important to assess their role perception and satisfaction. The purpose of this study was to evaluate these concepts and their relationships to stress and intent to stay. A 90-item descriptive survey, including a new role perception scale and the Misener Nurse Practitioner Job Satisfaction Scale, was administered to all NPs at a Midwestern AMC. The response rate was 62.4% (n = 181). Overall, the NPs had moderate role perception (M = 4.30, SD = 1.23) and were somewhat satisfied (M = 4.23, SD = 0.74). Over a third (39.4%) reported they were unsure about staying or did not intend to stay in their position. Intent to stay and stress were moderately correlated with overall satisfaction and weakly correlated with role perception. There were significant differences in the intrapractice and professional aspects of job satisfaction based on their supervisor. With increased NP needs, it is crucial for AMCs and NP supervisors to assess role perception, satisfaction, and stress among NPs in order to ensure a stable, satisfied, and productive workforce. ©2015 American Association of Nurse Practitioners.

Deciphering the tectonometamorphis history of the Anarak Metamorphic Complex, Central Iran

NASA Astrophysics Data System (ADS)

Zanchetta, Stefano; Malaspina, Nadia; Zanchi, Andrea; Martin, Silvana; Benciolini, Luca; Berra, Fabrizio; Javadi, Hamid Reza; Koohpeyma, Meysam; Ghasemi, Mohammad R.; Sheikholeslami, Mohammad Reza

2014-05-01

The Cimmerian orogeny shaped the southern margin of Eurasia during the Late Permian and the Triassic. Several microplates, detached from Gondwana in the Early Permian, migrated northward to be accreted to the Eurasia margin. In the reconstruction of such orogenic event Iran is a key area. The occurrence of several "ophiolites" belt of various age, from Paleozoic to Cretaceous, poses several questions on the possibility that a single rather than multiple Paleotethys sutures occur between Eurasia and Iran. In this scenario the Anarak region in Central Iran still represents a conundrum. Contrasting geochronological, paleontological, paleomagnetic data and reported field evidence suggest different origins for the Anarak Metamorphic Complex (AMC). The AMC is either interpreted to be part of microplate of Gondwanan affinity, a relic of an accretionary wedge developed at the Eurasia margin during the Paleothetys subduction or part of the Cimmerian suture zone, occurring in NE Iran, displaced to central Iran by counterclockwise rotation of the central Iranian blocks from the Triassic. Our field structural data, petrographic and geochemical data, carried out in the frame of the DARIUS PROGRAMME, indicate that the AMC is not a single coherent block, but it consists of several units (Morghab, Chah Gorbeh, Patyar, Palhavand Gneiss, Lakh Marble, Doshak and dismembered "ophiolites") which display different tectonometamorphic evolutions. The Morghab and Chah Gorbeh units share a common history and they preserve, as a peculiar feature within metabasites, a prograde metamorphism with sin- to post-deformation growth of blueschists facies assemblages on pre-existing greenschist facies mineralogical associations. LT-HP metamorphism responsible for the growth of sodic amphibole has been recognized also within marble lenses at the southern limit of the Chah Gorbeh unit. Finally, evidence of LT-HP metamorphism also occur in the metabasites and possibly also in the serpentinites that form most of the "ophiolites" within the AMC. Structural analyses show that the Chah Gorbeh, Morghab units and the "ophiolites" have been tectonically coupled during at least two deformational phases that occurred at greenschist facies conditions and predate the LT-HP metamorphic overprint. Available geochronological data loosely constraints the subduction event in the Late Permian - Early Triassic times. Subsequent deformation events that occurred during the whole Mesozoic and the Cenozoic up to the Miocene and possibly later, resulted in folding, thrusting and faulting that dismembered the original tectonic contacts. Therefore, the correlations among deformation structures and metamorphic events in the different units are not straightforward. The other units of the AMC lack evidence of HP metamorphism, especially the Lakh Marble a large thrust sheet that occupies the uppermost structural position in the AMC. The contact with the underlying units is invariably tectonic, thus no original relationships have been preserved. So, if structural and petrographic data point out an accretionary wedge setting for the evolution of the Chah Gorbeh, Morghab and the "ophiolites", geodynamic significance and paleogeographic attribution of other units still remain controversial. In progress U-Pb dating of undeformed intrusive bodies and metamorphic minerals in the LT-HP rocks will soon help to better constrain the evolution of the ACM.

Catalytic Function and Substrate Specificity of the Papain-Like Protease Domain of nsp3 from the Middle East Respiratory Syndrome Coronavirus

PubMed Central

Báez-Santos, Yahira M.; Mielech, Anna M.; Deng, Xufang; Baker, Susan

2014-01-01

ABSTRACT The papain-like protease (PLpro) domain from the deadly Middle East respiratory syndrome coronavirus (MERS-CoV) was overexpressed and purified. MERS-CoV PLpro constructs with and without the putative ubiquitin-like (UBL) domain at the N terminus were found to possess protease, deubiquitinating, deISGylating, and interferon antagonism activities in transfected HEK293T cells. The quaternary structure and substrate preferences of MERS-CoV PLpro were determined and compared to those of severe acute respiratory syndrome coronavirus (SARS-CoV) PLpro, revealing prominent differences between these closely related enzymes. Steady-state kinetic analyses of purified MERS-CoV and SARS-CoV PLpros uncovered significant differences in their rates of hydrolysis of 5-aminomethyl coumarin (AMC) from C-terminally labeled peptide, ubiquitin, and ISG15 substrates, as well as in their rates of isopeptide bond cleavage of K48- and K63-linked polyubiquitin chains. MERS-CoV PLpro was found to have 8-fold and 3,500-fold higher catalytic efficiencies for hydrolysis of ISG15-AMC than for hydrolysis of the Ub-AMC and Z-RLRGG-AMC substrates, respectively. A similar trend was observed for SARS-CoV PLpro, although it was much more efficient than MERS-CoV PLpro toward ISG15-AMC and peptide-AMC substrates. MERS-CoV PLpro was found to process K48- and K63-linked polyubiquitin chains at similar rates and with similar debranching patterns, producing monoubiquitin species. However, SARS-CoV PLpro much preferred K48-linked polyubiquitin chains to K63-linked chains, and it rapidly produced di-ubiquitin molecules from K48-linked chains. Finally, potent inhibitors of SARS-CoV PLpro were found to have no effect on MERS-CoV PLpro. A homology model of the MERS-CoV PLpro structure was generated and compared to the X-ray structure of SARS-CoV PLpro to provide plausible explanations for differences in substrate and inhibitor recognition. IMPORTANCE Unlocking the secrets of how coronavirus (CoV) papain-like proteases (PLpros) perform their multifunctional roles during viral replication entails a complete mechanistic understanding of their substrate recognition and enzymatic activities. We show that the PLpro domains from the MERS and SARS coronaviruses can recognize and process the same substrates, but with different catalytic efficiencies. The differences in substrate recognition between these closely related PLpros suggest that neither enzyme can be used as a generalized model to explain the kinetic behavior of all CoV PLpros. As a consequence, decoding the mechanisms of PLpro-mediated antagonism of the host innate immune response and the development of anti-CoV PLpro enzyme inhibitors will be a challenging undertaking. The results from this study provide valuable information for understanding how MERS-CoV PLpro-mediated antagonism of the host innate immune response is orchestrated, as well as insight into the design of inhibitors against MERS-CoV PLpro. PMID:25142582

Assessing the physical loading of wearable computers.

PubMed

Knight, James F; Baber, Chris

2007-03-01

Wearable computers enable workers to interact with computer equipment in situations where previously they were unable. Attaching a computer to the body though has an unknown physical effect. This paper reports a methodology for addressing this, by assessing postural effects and the effect of added weight. Using the example of arm-mounted computers (AMCs), the paper shows that adopting a posture to interact with an AMC generates fatiguing levels of stress and a load of 0.54 kg results in increased level of stress and increased rate of fatigue. The paper shows that, due to poor postures adopted when wearing and interacting with computers and the weight of the device attached to the body, one possible outcome for prolonged exposure is the development of musculoskeletal disorders.

A Novel Approach for Enhancement of Automobile Clutch Engagement Quality Using Mechatronics Based Automated Clutch System

NASA Astrophysics Data System (ADS)

Tripathi, K.

2013-01-01

In automated manual clutch (AMC) a mechatronic system controls clutch force trajectory through an actuator governed by a control system. The present study identifies relevant characteristics of this trajectory and their effects on driveline dynamics and engagement quality. A new type of force trajectory is identified which gives the good engagement quality. However this trajectory is not achievable through conventional clutch control mechanism. But in AMC a mechatronic system based on electro-hydraulic or electro-mechanical elements can make it feasible. A mechatronic system is presented in which a mechatronic add-on system can be used to implement the novel force trajectory, without the requirement of replacing the traditional diaphragm spring based clutch in a vehicle with manual transmission.

US Army Research Office research in progress, July 1, 1991--June 30, 1992

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

Not Available

1992-12-31

The US Army Research Office, under the US Army Materiel Command (AMC), is responsible for coordinating and supporting research in the physical and engineering sciences, in materials science, geosciences, biology, and mathematics. This report describes research directly supported by the Army Research Projects Agency, and several AMC and other Army commands. A separate section is devoted to the research program at the US Army Research, Development and Standardization Group - United Kingdom. The present volume includes the research program in physics, chemistry, biological sciences, mathematics, engineering sciences, metallurgy and materials science, geosciences, electronics, and the European Research Program. It coversmore » the 12-month period from 1 July 1991 through 30 June 1992.« less

Is cost-effective healthcare compatible with publicly financed academic medical centres?

PubMed

Chia, Whay Kuang; Toh, Han Chong

2013-01-01

Probably more than any country, Singapore has made significant investment into the biomedical enterprise as a proportion of its economy and size. This focus recently witnessed a shift towards a greater emphasis on translational and clinical development. Key to the realisation of this strategy will be Academic Medical Centres (AMCs), as a principal tool to developing and applying useful products for the market and further improving health outcomes. Here, we explore the principal value proposition of the AMC to Singapore society and its healthcare system. We question if the values inherent within academic medicine--that of inquiry, innovation, pedagogy and clinical exceptionalism--can be compatible with the seemingly paradoxical mandate of providing cost-effective or rationed healthcare.

Outcomes of Infrainguinal Revascularizations with Endovascular First Strategy in Critical Limb Ischemia

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

Jens, Sjoerd, E-mail: s.jens@amc.uva.nl; Conijn, Anne P., E-mail: a.p.conijn@amc.uva.nl; Frans, Franceline A., E-mail: f.a.frans@amc.uva.nl

PurposeThis study was designed to study the outcome of infrainguinal revascularization in patients with critical limb ischemia (CLI) in an institution with a preference towards endovascular intervention first in patients with poor condition, unfavourable anatomy for surgery, no venous material for bypass, and old age.MethodsA prospective, observational cohort study was conducted between May 2007 and May 2010 in patients presenting with CLI. At baseline, the optimal treatment was selected, i.e., endovascular or surgical treatment. In case of uncertainty about the preferred treatment, a multidisciplinary team (MDT) was consulted. Primary endpoints were quality of life and functional status 6 and 12 monthsmore » after initial intervention, assessed by the VascuQol and AMC Linear Disability Score questionnaires, respectively.ResultsIn total, 113 patients were included; 86 had an endovascular intervention and 27 had surgery. During follow-up, 41 % underwent an additional ipsilateral revascularisation procedure. For the total population, and endovascular and surgery subgroups, the VascuQol sum scores improved after 6 and 12 months (p < 0.01 for all outcomes) compared with baseline. The functional status improved (p = 0.043) after 12 months compared with baseline for the total population. Functional status of the surgery subgroup improved significantly after 6 (p = 0.031) and 12 (p = 0.044) months, but not that of the endovascular subgroup.ConclusionsOverall, the strategy of performing endovascular treatment first in patients with poor condition, unfavourable anatomy for surgery, no venous material for bypass, and old age has comparable or even slightly better results compared with the BASIL trial and other cohort studies. All vascular groups should discuss whether their treatment strategy should be directed at treating CLI patients preferably endovascular first and consider implementing an MDT to optimize patient outcomes.« less

The Effects of the Concrete-Representational-Abstract Integration Strategy on the Ability of Students with Learning Disabilities to Multiply Linear Expressions within Area Problems

ERIC Educational Resources Information Center

Strickland, Tricia K.; Maccini, Paula

2013-01-01

We examined the effects of the Concrete-Representational-Abstract Integration strategy on the ability of secondary students with learning disabilities to multiply linear algebraic expressions embedded within contextualized area problems. A multiple-probe design across three participants was used. Results indicated that the integration of the…

What's in a Name? The Necessary Transformation of the Academic Medical Center in the Era of Population Health and Accountable Care.

PubMed

DiSesa, Verdi J; Kaiser, Larry R

2015-07-01

Academic medical centers (AMCs) and the physicians and other professionals who lead them need to recognize they are in a business that is making a transition from a system of "sickness" care to one of "health" care, accountable for the health of defined populations and for the value (quality divided by cost) of the services provided. This change has profound implications for how AMCs conceive themselves, how they function, and how they are paid for the work that they do. A failure to recognize how the disruption of the mission of AMCs is changing may impair them as irrevocably as other changes caused the demise of Kodak, once the world's leader in the manufacture and sale of photographic film and cameras. Leaders of academic medicine need to understand, respond to, and ultimately lead the transformation of our system of health. In this Commentary, the authors review the pressures driving these changes and potential responses to them-a process already under way. They summarize the issues in the question "Should the words 'health' and 'system' take the place of 'medical' and 'center' in our institutions' names and, more important, in how we conceive of what we do?" The authors propose the name "academic health system" to better identify primary objectives to measure success by the health of patients.

Cargo-free particles of ammonio methacrylate copolymers: From pharmaceutical inactive ingredients to effective anticancer immunotherapeutics.

PubMed

Shetab Boushehri, Maryam Alsadat; Stein, Valentin; Lamprecht, Alf

2018-06-01

Nanoparticles create exciting platforms for anticancer immunotherapy and vaccination, though their inherent immunomodulatory properties have remained underexploited. Ammonio methacrylate copolymers (AMC) are well-established excipients in pharmaceutical industry and components of controlled-release oral formulations. Here, we demonstrate that nanoscaling of type A and B AMC (Eudragit ® RL and RS) endows these inactive ingredients immunostimulatory properties exploitable for cancer therapy. The particles induce the secretion of various pro-inflammatory cytokines and chemokines from the cells of innate immunity. Though the underlying mechanisms are not fully uncovered, the current work established the partial involvement of Toll-like Receptor 4 (TLR4) and Nuclear factor κB (NF-κB). The size and charge-dependency of the particles' pro-inflammatory properties and cytokine/chemokine induction profile was also demonstrated. Within the context of cancer immunotherapy, biweekly peritumoral nanoparticle injection led to a complete regression of the syngeneic colorectal tumor, or a significant growth retardation thereof, considerably extending the survival of tumor-bearing animals. Additionally, presence of the immunological memory in treated animals was established. Given their better economical and relatively safer profile compared to well-established chemo- and immunotheraputics, and their ability to serve as carriers for drug targeting, vaccination and combination therapy, AMC nanoparticles (AMCNP) are fascinating subjects for further research in the field of cancer therapy. Copyright © 2018 Elsevier Ltd. All rights reserved.

Efficient Implementation of MrBayes on Multi-GPU

PubMed Central

Zhou, Jianfu; Liu, Xiaoguang; Wang, Gang

2013-01-01

MrBayes, using Metropolis-coupled Markov chain Monte Carlo (MCMCMC or (MC)3), is a popular program for Bayesian inference. As a leading method of using DNA data to infer phylogeny, the (MC)3 Bayesian algorithm and its improved and parallel versions are now not fast enough for biologists to analyze massive real-world DNA data. Recently, graphics processor unit (GPU) has shown its power as a coprocessor (or rather, an accelerator) in many fields. This article describes an efficient implementation a(MC)3 (aMCMCMC) for MrBayes (MC)3 on compute unified device architecture. By dynamically adjusting the task granularity to adapt to input data size and hardware configuration, it makes full use of GPU cores with different data sets. An adaptive method is also developed to split and combine DNA sequences to make full use of a large number of GPU cards. Furthermore, a new “node-by-node” task scheduling strategy is developed to improve concurrency, and several optimizing methods are used to reduce extra overhead. Experimental results show that a(MC)3 achieves up to 63× speedup over serial MrBayes on a single machine with one GPU card, and up to 170× speedup with four GPU cards, and up to 478× speedup with a 32-node GPU cluster. a(MC)3 is dramatically faster than all the previous (MC)3 algorithms and scales well to large GPU clusters. PMID:23493260

Efficient implementation of MrBayes on multi-GPU.

PubMed

Bao, Jie; Xia, Hongju; Zhou, Jianfu; Liu, Xiaoguang; Wang, Gang

2013-06-01

MrBayes, using Metropolis-coupled Markov chain Monte Carlo (MCMCMC or (MC)(3)), is a popular program for Bayesian inference. As a leading method of using DNA data to infer phylogeny, the (MC)(3) Bayesian algorithm and its improved and parallel versions are now not fast enough for biologists to analyze massive real-world DNA data. Recently, graphics processor unit (GPU) has shown its power as a coprocessor (or rather, an accelerator) in many fields. This article describes an efficient implementation a(MC)(3) (aMCMCMC) for MrBayes (MC)(3) on compute unified device architecture. By dynamically adjusting the task granularity to adapt to input data size and hardware configuration, it makes full use of GPU cores with different data sets. An adaptive method is also developed to split and combine DNA sequences to make full use of a large number of GPU cards. Furthermore, a new "node-by-node" task scheduling strategy is developed to improve concurrency, and several optimizing methods are used to reduce extra overhead. Experimental results show that a(MC)(3) achieves up to 63× speedup over serial MrBayes on a single machine with one GPU card, and up to 170× speedup with four GPU cards, and up to 478× speedup with a 32-node GPU cluster. a(MC)(3) is dramatically faster than all the previous (MC)(3) algorithms and scales well to large GPU clusters.

Ex Vivo Induction of Multiple Myeloma-specific Immune Responses by Monocyte-derived Dendritic Cells Following Stimulation by Whole-tumor Antigen of Autologous Myeloma Cells.

PubMed

Vasileiou, Spyridoula; Baltadakis, Ioannis; Delimpasi, Sosanna; Karatza, Maria-Helena; Liapis, Konstantinos; Garofalaki, Maria; Tziotziou, Eirini; Poulopoulou, Zoe; Karakasis, Dimitri; Harhalakis, Nicholas

2017-09-01

The introduction of novel agents has significantly expanded treatment options for multiple myeloma (MM), albeit long-term disease control cannot be achieved in the majority of patients. Vaccination with MM antigen-loaded dendritic cells (DCs) represents an alternative strategy that is currently being explored. The aim of this study was to assess the immunogenic potential of ex vivo-generated monocyte-derived DCs (moDCs), following stimulation with the whole-antigen array of autologous myeloma cells (AMC). MoDCs were loaded with antigens of myeloma cells by 2 different methods: phagocytosis of apoptotic bodies from γ-irradiated AMC, or transfection with AMC total RNA by square-wave electroporation. Twenty patients with MM were enrolled in the study. Following stimulation and maturation, moDCs were tested for their capacity to induce T-helper 1 and cytotoxic T lymphocyte responses in vitro. Both strategies were effective in the induction of myeloma-specific cytotoxic T lymphocyte and T-helper 1 cells, as demonstrated by cytotoxicity and ELISpot assays. On the whole, T-cell responses were observed in 18 cases by either method of DC pulsing. We conclude that both whole-tumor antigen approaches are efficient in priming autologous antimyeloma T-cell responses and warrant further study aiming at the development of individualized DC vaccines for MM patients.

Friction Stir Processing of Copper-Coated SiC Particulate-Reinforced Aluminum Matrix Composite

PubMed Central

Huang, Chih-Wei; Aoh, Jong-Ning

2018-01-01

In the present work, we proposed a novel friction stir processing (FSP) to produce a locally reinforced aluminum matrix composite (AMC) by stirring copper-coated SiC particulate reinforcement into Al6061 alloy matrix. Electroless-plating process was applied to deposit the copper surface coating on the SiC particulate reinforcement for the purpose of improving the interfacial adhesion between SiC particles and Al matrix. The core-shell SiC structure provides a layer for the atomic diffusion between aluminum and copper to enhance the cohesion between reinforcing particles and matrix on one hand, the dispersion of fine copper in the Al matrix during FSP provides further dispersive strengthening and solid solution strengthening, on the other hand. Hardness distribution and tensile results across the stir zone validated the novel concept in improving the mechanical properties of AMC that was realized via FSP. Optical microscope (OM) and Transmission Electron Microscopy (TEM) investigations were conducted to investigate the microstructure. Energy dispersive spectrometer (EDS), electron probe micro-analyzer (EPMA), and X-ray diffraction (XRD) were explored to analyze the atomic inter-diffusion and the formation of intermetallic at interface. The possible strengthening mechanisms of the AMC containing Cu-coated SiC particulate reinforcement were interpreted. The concept of strengthening developed in this work may open a new way of fabricating of particulate reinforced metal matrix composites. PMID:29652846

Clinical research: assessing the future in a changing environment; summary report of conference sponsored by the American Medical Association Council on Scientific Affairs, Washington, DC, March 1996.

PubMed

Meyer, M; Genel, M; Altman, R D; Williams, M A; Allen, J R

1998-03-01

Concerns about funding of clinical research underlie all other problems identified at the Council on Scientific Affairs conference. Future National Institutes of Health (NIH) budgets are likely to be constant at best, and the general public expects cost containment to be an ongoing goal; this is exacerbated by the impending Medicare Trust Fund crisis. Meanwhile, traditional financial support of clinical research in academic medical centers (AMCs) through cross-subsidization is imperiled by competitive pressures largely caused by managed care. Although managed care organizations (MCOs) are potentially rich sources of funding and other resources, and some not-for-profit companies are conducting some research, for-profit MCOs have not demonstrated an understanding of the importance of clinical research. Young physicians are being discouraged from careers as clinical researchers and established investigators are "dropping out" because of demands for clinical productivity and competition for research grants, loss of patients/research subjects to managed care, perceived lack of status and compensation, and overall uncertainty about continued financial support. Efforts to assist current and potential clinical investigators are discussed in this report. Loss of patients, denial of reimbursement, and competition with MCOs and contract research organizations (CROs) have placed AMCs under unprecedented pressure. However, research centers located in AMCs have allowed investigators to conduct clinical research by providing a "protected environment." Furthermore, many AMCs are determined to continue conducting clinical research and are addressing related problems. Although the NIH will continue to be a major source of funding for clinical research, partnerships between various private and public entities provide important opportunities to maximize the productivity of all individuals and institutions involved. Potential partnerships include MCOs, AMCs, CROs, pharmaceutical companies and other industry, the Department of Defense, the Veterans Health Administration, practice-based physicians, and private foundations and patient support groups. "Partnerships in advocacy" for clinical research will be essential. Efforts to recruit for-profit MCOs to the clinical research endeavor identified in this report include (1) emphasizing issues of interest to them (eg, outcomes research); (2) stressing the significance of some research to the marketplace; (3) developing criteria to distinguish individual MCOs on the basis of their contribution to the public interest; (4) equating money spent on research with "R&D dollars" spent in nonmedical business enterprises; and (5) educating purchasers of health care (eg, corporate health plan directors) about clinical research. Conducting clinical research in all managed care settings requires leadership, the understanding and cooperation of physicians and support staff, wise use of limited resources (ie, funding only the best research projects), sound methodology, and above all, the perception that the research will ultimately improve patient care.

Assessment of molecular contamination in mask pod

NASA Astrophysics Data System (ADS)

Foray, Jean Marie; Dejaune, Patrice; Sergent, Pierre; Gough, Stuart; Cheung, D.; Davenet, Magali; Favre, Arnaud; Rude, C.; Trautmann, T.; Tissier, Michel; Fontaine, H.; Veillerot, M.; Avary, K.; Hollein, I.; Lerit, R.

2008-04-01

Context/ study Motivation: Contamination and especially Airbone Molecular Contamination (AMC) is a critical issue for mask material flow with a severe and fairly unpredictable risk of induced contamination and damages especially for 193 nm lithography. It is therefore essential to measure, to understand and then try to reduce AMC in mask environment. Mask material flow was studied in a global approach by a pool of European partners, especially within the frame of European MEDEA+ project, so called "MUSCLE". This paper deals with results and assessment of mask pod environment in term of molecular contamination in a first step, then in a second step preliminary studies to reduce mask pod influence and contamination due to material out gassing. Approach and techniques: A specific assessment of environmental / molecular contamination along the supply chain was performed by all partners. After previous work presented at EMLC 07, further studies were performed on real time contamination measurement pod at different sites locations (including Mask manufacturing site, blank manufacturing sites, IC fab). Studies were linked to the main critical issues: cleaning, storage, handling, materials and processes. Contamination measurement campaigns were carried out along the mask supply chain using specific Adixen analyzer in order to monitor in real time organic contaminants (ppb level) in mask pods. Key results would be presented: VOC, AMC and humidity level on different kinds of mask carriers, impact of basic cleaning on pod outgassing measurement (VOC, NH3), and process influence on pod contamination... In a second step, preliminary specific pod conditioning studies for better pod environment were performed based on Adixen vacuum process. Process influence had been experimentally measured in term of molecular outgassing from mask pods. Different AMC experimental characterization methods had been carried out leading to results on a wide range of organic and inorganic contaminants: by inline techniques based on Adixen humidity, also VOC and organic sensors, together by off-line techniques already used in the extensive previous mask pods benchmark (TD-GCMS & Ionic Chromatography). Humidity and VOC levels from mask carriers had shown significant reduction after Adixen pod conditioning process. Focus had been made on optimized vacuum step (for AMC) after particles carrier cleaning cycle. Based upon these key results new procedures, as well as guidelines for mask carrier cleaning optimization are proposed to improve pod contamination control. Summary results/next steps: This paper reports molecular contamination measurement campaigns performed by a pool of European partners along the mask supply chain. It allows us to investigate, identify and quantify critical molecular contamination in mask pod, as well as VOC and humidity, issues depending on locations, uses, and carrier's type. Preliminary studies highlight initial process solutions for pods conditioning that are being used for short term industrialization and further industrialized.

Part I. Corrosion studies of continuous alumina fiber reinforced aluminum-matrix composites. Part II. Galvanic corrosion between continuous alumina fiber reinforced aluminum-matrix composites and 4340 steel

NASA Astrophysics Data System (ADS)

Zhu, Jun

Part I. The corrosion performance of continuous alumina fiber reinforced aluminum-matrix composites (CF-AMCs) was investigated in both the laboratory and field environments by comparing them with their respective monolithic matrix alloys, i.e., pure Al, A1-2wt%Cu T6, and Al 6061 T6. The corrosion initiation sites were identified by monitoring the changes in the surface morphology. Corrosion current densities and pH profiles at localized corrosion sites were measured using the scanning-vibrating electrode technique and the scanning ion-selective electrode technique, respectively. The corrosion damage of the materials immersed in various electrolytes, as well as those exposed in a humidity chamber and outdoor environments, was evaluated. Potentiodynamic polarization behavior was also studied. The corrosion initiation for the composites in 3.15 wt% NaCl occurred primarily around the Fe-rich intermetallic particles, which preferentially existed around the fiber/matrix interface on the composites. The corrosion initiation sites were also caused by physical damage (e.g., localized deformation) to the composite surface. At localized corrosion sites, the buildup of acidity was enhanced by the formation of micro-crevices resulting from fibers left in relief as the matrix corroded. The composites that were tested in exposure experiments exhibited higher corrosion rates than their monolithic alloys. The composites and their monolithic alloys were subjected to pitting corrosion when anodically polarized in the 3.15 wt% NaCl, while they passivated when anodically polarized in 0.5 M Na2SO4. The experimental results indicated that the composites exhibited inferior corrosion resistance compared to their monolithic matrix alloys. Part II. Galvanic corrosion studies were conducted on CF-AMCs coupled to 4340 steel since CF-AMCs have low density and excellent mechanical properties and are being considered as potential jacketing materials for reinforcing steel gun barrels. Coupled and uncoupled coupons were immersed in various electrolytes, exposed to a humidity chamber, and exposed at outdoor test sites. Results showed that the corrosion rates of the CF-AMCs increased, while those of the 4340 steel decreased after being coupled together, in most cases. Crevice corrosion was also observed in these exposure experiments. Zero resistance ammeter (ZRA) experiments were conducted to record the galvanic-corrosion rates and potentials of the couples. The CF-AMCs were found to serve as anodes, while the steel was cathodic, in most test conditions. Galvanic performance predicted by polarization experiments was in close agreement with the ZRA results. Key words. Aluminum, metal-matrix composites, alumina fiber, pitting corrosion, galvanic corrosion.

Computing decay rates for new physics theories with FEYNRULES and MADGRAPH 5_AMC@NLO

NASA Astrophysics Data System (ADS)

Alwall, Johan; Duhr, Claude; Fuks, Benjamin; Mattelaer, Olivier; Öztürk, Deniz Gizem; Shen, Chia-Hsien

2015-12-01

We present new features of the FEYNRULES and MADGRAPH 5_AMC@NLO programs for the automatic computation of decay widths that consistently include channels of arbitrary final-state multiplicity. The implementations are generic enough so that they can be used in the framework of any quantum field theory, possibly including higher-dimensional operators. We extend at the same time the conventions of the Universal FEYNRULES Output (or UFO) format to include decay tables and information on the total widths. We finally provide a set of representative examples of the usage of the new functions of the different codes in the framework of the Standard Model, the Higgs Effective Field Theory, the Strongly Interacting Light Higgs model and the Minimal Supersymmetric Standard Model and compare the results to available literature and programs for validation purposes.

Orthographic Stereo Correlator on the Terrain Model for Apollo Metric Images

NASA Technical Reports Server (NTRS)

Kim, Taemin; Husmann, Kyle; Moratto, Zachary; Nefian, Ara V.

2011-01-01

A stereo correlation method on the object domain is proposed to generate the accurate and dense Digital Elevation Models (DEMs) from lunar orbital imagery. The NASA Ames Intelligent Robotics Group (IRG) aims to produce high-quality terrain reconstructions of the Moon from Apollo Metric Camera (AMC) data. In particular, IRG makes use of a stereo vision process, the Ames Stereo Pipeline (ASP), to automatically generate DEMs from consecutive AMC image pairs. Given camera parameters of an image pair from bundle adjustment in ASP, a correlation window is defined on the terrain with the predefined surface normal of a post rather than image domain. The squared error of back-projected images on the local terrain is minimized with respect to the post elevation. This single dimensional optimization is solved efficiently and improves the accuracy of the elevation estimate.

Robust Mosaicking of Stereo Digital Elevation Models from the Ames Stereo Pipeline

NASA Technical Reports Server (NTRS)

Kim, Tae Min; Moratto, Zachary M.; Nefian, Ara Victor

2010-01-01

Robust estimation method is proposed to combine multiple observations and create consistent, accurate, dense Digital Elevation Models (DEMs) from lunar orbital imagery. The NASA Ames Intelligent Robotics Group (IRG) aims to produce higher-quality terrain reconstructions of the Moon from Apollo Metric Camera (AMC) data than is currently possible. In particular, IRG makes use of a stereo vision process, the Ames Stereo Pipeline (ASP), to automatically generate DEMs from consecutive AMC image pairs. However, the DEMs currently produced by the ASP often contain errors and inconsistencies due to image noise, shadows, etc. The proposed method addresses this problem by making use of multiple observations and by considering their goodness of fit to improve both the accuracy and robustness of the estimate. The stepwise regression method is applied to estimate the relaxed weight of each observation.

Biallelic mutation of UNC50, encoding a protein involved in AChR trafficking, is responsible for arthrogryposis.

PubMed

Abiusi, Emanuela; D'Alessandro, Manuela; Dieterich, Klaus; Quevarec, Loic; Turczynski, Sandrina; Valfort, Aurore-Cecile; Mezin, Paulette; Jouk, Pierre Simon; Gut, Marta; Gut, Ivo; Bessereau, Jean Louis; Melki, Judith

2017-10-15

Arthrogryposis multiplex congenita (AMC) is a developmental condition characterized by multiple joint contractures resulting from reduced or absent fetal movements. Homozygosity mapping of disease loci combined with whole exome sequencing in a consanguineous family presenting with lethal AMC allowed the identification of a homozygous frameshift deletion in UNC50 gene (c.750_751del:p.Cys251Phefs*4) in the index case. To assess the effect of the mutation, an equivalent mutation in the Caenorhabditis elegans orthologous gene was created using CRISPR/Cas9. We demonstrated that unc-50(kr331) modification caused the loss of acetylcholine receptor (AChR) expression in C. elegans muscle. unc-50(kr331) animals were as resistant to the cholinergic agonist levamisole as unc-50 null mutants suggesting that AChRs were no longer expressed in this animal model. This was confirmed by using a knock-in strain in which a red fluorescent protein was inserted into the AChR locus: no signal was detected in unc-50(kr331) background, suggesting that UNC-50, a protein known to be involved in AChR trafficking, was no longer functional. These data indicate that biallelic mutation in the UNC50 gene underlies AMC through a probable loss of AChR expression at the neuromuscular junction which is essential for the cholinergic transmission during human muscle development. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Science at the interstices: an evolution in the academy.

PubMed

Balser, Jeffrey R; Baruchin, Andrea

2008-09-01

Biomedical science is at an evolutionary turning point. Many of the rate-limiting steps to realizing the next generation of personalized, highly targeted diagnostics and therapeutics rest at the interstices between biomedical science and the classic, university-based disciplines, such as physics, mathematics, computational science, engineering, social sciences, business, and law. Institutes, centers, or other entities created to foster interdisciplinary science are rapidly forming to tackle these formidable challenges, but they are plagued with substantive barriers, born of traditions, processes, and culture, which impede scientific progress and endanger success. Without a more seamless interdisciplinary framework, academic health centers will struggle to move transformative advances in technology into the foundation of biomedical science, and the equally challenging advancement of models that effectively integrate new molecular diagnostics and therapies into the business and social fabric of our population will be similarly hampered. At the same time, excess attention on rankings tied to competition for National Institutes of Health and other federal funds adversely encourages academic medical centers (AMCs) and universities to hoard, rather than share, resources effectively and efficiently. To fully realize their discovery potential, AMCs must consider a substantive realignment relative to one another, as well as with their associated universities, as the academy looks toward innovative approaches to provide a more supportive foundation for the emergent biomedical research enterprise. The authors discuss potential models that could serve to lower barriers to interdisciplinary science, promoting a new synergy between AMCs and their parent universities.

Adult Schistosoma mansoni express cathepsin L proteinase activity.

PubMed

Smith, A M; Dalton, J P; Clough, K A; Kilbane, C L; Harrop, S A; Hole, N; Brindley, P J

1994-09-01

This report presents the deduced amino acid sequence of a novel cathepsin L proteinase from Schistosoma mansoni, and describes cathepsin L-like activity in extracts of adult schistosomes. Using consensus primers specific for cysteine proteinases, gene fragments were amplified from adult S. mansoni cDNA by PCR and cloned. One of these fragments showed marked identity to Sm31, the cathepsin B cysteine proteinase of adult S. mansoni, whereas another differed from Sm31 and was employed as a probe to isolate two cDNAs from an adult S. mansoni gene library. Together these cDNAs encoded a novel preprocathepsin L of 319 amino acids; this zymogen is predicted to be processed in vivo into a mature, active cathepsin L proteinase of 215 amino acids. Closest homologies were with cathepsins L from rat, mouse, and chicken (46-47% identity). Southern hybridization analysis suggested that only one or a few copies of the gene was present per genome, demonstrated that its locus was distinct from that of Sm31, and that a homologous sequence was present in Schistosoma japonicum. Because these results indicated that schistosomes expressed a cathepsin L proteinase, extracts of adult S. mansoni were examined for acidic, cysteine proteinase activity. Based on rates of cleavage of peptidyl substrates employed to discriminate between classes of cysteine proteinases, namely cathepsin L (Z-phe-arg-AMC), cathepsin B (Z-arg-arg-AMC) and cathepsin H (Bz-arg-AMC), the extracts were found to contain vigorous cathepsin L-like activity.(ABSTRACT TRUNCATED AT 250 WORDS)

Leadership values in academic medicine.

PubMed

Souba, Wiley W; Day, David V

2006-01-01

To gain a deeper understanding of the guiding core values that deans of academic medical centers (AMCs) considered most essential for their leadership and the major leadership challenges that confront them. In 2003-04, semistructured interviews of 18 deans at U.S. colleges of medicine or AMCs were organized around four dimensions: background, leadership challenges, organizational effectiveness, and systems enablers/restrainers for leadership. A values Q-sort was used to determine how widely core values were shared among deans and how the complex challenges they faced did or did not align with these values. Fourteen of the 18 (78%) deans identified financial difficulties as their most pressing leadership challenge, followed by weak institutional alignment (61%), staffing problems (33%), and poor morale (28%). Open, candid communication was reported as the most effective means of addressing these complex problems. Enacting espoused shared values and having a positive attitude were identified as the most important enablers of systemic leadership, whereas micromanagement and difficult people were the major restraints. Q-sort results on 38 positive leadership values indicated that participants considered integrity most essential. Integrity was positively correlated with humanistic values and negatively correlated with results. Vision, another highly espoused value, correlated strongly with performance-oriented values but correlated negatively with humanistic values. A dynamic tension exists in AMCs between humanistic values and performance-based core values. The ability to manage that tension (i.e., when to prioritize one set of values over the other) is inherent in a dean's work.

Exclusionary Discipline of Students with Disabilities: Student and School Characteristics Predicting Suspension

ERIC Educational Resources Information Center

Sullivan, Amanda L.; Van Norman, Ethan R.; Klingbeil, David A.

2014-01-01

Given the negative outcomes associated with suspension, scholars and practitioners are concerned with discipline disparities. This study explored patterns and predictors of suspension in a sample of 2,750 students with disabilities in 39 schools in a Midwestern district. Hierarchical generalized linear modeling demonstrated that disability type,…

Longitudinal Models of Reading Achievement of Students with Learning Disabilities and without Disabilities

ERIC Educational Resources Information Center

Sullivan, Amanda L.; Kohli, Nidhi; Farnsworth, Elyse M.; Sadeh, Shanna; Jones, Leila

2017-01-01

Objective: Accurate estimation of developmental trajectories can inform instruction and intervention. We compared the fit of linear, quadratic, and piecewise mixed-effects models of reading development among students with learning disabilities relative to their typically developing peers. Method: We drew an analytic sample of 1,990 students from…

Conversion of Provider EMR Training from Instructor-Led Training to eLearning at an Academic Medical Center.

PubMed

Sharp, Karen; Williams, Michele; Aldrich, Alison; Bogacz, Adrienne; Denier, Sighle; McAlearney, Ann S

2017-07-26

This case study overviews the conversion of provider training of the electronic medical record (EMR) from an instructor-led training (ILT) program to eLearning at an Academic Medical Center (AMC). This conversion provided us with both a useful training tool and the opportunity to maximize efficiency within both our training and optimization team and organization. eLearning Development Principles were created and served as a guide to assist us with designing an eLearning curriculum using a five step process. The result was a new training approach that allowed learners to complete training at their own pace, and even test out of sections based on demonstrated competency. The information we have leads us to believe that a substantial return on our investment can be obtained from the conversion with positive impacts that have served as the foundation for the future of end user EMR training at our AMC.

Conformal dual-band textile antenna with metasurface for WBAN application

NASA Astrophysics Data System (ADS)

Giman, Fatin Nabilah; Soh, Ping Jack; Jamlos, Mohd Faizal; Lago, Herwansyah; Al-Hadi, Azremi Abdullah; Abdulmalek, Mohamedfareq; Abdulaziz, Nidhal

2017-01-01

This paper presents the design of a dual-band wearable planar slotted dipole integrated with a metasurface. It operates in the 2.45 GHz (lower) and 5.8 GHz (upper) bands and made fully using textiles to suit wireless body area network applications. The metasurface in the form of an artificial magnetic conductor (AMC) plane is formed using a rectangular patch incorporated with a diamond-shaped slot to generate dual-phase response. This plane is then integrated with the planar slotted dipole antenna prior to its assessment in free space and bent configurations. Simulations and measurements indicated a good agreement, and the antenna featured an impedance bandwidth of 164 and 592 MHz in the lower and upper band, respectively. The presence of the AMC plane also minimized the backward radiation toward the human body and enhanced realized gains by up to 3.01 and 7.04 dB in the lower and upper band.

A comprehensive influenza campaign in a managed care setting.

PubMed

Pearson, D C; Jackson, L A; Wagener, B; Sarver, L

1998-11-01

Group Health Cooperative, a large, membership-governed, staff model health maintenance organization (HMO), has designed a comprehensive influenza campaign for identifying, recruiting and vaccinating enrollees at increased risk for influenza-related complications. The Cooperative's Centre for Health Promotion is responsible for the overall planning, implementation and evaluation of the influenza campaign. The model for delivering influenza immunizations has been designed to build on the strengths and capabilities of a staff model HMO with sophisticated automated information systems. The model permits area medical centres (AMCs) and physicians to use the materials and intervention strategies generated by the Centre for Health Promotion, while at the same time allowing them flexibility to design and use their own intervention strategies to increase compliance. More importantly, the model reduces resource requirements on AMCs and physicians to plan and maintain internal immunization efforts. Recommendations for improving the influenza campaign are discussed.

aMC fast: automation of fast NLO computations for PDF fits

NASA Astrophysics Data System (ADS)

Bertone, Valerio; Frederix, Rikkert; Frixione, Stefano; Rojo, Juan; Sutton, Mark

2014-08-01

We present the interface between M adG raph5_ aMC@NLO, a self-contained program that calculates cross sections up to next-to-leading order accuracy in an automated manner, and APPL grid, a code that parametrises such cross sections in the form of look-up tables which can be used for the fast computations needed in the context of PDF fits. The main characteristic of this interface, which we dub aMC fast, is its being fully automated as well, which removes the need to extract manually the process-specific information for additional physics processes, as is the case with other matrix-element calculators, and renders it straightforward to include any new process in the PDF fits. We demonstrate this by studying several cases which are easily measured at the LHC, have a good constraining power on PDFs, and some of which were previously unavailable in the form of a fast interface.

Mechanical and Tribological Characteristics of the AMC, Prepared by P/M Route along with Thermo-Mechanical Treatment

NASA Astrophysics Data System (ADS)

Mohapatra, Sambit Kumar; Maity, Kalipada; Bhuyan, Subrat Kumar; Prasad Satpathy, Mantra

2018-03-01

Thermo mechanical treatments have the ameliorated impacts on the mechanical and tribological properties of powder metallurgy components. In this investigation an aluminium matrix composite (AMC) {Al (92) + Mg (5) + Gr (1) + Ti (2)} has been prepared by following powder metallurgy technique, with double axial compaction and ulterior sintering. Secondary thermo-mechanical treatment i.e. hot extrusion through mathematical contoured cosine profiled die was considered. The die causes minimum velocity relative differences across the extrusion exit cross-section, which provides smooth material flow. Comparative result analysis for the mechanical and tribological characteristics of the specimen before and after extrusion was concentrated. Extrusion engenders significant amount of improvements of the properties those are attributed to excellent bond strength and uniform density distribution due to high compressive stress. Oxidative and delaminated wear mechanisms were found predominating type. To furnish the suitable explanation scanning electron microscopies have been performed for the wear surfaces.

A newly recognized syndrome of severe growth deficiency, microcephaly, intellectual disability, and characteristic facial features.

PubMed

Vinkler, Chana; Leshinsky-Silver, Esther; Michelson, Marina; Haas, Dorothea; Lerman-Sagie, Tally; Lev, Dorit

2014-01-01

Genetic syndromes with proportionate severe short stature are rare. We describe two sisters born to nonconsanguineous parents with severe linear growth retardation, poor weight gain, microcephaly, characteristic facial features, cutaneous syndactyly of the toes, high myopia, and severe intellectual disability. During infancy and early childhood, the girls had transient hepatosplenomegaly and low blood cholesterol levels that normalized later. A thorough evaluation including metabolic studies, radiological, and genetic investigations were all normal. Cholesterol metabolism and transport were studied and no definitive abnormality was found. No clinical deterioration was observed and no metabolic crises were reported. After due consideration of other known hereditary causes of post-natal severe linear growth retardation, microcephaly, and intellectual disability, we propose that this condition represents a newly recognized autosomal recessive multiple congenital anomaly-intellectual disability syndrome. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

The Armstrong Institute: An Academic Institute for Patient Safety and Quality Improvement, Research, Training, and Practice.

PubMed

Pronovost, Peter J; Holzmueller, Christine G; Molello, Nancy E; Paine, Lori; Winner, Laura; Marsteller, Jill A; Berenholtz, Sean M; Aboumatar, Hanan J; Demski, Renee; Armstrong, C Michael

2015-10-01

Academic medical centers (AMCs) could advance the science of health care delivery, improve patient safety and quality improvement, and enhance value, but many centers have fragmented efforts with little accountability. Johns Hopkins Medicine, the AMC under which the Johns Hopkins University School of Medicine and the Johns Hopkins Health System are organized, experienced similar challenges, with operational patient safety and quality leadership separate from safety and quality-related research efforts. To unite efforts and establish accountability, the Armstrong Institute for Patient Safety and Quality was created in 2011.The authors describe the development, purpose, governance, function, and challenges of the institute to help other AMCs replicate it and accelerate safety and quality improvement. The purpose is to partner with patients, their loved ones, and all interested parties to end preventable harm, continuously improve patient outcomes and experience, and eliminate waste in health care. A governance structure was created, with care mapped into seven categories, to oversee the quality and safety of all patients treated at a Johns Hopkins Medicine entity. The governance has a Patient Safety and Quality Board Committee that sets strategic goals, and the institute communicates these goals throughout the health system and supports personnel in meeting these goals. The institute is organized into 13 functional councils reflecting their behaviors and purpose. The institute works daily to build the capacity of clinicians trained in safety and quality through established programs, advance improvement science, and implement and evaluate interventions to improve the quality of care and safety of patients.

Academic medicine: a key partner in strengthening the primary care infrastructure via teaching health centers.

PubMed

Rieselbach, Richard E; Crouse, Byron J; Neuhausen, Katherine; Nasca, Thomas J; Frohna, John G

2013-12-01

In the United States, a worsening shortage of primary care physicians, along with structural deficiencies in their training, threaten the primary care system that is essential to ensuring access to high-quality, cost-effective health care. Community health centers (CHCs) are an underused resource that could facilitate rapid expansion of the primary care workforce and simultaneously prepare trainees for 21st-century practice. The Teaching Health Center Graduate Medical Education (THCGME) program, currently funded by the Affordable Care Act, uses CHCs as training sites for primary-care-focused graduate medical education (GME).The authors propose that the goals of the THCGME program could be amplified by fostering partnerships between CHCs and teaching hospitals (academic medical centers [AMCs]). AMCs would encourage their primary care residency programs to expand by establishing teaching health center (THC) tracks. Modifications to the current THCGME model, facilitated by formal CHC and academic medicine partnerships (CHAMPs), would address the primary care physician shortage, produce physicians prepared for 21st-century practice, expose trainees to interprofessional education in a multidisciplinary environment, and facilitate the rapid expansion of CHC capacity.To succeed, CHAMP THCs require a comprehensive consortium agreement designed to ensure equity between the community and academic partners; conforming with this agreement will provide the high-quality GME necessary to ensure residency accreditation. CHAMP THCs also require a federal mechanism to ensure stable, long-term funding. CHAMP THCs would develop in select CHCs that desire a partnership with AMCs and have capacity for providing a community-based setting for both GME and health services research.

Metafrontier frameworks for studying hospital productivity growth and quality changes.

PubMed

Chen, Kuan-Chen; Chien, Li-Nien; Hsu, Yi-Hsin; Yu, Ming-Miin

2016-12-01

The objective of this study was to evaluate productivity growth and quality changes among different levels of accredited hospitals. This study used an attribute-incorporating Malmquist productivity index (MPI) under the metafrontier framework. This is the first attempt to compare productivity changes among hospitals operating under different production frontiers. The data consisted of 20 academic medical centers (AMCs), 61 metropolitan hospitals (MPs) and 112 local community hospitals (LCs) in Taiwan during the period 2007-2010. This study measured productivity growth and further identified technological gaps and catch-ups in different groups of hospitals with respect to the metafrontier. At the same time, comparisons of changes in quality among different levels of hospitals were also examined. We found that the sample hospitals of AMCs and MPs experienced productivity improvements mainly due to technological progress, but their efficiency and technology gap ratio (TGR) deteriorated. As for LCs, progress in technology along with improvements in their efficiency and TGR led to the highest productivity upgrade among the three groups of hospitals. We also found that the sample hospitals among the three groups showed improvements in quality. Moreover, hospitals in the local community group exhibited greater quality progress than the AMCs and MPs over the sample period. This paper presents a number of useful decompositions of the metafrontier MPI, which can provide useful insights into changes that are due to efficiency, quality improvements and/or technological changes in the healthcare sector. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Local epidemiology and resistance profiles in acute uncomplicated cystitis (AUC) in women: a prospective cohort study in an urban urological ambulatory setting.

PubMed

Seitz, Michael; Stief, Christian; Waidelich, Raphaela

2017-10-16

Acute uncomplicated cystitis (AUC) is a common ailment in the urological setting. Guidelines for urinary tract infections are based on large-scale multi-centre, epidemiological and international studies. The objective of this observational study was to establish whether the results of a multi-centre study on the resistance profile of Escherichia coli (E. coli) in patients with AUC could be directly applied to an urological practice in a major European city or whether there are divergences in the resistance profile. An observational study was applied prospectively to 502 patients with AUC between January 2015 and January 2017). Personal data were anonymised. Exclusion criteria were the patient's age (<18) and treatment with an antibiotic in the week preceding examination. The average age was 32 (range 18-56). The most commonly detected bacteria was E. coli with 86%, followed by Enterococcus faecalis with 10% and Klebsiella pneumoniae with 4%. Resistance tests showed E. coli to be highly sensitive to fosfomycin (99.2%), nitrofurantoin (98.1%) and cefpodoxime (92.9%). E. coli exhibited resistance to ciprofloxacin (CIP) in 15.1%, to trimethoprim/sulfamethoxazole (TRS) in 25.2% and to amoxicillin/clavulanic acid (AMC) in 34% of cases. The comparison between data from this study and data from a multi-centre European (ECO-SENSI, ECO-SENSII and the 2014 update) showed relatively good sensitivity rates for fosfomycin and nitrofurantoin but significant differences in respect of resistance levels to TRS, CIP and AMC. AUC should therefore only be treated with TRS, CIP and AMC after a susceptibility test has been carried out.

Use of Case History Data for the Development of Equations in Predicting High Risk, Reading Disabled Students.

ERIC Educational Resources Information Center

Stratton, Beverly D.; And Others

Demographic data on 92 subjects identified as having reading problems were used to develop equations useful in identifying high risk, reading disabled students. Multiple linear regression analysis of the data indicated that reading disability (1) had a significant positive relationship with birth order and number of siblings; (2) had a positive…

Improved understanding of solute concentration-discharge dynamics through state-of-the-art antecedent moisture content (AMC) monitoring and analysis

NASA Astrophysics Data System (ADS)

Eludoyin, A. O.; Brazier, R.; Quine, T.; Bol, R.; Orr, R.; Griffith, B.

2012-04-01

The relationship between solute/sediment concentration and discharge (c-Q) can be neither understood nor predicted without full understanding of the antecedent moisture content (AMC). Many preceding studies have ignored this variable in part because of the problems associated with accurate and full documentation of AMC. This study presents new insights into the control of AMC on c-Q made possible through work on the uniquely well-instrumented 'NorthWyke Farm Platform' which was commissioned in April 2011 as a UK national capability for collaborative research, training and knowledge exchange in agro-environmental sciences for agricultural productivity and ecosystem responses to different management practices. The Farm Platform was designed into 15 hydrological units based on a predicted 50-year flood event, each with H-flume at catchment outlet. 9.2 km of French drains were installed at 800mm soil depth with perforated plastic drainage pipe installed to collect surface and near surface flow from the catchments. Each flume receives flow from 2 branches of each French drain system and discharges via concrete piping and a sampling pit. Where required the catchment is protected from groundwater seepage and surface runoff ingress from adjacent catchment with open ditches and sealed pipes. Discharge is measured at each flume with an ISCO bubbler flowmeter, and concentrations of Total Organic Carbon (TOC), Ammonium (NH4-N), Nitrate (NO3-N), Dissolved Oxygen (DO), total Phosphorus, chloride, pH and turbidity are monitored at 15 minutes intervals. In addition, rainfall, soil temperature and soil moisture are monitored at the same timestep. This study analyses discharge and soil moisture data alongside TOC, NO3-N and PO4-P at 15 min intervals in rain events between November 28 and December 13, 2011. Soil moisture exhibited moderately strong relationships with TOC and NO3 (r≥ -0.38; p≤0.05), but a weak one with PO4. Discharge, on the other hand, exhibited a weak (r ≤0.08; p>0.05) with all the ions. These results suggest that the behaviour of these ions is not explained by discharge alone. Analysis is in progress to determine the influence of soil moisture on hysteresis loops of these ions, as well as their contribution, with other end members to runoff in this study.

Comparison of Classification Methods for P300 Brain-Computer Interface on Disabled Subjects

PubMed Central

Manyakov, Nikolay V.; Chumerin, Nikolay; Combaz, Adrien; Van Hulle, Marc M.

2011-01-01

We report on tests with a mind typing paradigm based on a P300 brain-computer interface (BCI) on a group of amyotrophic lateral sclerosis (ALS), middle cerebral artery (MCA) stroke, and subarachnoid hemorrhage (SAH) patients, suffering from motor and speech disabilities. We investigate the achieved typing accuracy given the individual patient's disorder, and how it correlates with the type of classifier used. We considered 7 types of classifiers, linear as well as nonlinear ones, and found that, overall, one type of linear classifier yielded a higher classification accuracy. In addition to the selection of the classifier, we also suggest and discuss a number of recommendations to be considered when building a P300-based typing system for disabled subjects. PMID:21941530

Microbiological quality and somatic cell count in bulk milk of dromedary camels (Camelus dromedarius): descriptive statistics, correlations, and factors of variation.

PubMed

Nagy, P; Faye, B; Marko, O; Thomas, S; Wernery, U; Juhasz, J

2013-09-01

The objectives of the present study were to monitor the microbiological quality and somatic cell count (SCC) of bulk tank milk at the world's first large-scale camel dairy farm for a 2-yr period, to compare the results of 2 methods for the enumeration of SCC, to evaluate correlation among milk quality indicators, and to determine the effect of specific factors (year, season, stage of lactation, and level of production) on milk quality indicators. The study was conducted from January 2008 to January 2010. Total viable count (TVC), coliform count (CC), California Mastitis Test (CMT) score, and SCC were determined from daily bulk milk samples. Somatic cell count was measured by using a direct microscopic method and with an automatic cell counter. In addition, production parameters [total daily milk production (TDM, kg), number of milking camels (NMC), average milk per camel (AMC, kg)] and stage of lactation (average postpartum days, PPD) were recorded for each test day. A strong correlation (r=0.33) was found between the 2 methods for SCC enumeration; however, values derived using the microscopic method were higher. The geometric means of SCC and TVC were 394×10(3) cells/mL and 5,157 cfu/mL during the observation period, respectively. Somatic cell count was >500×10(3) cells/mL on 14.6% (106/725) and TVC was >10×10(3) cfu/mL on 4.0% (30/742) of the test days. Both milk quality indicators had a distinct seasonal pattern. For log SCC, the mean was lowest in summer and highest in autumn. The seasonal pattern of log TVC was slightly different, with the lowest values being recorded during the spring. The monthly mean TVC pattern showed a clear difference between years. Coliform count was <10 cfu/mL in most of the samples (709/742, 95.6%). A positive correlation was found between log SCC and log TVC (r=0.32), between log SCC and CMT score (r=0.26), and between log TVC and CC in yr 1 (r=0.30). All production parameters and stage of lactation showed strong seasonal variation. Log SCC was negatively correlated with TDM (r=-0.35), AMC (r=-0.37), and NMC (r=-0.15) and positively correlated with PPD (r=0.40). Log TVC had a negative correlation with AMC (r=-0.40) but a positive correlation with NMC (r=0.32), TDM (r=0.16), and PPD (r=0.45). The linear mixed model with stepwise variable selection showed that the main sources of log SCC variation were PPD, TDM, PPD × season, and season. For log TVC, the same factors and year contributed to the variation. Copyright © 2013 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Comparing the Relationship Between Age and Length of Disability Across Common Chronic Conditions

PubMed Central

Jetha, Arif; Besen, Elyssa; Smith, Peter M.

2016-01-01

Objective: The aim of this study was to compare the association between age and disability length across common chronic conditions. Methods: Analysis of 39,915 nonwork-related disability claims with a diagnosis of arthritis, diabetes, hypertension, coronary artery disease, depression, low back pain, chronic pulmonary disease, or cancer. Ordinary least squares regression models examined age-length of disability association across chronic conditions. Results: Arthritis (76.6 days), depression (63.2 days), and cancer (64.9 days) were associated with longest mean disability lengths; hypertension was related to shortest disability lengths (41.5 days). Across chronic conditions, older age was significantly associated with longer work disability. The age–length of disability association was most significant for chronic pulmonary disease and cancer. The relationship between age and length of work disability was linear among most chronic conditions. Conclusions: Work disability prevention strategies should consider both employee age and chronic condition diagnosis. PMID:27164446

ORGANIC EMISSIONS FROM AUTOMOBILE INTERIORS

EPA Science Inventory

The report gives results of an evaluation of six subcompact automobiles for the emission of vinyl chloride monomer (VCM) and other organics into the passenger compartment. Evaluated were a Ford Pinto, AMC Gremlin, GMC Vega, GMC Chevette, NMC Datsun 710, and VW Rabbit. VCM was qua...

Anophthalmos, microphthalmos, and Coloboma in the United kingdom: clinical features, results of investigations, and early management.

PubMed

Shah, Shaheen P; Taylor, Amy E; Sowden, Jane C; Ragge, Nicky; Russell-Eggitt, Isabelle; Rahi, Jugnoo S; Gilbert, Clare E

2012-02-01

To describe the clinical features of children with anophthalmos, microphthalmos, and typical coloboma (AMC). Descriptive, observational, cross-sectional study of the United Kingdom. A total of 135 children with AMC newly diagnosed over an 18-month period beginning in October 2006. Cases were identified using active surveillance through an established ophthalmic surveillance system. Eligible cases were followed up 6 months after first notification. Phenotypic characteristics, both ocular and systemic, clinical investigations, causes, and interventions. A total of 210 eyes (of 135 children) were affected by AMC, of which 153 had isolated coloboma or coloboma with microphthalmos. The most common colobomatous anomaly was a chorioretinal defect present in 109 eyes (71.2%). Some 44% of children were bilaterally visually impaired. Systemic abnormalities were present in 59.7% of children, with craniofacial anomalies being the most common. Children with bilateral disease had a 2.7 times higher odds (95% confidence interval, 1.3-5.5, P = 0.006) of having systemic involvement than unilaterally affected children. Neurologic imaging was the most frequent investigation (58.5%) performed. Less than one third (30.3%) of the children with microphthalmos had ocular axial lengths measured. Eight children had confirmed genetic mutations. Approximately half (49.2%) of the children required ocular intervention. Colobomatous defects were the most common phenotype within this spectrum of anomalies in the United Kingdom. The high frequency of posterior segment colobomatous involvement means that a dilated fundal examination should be made in all cases. The significant visual and systemic morbidity in affected children underlines the importance of a multidisciplinary approach to management. Copyright © 2012 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Microbiological evaluation of ready-to-eat iceberg lettuce during shelf-life and effectiveness of household washing methods

PubMed Central

Bencardino, Daniela; Vitali, Luca Agostino; Petrelli, Dezemona

2018-01-01

The aim of this study was to assess the microbiological quality of ready-to-eat (RTE) iceberg lettuce. Our investigation was based on the consumption tendency of university students considered a target market for this product. A total of 78 RTE samples were collected from chain supermarkets and analysed for the enumeration of aerobic mesophilic count (AMC), Escherichia coli and the detection of Salmonella spp. and Listeria monocytogenes. All samples were negative for the presence of pathogens. The mean value of AMC at the beginning, in the middle and after the expiration date was: 6.88, 8.51 and 8.72 log CFU g-1, respectively. The same investigation was performed on 12 samples of fresh iceberg lettuce samples. No pathogens were found and the mean value of AMC was lower than the RTE category (5.73 log CFU g-1; P<0.05). The effectiveness of 5 washing methods was determined on 15 samples of both fresh and RTE iceberg lettuce. Samples were washed for 15’ and 30’ in tap water (500 mL), tap water with NaCl (4 g/500 mL), tap water with bicarbonate (8 g/500 mL), tap water with vinegar (10 mL/500 mL) and tap water with chlorine-based disinfectant (10 mL/500 mL). A significant bacterial load reduction was recorded for vinegar and disinfectant after 30’ and 15’, respectively. Overall, these results showed that RTE iceberg lettuce is more contaminated than the fresh product. Also, the consumption in the first few days of packaging and after washing with disinfectants reduces the risk for health consumers. PMID:29732325

Confronting conflict: addressing institutional conflicts of interest in academic medical centers.

PubMed

Liang, Bryan A; Mackey, Tim

2010-01-01

Individual conflicts of interest are rife in healthcare, and substantial attention has been given to address them. Yet a more substantive concern-institutional conflicts of interest ("ICOIs") in academic medical centers ("AMCs") engaged in research and clinical care-have yet to garner sufficient attention, despite their higher stakes for patient safety and welfare. ICOIs are standard in AMCs, are virtually unregulated, and have led to patient deaths. Upon review of ICOIs, we find a clear absence of substantive efforts to confront these conflicts. We also assess the Jesse Gelsinger case, which resulted in the death of a study participant exemplifying a deep-seated culture of institutional indifference and complicity in unmanaged conflicts. Federal policy, particularly the Bayh-Dole Act, also creates and promotes ICOIs. Efforts to address ICOIs are narrow or abstract, and do not provide for a systemic infrastructure with effective enforcement mechanisms. Hence, in this paper, we provide a comprehensive proposal to address ICOIs utilizing a "Centralized System" model that would proactively review, manage, approve, and conduct assessments of conflicts, and would have independent power to evaluate and enforce any violations via sanctions. It would also manage any industry funds and pharmaceutical samples and be a condition of participation in public healthcare reimbursement and federal grant funding. The ICOI policy itself would provide for disclosure requirements, separate management of commercial enterprise units from academic units, voluntary remediation of conflicts, and education on ICOIs. Finally, we propose a new model of medical education-academic detailing-in place of current marketing-focused "education." Using such a system, AMCs can wean themselves from industry reliance and promote a culture of accountability and independence from industry influence. By doing so, clinical research and treatment can return to a focus on patient care, not profits.

Eruptive and tectonic history of the Endeavour Segment, Juan de Fuca Ridge, based on AUV mapping data and lava flow ages

USGS Publications Warehouse

Clague, David A.; Dreyer, Brian M; Paduan, Jennifer B; Martin, Julie F; Caress, David W; Gillespie, James B.; Kelley, Deborah S; Thomas, Hans; Portner, Ryan A; Delaney, John R; Guilderson, Thomas P.; McGann, Mary L.

2014-01-01

High-resolution bathymetric surveys from autonomous underwater vehicles ABE and D. Allan B. were merged to create a coregistered map of 71.7 km2 of the Endeavour Segment of the Juan de Fuca Ridge. Radiocarbon dating of foraminifera in cores from three dives of remotely operated vehicle Doc Ricketts provide minimum eruption ages for 40 lava flows that are combined with the bathymetric data to outline the eruptive and tectonic history. The ages range from Modern to 10,700 marine-calibrated years before present (yr BP). During a robust magmatic phase from >10,700 yr BP to ~4300 yr BP, flows erupted from an axial high and many flowed >5 km down the flanks; some partly buried adjacent valleys. Axial magma chambers (AMCs) may have been wider than today to supply dike intrusions over a 2 km wide axial zone. Summit Seamount formed by ~4770 yr BP and was subsequently dismembered during a period of extension with little volcanism starting ~4300 yr BP. This tectonic phase with only rare volcanic eruptions lasted until ~2300 yr BP and may have resulted in near-solidification of the AMCs. The axial graben formed by crustal extension during this period of low magmatic activity. Infrequent eruptions occurred on the flanks between 2620–1760 yr BP and within the axial graben since ~1750 yr BP. This most recent phase of limited volcanic and intense hydrothermal activity that began ~2300 yr BP defines a hydrothermal phase of ridge development that coincides with the present-day 1 km wide AMCs and overlying hydrothermal vent fields.

Analysis, comparison, and contrast of two primary maintenance contracting techniques used by the Florida Department of Transportation.

DOT National Transportation Integrated Search

2016-08-01

The Florida Department of Transportations (FDOT) Asset Maintenance Contracting Program (AMC) was analyzed during this study to determine if it reduced cost or affected work quality when compared with more-traditional contracts. A survey was conduc...

PRE-QAPP AGREEMENT (PQA) AND ANALYTICAL METHOD CHECKLISTS (AMCS): TOOLS FOR PLANNING RESEARCH PROJECTS

EPA Science Inventory

The Land Remediation and Pollution Control Division (LRPCD) QA Manager strives to assist LRPCD researchers in developing functional planning documents for their research projects. As part of the planning process, several pieces of information are needed, including information re...

The AIST Managed Cloud Environment

NASA Astrophysics Data System (ADS)

Cook, S.

2016-12-01

ESTO is currently in the process of developing and implementing the AIST Managed Cloud Environment (AMCE) to offer cloud computing services to ESTO-funded PIs to conduct their project research. AIST will provide projects access to a cloud computing framework that incorporates NASA security, technical, and financial standards, on which project can freely store, run, and process data. Currently, many projects led by research groups outside of NASA do not have the awareness of requirements or the resources to implement NASA standards into their research, which limits the likelihood of infusing the work into NASA applications. Offering this environment to PIs will allow them to conduct their project research using the many benefits of cloud computing. In addition to the well-known cost and time savings that it allows, it also provides scalability and flexibility. The AMCE will facilitate infusion and end user access by ensuring standardization and security. This approach will ultimately benefit ESTO, the science community, and the research, allowing the technology developments to have quicker and broader applications.

Does attention redirection contribute to the effectiveness of attention bias modification on social anxiety?

PubMed

Yao, Nisha; Yu, Hongyu; Qian, Mingyi; Li, Songwei

2015-12-01

Attention bias modification (ABM) is designed to modify threat-related attention bias and thus alleviate anxiety. The current research examined whether consistently directing attention towards targeted goals per se contributes to ABM efficacy. We randomly assigned 68 non-clinical college students with elevated social anxiety to non-valence-specific attend-to-geometrics (AGC), attention modification (AMC), or attention control (ACC) conditions. We assessed subjective, behavioral, and physiological reactivity to a speech task and self-reported social anxiety symptoms. After training, participants in the AMC exhibited an attention avoidance from threat, and those in the AGC responded more rapidly toward targeted geometrics. There was a significant pre- to post-reduction in subjective speech distress across groups, but behavioral and physiological reactivity to speech, as well as self-report social anxiety symptoms, remained unchanged. These results lead to questions concerning effectiveness of ABM training for reducing social anxiety. Further examination of the current ABM protocol is required. Copyright © 2015 Elsevier Ltd. All rights reserved.

Regulatory impairments following selective kainic acid lesions of the neostriatum.

PubMed

Dunnett, S B; Iversen, S D

1980-12-01

Kainic acid lesions were made to the anteromedial (AMC) or ventrolateral (VLC) caudate nucleus and the projection areas of medial and sulcal prefrontal cortex (PFC), respectively. By the second day following lesion, all control and AMC rats had recovered normal food and water intake. By contrast, VLC lesions resulted in severe aphagia and adipsia lasting 3-15 days, accompanied by a rapid loss in weight. Animals were kept alive by palatable food supplement and force-feeding as required. Once all animals had recovered normal food and water intake (3-5 weeks) drinking to various physiological challenges--5% hypertonic saline s.c., food deprivation, quinine adulteration of water and 40% polyethylene glycol--were found to be normal in both lesion groups. By 3 months after lesion the groups did not differ in weight. Acute aphagia and adipsia had been reported following ablation of the sulcal but not the medial PFC in rats. The present experiment obtains parallel results in the PFC projection areas within the neostriatum.

Automatic Modulation Classification Based on Deep Learning for Unmanned Aerial Vehicles.

PubMed

Zhang, Duona; Ding, Wenrui; Zhang, Baochang; Xie, Chunyu; Li, Hongguang; Liu, Chunhui; Han, Jungong

2018-03-20

Deep learning has recently attracted much attention due to its excellent performance in processing audio, image, and video data. However, few studies are devoted to the field of automatic modulation classification (AMC). It is one of the most well-known research topics in communication signal recognition and remains challenging for traditional methods due to complex disturbance from other sources. This paper proposes a heterogeneous deep model fusion (HDMF) method to solve the problem in a unified framework. The contributions include the following: (1) a convolutional neural network (CNN) and long short-term memory (LSTM) are combined by two different ways without prior knowledge involved; (2) a large database, including eleven types of single-carrier modulation signals with various noises as well as a fading channel, is collected with various signal-to-noise ratios (SNRs) based on a real geographical environment; and (3) experimental results demonstrate that HDMF is very capable of coping with the AMC problem, and achieves much better performance when compared with the independent network.

Automatic Modulation Classification Based on Deep Learning for Unmanned Aerial Vehicles

PubMed Central

Ding, Wenrui; Zhang, Baochang; Xie, Chunyu; Li, Hongguang; Liu, Chunhui; Han, Jungong

2018-01-01

Deep learning has recently attracted much attention due to its excellent performance in processing audio, image, and video data. However, few studies are devoted to the field of automatic modulation classification (AMC). It is one of the most well-known research topics in communication signal recognition and remains challenging for traditional methods due to complex disturbance from other sources. This paper proposes a heterogeneous deep model fusion (HDMF) method to solve the problem in a unified framework. The contributions include the following: (1) a convolutional neural network (CNN) and long short-term memory (LSTM) are combined by two different ways without prior knowledge involved; (2) a large database, including eleven types of single-carrier modulation signals with various noises as well as a fading channel, is collected with various signal-to-noise ratios (SNRs) based on a real geographical environment; and (3) experimental results demonstrate that HDMF is very capable of coping with the AMC problem, and achieves much better performance when compared with the independent network. PMID:29558434

Exploring Growth Trajectories of Problem Behavior in Young Children

ERIC Educational Resources Information Center

McCaffrey, Bethany L.

2012-01-01

Given the negative outcomes associated with problem behavior and the heightened risk for children with disabilities to display problematic behavior, the current study implemented hierarchical linear modeling to explore the growth trajectories of problem behavior in a nationally representative sample of preschool children with disabilities. Results…

Identification of International Classification of Functioning, Disability and Health categories for patients with peripheral arterial disease.

PubMed

Vyskocil, Erich; Gruther, Wolfgang; Steiner, Irene; Schuhfried, Othmar

2014-07-01

Disease-specific categories of the International Classification of Functioning, Disability and Health have not yet been described for patients with chronic peripheral arterial obstructive disease (PAD). The authors examined the relationship between the categories of the Brief Core Sets for ischemic heart diseases with the Peripheral Artery Questionnaire and the ankle-brachial index to determine which International Classification of Functioning, Disability and Health categories are most relevant for patients with PAD. This is a retrospective cohort study including 77 patients with verified PAD. Statistical analyses of the relationship between International Classification of Functioning, Disability and Health categories as independent variables and the endpoints Peripheral Artery Questionnaire or ankle-brachial index were carried out by simple and stepwise linear regression models adjusting for age, sex, and leg (left vs. right). The stepwise linear regression model with the ankle-brachial index as dependent variable revealed a significant effect of the variables blood vessel functions and muscle endurance functions. Calculating a stepwise linear regression model with the Peripheral Artery Questionnaire as dependent variable, a significant effect of age, emotional functions, energy and drive functions, carrying out daily routine, as well as walking could be observed. This study identifies International Classification of Functioning, Disability and Health categories in the Brief Core Sets for ischemic heart diseases that show a significant effect on the ankle-brachial index and the Peripheral Artery Questionnaire score in patients with PAD. These categories provide fundamental information on functioning of patients with PAD and patient-centered outcomes for rehabilitation interventions.

Labor inclusion of individuals with disabilities: Managers' conceptions as a contributing factor.

PubMed

Brite, Roberta; Nunes, Francisco; Souza, Danielle

2015-01-01

This study aims to analyze the managers' conceptions involved in the process of labor inclusion in 18 supermarkets with 5,000 employees, 300 of whom with disabilities. A group of 90 managers working with people with disability completed a Conceptions of Disability Inventory (CDI) about their conceptions of people with disabilities. Their responses were categorized as follows: (a) disability as a spiritual manifestation; b) disability as a deviation from normality; (c) disability based on assumptions of inclusion; (d) disability assessed from performance criteria; (e) disability assessed from the connection established with the work organization; (f) disability conceived by contracting benefits, and (g) disability based on the perception of the need for training. Based on the outcomes of the Pearson Correlation Matrix, significant linear correlations were found in seven managers' conceptions of disability. The results also indicate that the managers' conceptions contributed to differentiated inclusionist actions based on their perceptions related to people with disabilities. This study data contributes to identifying the best practices in labor inclusion. The outcomes of the present study could lead to development of a public policy aimed towards humanizing job alternatives for people with disability.

75 FR 21264 - Privacy Act of 1974; System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-23

... Defense. A0030-22 AMC System name: Army Food Management Information System Records System location.... 9397, as amended. Purpose(s): The Army Food Management Information System will be used to automate the...: Supervisor, Army Food Management Information System, Program Manager, 401 First Street, Suite 157, Fort Lee...

Controlled release of Pantoea agglomerans E325 for biocontrol of fire blight

USDA-ARS?s Scientific Manuscript database

Microencapsulation and controlled release of Pantoea agglomerans strain E325 (E325), which is an antagonist to bacterial pathogen (Erwinia amylovora) of fire blight, a devastating disease of apple and pear, have been investigated. Uniform core-shell alginate microcapsules (AMCs), 60-300 µm in diamet...

Options for Organizing the Tanker Airlift Control Center Flight Dispatch Function: An Exploratory Concept Study

DTIC Science & Technology

2000-06-01

it poised to fall? Am I prepared to pay the applicable capital gains tax ? Each of these questions could represent a decision frame. The...Center (FEDSIM). AMC Corporate Systems Analysis, Design , and Implementation PEP 18 TACC Project. Falls Chruch , VA: Federal Systems Integration and

The Geography Olympiad in Mexico

ERIC Educational Resources Information Center

Garcia-Garcia, Fernando

2007-01-01

The formal organisation of science Olympiads in Mexico dates from 1987, when a national contest on Mathematics was held in order to identify a team to represent the country in the International Mathematics Olympiad. In 1991, the Mexican Academy of Sciences ("Academia Mexicana de Ciencias"-AMC) created the National Science Olympiads…

Urgent Aeromedical Evacuation Network Capacity Planning

DTIC Science & Technology

2013-03-01

What if AMC had one strategically positioned AC for the Urgent / Priority AE mission and the redistribution needs they encounter? This idea stems ...KtMI~rAFB _~...,_ Po~AFB ;------------~ Service Tirr~e Estimates I CO\\" CLl "SIO\\" • C-378 performs bestfrom a cost perspective • Contracted

Counselors' Measures of Attitudes and Knowledge of Working with Biracial and Multiracial Youth

ERIC Educational Resources Information Center

Johnson, Nancy L.

2009-01-01

The focus of this study was to determine if there is a relationship between generalized multicultural awareness and knowledge as measured by the "Attitudes toward Multicultural Children Scale" ("AMCS") and the "Multicultural Counseling Vignette" ("MCV"). How race, gender, education, and years of experience…

The American Archival Profession and Information Technology Standards.

ERIC Educational Resources Information Center

Cox, Richard J.

1992-01-01

Discussion of the use of standards by archivists highlights the U.S. MARC AMC (Archives-Manuscript Control) format for reporting archival records and manuscripts; their interest in specific standards being developed for the OSI (Open Systems Interconnection) reference model; and the management of records in electronic formats. (16 references) (LAE)

America’s Army: The Strength of the Nation. 2010 Army Posture Statement

DTIC Science & Technology

2010-02-19

Task Force ARFORGEN Army Force Generation AFRICOM Africa Command AMAP Army Medical Action Plan AMC Army Material Command APS Army Prepositioned Stocks ...Facilities EBCT Evaluation Brigade Combat Team EOD Explosive Ordnance Disposal ES2 Every Soldier a Sensor ETF Enterprise Task Force FCS Future Combat

32 CFR 813.6 - Planning and requesting combat documentation.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Joint Operation Planning and Execution System, that in turn, requests support from HQ AMC. HQ USAF can... 32 National Defense 6 2010-07-01 2010-07-01 false Planning and requesting combat documentation... SALES AND SERVICES VISUAL INFORMATION DOCUMENTATION PROGRAM § 813.6 Planning and requesting combat...

Longitudinal Correlates of Maternal Depression among Mothers of Children with or without Intellectual Disability

ERIC Educational Resources Information Center

Zeedyk, Sasha M.; Blacher, Jan

2017-01-01

This study identified trajectories of depressive symptoms among mothers of children with or without intellectual disability longitudinally across eight time points. Results of fitting a linear growth model to the data from child ages 3-9 indicated that child behavior problems, negative financial impact, and low dispositional optimism all…

(Where) Is Functional Decline Isolating? Disordered Environments and the Onset of Disability.

PubMed

Schafer, Markus H

2018-03-01

The onset of disability is believed to undermine social connectedness and raise the risk of social isolation, yet spatial environments are seldom considered in this process. This study examines whether unruly home and neighborhood conditions intensify the association between disability onset and several dimensions of social connectedness. I incorporate longitudinal data from the National Social Life, Health, and Aging Project, which contains environmental evaluations conducted by trained observers ( N = 1,558). Results from Poisson, ordinal logistic, and linear regression models reveal heterogeneous consequences of disablement: disability onset was associated with reduced core network size, fewer friends, lower likelihood of social interaction, and less overall social connectedness-though mainly when accompanied by higher levels of household disorder. There was limited evidence that neighborhood disorder moderated consequences of disability. Findings point to the importance of the home as an environmental resource and underscore important contextual contingencies in the isolating consequences of disability.

Waist circumference, body mass index, and disability among older adults in Latin American and the Caribbean

PubMed Central

Nam, Sanggon; Kuo, Yong-Fang; Markides, Kyriakos S; Al Snih, Soham

2012-01-01

Purpose To examine the association between waist circumference (WC) and body mass index (BMI) on disability among older adults from Latin America and the Caribbean. Methods Cross-sectional, multicenter city study of 5,786 subjects aged 65 years and older from the Health, Well-Being and Aging in Latin America and the Caribbean Study (SABE) (1999-2000). Sociodemographic variables, smoking status, medical conditions, BMI, WC, and activities of daily living (ADL) were obtained. Results Prevalence of high WC (>88 cm) in women ranged from 48.5% (Havana) to 72.7% (Mexico City), while among men (>102 cm) it ranged from 12.5% (Bridgetown) to 32.5% (Santiago). The associations between WC and ADL disability were “J” shaped, with higher risks of ADL disability observed above 110 cm for women in Bridgetown, Santiago, Havana, and Montevideo. The association in Sao Paulo is plateau with higher risk above 100 cm, and the association in Mexico City is closer to linear. Among men the associations were “U” (Bridgetown, Sao Paulo, and Havana), “J” shaped (Montevideo), plateau (Santiago), and closer to linear in Mexico City (Figure 3). When WC and BMI were analyzed together, we found that participants from Sao Paolo, Santiago, Havana, and Montevideo in the overweight or obese category with high WC were significantly more likely to report ADL disability after adjusting for all covariates. Conclusion The findings of this study suggests that both general and abdominal adiposity are associated with disability and support the use of WC in addition to BMI to assess risk of disability in older adults. PMID:22564360

6,220 institutionalised people with intellectual disability referred for visual assessment between 1993 and 2003: overview and trends.

PubMed

van Isterdael, C E D; Stilma, J S; Bezemer, P D; Tijmes, N T

2006-10-01

To summarise the results of visual performance tests and other data of institutionalised people with intellectual disability referred to a visual advisory centre (VAC) between 1993 and 2003, and to determine trends in these data. A retrospective medical record review was undertaken of 6,220 consecutive people examined ophthalmologically according to a standard protocol by one VAC that specialised in visual assessment and treatment of people with intellectual disability, between 1993 and 2003. chi2 test for linear trend was used and linear regression coefficients were calculated. The proportion of people aged > or =50 years increased from 19.3% to 34.2% between 1995 and 2003 (p<0.001); the combined figure of severe or profound intellectual disability decreased from 80.0% to 52.6% (p<0.001); the proportion of mobile people increased from 52.1% to 98.0% (p<0.001); the combined proportion of people with visual impairment or blindness decreased from 70.9% to 22.9% (p<0.001), and that of people with visual disorders decreased from 89.6% to 75.3% (p<0.001). Causes of intellectual disability were identified in 58.4% people; 20.8% had Down's syndrome. Many ocular diagnoses were found, indicating the need for ophthalmological monitoring. Specialised centres are helpful, because assessment and treatment of people with intellectual disability is complicated and time consuming. Protocols for efficient referral will have to be developed. A major task lies ahead to improve the treatment rates of refractive errors, cataract and strabismus, and to find specific causes of intellectual disability.

Parental Perceptions of Physical Activity Benefits for Youth With Developmental Disabilities.

PubMed

Pitchford, E Andrew; Siebert, Erin; Hamm, Jessica; Yun, Joonkoo

2016-01-01

Physical activity promotion is of need for youth with developmental disabilities. Parental perceptions of physical activity benefits may influence youth behaviors. This study investigated the relationship between parental beliefs on the importance of physical activity and physical activity levels among youth with disabilities. Parents and caregivers of 113 youth with disabilities reported on the perceived benefits of physical activity, the child's physical activity level, and demographic information. Linear regression analyses to examine the relative association between parental perceived benefits and child physical activity (R² = 0.19) indicated that physical activity level was predicted by parental beliefs and child gender. Health promotion for youth with disabilities should consider educating parents and caregivers of physical activity benefits, in addition to creating more opportunities.

Predicting the effect of disability on employment status and income.

PubMed

Randolph, Diane Smith

2004-01-01

Research shows that participation in employment contributes to life satisfaction for persons with disabilities [18]. Title I of the Americans with Disabilities Act (ADA) sought to prohibit discrimination against persons with disabilities in the workplace, however, the ADA's effectiveness remains controversial. This research utilizes data from the disability supplement of the 2000 Behavioral Risk Factor Surveillance System to examine the impact of disability status on predicting employment status and income. Confounding variables such as gender, age, educational level, race and marital/parental status are examined regarding their influence on results. Results from analysis utilizing zero-order correlation, linear and logistic regression analysis techniques revealed that disability status has a significant predictive effect on inability to work. Furthermore, results continue to show that despite legislation, the higher the level of disability, the lower the employment status (those employed for wages) and income. Finally, disability status, coupled with being female or decreased educational level, consistently shows significance in predicting lower employment status and income than men or non-minorities with disabilities. Future research opportunities and policy implications are discussed with regard to the results presented.

Does Access Matter? Time in General Education and Achievement for Students with Disabilities

ERIC Educational Resources Information Center

Cosier, Meghan; Causton-Theoharis, Julie; Theoharis, George

2013-01-01

This study examined the relationship between hours in general education and achievement in reading and mathematics for students with disabilities. The study population included more than 1,300 students between the ages of 6 and 9 years old within 180 school districts. Hierarchical linear modeling (HLM) was utilized with the Pre-Elementary…

Using Virtual Interactive Training Agents (ViTA) with Adults with Autism and Other Developmental Disabilities

ERIC Educational Resources Information Center

Burke, Shanna L.; Bresnahan, Tammy; Li, Tan; Epnere, Katrina; Rizzo, Albert; Partin, Mary; Ahlness, Robert M.; Trimmer, Matthew

2018-01-01

Conversational virtual human (VH) agents are increasingly used to support role-play experiential learning. This project examined whether a Virtual Interactive Training Agent (ViTA) system would improve job interviewing skills in individuals with autism and developmental disabilities (N = 32). A linear mixed model was employed to evaluate adjusted…

Advanced Infantry Training: An Empirical Analysis Of (0341) Mortarman Success While Attending Advanced Mortarman Course

DTIC Science & Technology

2017-12-01

13 Table 2. TFDW File Descriptions ... evaluation FO Forward Observer FY Fiscal year GT General technical HLZ Helicopter landing zone ID Identification ITB Infantry Training...survive during AMCs most difficult training phases, to include FDC and advanced FDC evaluations . These events require a heightened degree of cognitive

The Volume and Mix of Inpatient Services Provided by Academic Medical Centers.

ERIC Educational Resources Information Center

Moy, Ernest; And Others

1996-01-01

A study examined trends in the volume and type of inpatient clinical diagnoses, common medical services, and specialized services in academic medical centers (AMCs)--integrated and independent, other teaching hospitals, and nonteaching hospitals. Results indicate that despite rapid change in the health care environment, little change has occurred…

Pollution Prevention Case Studies: Implications for Army Institutional Processes

DTIC Science & Technology

1994-06-01

waste (FAMC), Optical Fabrication by switching from glass to Laboratory (OFL) plastiC lens production Fort Lewis FORSCOM Develop installation...Role of Compliance Pressures ...................................................................................... 51 6.8 Waste and Recyclables ...Anny Depot AMC Reduce chromium waste (CCAD) through change in Aluminum coating process Fitzsimmons Anny Medical Center HSC Decrease heavy metal

Smart Systems for Logistics Command and Control (SSLC2)

DTIC Science & Technology

2004-06-01

design options 12 AFRL Risk Abatement (continued) • Awareness of key development projects: • AF Portal • GCSS-AF • TBMCS-UL • Enterprise Data Warehouse ... Logistics Enterprise Architecture • Early identification of Transition Agents 13 Collaboration Partners • AF-ILMM • AMC/A-4 • AFC2ISRC • AFMC LSO

Air Mobility Command Global Reach to Africa: Sustained Rapid Global Mobility to United States Africa Command

DTIC Science & Technology

2009-06-12

the entire Global Reach Laydown (GRL) strategy. Finally, analysis within this paper shows a correlation between political climate , basing, ground...17 Analysis of Literature...study researched Air Mobility Command (AMC) delivery of DoD resources to and through USAFRICOM. Specifically, the research and analysis within

Identification and Classification of Orthogonal Frequency Division Multiple Access (OFDMA) Signals Used in Next Generation Wireless Systems

DTIC Science & Technology

2012-03-01

advanced antenna systems AMC adaptive modulation and coding AWGN additive white Gaussian noise BPSK binary phase shift keying BS base station BTC ...QAM-16, and QAM-64, and coding types include convolutional coding (CC), convolutional turbo coding (CTC), block turbo coding ( BTC ), zero-terminating

Research Strategies for Academic Medical Centers: A Framework for Advancements toward Translational Excellence

ERIC Educational Resources Information Center

Haley, Rand; Champagne, Thomas J., Jr.

2017-01-01

This review article presents a simplified framework for thinking about research strategy priorities for academic medical centers (AMCs). The framework can serve as a precursor to future advancements in translational medicine and as a set of planning guideposts toward ultimate translational excellence. While market pressures, reform uncertainties,…

Clay Tablets to Micro Chips: The Evolution of Archival Practice into the Twenty-First Century.

ERIC Educational Resources Information Center

Hannestad, Stephen E.

1991-01-01

Describes archival concepts and theories and their evolution in recent times. Basic archival functions--appraisal, arrangement, description, reference, preservation, and publication--are introduced. Early applications of automation to archives (including SPINDEX, NARS-5, NARS-A-1, MARC AMC, presNET, CTRACK, PHOTO, and DIARY) and automation trends…

Impact of Volcanic Activity on AMC Channel Operations

DTIC Science & Technology

2014-06-13

active volcanic settings in the world. The location and behavior of volcanoes are a direct result of tectonic plate boundaries and the dynamic nature...Figure 2: Ash Detected Outside Iceland within 40°–70°N and 40°W–30°E (Scientific Reports, 2014) The potential for tectonic plate movement

Performance Characteristics of Automotive Engines in the United States : First Series - Report No. 13 - 1975 American Motors 258 CID (4.2 Liters)

DOT National Transportation Integrated Search

1978-04-01

Experimental data were obtained in dynamometer tests of a 1975 AMC 258-CID production 1V engine to determine fuel consumption and emissions (hydrocarbon, carbon monoxide, oxides of nitrogen) at steady-state engine-operating modes. The objective of th...

Asan medical information system for healthcare quality improvement.

PubMed

Ryu, Hyeon Jeong; Kim, Woo Sung; Lee, Jae Ho; Min, Sung Woo; Kim, Sun Ja; Lee, Yong Su; Lee, Young Ha; Nam, Sang Woo; Eo, Gi Seung; Seo, Sook Gyoung; Nam, Mi Hyun

2010-09-01

This purpose of this paper is to introduce the status of the Asan Medical Center (AMC) medical information system with respect to healthcare quality improvement. Asan Medical Information System (AMIS) is projected to become a completely electronic and digital information hospital. AMIS has played a role in improving the health care quality based on the following measures: safety, effectiveness, patient-centeredness, timeliness, efficiency, privacy, and security. AMIS CONSISTED OF SEVERAL DISTINCTIVE SYSTEMS: order communication system, electronic medical record, picture archiving communication system, clinical research information system, data warehouse, enterprise resource planning, IT service management system, and disaster recovery system. The most distinctive features of AMIS were the high alert-medication recognition & management system, the integrated and severity stratified alert system, the integrated patient monitoring system, the perioperative diabetic care monitoring and support system, and the clinical indicator management system. AMIS provides IT services for AMC, 7 affiliated hospitals and over 5,000 partners clinics, and was developed to improve healthcare services. The current challenge of AMIS is standard and interoperability. A global health IT strategy is needed to get through the current challenges and to provide new services as needed.

Eclogites and garnet clinopyroxenites in the Anrakhai complex, Central Asian Orogenic Belt, Southern Kazakhstan: P-T evolution, protoliths and some geodynamic implications

NASA Astrophysics Data System (ADS)

Pilitsyna, Anfisa V.; Tretyakov, Andrey A.; Degtyarev, Kirill E.; Cuthbert, Simon J.; Batanova, Valentina G.; Kovalchuk, Elena V.

2018-03-01

The Anrakhai Metamorphic Complex (AMC), located in the SE part of the Chu-Ili Mountains of Southern Kazakhstan in the western part of Central Asian Orogenic Belt, exhibits occurrences of HP metamorphic rocks in the form of eclogites and garnet clinopyroxenites with peak metamorphic conditions of 750-850° and 15-19 kbar estimated with both conventional geothermobarometric methods and phase diagram modeling. P-T estimates as well as intimate field relations evidently imply a common metamorphic history for eclogites and garnet clinopyroxenites of the AMC. These high-pressure, medium temperature eclogite facies P-T conditions are indicative of a collision or subduction tectonic setting. Major and trace element geochemistry suggests that they probably had a common magmatic origin as part of a suite of differentiated tholeiitic intrusions. Furthermore, distinctive mineral and chemical compositions of these eclogites and garnet clinopyroxenites correspond to the Fe-Ti type of ultramafic rocks suggesting that they may have been derivatives of intraplate tholeiitic melts, introduced into continental crust before HP metamorphism.

Elution kinetics, antimicrobial activity, and mechanical properties of 11 different antibiotic loaded acrylic bone cement.

PubMed

Gálvez-López, Ruben; Peña-Monje, Alejandro; Antelo-Lorenzo, Ramón; Guardia-Olmedo, Juan; Moliz, Juan; Hernández-Quero, José; Parra-Ruiz, Jorge

2014-01-01

Antibiotic-loaded acrylic bone cements (ALABC) spacers are routinely used in the treatment of prosthetic joint infections. The objectives of our study were to evaluate different ALABC for elution kinetics, thermal stability, and mechanical properties. A 10 or 20% mixture (w/w) beads of medium viscosity bone cement (DePuy, Inc) and vancomycin (VAN), gentamycin (GM), daptomycin (DAP), moxifloxacin (MOX), rifampicin (RIF), cefotaxime (CTX), cefepime (FEP), amoxicillin clavulanate (AmC), ampicillin (AMP), meropenem (MER), and ertapenem (ERT) were formed and placed into wells filled with phosphate-buffered saline. Antibiotic concentrations were determined using high-performance liquid chromatography. Antimicrobial activity was tested against Micrococcus luteus ATCC 9341 or Escherichia coli ATCC 25922. AmC, AMP, and FEP concentration rapidly decreased after day 2, being almost undetectable at day 4. Sustained and high elution rates were observed with VAN, GM, MOX, and RIF for the 30-day duration of the experiment. DAP, MER, ERT, and CTX elution rates constantly decreased from day 4. All antibiotics tested retained antimicrobial activity proving thermal stability. Mechanical properties of ALABC were maintained except when RIF was used. © 2013.

Critical pathogenic steps to high risk Helicobacter pylori gastritis and gastric carcinogenesis

PubMed Central

Lee, Inchul

2014-01-01

Helicobacter pylori (H. pylori) gastritis may progress to high risk gastropathy and cancer. However, the pathological progression has not been characterized in detail. H. pylori induce persistent inflammatory infiltration. Neutrophils are unique in that they directly infiltrate into foveolar epithelium aiming the proliferative zone specifically. Neutrophilic proliferative zone foveolitis is a critical pathogenic step in H. pylori gastritis inducing intensive epithelial damage. Epithelial cells carrying accumulated genomic damage and mutations show the Malgun (clear) cell change, characterized by large clear nucleus and prominent nucleolus. Malgun cells further undergo atypical changes, showing nuclear folding, coarse chromatin, and multiple nucleoli. The atypical Malgun cell (AMC) change is a novel premalignant condition in high risk gastropathy, which may progress and undergo malignant transformation directly. The pathobiological significance of AMC in gastric carcinogenesis is reviewed. A new diagnosis system of gastritis is proposed based on the critical pathologic steps classifying low and high risk gastritis for separate treatment modality. It is suggested that the regulation of H. pylori-induced neutrophilic foveolitis might be a future therapeutic goal replacing bactericidal antibiotics approach. PMID:24914362

Critical pathogenic steps to high risk Helicobacter pylori gastritis and gastric carcinogenesis.

PubMed

Lee, Inchul

2014-06-07

Helicobacter pylori (H. pylori) gastritis may progress to high risk gastropathy and cancer. However, the pathological progression has not been characterized in detail. H. pylori induce persistent inflammatory infiltration. Neutrophils are unique in that they directly infiltrate into foveolar epithelium aiming the proliferative zone specifically. Neutrophilic proliferative zone foveolitis is a critical pathogenic step in H. pylori gastritis inducing intensive epithelial damage. Epithelial cells carrying accumulated genomic damage and mutations show the Malgun (clear) cell change, characterized by large clear nucleus and prominent nucleolus. Malgun cells further undergo atypical changes, showing nuclear folding, coarse chromatin, and multiple nucleoli. The atypical Malgun cell (AMC) change is a novel premalignant condition in high risk gastropathy, which may progress and undergo malignant transformation directly. The pathobiological significance of AMC in gastric carcinogenesis is reviewed. A new diagnosis system of gastritis is proposed based on the critical pathologic steps classifying low and high risk gastritis for separate treatment modality. It is suggested that the regulation of H. pylori-induced neutrophilic foveolitis might be a future therapeutic goal replacing bactericidal antibiotics approach.

Drinking Water Quality Surveillance in a Vulnerable Urban Ward of Ahmedabad.

PubMed

Iyer, Veena; Choudhury, Nandini; Azhar, Gulrez Shah; Somvanshi, Bhushan

2014-05-01

The World Bank estimates that 21% of all communicable diseases in India are related to unsafe water with diarrhoea alone causing more than 0.1 million deaths annually. The WHO drinking water surveillance parameters of quality, quantity, accessibility, affordability and continuity were assessed in one vulnerable ward of Ahmedabad-a fast growing city in Western India. Interviews with key informants of the ward office, health centre and water supply department, secondary analysis and mapping of field test reports and a questionnaire-based survey of different household types were conducted. We found that Ahmedabad Municipal Corporation (AMC) supplies water to the ward intermittently for two hours during the day. Housing society clusters supplement their AMC water supply with untested bore-well water. The water quality surveillance system is designed for a twenty-four-hour piped distribution of treated surface water. However, in order to maintain surveillance over an intermittent supply that includes ground water, the sampling process should include periodic surveys of water actually consumed by the citizens. The laboratory capacity of the Central Water Testing Laboratory should expand to include more refined tests for microbial and chemical contamination.

Amplitude Modulator Chassis

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

Erbert, G

2009-09-01

The Amplitude Modulator Chassis (AMC) is the final component in the MOR system and connects directly to the PAM input through a 100-meter fiber. The 48 AMCs temporally shape the 48 outputs of the MOR using an arbitrary waveform generator coupled to an amplitude modulator. The amplitude modulation element is a two stage, Lithium Niobate waveguide device, where the intensity of the light passing through the device is a function of the electrical drive applied. The first stage of the modulator is connected to a programmable high performance Arbitrary Waveform Generator (AWG) consisting of 140 impulse generators space 250 psmore » apart. An arbitrary waveform is generated by independently varying the amplitude of each impulse generator and then summing the impulses together. In addition to the AWG a short pulse generator is also connected to the first stage of the modulator to provide a sub 100-ps pulse used for timing experiments. The second stage of the modulator is connect to a square pulse generator used to further attenuate any pre or post pulse light passing through the first stage of the modulator. The fast rise and fall time of the square pulse generator is also used to produce fast rise and fall times of the AWG by clipping the AWG pulse. For maximum extinction, a pulse bias voltage is applied to each stage of the modulator. A pulse voltage is applied as opposed to a DC voltage to prevent charge buildup on the modulator. Each bias voltage is adjustable to provide a minimum of 50-dB extinction. The AMC is controlled through ICCS to generate the desired temporal pulse shape. This process involves a closed-loop control algorithm, which compares the desired temporal waveform to the produced optical pulse, and iterates the programming of the AWG until the two waveforms agree within an allowable tolerance.« less

Improved power steering with double and triple ring waveguide systems: the impact of the operating frequency.

PubMed

Kok, H P; de Greef, M; Borsboom, P P; Bel, A; Crezee, J

2011-01-01

Regional hyperthermia systems with 3D power steering have been introduced to improve tumour temperatures. The 3D 70-MHz AMC-8 system has two rings of four waveguides. The aim of this study is to evaluate whether T(90) will improve by using a higher operating frequency and whether further improvement is possible by adding a third ring. Optimised specific absorption rate (SAR) distributions were evaluated for a centrally located target in tissue-equivalent phantoms, and temperature optimisation was performed for five cervical carcinoma patients with constraints to normal tissue temperatures. The resulting T(90) and the thermal iso-effect dose (i.e. the number of equivalent min at 43°C) were evaluated and compared to the 2D 70-MHz AMC-4 system with a single ring of four waveguides. FDTD simulations were performed at 2.5 × 2.5 × 5 mm(3) resolution. The applied frequencies were 70, 100, 120, 130, 140 and 150 MHz. Optimised SAR distributions in phantoms showed an optimal SAR distribution at 140 MHz. For the patient simulations, an optimal increase in T(90) was observed at 130 MHz. For a two-ring system at 70 MHz the gain in T(90) was about 0.5°C compared to the AMC-4 system, averaged over the five patients. At 130 MHz the average gain in T(90) was ~1.5°C and ~2°C for a two and three-ring system, respectively. This implies an improvement of the thermal iso-effect dose with a factor ~12 and ~30, respectively. Simulations showed that a 130-MHz two-ring waveguide system yields significantly higher tumour temperatures compared to 70-MHz single-ring and double-ring waveguide systems. Temperatures were further improved with a 130-MHz triple-ring system.

Clinical Predictive Models for Chemotherapy-Induced Febrile Neutropenia in Breast Cancer Patients: A Validation Study

PubMed Central

Zhu, Liling; Su, Fengxi; Jia, Weijuan; Deng, Xiaogeng

2014-01-01

Background Predictive models for febrile neutropenia (FN) would be informative for physicians in clinical decision making. This study aims to validate a predictive model (Jenkin’s model) that comprises pretreatment hematological parameters in early-stage breast cancer patients. Patients and Methods A total of 428 breast cancer patients who received neoadjuvant/adjuvant chemotherapy without any prophylactic use of colony-stimulating factor were included. Pretreatment absolute neutrophil counts (ANC) and absolute lymphocyte counts (ALC) were used by the Jenkin’s model to assess the risk of FN. In addition, we modified the threshold of Jenkin’s model and generated Model-A and B. We also developed Model-C by incorporating the absolute monocyte count (AMC) as a predictor into Model-A. The rates of FN in the 1st chemotherapy cycle were calculated. A valid model should be able to significantly identify high-risk subgroup of patients with FN rate >20%. Results Jenkin’s model (Predicted as high-risk when ANC≦3.1*10∧9/L;ALC≦1.5*10∧9/L) did not identify any subgroups with significantly high risk (>20%) of FN in our population, even if we used different thresholds in Model-A(ANC≦4.4*10∧9/L;ALC≦2.1*10∧9/L) or B(ANC≦3.8*10∧9/L;ALC≦1.8*10∧9/L). However, with AMC added as an additional predictor, Model-C(ANC≦4.4*10∧9/L;ALC≦2.1*10∧9/L; AMC≦0.28*10∧9/L) identified a subgroup of patients with a significantly high risk of FN (23.1%). Conclusions In our population, Jenkin’s model, cannot accurately identify patients with a significant risk of FN. The threshold should be changed and the AMC should be incorporated as a predictor, to have excellent predictive ability. PMID:24945817

High absolute basophil count is a powerful independent predictor of inferior overall survival in patients with primary myelofibrosis.

PubMed

Lucijanic, Marko; Livun, Ana; Stoos-Veic, Tajana; Pejsa, Vlatko; Jaksic, Ozren; Cicic, David; Lucijanic, Jelena; Romic, Zeljko; Orehovec, Biserka; Aralica, Gorana; Miletic, Marko; Kusec, Rajko

2018-05-01

To investigate the clinical and prognostic significance of absolute basophil count (ABC) in patients with primary myelofibrosis (PMF). We retrospectively investigated 58 patients with PMF treated in our institution in the period from 2006 to 2017. ABC was obtained in addition to other hematological and clinical parameters. Patients were separated into high and low ABC groups using the Receiver operating characteristic curve analysis. ABC was higher in PMF patients than in healthy controls (P < 0.001). Patients with high ABC had higher white blood cells (P < 0.001), higher red cell distribution width (P = 0.035), higher lactate dehydrogenase (P < 0.001), more frequently had circulatory blasts (P < 0.001), constitutional symptoms (P = 0.030) and massive splenomegaly (P = 0.014). ABC was also positively correlated with absolute monocyte count (AMC) (P < 0.001) and other components of differential blood count. There was no difference in ABC regarding driver mutations or degree of bone marrow fibrosis. Univariately, high ABC was significantly associated with inferior overall survival (hazard ratio (HR) 4.79, P < 0.001). This effect remained statistically significant (HR 4.27, P = 0.009) in a multivariate Cox regression model adjusted for age, gender, Dynamic International Prognostic Scoring System (HR 2.6, P = 0.001) and AMC (HR 8.45, P = 0.002). High ABC reflects higher disease activity and stronger proliferative potential of disease. ABC and AMC independently predict survival and therefore seem to reflect different underlying pathophysiologic processes. Hence, both have a potential for improvement of current prognostic scores. Basophils represent a part of malignant clone in PMF and are associated with unfavorable disease features and poor prognosis which is independent of currently established prognostic scoring system and monocytosis.

Does Age Affect the Relationship Between Pain and Disability? A Descriptive Study in Individuals Suffering From Chronic Low Back Pain.

PubMed

Houde, Francis; Cabana, François; Léonard, Guillaume

2016-01-01

Previous studies have revealed a weak to moderate relationship between pain and disability in individuals suffering from low back pain (LBP). However, to our knowledge, no studies have evaluated if this relationship is different between young and older adults. The objective of this descriptive, cross-sectional study was to determine whether the relationship between LBP intensity and physical disability is different between young and older adults. Pain intensity (measured with a visual analog scale) and physical disability scores (measured with the Oswestry Disability Index) were collected from the medical files of 164 patients with LBP. Separate Pearson correlation coefficients were calculated between these 2 variables for young (mean age 40 ± 6 years, n = 82) and older (62 ± 9 years, n = 82) individuals and a Fisher r-to-z transformation was used to test for group differences in the strength of the relationship. Linear regression analyses were also performed to determine whether the slope of the association was different between the 2 groups. A significant and positive association was found between pain intensity and disability for both young and older individuals. However, the correlation was stronger in the young group (r = 0.66; P < .01) than in the older group (r = 0.44; P < .01) (Fisher Z = 2.03; P < .05). The linear regression model also revealed that the slope of the relationship was steeper in the young group (P < .05). Although both young and older individuals showed a significant association between pain intensity and disability, the relationship between these 2 variables was more tenuous in older individuals than in young patients. Future research is essential to identify the factors underlying this age-related difference.

Diabetes mellitus may affect short-term outcome of Guillain-Barré syndrome.

PubMed

Peric, Stojan; Bozovic, Ivo; Bjelica, Bogdan; Berisavac, Ivana; Stojiljkovic, Olivera; Basta, Ivana; Beslac-Bumbasirevic, Ljiljana; Rakocevic-Stojanovic, Vidosava; Lavrnic, Dragana; Stevic, Zorica

2017-06-01

We sought to determine influence of diabetes mellitus on Guillain-Barré syndrome (GBS) course and short-term prognosis. Among the 257 GBS patients included in this retrospective study, diabetes mellitus was present in 17%. The degree of disability at admission and on discharge was assessed according to the GBS Disability Scale (mild disability = 0-3, severe disability = 4-6). Even after correction for age, diabetes mellitus was significantly associated with more severe disability at nadir (odds ratio, OR = 3.4, p < 0.05) and on discharge (OR = 2.0, p < 0.05). Linear regression analysis with multiple factors included showed that age and presence of diabetes were significant predictors of severe disability at nadir (adjusted R 2 = 0.21, p < 0.05), and on discharge (adjusted R 2 = 0.19, p < 0.05). The presence of diabetes mellitus affects short-term prognosis of GBS, independent of age. © 2017 Peripheral Nerve Society.

Effects of Gas Plasma Treatments on Surface Properties of Commercial Polymer Films

DTIC Science & Technology

1991-04-01

Proving Ground , MD 21005 Comander, AMC ATTN: A•COE-SC 5001 Eisenhower Ave. 001 Alexandria, VA 22333-0001 Coumander, LMCBCO ATTN: AMSLC-CG, CO, CS (In...Two coptes for OTIC will Alexandria, VA 22304-6145 b et fra $TINFO Office.) Director US Amy Material Systems Analysis Actv ATTN: DRXSY-MP 001 Aberden

2009 Joint CBRN Conference

DTIC Science & Technology

2009-06-25

Operational Science & Technology Conference & Exhibition August 3 - 6, 2009 Honolulu, HI "Synchronizing Operators and Technologists " Warheads & Ballistics...1027 Microbial-Vac Systems Inc. 627 Military Medical Technology 1115 Modec, Inc...AT&L) TRADOC VCSAFORSCOM INSCOM Medical Dept BD RDE COMMAND AMC RDECs ARL SLAD ATEC AEC DTC OTC HELSTF USAKA/RTS ASA(ALT) PEO STRI PM ITTS IMO TMO

Intelligence and Electronic Warfare (IEW) Streamlining Project. Volume 2. Directives and Related Study Documents. Revision

DTIC Science & Technology

1992-11-18

CDR INSCOM FT BELVOIR VA//IACG/IALOfa// INfO Nd DA WASH DC// DAHO -FDZ/DALO-SNIC/DANI-PI// CDR AMC ALEXANDRIA VA//AIICLG/AHCLG-SID// CDR CECON FT...Nondevelopmental Items (COTS/NDI) communications for more than 22 years. The explosion of technology has provided new capabilities and has challenged the

United States Air Force Analysis Extract AFSC 2A6X4 Aircraft Fuel Systems (Active Duty)

DTIC Science & Technology

2001-02-01

8217AFOMS (AETC) Randolph AFB TX’ V0226 Spec tools/equip use/oper - Rollers or Stitchers ACTIVE...8217AFOMS (AETC) Randolph AFB TX’ V0226 Spec tools/equip use/oper - Rollers or Stitchers ...equip use/oper - Rollers or Stitchers USAFE AETC PACAF AFSOC ACC AMC AFMC

75 FR 31465 - United States, State of Illinois, State of Colorado, and State of Indiana

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-03

..., and often offer full-service restaurants or in-service dining. Premiere theatres also differ from... selection is deemed not to be a suitable alternative, the United States shall in its sole discretion select... suitable alternative pursuant to Section VI(A). If AMC's selection is deemed not to be a suitable...

Sulfur Mustard Induces Apoptosis in Cultured Normal Human Airway Epithelial Cells: Evidence of a Dominant Caspase-8-Mediated Pathway and Differential Cellular Responses

DTIC Science & Technology

2008-01-01

proteases that cleave their substrates after aspartic acid residues (cysteine aspartase). Thus, in these assays, free fluorescent AMC, generated as a...for her technical assistance and also thank Drs. Alan Brimfield and Clarence A. Broomfield of the US Army Medical Research Institute of Chemical

Pollution Abatement and Prevention Analysis (PAPA) Study.

DTIC Science & Technology

1994-07-01

of information. Including suggestions for reducing this burden, to Washington Headquarters Services , Directorate for information Operations and Reports...areas include solid and hazardous waste management, wastewater discharge, noise abatement, endangered species, wetlands, air quality attainment, and...support this study. The Environmental Quality Office of HQ AMC provided policy and program guidance while the sites provided the specific pollution

Associations between disc space narrowing, anterior osteophytes and disability in chronic mechanical low back pain: a cross sectional study.

PubMed

Perera, Romain Shanil; Dissanayake, Poruwalage Harsha; Senarath, Upul; Wijayaratne, Lalith Sirimevan; Karunanayake, Aranjan Lional; Dissanayake, Vajira Harshadeva Weerabaddana

2017-05-15

Radiographic features of lumbar disc degeneration (LDD) are common findings in patients with chronic mechanical low back pain; however, its role in disability and intensity of pain is debatable. This study aims to investigate the associations of the x-ray features of LDD and lumbar spondylolisthesis with severity of disability and intensity of pain. A cross-sectional study was conducted on 439 patients with chronic mechanical low back pain who attended the rheumatology clinic, National Hospital of Sri Lanka, Colombo, from May 2012 to May 2014. Severity of disability was measured using Modified Oswestry Disability Index and intensity of pain was assessed using numeric rating scale (0-100). X-ray features of LDD (disc space narrowing, anterior osteophytes and overall LDD) and spondylolisthesis were assessed in lateral recumbent lumbar x-rays (L1/L2 to L5/S1) and graded by a consultant radiologist blinded to clinical data. Generalised linear model with linear response was used to assess the associations of x-ray features of LDD with severity of disability and intensity of pain adjusting for age, gender, body mass index and pain radiating into legs. Mean age was 48.99 ± 11.21 and 323 (73.58%) were females. 87 (19.82%) were obese. Mean severity of disability was 30.95 ± 13.67 and mean intensity of pain was 45.50 ± 20.37. 69 (15.72%), 26 (5.92%) and 85 (19.36%) patients had grade 2 disc space narrowing, anterior osteophytes and overall LDD, respectively. 51 (11.62%) patients had lumbar spondylolisthesis. Grade of disc space narrowing and overall LDD were not associated with severity of disability or intensity of pain. The presence of lumbar spondylolisthesis was associated with severity of disability. Female gender and pain radiating into legs were associated with severity of disability and intensity of pain. Advancing age was associated with x-ray features of LDD and lumbar spondylolisthesis. Lumbar spondylolisthesis is associated with severity of disability in patients with chronic mechanical low back pain. Associations of x-ray features of LDD with severity of disability and intensity of pain are inconclusive. Female gender and pain radiating into legs are significant confounders.

Characterization of labile organic carbon in coastal wetland soils of the Mississippi River deltaic plain: relationships to carbon functionalities.

PubMed

Dodla, Syam K; Wang, Jim J; Delaune, Ronald D

2012-10-01

Adequate characterization of labile organic carbon (LOC) is essential to the understanding of C cycling in soil. There has been very little evaluation about the nature of LOC characterizations in coastal wetlands, where soils are constantly influenced by different redox fluctuations and salt water intrusions. In this study, we characterized and compared LOC fractions in coastal wetland soils of the Mississippi River deltaic plain using four different methods including 1) aerobically mineralizable C (AMC), 2) cold water extractable C (CWEC), 3) hot water extractable C (HWEC), and 4) salt extractable C (SEC), as well as acid hydrolysable C (AHC) which includes both labile and slowly degradable organic C. Molecular organic C functional groups of these wetland soils were characterized by (13)C solid-state nuclear magnetic resonance (NMR). The LOC and AHC increased with soil organic C (SOC) regardless of wetland soil type. The LOC estimates by four different methods were positively and significantly linearly related to each other (R(2)=0.62-0.84) and with AHC (R(2)=0.47-0.71). The various LOC fractions accounted for ≤4.3% of SOC whereas AHC fraction represented 16-49% of SOC. AMC was influenced positively by O/N-alkyl and carboxyl C but negatively by alkyl C, whereas CWEC and SEC fractions were influenced only positively by carboxyl C but negatively by alkyl C in SOC. On the other hand, HWEC fraction was found to be only influenced positively by carbonyl C, and AHC positively by O/N-alkyl and alkyl C but negatively by aromatic C groups in SOC. Overall these relations suggested different contributions of various molecular organic C moieties to LOC in these wetlands from those often found for upland soils. The presence of more than 50% non-acid hydrolysable C suggested the dominance of relatively stable SOC pool that would be sequestered in these Mississippi River deltaic plain coastal wetland soils. The results have important implications to the understanding of the liability and refractory character of SOC in these wetlands as recent studies suggest marsh SOC to be an important C source in fueling hypoxia in the northern Gulf of Mexico. Copyright © 2012 Elsevier B.V. All rights reserved.

Impact of a film portrayal of a police officer with spinal cord injury on attitudes towards disability: a media effects experiment.

PubMed

Reinhardt, Jan D; Pennycott, Andrew; Fellinghauer, Bernd A G

2014-01-01

The portrayal of disabled people in the media can influence the public's perception of disability in both positive and negative ways. In this article, an experimental before and after design is used to determine the effects of a short film on the attitudes of non-disabled and disabled persons concerning employment and productivity of persons with disabilities. Three questions were posed to 480 study participants prior to and following a short film featuring a police officer with paraplegia. Linear mixed models were used to assess the effects of time point and disability status on the responses. The non-disabled participants' ratings of eligibility for employment of a paraplegic man and estimates of the employment rate of disabled people were significantly enhanced following the film. Nevertheless, the film had no significant effects on the ratings given by participants with disabilities in terms of eligibility, employment rate or productivity. This investigation highlights the potentially important influence of media portrayal and coverage of people with disabilities on attitudes of the public concerning disability. Restrictions in participation may result from an interaction of persons with impairments with an environment that is dominated by negative attitudes towards disability The portrayal of disabled people in the media can influence the public's attitudes towards disability in both positive and negative ways In this experimental study, attitudes of the general public were significantly improved following viewing a short film featuring a positive media portrayal of a police officer with paraplegia.

Behavior Correlates of Post-Stroke Disability Using Data Mining and Infographics.

PubMed

Yoon, Sunmoo; Gutierrez, Jose

Disability is a potential risk for stroke survivors. This study aims to identify disability risk factors associated with stroke and their relative importance and relationships from a national behavioral risk factor dataset. Data of post-stroke individuals in the U.S (n=19,603) including 397 variables were extracted from a publically available national dataset and analyzed. Data mining algorithms including C4.5 and linear regression with M5s methods were applied to build association models for post-stroke disability using Weka software. The relative importance and relationship of 70 variables associated with disability were presented in infographics for clinicians to understand easily. Fifty-five percent of post-stroke patients experience disability. Exercise, employment and satisfaction of life were relatively important factors associated with disability among stroke patients. Modifiable behavior factors strongly associated with disability include exercise (OR: 0.46, P<0.01) and good rest (OR 0.37, P<0.01). Data mining is promising to discover factors associated with post-stroke disability from a large population dataset. The findings can be potentially valuable for establishing the priorities for clinicians and researchers and for stroke patient education. The methods may generalize to other health conditions.

Awareness of driving disability in people with stroke tested in a simulator.

PubMed

Patomella, Ann-Helen; Kottorp, Anders; Tham, Kerstin

2008-09-01

The aim of this study was to explore and describe awareness of driving disability in people with driving difficulties after stroke. The study comprised a consecutive sample of 38 participants with stroke who showed difficulties in a technically advanced, interactive driving simulator. Driving ability in the simulator was measured using Performance Analysis of Driving Ability (P-Drive). Awareness of driving disability was measured using a modified version of Assessment of Awareness of Disability (AAD), measuring the discrepancy between observed driving actions and self-reported disability after a driving evaluation in a simulator. A majority of the participants (n = 36) demonstrated driving ability that was below the cut-off criterion for P-Drive. Furthermore, a majority of the items measuring awareness of driving disability were scored low, indicating that participants with stroke who did not pass a driving evaluation also had limited awareness of driving disability. A General Linear Model analysis indicated that awareness of driving disability and cognitive screening outcome explained 74% of the variance in driving ability. This study indicated that a majority of the people with stroke who fail a driving evaluation also have limited awareness of their disability, which indicates the need to address awareness in driving evaluations.

Behavior Correlates of Post-Stroke Disability Using Data Mining and Infographics

PubMed Central

Yoon, Sunmoo; Gutierrez, Jose

2015-01-01

Purpose Disability is a potential risk for stroke survivors. This study aims to identify disability risk factors associated with stroke and their relative importance and relationships from a national behavioral risk factor dataset. Methods Data of post-stroke individuals in the U.S (n=19,603) including 397 variables were extracted from a publically available national dataset and analyzed. Data mining algorithms including C4.5 and linear regression with M5s methods were applied to build association models for post-stroke disability using Weka software. The relative importance and relationship of 70 variables associated with disability were presented in infographics for clinicians to understand easily. Results Fifty-five percent of post-stroke patients experience disability. Exercise, employment and satisfaction of life were relatively important factors associated with disability among stroke patients. Modifiable behavior factors strongly associated with disability include exercise (OR: 0.46, P<0.01) and good rest (OR 0.37, P<0.01). Conclusions Data mining is promising to discover factors associated with post-stroke disability from a large population dataset. The findings can be potentially valuable for establishing the priorities for clinicians and researchers and for stroke patient education. The methods may generalize to other health conditions. PMID:26835413

Advanced Vehicle Power Technology Alliance Technical Workshop and Operations Report

DTIC Science & Technology

2011-10-05

Vehicle Exhaust TEG 2016 1 TEG: Thermo-Electric Generator UNCLASSIFIED: Distribution Statement A. Approved for public release. E16...Equipment 2016 Validation Data: − Power Electronics ― 2020 ― ― UNCLASSIFIED: Distribution Statement A. Approved for public release...Materiel Command (AMC) UNCLASSIFIED: Distribution Statement A. Approved for Public Release Report Documentation Page Form ApprovedOMB No. 0704-0188

Health Care Utilization and Expenditures for Children with Autism: Data from U.S. National Samples

ERIC Educational Resources Information Center

Liptak, Gregory S.; Stuart, Tami; Auinger, Peggy

2006-01-01

Little is known about the use of medical services by children who have autism (ASD). Provide nationally representative data for health service utilization and expenditures of children with ASD. Cross-sectional survey using the Medical Expenditure Panel (MEPS), and National (Hospital) Ambulatory Medical Care Surveys (N(H)AMCS). A total of 80…

HD Diesel Hybrid Truck Powertrain Study

DTIC Science & Technology

2012-09-11

Z39-18 Command Chain ij Army Materiel Command (AMC) - Huntsville, AL :""V-..... Research, Development & Engineering Command (RDECOM) -Aberdeen, MD...WARFIGHTER FOCUSED. Unclassified Li-lon I Ultracap Hybrid Energy Storage Microgrids Radiators Power Controllers for Power Management JP-8 Fuel...hybrid electric vehicle ( Honda Insight) entered this market in 1999 while the first commercial diesel-electric hybrid truck was produced by Navistar in

Terahertz Magnetic Mirror Realized with Dielectric Resonator Antennas.

PubMed

Headland, Daniel; Nirantar, Shruti; Withayachumnankul, Withawat; Gutruf, Philipp; Abbott, Derek; Bhaskaran, Madhu; Fumeaux, Christophe; Sriram, Sharath

2015-11-25

Single-crystal silicon is bonded to a metal-coated substrate and etched in order to form an array of microcylinder passive terahertz dielectric resonator antennas (DRAs). The DRAs exhibit a magnetic response, and hence the array behaves as an efficient artificial magnetic conductor (AMC), with potential for terahertz antenna and sensing applications. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Methodology Investigation of AI(Artificial Intelligence) Test Officer Support Tool. Volume 1

DTIC Science & Technology

1989-03-01

American Association for Artificial inteligence A! ............. Artificial inteliigence AMC ............ Unt:ed States Army Maeriel Comand ASL...block number) FIELD GROUP SUB-GROUP Artificial Intelligence, Expert Systems Automated Aids to Testing 9. ABSTRACT (Continue on reverse if necessary and...identify by block number) This report covers the application of Artificial Intelligence-Techniques to the problem of creating automated tools to

Computing Visible-Surface Representations,

DTIC Science & Technology

1985-03-01

Terzopoulos N00014-75-C-0643 9. PERFORMING ORGANIZATION NAME AMC ADDRESS 10. PROGRAM ELEMENT. PROJECT, TASK Artificial Inteligence Laboratory AREA A...Massachusetts Institute of lechnolog,. Support lbr the laboratory’s Artificial Intelligence research is provided in part by the Advanced Rtccarcl Proj...dynamically maintaining visible surface representations. Whether the intention is to model human vision or to design competent artificial vision systems

A Study to Identify the Characteristics of the Beneficiaries Residing Within the Catchment Area of Keller AMC

DTIC Science & Technology

1992-06-01

10562 45 Ossining 10566 72 Peekskill 10570 8 Pleasantville 10573 43 Port Chester 10576 6 Pound Ridge 10578 5 Purdys 10579 10 Putnum Vly 10580 31 Rye...10562 30 Ossining 10566 68 Peekskill 10570 17 Pleasantville 10573 39 Port Chester 10576 7 Pound Ridge 10577 2 Purchase 10578 6 Purdys 10579 11 Putnam

Challenging the Future - Journey to Excellence. Aeropropulsion strategic plan for the 1990's

NASA Astrophysics Data System (ADS)

Over the past several months, the Lewis Aeropropulsion Management Council (AMC) has conducted a critical assessment of its strategic plan. This assessment clearly indicated a need for change, both in the aeropropulsion program emphasis and in the approach to carrying out that program. Customers sent a strong message that the program must improve the timeliness of research and technology products and services and must work more closely with them to develop and transfer new technology. The strategic plan defines AMC's vision for the future and underlying organizational values. It contains a set of broad strategies and actions that point the way toward achieving the goals of customer satisfaction, organizational effectiveness, and programmatic excellence. Those strategies are expected to form the basis for the development of specific tactical plans by Lewis aeropropulsion thrust teams, divisions, and branches. To guide tactical planning of the aeropropulsion program, this strategic plan outlines the agency's strategic directions and long-range aeronautics goals, the aeropropulsion goals and key objectives for achieving them, projections of Lewis aeropropulsion budgets, planned allocations of resources, and the processes that will be used to measure success in carrying out the strategic plan.

Analysis of Historical Trends and Recent Elimination of Malaria from Sri Lanka and Its Applicability for Malaria Control in Other Countries

PubMed Central

Wijesundere, Dilkushi Anula; Ramasamy, Ranjan

2017-01-01

Sri Lanka is a tropical island located South of India in the Indian Ocean. Malaria has been prevalent in the island for centuries but the country succeeded in eliminating the disease in 2013. Factors governing the past endemicity of malaria and its successful elimination from Sri Lanka in 2013 are analyzed. There is evidence that malaria might have been first introduced in the thirteenth century into a dry zone area with extensive irrigation works. Regular widespread epidemics of the disease have been documented in the twentieth century. The island nature of Sri Lanka, generally low transmission rates, widespread and accessible government hospitals and clinics that provide free and readily available diagnosis and treatment for malaria, adequate financial support and commitment to the Antimalaria Campaign (AMC), national and decentralized malaria control efforts sustained over a long period by dedicated and competent AMC staff, and the absence of zoonotic malaria are recognized as key factors responsible for eliminating malaria from Sri Lanka. These factors are analyzed in the context of their relevance to the present malaria elimination efforts in other countries with the overall aim of globally eradicating the disease. PMID:28894732

Analysis of Historical Trends and Recent Elimination of Malaria from Sri Lanka and Its Applicability for Malaria Control in Other Countries.

PubMed

Wijesundere, Dilkushi Anula; Ramasamy, Ranjan

2017-01-01

Sri Lanka is a tropical island located South of India in the Indian Ocean. Malaria has been prevalent in the island for centuries but the country succeeded in eliminating the disease in 2013. Factors governing the past endemicity of malaria and its successful elimination from Sri Lanka in 2013 are analyzed. There is evidence that malaria might have been first introduced in the thirteenth century into a dry zone area with extensive irrigation works. Regular widespread epidemics of the disease have been documented in the twentieth century. The island nature of Sri Lanka, generally low transmission rates, widespread and accessible government hospitals and clinics that provide free and readily available diagnosis and treatment for malaria, adequate financial support and commitment to the Antimalaria Campaign (AMC), national and decentralized malaria control efforts sustained over a long period by dedicated and competent AMC staff, and the absence of zoonotic malaria are recognized as key factors responsible for eliminating malaria from Sri Lanka. These factors are analyzed in the context of their relevance to the present malaria elimination efforts in other countries with the overall aim of globally eradicating the disease.

A comparison of two infiltration models applied to simulation of overland flow over a two-dimensional flume.

PubMed

Mallari, K J B; Kim, H; Pak, G; Aksoy, H; Yoon, J

2015-01-01

At the hillslope scale, where the rill-interrill configuration plays a significant role, infiltration is one of the major hydrologic processes affecting the generation of overland flow. As such, it is important to achieve a good understanding and accurate modelling of this process. Horton's infiltration has been widely used in many hydrologic models, though it has been occasionally found limited in handling adequately the antecedent moisture conditions (AMC) of soil. Holtan's model, conversely, is thought to be able to provide better estimation of infiltration rates as it can directly account for initial soil water content in its formulation. In this study, the Holtan model is coupled to an existing overland flow model, originally using Horton's model to account for infiltration, in an attempt to improve the prediction of runoff. For calibration and validation, experimental data from a two-dimensional flume which is incorporated with hillslope configuration have been used. Calibration and validation results showed that Holtan's model was able to improve the modelling results with better performance statistics than the Horton-coupled model. Holtan's infiltration equation, which allows accounting for AMC, provided an advantage and resulted in better runoff prediction of the model.

Challenging the Future - Journey to Excellence. Aeropropulsion strategic plan for the 1990's

NASA Technical Reports Server (NTRS)

1990-01-01

Over the past several months, the Lewis Aeropropulsion Management Council (AMC) has conducted a critical assessment of its strategic plan. This assessment clearly indicated a need for change, both in the aeropropulsion program emphasis and in the approach to carrying out that program. Customers sent a strong message that the program must improve the timeliness of research and technology products and services and must work more closely with them to develop and transfer new technology. The strategic plan defines AMC's vision for the future and underlying organizational values. It contains a set of broad strategies and actions that point the way toward achieving the goals of customer satisfaction, organizational effectiveness, and programmatic excellence. Those strategies are expected to form the basis for the development of specific tactical plans by Lewis aeropropulsion thrust teams, divisions, and branches. To guide tactical planning of the aeropropulsion program, this strategic plan outlines the agency's strategic directions and long-range aeronautics goals, the aeropropulsion goals and key objectives for achieving them, projections of Lewis aeropropulsion budgets, planned allocations of resources, and the processes that will be used to measure success in carrying out the strategic plan.

Factors associated with persons with disability employment in India: a cross-sectional study.

PubMed

Naraharisetti, Ramya; Castro, Marcia C

2016-10-07

Over twenty million persons with disability in India are increasingly being offered poverty alleviation strategies, including employment programs. This study employs a spatial analytic approach to identify correlates of employment among persons with disability in India, considering sight, speech, hearing, movement, and mental disabilities. Based on 2001 Census data, this study utilizes linear regression and spatial autoregressive models to identify factors associated with the proportion employed among persons with disability at the district level. Models stratified by rural and urban areas were also considered. Spatial autoregressive models revealed that different factors contribute to employment of persons with disability in rural and urban areas. In rural areas, having mental disability decreased the likelihood of employment, while being female and having movement, or sight impairment (compared to other disabilities) increased the likelihood of employment. In urban areas, being female and illiterate decreased the likelihood of employment but having sight, mental and movement impairment (compared to other disabilities) increased the likelihood of employment. Poverty alleviation programs designed for persons with disability in India should account for differences in employment by disability types and should be spatially targeted. Since persons with disability in rural and urban areas have different factors contributing to their employment, it is vital that government and service-planning organizations account for these differences when creating programs aimed at livelihood development.

Aspects of constitutive and acquired antibioresistance in Aeromonas hydrophila strains isolated from water sources.

PubMed

Balotescu, Carmen; Israil, Anca; Radu, Roxana; Alexandru, Ionela; Dobre, Georgeta

2003-01-01

Over the last three decades, the literature pointed out the implications of Aeromonas species in human pathology. These species were described as being involved in intestinal (several outbreaks of acute gastroenteritis of choleric/dysenteric form or chronic diarrhoea, ulcerative colitis, etc.) in normal adults or children, as well as in extraintestinal infections in immunocompromised hosts. This last aspect included a large range of cutaneous injuries (micronecrosis, abscesses, bums, cellulites, furunculosis), joint, bones, respiratory, urinary tract, ocular infections up to meningitis, endocarditis, peritonitis, hepatobilliary disease, endotoxic shock and septicemia (as consequence of leech microvascular surgery). During the last decade, the literature reported a high mortality in Aeromonas infections determined by certain phenospecies (A. hydrophila and A. veronii) especially in extraintestinal infections in immunocompromised patients. In microbiologists' opinion this high rate of mortality was probably due to poor knowledge concerning the aspects of antibioresistance in Aeromonas strains, to empiric treatments with antibiotics to which these bacteria exhibiting constitutive resistance lead to insuccessful results, and at last to the increasing trend of aeromonads resistance to certain antibiotics after 1996. The literature mentioned also that for a great number of Beta-lactamase producing Aeromonas strains, the use of microdilution method (by comparison to disk diffusion in agar medium) giving false results made more difficult the true knowledge of Aeromonas antibioresistance patterns. At the same time, in 2002, the literature mentioned 4 ecological compartments considered as "reservoirs for dissemination and transfer of microbial antibioresistance i.e. humans, animals, plants and natural soil and water. In the last time, more and more data of the literature revealed that some bacteria with role of reservoir of antibioresistance in the natural environment, even without a direct medical impact, however they could play an indirect one remaining permanent sources of R genes for bacterial strains with pathogenic abilities implicated in human pathology (i.e. Aeromonas infections in man related to different professional activities such as fishing, surfing, swimming, diving, etc.). The purpose of this work was to determine the aspects related to constitutive and acquired antibioresistance in 35 A. hydrophila strains isolated in aquatic environment of Danube Delta (10 salmaster waters, 5 aquatic plants, 5 fish intestinal content, 5 fish sapling, 5 snake and oyster shells). The strains were biochemically identified by using API20E and API20NE kits. The antibioresistance spectrum was determined by disk diffusion method following NCCLS 2000 recommendations. The choice and disposal of antibiotics on the Mueller Hinton plate was done to allow the interpretive reading and the phenotypic detection of different antibioresistance mechanisms, as follows: beta-lactamases (PEN, ME, AMX, AMC, CAZ) and carbapenemase (IMP) production; porin deficiency (FOX); efflux mechanism (C, TE, NOR). All tested strains exhibited high resistance to penicillin, aspect pleading for constitutive penicillinase production in Aeromonas strains. With reference to other penicillins (ME, AMX, AMC) and cephalosporins (CAZ, FOX) the tested strains exhibited 2 different antibioresistance patterns: AMX-R, AMC-S, CAZ-S (65%) indicating the presence of beta-lactamase sensitive to inhibitors and AMX-R, AMC-R, CAZ-S (22%) indicating the presence of beta-lactamase resistant to inhibitors. Resistance to FOX in 8% of strains signifies a phenotypical marker for the presence of porin deficiency. Only one Aeromonas strain (2.8%) was resistant to IMP. Three strains (8%) were simultaneous resistant to TE and TMP/SMX, NOR and CHL probably due to the presence of a resistance plasmid (codifying an efflux/ enzymatic mechanism). These aspects are pleading for the necessity to investigate the bacterial antibioresistance patterns of bacterial strains isolated from the environment, in the purpose to identify the factors responsible for the spreading of certain antibioresistance mechanisms in the external medium as risk factors for the colonization process with possible impact upon the human pathology.

Patient satisfaction, empowerment, and health and disability status effects of a disease management-health promotion nurse intervention among Medicare beneficiaries with disabilities.

PubMed

Friedman, Bruce; Wamsley, Brenda R; Liebel, Dianne V; Saad, Zabedah B; Eggert, Gerald M

2009-12-01

To report the impact on patient and informal caregiver satisfaction, patient empowerment, and health and disability status of a primary care-affiliated disease self-management-health promotion nurse intervention for Medicare beneficiaries with disabilities and recent significant health services use. The Medicare Primary and Consumer-Directed Care Demonstration was a 24-month randomized controlled trial that included a nurse intervention. The present study (N = 766) compares the nurse (n = 382) and control (n = 384) groups. Generalized linear models for repeated measures, linear regression, and ordered logit regression were used. The patients whose activities of daily living (ADL) were reported by the same respondent at baseline and 22 months following baseline had significantly fewer dependencies at 22 months than did the control group (p = .038). This constituted the vast majority of respondents. In addition, patient satisfaction significantly improved for 6 of 7 domains, whereas caregiver satisfaction improved for 2 of 8 domains. However, the intervention had no effect on empowerment, self-rated health, the SF-36 physical and mental health summary scores, and the number of dependencies in instrumental ADL. If confirmed in other studies, this intervention holds the potential to reduce the rate of functional decline and improve satisfaction for Medicare beneficiaries with ADL dependence.

Attitudes Toward Nursing Students With Disabilities: Promoting Social Inclusion.

PubMed

Shpigelman, Carmit-Noa; Zlotnick, Cheryl; Brand, Rachel

2016-08-01

Nursing education programs rarely refer to individuals with disabilities as potential nursing students; more often, the assumption is that they are patients. Thus, this study aimed to capture nursing students' perspectives of social inclusion through examination of their attitudes toward nursing student colleagues with disabilities. Paper-and-pencil structured surveys containing two validated scales were collected from Israeli nursing students (N = 270). Analyses included measuring associations using Pearson's correlation coefficient and general linear regression models. Nursing students held relatively negative attitudes toward colleagues with disabilities, and these negative attitudes were correlated to attitudes toward people with disabilities in general, even after adjusting for noted confounders. Nurse educators and nursing students should be aware of prejudicial attitudes with their respective communities toward nursing student colleagues with disabilities, and they should work toward a better understanding that cultural competence and awareness extends not only to patients but also to one's colleagues. [J Nurs Educ. 2016;55(8):441-449.]. Copyright 2016, SLACK Incorporated.

[Hyperechogenic fetal bowel as a marker of fetal cystic fibrosis].

PubMed

Sukupová, M; Dhaifalah, I; Adamík, Z; Havalová, J

2015-01-01

Hyperechogenic bowel (HB) occurs in 0.1 to 1.8% of normal pregnancies. In most cases it has no consequence for the foetus, but can be associated with cystic fibrosis (CF), chromosomal defects, genetic syndromes, viral infections, gastrointestinal pathology, missed gravidity, IUGR and preterm labour. Assessment the risk of the foetus having CF or other abnormalities when HB was detected during ultrasound screening in the second trimester of pregnancy in our centre. Retrospective study. Department of Obstetrics and Gynecology, Centre of Fetal Medicine and Genetics, KNTB a.s. Zlín. Retrospective analysis of 149 cases of HB between 17 to 22 weeks of pregnancy detected from January 2008 to April 2012. HB was evaluated according to its degree of echogenicity (Slotnik/Abuhamed classification), presence or absence of other ultrasound markers and the result of first trimester combined screening result. When stage II or III HB and/or borderline risk in first trimester screening, and presence of other ultrasound markers was detected, amniocentesis (AMC) was performed to investigate the karyotype, mutations in the CFTR gene and presence of viral infections (cytomegalovirus and parvovirus B19). If stage I or II HB and/or negative I. trimester screening and no other ultrasound markers, viral infections and mutations in the CFTR gene were investigated form maternal blood. If positive, paternal blood sampling testing for mutation in the CFTR gene was performed. If a mutation was detected in both parents, AMC was performed. Mutations of the CFTR gene was investigated with a commercial panel of 33 to 50 most common mutations. Postnatally the outcome of neonatal screening for CF(IRT) and any newborns with congenital malformations were ascertained. HB was seen in 149 foetuses, AMC was performed in 94 (63%), and blood sampling in 55 (37%). Two mutations in the CFTR gene associated with a severe form of CF (deltaF508/3849 KBC +10 T) were found in one foetus from the AMC group with stage III HB. The parents decided to terminate the pregnancy. The incidence of HB in our group was 0.7%. In 4 foetuses (2.7%) with stage II HB heterozygous deltaF508 mutation was found, in the rest no mutations were detected. Parents of heterozygous carriers underwent genetic consultation. Postnatal CF screening (IRT level from a heel prick sample) was negative; therefore no further molecular genetic analysis was performed. Infection was detected in three foetuses; one case was managed with intrauterine transfusion and in the other two cases parents decided for termination. Four cases (2.7%) were terminated because of severe congenital anomalies. Minor congenital abnormalities were detected in seven (4.7%) cases. Intrauterine death was detected in three (2%) pregnancies. Based on our results, HB can be considered as a significant marker for the risk of CF, especially in HB stages II and III. It also demonstrates the importance of this marker for the risk of other foetal abnormalities.

Inequality in Disability in Bangladesh

PubMed Central

Tareque, Md. Ismail; Begum, Sharifa; Saito, Yasuhiko

2014-01-01

Objective To investigate inequality in disability in Bangladesh. Methods The study used both household level and individual level data from a large nationally representative data set, Bangladesh’s Household Income and Expenditure Survey - 2010. Principal component analysis was used to construct a wealth index based on household assets from household level data. Then, using data from 49,809 individuals aged 5 years and over, chi-square tests and logistic regression were performed to test the association between wealth level and disability. Findings Women and older people are significantly more likely to report having disabilities than men and younger people. For middle and rich families, respectively, there is a 14 percent lower likelihood of reporting disabilities than for poor families. Changes in the probability of having disabilities are linear with increasing wealth. In addition, the study identifies some significant factors affecting disability, namely, age, sex, education, marital status, and place of residence including divisional differences. Conclusion In Bangladesh, worse health among the poor argues for policies prioritizing this group while at the same time giving special attention to women and the elderly. PMID:25075513

Screening for disability in the inner city.

PubMed Central

Patrick, D L; Darby, S C; Green, S; Horton, G; Locker, D; Wiggins, R D

1981-01-01

A 10% sample of private households on the electoral register of the London borough of Lambeth was screened for disable persons aged 16 and over, using a postal questionnaire. After three mailings and individual follow-up of non-responders, 87% of the sample households returned questionnaires. Disability was defined in the screening questionnaire as functional limitations or activity restrictions consequent upon disease or impairment. The overall point prevalence of disability was estimated at 15.4% and the most frequently reported impairments were those of the sense organs, bones, central nervous, circulatory, and respiratory systems. Hearing difficulties were the single most frequently reported functional limitation. A log-linear modelling procedure identified age, marital status, and working status as the factors most strongly associated with disability for both men and women. In addition, men aged 50-64 and not working, and men in manual occupations and living alone, were more likely to report disability. These findings indicate that some population groups are disable by functional limitations and activity restrictions not included in office criteria of identification and assessment. These criteria might be broadened, and serves planned for those population groups with higher rates of reported disability. PMID:6455485

Outcome Trends after US Military Concussive Traumatic Brain Injury.

PubMed

Mac Donald, Christine L; Johnson, Ann M; Wierzechowski, Linda; Kassner, Elizabeth; Stewart, Theresa; Nelson, Elliot C; Werner, Nicole J; Adam, Octavian R; Rivet, Dennis J; Flaherty, Stephen F; Oh, John S; Zonies, David; Fang, Raymond; Brody, David L

2017-07-15

Care for US military personnel with combat-related concussive traumatic brain injury (TBI) has substantially changed in recent years, yet trends in clinical outcomes remain largely unknown. Our prospective longitudinal studies of US military personnel with concussive TBI from 2008-2013 at Landstuhl Regional Medical Center in Germany and twp sites in Afghanistan provided an opportunity to assess for changes in outcomes over time and analyze correlates of overall disability. We enrolled 321 active-duty US military personnel who sustained concussive TBI in theater and 254 military controls. We prospectively assessed clinical outcomes 6-12 months later in 199 with concussive TBI and 148 controls. Global disability, neurobehavioral impairment, depression severity, and post-traumatic stress disorder (PTSD) severity were worse in concussive TBI groups in comparison with controls in all cohorts. Global disability primarily reflected a combination of work-related and nonwork-related disability. There was a modest but statistically significant trend toward less PTSD in later cohorts. Specifically, there was a decrease of 5.9 points of 136 possible on the Clinician Administered PTSD Scale (-4.3%) per year (95% confidence interval, 2.8-9.0 points, p = 0.0037 linear regression, p = 0.03 including covariates in generalized linear model). No other significant trends in outcomes were found. Global disability was more common in those with TBI, those evacuated from theater, and those with more severe depression and PTSD. Disability was not significantly related to neuropsychological performance, age, education, self-reported sleep deprivation, injury mechanism, or date of enrollment. Thus, across multiple cohorts of US military personnel with combat-related concussion, 6-12 month outcomes have improved only modestly and are often poor. Future focus on early depression and PTSD after concussive TBI appears warranted. Adverse outcomes are incompletely explained, however, and additional studies with prospective collection of data on acute injury severity and polytrauma, as well as reduced attrition before follow-up will be required to fully address the root causes of persistent disability after wartime injury.

Burden and depression in primary caregivers of persons with visual impairment.

PubMed

Khare, Shubhank; Rohatgi, Jolly; Bhatia, Manjeet Singh; Dhaliwal, Upreet

2016-08-01

Caregivers who assist persons with visual impairment often neglect their needs, resulting in burden and depression. Rehabilitation efforts, directed to the disabled, seldom target the caregiver. To assess burden and depression in persons caring for blind individuals. This was a cross-sectional study carried out in the outpatient department of a tertiary-level teaching hospital in New Delhi. Institutional Ethical Board approval was obtained and written informed consent too was obtained from the participants involved in this study. Persons with best-corrected vision <20/200 in the better eye, and their primary caregivers, were recruited. We recorded demography, other illness/disability, household income, relationship with disabled person, and caregiver burden (Caregiver Burden Scale) and depression (Centre for Epidemiologic Studies Depression Scale). Statistical analysis was carried out using SPSS version 20 (Released 2011. Armonk, NY: IBM Corp.); range, average, and standard deviation were determined for age, burden, and depression. The association between burden and depression was determined using Pearson's correlation; the relationship between degree of disability and caregiver burden and depression was determined using unpaired t-test; using multiple linear regression, factors were found to be statistically significant; significance was taken at P < 0.05. Twenty-seven (53.0%) men and 24 (47.0%) women had visual impairment. Most caregivers (n = 40; 81.6%) were first-degree relatives or a spouse; 32 (65%) had schooling <5 years; and 29 (59%) were unemployed. Depression ranged from 21 to 52 (average 43.2 ± 5.71); it correlated with degree of disability (P = 0.012), household income (r = -0.320; P = 0.025), and burden (r = 0.616; P < 0.001). Burden ranged from 30 to 73 (average 54.5 ± 6.73) and correlated with degree of disability (P = 0.006). On multiple linear regression, burden predicted depression (r = 0.557; P < 0.001). Caregivers merit community support, financial benefit, interventions to diagnose and treat depression, and training in coping. Centers that provide disability certification could offer counseling.

Correlation among scapular asymmetry, neck pain, and neck disability index (NDI) in young women with slight neck pain.

PubMed

Kim, Su-Rim; Kang, Mi-Hee; Bahng, Sun-Young; An, Jin-Kyoung; Lee, Ji-Young; Park, Sang-Young; Kim, Seong-Gil

2016-05-01

[Purpose] This study aimed to investigate the correlations among scapular asymmetry, neck pain, and neck disability index in women in their 20s with slight neck pain. [Subjects and Methods] A total of 60 female students at U university in Gyeongsangbuk-do, South Korea, participated in this study. The lateral scapular slide test, which measures the distance between the thorax and scapula, was used to analyze the scapular asymmetry. The lateral scapular slide test was performed in three positions. The visual analogue scale and neck disability index were used to measure neck pain. [Results] In the lateral scapular slide test in position 3 (shoulder abduction at 90 degrees), the scapular left-right asymmetry and VAS showed a moderate positive linear relationship, with r=0.344. The VAS and NDI showed a moderate positive linear relationship, with r = 0.632. [Conclusion] Scapular asymmetry indicates imbalance of surrounding muscles of the scapula and is related to neck pain based on the results of measuring the distance from the thorax to the scapula.

A method for introduction of Al2O3 nanofiber into aluminum alloy

NASA Astrophysics Data System (ADS)

Chen, Yijin; Qin, He; Kurganova, Y. A.; Gaaze, V. K.

2018-04-01

Experimental samples of aluminum matrix composites (AMCs) reinforced with Al2O3 nanofibers were obtained. In order to increase the wettability in liquid phase combination conditions, it is proposed to use copper powder as a carrier of nanofiber. When studying the structure of the samples, a modifying effect of the introduction of reinforcement, demonstrated by grinding the grain, was revealed.

Effects of Leak Detection/Location on Underground Heat Distribution System (UHDS) Life Cycle Costs: A Probabilistic Model

DTIC Science & Technology

1991-12-01

ADA167556 (USACERL, March 1986). E. Segan and C. Chen ’K. Cooper et a]. 9 spots associated with leaks are detected with either a digital temperature...HSHG.DEX ATTN: NAPEN-FL Walte Road AMC 20307 Norto APB. CA 92409 ATTN: Faciliion Ensgime ATIN: APRC-MX4DB US Ary Roagr Diviaiur AWlN: Libary (13

Drawing The Red Line: Cost Benefit Analysis on Large Life Rafts

DTIC Science & Technology

2013-06-13

Patterson Air Force Base, Ohio DISTRIBUTION STATEMENT A . APPROVED FOR PUBLIC RELEASE; DISTRIBUTION IS UNLIMITED. The...Anderson, BS, MS Major, USAF June 2013 DISTRIBUTION STATEMENT A . APPROVED FOR PUBLIC RELEASE; DISTRIBUTION UNLIMITED. AFIT-ENS-GRP-13-J-1...AMC has set up a Fuel-Efficiency Office (FEO) in order to analyze costs and make decisions that will save money on operational expenses related to

Heat Recovery at Army Materiel Command (AMC) Facilities

DTIC Science & Technology

1988-06-01

industrial complexes and somewhat smaller commercial/ HVAC ** systems, a portion of this waste heat can be recovered, improving energy efficiency. Heat...devices are used in sequence. Other shell-and-tube applications include heat transfer from process liquids, condensates, and cooling water. Two...pipe consists of a sealed element involving an annular capillary wick con- tained inside the full length of the tube, with an appropriate entrained

Determining Mobility Support Advisory Squadron Effectiveness in Support of Building Partner Capacity

DTIC Science & Technology

2012-06-15

Pamela Bennet Bardot, USAF Expeditionary Center Librarian - Extraordinaire for graciously entertaining my numerous requests for information and helping... standardized , realistic set of performance criteria can ensure standardization between the MSAS and give AMC a baseline from which to inspect compliance...continue to mature. They include: • Lacking a universally recognized and utilized lexicon. In reference to working with PNs, common , interchangeably

Defense AT&L. November-December 2010

DTIC Science & Technology

2010-12-01

musician , actor, dancer, or wizard. Whether the hero is a young hopeful or a washed-up has-been, he or she...Acquisition Projects Bryan Felkoski and Rob Malone The Army’s Chemical Materials Agency has developed a successful risk-based scheduling process for...Pillsbury talks about how AMC develops , delivers, and sustains materiel to ensure a dominant joint force for the U.S. and our allies, and how

A new prognostic score for elderly patients with diffuse large B-cell lymphoma treated with R-CHOP: the prognostic role of blood monocyte and lymphocyte counts is absent.

PubMed

Procházka, Vít; Pytlík, Robert; Janíková, Andrea; Belada, David; Sálek, David; Papajík, Tomáš; Campr, Vít; Fürst, Tomáš; Furstova, Jana; Trněný, Marek

2014-01-01

Absolute lymphocyte count (ALC) and absolute monocyte count (AMC) have been documented as independent predictors of survival in patients with newly diagnosed Diffuse Large B-cell Lymphoma (DLBCL). Analysis of the prognostic impact of ALC and AMC in the context of International Prognostic Index (IPI) and other significant variables in elderly population treated in the R-CHOP regime has not been carried out yet. In this retrospective study, a cohort of 443 newly diagnosed DLBCL patients with age ≥ 60 was analyzed. All patients were treated with the R-CHOP therapy. An extensive statistical analysis was performed to identify risk factors of 3-year overall survival (OS). In multivariate analysis, only three predictors proved significant: Eastern Cooperative Oncology Group performance status (ECOG), age and bulky disease presence. These predictors were dichotomized (ECOG ≥ 1, age ≥ 70, bulk ≥ 7.5) to create a novel four-level score. This score predicted 3-year OS of 94.0%, 77.4%, 62.7% and 35.4% in the low-, low-intermediate, high-intermediate and high-risk groups, respectively (P<0.001). Further, a three-level score was tested which stratifies the population better (3-year OS: 91.9%, 67.2%, 36.2% in the low, intermediate and high-risk groups, respectively) but is more difficult to interpret. Both the 3- and 4-level scores were compared to standard scoring systems and, in our population, were shown to be superior in terms of patients risk stratification with respect to 3-year OS prediction. The results were successfully validated on an independent cohort of 162 patients of similar group characteristics. The prognostic role of baseline ALC, AMC or their ratio (LMR) was not confirmed in the multivariate context in elderly population with DLBCL treated with R-CHOP. The newly proposed age-specific index stratifies the elderly population into risk groups more precisely than the conventional IPI and its existing variants.

WE-G-213CD-06: Implementation of Real-Time Tumor Tracking Using Robotic Couch.

PubMed

Buzurovic, I; Yu, Y; Podder, T

2012-06-01

The purpose of this study was to present a novel method for real- time tumor tracking using a commercially available robotic treatment couch, and to evaluate tumor tracking accuracy. Commercially available robotic couches are capable of positioning patients with high level of accuracy; however, currently there is no provision for compensating tumor motion using these systems. Elekta's existing commercial couch (PreciseTM Table) was used without changing its design. To establish the real-time couch motion for tracking, a novel control system was developed and implemented. The tabletop could be moved in horizontal plane (laterally and longitudinally) using two Maxon-24V motors with gearbox combination. Vertical motion was obtained using robust 70V-Rockwell Automation motor. For vertical motor position sensing, we used Model 755A-Accu- Coder encoder. Two Baumer-ITD_01_4mm shaft encoders were used for the lateral and longitudinal motions of the couch. Motors were connected to the Advance Motion Controls (AMC) amplifiers: for the vertical motion, motor AMC-20A20-INV amplifier was used, and two AMC-Z6A8 amplifiers were applied for the lateral and longitudinal couch motions. The Galil DMC-4133 controller was connected to standard PC computer using USB port. The system had two independent power supplies: Galil PSR-12- 24-12A, 24vdc power supply with diodes for controller and 24vdc motors and amplifiers, and Galil-PS300W72 72vdc power supply for vertical motion. Control algorithms were developed for position and velocity adjustment. The system was tested for real-time tracking in the range of 50mm in all 3 directions (superior-inferior, lateral, anterior- posterior). Accuracies were 0.15, 0.20, and 0.18mm, respectively. Repeatability of the desired motion was within ± 0.2mm. Experimental results of couch tracking show feasibility of real-time tumor tracking with high level of accuracy (within sub-millimeter range). This tracking technique potentially offers a simple and effective method to minimize healthy tissues irradiation.Acknowledgement: Study supported by Elekta,Ltd. Study supported by Elekta, Ltd. © 2012 American Association of Physicists in Medicine.

IQ is an independent predictor of glycated haemoglobin level in young and middle-aged adults with intellectual disability.

PubMed

Yano, T; Miki, T; Itoh, T; Ohnishi, H; Asari, M; Chihiro, S; Yamamoto, A; Aotsuka, K; Kawakami, N; Ichikawa, J; Hirota, Y; Miura, T

2015-01-01

Here we examined whether intellectual disability is independently associated with hyperglycaemia. We recruited 233 consecutive young and middle-aged adults with intellectual disability. After exclusion of subjects on medication for metabolic diseases or with severe intellectual disability (IQ < 35), 121 subjects were divided by IQ into a group with moderate intellectual disability (35 ≤ IQ ≤ 50), a mild intellectual disability group (51 ≤ IQ ≤ 70) and a borderline group (IQ > 70). HbA1c level was higher in subjects with moderate intellectual disability (42 ± 9 mmol/mol; 6.0 ± 0.8%) than those in the borderline group (36 ± 4 mmol/mol; 5.5 ± 0.3%) and mild intellectual disability group (37 ± 5 mmol/mol; 5.5 ± 0.5%) groups. HbA1c level was correlated with age, BMI, blood pressure, serum triglycerides and IQ in simple linear regression analysis. Multiple regression analysis indicated that IQ, age, BMI and diastolic blood pressure were independent explanatory factors of HbA1c level. An unfavourable effect of intellectual disability on lifestyle and untoward effect of hyperglycaemia on cognitive function may underlie the association of low IQ with hyperglycaemia. © 2014 The Authors. Diabetic Medicine © 2014 Diabetes UK.

[Psychiatric Rehabilitation - From the Linear Continuum Approach Towards Supported Inclusion].

PubMed

Richter, Dirk; Hertig, Res; Hoffmann, Holger

2016-11-01

Background: For many decades, psychiatric rehabilitation in the German-speaking countries is following a conventional linear continuum approach. Methods: Recent developments in important fields related to psychiatric rehabilitation (UN Convention on the Rights of People with Disabilities, theory of rehabilitation, empirical research) are reviewed. Results: Common to all developments in the reviewed fields are the principles of choice, autonomy and social inclusion. These principles contradict the conventional linear continuum approach. Conclusions: The linear continuum approach of psychiatric rehabilitation should be replaced by the "supported inclusion"-approach. © Georg Thieme Verlag KG Stuttgart · New York.

Does social support modify the effect of disability acquisition on mental health? A longitudinal study of Australian adults.

PubMed

Aitken, Zoe; Krnjacki, Lauren; Kavanagh, Anne Marie; LaMontagne, Anthony Daniel; Milner, Allison

2017-10-01

Disability acquisition in adulthood is associated with deterioration in mental health. Social support may act as a "buffer" against poor mental health following disability acquisition. We tested the hypothesis that women and men with low social support experienced larger declines in mental health on acquisition of a disability compared to women and men with high social support. We assessed whether social support, measured both prior and subsequent to disability acquisition, modified the association between disability acquisition and mental health using 14 annual waves of data from the Household, Income and Labour Dynamics in Australia Survey. Participants reported at least two consecutive waves of disability preceded by at least two consecutive waves without disability (2200 participants, 15,724 observations). Fixed-effects linear regression models were used to estimate average differences in mental health between waves with and without disability, for women and men separately. We tested for effect measure modification of the association by social support, including a three-way interaction between disability and social support prior and subsequent to disability acquisition. Though the effects of disability acquisition on mental health were much larger for women, for both women and men there was a consistent pattern of association with social support. There was evidence that social support modified the association between disability acquisition and mental health, with the largest effects for those experiencing a change from high to low social support subsequent to disability and for people with consistently low social support. These findings highlight the importance of developing new policy and practice strategies to improve the mental health of people with disabilities, including interventions to promote social support at the time of disability acquisition.

The association between biopsychosocial factors and disability in a national health survey in South Africa.

PubMed

Naidoo, P; Sewpaul, R; Nyembezi, A; Reddy, P; Louw, K; Desai, R; Stein, D J

2018-07-01

The association between psychosocial factors and disability is less clear. This study investigated the biological and psychosocial (employment and psychological distress) factors associated with level of disability in an adult sample in South Africa. Data were analysed from a cross-sectional survey among adults aged 18-64 (n = 4974). Multiple linear regression was used to investigate the associations of the selected variables with disability. The mean percentage score on the WHODAS scale of disability was 5.31% (95% CI: 4.74-5.88). Age (p < 0.001) and race (p = 0.0002) were significantly associated with disability, and history of stroke (β = 7.19, 95% CI: 3.19-11.20) and heart-related conditions (β = 2.08, 95% CI: [0.23-3.93) showed positive associations. Of the psychosocial variables, psychological distress (β = 10.49 [8.63-12.35]) showed a strong positive association while employment (-1.62 [-2.36 to -0.88]) showed a negative association with disability. The association between demographic factors, medical conditions and increased disability confirms the findings in the literature. The finding that psychological distress is associated with increased disability has not been frequently reported. This study highlights specific psychosocial targets that may be usefully addressed by health policies and interventions in order to improve disability management.

Earnings and Financial Compensation from Social Security Systems Correlate Strongly with Disability for Multiple Sclerosis Patients.

PubMed

Kavaliunas, Andrius; Wiberg, Michael; Tinghög, Petter; Glaser, Anna; Gyllensten, Hanna; Alexanderson, Kristina; Hillert, Jan

2015-01-01

Multiple sclerosis (MS) patients earn lower incomes and receive higher benefits. However, there is limited knowledge of how this is correlated with their disability. To elucidate sources and levels of income among MS patients with different disability, assessed with the Expanded Disability Status Scale. A total of 7929 MS patients aged 21-64 years and living in Sweden in 2010 were identified for this cross-sectional study. Descriptive statistics, logistic and truncated linear regression models were used to estimate differences between MS patients regarding earnings, disability pension, sickness absence, disability allowance, unemployment compensation, and social assistance. The average level of earnings was ten times lower and the average level of health- related benefits was four times higher when comparing MS patients with severe and mild disability. MS patients with severe disability had on average SEK 166,931 less annual income from earnings and SEK 54,534 more income from benefits compared to those with mild disability. The combined average income for MS patients was 35% lower when comparing patients in the same groups. The adjusted risk ratio for having earnings among MS patients with severe disability compared to the patients with mild disability was 0.33 (95% CI 0.29-0.39), while the risk ratio for having benefits was 1.93 (95% CI 1.90-1.94). Disease progression affects the financial situation of MS patients considerably. Correlations between higher disability and patient income were observed, suggesting that earnings and benefits could be used as measures of MS progression and proxies of disability.

Mental Health Following Acquisition of Disability in Adulthood--The Impact of Wealth.

PubMed

Kavanagh, Anne Marie; Aitken, Zoe; Krnjacki, Lauren; LaMontagne, Anthony Daniel; Bentley, Rebecca; Milner, Allison

2015-01-01

Acquisition of a disability in adulthood has been associated with a reduction in mental health. We tested the hypothesis that low wealth prior to disability acquisition is associated with a greater deterioration in mental health than for people with high wealth. We assess whether level of wealth prior to disability acquisition modifies this association using 12 waves of data (2001-2012) from the Household, Income and Labour Dynamics in Australia survey--a population-based cohort study of working-age Australians. Eligible participants reported at least two consecutive waves of disability preceded by at least two consecutive waves without disability (1977 participants, 13,518 observations). Fixed-effects linear regression was conducted with a product term between wealth prior to disability (in tertiles) and disability acquisition with the mental health component score of the SF-36 as the outcome. In models adjusted for time-varying confounders, there was evidence of negative effect measure modification by prior wealth of the association between disability acquisition and mental health (interaction term for lowest wealth tertile: -2.2 points, 95% CI -3.1 points, -1.2, p<0.001); low wealth was associated with a greater decline in mental health following disability acquisition (-3.3 points, 95% CI -4.0, -2.5) than high wealth (-1.1 points, 95% CI -1.7, -0.5). The findings suggest that low wealth prior to disability acquisition in adulthood results in a greater deterioration in mental health than among those with high wealth.

Mental Health Following Acquisition of Disability in Adulthood—The Impact of Wealth

PubMed Central

Kavanagh, Anne Marie; Aitken, Zoe; Krnjacki, Lauren; LaMontagne, Anthony Daniel; Bentley, Rebecca; Milner, Allison

2015-01-01

Background Acquisition of a disability in adulthood has been associated with a reduction in mental health. We tested the hypothesis that low wealth prior to disability acquisition is associated with a greater deterioration in mental health than for people with high wealth. Methods We assess whether level of wealth prior to disability acquisition modifies this association using 12 waves of data (2001–2012) from the Household, Income and Labour Dynamics in Australia survey–a population-based cohort study of working-age Australians. Eligible participants reported at least two consecutive waves of disability preceded by at least two consecutive waves without disability (1977 participants, 13,518 observations). Fixed-effects linear regression was conducted with a product term between wealth prior to disability (in tertiles) and disability acquisition with the mental health component score of the SF–36 as the outcome. Results In models adjusted for time-varying confounders, there was evidence of negative effect measure modification by prior wealth of the association between disability acquisition and mental health (interaction term for lowest wealth tertile: -2.2 points, 95% CI -3.1 points, -1.2, p<0.001); low wealth was associated with a greater decline in mental health following disability acquisition (-3.3 points, 95% CI -4.0, -2.5) than high wealth (-1.1 points, 95% CI -1.7, -0.5). Conclusion The findings suggest that low wealth prior to disability acquisition in adulthood results in a greater deterioration in mental health than among those with high wealth. PMID:26444990

Consolidating AMC’s Contingency Response Capabilities: A Delphi Study

DTIC Science & Technology

2015-06-19

Africa in support of Operation UNITED ASSISTANCE, the international response to contain the Ebola epidemic (US Transportation Command, 2014). Though JTF...DO, 2015). The deployment of the 817 CRG to Liberia also underutilized its full capacity as only 79 Airmen and 10 Soldiers of the 140-member JTF-PO...pdf 89 Gonzalez, G. S. (2014, November 13). JTF-PO Leaves Liberia . Retrieved from US Air Force Expeditionary Center: http

Consolidation of Fe-N Magnets Using Equal Channel Angular Extrusion

DTIC Science & Technology

2016-03-23

Consolidation of Fe-N Magnets Using Equal Channel Angular Extrusion SG Sankar Advanced Materials Corporation (AMC), Pittsburgh, PA LJ Kecskes Weapons and...at the US Army Research Laboratory (ARL), Weapons and Materials Research Directorate, at Aberdeen Proving Ground, Maryland. Unlike conventional...Widenmeyer M, Hansen TC, Niewa R. Formation and decomposition of metastable α’’-Fe16N2 from in-situ powder neutron diffraction and thermal analysis. Zeit

Implementing Electronic Data Interchange to Provide In-Transit Visibility

DTIC Science & Technology

2000-06-01

As a source system for GTN, DTTS-E will interface with GTN to provide satellite-tracking data from the QualComm Regional Dispatch/Monitor Station...DTTS-E data (subject to data quality constraints and the extent of the QualComm Satellite Tracking application) provides the location of organic...vehicle assets equipped with the European QualComm Satellite Tracking transponders. GATES = Global Air Transportation Execution System (AMC) A

Cost Per Flying Hour Analysis of the C-141

DTIC Science & Technology

1997-09-01

Government Printing Office, 1996. Horngren , Charles T. Cost Accounting : A Managerial Emphasis (Eighth Edition). New Jersey: Prentice Hall, 1994. Hough...standard accounting techniques. This analysis of AMC’s current costs and their applicability to the price charged to the customer shall be the focus of... Horngren et al.,1994:864). There are three generally recognized methods of determining a transfer price (Arnstein and Gilabert, 1980:189). Cost based

Forecasting Demand for KC-135 Sorties: Deploy to Dwell Impacts

DTIC Science & Technology

2013-06-01

fighter movements from individual units are rampant (6 OSS/ OSOS , 2013). However, TACC directed missions in this category are scarce, if not non...existent (6 OSS/ OSOS , 2013). Recent TACC tasked missions that appear to support CONUS fighter movements were training related: pre-deployment preparation...and large scale exercises directed by the Joint Staff (6 OSS/ OSOS , 2013). Anecdotal evidence that AMC supports CONUS fighter movements was flawed

Sourcing and Global Distribution of Medical Supplies

DTIC Science & Technology

2014-01-01

dots in this figure represent OCONUS MTFs and the yellow star icons indicate locations of the OCONUS theater lead agents for medical materiel (TLAMMs... Symbol Definition AFMOA Air Force Medical Operations Agency AMC Air Mobility Command APS Army prepositioned stock Cat A Category A CJCS chairman of...provide medical materiel to military units. DLA has enacted PV and other contracts to support all military units that make it possible for units around

VHF-FM Portion of the Single Channel Ground and Airborne Radio Subsystem Concept Formulation Package. Appendix 4. Cost and Operational Effectiveness Analysis

DTIC Science & Technology

1975-10-01

VINSON, JR. ^ Major General, GS Deputy Chief of Staff for Combat Developments CF: w incl HQDA ( DAHO -SGTF) - 15 HQDA (DAMO-RQC) - 1 HQDA (DAMO...TC) - 1 HQDA (DAMO-ZD) - 1 HQDA ( DAhO -FI) - 1 HQDA (DALO) - 1 HQDA (DAMA-CS) - 1 HQDA (DACA) - 1 HQDA (DAPE) - 1 HQDA (DUSA(OR)) - 1 Cdr AMC

Aviation System Safety Risk Management Tool Analysis. Volume 2: Appendices

DTIC Science & Technology

1993-10-01

Part Number FY AMC Case Number BATERY BB433AA 81 E 810421201 E’ BATTERY BB433AA 81 E 810421181 [’ BATTERY BB433AA 81 E 810514141 [’ BATIERY BB433AA 81...830520061 [- BAT=ERY NOT REC 83 E 830514071 -l BATTERY NOT REC 82 E 811102131 El BATERY NOT REC 82 E 820715191 " BATTERY NOT REC 82 E 820902051 "- BATERY NOT

Are Pilots Graduating SUPT Today Meeting AMC’s Current and Future Needs

DTIC Science & Technology

2012-02-05

expect. The future operating environment is expected to be characterized by uncertainty , complexity, rapid change and persistent conflict. As...Procedures  Navigation: Visual, VFR, and IFR  Situational Awareness  Task Management  Three-Dimensional Maneuvering Two methods are used...operations under Instrument or VFR to include day / night IFR operations in the terminal and enroute environment. c. The conduct of mission in a

75 FR 6397 - AMC USA, Inc. v. International First Service S.A. a/k/a IFS S.A, its Agents, Affiliated, Related...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-09

.../k/a IFS S.A, its Agents, Affiliated, Related and Partner Companies, and International First Service Argentina a/k/a AR-IFS, its Agents, Affiliated, Related and Partner Companies, and International First Service USA, Inc. a/k/a IFS USA, Inc. d/b/a Global Wine Logistics USA Inc. a/k/a GWL USA, Inc., and Global...

The Potential for Additional Channel Airlift in a Low Cargo Demand Theater

DTIC Science & Technology

2014-06-13

benefit of providing additional channel airlift in the AFRICOM Theater. Assumptions/Limitations The research problem has many variables, so the... salesman USTRANSCOM via AMC has a variety of airlift services it can offer its customers. Annex 3-17 Air Mobility Operations defines airlift as...International, 2008) Given the trouble land based travel offers the alternative for military operations is to route cargo and personnel by air. Air

[Medical expert assessment, objectivity and justice in disability pension cases. ].

PubMed

Solli, Hans Magnus

2003-08-14

The formal principle of justice is often interpreted as the requirement of objectivity when a person's situation is to be evaluated in the light of social justice. The aim of this article is to analyse whether or not the formal principle of justice is fulfilled by the ontological and the epistemological concept of objectivity when disability claims are evaluated medically in relation to the Norwegian legislation on disability benefits. material is legal and medical texts about medical disability evaluation. The method is text analysis. The main result is that the concept of ontological objectivity functions as the criterion of objectivity when the causal relations between sickness, impairment and disability are explained. This criterion is, however, problematic because it is based on the assumption that there is a linear causal model of these relations, which precludes the explanation of many cases of disability. The ontological concept of objectivity is not a necessary condition for impartiality and formal justice in relation to the causal relation between sickness and disability. In some situations this concept is a sufficient condition. The epistemological concept of objectivity is a sufficient condition, but it is not a necessary condition. Some cases must be reviewed on a discretionary basis.

The trajectories of overall disability in the first 5 years after moderate and severe traumatic brain injury.

PubMed

Forslund, Marit V; Roe, Cecilie; Perrin, Paul B; Sigurdardottir, Solrun; Lu, Juan; Berntsen, Svein; Andelic, Nada

2017-01-01

To assess longitudinal trajectories of overall disability after moderate-to-severe traumatic brain injury (TBI) and to examine whether those trajectories could be predicted by socio-demographic and injury characteristics. Demographics and injury characteristics of 105 individuals with moderate-to-severe TBI were extracted from medical records. At the 1-, 2-, and 5-year follow-ups, TBI-related disability was assessed by the GOSE. A hierarchical linear model (HLM) was used to examine functional outcomes up to 5 years following injury and whether those outcomes could be predicted by: time, gender, age, relationship, education, employment pre-injury, occupation, GCS, cause of injury, length of post-traumatic amnesia (PTA), CT findings and injury severity score, as well as the interactions between each of these predictors and time. Higher GOSE trajectories (lower disability) were predicted by younger age at injury and shorter PTA, as well as by the interaction terms of time*PTA and time*employment. Those who had been employed at injury decreased in disability over time, while those who had been unemployed increased in disability. The study results support the view that individual factors generally outweigh injury-related factors as predictors of disability after TBI, except for PTA.

Mutations in GLDN, Encoding Gliomedin, a Critical Component of the Nodes of Ranvier, Are Responsible for Lethal Arthrogryposis.

PubMed

Maluenda, Jérôme; Manso, Constance; Quevarec, Loic; Vivanti, Alexandre; Marguet, Florent; Gonzales, Marie; Guimiot, Fabien; Petit, Florence; Toutain, Annick; Whalen, Sandra; Grigorescu, Romulus; Coeslier, Anne Dieux; Gut, Marta; Gut, Ivo; Laquerrière, Annie; Devaux, Jérôme; Melki, Judith

2016-10-06

Arthrogryposis multiplex congenita (AMC) is a developmental condition characterized by multiple joint contractures resulting from reduced or absent fetal movements. Through linkage analysis, homozygosity mapping, and exome sequencing in four unrelated families affected by lethal AMC, we identified biallelic mutations in GLDN in the affected individuals. GLDN encodes gliomedin, a secreted cell adhesion molecule involved in the formation of the nodes of Ranvier. Transmission electron microscopy of the sciatic nerve from one of the affected individuals showed a marked lengthening defect of the nodes. The GLDN mutations found in the affected individuals abolish the cell surface localization of gliomedin and its interaction with its axonal partner, neurofascin-186 (NF186), in a cell-based assay. The axoglial contact between gliomedin and NF186 is essential for the initial clustering of Na + channels at developing nodes. These results indicate a major role of gliomedin in node formation and the development of the peripheral nervous system in humans. These data indicate that mutations of GLDN or CNTNAP1 (MIM: 616286), encoding essential components of the nodes of Ranvier and paranodes, respectively, lead to inherited nodopathies, a distinct disease entity among peripheral neuropathies. Copyright © 2016 American Society of Human Genetics. Published by Elsevier Inc. All rights reserved.

Characterization of molybdenum particles reinforced Al6082 aluminum matrix composites with improved ductility produced using friction stir processing

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

Selvakumar, S., E-mail: lathaselvam1963@gmail.com

Aluminum matrix composites (AMCs) reinforced with various ceramic particles suffer a loss in ductility. Hard metallic particles can be used as reinforcement to improve ductility. The present investigation focuses on using molybdenum (Mo) as potential reinforcement for Mo(0,6,12 and 18 vol.%)/6082Al AMCs produced using friction stir processing (FSP). Mo particles were successfully retained in the aluminum matrix in its elemental form without any interfacial reaction. A homogenous distribution of Mo particles in the composite was achieved. The distribution was independent upon the region within the stir zone. The grains in the composites were refined considerably due to dynamic recrystallization andmore » pinning effect. The tensile test results showed that Mo particles improved the strength of the composite without compromising on ductility. The fracture surfaces of the composites were characterized with deeply developed dimples confirming appreciable ductility. - Highlights: •Molybdenum particles used as reinforcement for aluminum composites to improve ductility. •Molybdenum particles were retained in elemental form without interfacial reaction. •Homogeneous dispersion of molybdenum particles were observed in the composite. •Molybdenum particles improved tensile strength without major loss in ductility. •Deeply developed dimples on the fracture surfaces confirmed improved ductility.« less

Crude and purified proteasome activity assays are affected by type of microplate.

PubMed

Cui, Ziyou; Gilda, Jennifer E; Gomes, Aldrin V

2014-02-01

Measurement of proteasome activity is fast becoming a commonly used assay in many laboratories. The most common method to measure proteasome activity involves measuring the release of fluorescent tags from peptide substrates in black microplates. Comparisons of black plates used for measuring fluorescence with different properties show that the microplate properties significantly affect the measured activities of the proteasome. The microplate that gave the highest reading of trypsin-like activity of the purified 20S proteasome gave the lowest reading of chymotrypsin-like activity of the 20S proteasome. Plates with medium binding surfaces from two different companies showed an approximately 2-fold difference in caspase-like activity for purified 20S proteasomes. Even standard curves generated using free 7-amino-4-methylcoumarin (AMC) were affected by the microplate used. As such, significantly different proteasome activities, as measured in nmol AMC released/mg/min, were obtained for purified 20S proteasomes as well as crude heart and liver samples when using different microplates. The naturally occurring molecule betulinic acid activated the chymotrypsin-like proteasome activity in three different plates but did not affect the proteasome activity in the nonbinding surface microplate. These findings suggest that the type of proteasome activity being measured and sample type are important when selecting a microplate. Copyright © 2013 Elsevier Inc. All rights reserved.

Saliency Detection via Absorbing Markov Chain With Learnt Transition Probability.

PubMed

Lihe Zhang; Jianwu Ai; Bowen Jiang; Huchuan Lu; Xiukui Li

2018-02-01

In this paper, we propose a bottom-up saliency model based on absorbing Markov chain (AMC). First, a sparsely connected graph is constructed to capture the local context information of each node. All image boundary nodes and other nodes are, respectively, treated as the absorbing nodes and transient nodes in the absorbing Markov chain. Then, the expected number of times from each transient node to all other transient nodes can be used to represent the saliency value of this node. The absorbed time depends on the weights on the path and their spatial coordinates, which are completely encoded in the transition probability matrix. Considering the importance of this matrix, we adopt different hierarchies of deep features extracted from fully convolutional networks and learn a transition probability matrix, which is called learnt transition probability matrix. Although the performance is significantly promoted, salient objects are not uniformly highlighted very well. To solve this problem, an angular embedding technique is investigated to refine the saliency results. Based on pairwise local orderings, which are produced by the saliency maps of AMC and boundary maps, we rearrange the global orderings (saliency value) of all nodes. Extensive experiments demonstrate that the proposed algorithm outperforms the state-of-the-art methods on six publicly available benchmark data sets.

Current State of Information Technologies for the Clinical Research Enterprise across Academic Medical Centers

PubMed Central

Murphy, Shawn N.; Dubey, Anil; Embi, Peter J.; Harris, Paul A.; Richter, Brent G.; Turisco, Fran; Weber, Griffin M.; Tcheng, James E.; Keogh, Diane

2012-01-01

Abstract Information technology (IT) to support clinical research has steadily grown over the past 10 years. Many new applications at the enterprise level are available to assist with the numerous tasks necessary in performing clinical research. However, it is not clear how rapidly this technology is being adopted or whether it is making an impact upon how clinical research is being performed. The Clinical Research Forum’s IT Roundtable performed a survey of 17 representative academic medical centers (AMCs) to understand the adoption rate and implementation strategies within this field. The results were compared with similar surveys from 4 and 6 years ago. We found the adoption rate for four prominent areas of IT‐supported clinical research had increased remarkably, specifically regulatory compliance, electronic data capture for clinical trials, data repositories for secondary use of clinical data, and infrastructure for supporting collaboration. Adoption of other areas of clinical research IT was more irregular with wider differences between AMCs. These differences appeared to be partially due to a set of openly available applications that have emerged to occupy an important place in the landscape of clinical research enterprise‐level support at AMC’s. Clin Trans Sci 2012; Volume #: 1–4 PMID:22686207

Near-Infrared Spectroscopy as a Novel Non-Invasive Tool to Assess Spiny Lobster Nutritional Condition

PubMed Central

Rodemann, Thomas; Carter, Chris G.

2016-01-01

Rapid non-invasive monitoring of spiny lobster nutritional condition has considerable application in the established fishery, live market and prospective aquaculture. The aim of this research was to test the feasibility of near-infrared spectroscopy (NIRS) as a novel non-invasive tool to assess the nutritional condition of three lobster species. Lobster (n = 92) abdominal muscle dry matter (AMDM) and carbon content (AMC) correlated significantly with indices of nutritional condition including hepatopancreas dry matter (HPDM; rho = 0.83, 0.78), total lipid content (HPTL; rho = 0.85, 0.87) and haemolymph total protein (TP; rho = 0.89, 0.87 respectively). Abdominal muscle nitrogen content (AMN) was a poor correlate of nutritional condition. Models based on FT-NIR scanning of whole lobster tails successfully predicted AMDM, AMN and AMC (RMSECV = 1.41%, 0.35% and 0.91%; R2 = 0.75, 0.65, 0.77, respectively), and to a lower accuracy HPDM, HPTL and TP (RMSECV = 6.22%, 8.37%, 18.4 g l-1; R2 = 0.51, 0.70, 0.83, respectively). NIRS was applied successfully to assess the condition of spiny lobsters non-invasively. This pilot study paves the way for the development of crustacean condition models using portable non-invasive devices in the laboratory or in the field. PMID:27442242

Changes of nutritional status after distal gastrectomy in patients with gastric cancer.

PubMed

Katsube, Takao; Konnno, Soichi; Murayama, Minoru; Kuhara, Kotaro; Sagawa, Masano; Yoshimatsu, Kazuhiko; Shiozawa, Shunnichi; Shimakawa, Takeshi; Naritaka, Yoshihiko; Ogawa, Kenji

2008-01-01

In Japan, distal gastrectomy is the most common operation performed to treat gastric cancer. However, this procedure often leads to postoperative problems such as weight loss. We assessed the changes of nutritional status early after operation and the associations of the postoperative body weight (as a percentage of the preoperative weight) and background factors in patients who underwent distal gastrectomy. We measured the changes of nutritional indices (mean body weight, TSF, AMC and Alb) and nutrition intake on the day before operation (before operation), before postoperative resumption of oral intake (before oral intake), and on the fifth day of a soft rice porridge diet (after soft rice). Background factors included gender, age, preoperative BMI and preoperative exercise. Mean body weight, TSF, and AMC significantly decreased from before operation, to the day before oral intake and to the day after soft rice. The postoperative body weight was not associated with the gender, age, or preoperative BMI. The frequency of regular preoperative exercise was associated with the postoperative body weight. The total daily calorie intake was 1,664 kcal (before operation), 398 kcal (before oral intake), and 949 kcal (after soft rice). To conclude, nutritional status changes significantly after distal gastrectomy. Early nutrition intervention may be needed in patients who undergo distal gastrectomy for gastric cancer.

NMR and TRLFS studies of Ln(iii) and An(iii) C5-BPP complexes.

PubMed

Adam, Christian; Beele, Björn B; Geist, Andreas; Müllich, Udo; Kaden, Peter; Panak, Petra J

2015-02-01

C5-BPP is a highly efficient N-donor ligand for the separation of trivalent actinides, An(iii), from trivalent lanthanides, Ln(iii). The molecular origin of the selectivity of C5-BPP and many other N-donor ligands of the BTP-type is still not entirely understood. We present here the first NMR studies on C5-BPP Ln(iii) and An(iii) complexes. C5-BPP is synthesized with 10% 15 N labeling and characterized by NMR and LIFDI-MS methods. 15 N NMR spectroscopy gives a detailed insight into the bonding of C5-BPP with lanthanides and Am(iii) as a representative for trivalent actinide cations, revealing significant differences in 15 N chemical shift for coordinating nitrogen atoms compared to Ln(iii) complexes. The temperature dependence of NMR chemical shifts observed for the Am(iii) complex indicates a weak paramagnetism. This as well as the observed large chemical shift for coordinating nitrogen atoms show that metal-ligand bonding in Am(C5-BPP) 3 has a larger share of covalence than in lanthanide complexes, confirming earlier studies. The Am(C5-BPP) 3 NMR sample is furthermore spiked with Cm(iii) and characterized by time-resolved laser fluorescence spectroscopy (TRLFS), yielding important information on the speciation of trace amounts of minor complex species.

The Spitzer Survey of Interstellar Clouds in the Gould Belt. VI. The Auriga-California Molecular Cloud Observed with IRAC and MIPS

NASA Technical Reports Server (NTRS)

Broekhoven-Fiene, Hannah; Matthews, Brenda C.; Harvey, Paul M.; Gutermuth, Robert A.; Huard, Tracy L.; Tothill, Nicholas F. H.; Nutter, David; Bourke, Tyler L.; DiFrancesco, James; Jorgensen, Jes K.;

Electric field distribution on surface of the artificial magnetic conductor: miniaturization process

NASA Astrophysics Data System (ADS)

Ramos, Welyson T. S.; Mesquita, Renato C.; Silva, Elson J.

2017-08-01

This paper presents a study of the influence of the geometric shape on the resonance frequency of the artificial magnetic conductor (AMC) by analysis of the electric field distributions on top of the surface metallic patch inside the unit cell. It is known that various parameters such as geometry, dielectric substrate thickness, gap between patches, length and width of patch, size of unit cell, permittivity and permeability strongly affect the resonance frequency. In attempts to elucidate the miniaturization process, as reference, a metallic square patch with a unit cell of size 10 mm × 10 mm was simulated and a resonance frequency of 5.75 GHz was obtained. The device has illuminated by a plane wave with polarization in the y direction. Additionally, different geometries were performed such as triangle, hexagon, circle and cross of Jerusalem. We realized that the field distribution can be used as an physical insight to understand the AMC miniaturization process. In particular, bow-tie geometry provided considerable electrical miniaturization compared with square patch, about 1.5 GHz. The results are supported by finite element method. Our findings suggest that shift at resonant frequency may be interpreted as a variation in the net induced electric polarizability on the surface of the metallic patches.

Design and application of a fluorogenic assay for monitoring inflammatory caspase activity.

PubMed

Ranganathan, Raj; Lenti, Gena; Tassone, Nicholas M; Scannell, Brian J; Southern, Cathrine A; Karver, Caitlin E

2018-02-15

Various fluorogenic assays exist for monitoring the activity of inflammatory caspases. However, there are no continuous assays that provide C-terminal substrate sequence specificity for inflammatory caspases. As a first step towards this, we have developed a continuous in vitro assay that relies on monitoring emission from tryptophan after cleavage of a quenching coumarin chromophore. The coumarin can be attached as an amino acid side chain or capping the C-terminus of the peptide. When the coumarin is a side chain, it allows for C-terminal and N-terminal sequence specificities to be explored. Using this assay, we obtained Michaelis-Menten kinetic data for four proof-of-principle peptides: WEHD-AMC (K M  = 15 ± 2 μM), WEHD-MCA (K M  = 93 ± 19 μM), WEHDG-MCA (K M  = 21 ± 6 μM) and WEHDA-MCA (K M  = 151 ± 37 μM), where AMC is 7-amino-4-methylcoumarin and MCA is β-(7-methoxy-coumarin-4-yl)-Ala. The results indicate the viability of this new assay approach in the design of effective fluorogenic substrates for inflammatory caspases. Copyright © 2017 Elsevier Inc. All rights reserved.

Obesity and cardiometabolic disease risk factors among US adolescents with disabilities.

PubMed

Messiah, Sarah E; Vidot, Denise C; Somarriba, Gabriel; Haney, Kanathy; Aytur, Semra; Natale, Ruby A; Brosco, Jeffrey P; Arheart, Kristopher L

2015-02-15

To generate prevalence estimates of weight status and cardiometabolic disease risk factors among adolescents with and without disabilities. Analysis of the 1999-2010 National Health and Nutrition Examination Survey data was conducted among 12-18 years old with (n = 256) and without disabilities (n = 5020). Mean values of waist circumference, fasting glucose, high-density-lipoprotein cholesterol, triglycerides, systolic and diastolic blood pressure and metabolic syndrome (MetS, ≥ 3 risk factors present) were examined by the following standardized body mass index (BMI) categories for those with and without disabilities; overweight (BMI ≥ 85(th) - < 95(th) percentile for age and sex), obesity (BMI ≥ 95(th) percentile) and severe obesity (BMI ≥35 kg/m(2)). Linear regression models were fit with each cardiometabolic disease risk factor independently as continuous outcomes to show relationships with disability status. Adolescents with disabilities were significantly more likely to be overweight (49.3%), obese (27.6%) and severely obese (12%) vs their peers without disabilities (33.1%, 17.5% and 3.6%, respectively, P ≤ 0.01 for all). A higher proportion of overweight, obese and severely obese children with disabilities had abnormal SBP, fasting lipids and glucose as well as MetS (18.9% of overweight, 32.3% of obese, 55% of severely obese) vs their peers without disabilities (9.7%, 16.8%, 36.3%, respectively). US adolescents with disabilities are over three times as likely to have MetS (OR = 3.45, 95%CI: 1.08-10.99, P = 0.03) vs their peers with no disabilities. Results show that adolescents with disabilities are disproportionately affected by obesity and poor cardiometabolic health vs their peers with no disabilities. Health care professionals should monitor the cardiometabolic health of adolescents with disabilities.

Influence of a Short-Term Disability Awareness Program on Knowledge and Attitudes of School-Aged Children in Southern Belize: Results of a Community-University Partnership.

PubMed

Magnusson, Dawn M; Cal, Francisco; Boissonnault, Jill S

2017-04-01

Little is known about the attitudes of children living in Central America toward people with disabilities or the effectiveness of a disability awareness program in influencing their knowledge and attitudes. The study objectives were to evaluate the effectiveness of a disability awareness program in influencing Belizean children's knowledge of and attitudes toward people with disabilities in the immediate short term and to describe the development of a university-community partnership that resulted in the development of a culturally appropriate disability awareness program. This was a single-group pretest-posttest quasi-experimental study with cluster sampling. Study participants included 247 children (11-14 years old) from 8 primary schools in Toledo District, Belize. A paper-based disability awareness survey measuring knowledge of and attitudes toward people with disabilities was administered before and after an intervention. The intervention was a 90-minute multimodal disability awareness program. Hierarchical linear modeling was used to model the influence of the intervention on knowledge of and attitudes toward people with disabilities. Significant improvements in knowledge of and attitudes toward people with disabilities were evident immediately after the intervention. Children were not randomized to a control group. Although this feature was a limitation in terms of study design, the researchers believed that respecting the wishes of the school principals by providing the disability awareness intervention to all students was important. This study provided an example of how a university-community partnership can positively influence community outcomes. Further research is needed to assess long-term changes in Belizean children's knowledge of, attitudes toward, and behaviors toward people with disabilities, as well as the social inclusion and participation of children with disabilities. © 2017 American Physical Therapy Association

Correlates of disability related to seizures in persons with epilepsy.

PubMed

Sajobi, Tolulope T; Jette, Nathalie; Fiest, Kirsten M; Patten, Scott B; Engbers, Jordan D T; Lowerison, Mark W; Wiebe, Samuel

2015-09-01

Seizure-related disability is an important contributor to health-related quality of life in persons with epilepsy. Yet, there is little information on patient-centered reports of seizure-related disability, as most studies focus on specific constructs of health-related disability, rather than epilepsy. We investigated how patients rate their own disability and how these ratings correlate with various clinical and sociodemographic characteristics. In a prospective cohort of 250 adults with epilepsy consecutively enrolled in the Neurological Disease and Depression Study (NEEDs), we obtained a broad range of clinical and patient-reported measures, including patients' ratings of seizure-related disability and epilepsy severity using self-completed, single-item, 7-point response global assessment scales. Spearman's correlation, multiple linear regression, and mediation analyses were used to examine the association between seizure-related disability scores and clinical and demographic characteristics of persons with epilepsy. The mean age and duration of epilepsy was 39.8 and 16.7 years, respectively. About 29.5% of the patients reported their seizures as "not at all disabling," whereas 5.8% of the patients reported them as "extremely disabling." Age, seizure freedom at 1 year, anxiety, and epilepsy severity were identified as statistically significant predictors of disability scores. The indirect effects of age and seizure freedom, attributable to mediation through epilepsy severity, accounted for 25.0% and 30.3% of the total effects of these determinants on seizure-related disability, respectively. Measuring seizure-related disability has heuristic value and it has important correlates and mediators that can be targeted for intervention in practice. Addressing modifiable factors associated with disability (e.g., seizure freedom and anxiety) could have a significant impact on decreasing the burden of disability in people with epilepsy. Wiley Periodicals, Inc. © 2015 International League Against Epilepsy.

Longitudinal models of reading achievement of students with learning disabilities and without disabilities.

PubMed

Sullivan, Amanda L; Kohli, Nidhi; Farnsworth, Elyse M; Sadeh, Shanna; Jones, Leila

2017-09-01

Accurate estimation of developmental trajectories can inform instruction and intervention. We compared the fit of linear, quadratic, and piecewise mixed-effects models of reading development among students with learning disabilities relative to their typically developing peers. We drew an analytic sample of 1,990 students from the nationally representative Early Childhood Longitudinal Study-Kindergarten Cohort of 1998, using reading achievement scores from kindergarten through eighth grade to estimate three models of students' reading growth. The piecewise mixed-effects models provided the best functional form of the students' reading trajectories as indicated by model fit indices. Results showed slightly different trajectories between students with learning disabilities and without disabilities, with varying but divergent rates of growth throughout elementary grades, as well as an increasing gap over time. These results highlight the need for additional research on appropriate methods for modeling reading trajectories and the implications for students' response to instruction. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Comparison of attitudes toward disability and people with disability among caregivers, the public, and people with disability: findings from a cross-sectional survey.

PubMed

Zheng, Qiaolan; Tian, Qi; Hao, Chun; Gu, Jing; Tao, Jianting; Liang, Zuoyi; Chen, Xinlin; Fang, Jiqian; Ruan, Jianhua; Ai, Qiuxiang; Hao, Yuantao

2016-09-29

A negative attitude toward disability is one of the potential barriers for people with disability (PWD) to achieve social equality. Although numerous studies have investigated attitudes toward disability, few have evaluated personal attitudes toward disability among PWD, and made comparisons with attitudes of healthy respondents. This study was to investigate and compare the attitudes of PWD, caregivers, and the public toward disability and PWD in China, to identify discrepancies in attitude among the three groupsand to examine potential influencing factors of attitude within each group. A cross-sectional study was conducted among 2912 PWD, 507 caregivers, and 354 members of the public in Guangzhou, China. Data were collected on participants' socio-demographic information and personal attitudes toward disability using the Attitude to Disability Scale (ADS). ANOVA and ANCOVA were applied to compare the level of attitude among the three groups. Simple and multiple linear regression analyses were used to investigate the relationship between each background factor and attitude within each group. Over 90 % of caregivers were PWD's family members. After controlling the socio-demographic characteristics, caregivers had the lowest total scores of ADS (caregivers: 47.7; PWD: 52.3; the public: 50.5). Caregivers who had taken care of PWD for longer durations of time had a more negative attitude toward disability. In contrast, PWD who had been disabled for longer times had a more positive attitude toward disability. The current national social security system of China does not adequately support PWD's family-member caregivers who may need assistance coping with their life with PWDs. More research is needed, and the development of a new health-care model for PWD is warranted.

Physical, lifestyle, psychological, and social determinants of pain intensity, pain disability, and the number of pain locations in depressed older adults.

PubMed

Hanssen, Denise J C; Naarding, Paul; Collard, Rose M; Comijs, Hannie C; Oude Voshaar, Richard C

2014-10-01

Late-life depression and pain more often co-occur than can be explained by chance. Determinants of pain in late-life depression are unknown, even though knowledge on possible determinants of pain in depression is important for clinical practice. Therefore, the objectives of the present study were 1) to describe pain characteristics of depressed older adults and a nondepressed comparison group, and 2) to explore physical, lifestyle, psychological, and social determinants of acute and chronic pain intensity, disability, and multisite pain in depressed older adults. Data from the Netherlands Study of Depression in Older Persons cohort, consisting of 378 depressed persons, diagnosed according to Diagnostic and Statistical Manual of Mental Disorders, 4th edition criteria, and 132 nondepressed persons aged 60 years and older, were used in a cross-sectional design. Pain characteristics were measured by the Chronic Graded Pain Scale. Multiple linear regression analyses were performed to explore the contribution of physical, lifestyle, psychological, and social determinants to outcomes pain intensity, disability, and the number of pain locations. Depressed older adults more often reported chronic pain and experienced their pain as more intense and disabling compared to nondepressed older adults. Adjusted for demographic, physical, and lifestyle characteristics, multinomial logistic regression analyses showed increased odds ratios (OR) for depression in acute pain (OR 3.010; P=0.005) and chronic pain (OR 4.544, P<0.001). In addition, linear regression analyses showed that acute and chronic pain intensity, disability, and multisite pain were associated with several biopsychosocial determinants, of which anxiety was most pronounced. Further research could focus on the temporal relationship between anxiety, late-life depression, and pain. Copyright © 2014 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

AMC’s Hydrogen Future: Sustainable Air Mobility

DTIC Science & Technology

2009-06-01

by bacteria . The Orinoco heavy oil has been degraded less than the Canadian oil sands making it easier to extract. The Orinoco oil contains 300...molecules tend to evaporate. Bacteria at the surface modify the oil leaving ring compounds. This causes the oil to become more viscous than conventional...267 billion barrels recoverable (Mommer, 2004). The difference between the oil sands and heavy oil is the degree to which the oil has been degraded

What Is the Future for SOF in the Arctic?

DTIC Science & Technology

2014-12-01

Beaufort Sea) and the August values of the listed variables (two-month lead time). The variables are ranked by their R2 values (highest R2 listed first...refueling AA additional activities AJP Allied Joint Publication (NATO) ALCOM Alaska Command (U.S.) AKO Arktisk Kommando, Arctic command (DNK) AMC...capabilities. Although the scope is limited to the three nations, the overall analysis and recommendations will be of value to all states with a

Avoiding Clean Air Act Enforcement Actions

DTIC Science & Technology

1994-06-01

process or common-source permits (for instance, all boilers or all sources within a defined area on one per- mit); or separate permits for every source of... boilers ; and explosive produc- tion processes. The limitations on NO. emissions may become more stringent if it is determined that these emissions...ISC = Infornmtbon Systems C~r;, INSCOM w; HSC m HhO Sewims Com- rand; FORSCOM - Forces Command; ARNG a Army Natonal Guwd; AMC = Army Maet Command

Chemical Agent Detector Kits

DTIC Science & Technology

1989-04-28

camera, and document test events and recorder procedures Thermometer +20C Psychrometer +5% 4 April 1989 TOP 8-2-555 Rough handling test and As specifie...not covered in AMC Regulation 385-131 will be performed iAW p oposals made by the Chemical Laboratory Division and approved by the Safety ¶ffice. 4.3...the packaged detector kit to higher and lower temperatures than it is expected to experience in actual packaged storage. Coordination should be made

Annual Historical Review FY89

DTIC Science & Technology

1991-03-01

Acquisition (DCSRDA) in the late 1970s and early 1980s . Immediately prior to assuming command of AMC, from August 1984 to April 1987, he served as the DCSRDA...Since 1980 , 78 studies had been completed, generating 250 military and over 8,900 civilian spaces as a result of contract conversions or the...explore the ServiceMaster proposal in lieu of continuing a commercial activities (CA) cost study, which was announced to Congress in December 1980 , but

Army Posture Statement: A Statement on the Posture of the United States Army, 2009

DTIC Science & Technology

2009-05-07

Research Institute Army Physical Readiness Training (FM 3-22.02) Army Preparatory School Army Prepositioned Stocks (APS) Army Reserve Employer Relations...ARFORGEN Army Force Generation AFRICOM Africa Command AMAP Army Medical Action Plan AMC Army Material Command APA Army Prepositioned Stocks AR Army...Ordnance Disposal ES2 Every Soldier a Sensor ETF Enterprise Task Force FCS Future Combat Systems FM Field Manual FORSCOM Forces Command FY Fiscal Year

AMC’s Future Strategic Airlifter: The Blended Wing Body?

DTIC Science & Technology

2010-06-01

winglets and deflected upwards. Not only does the noise reduction help reduce noise pollution, but it increases the stealth capability of the airlifter...deflected between the large winglets further keeping the waves from extending out from the aircraft to the sides. Based on this observation, Boeing...decided to move the winglets in towards the engines to further shield and deflect sound waves straight above the aircraft as shown in the figures 16

A simple laser-based device for simultaneous microbial culture and absorbance measurement

NASA Astrophysics Data System (ADS)

Abrevaya, X. C.; Cortón, E.; Areso, O.; Mauas, P. J. D.

2013-07-01

In this work we present a device specifically designed to study microbial growth with several applications related to environmental microbiology and other areas of research as astrobiology. The Automated Measuring and Cultivation device (AMC-d) enables semi-continuous absorbance measurements directly during cultivation. It can measure simultaneously up to 16 samples. Growth curves using low and fast growing microorganism were plotted, including Escherichia coli and Haloferax volcanii, a halophilic archaeon.

References on Compression of Freeze-Dried Foods

DTIC Science & Technology

1978-08-01

ready-to-eat, freeze-dried scrambled egg . Swift and Co., Contract No. DA 19- 129-AMC-121. 67-49-FD (FD-54). January 1967 (AD 650637). In the design...significantly poorer in organoleptic properties than from grades A and B eggs. Freeze- dried scrambled egg packed in cans kept better in storage than when...scrambled, cooked, freeze-dried whole egg product was developed which possessed the appearance, aroma, flavor and texture similar to pan- fried scrambled

Quantifying the Relationship between AMC Resources and U.S. Army Materiel Readiness

DTIC Science & Technology

1989-08-25

Resource Management report 984 for the same period. Insufficient data precluded analysis of the OMA PEs Total Package Fielding and Life Cycle Software...procurement, had the greatest failure rates when subjected to the statistical tests merely because of the reduced number of data pairs. Analyses of...ENGINEERING DEVELOPMENT 6.5 - MANAGEMENT AND SUPPORT 6.7 - OPERATIONAL SYSTEM DEVELOPMENT P2 - GENERAL PURPOSE FORCES P3 - INTELIGENCE AND COMMUNICATIONS P7

Burden and depression in primary caregivers of persons with visual impairment

PubMed Central

Khare, Shubhank; Rohatgi, Jolly; Bhatia, Manjeet Singh; Dhaliwal, Upreet

2016-01-01

Context: Caregivers who assist persons with visual impairment often neglect their needs, resulting in burden and depression. Rehabilitation efforts, directed to the disabled, seldom target the caregiver. Aim: To assess burden and depression in persons caring for blind individuals. Settings and Design: This was a cross-sectional study carried out in the outpatient department of a tertiary-level teaching hospital in New Delhi. Materials and Methods: Institutional Ethical Board approval was obtained and written informed consent too was obtained from the participants involved in this study. Persons with best-corrected vision <20/200 in the better eye, and their primary caregivers, were recruited. We recorded demography, other illness/disability, household income, relationship with disabled person, and caregiver burden (Caregiver Burden Scale) and depression (Centre for Epidemiologic Studies Depression Scale). Statistical Analysis: Statistical analysis was carried out using SPSS version 20 (Released 2011. Armonk, NY: IBM Corp.); range, average, and standard deviation were determined for age, burden, and depression. The association between burden and depression was determined using Pearson's correlation; the relationship between degree of disability and caregiver burden and depression was determined using unpaired t-test; using multiple linear regression, factors were found to be statistically significant; significance was taken at P < 0.05. Results: Twenty-seven (53.0%) men and 24 (47.0%) women had visual impairment. Most caregivers (n = 40; 81.6%) were first-degree relatives or a spouse; 32 (65%) had schooling <5 years; and 29 (59%) were unemployed. Depression ranged from 21 to 52 (average 43.2 ± 5.71); it correlated with degree of disability (P = 0.012), household income (r = −0.320; P = 0.025), and burden (r = 0.616; P < 0.001). Burden ranged from 30 to 73 (average 54.5 ± 6.73) and correlated with degree of disability (P = 0.006). On multiple linear regression, burden predicted depression (r = 0.557; P < 0.001). Conclusions: Caregivers merit community support, financial benefit, interventions to diagnose and treat depression, and training in coping. Centers that provide disability certification could offer counseling. PMID:27688278

Dimensions and predictors of disability—A baseline study of patients entering somatic rehabilitation in secondary care

PubMed Central

2018-01-01

Purpose The purpose of this study was to investigate disability among patients who were accepted for admission to a Norwegian rehabilitation center and to identify predictors of disability. Materials and methods In a cross-sectional study including 967 adult participants, the World Health Organization Disability Assessment Schedule version 2.0 36-item version was used for assessing overall and domain-specific disability as outcome variables. Patients completed the Hospital Anxiety and Depression Scale (HADS), EuroQoL EQ-5D-5L and questions about multi-morbidity, smoking and perceived physical fitness. Additionally, the main health condition, sociodemographic and environmental variables obtained from referrals and public registers were used as predictor variables. Descriptive statistics and linear regression analyses were performed. Results The mean (standard error) overall disability score was 30.0 (0.5), domain scores ranged from 11.9 to 44.7. Neurological diseases, multi-morbidity, low education, impaired physical fitness, pain, and higher HADS depressive score increased the overall disability score. A low HADS depressive score predicted a lower disability score in all domains. Conclusions A moderate overall disability score was found among patients accepted for admission to a rehabilitation center but “life activities” and “participation in society” had the highest domain scores. This should be taken into account when rehabilitation strategies are developed. PMID:29499064

Calculation of prevalence estimates through differential equations: application to stroke-related disability.

PubMed

Mar, Javier; Sainz-Ezkerra, María; Moler-Cuiral, Jose Antonio

2008-01-01

Neurological diseases now make up 6.3% of the global burden of disease mainly because they cause disability. To assess disability, prevalence estimates are needed. The objective of this study is to apply a method based on differential equations to calculate the prevalence of stroke-related disability. On the basis of a flow diagram, a set of differential equations for each age group was constructed. The linear system was solved analytically and numerically. The parameters of the system were obtained from the literature. The model was validated and calibrated by comparison with previous results. The stroke prevalence rate per 100,000 men was 828, and the rate for stroke-related disability was 331. The rates steadily rose with age, but the group between the ages of 65 and 74 years had the highest total number of individuals. Differential equations are useful to represent the natural history of neurological diseases and to make possible the calculation of the prevalence for the various states of disability. In our experience, when compared with the results obtained by Markov models, the benefit of the continuous use of time outweighs the mathematical requirements of our model. (c) 2008 S. Karger AG, Basel.

The cost of an additional disability-free life year for older Americans: 1992-2005.

PubMed

Cai, Liming

2013-02-01

To estimate the cost of an additional disability-free life year for older Americans in 1992-2005. This study used 1992-2005 Medicare Current Beneficiary Survey, a longitudinal survey of Medicare beneficiaries with a rotating panel design. This analysis used multistate life table model to estimate probabilities of transition among a discrete set of health states (nondisabled, disabled, and dead) for two panels of older Americans in 1992 and 2002. Health spending incurred between annual health interviews was estimated by a generalized linear mixed model. Health status, including death, was simulated for each member of the panel using these transition probabilities; the associated health spending was cross-walked to the simulated health changes. Disability-free life expectancy (DFLE) increased significantly more than life expectancy during the study period. Assuming that 50 percent of the gains in DFLE between 1992 and 2005 were attributable to increases in spending, the average discounted cost per additional disability-free life year was $71,000. There were small differences between gender and racial/ethnic groups. The cost of an additional disability-free life year was substantially below previous estimates based on mortality trends alone. © Health Research and Educational Trust.

Determinants of work ability and its predictive value for disability.

PubMed

Alavinia, S M; de Boer, A G E M; van Duivenbooden, J C; Frings-Dresen, M H W; Burdorf, A

2009-01-01

Maintaining the ability of workers to cope with physical and psychosocial demands at work becomes increasingly important in prolonging working life. To analyse the effects of work-related factors and individual characteristics on work ability and to determine the predictive value of work ability on receiving a work-related disability pension. A longitudinal study was conducted among 850 construction workers aged 40 years and older, with average follow-up period of 23 months. Disability was defined as receiving a disability pension, granted to workers unable to continue working in their regular job. Work ability was assessed using the work ability index (WAI). Associations between work-related factors and individual characteristics with work ability at baseline were evaluated using linear regression analysis, and Cox regression analysis was used to evaluate the predictive value of work ability for disability. Work-related factors were associated with a lower work ability at baseline, but had little prognostic value for disability during follow-up. The hazard ratios for disability among workers with a moderate and poor work ability at baseline were 8 and 32, respectively. All separate scales in the WAI had predictive power for future disability with the highest influence of current work ability in relation to job demands and lowest influence of diseases diagnosed by a physician. A moderate or poor work ability was highly predictive for receiving a disability pension. Preventive measures should facilitate a good balance between work performance and health in order to prevent quitting labour participation.

Procedural Portfolio Planning in Plastic Surgery, Part 2: Collaboration Between Surgeons and Hospital Administrators to Develop a Funds Flow Model for Procedures Performed at an Academic Medical Center.

PubMed

Hultman, Charles Scott

2016-06-01

Although plastic surgeons make important contributions to the clinical, educational, and research missions of academic medical centers (AMCs), determining the financial value of a plastic surgery service can be difficult, due to complex cost accounting systems. We analyzed the financial impact of plastic surgery on an AMC, by examining the contribution margins and operating income of surgical procedures. We collaborated with hospital administrators to implement 3 types of strategic changes: (1) growth of areas with high contribution margin, (2) curtailment of high-risk procedures with negative contribution margin, (3) improved efficiency of mission-critical services with high resource consumption. Outcome measures included: facility charges, hospital collections, contribution margin, operating margin, and operating room times. We also studied the top 50 Current Procedural Terminology codes (total case number × charge/case), ranking procedures for profitability, as determined by operating margin. During the 2-year study period, we had no turnover in faculty; did not pursue any formal marketing; did not change our surgical fees, billing system, or payer mix; and maintained our commitment to indigent care. After rebalancing our case mix, through procedural portfolio planning, average hospital operating income/procedure increased from $-79 to $+816. Volume and diversity of cases increased, with no change in payer mix. Although charges/case decreased, both contribution margin and operating margin increased, due to improved throughput and decreased operating room times. The 5 most profitable procedures for the hospital were hernia repair, mandibular osteotomy, hand skin graft, free fibula flap, and head and neck flap, whereas the 5 least profitable were latissimus breast reconstruction, craniosynostosis repair, free-flap breast reconstruction, trunk skin graft, and cutaneous free flap. Total operating income for the hospital, from plastic surgery procedures, increased from $-115,103 to $+1,277,040, of which $350,000 (25%) was returned to the practice plan as enterprise funds to support program development. Through focused strategic initiatives, plastic surgeons and hospital administrators can work together to unlock the latent value of a plastic surgery service to an AMC. Specific financial benefits to the hospital include increased contribution margin and operating income, the latter of which can be reinvested in the plastic surgery service through a gain-sharing model.

Genetic characterization of the mechanisms of resistance to amoxicillin/clavulanate and third-generation cephalosporins in Salmonella enterica from three Spanish hospitals.

PubMed

de Toro, María; Sáenz, Yolanda; Cercenado, Emilia; Rojo-Bezares, Beatriz; García-Campello, Marta; Undabeitia, Esther; Torres, Carmen

2011-09-01

The mechanisms of antimicrobial resistance were characterized in 90 Salmonella enterica isolates either resistant or with intermediate resistance to amoxicillin/clavulanate (AMC(R/I)) or resistant to third-generation cephalosporins (C3G(R)). These isolates were recovered in three Spanish hospitals during 2007-2009. The C3G(R) phenotype was expressed by three isolates that carried the following extended-spectrum β-lactamase genes: phage-associated bla(CTX M-10) in S. Virchow, bla(CTX-M-14a) surrounded by ISEcp1 and IS903 in S. Enteritidis, and bla(CTX-M-15) linked to ISEcp1 and orf477 in S. Gnesta (first description in this serotype). The AMC(R/I) phenotype was found in 87 isolates (79 S. Typhimurim, 7 S. Enteritidis, and one S. Thompson). The bla(PSE-1) gene, followed by bla(OXA-1) was mostly found among S. Typhimurim, and the bla(TEM-1) gene among S. Enteritidis. Three different gene combinations [bla(PSE-1) +floR+aadA2+sul+tet(G); bla(OXA-1) +catA+aadA1/strA-strB+sul+tet(B) and bla(TEM-1) + cmlA1+aadA/strA-strB+sul+tet(A)/tet(B) genes] were associated with the ampicillin-chloramphenicol-streptomycin-sulfonamides-tetracycline phenotype in 68 AMC(R/I) S. enterica isolates. Class 1 integrons were observed in 79% of the isolates and in most of them (45 isolates) two integrons including the aadA2 and bla(PSE-1) gene cassettes, respectively, were detected. The bla(OXA-1) +aadA1 arrangement was detected in 23 isolates, and the aac(6')-Ib-cr+bla(OXA-1) +catB3+arr3 in another one. Non-classic class 1 integrons were found in three isolates: dfrA12+orfF+aadA2+cmlA1+aadA1 (1 isolate), dfrA12+orfF+aadA2+ cmlA1+aadA1+qacH+IS440+sul3 (1 isolate) and dfrA12+orfF+aadA2+cmlA1+aadA1+qacH+IS440+ sul3+orf1+mef(B)Δ-IS26 (1 isolate). Taken together, these results underline the need for clinical concern regarding β-lactam resistance in Salmonella and thus for continuous monitoring.

A novel mathematical model considering change of diffusion coefficient for predicting dissolution behavior of acetaminophen from wax matrix dosage form.

PubMed

Nitanai, Yuta; Agata, Yasuyoshi; Iwao, Yasunori; Itai, Shigeru

2012-05-30

From wax matrix dosage forms, drug and water-soluble polymer are released into the external solvent over time. As a consequence, the pore volume inside the wax matrix particles is increased and the diffusion coefficient of the drug is altered. In the present study, we attempted to derive a novel empirical mathematical model, namely, a time-dependent diffusivity (TDD) model, that assumes the change in the drug's diffusion coefficient can be used to predict the drug release from spherical wax matrix particles. Wax matrix particles were prepared by using acetaminophen (APAP), a model drug; glyceryl monostearate (GM), a wax base; and aminoalkyl methacrylate copolymer E (AMCE), a functional polymer that dissolves below pH 5.0 and swells over pH 5.0. A three-factor, three-level (3(3)) Box-Behnken design was used to evaluate the effects of several of the variables in the model formulation, and the release of APAP from wax matrix particles was evaluated by the paddle method at pH 4.0 and pH 6.5. When comparing the goodness of fit to the experimental data between the proposed TDD model and the conventional pure diffusion model, a better correspondence was observed for the TDD model in all cases. Multiple regression analysis revealed that an increase in AMCE loading enhanced the diffusion coefficient with time, and that this increase also had a significant effect on drug release behavior. Furthermore, from the results of the multiple regression analysis, a formulation with desired drug release behavior was found to satisfy the criteria of the bitter taste masking of APAP without lowering the bioavailability. That is to say, the amount of APAP released remains below 15% for 10 min at pH 6.5 and exceeds 90% within 30 min at pH 4.0. The predicted formulation was 15% APAP loading, 8.25% AMCE loading, and 400 μm mean particle diameter. When wax matrix dosage forms were prepared accordingly, the predicted drug release behavior agreed well with experimental values at each pH level. Therefore, the proposed model is feasible as a useful tool for predicting drug release behavior, as well as for designing the formulation of wax matrix dosage forms. Copyright © 2012 Elsevier B.V. All rights reserved.

Interleukin-33 in the Human Placenta

PubMed Central

Topping, Vanessa; Romero, Roberto; Than, Nandor Gabor; Tarca, Adi L.; Xu, Zhonghui; Kim, Sun Young; Wang, Bing; Yeo, Lami; Kim, Chong Jai; Hassan, Sonia S.; Kim, Jung-Sun

2012-01-01

Objective Interleukin-33 (IL-33) is the newest member of the IL-1 cytokine family, a group of key regulators of inflammation. The purpose of this study was to determine whether IL-33 is expressed in the human placenta and to investigate its expression in the context of acute and chronic chorioamnionitis. Methods Placental tissues were obtained from five groups of patients: (1) normal pregnancy at term without labor (n=10); (2) normal pregnancy at term in labor (n=10); (3) preterm labor without inflammation (n=10); (4) preterm labor with acute chorioamnionitis (n=10); and (5) preterm labor with chronic chorioamnionitis (n=10). Immunostaining was performed to determine IL-33 protein expression patterns in the placental disk, chorioamniotic membranes, and umbilical cord. mRNA expression of IL-33 and its receptor IL1RL1 (ST2) was measured in primary amnion epithelial and mesenchymal cells (AECs and AMCs, n=4) and human umbilical vein endothelial cells (HUVECs, n=4) treated with IL-1β (1ng/ml and 10ng/ml) and CXCL10 (0.5ng/ml and 1ng/ml or 5ng/ml). Results 1) Nuclear IL-33 expression was found in endothelial and smooth muscle cells in the placenta, chorioamniotic membranes, and umbilical cord; 2) IL-33 was detected in the nucleus of CD14+ macrophages in the chorioamniotic membranes, chorionic plate, and umbilical cord, and in the cytoplasm of myofibroblasts in the Wharton’s jelly; 3) acute (but not chronic) chorioamnionitis was associated with the presence of IL-33+ macrophages in the chorioamniotic membranes and umbilical cord; 4) expression of IL-33 or IL1RL1 (ST2) mRNA in AECs was undetectable; 5) IL-33 mRNA expression increased in AMCs and HUVECs after IL-1β treatment but did not change with CXCL10 treatment; and 6) IL1RL1 (ST2) expression decreased in AMCs and increased in HUVECs after IL-1β but not CXCL10 treatment. Conclusions IL-33 is expressed in the nucleus of placental endothelial cells, CD14+ macrophages, and myofibroblasts in the Wharton’s jelly. IL-1β can induce the expression of IL-33 and its receptor. Protein expression of IL-33 is detectable in macrophages of the chorioamniotic membranes in acute (but not chronic) chorioamnionitis. PMID:23039129

The longitudinal impact of depression on disability in Parkinson disease.

PubMed

Pontone, Gregory M; Bakker, Catherine C; Chen, Shaojie; Mari, Zoltan; Marsh, Laura; Rabins, Peter V; Williams, James R; Bassett, Susan S

2016-05-01

Depression in Parkinson disease (PD) is a common problem that worsens quality of life and causes disability. However, little is known about the longitudinal impact of depression on disability in PD. This study examined the association between disability and DSM-IV-TR depression status across six years. Longitudinal cohort study with assessments at study entry, year two, four, and six conducted in the Morris K. Udall Parkinson Disease Research Center. Recruitment totaled 137 adult men and women with idiopathic PD in which up to six years of data on demographic, motor, and non-motor variables was collected. Movement disorder specialists used the structured interview for DSM-IV-TR depressive disorders and the Northwestern Disability Scale to assess depression and disability. A generalized linear mixed model was fitted with Northwestern Disability Scale score as the dependent variable to determine the effect of baseline depression status on disability. A total of 43 participants were depressed at baseline compared to 94 without depression. Depressed participants were more likely to be female, were less educated, were less likely to take dopamine agonists, and more likely to have motor fluctuations. Controlling for these variables, symptomatic depression predicted greater disability compared to both never depressed (p = 0.0133) and remitted depression (p = 0.0009). Disability associated with symptomatic depression at baseline was greater over the entire six-year period compared to participants with remitted depressive episodes or who were never depressed. Persisting depression is associated with a long-term adverse impact on daily functioning in PD. Adequate treatment or spontaneous remission of depression improves ADL function. Copyright © 2015 John Wiley & Sons, Ltd.

Differential changes in functional disability and pain intensity over the course of psychological treatment for children with chronic pain

PubMed Central

Lynch-Jordan, Anne M.; Sil, Soumitri; Peugh, James; Cunningham, Natoshia; Kashikar-Zuck, Susmita; Goldschneider, Kenneth R.

2015-01-01

Patients presenting for treatment of chronic pain often believe that pain reduction must be achieved before returning to normal functioning. However, treatment programs for chronic pain typically take a rehabilitative approach, emphasizing decreasing pain-related disability first with the expectation that pain reduction will follow. This information is routinely provided to patients, yet no studies have systematically examined the actual trajectories of pain and disability in a clinical care setting. In this study of youth with chronic pain (N = 94, 8 to 18 years), it was hypothesized that 1) functional disability and pain would decrease over the course of psychological treatment for chronic pain and 2) functional disability would decrease more quickly than pain intensity. Participants received cognitive behavioral therapy (CBT) for pain management (M = 5.6 sessions) plus standard medical care. The Functional Disability Inventory and a Numeric Rating Scale of average pain intensity were completed by the child at every CBT session. Hierarchical linear modeling was conducted to examine the longitudinal trajectories of disability and pain. Standardized estimates of the slopes of change were obtained to test differences in rates of change between pain and disability. Results showed an overall significant decline in functional disability over time. Although pain scores reduced slightly from pretreatment to posttreatment, the longitudinal decline over treatment was not statistically significant. As expected, the rate of change of disability was significantly more rapid than pain. Evidence for variability in treatment response was noted, suggesting the need for additional research into individual trajectories of change in pediatric pain treatment. PMID:24954165

Effects of Contoured Pallets on AMC Mission Efficiency

DTIC Science & Technology

2011-06-01

carrier moves it on a B-747-100 as if it was a B-747-400, all while not planning to take advantage of the additional cargo capacity of the newer...nature of the cargo being moved and determine if opportunities existed to take advantage of increased MD-11 airlift. Each model had different...types of cargo can help efficiency by planning contoured requirements to take advantage of the fact that while moving these pallets underutilizes

AMC-SWMO Countermeasures Study. Volume 1. Guide to How Countermeasures Affect Smart Weapons

DTIC Science & Technology

1993-06-01

low reflectivity) in a white background (high reflectivity). 4.1.2 IR Slanature Alteration Nonimaging IR signature alteration techniques involve...spots. These techniques can 4-5 SEEKER S......DETETEDSIGNAL AL CONTRAST BETWEEN TARGET AND BACKGROUND Ltgf-’ £tgt L(Ttgt )+ pjgt Lsky/sun/jl 0u Solar ...Reflected Lbklg: 4Okg L(1bkg ) + kg Lsky/sunvcloud Cloud/Sky Reflected Ground Reflected where, Target Emitted Solar Reflected L = integrated radiance

Technology Description Sheets form the AMC 1990 Technology Expo Held in Aberdeen Proving Ground, Maryland on 1-4 October 1990

DTIC Science & Technology

1990-10-04

emission signals) " Compactness (can be hand-held). The ISOPADS was demonstrated to troop units at the Army Training Command, Grafenwoehr , West...To be controlled, the microwave chips and modules must be interconnected with remotely located components and subsystems. Utilizing metallic cables...forward observer systcm being developed for use in situations too dangerous for soldiers. such as nuclear- contaminated areas or in support of a minefield

Countering Strategic Preclusion: The Requirement for Truly Global Reach in the 21st Century

DTIC Science & Technology

2012-06-01

Website, http://www.618tacc. amc.af.mil/shared/ media /document/AFD-110602-022.pdf (accessed 24 May 2012). The inter-theater airlift support to Operation...Crisis,” Pacific Air Forces Official Website, http://www.pacaf. af.mil/shared/ media /document/AFD-110330-077.pdf [accessed 24 May 2012...Reconnaissance Office (NRO), which lists as one of its key functions providing targeting and BDA support to military operations. These are

Korean Affairs Report

DTIC Science & Technology

1986-09-09

U.S. Volvo 13. Other 14. Subtotal 15. Toyota 16. Nissan 17. Honda 18. Mazda 19. Mitsubishi 20. Fujitsu 21. Isuzu 22. Suzuki 23. Japanese...cars & Percent Unit=1,000 3. Company 4. U.S.-Made Cars 5. Imported Cars 6. GM 7. Ford 8. Chrysler 9. AMC 10. U.S. Nissan 11. U.S. Honda 12...24 percent. This is a surprisingly large increase compared with the current 1.7 percent. Until 1983, the prospect of Korean automobile exports was

Final Report of the AMC Committee-Armament. Armament Development Center Concept Plan. Volume 2

DTIC Science & Technology

1974-12-01

Considerations 111-22 Section C Operational Considerations 111-26 Section D Community Economic Impact 111-35 Statements Section E Delphi Benefit Analysis 111-37...Cost Analysis 111-3 B Personnel Considerations III-22 C Operational Considerations 111-26 D Community Economic Impact Statements 111-35 E Delphi ...sidered to be minimal. 111-36 S SECTION E. Delphi Benefit Analysis 1. Introduction. The assessment and comparison of the relative benefits of the various

Department of Defense Energy Strategy: Teaching an Old Dog New Tricks

DTIC Science & Technology

2007-04-01

extensively by terrorists outside and within the United States. Rebels have targeted one oil pipeline in Colombia over 600 times since 1995. In 1996 ...fourth look at re-engining the B-52H fleet since 1996 . The first three Air Force studies concluded re-engining was not economically justifiable... Peterson , to AMC OG/CCs, memorandum. 12 James, Bullet Background Paper on Hawaii ANG. 13 Muellner, USAF Energy Forum. KC-135 Fact Sheet, http

Investigation of internal structure of fine granules by microtomography using synchrotron X-ray radiation.

PubMed

Noguchi, Shuji; Kajihara, Ryusuke; Iwao, Yasunori; Fujinami, Yukari; Suzuki, Yoshio; Terada, Yasuko; Uesugi, Kentaro; Miura, Keiko; Itai, Shigeru

2013-03-10

Computed tomography (CT) using synchrotron X-ray radiation was evaluated as a non-destructive structural analysis method for fine granules. Two kinds of granules have been investigated: a bromhexine hydrochloride (BHX)-layered Celphere CP-102 granule coated with pH-sensitive polymer Kollicoat Smartseal 30-D, and a wax-matrix granule constructed from acetaminophen (APAP), dibasic calcium phosphate dehydrate, and aminoalkyl methacrylate copolymer E (AMCE) manufactured by melt granulation. The diameters of both granules were 200-300 μm. CT analysis of CP-102 granule could visualize the laminar structures of BHX and Kollicoat layers, and also visualize the high talc-content regions in the Kollicoat layer that could not be detected by scanning electron microscopy. Moreover, CT analysis using X-ray energies above the absorption edge of Br specifically enhanced the contrast in the BHX layer. As for granules manufactured by melt granulation, CT analysis revealed that they had a small inner void space due to a uniform distribution of APAP and other excipients. The distribution of AMCE revealed by CT analysis was also found to involve in the differences of drug dissolution from the granules as described previously. These observations demonstrate that CT analysis using synchrotron X-ray radiation is a powerful method for the detailed internal structure analysis of fine granules. Copyright © 2013 Elsevier B.V. All rights reserved.

Diagnostic challenges and case management of the first imported case of Plasmodium knowlesi in Sri Lanka.

PubMed

Dewanee Ranaweera, A; Danansuriya, Manjula N; Pahalagedera, Kusumawathie; de A W Gunasekera, W M Kumudunayana T; Dharmawardena, Priyani; Mak, Keng Wai; Wong, Pei-Sze Jeslyn; Li, Mei-Zhi Irene; Tan, Cheong Huat; Hapuarachchi, Hapuarachchige C; Herath, Hema D B; Fernando, Deepika

2017-03-21

Sri Lanka has achieved 'malaria-free' status and is now in the phase of prevention of re-introduction of malaria. Imported malaria remains a challenge to resurgence of the disease. The diagnostic challenges encountered and the rapid response initiated to manage a Plasmodium infection, which was later confirmed as Plasmodium knowlesi, the first reported case from Sri Lanka, is discussed. An army officer who returned from Malaysia in October 2016 was found to be positive for Plasmodium both by microscopy and rapid diagnostic test (RDT) by the Anti Malaria Campaign Sri Lanka (AMC) during his third visit to a health care provider. Microscopy findings were suspicious of P. knowlesi infection as the smears showed parasite stages similar to both Plasmodium malariae and Plasmodium falciparum. Nested PCR at AMC confirmed Plasmodium genus, but not the species. In the absence of species confirmation, the patient was treated as a case of P. falciparum. The presence of P. knowlesi was later confirmed by a semi-nested PCR assay performed at the Environmental Health Institute, National Environmental Agency in Singapore. The parasite strain was also characterized by sequencing the circumsporozoite gene. Extensive case investigation including parasitological and entomological surveillance was carried out. Plasmodium knowlesi should be suspected in patients returning from countries in the South Asian region where the parasite is prevalent and when blood smear results are inconclusive.

Caspase-1 Specific Light-Up Probe with Aggregation-Induced Emission Characteristics for Inhibitor Screening of Coumarin-Originated Natural Products.

PubMed

Lin, Hao; Yang, Haitao; Huang, Shuai; Wang, Fujia; Wang, Dong-Mei; Liu, Bin; Tang, Yi-Da; Zhang, Chong-Jing

2018-04-18

Caspase-1 is a key player in pyroptosis and inflammation. Caspase-1 inhibition is found to be beneficial to various diseases. Coumarin-originated natural products have an anti-inflammation function, but their direct inhibition effect to caspase-1 remains unexplored. To evaluate their interactions, the widely used commercial coumarin-based probe (Ac-YVAD-AMC) is not suitable, as the background signal from coumarin-originated natural products could interfere with the screening results. Therefore, fluorescent probes using a large Stokes shift could help solve this problem. In this work, we chose the fluorophore of tetraphenylethylene-thiophene (TPETH) with aggregation-induced emission characteristics and a large Stokes shift of about 200 nm to develop a molecular probe. Bioconjugation between TPETH and hydrophilic peptides (DDYVADC) through a thiol-ene reaction generated a light-up probe, C1-P3. The probe has little background signal in aqueous media and exerts a fluorescent turn-on effect in the presence of caspase-1. Moreover, when evaluating the inhibition potency of coumarin-originated natural products, the new probe could generate a true and objective result but not for the commercial probe (Ac-YVAD-AMC), which is evidenced by HPLC analysis. The quick light-up response and accurate screening results make C1-P3 very useful in fundamental study and inhibitior screening toward caspase-1.

EphA3 maintains radioresistance in head and neck cancers through epithelial mesenchymal transition.

PubMed

Kim, Song Hee; Lee, Won Hyeok; Kim, Seong Who; Je, Hyoung Uk; Lee, Jong Cheol; Chang, Hyo Won; Kim, Young Min; Kim, Kyungbin; Kim, Sang Yoon; Han, Myung Woul

2018-07-01

Radiotherapy is a well-established therapeutic modality used in the treatment of many cancers. However, radioresistance remains a serious obstacle to successful treatment. Radioresistance can cause local recurrence and distant metastases in some patients after radiation treatment. Thus, many studies have attempted to identify effective radiosensitizers. Eph receptor functions contribute to tumor development, modulating cell-cell adhesion, invasion, neo-angiogenesis, tumor growth and metastasis. However, the role of EphA3 in radioresistance remains unclear. In the current study, we established a stable radioresistant head and neck cancer cell line (AMC HN3R cell line) and found that EphA3 was expressed predominantly in the radioresistant head and neck cancer cell line through DNA microarray, real time PCR and Western blotting. Additionally, we found that EphA3 was overexpressed in recurrent laryngeal cancer specimens after radiation therapy. EphA3 mediated the tumor invasiveness and migration in radioresistant head and neck cancer cell lines and epithelial mesenchymal transition- related protein expression. Inhibition of EphA3 enhanced radiosensitivity in the AMC HN 3R cell line in vitro and in vivo study. In conclusion, our results suggest that EphA3 is overexpressed in radioresistant head and neck cancer and plays a crucial role in the development of radioresistance in head and neck cancers by regulating the epithelial mesenchymal transition pathway. Copyright © 2018 Elsevier Inc. All rights reserved.

Big Pharma on the Farm: Students Are Exposed to Pharmaceutical Marketing More Often in Rural Clinics.

PubMed

Evans, David V; Keys, Toby; Desnick, Laurel; A Andrilla, C Holly; Bienz, Danielle; Rosenblatt, Roger

2016-07-01

Pharmaceutical marketing techniques are effective in changing the behavior of health care providers in ways that deviate from evidence-based practices. To mitigate the influence of pharmaceutical marketing on learners, academic medical centers (AMCs) have adopted policies to limit student/industry interaction. Many clinical experiences occur outside of the AMC. The purpose of this study was to compare medical students' exposure to pharmaceutical marketing in off-campus rural and urban underserved clinical sites. The University of Washington School of Medicine Rural and Underserved Opportunities Program (RUOP) places rising second-year medical students in underserved clinical sites in five northwestern states. We surveyed RUOP students to evaluate their exposure to pharmaceutical marketing. Of 120 students, 86 (72%) completed surveys. Sixty-five (76%) did their RUOP rotation in rural areas. Students in rural locations were more likely to report exposure to pharmaceutical marketing. Distribution of free drug samples was reportedly three times higher in rural than urban sites (54% versus 15%). Doctors meeting with sales representatives were reported as four times higher in rural clinics (40% versus 10%). Students at rural sites reported exposure to pharmaceutical marketing more than those in urban settings. Rural medical educators should provide faculty development for community clinicians on the influences of pharmaceutical marketing on learners. Medical schools must review local clinic and institution-wide policies to limit pharmaceutical marketing exposure to learners in the rural learning environment.

Does Social Support Moderate the Association Among Major Depression, Generalized Anxiety Disorder, and Functional Disability in Adults With Diabetes?

PubMed

Levy, Melanie; Burns, Rachel J; Deschênes, Sonya S; Schmitz, Norbert

Diabetes requires complex self-management routines to prevent the development of functional disability. Relative to people without diabetes, those with diabetes are more likely to have comorbid major depressive disorder (MDD) and generalized anxiety disorder (GAD), which also increase the likelihood of functional disability. Social support is associated with positive health outcomes in people with comorbid diabetes and mental disorders and may serve as a buffer against functional disability, though this possibility has yet to be examined. This study examined whether social support moderates the association between MDD or GAD and functional disability in adults with diabetes. Adults with MDD or GAD were expected to report greater disability than those without MDD or GAD. This association was expected to be stronger in people reporting lower social support relative to those reporting higher social support. Data came from the cross-sectional 2012 Canadian Community Health Survey-Mental Health (n = 1764). Diabetes status, social support, and functional disability were assessed via self-report; past-year MDD and GAD were assessed with structured diagnostic interviews. Linear regression analyses, conducted separately for MDD and GAD, indicated main effects of past-year MDD and GAD, such that those with a mental disorder reported greater functional disability than those without a mental disorder. Social support did not moderate the associations between either MDD and functional disability or GAD and functional disability. In this nationally representative population study, both MDD and GAD predicted greater functional disability in adults with diabetes. Social support, however, did not moderate these associations. Copyright © 2017 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

Intellectual disability and patient activation after release from prison: a prospective cohort study.

PubMed

Young, J T; Cumming, C; van Dooren, K; Lennox, N G; Alati, R; Spittal, M J; Brophy, L; Preen, D B; Kinner, S A

2017-10-01

Intellectual disability and patient activation may be important drivers of inequities in health service access and health outcomes for people with intellectual disability transitioning from prison to the community. We assessed the association between intellectual disability and patient activation after prison release and examined whether this association varied, depending on whether intellectual disability was identified prior to prison release. Overall, 936 prisoners were screened for intellectual disability by using the Hayes Ability Screening Index and completed the Patient Activation Measure (PAM) within 6 weeks of prison release and again at 1, 3 and 6 months post-release. We estimated the association between intellectual disability status and PAM scores by using a multilevel linear model, adjusting for sociodemographic, behavioural, health and criminogenic factors. We used propensity score matching to estimate the impact of being identified with intellectual disability prior to release from prison on the change in mean PAM score after prison release. Compared with those who screened negative for intellectual disability, ex-prisoners who screened positive, both with and without prior identification of intellectual disability, had significantly decreased mean PAM scores [(B = -4.3; 95% CI: -6.3, -2.4) and (B = -4.5; 95% CI: -6.8, -2.3), respectively] over 6 months of follow-up. Among those who reported being identified with intellectual disability prior to release from prison, a significant increase in PAM score at the 6-month follow-up interview (B = 5.89; 95% CI: 2.35, 9.42; P = 0.001) was attributable to being identified with intellectual disability prior to release. Ex-prisoners screening positive for possible intellectual disability have decreased patient activation for at least 6 months after release from prison. However, individuals whose possible intellectual disability is unidentified appear to be particularly vulnerable. Incarceration is a pivotal opportunity for the identification of intellectual disability and for initiating transitional linkages to health and intellectual disability-specific community services for this marginalised population. © 2017 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

Quality of life in relation to upper and lower respiratory conditions among retired 9/11-exposed firefighters with pulmonary disability.

PubMed

Berninger, Amy; Webber, Mayris P; Weakley, Jessica; Gustave, Jackson; Zeig-Owens, Rachel; Lee, Roy; Al-Othman, Fairouz; Cohen, Hillel W; Kelly, Kerry; Prezant, David J

2010-12-01

To examine health-related quality of life (HRQoL) and World Trade Center (WTC) cough syndrome conditions in male firefighters who retired due to a 9/11-related pulmonary disability. From 3/1/2008 to 1/31/2009, we contacted 275 disability-retired firefighters and compared their HRQoL and current aerodigestive conditions to those from WTC-exposed non-disabled retired and active firefighters. Relationships between HRQoL and explanatory variable(s) were examined using multivariable linear regression models. Mean physical component summary (PCS) scores were lowest in disabled retirees compared with non-disabled retirees and actives: 36.4 (9.6), 49.4 (8.7), and 53.1 (5.1), respectively (P < 0.0001). Mean mental component summary (MCS) scores were closer: 44.5 (11.9), 48.1 (8.5), and 48.7 (7.4), respectively (P < 0.0001). In multivariable models, after adjustment for many factors, PCS scores were not associated with early WTC arrival, but were inversely associated with disability retirement and all WTC cough syndrome conditions. MCS scores were inversely associated with early WTC arrival and most WTC cough syndrome conditions, but were not associated with disability retirement. WTC cough syndrome conditions predict lower HRQoL scores even 8 years after exposure, independent of retirement status. These data suggest that monitoring physical conditions of individuals with occupational exposures might help identify those at risk for impaired HRQoL.

Rasch-built Overall Disability Scale (R-ODS) for immune-mediated peripheral neuropathies.

PubMed

van Nes, S I; Vanhoutte, E K; van Doorn, P A; Hermans, M; Bakkers, M; Kuitwaard, K; Faber, C G; Merkies, I S J

2011-01-25

To develop a patient-based, linearly weighted scale that captures activity and social participation limitations in patients with Guillain-Barré syndrome (GBS), chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), and gammopathy-related polyneuropathy (MGUSP). A preliminary Rasch-built Overall Disability Scale (R-ODS) containing 146 activity and participation items was constructed, based on the WHO International Classification of Functioning, Disability and Health, literature search, and patient interviews. The preliminary R-ODS was assessed twice (interval: 2-4 weeks; test-retest reliability studies) in 294 patients who experienced GBS in the past (n = 174) or currently have stable CIDP (n = 80) or MGUSP (n = 40). Data were analyzed using the Rasch unidimensional measurement model (RUMM2020). The preliminary R-ODS did not meet the Rasch model expectations. Based on disordered thresholds, misfit statistics, item bias, and local dependency, items were systematically removed to improve the model fit, regularly controlling the class intervals and model statistics. Finally, we succeeded in constructing a 24-item scale that fulfilled all Rasch requirements. "Reading a newspaper/book" and "eating" were the 2 easiest items; "standing for hours" and "running" were the most difficult ones. Good validity and reliability were obtained. The R-ODS is a linearly weighted scale that specifically captures activity and social participation limitations in patients with GBS, CIDP, and MGUSP. Compared to the Overall Disability Sum Score, the R-ODS represents a wider range of item difficulties, thereby better targeting patients with different ability levels. If responsive, the R-ODS will be valuable for future clinical trials and follow-up studies in these conditions.

Training to walk amid uncertainty with Re-Step: measurements and changes with perturbation training for hemiparesis and cerebral palsy.

PubMed

Bar-Haim, Simona; Harries, Netta; Hutzler, Yeshayahu; Belokopytov, Mark; Dobrov, Igor

2013-09-01

To describe Re-Step™, a novel mechatronic shoe system that measures center of pressure (COP) gait parameters and complexity of COP dispersion while walking, and to demonstrate these measurements in healthy controls and individuals with hemiparesis and cerebral palsy (CP) before and after perturbation training. The Re-Step™ was used to induce programmed chaotic perturbations to the feet while walking for 30 min for 36 sessions over 12-weeks of training in two subjects with hemiparesis and two with CP. Baseline measurements of complexity indices (fractal dimension and approximate entropy) tended to be higher in controls than in those with disabilities, while COP variability, mean and variability of step time and COP dispersion were lower. After training the disabled subjects these measurement values tended toward those of the controls, along with a decrease in step time, 10 m walk time, average step time, percentage of double support and increased Berg balance score. This pilot trial reveals the feasibility and applicability of this unique measurement and perturbation system for evaluating functional disabilities and changes with interventions to improve walking. Implication for Rehabilitation Walking, of individuals with cerebral palsy and hemiparesis following stroke, can be viewed in terms of a rigid motor behavior that prevents adaptation to changing environmental conditions. Re-Step system (a) measures and records linear and non-linear gait parameters during free walking to provide a detailed evaluation of walking disabilities, (b) is an intervention training modality that applies unexpected perturbations during walking. This perturbation intervention may improve gait and motor functions of individuals with hemiparesis and cerebral plasy.

Visual field impairment captures disease burden in multiple sclerosis.

PubMed

Ortiz-Perez, Santiago; Andorra, Magí; Sanchez-Dalmau, Bernardo; Torres-Torres, Rubén; Calbet, David; Lampert, Erika J; Alba-Arbalat, Salut; Guerrero-Zamora, Ana M; Zubizarreta, Irati; Sola-Valls, Nuria; Llufriu, Sara; Sepúlveda, María; Saiz, Albert; Villoslada, Pablo; Martinez-Lapiscina, Elena H

2016-04-01

Monitoring disease burden is an unmeet need in multiple sclerosis (MS). Identifying patients at high risk of disability progression will be useful for improving clinical-therapeutic decisions in clinical routine. To evaluate the role of visual field testing in non-optic neuritis eyes (non-ON eyes) as a biomarker of disability progression in MS. In 109 patients of the MS-VisualPath cohort, we evaluated the association between visual field abnormalities and global and cognitive disability markers and brain and retinal imaging markers of neuroaxonal injury using linear regression models adjusted for sex, age, disease duration and use of disease-modifying therapies. We evaluated the risk of disability progression associated to have baseline impaired visual field after 3 years of follow-up. Sixty-two percent of patients showed visual field defects in non-ON eyes. Visual field mean deviation was statistically associated with global disability; brain (normalized brain parenchymal, gray matter volume and lesion load) and retinal (peripapillary retinal nerve fiber layer thickness and macular ganglion cell complex thickness) markers of neuroaxonal damage. Patients with impaired visual field had statistically significative greater disability, lower normalized brain parenchymal volume and higher lesion volume than patients with normal visual field testing. MS patients with baseline impaired VF tripled the risk of disability progression during follow-up [OR = 3.35; 95 % CI (1.10-10.19); p = 0.033]. The association of visual field impairment with greater disability and neuroaxonal injury and higher risk of disability progression suggest that VF could be used to monitor MS disease burden.

Association between visual impairment and patient-reported visual disability at different stages of cataract surgery.

PubMed

Acosta-Rojas, E Ruthy; Comas, Mercè; Sala, Maria; Castells, Xavier

2006-10-01

To evaluate the association between visual impairment (visual acuity, contrast sensitivity, stereopsis) and patient-reported visual disability at different stages of cataract surgery. A cohort of 104 patients aged 60 years and over with bilateral cataract was assessed preoperatively, after first-eye surgery (monocular pseudophakia) and after second-eye surgery (binocular pseudophakia). Partial correlation coefficients (PCC) and linear regression models were calculated. In patients with bilateral cataracts, visual disability was associated with visual acuity (PCC = -0.30) and, to a lesser extent, with contrast sensitivity (PCC = 0.16) and stereopsis (PCC = -0.09). In monocular and binocular pseudophakia, visual disability was more strongly associated with stereopsis (PCC = -0.26 monocular and -0.51 binocular) and contrast sensitivity (PCC = 0.18 monocular and 0.34 binocular) than with visual acuity (PCC = -0.18 monocular and -0.18 binocular). Visual acuity, contrast sensitivity and stereopsis accounted for between 17% and 42% of variance in visual disability. The association of visual impairment with patient-reported visual disability differed at each stage of cataract surgery. Measuring other forms of visual impairment independently from visual acuity, such as contrast sensitivity or stereopsis, could be important in evaluating both needs and outcomes in cataract surgery. More comprehensive assessment of the impact of cataract on patients should include measurement of both visual impairment and visual disability.

Change in vision, visual disability, and health after cataract surgery.

PubMed

Helbostad, Jorunn L; Oedegaard, Maria; Lamb, Sarah E; Delbaere, Kim; Lord, Stephen R; Sletvold, Olav

2013-04-01

Cataract surgery improves vision and visual functioning; the effect on general health is not established. We investigated if vision, visual functioning, and general health follow the same trajectory of change the year after cataract surgery and if changes in vision explain changes in visual disability and general health. One-hundred forty-eight persons, with a mean (SD) age of 78.9 (5.0) years (70% bilateral surgery), were assessed before and 6 weeks and 12 months after surgery. Visual disability and general health were assessed by the CatQuest-9SF and the Short Formular-36. Corrected binocular visual acuity, visual field, stereo acuity, and contrast vision improved (P < 0.001) from before to 6 weeks after surgery, with further improvements of visual acuity evident up to 12 months (P = 0.034). Cataract surgery had an effect on visual disability 1 year later (P < 0.001). Physical and mental health improved after surgery (P < 0.01) but had returned to presurgery level after 12 months. Vision changes did not explain visual disability and general health 6 weeks after surgery. Vision improved and visual disability decreased in the year after surgery, whereas changes in general health and visual functioning were short-term effects. Lack of associations between changes in vision and self-reported disability and general health suggests that the degree of vision changes and self-reported health do not have a linear relationship.

Factors influencing acceptance of disability in individuals with spinal cord injury in Neiva, Colombia, South America.

PubMed

Nicholls, Elizabeth; Lehan, Tara; Plaza, Silvia Leonor Olivera; Deng, Xiaoyan; Romero, Jose Libardo Perdomo; Pizarro, Jose Anselmo Arango; Carlos Arango-Lasprilla, Juan

2012-01-01

The aim of the present study was to determine the level of acceptance of disability as measured by the Acceptance of Disability Scale (ADS) within a sample of individuals with spinal cord injury (SCI) from Neiva, Colombia and to examine the influence of sociodemographic variables, injury characteristics, and level of depression on ADS score. The ADS was administered to 40 adults with SCI from Nieva, Colombia who were recruited from an organization that connects individuals with disabilities to resources. Most (92.5%) participants were men, with a mean age of 34.75 years and approximately 12 years since injury. Fifty-five percent of subjects were diagnosed with paraplegia and the remainder with tetraplegia. Descriptive, linear model and multiple regression analyses were used to describe the relationship between the independent and dependent variables. The mean total ADS score of this sample was 171.5, indicating overall low disability acceptance. After controlling for level of depression and time since injury, gender was significantly related to ADS score such that women reported higher acceptance of disability. After controlling for gender and time since injury, level of depression was significantly related to ADS score. Acceptance of disability is a serious problem in this group of SCI survivors in Neiva, Colombia, especially among women and individuals with higher levels of depression. Because acceptance of disability is likely a problem for many individuals living with disability in the developing world, future researchers should investigate what interventions (e.g. counseling, pharmacological intervention, social service programs) can be implemented to improve acceptance of disability in this population. © 2012 Informa UK, Ltd.

An Analysis of AH-1Z Helicopter Pilots and Qualifications: The Impact of Fleet Squadron Training Progression Timelines

DTIC Science & Technology

2018-03-01

remaining 3000- series time block. Although there are fewer flight hours when compared to AHC, the coordination with external agencies may increase the...training duration to complete FAC(A). Additionally, pilots may conduct 4000 to 6000 series events concurrently, thus expanding the training time . 4...A)I training. Because FAC(A)I is included in the 5000- series training block, the time period cannot be finitely determined. 8. FL and AMC are the

A Study to Identify the Characteristics of the Beneficiaries Residing Within the Catchment Area of Keller AMC

DTIC Science & Technology

1992-06-01

civilian providers. Morrill (1987) performed the first step of the marketing effort, which was marketing research . First, Morrill began searching for a...strategy I adopt from them is a marketing research strategy. According to Kotler and Clarke, "The marketing research process consists of five steps...and report presentation" (p. 184). My paper will follow this marketing research process. The first step of this process is covered in the statement of

Integrating Joint Intratheater Airlift Command and Control with the Needs of the Modular Army: A Perspective of Current and Past Nonlinear Operations

DTIC Science & Technology

2008-06-13

Mobility Division AMLO Air Mobility Liaison Officer AMR Air Movement Request AO Area of Operations AOC Air and Space Operations Center BAE...those forces and by doctrine can only advise the AOC Director. Adding to this confused chain of command, the Air Mobility Liaison Officers ( AMLO ...there is not a commander of airlift forces and the AMLO typically answers to Air Mobility Command’s (AMC) 18th Air Force Commander when deployed to

Proceedings of the Open Sessions of the Workshop on Imaging Trackers and Autonomous Acquisition Applications for Missile Guidance Held at Redstone Arsenal, Alabama on 19-20 November 1979

DTIC Science & Technology

1979-11-01

a generalized cooccurrence matrix. Describing image texture is an important problem in the design of image understanding systems . Applications as...display system design optimization and video signal processing. Based on a study by Southern Research Institute , a number of options were identified...Specification for Target Acquisition Designation System (U), RFP # AMC-DP-AAH-H4020, i2 Apr 77. 4. Terminal Homing Applications of Solid State Image

Assessment of Correlation of Distal Mean Arterial Pressure with Aortic Blood Flow during Partial Resuscitative Endovascular Balloon Aortic Occlusion (P-REBOA) in a Swine (Sus scrofa) Controlled Hemorrhage Model

DTIC Science & Technology

2017-11-06

60th Medical Group (AMC), Travis AFB, CA INSTITUTIONAL ANIMAL CARE AND USE COMMITTEE (IACUC) FINAL REPORT SUMMARY (Please type all information. Use...Pressure with Aortic Blood Flow during Partial Resuscitative Endovascular Balloon Aortic Occlusion (P-REBOA) in a Swine (Sus scrofa) Controlled Hemorrhage...to Date Sus scrofa 8 8 2. PROTOCOL TYPE /CHARACTERISTICS: (Check all applicable terms in EACH column) _ Training: Live Animal Medical Readiness

AMC-SWMO Countermeasures Study. Volume 1. Guide to How Countermeasures Affect Smart Weapons

DTIC Science & Technology

1992-01-01

4.1.2 IR Signature Alteration Nonimaging IR signature alteration techniques involve thermal management. The pertinent signature is Mhe difference between...appear the same to a nonimaging (point source) sensor, where the target area is always less th3n the instantaneous field-of-view (IFOV). Figure 4-3 shows...L Ltgt- Lbkg CONTRAST BETWEEN TARGET AND BACKGROUND Ltgt= rtgt L(Ttgt ) + Rigt Lsky/sun/cloud Solar Reflected -bkgb %kg L(Tbkg ) + Pbkg Lsky/sun/cloud

Technique Refinement and Validation of Variable Aortic Occlusion via Extracorporeal Flow Circuit in a Pig Model (Sus scrofa) of Uncontrolled Hemorrhage with Subsequent Resuscitation and Critical Care

DTIC Science & Technology

2016-07-24

60th Medical Group (AMC), Travis AFB, CA INSTITUTIONAL ANIMAL CARE AND USE COMMITTEE (IACUC) FINAL REPORT SUMMARY (Please type all information. Use...TRIENNIAL REVISION DATE: N/A FUNDING SOURCE: HQ USAF SG 1. RECORD OF ANIMAL USAGE: Animal Species: Total # Approved # Used this FY Total # Used to...Restraint Training: non-Live Animal Health Promotion Research: Survival (chronic) Prevention x_ Research: non-Survival (acute) Utilization Mgt. Other

Frequency Based Continuation Training (FBCT): A Concept for use in the Mobility Air Forces (MAF)

DTIC Science & Technology

2014-06-13

allowed the researcher to predict the impact of training period changes upon the completion percentage for a given event. These changes were then...before sunrise, … (c) Instrument experience. Except as provided in paragraph (e) of this section, a person may act as pilot in command under IFR or...be required in order to determine the real-world impact of a FBCT system on aircrew readiness. The author recommends AMC conduct a small-group

Unit Materiel Fielding Point Europe.

DTIC Science & Technology

1985-10-01

NCAO to other non-AMC staging sites was the most costly alternative with respect to transportation. 33 1b This page left blank intentionally. 34...DIFFERFNT TYPES) wILL RE CONS’OL- IOATEn AT THE ncAO UMFP A. T TMHTN TIPE. PROJFCTEI) RFOUIREMENTS FOR rOVFREn STORAr;F AT THE F-Za REMAT~i WFLL RFLOWt TOTAL...subject as above. b. Letter, AMXLC-S, your HO, 13 Jun 85, subject: NCAO UMFP Analysis (Report Number 514101). 2. Reference la requested supply data on

A Framework to Determine New System Requirements Under Design Parameter and Demand Uncertainties

DTIC Science & Technology

2015-05-13

Demand fluctuation on a day to day basis – Routes flown vary based on demand – Limited aircraft types: C-5, C-17, C-130, Boeing 747 -F, KC-135, etc...dataset – Demand for subset served by C-5, C-17 and 747 -F (~75% of total demand) – Fixed density and dimension of pallet (463 L) • Our aircraft...fleet consists of only the C-5, C-17 and 747 -F. Source: www.amc.af.mil 30

A Fully Coupled, Automated Formation Control System for Dissimilar Aircraft in Maneuvering Formation Flight

DTIC Science & Technology

1991-03-01

Command contracted with IBM in the mid seventies to build a drone formation control system capable of controlling a number of drone aircraft... Number 6, 1 July 1964 to 26 February 1965. Contract Number DA-36-039-AMC� (E), 1E1-20601-A219-03. Burlington, Massachusetts: Radio Corporation of ...PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) 8. PERFORMING ORGANIZATIONREPORT NUMBER Air Force Institute of Technology, WPAFB OH 45433-6583 AFIT/GE

Environmental Assessment of Installation Development at McGuire Air Force Base, New Jersey

DTIC Science & Technology

2008-02-01

months. The primary fuel used by the boilers is natural gas , but they are also capable of using oil as a backup. Excess heating is capacity available... oil ft 2 square feet FUB Facilities Utilization Board FY fiscal year GIS Geographical Information System GOV government-owned vehicle GRDC...under the command and control of AMC, approximately 18 miles southeast of downtown Trenton, New Jersey. It is bounded by the U.S. Army’s Fort Dix

Department of Defense Energy Strategy. Teaching an Old Dog New Tricks (Walker Paper, Number 10)

DTIC Science & Technology

2008-01-01

outside and within the United States. Rebels have targeted one oil pipeline in Colombia more than 600 times since 1995. In 1996 , London police...ing the USAF B-52H fleet. This study was the fourth look at reengining the B-52H fleet since 1996 . The first three Air Force studies concluded...16. 10. Clary, Air Force Aviations Operations. 11. Peterson to AMC OG/CCs, memorandum. 12. James, Bullet Background Paper on Hawaii ANG. 13

Disability in the upper extremity and quality of life in hand-arm vibration syndrome.

PubMed

Poole, Kerry; Mason, Howard

2005-11-30

To investigate whether hand-arm vibration syndrome (HAVS) leads to disability in the upper extremity or deficit in quality of life (QoL) using validated questionnaire tools, and to establish whether these effects are related to the Stockholm Workshop Staging (SWS). This was a postal cross-sectional questionnaire study with a 50% response rate. Four hundred and forty-four males, who had been diagnosed and staged according to the SWS were sent the Disability in the Arm, Shoulder and Hand (DASH) and the SF-36v2 QoL questionnaires. HAVS cases had significantly greater DASH disability scores and reduced QoL physical and mental component scores compared to published normal values. Those HAVS cases with a presumptive diagnosis of Carpal Tunnel Syndrome(CTS) had even higher disability scores. There was a clear, linear relationship between both the DASH disability score and the physical component of the QoL and sensorineural SWS, but not with the vascular SWS. HAVS has a significant effect on an individual's perceived ability to perform everyday tasks involving the upper extremity, and their quality of life. Physical capability may be further compromised in those individuals who have a presumptive diagnosis of CTS. These findings may have important implications regarding management of the affected worker.

Relationship between self-reported upper limb disability and quantitative tests in hand-arm vibration syndrome.

PubMed

Poole, Kerry; Mason, Howard

2007-03-15

To establish the relationship between quantitative tests of hand function and upper limb disability, as measured by the Disability of the Arm, Shoulder and Hand (DASH) questionnaire, in hand-arm vibration syndrome (HAVS). A total of 228 individuals with HAVS were included in this study. Each had undergone a full HAVS assessment by an experienced physician, including quantitative tests of vibrotactile and thermal perception thresholds, maximal hand-grip strength (HG) and the Purdue pegboard (PP) test. Individuals were also asked to complete a DASH questionnaire. PP and HG of the quantitative tests gave the best and statistically significant individual correlations with the DASH disability score (r2 = 0.168 and 0.096). Stepwise linear regression analysis revealed that only PP and HG measurements were statistically significant predictors of upper limb disability (r2 = 0.178). Overall a combination of the PP and HG measurements, rather than each alone, gave slightly better discrimination, although not statistically significant, between normal and abnormal DASH scores with a sensitivity of 73.1% and specificity of 64.3%. Measurements of manual dexterity and hand-grip strength using PP and HG may be useful in helping to confirm lack of upper limb function and 'perceived' disability in HAVS.

The Cost of an Additional Disability-Free Life Year for Older Americans: 1992–2005

PubMed Central

Cai, Liming

2013-01-01

Objective To estimate the cost of an additional disability-free life year for older Americans in 1992–2005. Data Source This study used 1992–2005 Medicare Current Beneficiary Survey, a longitudinal survey of Medicare beneficiaries with a rotating panel design. Study Design This analysis used multistate life table model to estimate probabilities of transition among a discrete set of health states (nondisabled, disabled, and dead) for two panels of older Americans in 1992 and 2002. Health spending incurred between annual health interviews was estimated by a generalized linear mixed model. Health status, including death, was simulated for each member of the panel using these transition probabilities; the associated health spending was cross-walked to the simulated health changes. Principal Findings Disability-free life expectancy (DFLE) increased significantly more than life expectancy during the study period. Assuming that 50 percent of the gains in DFLE between 1992 and 2005 were attributable to increases in spending, the average discounted cost per additional disability-free life year was $71,000. There were small differences between gender and racial/ethnic groups. Conclusions The cost of an additional disability-free life year was substantially below previous estimates based on mortality trends alone. PMID:22670874

The Kassel Laboratory Astrophysics Thz Spectrometrs

NASA Astrophysics Data System (ADS)

Chantzos, Johanna; Herberth, Doris; Kutzer, Pia; Muster, Christoph; Fuchs, Guido W.; Giesen, Thomas

2016-06-01

We present a brief overview of the recently established laboratory astrophysics group in Kassel/Germany with a focus on our THz technology. After an outline of our laboratory equipment and recent projects the talk will focus on our new fast spectral scan technique for molecular jet experiments. Here, a new test setup for broadband fast sweep spectrometry in the MW to submm wavelength region has been realized and can be applied to identify transient molecules in a supersonic jet. An arbitrary waveform generator (AWG) is used to generate chirped pulses with a linear frequency sweep in the MHz regime. Pulse durations are of a few microseconds. These pulses are up-converted in frequency, e.g. into the 50 GHz microwave frequency range utilizing a synthesizer, or using a synthesizer plus standard amplifier multiplier chain (AMC) to reach the 100-300 GHz region. As test, NH_3 has been measured between 18-26 GHz in a supersonic jet of 500 μ s duration. Acetonitrile (CH_3CN) was tested in the (90-110) GHz range. The spectrometer is capable of providing fast, broadband and low-noise measurements. Experiments with non-stabel molecular production conditions can greatly benefit from these advantages. The setup enables the study of Van-der-Waals-clusters, as well as carbon chain molecules and small metal-containing refractory molecules when combined with appropriate molecule sources.

38 CFR 4.56 - Evaluation of muscle disabilities.

Code of Federal Regulations, 2012 CFR

2012-07-01

... shrapnel fragment, without explosive effect of high velocity missile, residuals of debridement, or... findings. Entrance and (if present) exit scars, small or linear, indicating short track of missile through... missile or large low-velocity missile, with debridement, prolonged infection, or sloughing of soft parts...

38 CFR 4.56 - Evaluation of muscle disabilities.

Code of Federal Regulations, 2014 CFR

2014-07-01

... shrapnel fragment, without explosive effect of high velocity missile, residuals of debridement, or... findings. Entrance and (if present) exit scars, small or linear, indicating short track of missile through... missile or large low-velocity missile, with debridement, prolonged infection, or sloughing of soft parts...

38 CFR 4.56 - Evaluation of muscle disabilities.

Code of Federal Regulations, 2013 CFR

2013-07-01

... shrapnel fragment, without explosive effect of high velocity missile, residuals of debridement, or... findings. Entrance and (if present) exit scars, small or linear, indicating short track of missile through... missile or large low-velocity missile, with debridement, prolonged infection, or sloughing of soft parts...

Shortage of supported housing for people with mental illness: Australia as an exemplar of an international problem.

PubMed

Cashin, Andrew

2014-02-01

Social and economic stability promotes recovery and treatment maintenance in people with mental disorders. Research findings are strong that there is a link between economic and housing stability and relapse. To achieve social and economic stability a whole of government approach is required. Policy is not a linear process but rather is an interactive and iterative process in which administrative discretion comes to bare. Demarcations and tensions in terms of interpretation of policy among departments are international phenomena. In Australia, issues exist in the government interdepartmental interpretation of disability that discriminates against those without intellectual disability in securing supported housing. This issue is a good exemplar of the challenges of a whole of government approach to support those with psychiatric disability. The example is of particular concern in light of housing affordability in Australia. The issue is contemporary as Australia rolls out the National Disability Insurance Scheme (NDIS) and struggles to fulfil a commitment to a whole of government approach to care and support for people with a psychiatric disability. Internationally the issue is timely as more countries embrace the philosophy of a whole of government approach to mental health care.

Slow walking model for children with multiple disabilities via an application of humanoid robot

NASA Astrophysics Data System (ADS)

Wang, ZeFeng; Peyrodie, Laurent; Cao, Hua; Agnani, Olivier; Watelain, Eric; Wang, HaoPing

2016-02-01

Walk training research with children having multiple disabilities is presented. Orthosis aid in walking for children with multiple disabilities such as Cerebral Palsy continues to be a clinical and technological challenge. In order to reduce pain and improve treatment strategies, an intermediate structure - humanoid robot NAO - is proposed as an assay platform to study walking training models, to be transferred to future special exoskeletons for children. A suitable and stable walking model is proposed for walk training. It would be simulated and tested on NAO. This comparative study of zero moment point (ZMP) supports polygons and energy consumption validates the model as more stable than the conventional NAO. Accordingly direction variation of the center of mass and the slopes of linear regression knee/ankle angles, the Slow Walk model faithfully emulates the gait pattern of children.

The relationship between physical impairments, quality of life and disability of the neck and upper limb in patients following neck dissection.

PubMed

Gane, Elise M; McPhail, Steven M; Hatton, Anna L; Panizza, Benedict J; O'Leary, Shaun P

2018-05-16

The purpose of this study was to examine the relationship between physical impairments, quality of life and disability in patients following neck dissection, with consideration of patient and clinical characteristics. Cross-sectional study of patients < 5 years after neck dissection for head and neck cancer. Quality of life and self-reported disability were measured with the Neck Dissection Impairment Index, Quick Disabilities of the Arm, Shoulder and Hand, and Neck Disability Index. Active neck and shoulder range of motion and isometric muscle strength were also assessed. Generalised linear modelling was used to explore relationships between variables. Eighty-four participants (68% male, median age 61 years) demonstrated reduced quality of life (median (interquartile range) score = 76 (49, 93) from 0 (worst) to 100 (best)), and mild levels of upper limb (14 (2, 32)) and neck disability (14 (6, 28)) (from 0 (best) to 100 (worst)). Bilateral neck dissection was associated with reduced quality of life (coeff (95% CI) = - 12.49 (- 24.69, - 0.29)). Post-operative chemoradiation therapy was associated with reduced quality of life (- 21.46 (- 37.57, - 5.35)) and neck disability (0.71 (0.10, 1.32)). Measures of shoulder flexibility or strength were associated with quality of life and self-reported disability. Quality of life and musculoskeletal disability after neck dissection are associated with factors from multiple domains including physical motor function and treatment modality. Having reduced shoulder flexibility or strength is related to functional deficits and quality of life after neck dissection for head and neck cancer.

Resting-state connectivity of pre-motor cortex reflects disability in multiple sclerosis.

PubMed

Dogonowski, A-M; Siebner, H R; Soelberg Sørensen, P; Paulson, O B; Dyrby, T B; Blinkenberg, M; Madsen, K H

2013-11-01

To characterize the relationship between motor resting-state connectivity of the dorsal pre-motor cortex (PMd) and clinical disability in patients with multiple sclerosis (MS). A total of 27 patients with relapsing-remitting MS (RR-MS) and 15 patients with secondary progressive MS (SP-MS) underwent functional resting-state magnetic resonance imaging. Clinical disability was assessed using the Expanded Disability Status Scale (EDSS). Independent component analysis was used to characterize motor resting-state connectivity. Multiple regression analysis was performed in SPM8 between the individual expression of motor resting-state connectivity in PMd and EDSS scores including age as covariate. Separate post hoc analyses were performed for patients with RR-MS and SP-MS. The EDSS scores ranged from 0 to 7 with a median score of 4.3. Motor resting-state connectivity of left PMd showed a positive linear relation with clinical disability in patients with MS. This effect was stronger when considering the group of patients with RR-MS alone, whereas patients with SP-MS showed no increase in coupling strength between left PMd and the motor resting-state network with increasing clinical disability. No significant relation between motor resting-state connectivity of the right PMd and clinical disability was detected in MS. The increase in functional coupling between left PMd and the motor resting-state network with increasing clinical disability can be interpreted as adaptive reorganization of the motor system to maintain motor function, which appears to be limited to the relapsing-remitting stage of the disease. © 2013 John Wiley & Sons A/S.

Neck motion, motor control, pain and disability: A longitudinal study of associations in neck pain patients in physiotherapy treatment.

PubMed

Meisingset, Ingebrigt; Stensdotter, Ann-Katrin; Woodhouse, Astrid; Vasseljen, Ottar

2016-04-01

Neck pain is associated with several alterations in neck motion and motor control, but most of the findings are based on cross-sectional studies. The aim of this study was to investigate associations between changes in neck motion and motor control, and changes in neck pain and disability in physiotherapy patients during a course of treatment. Prospective cohort study. Subjects with non-specific neck pain (n = 71) participated in this study. Neck flexibility, joint position error (JPE), head steadiness, trajectory movement control and postural sway were recorded before commencement of physiotherapy (baseline), at 2 weeks, and at 2 months. Numerical Rating Scale and Neck Disability Index were used to measure neck pain and disability at the day of testing. To analyze within subjects effects in neck motion and motor control, neck pain, and disability over time we used fixed effects linear regression analysis. Changes in neck motion and motor control occurred primarily within 2 weeks. Reduction in neck pain was associated with increased cervical range of motion in flexion-/extension and increased postural sway when standing with eyes open. Decreased neck disability was associated with some variables for neck flexibility and trajectory movement control. Cervical range of motion in flexion-/extension was the only variable associated with changes in both neck pain and neck disability. This study shows that few of the variables for neck motion and motor control were associated with changes neck pain and disability over a course of 2 months with physiotherapy treatment. Copyright © 2015 Elsevier Ltd. All rights reserved.

Psychological predictors for health-related quality of life and disability in persons with chronic obstructive pulmonary disease (COPD).

PubMed

Mewes, Ricarda; Rief, Winfried; Kenn, Klaus; Ried, Jens; Stenzel, Nikola

2016-01-01

Individuals with chronic obstructive pulmonary disease (COPD) exhibit low physical and mental health-related quality of life (HRQL) and high susceptibility to disability. We investigated the influence of psychological factors on HRQL and disability in COPD individuals recruited from the general population. In line with Leventhal's common sense model, we expected psychological factors to be associated with HRQL and disability even after controlling for medical status. Individuals with COPD (n = 502; 59.7 years old; GOLD grades were I: 3%, II: 17%, III: 34%, IV: 46%) were assessed through an online survey administered via COPD patient organisations in Germany. Individuals filled in the Short Form Health Survey (SF-12), COPD Assessment Test, Patient Health Questionnaire (modules: GAD-2, PHQ-15, PHQ-9), Brief Illness Perception Questionnaire, a questionnaire that assesses causal illness attributions, and the internal illness-related locus of control scale of the 'KKG questionnaire for the assessment of control beliefs about illness and health'. Multiple linear regressions were calculated. The investigated factors explained high variances (disability = 56%, physical HRQL = 28%, mental HRQL = 63%, p ≤ .001). Better mental health, more optimistic illness perceptions, attribution to psychological causes, and stronger internal locus of control were associated with lower disability and better HRQL. Comorbid somatic symptoms contributed to high disability and low quality of life. Psychological factors, such as illness perception, attribution and internal locus of control, were associated with disability and HRQL. These factors should be considered when designing treatments for individuals with COPD, and adequate interventions should be provided to enhance illness understanding and self-management skills.

Rapid and general profiling of protease specificity by using combinatorial fluorogenic substrate libraries

PubMed Central

Harris, Jennifer L.; Backes, Bradley J.; Leonetti, Francesco; Mahrus, Sami; Ellman, Jonathan A.; Craik, Charles S.

2000-01-01

A method is presented for the preparation and use of fluorogenic peptide substrates that allows for the configuration of general substrate libraries to rapidly identify the primary and extended specificity of proteases. The substrates contain the fluorogenic leaving group 7-amino-4-carbamoylmethylcoumarin (ACC). Substrates incorporating the ACC leaving group show kinetic profiles comparable to those with the traditionally used 7-amino-4-methylcoumarin (AMC) leaving group. The bifunctional nature of ACC allows for the efficient production of single substrates and substrate libraries by using 9-fluorenylmethoxycarbonyl (Fmoc)-based solid-phase synthesis techniques. The approximately 3-fold-increased quantum yield of ACC over AMC permits reduction in enzyme and substrate concentrations. As a consequence, a greater number of substrates can be tolerated in a single assay, thus enabling an increase in the diversity space of the library. Soluble positional protease substrate libraries of 137,180 and 6,859 members, possessing amino acid diversity at the P4-P3-P2-P1 and P4-P3-P2 positions, respectively, were constructed. Employing this screening method, we profiled the substrate specificities of a diverse array of proteases, including the serine proteases thrombin, plasmin, factor Xa, urokinase-type plasminogen activator, tissue plasminogen activator, granzyme B, trypsin, chymotrypsin, human neutrophil elastase, and the cysteine proteases papain and cruzain. The resulting profiles create a pharmacophoric portrayal of the proteases to aid in the design of selective substrates and potent inhibitors. PMID:10869434

Transitioning From Volume to Value: One Academic Medical Center's Approach to Improving Population Health.

PubMed

Halvorson, Stephanie A C; Tanski, Mary E; Yackel, Thomas R

2017-05-01

The U.S. health care system is undergoing a major transformation. Clinical delivery systems are now being paid according to the value of the care they provide, in accordance with the Triple Aim, which incorporates improving the quality and cost of care and the patient experience. Increasingly, financial risk is being transferred from insurers to clinical delivery systems that become responsible for both episode-based clinical care and the longitudinal care of patients. Thus, these delivery systems need to develop strategies to manage the health of populations. Academic medical centers (AMCs) serve a unique role in many markets yet may be ill prepared for this transformation. In 2013, Oregon Health & Science University (OHSU) partnered with a large health insurer and six other hospitals across the state to form Propel Health, a collaborative partnership designed to deliver the tools, methods, and support necessary for population health management. OHSU also developed new internal structures and transformed its business model to embrace this value-based care model. Each Propel Health partner included the employees and dependents enrolled in its employee medical plan, for approximately 55,000 covered individuals initially. By 2017, Propel Health is expected to cover 110,000 individuals. Other outcomes to measure in the future include the quality and cost of care provided under this partnership. Anticipated challenges to overcome include insufficient primary care networks, conflicting incentives, local competition, and the magnitude of the transformation. Still, the time is right for AMCs to commit to improving the health of populations.

Role of collaborative academic partnerships in surgical training, education, and provision.

PubMed

Riviello, Robert; Ozgediz, Doruk; Hsia, Renee Y; Azzie, Georges; Newton, Mark; Tarpley, John

2010-03-01

The global disparities in both surgical disease burden and access to delivery of surgical care are gaining prominence in the medical literature and media. Concurrently, there is an unprecedented groundswell in idealism and interest in global health among North American medical students and trainees in anesthesia and surgical disciplines. Many academic medical centers (AMCs) are seeking to respond by creating partnerships with teaching hospitals overseas. In this article we describe six such partnerships, as follows: (1) University of California San Francisco (UCSF) with the Bellagio Essential Surgery Group; (2) USCF with Makerere University, Uganda; (3) Vanderbilt with Baptist Medical Center, Ogbomoso, Nigeria; (4) Vanderbilt with Kijabe Hospital, Kenya; (5) University of Toronto, Hospital for Sick Children with the Ministry of Health in Botswana; and (6) Harvard (Brigham and Women's Hospital and Children's Hospital Boston) with Partners in Health in Haiti and Rwanda. Reflection on these experiences offers valuable lessons, and we make recommendations of critical components leading to success. These include the importance of relationships, emphasis on mutual learning, the need for "champions," affirming that local training needs to supersede expatriate training needs, the value of collaboration in research, adapting the mission to locally expressed needs, the need for a multidisciplinary approach, and the need to measure outcomes. We conclude that this is an era of cautious optimism and that AMCs have a critical opportunity to both shape future leaders in global surgery and address the current global disparities.

Development in corrosion resistance by microstructural refinement in Zr-16 SS 304 alloy using suction casting technique

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

Das, N., E-mail: nirupamd@barc.gov.in; Sengupta, P.; Abraham, G.

Highlights: • Grain refinement was made in Zr–16 wt.% SS alloy while prepared by suction casting process. • Distribution of Laves phase, e.g., Zr{sub 2}(Fe, Cr) was raised in suction cast (SC) Zr–16 wt.% SS. • Corrosion resistance was improved in SC alloy compared to that of arc-melt-cast alloy. • Grain refinement in SC alloy assisted for an increase in its corrosion resistance. - Abstract: Zirconium (Zr)-stainless steel (SS) hybrid alloys are being considered as baseline alloys for developing metallic-waste-form (MWF) with the motivation of disposing of Zr and SS base nuclear metallic wastes. Zr–16 wt.% SS, a MWF alloymore » optimized from previous studies, exhibit significant grain refinement and changes in phase assemblages (soft phase: Zr{sub 2}(Fe, Cr)/α-Zr vs. hard phase: Zr{sub 3}(Fe, Ni)) when prepared by suction casting (SC) technique in comparison to arc-cast-melt (AMC) route. Variation in Cr-distribution among different phases are found to be low in suction cast alloy, which along with grain refinement restricted Cr-depletion at the Zr{sub 2}(Fe, Cr)/Zr interfaces, prone to localized attack. Hence, SC alloy, compared to AMC alloy, showed lower current density, higher potential at the breakdown of passivity and higher corrosion potential during polarization experiments (carried out under possible geological repository environments, viz., pH 8, 5 and 1) indicating its superior corrosion resistance.« less

Purification and Characterization of an Arginine Aminopeptidase from Lactobacillus sakei

PubMed Central

Sanz, Yolanda; Toldrá, Fidel

2002-01-01

An arginine aminopeptidase (EC 3.4.11.6) that exclusively hydrolyzes basic amino acids from the amino (N) termini of peptide substrates has been purified from Lactobacillus sakei. The purification procedure consisted of ammonium sulfate fractionation and three chromatographic steps, which included hydrophobic interaction, gel filtration, and anion-exchange chromatography. This procedure resulted in a recovery rate of 4.2% and a 500-fold increase in specific activity. The aminopeptidase appeared to be a trimeric enzyme with a molecular mass of 180 kDa. The activity was optimal at pH 5.0 and 37°C. The enzyme was inhibited by sulfhydryl group reagents and several divalent cations (Cu2+, Hg2+, and Zn2+) but was activated by reducing agents, metal-chelating agents, and sodium chloride. The enzyme showed a preference for arginine at the N termini of aminoacyl derivatives and peptides. The Km values for Arg-7-amido-4-methylcoumarin (AMC) and Lys-AMC were 15.9 and 26.0 μM, respectively. The nature of the amino acid residue at the C terminus of dipeptides has an effect on hydrolysis rates. The activity was maximal toward dipeptides with Arg, Lys, or Ala as the C-terminal residue. The properties of the purified enzyme, its potential function in the release of arginine, and its further metabolism are discussed because, as a whole, it could constitute a survival mechanism for L. sakei in the meat environment. PMID:11916721

NMR and TRLFS studies of Ln(iii) and An(iii) C5-BPP complexes† †Electronic supplementary information (ESI) available: LIFDI-MS spectra and additional NMR spectra. See DOI: 10.1039/c4sc03103b

PubMed Central

Beele, Björn B.; Geist, Andreas; Müllich, Udo; Kaden, Peter; Panak, Petra J.

2015-01-01

C5-BPP is a highly efficient N-donor ligand for the separation of trivalent actinides, An(iii), from trivalent lanthanides, Ln(iii). The molecular origin of the selectivity of C5-BPP and many other N-donor ligands of the BTP-type is still not entirely understood. We present here the first NMR studies on C5-BPP Ln(iii) and An(iii) complexes. C5-BPP is synthesized with 10% 15N labeling and characterized by NMR and LIFDI-MS methods. 15N NMR spectroscopy gives a detailed insight into the bonding of C5-BPP with lanthanides and Am(iii) as a representative for trivalent actinide cations, revealing significant differences in 15N chemical shift for coordinating nitrogen atoms compared to Ln(iii) complexes. The temperature dependence of NMR chemical shifts observed for the Am(iii) complex indicates a weak paramagnetism. This as well as the observed large chemical shift for coordinating nitrogen atoms show that metal–ligand bonding in Am(C5-BPP)3 has a larger share of covalence than in lanthanide complexes, confirming earlier studies. The Am(C5-BPP)3 NMR sample is furthermore spiked with Cm(iii) and characterized by time-resolved laser fluorescence spectroscopy (TRLFS), yielding important information on the speciation of trace amounts of minor complex species. PMID:29560242

Early Experiences After Adopting a Quality Improvement Portfolio Into the Academic Advancement Process.

PubMed

Sehgal, Niraj L; Neeman, Naama; King, Talmadge E

2017-01-01

Academic medical centers (AMCs) and their academic departments are increasingly assuming leadership in the education, science, and implementation of quality improvement (QI) and patient safety efforts. Fostering, recognizing, and promoting faculty leading these efforts is challenging using traditional academic metrics for advancement. The authors adapted a nationally developed QI portfolio, adopted it into their own department's advancement process in 2012, and tracked its utilization and impact over the first two years of implementation. Sixty-seven QI portfolios were submitted with 100% of faculty receiving their requested academic advancement. Women represented 60% of the submitted portfolios, while the Divisions of General Internal Medicine and Hospital Medicine accounted for 60% of the submissions. The remaining 40% were from faculty in 10 different specialty divisions. Faculty attitudes about the QI portfolio were overwhelmingly positive, with 83% agreeing that it "was an effective tool for helping to better recognize faculty contributions in QI work" and 85% agreeing that it "was an effective tool for elevating the importance of QI work in our department." The QI portfolio was one part of a broader effort to create opportunities to recognize and support faculty involved in improvement work. Further adapting the tool to ensure that it complements-rather than duplicates-other elements of the advancement process is critical for continued utilization by faculty. This will also drive desired dissemination to other departments locally and other AMCs nationally who are similarly committed to cultivating faculty career paths in systems improvement.

Efficient radiative transfer methods for continuum and line transfer in large three-dimensional models

NASA Astrophysics Data System (ADS)

Juvela, Mika J.

The relationship between physical conditions of an interstellar cloud and the observed radiation is defined by the radiative transfer problem. Radiative transfer calculations are needed if, e.g., one wants to disentangle abundance variations from excitation effects or wants to model variations of dust properties inside an interstellar cloud. New observational facilities (e.g., ALMA and Herschel) will bring improved accuracy both in terms of intensity and spatial resolution. This will enable detailed studies of the densest sub-structures of interstellar clouds and star forming regions. Such observations must be interpreted with accurate radiative transfer methods and realistic source models. In many cases this will mean modelling in three dimensions. High optical depths and observed wide range of linear scales are, however, challenging for radiative transfer modelling. A large range of linear scales can be accessed only with hierarchical models. Figure 1 shows an example of the use of a hierarchical grid for radiative transfer calculations when the original model cloud (L=10 pc, =500 cm-3) was based a MHD simulation carried out on a regular grid (Juvela & Padoan, 2005). For computed line intensities an accuracy of 10% was still reached when the number of individual cells (and the run time) was reduced by a factor of ten. This illustrates how, as long as cloud is not extremely optically thick, most of the emission comes from a small sub-volume. It is also worth noting that while errors are ~10% for any given point they are much smaller when compared with intensity variations. In particular, calculations on hierarchical grid recovered the spatial power spectrum of line emission with very good accuracy. Monte Carlo codes are used widely in both continuum and line transfer calculations. Like any lambda iteration schemes these suffer from slow convergence when models are optically thick. In line transfer Accelerated Monte Carlo methods (AMC) present a partial solution to this problem (Juvela & Padoan, 2000; Hogerheijde & van der Tak, 2000). AMC methods can be used similarly in continuum calculations to speed up the computation of dust temperatures (Juvela, 2005). The sampling problems associated with high optical depths can be solved with weighted sampling and the handling of models with τV ~ 1000 is perfectly feasible. Transiently heated small dust grains pose another problem because the calculation of their temperature distribution is very time consuming. However, a 3D model will contain thousands of cells at very similar conditions. If dust temperature distributions are calculated only once for such a set an approximate solution can be found in a much shorter time time. (Juvela & Padoan, 2003; see Figure 2a). MHD simulations with Automatic Mesh Refinement (AMR) techniques present an exciting development for the modelling of interstellar clouds. Cloud models consist of a hierarchy of grids with different grid steps and the ratio between the cloud size and the smallest resolution elements can be 106 or even larger. We are currently working on radiative transfer codes (line and continuum) that could be used efficiently on such grids (see Figure 2b). The radiative transfer problem can be solved relatively independently on each of the sub-grids. This means that the use of convergence acceleration methods can be limited to those sub-grids where they are needed and, on the other hand, parallelization of the code is straightforward.

Disability in people affected by leprosy: the role of impairment, activity, social participation, stigma and discrimination.

PubMed

van Brakel, Wim H; Sihombing, Benyamin; Djarir, Hernani; Beise, Kerstin; Kusumawardhani, Laksmi; Yulihane, Rita; Kurniasari, Indra; Kasim, Muhammad; Kesumaningsih, Kadek I; Wilder-Smith, Annelies

2012-01-01

Leprosy-related disability is a challenge to public health, and social and rehabilitation services in endemic countries. Disability is more than a mere physical dysfunction, and includes activity limitations, stigma, discrimination, and social participation restrictions. We assessed the extent of disability and its determinants among persons with leprosy-related disabilities after release from multi drug treatment. We conducted a survey on disability among persons affected by leprosy in Indonesia, using a Rapid Disability Appraisal toolkit based on the International Classification of Functioning, Disability and Health. The toolkit included the Screening of Activity Limitation and Safety Awareness (SALSA) scale, Participation Scale, Jacoby Stigma Scale (anticipated stigma), Explanatory Model Interview Catalogue (EMIC) stigma scale and Discrimination assessment. Community members were interviewed using a community version of the stigma scale. Multivariate linear regression was done to identify factors associated with social participation. Overall 1,358 persons with leprosy-related disability (PLD) and 931 community members were included. Seventy-seven percent of PLD had physical impairments. Impairment status deteriorated significantly after release from treatment (from 59% to 77%). Around 60% of people reported activity limitations and participation restrictions and 36% anticipated stigma. As for participation restrictions and stigma, shame, problems related to marriage and difficulties in employment were the most frequently reported problems. Major determinants of participation were severity of impairment and level of education, activity and stigma. Reported severity of community stigma correlated with severity of participation restrictions in the same districts. The majority of respondents reported problems in all components of disability. The reported physical impairment after release from treatment justifies ongoing monitoring to facilitate early prevention. Stigma was a major determinant of social participation, and therefore disability. Stigma reduction activities and socio-economic rehabilitation are urgently needed in addition to strategies to reduce the development of further physical impairment after release from treatment.

Disability in people affected by leprosy: the role of impairment, activity, social participation, stigma and discrimination

PubMed Central

van Brakel, Wim H.; Sihombing, Benyamin; Djarir, Hernani; Beise, Kerstin; Kusumawardhani, Laksmi; Yulihane, Rita; Kurniasari, Indra; Kasim, Muhammad; Kesumaningsih, Kadek I.; Wilder-Smith, Annelies

2012-01-01

Background Leprosy-related disability is a challenge to public health, and social and rehabilitation services in endemic countries. Disability is more than a mere physical dysfunction, and includes activity limitations, stigma, discrimination, and social participation restrictions. We assessed the extent of disability and its determinants among persons with leprosy-related disabilities after release from multi drug treatment. Methods We conducted a survey on disability among persons affected by leprosy in Indonesia, using a Rapid Disability Appraisal toolkit based on the International Classification of Functioning, Disability and Health. The toolkit included the Screening of Activity Limitation and Safety Awareness (SALSA) scale, Participation Scale, Jacoby Stigma Scale (anticipated stigma), Explanatory Model Interview Catalogue (EMIC) stigma scale and Discrimination assessment. Community members were interviewed using a community version of the stigma scale. Multivariate linear regression was done to identify factors associated with social participation. Results Overall 1,358 persons with leprosy-related disability (PLD) and 931 community members were included. Seventy-seven percent of PLD had physical impairments. Impairment status deteriorated significantly after release from treatment (from 59% to 77%). Around 60% of people reported activity limitations and participation restrictions and 36% anticipated stigma. As for participation restrictions and stigma, shame, problems related to marriage and difficulties in employment were the most frequently reported problems. Major determinants of participation were severity of impairment and level of education, activity and stigma. Reported severity of community stigma correlated with severity of participation restrictions in the same districts. Discussion The majority of respondents reported problems in all components of disability. The reported physical impairment after release from treatment justifies ongoing monitoring to facilitate early prevention. Stigma was a major determinant of social participation, and therefore disability. Stigma reduction activities and socio-economic rehabilitation are urgently needed in addition to strategies to reduce the development of further physical impairment after release from treatment. PMID:22826694

Social-ecological influences on interpersonal support in people with physical disability.

PubMed

Devereux, Paul G; Bullock, Charles C; Gibb, Zebbedia G; Himler, Heidi

2015-10-01

People with physical disability report lower amounts of emotional and informational social support compared with other populations but it is unclear how influences at the broader societal level impact support in this population. To address this question, Berkman and Glass's social-ecological model was used to examine the influence of upstream factors on interpersonal support in people with physical disability. It was predicted that these factors would influence support even after controlling for the traditional measures linked to social support. 331 adult participants with physical disability (43% female; mean age = 42.7; 88% White) completed an online cross-sectional survey measuring types and sources of social support, social integration, disability impact in social domains, environmental barriers, and relevant psychosocial variables such as depression. A hierarchical linear regression analysis showed that level of disability, perceived tangible support, social integration, depressive symptoms, environmental barriers, occupational independence, and having family or friends as primary support sources were significantly associated with perceived support at the final step (R(2) = .60, F(22, 255) = 17.68, p < .001). The social-ecological measures, environmental barriers and social integration, had the largest associations with interpersonal support. Results demonstrate the importance of measuring distinct support constructs and how the broader social environment may matter more in interpersonal support perceptions for people with disability than typical measures studied in the literature. Improving environmental factors will help improve social support. Copyright © 2015 Elsevier Inc. All rights reserved.

Impact of a Safe Resident Handling Program in Nursing Homes on Return-to-Work and Re-injury Outcomes Following Work Injury.

PubMed

Kurowski, Alicia; Pransky, Glenn; Punnett, Laura

2018-05-21

Purpose This study examined the impact of a Safe Resident Handling Program (SRHP) on length of disability and re-injury, following work-related injuries of nursing home workers. Resident handling-related injuries and back injuries were of particular interest. Methods A large national nursing home corporation introduced a SRHP followed by three years of training for 136 centers. Lost-time workers' compensation claims (3 years pre-SRHP and 6 years post-SRHP) were evaluated. For each claim, length of first episode of disability and recurrence of disabling injury were evaluated over time. Differences were assessed using Chi square analyses and a generalized linear model, and "avoided" costs were projected. Results The SRHP had no impact on length of disability, but did appear to significantly reduce the rate of recurrence among resident handling-related injuries. As indemnity and medical costs were three times higher for claimants with recurrent disabling injuries, the SRHP resulted in significant "avoided" costs due to "avoided" recurrence. Conclusions In addition to reducing overall injury rates, SRHPs appear to improve long-term return-to-work success by reducing the rate of recurrent disabling injuries resulting in work disability. In this study, the impact was sustained over years, even after a formal training and implementation program ended. Since back pain is inherently a recurrent condition, results suggest that SRHPs help workers remain at work and return-to-work.

Evaluation of the association between Hispanic ethnicity and disease activity and severity in a large cohort of patients with juvenile idiopathic arthritis.

PubMed

Pelajo, Christina F; Angeles-Han, Sheila T; Prahalad, Sampath; Sgarlat, Caitlin M; Davis, Trevor E; Miller, Laurie C; Lopez-Benitez, Jorge M

2013-10-01

To examine the association between ethnicity and disease activity in patients with juvenile idiopathic arthritis (JIA), and to determine the association of ethnicity with disease severity and disability in this population. CARRAnet, a US database containing information (collected between May 2010 and June 2011) on almost 3,000 subjects with JIA, was used. Demographic variables were compared between Hispanic patients and non-Hispanic patients. Mann-Whitney and chi-square tests were used to compare indicators of disease activity, as well as imaging evidence of joint damage, and Childhood Health Assessment Questionnaire (CHAQ) scores between ethnicities. Two linear regression models were used to determine the association of ethnicity with number of active joints in JIA, and the association between ethnicity and disability (CHAQ scores). A total of 2,704 patients with JIA (277 Hispanic; 2,427 non-Hispanic) were included. Income and health insurance coverage were higher in non-Hispanics. RF-positive polyarticular JIA, positive RF and anti-CCP, as well as use of systemic steroids were more frequent in Hispanics. Imaging evidence of joint damage was present in 32 % of the Hispanic patients compared to 24 % of the non-Hispanic patients (p = 0.008). In multivariate linear regression analyses, the number of active joints was significantly higher in Hispanics than in non-Hispanics (p = 0.03), as well as CHAQ scores (p = 0.003), after adjusting for confounders. Hispanic patients with JIA had higher disease activity than non-Hispanic patients, as well as higher disease severity and disability. Since ethnicity influences disease activity, severity, and disability, different management and treatment plans should be planned accordingly.

Factors Related to Social Support in Neurological and Mental Disorders

PubMed Central

Kamenov, Kaloyan; Cabello, Maria; Caballero, Francisco Félix; Cieza, Alarcos; Sabariego, Carla; Raggi, Alberto; Anczewska, Marta; Pitkänen, Tuuli; Ayuso-Mateos, Jose Luis

2016-01-01

Despite the huge body of research on social support, literature has been primarily focused on its beneficial role for both physical and mental health. It is still unclear why people with mental and neurological disorders experience low levels of social support. The main objective of this study was to explore what are the strongest factors related to social support and how do they interact with each other in neuropsychiatric disorders. The study used cross-sectional data from 722 persons suffering from dementia, depression, epilepsy, migraine, multiple sclerosis, Parkinson's disease, schizophrenia, stroke, and substance use disorders. Multiple linear regressions showed that disability was the strongest factor for social support. Extraversion and agreeableness were significant personality variables, but when the interaction terms between personality traits and disability were included, disability remained the only significant variable. Moreover, level of disability mediated the relationship between personality (extraversion and agreeableness) and level of social support. Moderation analysis revealed that people that had mental disorders experienced lower levels of support when being highly disabled compared to people with neurological disorders. Unlike previous literature, focused on increasing social support as the origin of improving disability, this study suggested that interventions improving day-to-day functioning or maladaptive personality styles might also have an effect on the way people perceive social support. Future longitudinal research, however, is warranted to explore causality. PMID:26900847

The effects of the smart environment on the information divide experienced by people with disabilities.

PubMed

Nam, Su-Jung; Park, Eun-Young

2017-04-01

Information and Communication Technology (ICT) is connected with every aspect of social, cultural, economic, educational, and commercial activity. Smart devices in particular have changed society and are necessary goods for modern people. Smart device usage is rapidly growing in everyday life, so the ability to use a smart device is increasingly important, yet there is little data supporting increased digital inclusion of people with disabilities in mobile device use. This study investigates the effects of the smart environment on the information divide experienced by people with disabilities. Data from the 2013 Information Divide Index Data of the National Information Society Agency was analyzed regarding three aspects: access, skill, and competence. The accessibility difference was investigated by comparing access to a PC or smart device in two groups. The effects of a smart environment on the information divide were analyzed using General Linear Modeling (GLM). The access rate was higher for the general group than for that of those with disabilities, and this difference appeared to be greater in the smart environment. The results of the GLM showed that disability and device access had statistically significant effects on skill and all aspects of competence. These results provide evidence that the smart environment further creates the information divide for people with disabilities. Strategies should be formed to reduce this divide, particularly within smart environments. Copyright © 2016 Elsevier Inc. All rights reserved.

Social Inequality and Labor Force Participation.

ERIC Educational Resources Information Center

King, Jonathan

The labor force participation rates of whites, blacks, and Spanish-Americans, grouped by sex, are explained in a linear regression model fitted with 1970 U. S. Census data on Standard Metropolitan Statistical Area (SMSA). The explanatory variables are: average age, average years of education, vocational training rate, disabled rate, unemployment…

Genetic Wild Card: A Marker for Learners at Risk.

ERIC Educational Resources Information Center

Williams, Christine A.

This paper surveys past and current theories about the workings of the mind, current brain research and psychological applications of non-linear dynamics. Parallels are drawn between the world of high-functioning autism, gifted individuals with learning disabilities, and aspects of genius. An organizing theory is presented, which includes these…

Enhancing Comprehension through Graphic Organizers.

ERIC Educational Resources Information Center

Ben-David, Renee

The purpose of this study was to determine whether graphic organizers serve as a better tool for comprehension assessment than traditional tests. Subjects, 16 seventh-grade learning disabled students, were given 8 weeks of instruction and assessments using both graphic organizer and linear note forms. Tests were graded, compared and contrasted to…

Teaching Algebraic Equations to Middle School Students with Intellectual Disabilities

ERIC Educational Resources Information Center

Baker, Joshua N.; Rivera, Christopher J.; Morgan, Joseph John; Reese, Noelle

2015-01-01

The purpose of this study was to replicate similar instructional techniques of Jimenez, Browder, and Courtade (2008) using a single-subject multiple-probe across participants design to investigate the effects of task analytic instruction coupled with semi-concrete representations to teach linear algebraic equations to middle school students with…

The Suppression of Enemy Air Defense within Twenty Kilometers of the Forward Edge of the Battle Area

DTIC Science & Technology

1979-06-08

AGENCY %4AMC A AORESI _3 4 oiroln li .) SECURITY CLASS (of this OPpof) ~~ Unclas~sified 15. OECL ASSI FICATION/ OWN iAONGOff’" SCHEDULE S16. DISTH18UTION...governmental agency . (References 12 this study should include forerzoing statement.) ABSTRACT TEE ,?UPPRESSI"nN OF ENEMY AIR DEFENSE WITHIN TWENTY KILOMETERS...what effect will a consolidated electronic warfare effort have upon this enviorment within twenty kilometers of the FEBA during the course of a "short

Platform Design for Fleet-Level Efficiency: Application for Air Mobility Command (AMC)

DTIC Science & Technology

2013-04-01

and networking that has been the hallmark of previous symposia. By purposely limiting attendance to 350 people, we encourage just that. This forum...F X Cap x C   (capacity) (7)       , , ,TO X X X XS Pallet AR W S T W D (aircraft take-off distance) (8) 6 36 XPallet (9...the solution space. Heuristic algorithms such as Simulated Annealing (SA), Genetic Algorithms ( GA ), and so forth, may be needed to solve the small

DDN (Defense Data Network) New User Guide

DTIC Science & Technology

1987-11-01

0 -944604-00- 5 ,X UNIX is a registered trademark of AT&T Bell Laboratories...21 S 0 0 N S MR A 0w l.a. . ,d. s:’V * ,t*. P.. 0 64 INDEX Access Code 14, 24 Host computer 5 , 6 Acoustic coupler 18 Hostname 16 AMC 50 ARPANET...groups. U DTIC0 0 I NI ’u1ld 1A LJ ; .:r .: ,c d - J•,:: •’: ,, ,:.3 . I1..... .. < , • .. _’’ "LY"_."_,...! ( • ••: •,a•.. -•.¢."....

Management of Vegetation on Ammunition Magazines at AMC Facilities

DTIC Science & Technology

1991-06-01

Ammunition sion by woody vegetation and annual weeds. Obviously Depots (AAD) and Army Testing and Evaluation Fa- the agronomic sciences are a long way from...Cool, humid Bauger Baraboo, Wis. 25 43.29 89.44 823 22 3 Holston Kingspon, Tenn. 141 36.33 82.33 1284 71 70 Indiana Cnarlestown. Ind. 176 38.46 85.39 525...Cool, humid Badger 25 70 14 47.0 30.0 Baraboo Holston 141 76 37 55.9 4i.2 Kingsport Indiana 176 79 34 57.0 42.0 Charlestown Ord. Pit Jefferson 34 79 33

Polychronicity and its Impact on Leader-Member Exchange and Outcome Behaviors

DTIC Science & Technology

2008-05-01

feet asense ofpride In r-C .C r C. dolng my job. Pagje 43 112 I be" fto Moch r r r r 711etwd w M 0 t r r IrI goS.l $ad "we~ at Kf joIsq~*s ,C VA"IL...Air Forma Of of th -e *" thdrAir Frce Adiemy *VON"b alwva It I hadnot ale"dput r- Ir4-4 so amc of MYOWl in the Mr Fore Academy, I meight omWer eo" to WW

HIT-6 and MIDAS as measures of headache disability in a headache referral population.

PubMed

Sauro, Khara M; Rose, Marianne S; Becker, Werner J; Christie, Suzanne N; Giammarco, Rose; Mackie, Gordon F; Eloff, Arnoldas G; Gawel, Marek J

2010-03-01

The objective of this study was to compare the headache impact test (HIT-6) and the migraine disability assessment scale (MIDAS) as clinical measures of headache-related disability. The degree of headache-related disability is an important factor in treatment planning. Many quality of life and headache disability measures exist but it is unclear which of the available disability measures is the most helpful in planning and measuring headache management. We compared HIT-6 and MIDAS scores from 798 patients from the Canadian Headache Outpatient Registry and Database (CHORD). Correlation and regression analyses were used to examine the relationships between the HIT-6 and MIDAS total scores, headache frequency and intensity, and Beck Depression Inventory (BDI-II) scores. A positive correlation was found between HIT-6 and MIDAS scores (r = 0.52). The BDI-II scores correlated equally with the HIT-6 and the MIDAS (r = 0.42). There was a non-monotonic relationship between headache frequency and the MIDAS, and a non-linear monotonic relationship between headache frequency and the HIT-6 (r = 0.24). The correlation was higher between the intensity and the HIT-6 scores (r = 0.46), than MIDAS (r = 0.26) scores. Seventy-nine percent of patients fell into the most severe HIT-6 disability category, compared with the 57% of patients that fell into the most severe MIDAS disability category. Significantly more patients were placed in a more severe category with the HIT-6 than with the MIDAS (McNemar chi-square = 191 on 6 d.f., P < .0001). The HIT-6 and MIDAS appear to measure headache-related disability in a similar fashion. However, some important differences may exist. Headache intensity appears to influence HIT-6 score more than the MIDAS, whereas the MIDAS was influenced more by headache frequency. Using the HIT-6 and MIDAS together may give a more accurate assessment of a patient's headache-related disability.

Doctor of physical therapy students' attitudes towards people with disabilities: a descriptive study.

PubMed

Yorke, Amy M; Ruediger, Thomas; Voltenburg, Nicole

2017-01-01

Purpose To describe attitudes of doctoral physical therapy (DPT) students towards people with disability and examine predictive ability of demographic variables on those attitudes. Methods Two established surveys, Attitudes Towards Disabled Persons-Form O (ATDP-O) and Disability Attitudes in Health Care (DAHC) were completed by first (Y1) and third year (Y3) students in a DPT programme. Demographics and information about students' contact experience with people with disabilities were collected through a brief questionnaire. Multiple linear regression models were constructed from predictor variables. Results Scores on the ATDP-O and the DAHC were not significantly different between the Y1 and Y3 DPT students. There was a modest correlation (r = 0.342, p < 0.001) between the ATDP-O and the DAHC. Being female and having work contact with people with disabilities both explained about 9% of the variance in the DAHC; while having a close family member explains about 4% of the variance in the ATDP-O. Conclusion Attitudes of DPT students over the course of their education did not change. The DAHC is a more recently developed tool and should continue to be investigated for its usefulness in healthcare professional students. Faculty should consider measuring attitudes and developing specific educational strategies to improve attitudes with the goal to improve patient care. Implications for Rehabilitation Attitudes towards people with disability can impact their health care. Physical therapy students, in general, express positive attitudes towards people with disabilities and no differences in attitudes were determined in a group of Year 1 and Year 3 doctoral physical therapy students. Opportunities exist to intentionally thread educational strategies throughout a professional curriculum to facilitate further development of positive attitudes in doctoral physical therapy students.

Black breast cancer survivors experience greater upper extremity disability.

PubMed

Dean, Lorraine T; DeMichele, Angela; LeBlanc, Mously; Stephens-Shields, Alisa; Li, Susan Q; Colameco, Chris; Coursey, Morgan; Mao, Jun J

2015-11-01

Over one-third of breast cancer survivors experience upper extremity disability. Black women present with factors associated with greater upper extremity disability, including: increased body mass index (BMI), more advanced disease stage at diagnosis, and varying treatment type compared with Whites. No prior research has evaluated the relationship between race and upper extremity disability using validated tools and controlling for these factors. Data were drawn from a survey study among 610 women with stage I-III hormone receptor positive breast cancer. The disabilities of the arm, shoulder and hand (QuickDASH) is an 11-item self-administered questionnaire that has been validated for breast cancer survivors to assess global upper extremity function over the past 7 days. Linear regression and mediation analysis estimated the relationships between race, BMI and QuickDASH score, adjusting for demographics and treatment types. Black women (n = 98) had 7.3 points higher average QuickDASH scores than White (n = 512) women (p < 0.001). After adjusting for BMI, age, education, cancer treatment, months since diagnosis, and aromatase inhibitor status, Black women had an average 4-point (95 % confidence interval 0.18-8.01) higher QuickDASH score (p = 0.04) than White women. Mediation analysis suggested that BMI attenuated the association between race and disability by 40 %. Even several years post-treatment, Black breast cancer survivors had greater upper extremity disability, which was partially mediated by higher BMIs. Close monitoring of high BMI Black women may be an important step in reducing disparities in cancer survivorship. More research is needed on the relationship between race, BMI, and upper extremity disability.

Series elastic actuation of an elbow rehabilitation exoskeleton with axis misalignment adaptation.

PubMed

Wu, Kuan-Yi; Su, Yin-Yu; Yu, Ying-Lung; Lin, Kuei-You; Lan, Chao-Chieh

2017-07-01

Powered exoskeletons can facilitate rehabilitation of patients with upper limb disabilities. Designs using rotary motors usually result in bulky exoskeletons to reduce the problem of moving inertia. This paper presents a new linearly actuated elbow exoskeleton that consists of a slider crank mechanism and a linear motor. The linear motor is placed beside the upper arm and closer to shoulder joint. Thus better inertia properties can be achieved while lightweight and compactness are maintained. A passive joint is introduced to compensate for the exoskeleton-elbow misalignment and intersubject size variation. A linear series elastic actuator (SEA) is proposed to obtain accurate force and impedance control at the exoskeleton-elbow interface. Bidirectional actuation between exoskeleton and forearm is verified, which is required for various rehabilitation processes. We expect this exoskeleton can provide a means of robot-aided elbow rehabilitation.

Perceptual suppression revealed by adaptive multi-scale entropy analysis of local field potential in monkey visual cortex.

PubMed

Hu, Meng; Liang, Hualou

2013-04-01

Generalized flash suppression (GFS), in which a salient visual stimulus can be rendered invisible despite continuous retinal input, provides a rare opportunity to directly study the neural mechanism of visual perception. Previous work based on linear methods, such as spectral analysis, on local field potential (LFP) during GFS has shown that the LFP power at distinctive frequency bands are differentially modulated by perceptual suppression. Yet, the linear method alone may be insufficient for the full assessment of neural dynamic due to the fundamentally nonlinear nature of neural signals. In this study, we set forth to analyze the LFP data collected from multiple visual areas in V1, V2 and V4 of macaque monkeys while performing the GFS task using a nonlinear method - adaptive multi-scale entropy (AME) - to reveal the neural dynamic of perceptual suppression. In addition, we propose a new cross-entropy measure at multiple scales, namely adaptive multi-scale cross-entropy (AMCE), to assess the nonlinear functional connectivity between two cortical areas. We show that: (1) multi-scale entropy exhibits percept-related changes in all three areas, with higher entropy observed during perceptual suppression; (2) the magnitude of the perception-related entropy changes increases systematically over successive hierarchical stages (i.e. from lower areas V1 to V2, up to higher area V4); and (3) cross-entropy between any two cortical areas reveals higher degree of asynchrony or dissimilarity during perceptual suppression, indicating a decreased functional connectivity between cortical areas. These results, taken together, suggest that perceptual suppression is related to a reduced functional connectivity and increased uncertainty of neural responses, and the modulation of perceptual suppression is more effective at higher visual cortical areas. AME is demonstrated to be a useful technique in revealing the underlying dynamic of nonlinear/nonstationary neural signal.

Sex Differences in Concomitant Trajectories of Self-Reported Disability and Measured Physical Capacity in Older Adults

PubMed Central

Allore, Heather G.; Mendes de Leon, Carlos F.; Gahbauer, Evelyne A.; Gill, Thomas M.

2016-01-01

Background: Despite documented age-related declines in self-reported functional status and measured physical capacity, it is unclear whether these functional indicators follow similar trajectories over time or whether the patterns of change differ by sex. Methods: We used longitudinal data from 687 initially nondisabled adults, aged 70 or older, from the Precipitating Events Project, who were evaluated every 18 months for nearly 14 years. Self-reported disability was assessed with a 12-item disability scale. Physical capacity was measured using grip strength and a modified version of Short Physical Performance Battery. Hierarchical linear models estimated the intra-individual trajectory of each functional indicator and differences in trajectories’ intercept and slope by sex. Results: Self-reported disability, grip strength, and Short Physical Performance Battery score declined over 13.5 years following nonlinear trajectories. Women experienced faster accumulation of self-reported disability, but slower declines in measured physical capacity, compared with men. Trajectory intercepts revealed that women had significantly weaker grip strength and reported higher levels of disability compared with men, with no differences in starting Short Physical Performance Battery scores. These findings were robust to adjustments for differences in sociodemographic characteristics, length-of-survival, health risk factors, and chronic-disease status. Conclusions: Despite the female disadvantage in self-reported disability, older women preserve measured physical capacity better than men over time. Self-reported and measured indicators should be viewed as complementary rather than interchangeable assessments of functional status for both clinical and research purposes, especially for sex-specific comparisons. PMID:27071781

Comparing Private Schools and Public Schools Using Hierarchical Linear Modeling. NCES 2006-461

ERIC Educational Resources Information Center

Braun, Henry; Jenkins, Frank; Grigg, Wendy

2006-01-01

The goal of the study was to examine differences in mean National Assessment of Educational Progress (NAEP) reading and mathematics scores between public and private schools when selected characteristics of students and/or schools were taken into account. Among the student characteristics considered were gender, race/ethnicity, disability status,…

Using Commercial-Off-The-Shelf Speech Recognition Software for Conning U.S. Warships

DTIC Science & Technology

2003-06-01

Linear Regression , 2nd Edition, (John Wiley & Sons, St. Paul, Minnesota, 1985), pp. 267-269. 44 Current Projects About the Sigmoid Curve, Sigmoid Curve...Disabilities Conference, Conference Proceedings, [www.csun.edu/cod/conf/1998/proceedings/csun98_052.htm], as of June 2, 2003. 43 Weisberg, S., Applied

Assessment of medical communication skills by computer: assessment method and student experiences.

PubMed

Hulsman, R L; Mollema, E D; Hoos, A M; de Haes, J C J M; Donnison-Speijer, J D

2004-08-01

A computer-assisted assessment (CAA) program for communication skills designated ACT was developed using the objective structured video examination (OSVE) format. This method features assessment of cognitive scripts underlying communication behaviour, a broad range of communication problems covered in 1 assessment, highly standardised assessment and rating procedures, and large group assessments without complex organisation. The Academic Medical Centre (AMC) at the University of Amsterdam, the Netherlands. Aims To describe the development of the AMC Communication Test (ACT); to describe our experiences with the examination and rating procedures; to present test score descriptives, and to present the students' opinions of ACT. The ACT presents films on history taking, breaking bad news and shared decision making. Each film is accompanied by 3 types of short essay questions derived from our assessment model: "knows", "knows why/when" and "knows how". Evaluation questions about ACT were integrated into the assessment. Participants A total of 210 third year medical undergraduates were assessed. This study reports on the 110 (53%) students who completed all evaluation questions. Marking 210 examinations took about 17 days. The test score matched a normal distribution and showed a good level of discrimination of the students. About 75% passed the examination. Some support for the validity of our assessment model was found in the students' differential performance on the 3 types of questions. The ACT was well received. Student evaluations confirmed our efforts to develop realistic films that related well to the communication training programme. The ACT is a useful assessment method which complements interpersonal assessment methods for the evaluation of the medical communication skills of undergraduates.

Commentary: A call to leadership: the role of the academic medical center in driving sustainable health system improvement through performance measurement.

PubMed

Nedza, Susan M

2009-12-01

As the government attempts to address the high cost of health care in the United States, the issues being confronted include variations in the quality of care administered and the inconsistent application of scientifically proven treatments. To improve quality, methods of measurement and reporting with rewards or, eventually, penalties based on performance, must be developed. To date, well-intentioned national policy initiatives, such as value-based purchasing, have focused primarily on the measurement of discrete events and on attempts to construct incentives. While important, the current approach alone cannot improve quality, ensure equitability, decrease variability, and optimize value. Additional thought-leadership is required, both theoretical and applied. Academic medical centers' (AMCs') scholarly and practical participation is needed. Although quality cannot be sustainably improved without measurement, the existing measures alone do not ensure quality. There is not enough evidence to support strong measure development and, further, not enough insight regarding whether the existing measures have their intended effect of enhancing health care delivery that results in quality outcomes for patients. Perhaps the only way that the United States health care system will achieve a standard of quality care is through the strong embrace, effective engagement, intellectual insights, educational contributions, and practical applications in AMCs. Quality will never be achieved through public policies or national initiatives alone but instead through the commitment of the academic community to forward the science of performance measurement and to ensure that measurement leads to better health outcomes for our nation.

Patients with community-acquired bacteremia of unknown origin: clinical characteristics and usefulness of microbiological results for therapeutic issues: a single-center cohort study.

PubMed

Courjon, Johan; Demonchy, Elisa; Degand, Nicolas; Risso, Karine; Ruimy, Raymond; Roger, Pierre-Marie

2017-05-19

Bacteremia of unknown origin (BUO) are associated with increased mortality compared to those with identified sources. Microbiological data of those patients could help to characterize an appropriate empirical antibiotic treatment before bloodcultures results are available during sepsis of unknown origin. Based on the dashboard of our ward that prospectively records several parameters from each hospitalization, we report 101 community-acquired BUO selected among 1989 bacteremic patients from July 2005 to April 2016, BUO being defined by the absence of clinical and paraclinical infectious focus and no other microbiological samples retrieving the bacteria isolated from blood cultures. The in-hospital mortality rate was 9%. We retrospectively tested two antibiotic associations: amoxicillin-clavulanic acid + gentamicin (AMC/GM) and 3rd generation cephalosporin + gentamicin (3GC/GM) considered as active if the causative bacteria was susceptible to at least one of the two drugs. The mean age was 71 years with 67% of male, 31 (31%) were immunocompromised and 52 (51%) had severe sepsis. Eleven patients had polymicrobial infections. The leading bacterial species involved were Escherichia coli 25/115 (22%), group D Streptococci 12/115 (10%), viridans Streptococci 12/115 (10%) and Staphylococcus aureus 11/115 (9%). AMC/GM displayed a higher rate of effectiveness compared to 3GC/GM: 100/101 (99%) vs 94/101 (93%) (p = 0.04): one Enterococcus faecium strain impaired the first association, Bacteroides spp. and Enterococcus spp. the second. In case of community-acquired sepsis of unknown origin, AMC + GM should be considered.

β-lactamases produced by amoxicillin-clavulanate-resistant enterobacteria isolated in Buenos Aires, Argentina: a new blaTEM gene.

PubMed

Di Conza, José A; Badaracco, Alejandra; Ayala, Juan; Rodríguez, Cynthia; Famiglietti, Angela; Gutkind, Gabriel O

2014-01-01

Resistance to β-lactam/β-lactamase inhibitors in enterobacteria is a growing problem that has not been intensively studied in Argentina. In the present work, 54/843 enterobacteria collected in a teaching hospital of Buenos Aires city were ampicillin-sulbactam-resistant isolates remaining susceptible to second- and third-generation cephalosporins. The enzymatic mechanisms present in the isolates, which were also amoxicillin-clavulanic acid (AMC)-resistant (18/54) were herein analyzed. Sequencing revealed two different variants of blaTEM-1, being blaTEM-1b the most frequently detected allelle (10 Escherichia coli, 3 Klebsiella pneumoniae, 2 Proteus mirabilis and 1 Raoultella terrigena) followed by blaTEM-1a (1 K. pneumoniae). Amoxicillin-clavulanate resistance seems to be mainly associated with TEM-1 overproduction (mostly in E. coli) or co-expressed with OXA-2-like and/or SHV β-lactamases (K. pneumoniae and P. mirabilis). A new blaTEM variant (TEM-163) was described in an E. coli strain having an AMC MIC value of 16/8μg/ml. TEM-163 contains Arg275Gln and His289Leu amino acid substitutions. On the basis of the high specific activity and low IC50 for clavulanic acid observed, the resistance pattern seems to be due to overproduction of the new variant of broad spectrum β-lactamase rather than to an inhibitor-resistant TEM (IRT)-like behavior. Copyright © 2014 Asociación Argentina de Microbiología. Publicado por Elsevier España. All rights reserved.

Simulating Future GPS Clock Scenarios with Two Composite Clock Algorithms

NASA Technical Reports Server (NTRS)

Suess, Matthias; Matsakis, Demetrios; Greenhall, Charles A.

2010-01-01

Using the GPS Toolkit, the GPS constellation is simulated using 31 satellites (SV) and a ground network of 17 monitor stations (MS). At every 15-minutes measurement epoch, the monitor stations measure the time signals of all satellites above a parameterized elevation angle. Once a day, the satellite clock estimates the station and satellite clocks. The first composite clock (B) is based on the Brown algorithm, and is now used by GPS. The second one (G) is based on the Greenhall algorithm. The composite clock of G and B performance are investigated using three ground-clock models. Model C simulates the current GPS configuration, in which all stations are equipped with cesium clocks, except for masers at USNO and Alternate Master Clock (AMC) sites. Model M is an improved situation in which every station is equipped with active hydrogen masers. Finally, Models F and O are future scenarios in which the USNO and AMC stations are equipped with fountain clocks instead of masers. Model F is a rubidium fountain, while Model O is more precise but futuristic Optical Fountain. Each model is evaluated using three performance metrics. The timing-related user range error having all satellites available is the first performance index (PI1). The second performance index (PI2) relates to the stability of the broadcast GPS system time itself. The third performance index (PI3) evaluates the stability of the time scales computed by the two composite clocks. A distinction is made between the "Signal-in-Space" accuracy and that available through a GNSS receiver.

Acute low back pain is marked by variability: An internet-based pilot study

PubMed Central

2011-01-01

Background Pain variability in acute LBP has received limited study. The objectives of this pilot study were to characterize fluctuations in pain during acute LBP, to determine whether self-reported 'flares' of pain represent discrete periods of increased pain intensity, and to examine whether the frequency of flares was associated with back-related disability outcomes. Methods We conducted a cohort study of acute LBP patients utilizing frequent serial assessments and Internet-based data collection. Adults with acute LBP (lasting ≤3 months) completed questionnaires at the time of seeking care, and at both 3-day and 1-week intervals, for 6 weeks. Back pain was measured using a numerical pain rating scale (NPRS), and disability was measured using the Oswestry Disability Index (ODI). A pain flare was defined as 'a period of increased pain lasting at least 2 hours, when your pain intensity is distinctly worse than it has been recently'. We used mixed-effects linear regression to model longitudinal changes in pain intensity, and multivariate linear regression to model associations between flare frequency and disability outcomes. Results 42 of 47 participants (89%) reported pain flares, and the average number of discrete flare periods per patient was 3.5 over 6 weeks of follow-up. More than half of flares were less than 4 hours in duration, and about 75% of flares were less than one day in duration. A model with a quadratic trend for time best characterized improvements in pain. Pain decreased rapidly during the first 14 days after seeking care, and leveled off after about 28 days. Patients who reported a pain flare experienced an almost 3-point greater current NPRS than those not reporting a flare (mean difference [SD] 2.70 [0.11]; p < 0.0001). Higher flare frequency was independently associated with a higher final ODI score (ß [SE} 0.28 (0.08); p = 0.002). Conclusions Acute LBP is characterized by variability. Patients with acute LBP report multiple distinct flares of pain, which correspond to discrete increases in pain intensity. A higher flare frequency is associated with worse disability outcomes. PMID:21974962

Young People with Intellectual Disability Transitioning to Adulthood: Do Behaviour Trajectories Differ in Those with and without Down Syndrome?

PubMed

Foley, Kitty-Rose; Taffe, John; Bourke, Jenny; Einfeld, Stewart L; Tonge, Bruce J; Trollor, Julian; Leonard, Helen

2016-01-01

Young people with intellectual disability exhibit substantial and persistent problem behaviours compared with their non-disabled peers. The aim of this study was to compare changes in emotional and behavioural problems for young people with intellectual disability with and without Down syndrome as they transition into adulthood in two different Australian cohorts. Emotional and behavioural problems were measured over three time points using the Developmental Behaviour Checklist (DBC) for those with Down syndrome (n = 323 at wave one) and compared to those with intellectual disability of another cause (n = 466 at wave one). Outcome scores were modelled using random effects regression as linear functions of age, Down syndrome status, ability to speak and gender. DBC scores of those with Down syndrome were lower than those of people without Down syndrome indicating fewer behavioural problems on all scales except communication disturbance. For both groups disruptive, communication disturbance, anxiety and self-absorbed DBC subscales all declined on average over time. There were two important differences between changes in behaviours for these two cohorts. Depressive symptoms did not significantly decline for those with Down syndrome compared to those without Down syndrome. The trajectory of the social relating behaviours subscale differed between these two cohorts, where those with Down syndrome remained relatively steady and, for those with intellectual disability from another cause, the behaviours increased over time. These results have implications for needed supports and opportunities for engagement in society to buffer against these emotional and behavioural challenges.

Long-term disability progression in primary progressive multiple sclerosis: a 15-year study.

PubMed

Rocca, Maria A; Sormani, Maria Pia; Rovaris, Marco; Caputo, Domenico; Ghezzi, Angelo; Montanari, Enrico; Bertolotto, Antonio; Laroni, Alice; Bergamaschi, Roberto; Martinelli, Vittorio; Comi, Giancarlo; Filippi, Massimo

2017-11-01

Prognostic markers of primary progressive multiple sclerosis evolution are needed. We investigated the added value of magnetic resonance imaging measures of brain and cervical cord damage in predicting long-term clinical worsening of primary progressive multiple sclerosis compared to simple clinical assessment. In 54 patients, conventional and diffusion tensor brain scans and cervical cord T1-weighted scans were acquired at baseline and after 15 months. Clinical evaluation was performed after 5 and 15 years in 49 patients. Lesion load, brain and cord atrophy, mean diffusivity and fractional anisotropy values from the brain normal-appearing white matter and grey matter were obtained. Using linear regression models, we screened the clinical and imaging variables as independent predictors of 15-year disability change (measured on the expanded disability status scale). At 15 years, 90% of the patients had disability progression. Integrating clinical and imaging variables at 15 months predicted disability changes at 15 years better than clinical factors at 5 years (R2 = 61% versus R2 = 57%). The model predicted long-term disability change with a precision within one point in 38 of 49 patients (77.6%). Integration of clinical and imaging measures allows identification of primary progressive multiple sclerosis patients at risk of long-term disease progression 4 years earlier than when using clinical assessment alone. © The Author (2017). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Catastrophizing, state anxiety, anger, and depressive symptoms do not correlate with disability when variations of trait anxiety are taken into account. a study of chronic low back pain patients treated in Spanish pain units [NCT00360802].

PubMed

Moix, Jenny; Kovacs, Francisco M; Martín, Andrés; Plana, María N; Royuela, Ana

2011-07-01

To assess the influence of pain severity, catastrophizing, anger, anxiety, and depression on nonspecific low back pain (LBP)-related disability in Spanish patients with chronic LBP. Study Design.  Cross-sectional correlation between psychological variables and disability. Methods.  One hundred twenty-three patients treated for chronic LBP in pain units within nine Spanish National Health Service Hospitals, in eight cities, were included in this study. Intensity of LBP and pain referred to the leg, disability, catastrophizing, anger, state anxiety, trait anxiety, and depression were assessed through previously validated questionnaires. The association of disability with these variables, as well as gender, age, academic level, work status, and use of antidepressants, was analyzed through linear regression models. Correlations between LBP, referred pain, disability, catastrophizing, anger, state anxiety, trait anxiety, and depression were significant, except for the ones between anger and LBP and between anger and referred pain. The multivariate regression model showed that when variations of trait anxiety were taken into account, the association of the other psychological variables with disability was no longer significant. The final model explained 49% of the variability of disability. Standardized coefficients were 0.452 for trait anxiety, 0.362 for intensity of LBP, 0.253 for failed back surgery, and -0.140 for higher academic level. Among Spanish chronic LBP patients treated at pain units, the correlation of catastrophizing, state anxiety, anger, and depression with disability ceases to be significant when variations of trait anxiety are taken into account. Further studies with LBP patients should determine whether anxiety trait mediates the effects of the other variables, explore its prognostic value, and assess the therapeutic effect of reducing it. Wiley Periodicals, Inc.

The Role of Negative Affect on Headache-Related Disability Following Traumatic Physical Injury.

PubMed

Pacella, Maria L; Hruska, Bryce; George, Richard L; Delahanty, Douglas L

2018-03-01

Acute postinjury negative affect (NA) may contribute to headache pain following physical injury. Early psychiatric-headache comorbidity conveys increased vulnerability to chronic headache-related disability and impairment. Yet, it is unknown whether NA is involved in the transition to chronic headache related-disability after injury. This prospective observational study examined the role of acute postinjury NA on subacute and chronic headache-related disability above and beyond nonpsychiatric factors. Eighty adult survivors of single-incident traumatic physical injury were assessed for negative affect (NA): a composite of depression and anxiety symptoms, and symptoms of posttraumatic stress disorder (PTSS) during the acute 2-week postinjury phase. NA was examined as the primary predictor of subacute (6-week) and chronic (3-month) headache-related disability; secondary analyses examined whether the individual NA components differentially impacted the outcomes. Hierarchical linear regression confirmed NA as a unique predictor of subacute (Cohen's f  2  = 0.130; P = .005) and chronic headache related-disability (Cohen's f  2  = 0.160; P = .004) beyond demographic and injury-related factors (sex, prior headaches, and closed head injury). Upon further analysis, PTSS uniquely predicted greater subacute (Cohen's f  2  = 0.105; P = .012) and chronic headache-related disability (Cohen's f  2  = 0.103; P = .022) above and beyond demographic and injury-related factors, depression, and anxiety. Avoidance was a robust predictor of subacute headache impairment (explaining 15% of the variance) and hyperarousal was a robust predictor of chronic headache impairment (10% of the variance). Although NA consistently predicted headache-related disability, PTSS alone was a unique predictor above and beyond nonpsychiatric factors, depression, and anxiety. These results are suggestive that early treatment of acute postinjury PTSS may correlate with reductions in disability and negative physical health sequelae associated with PTSS and chronic headache. © 2017 American Headache Society.

Malnutrition and Childhood Disability in Turkana, Kenya: Results from a Case-Control Study.

PubMed

Kuper, Hannah; Nyapera, Velma; Evans, Jennifer; Munyendo, David; Zuurmond, Maria; Frison, Severine; Mwenda, Victoria; Otieno, David; Kisia, James

2015-01-01

Children with disabilities may be particularly vulnerable to malnutrition, as a result of exclusions and feeding difficulties. However, there is limited evidence currently available on this subject. A population-based case-control study was conducted in Turkana County, Kenya, between July and August 2013. Key informants in the community identified children aged 6 months to 10 years who they believed may have a disability. These children were screened by a questionnaire (UNICEF-Washington Group) and assessed by a paediatrician to confirm whether they had a disability and the type. Two controls without disabilities were selected per case: A sibling control (sibling nearest in age) and a neighbourhood control (nearest neighbour within one year of age). The caregiver completed a questionnaire on behalf of the child (e.g. information on feeding, poverty, illness, education), and anthropometric measures were taken. We undertook multivariable logistic and linear regression analyses to estimate the relationship between disability and malnutrition. The study included 311 cases with disabilities, 196 sibling controls and 300 neighbour controls. Children with disabilities were more likely to report a range of feeding difficulties. They were 1.6-2.9 times more likely to have malnutrition in comparison to neighbour controls or family controls, including general malnutrition (low weight for age), stunting (low height for age), low body mass index (BMI) or low mid upper arm circumference (MUAC) for age. Children with disabilities were almost twice as likely to have wasting (low weight for height) in comparison to neighbour controls (OR = 1.9, 95% CI 1.1-3.2), but this difference was not apparent compared with siblings (OR = 1.5, 95% CI 0.8-2.7). Children with disabilities also faced other exclusions. For instance those aged 5+ were much more likely not to attend school than neighbour controls (OR = 8.5, 95% CI 4.3-16.9). Children with disabilities were particularly vulnerable to malnutrition, even within this area of food insecurity and widespread malnutrition. Efforts need to be made to include children with disabilities within food supplementation programmes, and school based programmes alone may be inadequate to meet this need. Exclusion of children with disabilities from education is also a priority area to be addressed.

Malnutrition and Childhood Disability in Turkana, Kenya: Results from a Case-Control Study

PubMed Central

Evans, Jennifer; Munyendo, David; Zuurmond, Maria; Frison, Severine; Mwenda, Victoria; Otieno, David; Kisia, James

2015-01-01

Background Children with disabilities may be particularly vulnerable to malnutrition, as a result of exclusions and feeding difficulties. However, there is limited evidence currently available on this subject. Methods A population-based case-control study was conducted in Turkana County, Kenya, between July and August 2013. Key informants in the community identified children aged 6 months to 10 years who they believed may have a disability. These children were screened by a questionnaire (UNICEF-Washington Group) and assessed by a paediatrician to confirm whether they had a disability and the type. Two controls without disabilities were selected per case: A sibling control (sibling nearest in age) and a neighbourhood control (nearest neighbour within one year of age). The caregiver completed a questionnaire on behalf of the child (e.g. information on feeding, poverty, illness, education), and anthropometric measures were taken. We undertook multivariable logistic and linear regression analyses to estimate the relationship between disability and malnutrition. Results The study included 311 cases with disabilities, 196 sibling controls and 300 neighbour controls. Children with disabilities were more likely to report a range of feeding difficulties. They were 1.6–2.9 times more likely to have malnutrition in comparison to neighbour controls or family controls, including general malnutrition (low weight for age), stunting (low height for age), low body mass index (BMI) or low mid upper arm circumference (MUAC) for age. Children with disabilities were almost twice as likely to have wasting (low weight for height) in comparison to neighbour controls (OR = 1.9, 95% CI 1.1–3.2), but this difference was not apparent compared with siblings (OR = 1.5, 95% CI 0.8–2.7). Children with disabilities also faced other exclusions. For instance those aged 5+ were much more likely not to attend school than neighbour controls (OR = 8.5, 95% CI 4.3–16.9). Conclusions Children with disabilities were particularly vulnerable to malnutrition, even within this area of food insecurity and widespread malnutrition. Efforts need to be made to include children with disabilities within food supplementation programmes, and school based programmes alone may be inadequate to meet this need. Exclusion of children with disabilities from education is also a priority area to be addressed. PMID:26689213

Social Security Disability Insurance Enrollment and Health Care Employment.

PubMed

Pellegrini, Lawrence C; Geissler, Kimberley H

2017-09-21

To examine the relationship between Social Security Disability Insurance (SSDI) enrollment and health care employment. State-year level data from government and other publicly available sources for all states (2000-2014). Population-weighted linear regression analyses model associations between each health care employment measure and each SSDI enrollment measure (i.e., SSDI overall, physical, or mental health enrollment rates), controlling for factors associated with health care employment, state fixed effects, and secular time trends. Data are gathered from publicly available sources. A one standard deviation increase in SSDI enrollment per 100,000 population is associated with a statistically significant 2.6 and 4.5 percent increase in the mean employment rate per 100,000 population for health care practitioner and technical occupations and health care support occupations, respectively. The size of this relationship varies by the type of disabling condition for SSDI enrollment (physical versus mental health). Social Security Disability Insurance enrollment is significantly associated with health care employment at the state level. Quantifying the magnitude of this relationship is important given high SSDI enrollment rates as well as evolving policy and demographic shifts related to the SSDI program. © Health Research and Educational Trust.

Does visual impairment lead to additional disability in adults with intellectual disabilities?

PubMed

Evenhuis, H M; Sjoukes, L; Koot, H M; Kooijman, A C

2009-01-01

This study addresses the question to what extent visual impairment leads to additional disability in adults with intellectual disabilities (ID). In a multi-centre cross-sectional study of 269 adults with mild to profound ID, social and behavioural functioning was assessed with observant-based questionnaires, prior to expert assessment of visual function. With linear regression analysis the percentage of variance, explained by levels of visual function, was calculated for the total population and per ID level. A total of 107/269 participants were visually impaired or blind (WHO criteria). On top of the decrease by ID visual impairment significantly decreased daily living skills, communication & language, recognition/communication. Visual impairment did not cause more self-absorbed and withdrawn behaviour or anxiety. Peculiar looking habits correlated with visual impairment and not with ID. In the groups with moderate and severe ID this effect seems stronger than in the group with profound ID. Although ID alone impairs daily functioning, visual impairment diminishes the daily functioning even more. Timely detection and treatment or rehabilitation of visual impairment may positively influence daily functioning, language development, initiative and persistence, social skills, communication skills and insecure movement.

The role of muscle mass and body fat on disability among older adults: A cross-national analysis.

PubMed

Tyrovolas, Stefanos; Koyanagi, Ai; Olaya, Beatriz; Ayuso-Mateos, Jose Luis; Miret, Marta; Chatterji, Somnath; Tobiasz-Adamczyk, Beata; Koskinen, Seppo; Leonardi, Matilde; Haro, Josep Maria

2015-09-01

The aim of this study was to evaluate the association of sarcopenia and sarcopenic obesity with disability among older adults (≥65years old) in nine high-, middle- and low-income countries from Asia, Africa, Europe, and Latin America. Data were available for 53,289 people aged ≥18years who participated in the Collaborative Research on Ageing in Europe (COURAGE) survey conducted in Finland, Poland, and Spain, and the WHO Study on global AGEing and adult health (SAGE) survey conducted in China, Ghana, India, Mexico, Russia, and South Africa, between 2007 and 2012. Skeletal muscle mass, skeletal muscle mass index, and percent body fat were calculated with specific population formulas. Sarcopenia and sarcopenic obesity were defined by specific cut-offs used in previous studies. Disability was assessed with the WHODAS 2.0 score (range 0-100) with higher scores corresponding to higher levels of disability. Multivariable linear regression analysis was conducted with disability as the outcome. The analytical sample consisted of 18,363 people (males; n=8116, females; n=10247) aged ≥65years with mean (SD) age 72.9 (11.1) years. In the fully-adjusted overall analysis, sarcopenic obesity was associated with greater levels of disability [b-coefficient 3.01 (95% CI 1.14-4.88)]. In terms of country-wise analyses, sarcopenia was associated with higher WHODAS 2.0 scores in China [b-coefficient 4.56 (95% CI: 3.25-5.87)], Poland [b-coefficient 6.66 (95% CI: 2.17-11.14)], Russia [b-coefficient 5.60 (95% CI: 2.03-9.16)], and South Africa [b-coefficient 7.75 (95% CI: 1.56-13.94)]. Prevention of muscle mass decline may contribute to reducing the global burden of disability. Copyright © 2015 Elsevier Inc. All rights reserved.

Health spending among working-age immigrants with disabilities compared to those born in the US.

PubMed

Tarraf, Wassim; Mahmoudi, Elham; Dillaway, Heather E; González, Hector M

2016-07-01

Immigrants have disparate access to health care. Disabilities can amplify their health care burdens. Examine how US- and foreign-born working-age adults with disabilities differ in their health care spending patterns. Medical Expenditures Panel Survey yearly-consolidated files (2000-2010) on working-age adults (18-64 years) with disabilities. We used three operational definitions of disability: physical, cognitive, and sensory. We examined annual total, outpatient/office-based, prescription medication, inpatient, and emergency department (ED) health expenditures. We tested bivariate logistic and linear regression models to, respectively, assess unadjusted group differences in the propensity to spend and average expenditures. Second, we used multivariable two-part models to estimate and test per-capita expenditures adjusted for predisposing, enabling, health need and behavior indicators. Adjusted for age and sex differences, US-born respondents with physical, cognitive, sensory spent on average $2977, $3312, and $2355 more in total compared to their foreign-born counterparts (P < 0.01). US-born spending was also higher across the four types of health care expenditures considered. Adjusting for the behavioral model factors, especially predisposing and enabling indicators, substantially reduced nativity differences in overall, outpatient/office-based and medication spending but not in inpatient and ED expenditures. Working-age immigrants with disabilities have lower levels of health care use and expenditures compared to their US-born counterparts. Affordable Care Act provisions aimed at increasing access to insurance and primary care can potentially align the consumption patterns of US- and foreign-born disabled working-age adults. More work is needed to understand the pathways leading to differences in hospital and prescription medication care. Copyright © 2016 Elsevier Inc. All rights reserved.

Validation of the World Health Organization Disability Assessment Schedule (WHO-DAS II) in Greek and its added value to the Short Form 36 (SF-36) in a sample of people with or without disabilities.

PubMed

Xenouli, Georgia; Xenoulis, Kostis; Sarafis, Pavlos; Niakas, Dimitris; Alexopoulos, Evangelos C

2016-07-01

There is controversy and ongoing interest on the measurement of functionality in the personal and social level. (1) to validate the Greek version of the World Health Organization Disability Assessment Schedule (WHO DAS II) and (2) to determine its added value to the physical and psychological health subscales of the Short Form 36 (SF-36). In a cross-sectional design, data were collected between December 2014 and March 2015 by using three questionnaires (WHO DAS II, SF-36, PSS-14) in a sample of people with disabilities (n = 101) and without disabilities (n = 109) in Athens, Greece. WHO DAS II internal consistency, construct and criterion-related validity were assessed by Cronbach alpha, exploratory factor analysis and correlations; its added value by multivariable linear regression. Cronbach Alpha's were satisfactory for the WHO DAS II, PSS-14 and SF-36 (0.85, 0.88 and 0.96 respectively). Exploratory factor analysis confirmed the existence of one or two factors in people with or without disabilities, respectively. WHO DAS II score showed significant negative correlation with the physical and mental health scale of SF-36 score, especially strong for physical health while was positively related to PSS-14 score. In multivariate analysis mental health appraisal was related to perceived stress in both groups. This study support the validity of the Greek version of WHO DAS II and warranted its use in assessment and follow up of people with disabilities, contributing to the development of suitable policies to cover their needs and providing comparable data with other surveys using the same instrument. Copyright © 2016 Elsevier Inc. All rights reserved.

Health Spending Among Working-Age Immigrants With Disabilities Compared To Those Born In The US

PubMed Central

Tarraf, Wassim; Mahmoudi, Elham; Dillaway, Heather E; Gonzalez, Hector M.

2016-01-01

Background Immigrants have disparate access to healthcare. Disabilities can amplify their healthcare burdens. Objective/Hypothesis Examine how US- and foreign-born working-age adults with disabilities differ in their healthcare spending patterns. Methods Medical Expenditures Panel Survey yearly-consolidated files (2000-2010) on working-age adults (18-64 years) with disabilities. We used three operational definitions of disability: physical, cognitive, and sensory. We examined annual total, outpatient/office-based, prescription medication, inpatient, and emergency department (ED) health expenditures. We tested bivariate logistic and linear regression models to, respectively, assess unadjusted group differences in the propensity to spend and average expenditures. Second, we used multivariable two-part models to estimate and test per-capita expenditures adjusted for predisposing, enabling, health need and behavior indicators. Results Adjusted for age and sex differences, US-born respondents with physical, cognitive, sensory spent on average $2,977, $3,312, and $2,355 more in total compared to their foreign-born counterparts (P<0.01). US-born spending was also higher across the four types of healthcare expenditures considered. Adjusting for the behavioral model factors, especially predisposing and enabling indicators, substantially reduced nativity differences in overall, outpatient/office-based and medication spending but not in inpatient and ED expenditures. Conclusions Working-age immigrants with disabilities have lower levels of healthcare use and expenditures compared to their US-born counterparts. Affordable Care Act provisions aimed at increasing access to insurance and primary care can potentially align the consumption patterns of US- and foreign-born disabled working-age adults. More work is needed to understand the pathways leading to differences in hospital and prescription medication care. PMID:26917103

Older age, higher perceived disability and depressive symptoms predict the amount and severity of work-related difficulties in persons with multiple sclerosis.

PubMed

Raggi, Alberto; Giovannetti, Ambra Mara; Schiavolin, Silvia; Brambilla, Laura; Brenna, Greta; Confalonieri, Paolo Agostino; Cortese, Francesca; Frangiamore, Rita; Leonardi, Matilde; Mantegazza, Renato Emilio; Moscatelli, Marco; Ponzio, Michela; Torri Clerici, Valentina; Zaratin, Paola; De Torres, Laura

2018-04-16

This cross-sectional study aims to identify the predictors of work-related difficulties in a sample of employed persons with multiple sclerosis as addressed with the Multiple Sclerosis Questionnaire for Job Difficulties. Hierarchical linear regression analysis was conducted to identify predictors of work difficulties: predictors included demographic variables (age, formal education), disease duration and severity, perceived disability and psychological variables (cognitive dysfunction, depression and anxiety). The targets were the questionnaire's overall score and its six subscales. A total of 177 participants (108 females, aged 21-63) were recruited. Age, perceived disability and depression were direct and significant predictors of the questionnaire total score, and the final model explained 43.7% of its variation. The models built on the questionnaire's subscales show that perceived disability and depression were direct and significant predictors of most of its subscales. Our results show that, among patients with multiple sclerosis, those who were older, with higher perceived disability and higher depression symptoms have more and more severe work-related difficulties. The Multiple Sclerosis Questionnaire for Job Difficulties can be fruitfully exploited to plan tailored actions to limit the likelihood of near-future job loss in persons of working age with multiple sclerosis. Implications for rehabilitation Difficulties with work are common among people with multiple sclerosis and are usually addressed in terms of unemployment or job loss. The Multiple Sclerosis Questionnaire for Job Difficulties is a disease-specific questionnaire developed to address the amount and severity of work-related difficulties. We found that work-related difficulties were associated to older age, higher perceived disability and depressive symptoms. Mental health issues and perceived disability should be consistently included in future research targeting work-related difficulties.

Developing an Item Bank to Measure Quality of Life in Individuals With Glaucoma, and the Results of the Interview With Patients: The Effect of Visual Function, Visual Field Progression Rate, Medical, and Surgical Treatments on Quality of Life.

PubMed

Matsuura, Masato; Hirasawa, Kazunori; Hirasawa, Hiroyo; Yanagisawa, Mieko; Murata, Hiroshi; Mayama, Chihiro; Asaoka, Ryo

2017-02-01

To construct a new item bank to measure quality of life (QOL) in glaucoma patients and to evaluate glaucoma patients' QOL using the item bank. An item bank of questions was generated through a literature review of QOL instruments useful for glaucoma patients. Using this item bank, a cognitive survey was performed on 203 patients with glaucoma (112 males and 91 females, 61.9±11.9 y old; mean±SD). The results were then analyzed using the Rasch analysis, and the Rasch-derived disability scores were predicted using linear modelling and the following clinical parameters: age, mean total deviation (mTD) in superior and inferior visual field (mTDsup/mTDinf), mTD progression rate, better visual acuity, worse visual acuity, number of eye drops administered per day, number of trabeculectomy procedures experienced in both eyes. A total of 23 questionnaires of QOL in glaucoma patients were identified resulting in an item bank of 187 questions related to the following tasks: reading/writing, walking, going out, eating and driving (direct disability) as well as questions concerned with worry/anxiety, social participation, and physical symptoms (indirect disability). In the optimal model for direct disability, age and mTDinf were identified as significant predictors, whereas number of eye drops administered per day and number of trabeculectomy experienced were included in the optimal model for indirect disability. A new item bank to measure QOL in glaucoma patients was developed and evaluated. Age and mTDinf were found to be related to direct disability while medical and surgical treatments were related to indirect disability.

Arthritis Self-Efficacy and Self-Efficacy for Resisting Eating: Relationships to Pain, Disability, and Eating Behavior in Overweight and Obese Individuals with Osteoarthritic Knee Pain

PubMed Central

Pells, Jennifer J.; Shelby, Rebecca A.; Keefe, Francis J.; Dixon, Kim E.; Blumenthal, James A.; LaCaille, Lara; Tucker, Jessica M.; Schmitt, Daniel; Caldwell, David S.; Kraus, Virginia B.

2008-01-01

This study examined arthritis self-efficacy and self-efficacy for resisting eating as predictors of pain, disability, and eating behaviors in overweight or obese patients with osteoarthritis (OA) of the knee. Patients (N=174) with a body mass index between 25 and 42 completed measures of arthritis-related self-efficacy, weight-related self-efficacy, pain, physical disability, psychological disability, overeating, and demographic and medical information. Hierarchical linear regression analyses were conducted to examine whether arthritis self-efficacy (efficacy for pain control, physical function, and other symptoms) and self-efficacy for resisting eating accounted for significant variance in pain, disability, and eating behaviors after controlling for demographic and medical characteristics. Analyses also tested whether the contributions of self-efficacy were domain specific. Results showed that self-efficacy for pain accounted for 14% (p=.01) of the variance in pain, compared to only 3% accounted for by self-efficacy for physical function and other symptoms. Self-efficacy for physical function accounted for 10% (p=.001) of the variance in physical disability, while self-efficacy for pain and other symptoms accounted for 3%. Self-efficacy for other (emotional) symptoms and resisting eating accounted for 21% (p<.05) of the variance in psychological disability, while self-efficacy for pain control and physical function were not significant predictors. Self-efficacy for resisting eating accounted for 28% (p=.001) of the variance in eating behaviors. Findings indicate that self-efficacy is important in understanding pain and behavioral adjustment in overweight or obese OA patients. Moreover, the contributions of self-efficacy were domain specific. Interventions targeting both arthritis self-efficacy and self-efficacy for resisting eating may be helpful in this population. PMID:17764844

Burden of disease due to cancer in Spain

PubMed Central

Fernández de Larrea-Baz, Nerea; Álvarez-Martín, Elena; Morant-Ginestar, Consuelo; Gènova-Maleras, Ricard; Gil, Ángel; Pérez-Gómez, Beatriz; López-Abente, Gonzalo

2009-01-01

Background Burden of disease is a joint measure of mortality and morbidity which makes it easier to compare health problems in which these two components enjoy different degrees of relative importance. The objective of this study is ascertaining the burden of disease due to cancer in Spain via the calculation of disability-adjusted life years (DALYs). Methods DALYs are the sum of years of life lost due to premature mortality and years lost due to disability. World Health Organization methodology and the following sources of data were used: the Mortality Register and Princeton Model Life Table for Years of life lost due to premature mortality and population, incidence estimates (Spanish tumour registries and fitting of generalized linear mixed models), duration (from data of survival in Spain from the EUROCARE-3 study and fitting of Weibull distribution function) and disability (weights published in the literature) for Years lost due to disability. Results There were 828,997 DALYs due to cancer (20.5 DALYs/1,000 population), 61% in men. Of the total, 51% corresponded to lung, colorectal, breast, stomach and prostate cancers. Mortality (84% of DALYs) predominated over disability. Subjects aged under 20 years accounted for 1.6% and those aged over 70 years accounted for 30.1% of DALYs. Conclusion Lung, colorectal and breast cancers are responsible for the highest number of DALYs in Spain. Even if the burden of disease due to cancer is predominantly caused by mortality, some cancers have a significant weight of disability. Information on 2000 burden of disease due to cancer can be useful to assess how it has evolved over time and the impact of medical advances on it in terms of mortality and disability. PMID:19183440

Antepartum depression and anxiety associated with disability in African women: cross-sectional results from the CDS study in Ghana and Côte d'Ivoire.

PubMed

Bindt, Carola; Appiah-Poku, John; Te Bonle, Marguerite; Schoppen, Stefanie; Feldt, Torsten; Barkmann, Claus; Koffi, Mathurin; Baum, Jana; Nguah, Samuel Blay; Tagbor, Harry; Guo, Nan; N'Goran, Eliezer; Ehrhardt, Stephan

2012-01-01

Common mental disorders, particularly unipolar depressive disorders, rank among the top 5 with respect to the global burden of disease. As a major public health concern, antepartum depression and anxiety not only affects the individual woman, but also her offspring. Data on the prevalence of common mental disorders in pregnant women in sub-Saharan Africa are scarce. We provide results from Ghana and Côte d'Ivoire. We subsequently recruited and screened n = 1030 women in the third trimester of their pregnancy for depressed mood, general anxiety, and perceived disability using the Patient Health Questionnaire depression module (PHQ-9), the 7-item Anxiety Scale (GAD-7), and the World Health Organisation Disability Assessment Schedule II (WHO-DAS 2.0, 12-item version). In addition to estimates of means and prevalence, a hierarchical linear regression model was calculated to determine the influence of antepartum depression and anxiety on disability. In Ghana, 26.6% of women showed substantially depressed mood. In Côte d'Ivoire, this figure was even higher (32.9%). Clear indications for a generalized anxiety disorder were observed in 11.4% and 17.4% of pregnant women, respectively. Comorbidity of both conditions was common, affecting about 7.7% of Ghanaian and 12.6% of Ivorian participants. Pregnant women in both countries reported a high degree of disability regarding everyday activity limitations and participation restrictions. Controlled for country and age, depression and anxiety accounted for 33% of variance in the disability score. Antepartum depression and anxiety were highly prevalent in our sample and contributed substantially to perceived disability. These serious threats to health must be further investigated and more data are needed to comprehensively quantify the problem in sub-Saharan Africa.

The Development of Sensitivity to Grammatical Violations in American Sign Language: Native versus Nonnative Signers

ERIC Educational Resources Information Center

Novogrodsky, Rama; Henner, Jon; Caldwell-Harris, Catherine; Hoffmeister, Robert

2017-01-01

Factors influencing native and nonnative signers' syntactic judgment ability in American Sign Language (ASL) were explored for 421 deaf students aged 7;6-18;5. Predictors for syntactic knowledge were chronological age, age of entering a school for the deaf, gender, and additional learning disabilities. Mixed-effects linear modeling analysis…

Including as a Care-ful Journey: A Parent's Perspective

ERIC Educational Resources Information Center

Scorgie, Kate; Wilgosh, Lorraine

2009-01-01

The authors argue for the need of a cyclical, rather than a linear, model of family coping and life management when a child has a disability. Longitudinal support for such a cyclical model of family life management is presented, with recognition that parental control of outcome lessens as the young person ages, because the adult world is not…

Scientific and technical collaboration between Russian and Ukranian researchers and manufacturers on the development of astronomical instruments equipped with advanced detection services

NASA Astrophysics Data System (ADS)

Vishnevsky, G. I.; Galyatkin, I. A.; Zhuk, A. A.; Iblyaminova, A. F.; Kossov, V. G.; Levko, G. V.; Nesterov, V. K.; Rivkind, V. L.; Rogalev, Yu. N.; Smirnov, A. V.; Gumerov, R. I.; Bikmaev, I. F.; Pinigin, G. I.; Shulga, A. V.; Kovalchyk, A. V.; Protsyuk, Yu. I.; Malevinsky, S. V.; Abrosimov, V. M.; Mironenko, V. N.; Savchenko, V. V.; Ivaschenko, Yu. N.; Andruk, V. M.; Dalinenko, I. N.; Vydrevich, M. G.

2003-01-01

The paper presents the possibilities and a list of tasks that are solved by collaboration between research and production companies, and astronomical observatories of Russia and Ukraine in the field of development, modernization and equipping of various telescopes (the AMC, RTT-150, Zeiss-600 and quantum-optical system Sazhen-S types) with advanced charge-coupled device (CCD) cameras. CCD imagers and ditital CCD cameras designed and manufactured by the "Electron-Optronic" Research & Production Company, St Petersburg, to equip astronomical telescopes and scientific instruments are described.

Organizational Development and the Marine Corps: are We Too Unique to Need It

DTIC Science & Technology

1979-12-01

KNlý, Raymond M./ Belongie e~ ~ ~~fJ cJaok*979 hesis Advisor: CDR Richard A. McGonigal Approved for public release; distribution unlimited =380 3 I0023 i...MUMANSt. Raymond M. Belongie 04I, EORMING4 ORGA.NIZATION NAME AMC% A 10~. P~G1Aj7M1 T.MNIPCJ T TASK Naval Posgaut School ARISA WRIC UNIT NPUMISIS Monterey...DEVELOPMENT AND THE MARINE CORPS: ARE WE TOO UNIQUE TO NEED IT? by Raymond M. Belongie Major, United States Marine Corps B.S.e University of Wisconsin-Oshkosh

Catchment area-based evaluation of the AMC-dependent SCS-CN-based rainfall-runoff models

NASA Astrophysics Data System (ADS)

Mishra, S. K.; Jain, M. K.; Pandey, R. P.; Singh, V. P.

2005-09-01

Using a large set of rainfall-runoff data from 234 watersheds in the USA, a catchment area-based evaluation of the modified version of the Mishra and Singh (2002a) model was performed. The model is based on the Soil Conservation Service Curve Number (SCS-CN) methodology and incorporates the antecedent moisture in computation of direct surface runoff. Comparison with the existing SCS-CN method showed that the modified version performed better than did the existing one on the data of all seven area-based groups of watersheds ranging from 0.01 to 310.3 km2.

Communication Effectiveness of the Army Civilian Personnel Program

DTIC Science & Technology

1966-06-01

Fort Devens Eastern CONARC/Troops 1880 Fort Lee Southern CONARC/School 2500 Fort MacArthur Western CONARC/Troops 1060 Fort Sam Houston Southern...A- t- I ta1 it ciu.1 rac t v’I I at I vi ii o I tih cim t c lt i oisit Itil Ih cm we𔃻:.’ tin t i f It i ,:i1 v .1 Nil I ii’j’or e’i I ACK NOWI I. M...Southern AMC/Supply 3000 Fort Benjamin Harrison Midwestern Audit/Finance 6000 Fort Benning Southern CONARC/Troops 3300 Fort Carson Western

Crystallization Experiments in the MgO-CO2-H2O system: Role of Amorphous Magnesium Carbonate Precursors in Magnesium Carbonate Hydrated Phases and Morphologies in Low Temperature Hydrothermal Fluids

NASA Astrophysics Data System (ADS)

Giampouras, Manolis; Garcia-Ruiz, Juan Manuel; Garrido, Carlos J.

2017-04-01

Numerous forms of hydrated or basic magnesium carbonates occur in the complex MgO-CO2-H2O system. Mineral saturation states from low temperature hydrothermal fluids in Semail Ophiolite (Oman), Prony Bay (New Caledonia) and Lost City hydrothermal field (mid-Atlantic ridge) strongly indicate the presence of magnesium hydroxy-carbonate hydrates (e.g. hydromagnesite) and magnesium hydroxides (brucite). Study of formation mechanisms and morphological features of minerals forming in the MgO-CO2-H2O system could give insights into serpentinization-driven, hydrothermal, alkaline environments, which are related to early Earth conditions. Temperature, hydration degree, pH and fluid composition are crucial factors regarding the formation, coexistence and transformation of such mineral phases. The rate of supersaturation, on the other hand, is a fundamental parameter to understand nucleation and crystal growth processes. All these parameters can be examined in a solution using different crystallization techniques. In the present study, we applied different crystallization techniques to synthesize and monitor the crystallization of Mg-bearing carbonates and hydroxides under abiotic conditions. Various crystallization techniques (counter-diffusion, vapor diffusion and unseeded solution mixing) were used to screen the formation conditions of each phase, transformation processes and structural development. Mineral and textural characterization of the different synthesized phases were carried out by X-ray diffraction (XRD), Raman spectroscopy and scanning electron microscopy coupled to dispersive energy spectroscopy (FE-SEM-EDS). Experimental investigation of the effect of pH level and silica content under variable reactant concentrations revealed the importance of Amorphous Magnesium Carbonate (AMC) in the formation of hydroxy-carbonate phases (hydromagnesite and dypingite). Micro-structural resemblance between AMC precursors and later stage crystalline phases highlights the critical role of internal molecule re-organization to form crystalline structures. Aggregation of AMC spherulites triggers biomimetic morphologies forming curling laminar structures and rings. The size and number of nesquehonite (MgCO3.3H2O) crystals are controlled by pH and Mg2+ ions at pH < 9. As pH increases, nesquehonite transforms to spherical, rosette-like dypingite and/or hydromagnesite. Crystallization experiments within silica gel impedes the normal growth of prismatic nesquehonite crystals and generates peculiar dendritic crystalline structures. Finally, vapor diffusion techniques resulted in synthesis of NH4+-bearing hydrated compounds after ammonium incorporation when [NH4+]/[Mg2+] ≥ 1 and ≥ 0.5M [NH4+]. Funding: We acknowledge funding from the People programme (Marie Curie Actions - ITN) of the European Union FP7 under REA Grant Agreement n˚ 608001.

Correlated Geophysical, Geochemical and Volcanological Manifestations of Plume-Ridge Interaction Along the Galápagos Spreading Center, 90.5-98° W

NASA Astrophysics Data System (ADS)

Sinton, J. M.; Detrick, R. S.; Canales, J. P.; Ito, G.; Behn, M.; Blacic, T.; Cushman, B.; Dixon, J.

2001-12-01

As the Galápagos plume is approached from the west along the Galápagos Spreading Center there are systematic increases in crustal thickness, and K/Ti and H2O content of recovered lavas. These increases correlate with progressive transitions from axial deep to axial high morphology along with decreases in axial depth, residual mantle Bouguer gravity anomaly (MBA), average swell depth, average lava Mg # (atomic MgO/(MgO+FeO)), and the frequency of isolated axial seamounts. Although K/Ti, H2O and Nb/Zr (likely indicators of plume source enrichment) show step-wise increases across the 95.5° W propagating offset, trends in crustal thickness, axial bathymetry, MBA, swell depth, and seamount frequency generally show either no effect or only local perturbations to regional trends. East of ~92.7° W, sharp increases in K/Ti, Nb/Zr, H2O, and Na8 (Na2O corrected for fractionation to 8 wt % MgO) coincide with the transition to axial high morphology, a rapid shoaling of axial magma chamber (AMC) seismic reflectors, and thinning of seismic layer 2A. Maximum values in K/Ti (>0.4), Nb/Zr (>0.10), H2O (>1.0 wt %), Na8 ( ~3.2) and crustal thickness (7.9 km), and minima in axial depth (<1700 m), Mg # (<40), and Ca8/Al8 (<0.7) all occur between 91.25° W and 92° W, whereas the minimum MBA (-25 mGal) and AMC depth ( ~0.5 sec 2-way travel time) are found near 92.25° W. These general correlations can be modeled by the combined effects of changes in source composition and melt generation processes on the thickness, composition and structure of the oceanic crust. Key elements of this model include: (1) compensation of the swell is partitioned between crustal thickening (2.3 km) between 98° W and 90.5° W [Ito et al., this meeting] and thermal and compositional buoyancy of the mantle [Canales et al., this meeting]; (2) increased melt production near the hotspot is associated with lower mean extents of melting from a larger region of an increasingly hydrous, and other incompatible element-enriched mantle [Cushman et al., this meeting]; and (3) higher magma supply results in stabilization of axial magma chambers at increasingly shallow crustal depths [Blacic et al., this meeting] and the dominance of fissure-fed rather than point-source volcanism. The hotspot-related effect of increased magma supply on axial morphology, AMC depth and volcanic style along this intermediate-spreading ridge is similar to that between slow and faster spreading mid-ocean ridges.

The Relation between the Fear-Avoidance Model and Constructs from the Social Cognitive Theory in Acute WAD.

PubMed

Sandborgh, Maria; Johansson, Ann-Christin; Söderlund, Anne

2016-01-01

In the fear-avoidance (FA) model social cognitive constructs could add to explaining the disabling process in whiplash associated disorder (WAD). The aim was to exemplify the possible input from Social Cognitive Theory on the FA model. Specifically the role of functional self-efficacy and perceived responses from a spouse/intimate partner was studied. A cross-sectional and correlational design was used. Data from 64 patients with acute WAD were used. Measures were pain intensity measured with a numerical rating scale, the Pain Disability Index, support, punishing responses, solicitous responses, and distracting responses subscales from the Multidimensional Pain Inventory, the Catastrophizing subscale from the Coping Strategies Questionnaire, the Tampa Scale of Kinesiophobia, and the Self-Efficacy Scale. Bivariate correlational, simple linear regression, and multiple regression analyses were used. In the statistical prediction models high pain intensity indicated high punishing responses, which indicated high catastrophizing. High catastrophizing indicated high fear of movement, which indicated low self-efficacy. Low self-efficacy indicated high disability, which indicated high pain intensity. All independent variables together explained 66.4% of the variance in pain disability, p < 0.001. Results suggest a possible link between one aspect of the social environment, perceived punishing responses from a spouse/intimate partner, pain intensity, and catastrophizing. Further, results support a mediating role of self-efficacy between fear of movement and disability in WAD.

Stability of cognitive performance in children with mild intellectual disability.

PubMed

Jenni, Oskar G; Fintelmann, Sylvia; Caflisch, Jon; Latal, Beatrice; Rousson, Valentin; Chaouch, Aziz

2015-05-01

Longitudinal studies that have examined cognitive performance in children with intellectual disability more than twice over the course of their development are scarce. We assessed population and individual stability of cognitive performance in a clinical sample of children with borderline to mild non-syndromic intellectual disability. Thirty-six children (28 males, eight females; age range 3-19y) with borderline to mild intellectual disability (Full-scale IQ [FSIQ] 50-85) of unknown origin were examined in a retrospective clinical case series using linear mixed models including at least three assessments with standardized intelligence tests. Average cognitive performance remained remarkably stable over time (high population stability, drop of only 0.38 IQ points per year, standard error=0.39, p=0.325) whereas individual stability was at best moderate (intraclass correlation of 0.58), indicating that about 60% of the residual variation in FSIQ scores can be attributed to between-child variability. Neither sex nor socio-economic status had a statistically significant impact on FSIQ. Although intellectual disability during childhood is a relatively stable phenomenon, individual stability of IQ is only moderate, likely to be caused by test-to-test reliability (e.g. level of child's cooperation, motivation, and attention). Therefore, clinical decisions and predictions should not rely on single IQ assessments, but should also consider adaptive functioning and previous developmental history. © 2014 Mac Keith Press.