Which Social Values Are Considered in Iranian Health System?

PubMed

Rashidian, Arash; Arab, Mohammad; Vaez Mahdavi, Mohammadreza; Ashtarian, Koimars; Mostafavi, Hakimeh

2018-05-01

Health systems have a set of limited resources for meeting the needs of communities. Health priority setting based on criteria and values is inevitable in such situation. This paper aims to identify the social values that are considered in Iranian health system. This qualitative study was conducted in 3 steps including collecting national documents and literature review, interviewing key informants, and a 2 round Delphi. Interviews and documents were analyzed through thematic framework analysis. Statistical guidance was applied for determining consensus cut-off in Delphi technique. Five social values including freedom of choice, equity, solidarity, severity of disease(s), and burden of disease(s) were considered more important than other values in the health priority setting decisions. Moreover, 2 non-value based factors including conflict of interest and lobbying had a high effect on decision making. Most health policy makers decide based on Egalitarian school, but restriction of resources in the country decreases the outcome. Moreover, personal judgments and preferences sometimes affect their decisions. It seems that developing a value-based framework and making it as a national guidance could have affirmative effect on health administers decisions. © 2018 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Development of the Likelihood of Low Glucose (LLG) algorithm for evaluating risk of hypoglycemia: a new approach for using continuous glucose data to guide therapeutic decision making.

PubMed

Dunn, Timothy C; Hayter, Gary A; Doniger, Ken J; Wolpert, Howard A

2014-07-01

The objective was to develop an analysis methodology for generating diabetes therapy decision guidance using continuous glucose (CG) data. The novel Likelihood of Low Glucose (LLG) methodology, which exploits the relationship between glucose median, glucose variability, and hypoglycemia risk, is mathematically based and can be implemented in computer software. Using JDRF Continuous Glucose Monitoring Clinical Trial data, CG values for all participants were divided into 4-week periods starting at the first available sensor reading. The safety and sensitivity performance regarding hypoglycemia guidance "stoplights" were compared between the LLG method and one based on 10th percentile (P10) values. Examining 13 932 hypoglycemia guidance outputs, the safety performance of the LLG method ranged from 0.5% to 5.4% incorrect "green" indicators, compared with 0.9% to 6.0% for P10 value of 110 mg/dL. Guidance with lower P10 values yielded higher rates of incorrect indicators, such as 11.7% to 38% at 80 mg/dL. When evaluated only for periods of higher glucose (median above 155 mg/dL), the safety performance of the LLG method was superior to the P10 method. Sensitivity performance of correct "red" indicators of the LLG method had an in sample rate of 88.3% and an out of sample rate of 59.6%, comparable with the P10 method up to about 80 mg/dL. To aid in therapeutic decision making, we developed an algorithm-supported report that graphically highlights low glucose risk and increased variability. When tested with clinical data, the proposed method demonstrated equivalent or superior safety and sensitivity performance. © 2014 Diabetes Technology Society.

A Model for Steering with Haptic-Force Guidance

NASA Astrophysics Data System (ADS)

Yang, Xing-Dong; Irani, Pourang; Boulanger, Pierre; Bischof, Walter F.

Trajectory-based tasks are common in many applications and have been widely studied. Recently, researchers have shown that even very simple tasks, such as selecting items from cascading menus, can benefit from haptic-force guidance. Haptic guidance is also of significant value in many applications such as medical training, handwriting learning, and in applications requiring precise manipulations. There are, however, only very few guiding principles for selecting parameters that are best suited for proper force guiding. In this paper, we present a model, derived from the steering law that relates movement time to the essential components of a tunneling task in the presence of haptic-force guidance. Results of an experiment show that our model is highly accurate for predicting performance times in force-enhanced tunneling tasks.

COMPREHENSIVE ASSESSMENT OF COMPLEX TECHNOLOGIES: INTEGRATING VARIOUS ASPECTS IN HEALTH TECHNOLOGY ASSESSMENT.

PubMed

Lysdahl, Kristin Bakke; Mozygemba, Kati; Burns, Jacob; Brönneke, Jan Benedikt; Chilcott, James B; Ward, Sue; Hofmann, Bjørn

2017-01-01

Despite recent development of health technology assessment (HTA) methods, there are still methodological gaps for the assessment of complex health technologies. The INTEGRATE-HTA guidance for effectiveness, economic, ethical, socio-cultural, and legal aspects, deals with challenges when assessing complex technologies, such as heterogeneous study designs, multiple stakeholder perspectives, and unpredictable outcomes. The objective of this article is to outline this guidance and describe the added value of integrating these assessment aspects. Different methods were used to develop the various parts of the guidance, but all draw on existing, published knowledge and were supported by stakeholder involvement. The guidance was modified after application in a case study and in response to feedback from internal and external reviewers. The guidance consists of five parts, addressing five core aspects of HTA, all presenting stepwise approaches based on the assessment of complexity, context, and stakeholder involvement. The guidance on effectiveness, health economics and ethics aspects focus on helping users choose appropriate, or further develop, existing methods. The recommendations are based on existing methods' applicability for dealing with problems arising with complex interventions. The guidance offers new frameworks to identify socio-cultural and legal issues, along with overviews of relevant methods and sources. The INTEGRATE-HTA guidance outlines a wide range of methods and facilitates appropriate choices among them. The guidance enables understanding of how complexity matters for HTA and brings together assessments from disciplines, such as epidemiology, economics, ethics, law, and social theory. This indicates relevance for a broad range of technologies.

Launch flexibility using NLP guidance and remote wind sensing

NASA Technical Reports Server (NTRS)

Cramer, Evin J.; Bradt, Jerre E.; Hardtla, John W.

1990-01-01

This paper examines the use of lidar wind measurements in the implementation of a guidance strategy for a nonlinear programming (NLP) launch guidance algorithm. The NLP algorithm uses B-spline command function representation for flexibility in the design of the guidance steering commands. Using this algorithm, the guidance system solves a two-point boundary value problem at each guidance update. The specification of different boundary value problems at each guidance update provides flexibility that can be used in the design of the guidance strategy. The algorithm can use lidar wind measurements for on pad guidance retargeting and for load limiting guidance steering commands. Examples presented in the paper use simulated wind updates to correct wind induced final orbit errors and to adjust the guidance steering commands to limit the product of the dynamic pressure and angle-of-attack for launch vehicle load alleviation.

Enhancing High Value Care in Gastroenterology Practice.

PubMed

Camilleri, Michael; Katzka, David A

2016-10-01

The objective of this review is to identify common areas in gastroenterology practice where studies performed provide an opportunity for enhancing value or lowering costs. We provide examples of topics in gastroenterology where clinicians could enhance value by either using less invasive testing, choosing a single best test, or by using patient symptoms to guide additional testing. The topics selected for review are selected in esophageal, pancreatic, and colorectal cancer; functional gastrointestinal diseases (irritable bowel syndrome, bacterial overgrowth, constipation); immune-mediated gastrointestinal diseases; and pancreaticobiliary pathology. We propose guidance to alter practice based on current evidence. These studies support the need to review current practice and to continue performing research to further validate the proposed guidance to enhance value of care in gastroenterology and hepatology. Copyright © 2016 AGA Institute. Published by Elsevier Inc. All rights reserved.

The economic impacts of hemlock woolly adelgid on residential landscape values: Sparta, New Jersey case study

Treesearch

T.P. Holmes; E.A. Murphy; D.D. Royle

2005-01-01

In this paper, we provide preliminary estimates of the impacts of the hemlock woolly adelgid on residential property values in Sparta, New Jersey, using the hedonic property value method. The literature on the aesthetic perceptions of forest landscapes is briefly reviewed to provide guidance in formulating economic hypotheses based on the assumption of an informative...

Use of Online Sources of Information by Dental Practitioners: Findings from The Dental Practice-Based Research Network

PubMed Central

Funkhouser, Ellen; Agee, Bonita S.; Gordan, Valeria V.; Rindal, D. Brad; Fellows, Jeffrey L.; Qvist, Vibeke; McClelland, Jocelyn; Gilbert, Gregg H.

2013-01-01

Objectives Estimate the proportion of dental practitioners who use online sources of information for practice guidance. Methods From a survey of 657 dental practitioners in The Dental Practice Based Research Network, four indicators of online use for practice guidance were calculated: read journals online, obtained continuing education (CDE) through online sources, rated an online source as most influential, and reported frequently using an online source for guidance. Demographics, journals read, and use of various sources of information for practice guidance in terms of frequency and influence were ascertained for each. Results Overall, 21% (n=138) were classified into one of the four indicators of online use: 14% (n=89) rated an online source as most influential and 13% (n=87) reported frequently using an online source for guidance; few practitioners (5%, n=34) read journals online, fewer (3%, n=17) obtained CDE through online sources. Use of online information sources varied considerably by region and practice characteristics. In general, the 4 indicators represented practitioners with as many differences as similarities to each other and to offline users. Conclusion A relatively small proportion of dental practitioners use information from online sources for practice guidance. Variation exists regarding practitioners’ use of online source resources and how they rate the value of offline information sources for practice guidance. PMID:22994848

The Impact of Students' Exploration Strategies on Discovery Learning Using Computer-Based Simulations

ERIC Educational Resources Information Center

Dalgarno, Barney; Kennedy, Gregor; Bennett, Sue

2014-01-01

Discovery-based learning designs incorporating active exploration are common within instructional software. However, researchers have highlighted empirical evidence showing that "pure" discovery learning is of limited value and strategies which reduce complexity and provide guidance to learners are important if potential learning…

75 FR 59160 - Radiation Protection Regulations and Guidance; Public Meetings and Request for Comments

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-27

..., which are based on a more diverse world population? Issue No. 2: Occupational Dose Limits The... between the ICRP values and the EPA values stems primarily from the use of a U.S. population cancer... worldwide population. In discussion with stakeholders to date, the majority have been generally in favor of...

Developing ecosystem services-based assessment endpoints for determining ecological risks to estuarine environments

EPA Science Inventory

Current U.S. EPA ecological risk assessment (ERA) guidance defines an assessment endpoint (AE) as an explicit expression of the environmental value that is to be protected, and recommends that AEs are selected based on ecological relevance, susceptibility to known or potential st...

Mission-based guidance system design for autonomous UAVs

NASA Astrophysics Data System (ADS)

Moon, Jongki

The advantages of UAVs in the aviation arena have led to extensive research activities on autonomous technology of UAVs to achieve specific mission objectives. This thesis mainly focuses on the development of a mission-based guidance system. Among various missions expected for future needs, autonomous formation flight (AFF) and obstacle avoidance within safe operation limits are investigated. In the design of an adaptive guidance system for AFF, the leader information except position is assumed to be unknown to a follower. Thus, the only measured information related to the leader is the line-of-sight (LOS) range and angle. Adding an adaptive element with neural networks into the guidance system provides a capability to effectively handle leader's velocity changes. Therefore, this method can be applied to the AFF control systems that use a passive sensing method. In this thesis, an adaptive velocity command guidance system and an adaptive acceleration command guidance system are developed and presented. Since relative degrees of the LOS range and angle are different depending on the outputs from the guidance system, the architecture of the guidance system changes accordingly. Simulations and flight tests are performed using the Georgia Tech UAV helicopter, the GTMax, to evaluate the proposed guidance systems. The simulation results show that the neural network (NN) based adaptive element can improve the tracking performance by effectively compensating for the effect of unknown dynamics. It has also been shown that the combination of an adaptive velocity command guidance system and the existing GTMax autopilot controller performs better than the combination of an adaptive acceleration command guidance system and the GTMax autopilot controller. The successful flight evaluation using an adaptive velocity command guidance system clearly shows that the adaptive guidance control system is a promising solution for autonomous formation flight of UAVs. In addition, an integrated approach is proposed to resolve the conflict between aggressive maneuvering needed for obstacle avoidance and the constrained maneuvering needed for envelope protection. A time-optimal problem with obstacle and envelope constraints is used for an integrated approach for obstacle avoidance and envelope protection. The Nonlinear trajectory generator (NTG) is used as a real-time optimization solver. The computational complexity arising from the obstacle constraints is reduced by converting the obstacle constraints into a safe waypoint constraint along with an implicit requirement that the horizontal velocity during the avoidance maneuver must be nonnegative. The issue of when to initiate a time-optimal avoidance maneuver is addressed by including a requirement that the vehicle must maintain its original flight path to the maximum extent possible. The simulation evaluations are preformed for the nominal case, the unsafe avoidance solution case, the multiple safe waypoint case, and the unidentified obstacle size case. Artificial values for the load factor limit and the longitudinal flap angle limit are imposed as safe operational boundaries. Also, simulation results for different limit values and different initial flight speed are compared. Simulation results using a nonlinear model of a rotary wing UAV demonstrate the feasibility of the proposed approach for obstacle avoidance with envelope protection.

The Rejection and Modification of Past Values: The Effect on the Adolescent's Developing Philosophy (A Concern for Guidance Personnel).

ERIC Educational Resources Information Center

Spowart, Andrew C.

School guidance and counseling programs have been quite effective in providing vocational guidance and counseling for mental health, but the effectiveness of these programs in the future is cause for concern as rapid scientific and technological advances influence youth's creation of ideas and values. Adults today have experienced such rapid…

De Minimis Thresholds for Federal Building Metering Appropriateness

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

Henderson, Jordan W.

2015-03-31

The U.S. Department of Energy (DOE) is required by statute and Presidential Memorandum to establish guidelines for agencies to meter their Federal buildings for energy (electricity, natural gas, and steam) and water. See 42 U.S.C. § 8253(e). DOE issued guidance in February 2006 on the installation of electric meters in Federal buildings. A recent update to the 2006 guidance accounts for more current metering practices within the Federal Government. The updated metering guidance specifies that all Federal buildings shall be considered “appropriate” for energy or water metering unless identified for potential exclusion. In developing the updated guidance to carry outmore » the statue, Congress also directed DOE to (among other things) establish exclusions from the metering requirements based on the de minimis quantity of energy use of a Federal building, industrial process, or structure. This paper discusses the method used to identify de minimis values.« less

Cuban Value Orientations. Cultural Monograph Number 1. Bilingual Multicultural Education Training Project for School Psychologists and Guidance Counselors.

ERIC Educational Resources Information Center

Florida Univ., Gainesville. Coll. of Education.

Information is provided in this monograph to facilitate understanding of Cuban cultural values and their implications for counseling limited English proficient students. Also provided is a beginning conceptual model for increasing the understanding of cross-cultural theory and practice. The overview of Cuban culture is based on a perspective of…

Improving Public Health through Innovations in Exposure Science

EPA Science Inventory

In the traditional risk assessment paradigm, exposure science is relegated to a supporting role, providing an exposure estimate for comparison with hazard-based guidance values to determine whether there may be an unacceptable risk to public health. More recently, exposure scien...

Feasibility Study of Needle Placement in Percutaneous Vertebroplasty: Cone-Beam Computed Tomography Guidance Versus Conventional Fluoroscopy

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

Braak, Sicco J., E-mail: sjbraak@gmail.com; Zuurmond, Kirsten, E-mail: kirsten.zuurmond@philips.com; Aerts, Hans C. J., E-mail: hans.cj.aerts@philips.com

2013-08-01

ObjectiveTo investigate the accuracy, procedure time, fluoroscopy time, and dose area product (DAP) of needle placement during percutaneous vertebroplasty (PVP) using cone-beam computed tomography (CBCT) guidance versus fluoroscopy.Materials and MethodsOn 4 spine phantoms with 11 vertebrae (Th7-L5), 4 interventional radiologists (2 experienced with CBCT guidance and two inexperienced) punctured all vertebrae in a bipedicular fashion. Each side was randomization to either CBCT guidance or fluoroscopy. CBCT guidance is a sophisticated needle guidance technique using CBCT, navigation software, and real-time fluoroscopy. The placement of the needle had to be to a specific target point. After the procedure, CBCT was performed tomore » determine the accuracy, procedure time, fluoroscopy time, and DAP. Analysis of the difference between methods and experience level was performed.ResultsMean accuracy using CBCT guidance (2.61 mm) was significantly better compared with fluoroscopy (5.86 mm) (p < 0.0001). Procedure time was in favor of fluoroscopy (7.39 vs. 10.13 min; p = 0.001). Fluoroscopy time during CBCT guidance was lower, but this difference is not significant (71.3 vs. 95.8 s; p = 0.056). DAP values for CBCT guidance and fluoroscopy were 514 and 174 mGy cm{sup 2}, respectively (p < 0.0001). There was a significant difference in favor of experienced CBCT guidance users regarding accuracy for both methods, procedure time of CBCT guidance, and added DAP values for fluoroscopy.ConclusionCBCT guidance allows users to perform PVP more accurately at the cost of higher patient dose and longer procedure time. Because procedural complications (e.g., cement leakage) are related to the accuracy of the needle placement, improvements in accuracy are clinically relevant. Training in CBCT guidance is essential to achieve greater accuracy and decrease procedure time/dose values.« less

Implications of Weltanschauungen for Value Formulation by Guidance Personnel

ERIC Educational Resources Information Center

Weinstock, Henry R.; O'Dowd, Peter S.

1970-01-01

Examines two divergent world-views (empiricism and ration alism) of human values, presenting definitions from many philosophers. Anticipates possibility of confluence of beliefs on nature of man which may offer guidance personnel more accurate tools for direction. (CJ)

Identifying Themes for Research-Based Development of Pedagogy and Guidance in Higher Education

ERIC Educational Resources Information Center

Jääskelä, Päivikki; Nissilä, Pia

2015-01-01

The high value accorded to the research-based development of education in higher education communities means that researchers in the field have an important role in determining the foci of such efforts. However, it is important to ask whether higher education research is providing answers that satisfy practical educational needs. In this study,…

Residential surface soil guidance applied worldwide to the pesticides added to the Stockholm Convention in 2009 and 2011.

PubMed

Jennings, Aaron A; Li, Zijian

2015-09-01

Due to the widespread use of agricultural and residential pesticides, the potential for pesticide soil contamination is a worldwide concern. In response, regulatory jurisdictions in at least 54 nations have promulgated guidance values to specify the maximum allowable concentration of pesticides in soils. Guidance values may be found for more than 700 pesticides. A previous analysis examined the values applied to the original "dirty dozen" persistent organic pollutant (POP) pesticides that were addressed in the 2001 Stockholm Convention (Aldrin, Chlordane, DDT, Dieldrin, Endrin, Heptachlor, Mirex, and Toxaphene). Results are presented here for the "new POP" pesticides that were added to the Stockholm Convention in 2009 and 2011 (isomers of Hexachlorocyclohexane, Chlordecone, and isomers of Endosulfan). The guidance value extremes used worldwide for these pesticides vary by as much as 8.5 orders of magnitude and the randomness in their distributions resembles that of lognormal random variables. However, there are nonrandom value clusters in some distributions that may identify values around which consensuses are forming. The current value distributions imply that a wide range of human health risks are being accepted. Hopefully, the results presented will help regulatory jurisdictions and the regulated communities identify values that should be revised to be adequately protective of human health. Copyright © 2015 Elsevier Ltd. All rights reserved.

Biomonitoring Equivalents (BE) Dossier for Toluene (Cas No. 108-88-3)

EPA Science Inventory

This document reviews available pharmacokinetic data and models for toluene and applies these data and models to existing health-based exposure guidance values from the US Environmental Protection Agency, the Agency for Toxic Substances and Disease Registry, Health Canada, and th...

Examining the implementation of NICE guidance: cross-sectional survey of the use of NICE interventional procedures guidance by NHS Trusts.

PubMed

Lowson, Karin; Jenks, Michelle; Filby, Alexandra; Carr, Louise; Campbell, Bruce; Powell, John

2015-06-30

In the UK, NHS hospitals receive large amounts of evidence-based recommendations for care delivery from the National Institute for Health and Care Excellence (NICE) and other organisations. Little is known about how NHS organisations implement such guidance and best practice for doing so. This study was therefore designed to examine the dissemination, decision-making, and monitoring processes for NICE interventional procedures (IP) guidance and to investigate the barriers and enablers to the implementation of such guidance. A cross-sectional survey questionnaire was developed and distributed to individuals responsible for managing the processes around NICE guidance in all 181 acute NHS hospitals in England, Scotland, Wales and Northern Ireland. A review of acute NHS hospital policies for implementing NICE guidance was also undertaken using information available in the public domain and from organisations' websites. The response rate to the survey was 75 % with 135 completed surveys received. Additionally, policies from 25 % of acute NHS hospitals were identified and analysed. NHS acute hospitals typically had detailed processes in place to implement NICE guidance, although organisations recognised barriers to implementation including organisational process barriers, clinical engagement and poor targeting with a large number of guidance issued. Examples of enablers to, and good practice for, implementation of guidance were found, most notably the value of shared learning experiences between NHS hospitals. Implications for NICE were also identified. These included making improvements to the layout of guidance, signposting on the website and making better use of their shared learning platform. Most organisations have robust processes in place to deal with implementing guidance. However, resource limitations and the scope of guidance received by organisations create barriers relating to organisational processes, clinician engagement and financing of new procedures. Guidance implementation can be facilitated through encouragement of shared learning by organisations such as NICE and open knowledge transfer between organisations.

An evaluation of freshwater mussel toxicity data in the derivation of water quality guidance and standards for copper

USGS Publications Warehouse

March, F.A.; Dwyer, F.J.; Augspurger, T.; Ingersoll, C.G.; Wang, N.; Mebane, C.A.

2007-01-01

The state of Oklahoma has designated several areas as freshwater mussel sanctuaries in an attempt to provide freshwater mussel species a degree of protection and to facilitate their reproduction. We evaluated the protection afforded freshwater mussels by the U.S. Environmental Protection Agency (U.S. EPA) hardness-based 1996 ambient copper water quality criteria, the 2007 U.S. EPA water quality criteria based on the biotic ligand model and the 2005 state of Oklahoma copper water quality standards. Both the criterion maximum concentration and criterion continuous concentration were evaluated. Published acute and chronic copper toxicity data that met American Society for Testing and Materials guidance for test acceptability were obtained for exposures conducted with glochidia or juvenile freshwater mussels. We tabulated toxicity data for glochidia and juveniles to calculate 20 species mean acute values for freshwater mussels. Generally, freshwater mussel species mean acute values were similar to those of the more sensitive species included in the U.S. EPA water quality derivation database. When added to the database of genus mean acute values used in deriving 1996 copper water quality criteria, 14 freshwater mussel genus mean acute values included 10 of the lowest 15 genus mean acute values, with three mussel species having the lowest values. Chronic exposure and sublethal effects freshwater mussel data available for four species and acute to chronic ratios were used to evaluate the criterion continuous concentration. On the basis of the freshwater mussel toxicity data used in this assessment, the hardness-based 1996 U.S. EPA water quality criteria, the 2005 Oklahoma water quality standards, and the 2007 U.S. EPA water quality criteria based on the biotic ligand model might need to be revised to afford protection to freshwater mussels. ?? 2007 SETAC.

Intellectual Development and Interaction Effectiveness with DISCOVER.

ERIC Educational Resources Information Center

Roselle, Bruce E.; Hummel, Thomas J.

1988-01-01

Used Knefelkamp's and Slepitza's (1976) model of career-related intellectual development to investigate how students at different levels of development think as they interact with a computer-assisted career guidance system, DISCOVER II, which comprises modules on understanding interests, values, and abilities; searching for occupations based on…

A New Method for Generating Distribution of Biomonitoring Equivalents to Support Exposure Assessment and Prioritization

EPA Science Inventory

Biomonitoring data are now available for hundreds of chemicals through state and national health surveys. Exposure guidance values also exist for many of these chemicals. Several methods are frequently used to evaluate biomarker data with respect to a guidance value. The “biomoni...

Pulmonary Masses: Initial Results of Cone-beam CT Guidance with Needle Planning Software for Percutaneous Lung Biopsy

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

Braak, Sicco J., E-mail: sjbraak@gmail.com; Herder, Gerarda J. M., E-mail: j.herder@antoniusziekenhuis.nl; Heesewijk, Johannes P. M. van, E-mail: j.heesewijk@antoniusziekenhuis.nl

2012-12-15

Purpose: To evaluate the outcome of percutaneous lung biopsy (PLB) findings using cone-beam computed tomographic (CT) guidance (CBCT guidance) and compared to conventional biopsy guidance techniques. Methods: CBCT guidance is a stereotactic technique for needle interventions, combining 3D soft-tissue cone-beam CT, needle planning software, and real-time fluoroscopy. Between March 2007 and August 2010, we performed 84 Tru-Cut PLBs, where bronchoscopy did not provide histopathologic diagnosis. Mean patient age was 64.6 (range 24-85) years; 57 patients were men, and 25 were women. Records were prospectively collected for calculating sensitivity, specificity, positive predictive value, negative predictive value, and accuracy. We also registeredmore » fluoroscopy time, room time, interventional time, dose-area product (DAP), and complications. Procedures were divided into subgroups (e.g., location, size, operator). Results: Mean lesion diameter was 32.5 (range 3.0-93.0) mm, and the mean number of samples per biopsy procedure was 3.2 (range 1-7). Mean fluoroscopy time was 161 (range 104-551) s, room time was 34 (range 15-79) min, mean DAP value was 25.9 (range 3.9-80.5) Gy{center_dot}cm{sup -2}, and interventional time was 18 (range 5-65) min. Of 84 lesions, 70 were malignant (83.3%) and 14 were benign (16.7%). Seven (8.3%) of the biopsy samples were nondiagnostic. All nondiagnostic biopsied lesions proved to be malignant during surgical resection. The outcome for sensitivity, specificity, positive predictive value, negative predictive value, and accuracy was 90% (95% confidence interval [CI] 86-96), 100% (95% CI 82-100), 100% (95% CI 96-100), 66.7% (95% CI 55-83), and 91.7% (95% CI 86-96), respectively. Sixteen patients (19%) had minor and 2 (2.4%) had major complications. Conclusion: CBCT guidance is an effective method for PLB, with results comparable to CT/CT fluoroscopy guidance.« less

Developing Sustainable Leadership

ERIC Educational Resources Information Center

Davies, Brent, Ed.

2007-01-01

Developing and sustaining leaders is a major challenge for all those involved in education today. This book contains a collection of essays from recognized authors to provide insights, frameworks and ideas on how to sustain school leaders and develop values-based leadership. It also offers guidance on countering short-term management solutions,…

76 FR 33307 - Strengthen and Promote the Role of Local Health Departments in Retail Food Safety Regulation (U-50)

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-08

..., scientifically-based guidance, training, program evaluation, and technical assistance. B. Research/Cooperative... officials. NACCHO values guide staff and leadership in work to achieve optimal health for all through an... annual appropriations and successful performance. III. Paper Application, Registration, and Submission...

[Real-time three-dimensional (4D) ultrasound-guided prostatic biopsies on a phantom. Comparative study versus 2D guidance].

PubMed

Long, Jean-Alexandre; Daanen, Vincent; Moreau-Gaudry, Alexandre; Troccaz, Jocelyne; Rambeaud, Jean-Jacques; Descotes, Jean-Luc

2007-11-01

The objective of this study was to determine the added value of real-time three-dimensional (4D) ultrasound guidance of prostatic biopsies on a prostate phantom in terms of the precision of guidance and distribution. A prostate phantom was constructed. A real-time 3D ultrasonograph connected to a transrectal 5.9 MHz volumic transducer was used. Fourteen operators performed 336 biopsies with 2D guidance then 4D guidance according to a 12-biopsy protocol. Biopsy tracts were modelled by segmentation in a 3D ultrasound volume. Specific software allowed visualization of biopsy tracts in the reference prostate and evaluated the zone biopsied. A comparative study was performed to determine the added value of 4D guidance compared to 2D guidance by evaluating the precision of entry points and target points. The distribution was evaluated by measuring the volume investigated and by a redundancy ratio of the biopsy points. The precision of the biopsy protocol was significantly improved by 4D guidance (p = 0.037). No increase of the biopsy volume and no improvement of the distribution of biopsies were observed with 4D compared to 2D guidance. The real-time 3D ultrasound-guided prostate biopsy technique on a phantom model appears to improve the precision and reproducibility of a biopsy protocol, but the distribution of biopsies does not appear to be improved.

Counseling, Guidance, and the Morality of Help-Giving

ERIC Educational Resources Information Center

Patton, Michael J.

1971-01-01

A review of: (1) The Counseling Center in Higher Education, Phillip J. Gallagher and George D. Demos, (2) The Guidance Process, Herman J. Peters, (3) Counseling and Guidance in the Twentieth Century: Reflections and Reformulations, William H. Van Hoose and John J. Pietrofesa, and (4) Value Orientations in Counseling and Psychotherapy: The Meanings…

A new proposed guidance system for beverage consumption in the United States.

PubMed

Popkin, Barry M; Armstrong, Lawrence E; Bray, George M; Caballero, Benjamin; Frei, Balz; Willett, Walter C

2006-03-01

The Beverage Guidance Panel was assembled to provide guidance on the relative health and nutritional benefits and risks of various beverage categories. The beverage panel was initiated by the first author. The Panel's purpose is to attempt to systematically review the literature on beverages and health and provide guidance to the consumer. An additional purpose of the Panel is to develop a deeper dialog among the scientific community on overall beverage consumption patterns in the United States and on the great potential to change this pattern as a way to improve health. Over the past several decades, levels of overweight and obesity have increased across all population groups in the United States. Concurrently, an increased daily intake of 150-300 kcal (for different age-sex groups) has occurred, with approximately 50% of the increased calories coming from the consumption of calorically sweetened beverages. The panel ranked beverages from the lowest to the highest value based on caloric and nutrient contents and related health benefits and risks. Drinking water was ranked as the preferred beverage to fulfill daily water needs and was followed in decreasing value by tea and coffee, low-fat (1.5% or 1%) and skim (nonfat) milk and soy beverages, noncalorically sweetened beverages, beverages with some nutritional benefits (fruit and vegetable juices, whole milk, alcohol, and sports drinks), and calorically sweetened, nutrient-poor beverages. The Panel recommends that the consumption of beverages with no or few calories should take precedence over the consumption of beverages with more calories.

Conducting systematic reviews of economic evaluations.

PubMed

Gomersall, Judith Streak; Jadotte, Yuri Tertilus; Xue, Yifan; Lockwood, Suzi; Riddle, Dru; Preda, Alin

2015-09-01

In 2012, a working group was established to review and enhance the Joanna Briggs Institute (JBI) guidance for conducting systematic review of evidence from economic evaluations addressing a question(s) about health intervention cost-effectiveness. The objective is to present the outcomes of the working group. The group conducted three activities to inform the new guidance: review of literature on the utility/futility of systematic reviews of economic evaluations and consideration of its implications for updating the existing methodology; assessment of the critical appraisal tool in the existing guidance against criteria that promotes validity in economic evaluation research and two other commonly used tools; and a workshop. The debate in the literature on the limitations/value of systematic review of economic evidence cautions that systematic reviews of economic evaluation evidence are unlikely to generate one size fits all answers to questions about the cost-effectiveness of interventions and their comparators. Informed by this finding, the working group adjusted the framing of the objectives definition in the existing JBI methodology. The shift is away from defining the objective as to determine one cost-effectiveness measure toward summarizing study estimates of cost-effectiveness and informed by consideration of the included study characteristics (patient, setting, intervention component, etc.), identifying conditions conducive to lowering costs and maximizing health benefits. The existing critical appraisal tool was included in the new guidance. The new guidance includes the recommendation that a tool designed specifically for the purpose of appraising model-based studies be used together with the generic appraisal tool for economic evaluations assessment to evaluate model-based evaluations. The guidance produced by the group offers reviewers guidance for each step of the systematic review process, which are the same steps followed in JBI reviews of other types of evidence. The updated JBI guidance will be useful for researchers wanting to synthesize evidence about economic questions, either as stand-alone reviews or part of comprehensive or mixed method evidence reviews. Although the updated methodology produced by the work of the working group has improved the JBI guidance for systematic reviews of economic evaluations, there are areas where further work is required. These include adjusting the critical appraisal tool to separate out questions addressing intervention cost and effectiveness measurement; providing more explicit guidance for assessing generalizability of findings; and offering a more robust method for evidence synthesis that facilitates achieving the more ambitious review objectives.

Age correction in monitoring audiometry: method to update OSHA age-correction tables to include older workers

PubMed Central

Dobie, Robert A; Wojcik, Nancy C

2015-01-01

Objectives The US Occupational Safety and Health Administration (OSHA) Noise Standard provides the option for employers to apply age corrections to employee audiograms to consider the contribution of ageing when determining whether a standard threshold shift has occurred. Current OSHA age-correction tables are based on 40-year-old data, with small samples and an upper age limit of 60 years. By comparison, recent data (1999–2006) show that hearing thresholds in the US population have improved. Because hearing thresholds have improved, and because older people are increasingly represented in noisy occupations, the OSHA tables no longer represent the current US workforce. This paper presents 2 options for updating the age-correction tables and extending values to age 75 years using recent population-based hearing survey data from the US National Health and Nutrition Examination Survey (NHANES). Both options provide scientifically derived age-correction values that can be easily adopted by OSHA to expand their regulatory guidance to include older workers. Methods Regression analysis was used to derive new age-correction values using audiometric data from the 1999–2006 US NHANES. Using the NHANES median, better-ear thresholds fit to simple polynomial equations, new age-correction values were generated for both men and women for ages 20–75 years. Results The new age-correction values are presented as 2 options. The preferred option is to replace the current OSHA tables with the values derived from the NHANES median better-ear thresholds for ages 20–75 years. The alternative option is to retain the current OSHA age-correction values up to age 60 years and use the NHANES-based values for ages 61–75 years. Conclusions Recent NHANES data offer a simple solution to the need for updated, population-based, age-correction tables for OSHA. The options presented here provide scientifically valid and relevant age-correction values which can be easily adopted by OSHA to expand their regulatory guidance to include older workers. PMID:26169804

Age correction in monitoring audiometry: method to update OSHA age-correction tables to include older workers.

PubMed

Dobie, Robert A; Wojcik, Nancy C

2015-07-13

The US Occupational Safety and Health Administration (OSHA) Noise Standard provides the option for employers to apply age corrections to employee audiograms to consider the contribution of ageing when determining whether a standard threshold shift has occurred. Current OSHA age-correction tables are based on 40-year-old data, with small samples and an upper age limit of 60 years. By comparison, recent data (1999-2006) show that hearing thresholds in the US population have improved. Because hearing thresholds have improved, and because older people are increasingly represented in noisy occupations, the OSHA tables no longer represent the current US workforce. This paper presents 2 options for updating the age-correction tables and extending values to age 75 years using recent population-based hearing survey data from the US National Health and Nutrition Examination Survey (NHANES). Both options provide scientifically derived age-correction values that can be easily adopted by OSHA to expand their regulatory guidance to include older workers. Regression analysis was used to derive new age-correction values using audiometric data from the 1999-2006 US NHANES. Using the NHANES median, better-ear thresholds fit to simple polynomial equations, new age-correction values were generated for both men and women for ages 20-75 years. The new age-correction values are presented as 2 options. The preferred option is to replace the current OSHA tables with the values derived from the NHANES median better-ear thresholds for ages 20-75 years. The alternative option is to retain the current OSHA age-correction values up to age 60 years and use the NHANES-based values for ages 61-75 years. Recent NHANES data offer a simple solution to the need for updated, population-based, age-correction tables for OSHA. The options presented here provide scientifically valid and relevant age-correction values which can be easily adopted by OSHA to expand their regulatory guidance to include older workers. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Experiences from implementing value-based healthcare at a Swedish University Hospital - an longitudinal interview study.

PubMed

Nilsson, Kerstin; Bååthe, Fredrik; Andersson, Annette Erichsen; Wikström, Ewa; Sandoff, Mette

2017-02-28

Implementing the value-based healthcare concept (VBHC) is a growing management trend in Swedish healthcare organizations. The aim of this study is to explore how representatives of four pilot project teams experienced implementing VBHC in a large Swedish University Hospital over a period of 2 years. The project teams started their work in October 2013. An explorative and qualitative design was used, with interviews as the data collection method. All the participants in the four pilot project teams were individually interviewed three times, with interviews starting in March 2014 and ending in November 2015. All the interviews were transcribed and analyzed using qualitative analysis. Value for the patients was experienced as the fundamental drive for implementing VBHC. However, multiple understandings of what value for patients' means existed in parallel. The teams received guidance from consultants during the first 3 months. There were pros and cons to the consultant's guidance. This period included intensive work identifying outcome measurements based on patients' and professionals' perspectives, with less interest devoted to measuring costs. The implementation process, which both gave and took energy, developed over time and included interventions. In due course it provided insights to the teams about the complexity of healthcare. The necessity of coordination, cooperation and working together inter-departmentally was critical. Healthcare organizations implementing VBHC will benefit from emphasizing value for patients, in line with the intrinsic drive in healthcare, as well as managing the process of implementation on the basis of understanding the complexities of healthcare. Paying attention to the patients' voice is a most important concern and is also a key towards increased engagement from physicians and care providers for improvement work.

Using Automated Scores of Student Essays to Support Teacher Guidance in Classroom Inquiry

ERIC Educational Resources Information Center

Gerard, Libby F.; Linn, Marcia C.

2016-01-01

Computer scoring of student written essays about an inquiry topic can be used to diagnose student progress both to alert teachers to struggling students and to generate automated guidance. We identify promising ways for teachers to add value to automated guidance to improve student learning. Three teachers from two schools and their 386 students…

A proposal to revive "parent guidance": an illustration of a brief intervention with the mother of a toddler.

PubMed

Sherick, Ivan

2009-01-01

A parent guidance intervention is illustrated. The value of such work is underscored to help parents and candidates in child analysis understand intergenerational psychopathology and its consequences for a child. Technical considerations of parent guidance are addressed. A revival of such work is advocated in child analysis training programs.

How did the public respond to the 2015 expert consensus public health guidance statement on workplace sedentary behaviour? A qualitative analysis.

PubMed

Gardner, Benjamin; Smith, Lee; Mansfield, Louise

2017-02-02

In June 2015, an expert consensus guidance statement was published recommending that office workers accumulate 2-4 h of standing and light activity daily and take regular breaks from prolonged sitting. This paper describes public responses to media coverage of the guidance, so as to understand public acceptability of the recommendations within the guidance, and perceptions of sitting and standing as health behaviours. UK news media websites that had reported on the sedentary workplace guidance statement, and permitted viewers to post comments responding to the story, were identified. 493 public comments, posted in a one-month period to one of six eligible news media websites, were thematically analysed. Three themes were extracted: (1) challenges to the credibility of the sedentary workplace guidance; (2) challenges to the credibility of public health; and (3) the guidance as a spur to knowledge exchange. Challenges were made to the novelty of the guidance, the credibility of its authors, the strength of its evidence base, and its applicability to UK workplaces. Public health was commonly mistrusted and viewed as a tool for controlling the public, to serve a paternalistic agenda set by a conspiracy of stakeholders with hidden non-health interests. Knowledge exchanges focused on correcting others' misinterpretations, raising awareness of historical or scientific context, debating current workplace health policies, and sharing experiences around sitting and standing. The guidance provoked exchanges of health-promoting ideas among some, thus demonstrating the potential for sitting reduction messages to be translated into everyday contexts by lay champions. However, findings also demonstrated confusion, misunderstanding and misapprehension among some respondents about the health value of sitting and standing. Predominantly unfavourable, mistrusting responses reveal significant hostility towards efforts to displace workplace sitting with standing, and towards public health science more broadly. Concerns about the credibility and purpose of public health testify to the importance of public engagement in public health guidance development.

Key Performance Indicators for the Assessment of Pediatric Pharmacotherapeutic Guidance

PubMed Central

Barrett, Jeffrey S.; Patel, Dimple; Jayaraman, Bhuvana; Narayan, Mahesh; Zuppa, Athena

2008-01-01

Given the paucity of actual guidance provided for managing pediatric drug therapy, prescribing caregivers must be able to draw on the limited published information in pediatrics and/or guidance provided in adults with some account for expected pediatric response. Guidance for managing drug therapy in children is clearly desirable. Our objectives were to construct key performance indicators (KPIs) for pediatric pharmacotherapy guidance to identify drugs where pharmacotherapy guidance would be most beneficial. A pilot survey to assess variation in caregiver appreciation for pediatric dosing guidance has also been constructed to provide a complementary subjective assessment. Three KPI categories, drug utilization (based on hospital admission and billing data collected from 2001 through 2006), medical need, and guidance outcome value along with a KPI composite score have been proposed. Low scores are favored with respect to prioritization for pharmacotherapy guidance. The pilot survey consisted of 15 questions to assess 1) physician knowledge regarding dosing guidance, 2) attitudes toward dose modification and patient individualization, 3) the accessibility, ease of use and appropriateness of existing data stores, and 4) frequency of dosing modification, consultation of dosing compendiums and estimate of success rate in dosing guidance. Pilot results suggest that dosing guidance is generally viewed as important and that the existing resources are insufficient to guide recommendations for all drugs. While the majority of respondents check more than one resource less than 25% of the time, at least 25% of the respondents check more than one resource 25–50% of the time. The majority viewed the relevance of dosing guidance very important to the management of drug therapy. The questionnaire is being extended to the primary care centers, the Kids First Network and specialty care centers. Results will guide the development of decision support systems (DSS) that provide patient-specific pharmacotherapy guidance as part of our pediatric knowledgebase initiative. For the top 25 most utilized agents at our institution over the last 6 years, KPI score ranged from 35 (dexamethasone) to 77 (cefazolin and ampicillin) with an average score of 55. Prototype DSS for tacrolimus and methotrexate are strongly supported by the KPI scoring which ranks their selection in the top 5% of drugs on formulary. KPI metrics provide an objective means of ranking agents for which pediatric pharmacotherapeutic guidance is clearly needed. PMID:23055875

Key performance indicators for the assessment of pediatric pharmacotherapeutic guidance.

PubMed

Barrett, Jeffrey S; Patel, Dimple; Jayaraman, Bhuvana; Narayan, Mahesh; Zuppa, Athena

2008-07-01

Given the paucity of actual guidance provided for managing pediatric drug therapy, prescribing caregivers must be able to draw on the limited published information in pediatrics and/or guidance provided in adults with some account for expected pediatric response. Guidance for managing drug therapy in children is clearly desirable. Our objectives were to construct key performance indicators (KPIs) for pediatric pharmacotherapy guidance to identify drugs where pharmacotherapy guidance would be most beneficial. A pilot survey to assess variation in caregiver appreciation for pediatric dosing guidance has also been constructed to provide a complementary subjective assessment. Three KPI categories, drug utilization (based on hospital admission and billing data collected from 2001 through 2006), medical need, and guidance outcome value along with a KPI composite score have been proposed. Low scores are favored with respect to prioritization for pharmacotherapy guidance. The pilot survey consisted of 15 questions to assess 1) physician knowledge regarding dosing guidance, 2) attitudes toward dose modification and patient individualization, 3) the accessibility, ease of use and appropriateness of existing data stores, and 4) frequency of dosing modification, consultation of dosing compendiums and estimate of success rate in dosing guidance. Pilot results suggest that dosing guidance is generally viewed as important and that the existing resources are insufficient to guide recommendations for all drugs. While the majority of respondents check more than one resource less than 25% of the time, at least 25% of the respondents check more than one resource 25-50% of the time. The majority viewed the relevance of dosing guidance very important to the management of drug therapy. The questionnaire is being extended to the primary care centers, the Kids First Network and specialty care centers. Results will guide the development of decision support systems (DSS) that provide patient-specific pharmacotherapy guidance as part of our pediatric knowledgebase initiative. For the top 25 most utilized agents at our institution over the last 6 years, KPI score ranged from 35 (dexamethasone) to 77 (cefazolin and ampicillin) with an average score of 55. Prototype DSS for tacrolimus and methotrexate are strongly supported by the KPI scoring which ranks their selection in the top 5% of drugs on formulary. KPI metrics provide an objective means of ranking agents for which pediatric pharmacotherapeutic guidance is clearly needed.

Automatic guidance and control laws for helicopter obstacle avoidance

NASA Technical Reports Server (NTRS)

Cheng, Victor H. L.; Lam, T.

1992-01-01

The authors describe the implementation of a full-function guidance and control system for automatic obstacle avoidance in helicopter nap-of-the-earth (NOE) flight. The guidance function assumes that the helicopter is sufficiently responsive so that the flight path can be readily adjusted at NOE speeds. The controller, basically an autopilot for following the derived flight path, was implemented with parameter values to control a generic helicopter model used in the simulation. Evaluation of the guidance and control system with a 3-dimensional graphical helicopter simulation suggests that the guidance has the potential for providing good and meaningful flight trajectories.

Development of a Methodology to Guide the Replacement of Agency Default Uncertainty Factors with Those Based on Data

EPA Science Inventory

The Agency's guidance for the derivation of RfD and RfC values call for the downward adjustment of exposure-response levels observed in animals and/or humans to account for the potentially greater sensitivity of humans as compared to test animals (UFA) and the differential sensit...

77 FR 16123 - Draft Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-19

...; Class II Special Controls Guidance Document: Nucleic Acid-Based In Vitro Diagnostic Devices for the... Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls Guidance Document... II Special Controls Guidance Document: Nucleic Acid-Based In Vitro Diagnostic Devices for the...

Three-Year Analysis of Value and Utilization After Development of an Ultrasound-Based Orthopedic Injection Clinic.

PubMed

Dukes, Chase; Melton, Thomas; Turner, Eric; Jackson, Andrew; Grassbaugh, Jason; Slevin, John; Arrington, Edward D; Eichinger, Josef K

2017-09-01

Sonography is an effective method of diagnosing and treating musculoskeletal conditions, and the use of ultrasound has been shown to improve the accuracy, safety, and efficacy of both therapeutic and diagnostic injections. In 2012, we established an injection clinic at our institution to address our growing need for diagnostic and therapeutic injections. We performed an analysis of value and utilization following the development of an orthopedic injection clinic. This included an evaluation of the cost of materials, equipment, and training required to develop and run the clinic, and an analysis of the services rendered and relative value units (RVUs) generated over 3 fiscal years (FYs). The cost to develop the clinic was $42,498.30. The cost to run the clinic thereafter was $16.90 to $21.60 per injection. By the end of FY 2012, 60% of providers performed at least 1 injection under ultrasound guidance. Every successive year thereafter, 100% of providers were using ultrasound guidance. In FY 2012, we performed 738 injections, 5.4% used ultrasound guidance and generated a total of 1,786.36 RVUs. In FY 2013, we performed 1,814 injections, 17.6% used ultrasound guidance, and generated a total of 7,224.5 RVUs. In FY 2014, we performed 2,821 injections, 25.2% used ultrasound guidance, and generated 13,786.82 RVUs. RVUs generated solely from ultrasound guided injections were 463.2 (2012), 3,694 (2013), 8,221.8 (2014). Injection accuracy was at least 98%. Average time until injection was 0 days. The cost to start an injection clinic is modest, with the potential for large annual growth and early return on investment, and can generate significant revenue by recapturing RVUs that would otherwise be lost to outside referrals. Furthermore, it helps to increase clinic throughput, maximize services rendered during a single patient visit improving the overall quality of their encounter, expands the clinical practice of our midlevel providers, offloads clinical time for surgical providers, and can help expedite clinical decision making. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

HIV testing in Europe: Evaluating the impact, added value, relevance and usability of the European Centre for Disease Prevention and Control (ECDC)'s 2010 HIV testing guidance.

PubMed

Sullivan, Ann K; Sperle, Ida; Raben, Dorthe; Amato-Gauci, Andrew J; Lundgren, Jens Dilling; Yazdanpanah, Yazdan; Jakobsen, Stine Finne; Tavoschi, Lara

2017-11-01

An evaluation of the 2010 ECDC guidance on HIV testing, conducted in October 2015-January 2016, assessed its impact, added value, relevance and usability and the need for updated guidance. Data sources were two surveys: one for the primary target audience (health policymakers and decision makers, national programme managers and ECDC official contact points in the European Union/European Economic Area (EU/EEA) countries and one for a broader target audience (clinicians, civil society organisations and international public health agencies); two moderated focus group discussions  (17 participants each); webpage access data; a literature citation review; and an expert consultation (18 participants) to discuss the evaluation findings. Twenty-three of 28 primary target audience and 31 of 51 broader target audience respondents indicated the guidance was the most relevant when compared with other international guidance. Primary target audience respondents in 11 of 23 countries reported that they had used the guidance in development, monitoring and/or evaluation of their national HIV testing policy, guidelines, programme and/or strategy, and 29 of 51 of the broader target audience respondents reported having used the guidance in their work. Both the primary and broader target audience considered it important or very important to have an EU/EEA-level HIV testing guidance (23/28 and 46/51, respectively). The guidance has been widely used to develop policies, guidelines, programmes and strategies in the EU/EEA and should be regularly updated due to continuous developments in the field in order to continue to serve as an important reference guidance in the region.

HIV testing in Europe: Evaluating the impact, added value, relevance and usability of the European Centre for Disease Prevention and Control (ECDC)’s 2010 HIV testing guidance

PubMed Central

Sullivan, Ann K; Sperle, Ida; Raben, Dorthe; Amato-Gauci, Andrew J; Lundgren, Jens Dilling; Yazdanpanah, Yazdan; Jakobsen, Stine Finne; Tavoschi, Lara

2017-01-01

Background: An evaluation of the 2010 ECDC guidance on HIV testing, conducted in October 2015–January 2016, assessed its impact, added value, relevance and usability and the need for updated guidance. Methods: Data sources were two surveys: one for the primary target audience (health policymakers and decision makers, national programme managers and ECDC official contact points in the European Union/European Economic Area (EU/EEA) countries and one for a broader target audience (clinicians, civil society organisations and international public health agencies); two moderated focus group discussions  (17 participants each); webpage access data; a literature citation review; and an expert consultation (18 participants) to discuss the evaluation findings. Results: Twenty-three of 28 primary target audience and 31 of 51 broader target audience respondents indicated the guidance was the most relevant when compared with other international guidance. Primary target audience respondents in 11 of 23 countries reported that they had used the guidance in development, monitoring and/or evaluation of their national HIV testing policy, guidelines, programme and/or strategy, and 29 of 51 of the broader target audience respondents reported having used the guidance in their work. Both the primary and broader target audience considered it important or very important to have an EU/EEA-level HIV testing guidance (23/28 and 46/51, respectively). Conclusion: The guidance has been widely used to develop policies, guidelines, programmes and strategies in the EU/EEA and should be regularly updated due to continuous developments in the field in order to continue to serve as an important reference guidance in the region. PMID:29208158

Using Automated Scores of Student Essays to Support Teacher Guidance in Classroom Inquiry

NASA Astrophysics Data System (ADS)

Gerard, Libby F.; Linn, Marcia C.

2016-02-01

Computer scoring of student written essays about an inquiry topic can be used to diagnose student progress both to alert teachers to struggling students and to generate automated guidance. We identify promising ways for teachers to add value to automated guidance to improve student learning. Three teachers from two schools and their 386 students participated. We draw on evidence from student progress, observations of how teachers interact with students, and reactions of teachers. The findings suggest that alerts for teachers prompted rich teacher-student conversations about energy in photosynthesis. In one school, the combination of the automated guidance plus teacher guidance was more effective for student science learning than two rounds of personalized, automated guidance. In the other school, both approaches resulted in equal learning gains. These findings suggest optimal combinations of automated guidance and teacher guidance to support students to revise explanations during inquiry and build integrated understanding of science.

Pre-examination factors affecting molecular diagnostic test results and interpretation: A case-based approach.

PubMed

Payne, Deborah A; Baluchova, Katarina; Peoc'h, Katell H; van Schaik, Ron H N; Chan, K C Allen; Maekawa, Masato; Mamotte, Cyril; Russomando, Graciela; Rousseau, François; Ahmad-Nejad, Parviz

2017-04-01

Multiple organizations produce guidance documents that provide opportunities to harmonize quality practices for diagnostic testing. The International Organization for Standardization ISO 15189 standard addresses requirements for quality in management and technical aspects of the clinical laboratory. One technical aspect addresses the complexities of the pre-examination phase prior to diagnostic testing. The Committee for Molecular Diagnostics of the International Federation for Clinical Chemistry and Laboratory Medicine (also known as, IFCC C-MD) conducted a survey of international molecular laboratories and determined ISO 15189 to be the most referenced guidance document. In this review, the IFCC C-MD provides case-based examples illustrating the value of select pre-examination processes as these processes relate to molecular diagnostic testing. Case-based examples in infectious disease, oncology, inherited disease and pharmacogenomics address the utility of: 1) providing information to patients and users, 2) designing requisition forms, 3) obtaining informed consent and 4) maintaining sample integrity prior to testing. The pre-examination phase requires extensive and consistent communication between the laboratory, the healthcare provider and the end user. The clinical vignettes presented in this paper illustrate the value of applying select ISO 15189 recommendations for general laboratory to the more specialized area of Molecular Diagnostics. Copyright © 2016 Elsevier B.V. All rights reserved.

European Universities' Guidance on Research Integrity and Misconduct.

PubMed

Aubert Bonn, Noémie; Godecharle, Simon; Dierickx, Kris

2017-02-01

Research integrity is imperative to good science. Nonetheless, many countries and institutions develop their own integrity guidance, thereby risking incompatibilities with guidance of collaborating institutions. We retrieved guidance for academic integrity and misconduct of 18 universities from 10 European countries and investigated accessibility, general content, principles endorsed, and definitions of misconduct. Accessibility and content differ substantially between institutions. There are general trends of common principles of integrity and definitions of misconduct, yet differences remain. Parallel with previous research, we distinguish different approaches in integrity guidance; one emphasizes broad values of integrity, and the other details negative behaviors of misconduct. We propose that a balance between both approaches is necessary to preserve trust, meaning, and realism of guidance on research integrity.

Meet Guidance Needs of Older Adults. Module CG C-16 of Category C--Implementing. Competency-Based Career Guidance Modules.

ERIC Educational Resources Information Center

Cook, Patricia; Stewart, Ellen

This learning module, one in a series of competency-based guidance program training packages focusing upon professional and paraprofessional competencies of guidance personnel, deals with meeting the guidance needs of older adults. Addressed in the module are the following topics: describing a negative and a positive bias, stereotype, or attitude…

Provide Career Guidance to Girls and Women. Module CG C-13 of Category C--Implementing. Competency-Based Career Guidance Modules.

ERIC Educational Resources Information Center

Birk, Janice M.; Colby, Pamela G.

This learning module, one in a series of competency-based guidance program training packages focusing upon professional and paraprofessional competencies of guidance personnel, deals with providing career guidance to girls and women. Addressed in the module are the following topics: society's influence on shaping differential roles and behaviors…

A region-based segmentation method for ultrasound images in HIFU therapy

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

Zhang, Dong, E-mail: dongz@whu.edu.cn; Liu, Yu; Yang, Yan

Purpose: Precisely and efficiently locating a tumor with less manual intervention in ultrasound-guided high-intensity focused ultrasound (HIFU) therapy is one of the keys to guaranteeing the therapeutic result and improving the efficiency of the treatment. The segmentation of ultrasound images has always been difficult due to the influences of speckle, acoustic shadows, and signal attenuation as well as the variety of tumor appearance. The quality of HIFU guidance images is even poorer than that of conventional diagnostic ultrasound images because the ultrasonic probe used for HIFU guidance usually obtains images without making contact with the patient’s body. Therefore, the segmentationmore » becomes more difficult. To solve the segmentation problem of ultrasound guidance image in the treatment planning procedure for HIFU therapy, a novel region-based segmentation method for uterine fibroids in HIFU guidance images is proposed. Methods: Tumor partitioning in HIFU guidance image without manual intervention is achieved by a region-based split-and-merge framework. A new iterative multiple region growing algorithm is proposed to first split the image into homogenous regions (superpixels). The features extracted within these homogenous regions will be more stable than those extracted within the conventional neighborhood of a pixel. The split regions are then merged by a superpixel-based adaptive spectral clustering algorithm. To ensure the superpixels that belong to the same tumor can be clustered together in the merging process, a particular construction strategy for the similarity matrix is adopted for the spectral clustering, and the similarity matrix is constructed by taking advantage of a combination of specifically selected first-order and second-order texture features computed from the gray levels and the gray level co-occurrence matrixes, respectively. The tumor region is picked out automatically from the background regions by an algorithm according to a priori information about the tumor position, shape, and size. Additionally, an appropriate cluster number for spectral clustering can be determined by the same algorithm, thus the automatic segmentation of the tumor region is achieved. Results: To evaluate the performance of the proposed method, 50 uterine fibroid ultrasound images from different patients receiving HIFU therapy were segmented, and the obtained tumor contours were compared with those delineated by an experienced radiologist. For area-based evaluation results, the mean values of the true positive ratio, the false positive ratio, and the similarity were 94.42%, 4.71%, and 90.21%, respectively, and the corresponding standard deviations were 2.54%, 3.12%, and 3.50%, respectively. For distance-based evaluation results, the mean values of the normalized Hausdorff distance and the normalized mean absolute distance were 4.93% and 0.90%, respectively, and the corresponding standard deviations were 2.22% and 0.34%, respectively. The running time of the segmentation process was 12.9 s for a 318 × 333 (pixels) image. Conclusions: Experiments show that the proposed method can segment the tumor region accurately and efficiently with less manual intervention, which provides for the possibility of automatic segmentation and real-time guidance in HIFU therapy.« less

Fault Management in an Objectives-Based/Risk-Informed View of Safety and Mission Success

NASA Technical Reports Server (NTRS)

Groen, Frank

2012-01-01

Theme of this talk: (1) Net-benefit of activities and decisions derives from objectives (and their priority) -- similarly: need for integration, value of technology/capability. (2) Risk is a lack of confidence that objectives will be met. (2a) Risk-informed decision making requires objectives. (3) Consideration of objectives is central to recent guidance.

AAA (2010) CAPD clinical practice guidelines: need for an update.

PubMed

DeBonis, David A

2017-09-01

Review and critique of the clinical value of the AAA CAPD guidance document in light of criteria for credible and useful guidance documents, as discussed by Field and Lohr. A qualitative review of the of the AAA CAPD guidelines using a framework by Field and Lohr to assess their relative value in supporting the assessment and management of CAPD referrals. Relevant literature available through electronic search tools and published texts were used along with the AAA CAPD guidance document and the chapter by Field and Lohr. The AAA document does not meet many of the key requirements discussed by Field and Lohr. It does not reflect the current literature, fails to help clinicians understand for whom auditory processing testing and intervention would be most useful, includes contradictory suggestions which reduce clarity and appears to avoid conclusions that might cast the CAPD construct in a negative light. It also does not include input from diverse affected groups. All of these reduce the document's credibility. The AAA CAPD guidance document will need to be updated and re-conceptualised in order to provide meaningful guidance for clinicians.

Development of Animal Physiology Practical Guidance Oriented Guided Inquiry for Student of Biology Department

NASA Astrophysics Data System (ADS)

Putra, Z. A. Z.; Sumarmin, R.; Violita, V.

2018-04-01

The guides used for practicing animal physiology need to be revised and adapted to the lecture material. This is because in the subject of Animal Physiology. The guidance of animal physiology practitioners is still conventional with prescription model instructions and is so simple that it is necessary to develop a practical guide that can lead to the development of scientific work. One of which is through practice guided inquiry guided practicum guide. This study aims to describe the process development of the practical guidance and reveal the validity, practicality, and effectiveness Guidance Physiology Animals guided inquiry inferior to the subject of Animal Physiology for students Biology Department State University of Padang. This type of research is development research. This development research uses the Plomp model. Stages performed are problem identification and analysis stage, prototype development and prototyping stage, and assessment phase. Data analysis using descriptive analysis. The instrument of data collection using validation and practical questionnaires, competence and affective field of competence observation and psychomotor and cognitive domain competence test. The result of this research shows that guidance of Inquiry Guided Initiative Guided Physiology with 3.23 valid category, practicality by lecturer with value 3.30 practical category, student with value 3.37 practical criterion. Affective effectiveness test with 93,00% criterion is very effective, psychomotor aspect 89,50% with very effective criteria and cognitive domain with value of 67, pass criterion. The conclusion of this research is Guided Inquiry Student Guided Protoxial Guidance For Students stated valid, practical and effective.

Structure-based thresholds of toxicological concern-guidance for application to substances present at low levels in the diet

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

Renwick, A.G.

Health-based guidance values, such as the ADI, use chemical-specific data to determine the highest intake that would be without significant adverse health effects. A threshold of toxicological concern (TTC) is a level of intake predicted to be without adverse effects based on the toxicity of structurally related compounds. The main advantage of the use of TTCs is that the risk of low exposures can be evaluated without the need for chemical-specific animal toxicity data. TTCs have been used for many years for screening the safety of packaging migrants by the FDA in the USA, and of flavoring substances, by themore » JECFA. A recent reassessment of the use of TTCs, organized by ILSI Europe, has developed a decision tree which allows a systematic approach to the evaluation of low levels of diverse chemicals in food. The decision tree incorporates a series of increasing TTC values into a step-wise approach. Potentially genotoxic carcinogens are considered first, based on the presence of known structural alerts. Aflatoxin-like, azoxy- and nitroso-compounds are removed from consideration because they are the most potent, and a practical TTC could not be established. Other compounds with structural alerts for genotoxicity are allocated a TTC of 0.15 {mu}g/person per day. Compounds without structural alerts for genotoxicity are evaluated based on chemical structure and intake using a series of TTC values derived by the application of a 100-fold uncertainty factor to the 5th percentile of the distribution of NOAELs from chronic studies on compounds sharing similar structural characteristics.« less

U-Factor (U-value) | Efficient Windows Collaborative

Science.gov Websites

Foundry Foundry New Construction Windows Window Selection Tool Selection Process Design Guidance Installation Replacement Windows Window Selection Tool Assessing Options Selection Process Design Guidance Installation Understanding Windows Benefits Design Considerations Measuring Performance Performance Standards

Guidance for Selecting Input Parameters in Modeling the Environmental Fate and Transport of Pesticides

EPA Pesticide Factsheets

Guidance to select and prepare input values for OPP's aquatic exposure models. Intended to improve the consistency in modeling the fate of pesticides in the environment and quality of OPP's aquatic risk assessments.

Influence of evidence-based guidance on health policy and clinical practice in England.

PubMed

Coleman, P; Nicholl, J

2001-12-01

To examine the influence of evidence-based guidance on health care decisions, a study of the use of seven different sources and types of evidence-based guidance was carried out in senior health professionals in England with responsibilities either for directing and purchasing health care based in the health authorities, or providing clinical care to patients in trust hospitals or in primary care. Postal survey. Three health settings: 46 health authorities, 162 acute and/or community trust hospitals, and 96 primary care groups in England. 566 subjects (46 directors of public health, 49 directors of purchasing, 375 clinical directors/consultants in hospitals, and 96 lead general practitioners). Knowledge of selected evidence-based guidance, previous use ever, beliefs in quality, usefulness, and perceived influence on practice. A usable response rate of 73% (407/560) was achieved; 82% (334/407) of respondents had consulted at least one source of evidence-based guidance ever in the past. Professionals in the health authorities were much more likely to be aware of the evidence-based guidance and had consulted more sources (mean number of different guidelines consulted 4.3) than either the hospital consultants (mean 1.9) or GPs in primary care (mean 1.8). There was little variation in the belief that the evidence-based guidance was of "good quality", but respondents from the health authorities (87%) were significantly more likely than either hospital consultants (52%) or GPs (57%) to perceive that any of the specified evidence-based guidance had influenced a change of practice. Across all settings, the least used route to accessing evidence-based guidance was the Internet. For several sources an effect was observed between use ever, the health region where the health professional worked, and the region where the guidance was produced or published. This was evident for some national sources as well as in those initiatives produced locally with predominantly local distribution networks. The evidence-based guidance specified was significantly more likely to be seen to have contributed to the decisions of public health specialists and commissioners than those of consultants in hospitals or of GPs in a primary care setting. Appropriate information support and dissemination systems that increase awareness, access, and use of evidence-based guidance at the clinical interface should be developed.

VLSI chips for vision-based vehicle guidance

NASA Astrophysics Data System (ADS)

Masaki, Ichiro

1994-02-01

Sensor-based vehicle guidance systems are gathering rapidly increasing interest because of their potential for increasing safety, convenience, environmental friendliness, and traffic efficiency. Examples of applications include intelligent cruise control, lane following, collision warning, and collision avoidance. This paper reviews the research trends in vision-based vehicle guidance with an emphasis on VLSI chip implementations of the vision systems. As an example of VLSI chips for vision-based vehicle guidance, a stereo vision system is described in detail.

Creating the Future of Evidence-Based Nutrition Recommendations: Case Studies from Lipid Research123

PubMed Central

Dwyer, Johanna T; Rubin, Kristin H; Psota, Tricia L; Liska, DeAnn J; Montain, Scott J

2016-01-01

Strategic translational research is designed to address research gaps that answer specific guidance questions. It provides translational value with respect to nutrition guidance and regulatory and public policy. The relevance and the quality of evidence both matter in translational research. For example, design decisions regarding population, intervention, comparator, and outcome criteria affect whether or not high-quality studies are considered relevant to specific guidance questions and are therefore included as evidence within the context of systematic review frameworks used by authoritative food and health organizations. The process used in systematic reviews, developed by the USDA for its Nutrition Evidence Library, is described. An eating pattern and cardiovascular disease (CVD) evidence review is provided as an example, and factors that differentiated the studies considered relevant and included in that evidence base from those that were excluded are noted. Case studies on ω-3 (n–3) fatty acids (FAs) and industrial trans-FAs illustrate key factors vital to relevance and translational impact, including choice of a relevant population (e.g., healthy, at risk, or diseased subjects; general population or high-performance soldiers); dose and form of the intervention (e.g., food or supplement); use of relevant comparators (e.g., technically feasible and realistic); and measures for both exposure and outcomes (e.g., inflammatory markers or CVD endpoints). Specific recommendations are provided to help increase the impact of nutrition research on future dietary guidance, policy, and regulatory issues, particularly in the area of lipids. PMID:27422509

75 FR 50744 - Notice of Intent To Request Revision and Extension of a Currently Approved Information Collection

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-17

... inventory and lamb crop; cattle inventory; cattle on feed; grazing fees; and land values. Uses of the... at 5 CFR part 1320. NASS also complies with OMB Implementation Guidance, ``Implementation Guidance...

Value-based recruitment in midwifery: do the values align with what women say is important to them?

PubMed

Callwood, Alison; Cooke, Debbie; Allan, Helen

2016-10-01

The aim of this study was to discuss theoretical conceptualization and definition of values and value-based recruitment in the context of women's views about what they would like from their midwife. Value-based recruitment received headline status in the UK government's response to pervasive deficiencies in compassionate care identified in the health service. Core values which aim to inform service user's experience are defined in the National Health Service Constitution but clarity about whether these encompass all that women say is important to them is needed. Discussion paper. A literature search included published papers written in English relating to values, VBR and women's views of a 'good' midwife with no date limiters. Definitions of values and value-based recruitment are examined. Congruence is explored between what women say is important to them and key government and professional regulatory documentation. The importance of a 'sustainable emotional' dimension in the midwife-mother relationship is suggested. Inconsistencies are identified between women's views, government, professional documentation and what women say they want. An omission of any reference to emotions or emotionality in value-based recruitment policy, professional recruitment and selection guidance documentation is identified. A review of key professional documentation, in relation to selection for 'values', is proposed. We argue for clarity and revision so that values embedded in value-based recruitment are consistent with health service users' views. An enhancement of the 'values' in the value-based recruitment framework is recommended to include the emotionality that women state is a fundamental part of their relationship with their midwife. © 2016 John Wiley & Sons Ltd.

Internet-based treatment for Romanian adults with panic disorder: protocol of a randomized controlled trial comparing a Skype-guided with an unguided self-help intervention (the PAXPD study).

PubMed

Ciuca, Amalia Maria; Berger, Thomas; Crişan, Liviu George; Miclea, Mircea

2016-01-14

Efficacy of self-help internet-based cognitive behavior therapy (ICBT) for anxiety disorders has been confirmed in several randomized controlled trials. However, the amount and type of therapist guidance needed in ICBT are still under debate. Previous studies have shown divergent results regarding the role of therapist guidance and its impact on treatment outcome. This issue is central to the development of ICBT programs and needs to be addressed directly. The present study aims to compare the benefits of regular therapist guidance via online real-time audio-video communication (i.e. Skype) to no therapist guidance during a 12-week Romanian self-help ICBT program for Panic Disorder. Both treatments are compared to a waiting-list control group. A parallel group randomized controlled trial is proposed. The participants, 192 Romanian adults fulfilling diagnostic criteria for panic disorder according to a diagnostic interview, conducted via secured Skype or telephone, are randomly assigned to one of the three conditions: independent use of the internet-based self-help program PAXonline, the same self-help treatment with regular therapist support via secured Skype, and waiting-list control group. The primary outcomes are severity of self-report panic symptoms (PDSS-SR) and diagnostic status (assessors are blind to group assignment), at the end of the intervention (12 weeks) and at follow-up (months 3 and 6). The secondary measures address symptoms of comorbid anxiety disorders, depression, quality of life, adherence and satisfaction with ICBT. Additional measures of socio-demographic characteristics, personality traits, treatment expectancies, catastrophic cognitions, body vigilance and working alliance are considered as potential moderators and/ or mediators of treatment outcome. To the best of our knowledge, the present study is the first effort to investigate the efficacy of a self-help internet-based intervention with therapist guidance via real-time video communication. A direct comparison between therapist guided versus unguided self-directed intervention for panic disorder will also be addressed for the first time. Findings from this study will inform researchers and practitioners about the added value of online video-therapy guidance sessions and the type of patients who may benefit the most from guided and unguided ICBT for Panic disorder. ACTRN12614000547640 (Australian New Zealand Clinical Trials Registry). Registered 22/05/2014.

Levitation and guidance force relaxations of the single-seeded and multi-seeded YBCO superconductors

NASA Astrophysics Data System (ADS)

Abdioglu, M.; Ozturk, K.; Kabaer, M.; Ekici, M.

2018-01-01

The stable levitation and guidance forces at higher force levels are important parameters for technological applicability of high temperature superconductors (HTSs) in Maglev and Flywheel energy storage systems. In this study, we have investigated the levitation and guidance force relaxation of both the single-seeded and multi-seeded YBCOs for different (HTS)-permanent magnetic guideway (PMG) arrangements in different cooling heights (CH). The measured saturated force values of Halbach PMG arrangements are bigger than the maximum force values of other PMGs. It is determined that the normalized magnetic levitation force (MLF) and normalized guidance force (GF) relaxation rate values decrease while the relaxation rates increase with increasing magnetic pole number and the effective external magnetic field area for both the single-seeded and multi-seeded YBCO. Also it can be said that the force stability at the higher force value of Halbach PMG arrangement indicates that the relaxation quality of Halbach PMG is better than that of the others. Additionally, it can be said that both the MLF and GF relaxation qualities of the multi-seeded YBCOs are better than that of the single-seeded ones. This magnetic force and relaxation results of the single-seeded and multi-seeded YBCOs are useful to optimize the loading capacity and lateral reliability of HTS Maglev and similar magnetic bearing systems.

'She believed in me'. What patients with depression value in their relationship with practitioners. A secondary analysis of multiple qualitative data sets.

PubMed

Percival, John; Donovan, Jenny; Kessler, David; Turner, Katrina

2017-02-01

Clinical guidance promotes the practitioner-patient relationship as integral to good quality person-centred care for patients with depression. However, patients can struggle to engage with practitioners and practitioners have indicated that they want more guidance on how to establish effective relationships with their patients. To identify what practitioner attributes patients with depression particularly value or find problematic. A secondary analysis of data collected during four qualitative studies, all of which entailed interviewing patients diagnosed with depression about their treatment experiences. Patients in the four studies had received different treatments. These included antidepressants, cognitive behaviour therapy, facilitated physical activity and listening visits. We thematically analysed 32 patient accounts. We identified two complimentary sets of important practitioner attributes: the first based on the practitioner's bearing; the second based on the practitioner's enabling role. We found that patients value practitioners who consider their individual manner, share relevant personal information, show interest and acceptance, communicate clearly and listen carefully, collaborate on manageable goals and sanction greater patient self-care and self-compassion. It was also evident that patients receiving different treatments value the same practitioner attributes and that when these key practitioner qualities were not evident, patients were liable not to re-attend or comply with treatment. The practitioner attributes that patients with depression most value have a positive impact on their engagement with treatment. Patients emphasise the importance of a practitioner's demeanour and encouragement, rather than the amount of time or specific treatment a practitioner is able to provide. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

Image guided versus palpation guided core needle biopsy of palpable breast masses: a prospective study

PubMed Central

Hari, Smriti; Kumari, Swati; Srivastava, Anurag; Thulkar, Sanjay; Mathur, Sandeep; Veedu, Prasad Thotton

2016-01-01

Background & objectives: Biopsy of palpable breast masses can be performed manually by palpation guidance or under imaging guidance. Based on retrospective studies, image guided biopsy is considered more accurate than palpation guided breast biopsy; however, these techniques have not been compared prospectively. We conducted this prospective study to verify the superiority and determine the size of beneficial effect of image guided biopsy over palpation guided biopsy. Methods: Over a period of 18 months, 36 patients each with palpable breast masses were randomized into palpation guided and image guided breast biopsy arms. Ultrasound was used for image guidance in 33 patients and mammographic (stereotactic) guidance in three patients. All biopsies were performed using 14 gauge automated core biopsy needles. Inconclusive, suspicious or imaging-histologic discordant biopsies were repeated. Results: Malignancy was found in 30 of 36 women in palpation guided biopsy arm and 27 of 36 women in image guided biopsy arm. Palpation guided biopsy had sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 46.7, 100, 100, 27.3 per cent, respectively, for diagnosing breast cancer. Nineteen of 36 women (52.8%) required repeat biopsy because of inadequate samples (7 of 19), suspicious findings (2 of 19) or imaging-histologic discordance (10 of 19). On repeat biopsy, malignancy was found in all cases of imaging-histologic discordance. Image guided biopsy had 96.3 per cent sensitivity and 100 per cent specificity. There was no case of inadequate sample or imaging-histologic discordance with image guided biopsy. Interpretation & conclusions: Our results showed that in palpable breast masses, image guided biopsy was superior to palpation guided biopsy in terms of sensitivity, false negative rate and repeat biopsy rates. PMID:27488003

DISCOVER: A Computer-Based Career Guidance and Counselor-Administrative Support System. Final Report. July 1974-August 1975.

ERIC Educational Resources Information Center

Harris-Bowlsbey, JoAnn

Based on the Computerized Vocational Information System (CVIS), Project DISCOVER was conceptualized in three parts: Guidance subsystem for direct use by individuals at three age levels (grades 4-6, grades 7-12, and adult) seeking career guidance; the counselor-support subsystem; and the administrator support subsystem. Guidance development and…

Guidance: Using RCRA's Results-Based Approaches and Tailored Oversight Guidance when Performing Superfund Oversight

EPA Pesticide Factsheets

Memorandum providing additional information in support of Superfund's administrative reform on PRP oversight. Superfund program managers should consider RCRA's Results-Based Guidance when developing oversight plans with PRPs.

Indoor Air Contamination from Hazardous Waste Sites: Improving the Evidence Base for Decision-Making.

PubMed

Johnston, Jill; MacDonald Gibson, Jacqueline

2015-11-27

At hazardous waste sites, volatile chemicals can migrate through groundwater and soil into buildings, a process known as vapor intrusion. Due to increasing recognition of vapor intrusion as a potential indoor air pollution source, in 2015 the U.S. Environmental Protection Agency (EPA) released a new vapor intrusion guidance document. The guidance specifies two conditions for demonstrating that remediation is needed: (1) proof of a vapor intrusion pathway; and (2) evidence that human health risks exceed established thresholds (for example, one excess cancer among 10,000 exposed people). However, the guidance lacks details on methods for demonstrating these conditions. We review current evidence suggesting that monitoring and modeling approaches commonly employed at vapor intrusion sites do not adequately characterize long-term exposure and in many cases may underestimate risks. On the basis of this evidence, we recommend specific approaches to monitoring and modeling to account for these uncertainties. We propose a value of information approach to integrate the lines of evidence at a site and determine if more information is needed before deciding whether the two conditions specified in the vapor intrusion guidance are satisfied. To facilitate data collection and decision-making, we recommend a multi-directional community engagement strategy and consideration of environment justice concerns.

A number of factors explain why WHO guideline developers make strong recommendations inconsistent with GRADE guidance.

PubMed

Alexander, Paul E; Gionfriddo, Michael R; Li, Shelly-Anne; Bero, Lisa; Stoltzfus, Rebecca J; Neumann, Ignacio; Brito, Juan P; Djulbegovic, Benjamin; Montori, Victor M; Norris, Susan L; Schünemann, Holger J; Thabane, Lehana; Guyatt, Gordon H

2016-02-01

Many strong recommendations issued by the World Health Organization (WHO) are based on low- or very low-quality (low certainty) evidence (discordant recommendations). Many such discordant recommendations are inconsistent with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidance. We sought to understand why WHO makes discordant recommendations inconsistent with GRADE guidance. We interviewed panel members involved in guidelines approved by WHO (2007-2012) that included discordant recommendations. Interviews, recorded and transcribed, focused on use of GRADE including the reasoning underlying, and factors contributing to, discordant recommendations. Four themes emerged: strengths of GRADE, challenges and barriers to GRADE, strategies to improve GRADE application, and explanations for discordant recommendations. Reasons for discordant recommendations included skepticism about the value of making conditional recommendations; political considerations; high certainty in benefits (sometimes warranted, sometimes not) despite assessing evidence as low certainty; and concerns that conditional recommendations will be ignored. WHO panelists make discordant recommendations inconsistent with GRADE guidance for reasons that include limitations in their understanding of GRADE. Ensuring optimal application of GRADE at WHO and elsewhere likely requires selecting panelists who have a commitment to GRADE principles, additional training of panelists, and formal processes to maximize adherence to GRADE principles. Copyright © 2016 Elsevier Inc. All rights reserved.

Indoor Air Contamination from Hazardous Waste Sites: Improving the Evidence Base for Decision-Making

PubMed Central

Johnston, Jill; MacDonald Gibson, Jacqueline

2015-01-01

At hazardous waste sites, volatile chemicals can migrate through groundwater and soil into buildings, a process known as vapor intrusion. Due to increasing recognition of vapor intrusion as a potential indoor air pollution source, in 2015 the U.S. Environmental Protection Agency (EPA) released a new vapor intrusion guidance document. The guidance specifies two conditions for demonstrating that remediation is needed: (1) proof of a vapor intrusion pathway; and (2) evidence that human health risks exceed established thresholds (for example, one excess cancer among 10,000 exposed people). However, the guidance lacks details on methods for demonstrating these conditions. We review current evidence suggesting that monitoring and modeling approaches commonly employed at vapor intrusion sites do not adequately characterize long-term exposure and in many cases may underestimate risks. On the basis of this evidence, we recommend specific approaches to monitoring and modeling to account for these uncertainties. We propose a value of information approach to integrate the lines of evidence at a site and determine if more information is needed before deciding whether the two conditions specified in the vapor intrusion guidance are satisfied. To facilitate data collection and decision-making, we recommend a multi-directional community engagement strategy and consideration of environment justice concerns. PMID:26633433

Atmospheric Ascent Guidance for Rocket-Powered Launch Vehicles

NASA Technical Reports Server (NTRS)

Dukeman, Greg A.

2002-01-01

An advanced ascent guidance algorithm for rocket- powered launch vehicles is developed. This algorithm cyclically solves the calculus-of-variations two-point boundary-value problem starting at vertical rise completion through main engine cutoff. This is different from traditional ascent guidance algorithms which operate in a simple open-loop mode until high dynamic pressure (including the critical max-Q) portion of the trajectory is over, at which time guidance operates under the assumption of negligible aerodynamic acceleration (i.e., vacuum dynamics). The initial costate guess is corrected based on errors in the terminal state constraints and the transversality conditions. Judicious approximations are made to reduce the order and complexity of the state/costate system. Results comparing guided launch vehicle trajectories with POST open-loop trajectories are given verifying the basic formulation of the algorithm. Multiple shooting is shown to be a very effective numerical technique for this application. In particular, just one intermediate shooting point, in addition to the initial shooting point, is sufficient to significantly reduce sensitivity to the guessed initial costates. Simulation results from a high-fidelity trajectory simulation are given for the case of launch to sub-orbital cutoff conditions as well as launch to orbit conditions. An abort to downrange landing site formulation of the algorithm is presented.

Guided and Unguided Internet-Based Treatment for Problematic Alcohol Use - A Randomized Controlled Pilot Trial.

PubMed

Sundström, Christopher; Gajecki, Mikael; Johansson, Magnus; Blankers, Matthijs; Sinadinovic, Kristina; Stenlund-Gens, Erik; Berman, Anne H

2016-01-01

The Internet has increasingly been studied as mode of delivery for interventions targeting problematic alcohol use. Most interventions have been fully automated, but some research suggests that adding counselor guidance may improve alcohol consumption outcomes. An eight-module Internet-based self-help program based on cognitive behavioral therapy (CBT) was tested among Internet help-seekers. Eighty participants with problematic alcohol use according to the Alcohol Use Disorders Identification Test (AUDIT; scores of ≥ 6 for women and ≥ 8 for men) were recruited online from an open access website and randomized into three different groups. All groups were offered the same self-help program, but participants in two of the three groups received Internet-based counselor guidance in addition to the self-help program. One of the guidance groups was given a choice between guidance via asynchronous text messages or synchronous text-based chat, while the other guidance group received counselor guidance via asynchronous text messages only. In the choice group, 65% (13 of 20 participants) chose guidance via asynchronous text messages. At the 10-week post-treatment follow-up, an intention-to-treat (ITT) analysis showed that participants in the two guidance groups (choice and messages) reported significantly lower past week alcohol consumption compared to the group without guidance; 10.8 (SD = 12.1) versus 22.6 (SD = 18.4); p = 0.001; Cohen's d = 0.77. Participants in both guidance groups reported significantly lower scores on the AUDIT at follow-up compared to the group without guidance, with a mean score of 14.4 (SD = 5.2) versus 18.2 (SD = 5.9); p = 0.003; Cohen's d = 0.68. A higher proportion of participants in the guidance groups said that they would recommend the program compared to the group without guidance (81% for choice; 93% for messages versus 47% for self-help). Self-help programs for problematic alcohol use can be more effective in reducing alcohol consumption over a 10-week period when counselor guidance is added. Clinicaltrials.gov NCT02384304.

Impact of refining the assessment of dietary exposure to cadmium in the European adult population.

PubMed

Ferrari, Pietro; Arcella, Davide; Heraud, Fanny; Cappé, Stefano; Fabiansson, Stefan

2013-01-01

Exposure assessment constitutes an important step in any risk assessment of potentially harmful substances present in food. The European Food Safety Authority (EFSA) first assessed dietary exposure to cadmium in Europe using a deterministic framework, resulting in mean values of exposure in the range of health-based guidance values. Since then, the characterisation of foods has been refined to better match occurrence and consumption data, and a new strategy to handle left-censoring in occurrence data was devised. A probabilistic assessment was performed and compared with deterministic estimates, using occurrence values at the European level and consumption data from 14 national dietary surveys. Mean estimates in the probabilistic assessment ranged from 1.38 (95% CI = 1.35-1.44) to 2.08 (1.99-2.23) µg kg⁻¹ bodyweight (bw) week⁻¹ across the different surveys, which were less than 10% lower than deterministic (middle bound) mean values that ranged from 1.50 to 2.20 µg kg⁻¹ bw week⁻¹. Probabilistic 95th percentile estimates of dietary exposure ranged from 2.65 (2.57-2.72) to 4.99 (4.62-5.38) µg kg⁻¹ bw week⁻¹, which were, with the exception of one survey, between 3% and 17% higher than middle-bound deterministic estimates. Overall, the proportion of subjects exceeding the tolerable weekly intake of 2.5 µg kg⁻¹ bw ranged from 14.8% (13.6-16.0%) to 31.2% (29.7-32.5%) according to the probabilistic assessment. The results of this work indicate that mean values of dietary exposure to cadmium in the European population were of similar magnitude using determinist or probabilistic assessments. For higher exposure levels, probabilistic estimates were almost consistently larger than deterministic counterparts, thus reflecting the impact of using the full distribution of occurrence values to determine exposure levels. It is considered prudent to use probabilistic methodology should exposure estimates be close to or exceeding health-based guidance values.

Guiding Learners through Technology-Based Instruction: The Effects of Adaptive Guidance Design and Individual Differences on Learning over Time

ERIC Educational Resources Information Center

Kanar, Adam M.; Bell, Bradford S.

2013-01-01

Adaptive guidance is an instructional intervention that helps learners to make use of the control inherent in technology-based instruction. The present research investigated the interactive effects of guidance design (i.e., framing of guidance information) and individual differences (i.e., pretraining motivation and ability) on learning basic and…

Write Proposals. Module CG B-2 of Category B--Supporting. Competency-Based Career Guidance Modules.

ERIC Educational Resources Information Center

Gustafson, Richard A.

This module is intended to help guidance personnel in a variety of educational and agency settings plan and develop successful proposals to assist in financing the improvement of existing or future career guidance programs. The module is one of a series of competency-based guidance program training packages focusing upon specific professional and…

Coaching and guidance with patient decision aids: A review of theoretical and empirical evidence

PubMed Central

2013-01-01

Background Coaching and guidance are structured approaches that can be used within or alongside patient decision aids (PtDAs) to facilitate the process of decision making. Coaching is provided by an individual, and guidance is embedded within the decision support materials. The purpose of this paper is to: a) present updated definitions of the concepts “coaching” and “guidance”; b) present an updated summary of current theoretical and empirical insights into the roles played by coaching/guidance in the context of PtDAs; and c) highlight emerging issues and research opportunities in this aspect of PtDA design. Methods We identified literature published since 2003 on shared decision making theoretical frameworks inclusive of coaching or guidance. We also conducted a sub-analysis of randomized controlled trials included in the 2011 Cochrane Collaboration Review of PtDAs with search results updated to December 2010. The sub-analysis was conducted on the characteristics of coaching and/or guidance included in any trial of PtDAs and trials that allowed the impact of coaching and/or guidance with PtDA to be compared to another intervention or usual care. Results Theoretical evidence continues to justify the use of coaching and/or guidance to better support patients in the process of thinking about a decision and in communicating their values/preferences with others. In 98 randomized controlled trials of PtDAs, 11 trials (11.2%) included coaching and 63 trials (64.3%) provided guidance. Compared to usual care, coaching provided alongside a PtDA improved knowledge and decreased mean costs. The impact on some other outcomes (e.g., participation in decision making, satisfaction, option chosen) was more variable, with some trials showing positive effects and other trials reporting no differences. For values-choice agreement, decisional conflict, adherence, and anxiety there were no differences between groups. None of these outcomes were worse when patients were exposed to decision coaching alongside a PtDA. No trials evaluated the effect of guidance provided within PtDAs. Conclusions Theoretical evidence continues to justify the use of coaching and/or guidance to better support patients to participate in decision making. However, there are few randomized controlled trials that have compared the effectiveness of coaching used alongside PtDAs to PtDAs without coaching, and no trials have compared the PtDAs with guidance to those without guidance. PMID:24624995

Vertical Guidance Performance Analysis of the L1–L5 Dual-Frequency GPS/WAAS User Avionics Sensor

PubMed Central

Jan, Shau-Shiun

2010-01-01

This paper investigates the potential vertical guidance performance of global positioning system (GPS)/wide area augmentation system (WAAS) user avionics sensor when the modernized GPS and Galileo are available. This paper will first investigate the airborne receiver code noise and multipath (CNMP) confidence (σair). The σair will be the dominant factor in the availability analysis of an L1–L5 dual-frequency GPS/WAAS user avionics sensor. This paper uses the MATLAB Algorithm Availability Simulation Tool (MAAST) to determine the required values for the σair, so that an L1–L5 dual-frequency GPS/WAAS user avionics sensor can meet the vertical guidance requirements of APproach with Vertical guidance (APV) II and CATegory (CAT) I over conterminous United States (CONUS). A modified MAAST that includes the Galileo satellite constellation is used to determine under what user configurations WAAS could be an APV II system or a CAT I system over CONUS. Furthermore, this paper examines the combinations of possible improvements in signal models and the addition of Galileo to determine if GPS/WAAS user avionics sensor could achieve 10 m Vertical Alert Limit (VAL) within the service volume. Finally, this paper presents the future vertical guidance performance of GPS user avionics sensor for the United States’ WAAS, Japanese MTSAT-based satellite augmentation system (MSAS) and European geostationary navigation overlay service (EGNOS). PMID:22319263

The Connection Between Forms of Guidance for Inquiry-Based Learning and the Communicative Approaches Applied—a Case Study in the Context of Pre-service Teachers

NASA Astrophysics Data System (ADS)

Lehtinen, Antti; Lehesvuori, Sami; Viiri, Jouni

2017-09-01

Recent research has argued that inquiry-based science learning should be guided by providing the learners with support. The research on guidance for inquiry-based learning has concentrated on how providing guidance affects learning through inquiry. How guidance for inquiry-based learning could promote learning about inquiry (e.g. epistemic practices) is in need of exploration. A dialogic approach to classroom communication and pedagogical link-making offers possibilities for learners to acquire these practices. The focus of this paper is to analyse the role of different forms of guidance for inquiry-based learning on building the communicative approach applied in classrooms. The data for the study comes from an inquiry-based physics lesson implemented by a group of five pre-service primary science teachers to a class of sixth graders. The lesson was video recorded and the discussions were transcribed. The data was analysed by applying two existing frameworks—one for the forms of guidance provided and another for the communicative approaches applied. The findings illustrate that providing non-specific forms of guidance, such as prompts, caused the communicative approach to be dialogic. On the other hand, providing the learners with specific forms of guidance, such as explanations, shifted the communication to be more authoritative. These results imply that different forms of guidance provided by pre-service teachers can affect the communicative approach applied in inquiry-based science lessons, which affects the possibilities learners are given to connect their existing ideas to the scientific view. Future research should focus on validating these results by also analysing inservice teachers' lessons.

Steering a Tractor by Means of an EMG-Based Human-Machine Interface

PubMed Central

Gomez-Gil, Jaime; San-Jose-Gonzalez, Israel; Nicolas-Alonso, Luis Fernando; Alonso-Garcia, Sergio

2011-01-01

An electromiographic (EMG)-based human-machine interface (HMI) is a communication pathway between a human and a machine that operates by means of the acquisition and processing of EMG signals. This article explores the use of EMG-based HMIs in the steering of farm tractors. An EPOC, a low-cost human-computer interface (HCI) from the Emotiv Company, was employed. This device, by means of 14 saline sensors, measures and processes EMG and electroencephalographic (EEG) signals from the scalp of the driver. In our tests, the HMI took into account only the detection of four trained muscular events on the driver’s scalp: eyes looking to the right and jaw opened, eyes looking to the right and jaw closed, eyes looking to the left and jaw opened, and eyes looking to the left and jaw closed. The EMG-based HMI guidance was compared with manual guidance and with autonomous GPS guidance. A driver tested these three guidance systems along three different trajectories: a straight line, a step, and a circumference. The accuracy of the EMG-based HMI guidance was lower than the accuracy obtained by manual guidance, which was lower in turn than the accuracy obtained by the autonomous GPS guidance; the computed standard deviations of error to the desired trajectory in the straight line were 16 cm, 9 cm, and 4 cm, respectively. Since the standard deviation between the manual guidance and the EMG-based HMI guidance differed only 7 cm, and this difference is not relevant in agricultural steering, it can be concluded that it is possible to steer a tractor by an EMG-based HMI with almost the same accuracy as with manual steering. PMID:22164006

Steering a tractor by means of an EMG-based human-machine interface.

PubMed

Gomez-Gil, Jaime; San-Jose-Gonzalez, Israel; Nicolas-Alonso, Luis Fernando; Alonso-Garcia, Sergio

2011-01-01

An electromiographic (EMG)-based human-machine interface (HMI) is a communication pathway between a human and a machine that operates by means of the acquisition and processing of EMG signals. This article explores the use of EMG-based HMIs in the steering of farm tractors. An EPOC, a low-cost human-computer interface (HCI) from the Emotiv Company, was employed. This device, by means of 14 saline sensors, measures and processes EMG and electroencephalographic (EEG) signals from the scalp of the driver. In our tests, the HMI took into account only the detection of four trained muscular events on the driver's scalp: eyes looking to the right and jaw opened, eyes looking to the right and jaw closed, eyes looking to the left and jaw opened, and eyes looking to the left and jaw closed. The EMG-based HMI guidance was compared with manual guidance and with autonomous GPS guidance. A driver tested these three guidance systems along three different trajectories: a straight line, a step, and a circumference. The accuracy of the EMG-based HMI guidance was lower than the accuracy obtained by manual guidance, which was lower in turn than the accuracy obtained by the autonomous GPS guidance; the computed standard deviations of error to the desired trajectory in the straight line were 16 cm, 9 cm, and 4 cm, respectively. Since the standard deviation between the manual guidance and the EMG-based HMI guidance differed only 7 cm, and this difference is not relevant in agricultural steering, it can be concluded that it is possible to steer a tractor by an EMG-based HMI with almost the same accuracy as with manual steering.

An explicit solution to the exoatmospheric powered flight guidance and trajectory optimization problem for rocket propelled vehicles

NASA Technical Reports Server (NTRS)

Jaggers, R. F.

1977-01-01

A derivation of an explicit solution to the two point boundary-value problem of exoatmospheric guidance and trajectory optimization is presented. Fixed initial conditions and continuous burn, multistage thrusting are assumed. Any number of end conditions from one to six (throttling is required in the case of six) can be satisfied in an explicit and practically optimal manner. The explicit equations converge for off nominal conditions such as engine failure, abort, target switch, etc. The self starting, predictor/corrector solution involves no Newton-Rhapson iterations, numerical integration, or first guess values, and converges rapidly if physically possible. A form of this algorithm has been chosen for onboard guidance, as well as real time and preflight ground targeting and trajectory shaping for the NASA Space Shuttle Program.

2005 ACGIH Lifting TLV: Employee-Friendly Presentation and Guidance for Professional Judgment

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

Splittstoesser, Riley; O'Farrell, Daniel Edward; Hill, John

The American Council of Governmental Industrial Hygienists (ACGIH) Lifting Threshold Limit Values (TLVs) provide a tool to reduce incidence of low back and shoulder injuries. However, application of the TLV is too complicated for floor-level workers and relies on professional judgment to assess commonly encountered tasks. This paper presents an Employee-Friendly Simplified Format of the TLV that has been adapted from Table 1 of the Lifting TLV presented in the 2005 TLVs and BEIs Based on the Documentation of the Threshold Limit Values for Chemical Substances and Physical Agents & Biological Exposure Indices. This simplified format can be employed bymore » floor-level workers to self-assess lifting tasks. The Ergonomics Project Team also provides research-based guidance for applying professional judgment consistent with standard industry practice: Extended Work Shifts – Reduce weight by 20% for shifts lasting 8 to 12 hours; Constrained Lower Body Posture – Reduce weight by 25% when lifting in such postures; Infrequently Performed Lifts – Lift up to 15 lbs. ≤3 lifts per hour within the zones marked “No safe limit for repetitive lifting” in the TLVs Table 1; Asymmetry beyond 30° – Reduce weight by 10 lbs. for lifts with up to 60° asymmetry from sagittal plane.« less

Controls for Reusable Launch Vehicles During Terminal Area Energy Management

NASA Technical Reports Server (NTRS)

Driessen, Brian J.

2005-01-01

During the terminal energy management phase of flight (last of three phases) for a reusable launch vehicle, it is common for the controller to receive guidance commands specifying desired values for (i) the roll angle roll q(sub roll), (ii) the acceleration a(sub n) in the body negative z direction, -k(sub A)-bar, and (iii) omega(sub 3), the projection of onto the body-fixed axis k(sub A)-bar, is always indicated by guidance to be zero. The objective of the controller is to regulate the actual values of these three quantities, i.e make them close to the commanded values, while maintaining system stability.

Does Methodological Guidance Produce Consistency? A Review of Methodological Consistency in Breast Cancer Utility Value Measurement in NICE Single Technology Appraisals.

PubMed

Rose, Micah; Rice, Stephen; Craig, Dawn

2018-06-01

Since 2004, National Institute for Health and Care Excellence (NICE) methodological guidance for technology appraisals has emphasised a strong preference for using the validated EuroQol 5-Dimensions (EQ-5D) quality-of-life instrument, measuring patient health status from patients or carers, and using the general public's preference-based valuation of different health states when assessing health benefits in economic evaluations. The aim of this study was to review all NICE single technology appraisals (STAs) for breast cancer treatments to explore consistency in the use of utility scores in light of NICE methodological guidance. A review of all published breast cancer STAs was undertaken using all publicly available STA documents for each included assessment. Utility scores were assessed for consistency with NICE-preferred methods and original data sources. Furthermore, academic assessment group work undertaken during the STA process was examined to evaluate the emphasis of NICE-preferred quality-of-life measurement methods. Twelve breast cancer STAs were identified, and many STAs used evidence that did not follow NICE's preferred utility score measurement methods. Recent STA submissions show companies using EQ-5D and mapping. Academic assessment groups rarely emphasized NICE-preferred methods, and queries about preferred methods were rare. While there appears to be a trend in recent STA submissions towards following NICE methodological guidance, historically STA guidance in breast cancer has generally not used NICE's preferred methods. Future STAs in breast cancer and reviews of older guidance should ensure that utility measurement methods are consistent with the NICE reference case to help produce consistent, equitable decision making.

TIM Version 3.0 beta Technical Description and User Guide - Appendix A - User's Guidance for TIM v.3.0(beta)

EPA Pesticide Factsheets

Provides detailed guidance to the user on how to select input parameters for running the Terrestrial Investigation Model (TIM) and recommendations for default values that can be used when no chemical-specific or species-specific information are available.

Revision of the APGEMS Dose Conversion Factor File Using Revised Factors from Federal Guidance Report 12 and 13.

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

Hay, Tristan R.; Rishel, Jeremy P.

2013-09-30

The Air Pollutant Graphical Environmental Monitoring System (APGEMS) is used by the Hanford Emergency Operation Center (EOC) to provide refined plume modeling of releases involving radionuclides. The dose conversion factors (DCFs) used by APGEMS to convert air concentration to dose are stored in a file called HUDUFACT.dat; the DCFs are based primarily on ICRP 30 compiled in the late 1980’s. This report updates the DCFs using more recent values reported in the Environmental Protection Agencies (EPAs) Federal Guidance Report (FGR) 12 and 13. FGR 12 provides external exposure (air submersion) DCFs for radionuclides in air; FGR 13 provides DCFs formore » radionuclides from inhalation. DCFs were updated for only those radionuclides listed in the original HUDUFACT.dat file. Since FGR 13 provides inhalation dose conversion factors as a function of age, revised DCF files were created for APGEMS for each age group. The “adult” DCF file is the most relevant to compare to the original DCF file being used in APGEMS; these DCF values are compared in this report.« less

Guidance values for microcystins in water and cyanobacterial supplement products (blue-green algal supplements): a reasonable or misguided approach?

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

Dietrich, Daniel; Hoeger, Stefan

2005-03-15

This article reviews current scientific knowledge on the toxicity and carcinogenicity of microcystins and compares this to the guidance values proposed for microcystins in water by the World Health Organization, and for blue-green algal food supplements by the Oregon State Department of Health. The basis of the risk assessment underlying these guidance values is viewed as being critical due to overt deficiencies in the data used for its generation: (i) use of one microcystin congener only (microcystin-LR), while the other presently known nearly 80 congeners are largely disregarded, (ii) new knowledge regarding potential neuro and renal toxicity of microcystins inmore » humans and (iii) the inadequacies of assessing realistic microcystin exposures in humans and especially in children via blue-green algal food supplements. In reiterating the state-of-the-art toxicology database on microcystins and in the light of new data on the high degree of toxin contamination of algal food supplements, this review clearly demonstrates the need for improved kinetic data of microcystins in humans and for discussion concerning uncertainty factors, which may result in a lowering of the present guidance values and an increased routine control of water bodies and food supplements for toxin contamination. Similar to the approach taken previously by authorities for dioxin or PCB risk assessment, the use of a toxin equivalent approach to the risk assessment of microcystins is proposed.« less

Guidance concepts for time-based flight operations

NASA Technical Reports Server (NTRS)

Vicroy, Dan D.

1990-01-01

Airport congestion and the associated delays are severe in today's airspace system and are expected to increase. NASA and the FAA is investigating various methods of alleviating this problem through new technology and operational procedures. One concept for improving airspace productivity is time-based control of aircraft. Research to date has focused primarily on the development of time-based flight management systems and Air Traffic Control operational procedures. Flight operations may, however, require special onboard guidance in order to satisfy the Air Traffic Control imposed time constraints. The results are presented of a simulation study aimed at evaluating several time-based guidance concepts in terms of tracking performance, pilot workload, and subjective preference. The guidance concepts tested varied in complexity from simple digital time-error feedback to an advanced time-referenced-energy guidance scheme.

Derivation of a chemical-specific adjustment factor (CSAF) for use in the assessment of risk from chronic exposure to ethylene glycol: Application of international programme for chemical safety guidelines

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

Palmer, Robert B.; Brent, Jeffrey

2005-09-01

The International Programme for Chemical Safety (IPCS) has developed a set of guidelines ('the Guidance') for the establishment of Chemical-Specific Adjustment Factors (CSAFs) for in the assessment of toxicity risk to the human population as a result of chemical exposure. The development of case studies is encouraged in the Guidance document and comments on them have been encouraged by the IPCS. One provision in the Guidance is for the determination of CSAFs based on human data. We present a case study of the use of the Guidance for the determination of the CSAF for ethylene glycol (EG) primarily utilizing clinicallymore » obtained data. The most relevant endpoint for this analysis was deemed to be acute renal injury. These data were applied based on an assessment of the known pharmaco/toxico-kinetic properties of EG. Because of the lack of both bioaccumulation of EG and reports of chronic or progressive renal injury from EG, it was concluded that the most appropriate model of chronic exposure is one of repeated acute episodes. The most relevant exposure metric was determined to be plasma glycolate concentration. Based on a prospective human study of EG-poisoned patients, the NOAEL for glycolate was found to be 10.1 mM. This value is similar to that obtained from animal data. The application of the Guidelines to this data resulted in a CSAF of 10.24, corresponding to a daily EG dose of 43.7 mg/kg/day. In 2000, Health Canada (HC) produced an animal data-based analysis of the maximum tolerated dose of EG. The results of our analysis are compared with those of HC, and the strengths and weaknesses of these two data types related to EG are discussed.« less

Residential surface soil guidance values applied worldwide to the original 2001 Stockholm Convention POP pesticides.

PubMed

Jennings, Aaron A; Li, Zijian

2015-09-01

Surface soil contamination is a worldwide problem. Many regulatory jurisdictions attempt to control human exposures with regulatory guidance values (RGVs) that specify a soil's maximum allowable concentration. Pesticides are important soil contaminants because of their intentional toxicity and widespread surface soil application. Worldwide, at least 174 regulatory jurisdictions from 54 United Nations member states have published more than 19,400 pesticide RGVs for at least 739 chemically unique pesticides. This manuscript examines the variability of the guidance values that are applied worldwide to the original 2001 Stockholm Convention persistent organic pollutants (POP) pesticides (Aldrin, Chlordane, DDT, Dieldrin, Endrin, Heptachlor, Mirex, and Toxaphene) for which at least 1667 RGVs have been promulgated. Results indicate that the spans of the RGVs applied to each of these pesticides vary from 6.1 orders of magnitude for Toxaphene to 10.0 orders of magnitude for Mirex. The distribution of values across these value spans resembles the distribution of lognormal random variables, but also contain non-random value clusters. Approximately 40% of all the POP RGVs fall within uncertainty bounds computed from the U.S. Environmental Protection Agency (USEPA) RGV cancer risk model. Another 22% of the values fall within uncertainty bounds computed from the USEPA's non-cancer risk model, but the cancer risk calculations yield the binding (lowest) value for all POP pesticides except Endrin. The results presented emphasize the continued need to rationalize the RGVs applied worldwide to important soil contaminants. Copyright © 2015 Elsevier Ltd. All rights reserved.

When product designers use perceptually based color tools

NASA Astrophysics Data System (ADS)

Bender, Walter R.

1998-07-01

Palette synthesis and analysis tools have been built based upon a model of color experience. This model adjusts formal compositional elements such as hue, value, chroma, and their contrasts, as well as size and proportion. Clothing and household product designers were given these tools to give guidance to their selection of seasonal palettes for use in production of the private-label merchandise of a large retail chain. The designers chose base palettes. Accents to these palettes were generated with and without the aid of the color tools. These palettes are compared by using perceptual metrics and interviews. The results are presented.

Parenting Needs of Urban, African American Fathers.

PubMed

Smith, Tyler K; Tandon, S Darius; Bair-Merritt, Megan H; Hanson, Janice L

2015-07-01

Fathers play a critical role in children's development; similarly, fatherhood positively affects men's health. Among the larger population of fathers relatively little is known about the parenting knowledge of urban, African American fathers. Focusing on urban, African American fathers, the objectives of this study were to (1) understand the primary sources from which fathers learn about parenting, (2) determine where and how fathers prefer to receive future parenting education, and (3) explore the information perceived as most valuable to fathers and how this compares with the recommended anticipatory guidance (Bright Futures-based) delivered during well visits. Five focus groups, with a total of 21 participants, were conducted with urban fathers at a community-based organization. Study eligibility included being more than 18 years old, English speaking, and having at least one child 0 to 5 years old. During the focus groups, fathers were asked where they received parenting information, how and where they preferred to receive parenting information, and what they thought about Bright Futures parenting guidelines. Fathers most commonly described receiving parenting information from their own relatives rather than from their child's health care provider. Most fathers preferred to learn parenting from a person rather than a technology-based source and expressed interest in learning more about parenting at community-based locations. Although fathers viewed health care providers' role as primarily teaching about physical health, they valued Bright Futures anticipatory guidance about parenting. Fathers valued learning about child rearing, health, and development. Augmenting physician counseling about Bright Futures with community-based parenting education may be beneficial for fathers. © The Author(s) 2014.

Taxonomy of instructions given to residents in laparoscopic cholecystectomy.

PubMed

Feng, Yuanyuan; Wong, Christopher; Park, Adrian; Mentis, Helena

2016-03-01

Although simulation-based training allows residents to become proficient in surgical skills outside the OR, residents still depend on senior surgeons' guidance in transferring skills accumulated from simulators into the operating room. This study aimed to identify and classify explicit instructions made by attending surgeons to their residents during laparoscopic surgery. Through these instructions, we examined the role gaze guidance plays in OR-based training. A total of ten laparoscopic cholecystectomy cases being performed by PGY4 residents were analyzed. The explicit directional instructions given by the mentoring attending surgeons to their residents were identified and classified into four categories based on their locations in the coordinate system. These categories were further combined into two classes, based on the target of instructions. The frequencies of instructions in the two classes were compared, and effect size was calculated. There were 1984 instructions identified in the ten cases. The instructions were categorized into instrument guidance (38.51%) and gaze guidance (61.49%). The instrument guidance focused on moving the instruments to perform surgical tasks, including directions to targets, instrument manipulation, and instrument interaction. The gaze guidance focused on achieving common ground during the operation, including target identification and target fixation. The frequency of gaze guidance is significantly higher than instrument guidance in a laparoscopic cholecystectomy (p < 0.001) with a large effect size (r = 0.6). Gaze guidance has become the main focus of OR-based training. The results show a tight connection between adopting expert gaze and performing surgical tasks and suggest that gaze training should be integrated into the simulation training.

Measuring Unmet Needs for Anticipatory Guidance Among Adolescents at School-Based Health Centers.

PubMed

Ramos, Mary M; Sebastian, Rachel A; Stumbo, Scott P; McGrath, Jane; Fairbrother, Gerry

2017-06-01

Our previously validated Youth Engagement with Health Services survey measures adolescent health care quality. The survey response format allows adolescents to indicate whether their needs for anticipatory guidance were met. Here, we describe the unmet needs for anticipatory guidance reported by adolescents and identify adolescent characteristics related to unmet needs for guidance. We administered the survey in 2013-2014 to 540 adolescents who used school-based health centers in Colorado and New Mexico. A participant was considered to have unmet needs for anticipatory guidance if they indicated that guidance was needed on a given topic but not received or guidance was received that did not meet their needs. We calculated proportions of students with unmet needs for guidance and examined associations between unmet needs for guidance and participant characteristics using the chi-square test and logistic regression. Among participants, 47.4% reported at least one unmet need for guidance from a health care provider in the past year. Topics with the highest proportions of adolescents reporting unmet needs included healthy diet (19.5%), stress (18.0%), and body image (17.0%). In logistic regression modeling, adolescents at risk for depression and those with minority or immigrant status had increased unmet needs for guidance. Adolescents reporting receipt of patient-centered care were less likely to report unmet needs for guidance. The Youth Engagement with Health Services survey provides needs-based measurement of anticipatory guidance received that may support targeted improvements in the delivery of adolescent preventive counseling. Interventions to improve patient-centered care and preventive counseling for vulnerable youth populations may be warranted. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Research-Based Knowledge: Researchers' Contribution to Evidence-Based Practice and Policy Making in Career Guidance

ERIC Educational Resources Information Center

Haug, Erik Hagaseth; Plant, Peter

2016-01-01

To present evidence for the outcomes of career guidance is increasingly seen as pivotal for a further professionalization of policy making and service provision. This paper puts an emphasis on researchers' contribution to evidence-based practice and policy making in career guidance. We argue for a broader and more pluralistic research strategy to…

Experimental Guidance for Isospin Symmetry Breaking Calculations via Single Neutron Pickup Reactions

NASA Astrophysics Data System (ADS)

Leach, K. G.; Garrett, P. E.; Bangay, J. C.; Bianco, L.; Demand, G. A.; Finlay, P.; Green, K. L.; Phillips, A. A.; Rand, E. T.; Sumithrarachchi, C. S.; Svensson, C. E.; Triambak, S.; Wong, J.; Ball, G.; Faestermann, T.; Krücken, R.; Hertenberger, R.; Wirth, H.-F.; Towner, I. S.

2013-03-01

Recent activity in superallowed isospin-symmetry-breaking correction calculations has prompted interest in experimental confirmation of these calculation techniques. The shellmodel set of Towner and Hardy (2008) include the opening of specific core orbitals that were previously frozen. This has resulted in significant shifts in some of the δC values, and an improved agreement of the individual corrected {F}t values with the adopted world average of the 13 cases currently included in the high-precision evaluation of Vud. While the nucleus-to-nucleus variation of {F}t is consistent with the conserved-vector-current (CVC) hypothesis of the Standard Model, these new calculations must be thoroughly tested, and guidance must be given for their improvement. Presented here are details of a 64Zn(ěcd, t)63Zn experiment, undertaken to provide such guidance.

Room to Grow; Career Guidance in Elementary School.

ERIC Educational Resources Information Center

Faust, Helen F.; And Others

Room to Grow is a career guidance program for children ages nine to twelve years. Conditions given attention to in this program are: (1) family attitudes and values, (2) socioeconomic conditions, (3) educational expectations, and (4) development of self concept. A general introduction to the program is presented. Fifteen projects for the teacher…

Ultrasound-Based Guidance for Partial Breast Irradiation Therapy

DTIC Science & Technology

2012-01-01

displace- 0278-0062/$20.00 © IEEE Authorized licensed use limited to: IEEE Xplore . Downloaded on January 5, 2009 at 17:37 from IEEE Xplore . Restrictions...Authorized licensed use limited to: IEEE Xplore . Downloaded on January 5, 2009 at 17:37 from IEEE Xplore . Restrictions apply. RIVAZ et al...better CNR values: the Authorized licensed use limited to: IEEE Xplore . Downloaded on January 5, 2009 at 17:37 from IEEE Xplore . Restrictions apply

A weak Hamiltonian finite element method for optimal guidance of an advanced launch vehicle

NASA Technical Reports Server (NTRS)

Hodges, Dewey H.; Calise, Anthony J.; Bless, Robert R.; Leung, Martin

1989-01-01

A temporal finite-element method based on a mixed form of the Hamiltonian weak principle is presented for optimal control problems. The mixed form of this principle contains both states and costates as primary variables, which are expanded in terms of nodal values and simple shape functions. Time derivatives of the states and costates do not appear in the governing variational equation; the only quantities whose time derivatives appear therein are virtual states and virtual costates. Numerical results are presented for an elementary trajectory optimization problem; they show very good agreement with the exact solution along with excellent computational efficiency and self-starting capability. The feasibility of this approach for real-time guidance applications is evaluated. A simplified model for an advanced launch vehicle application that is suitable for finite-element solution is presented.

Computer-based Written Emotional Disclosure: The Effects of Advance or Real-time Guidance and Moderation by Big 5 Personality Traits

PubMed Central

Beyer, Jonathan A.; Lumley, Mark A.; Latsch, Deborah A.; Oberleitner, Lindsay M.S.; Carty, Jennifer N.; Radcliffe, Alison M.

2014-01-01

Standard written emotional disclosure (WED) about stress, which is private and unguided, yields small health benefits. The effect of providing individualized guidance to writers may enhance WED, but has not been tested. This trial of computer-based WED compared two novel therapist-guided forms of WED—advance guidance (before sessions) or real-time guidance (during sessions, through instant messaging)—to both standard WED and control writing; it also tested Big 5 personality traits as moderators of guided WED. Young adult participants (n = 163) with unresolved stressful experiences were randomized to conditions, had three, 30-min computer-based writing sessions, and were reassessed 6 weeks later. Contrary to hypotheses, real-time guidance WED had poorer outcomes than the other conditions on several measures, and advance guidance WED also showed some poorer outcomes. Moderator analyses revealed that participants with low baseline agreeableness, low extraversion, or high conscientiousness had relatively poor responses to guidance. We conclude that providing guidance for WED, especially in real-time, may interfere with emotional processing of unresolved stress, particularly for people whose personalities have poor fit with this interactive form of WED. PMID:24266598

Aid Professional Growth. Module CG D-2 of Category D--Operating. Competency-Based Career Guidance Modules.

ERIC Educational Resources Information Center

Ruff, Eldon E.

This learning module, one in a series of competency-based guidance program training packages focusing upon professional and paraprofessional competencies of guidance personnel, deals with aiding professional growth. Addressed in the module are the following topics: assessing competencies; determining certification, licensure, and registration…

Effectiveness of Stellate Ganglion Block Under Fuoroscopy or Ultrasound Guidance in Upper Extremity CRPS.

PubMed

Imani, Farnad; Hemati, Karim; Rahimzadeh, Poupak; Kazemi, Mohamad Reza; Hejazian, Kokab

2016-01-01

Stellate Ganglion Block (SGB) is an effective technique which may be used to manage upper extremities pain due to Chronic Regional Pain Syndrome (CRPS), in this study we tried to evaluate the effectiveness of this procedure under two different guidance for management of this syndrome. The purpose of this study was to evaluate the effectiveness of ultrsound guide SGB by comparing it with the furoscopy guided SGB in upper extermities CRPS patients in reducing pain & dysfuction of the affected link. Fourteen patients with sympathetic CRPS in upper extremities in a randomized method with block randomization divided in two equal groups (with ultrasound or fluoroscopic guidance). First group was blocked under fluoroscopic guidance and second group blocked under ultrasound guidance. After correct positioning of the needle, a mixture of 5 ml bupivacaine 0.25% and 1 mL of triamcinolone was injected. These data represent no meaningful statistical difference between the two groups in terms of the number of pain attacks before the blocks, a borderline correlation between two groups one week and one month after the block and a significant statistical correlation between two groups three month after the block. These data represent no meaningful statistical difference between the patients of any group in terms of the pain intensity (from one week to six months after block), p-value = 0.61. These data represent a meaningful statistical difference among patients of any group and between the two groups in terms of the pain intensity (before the block until six months after block), p-values were 0.001, 0.031 respectively. According the above mentioned data, in comparison with fluoroscopic guidance, stellate ganglion block under ultrasound guidance is a safe and effective method with lower complication and better improvement in patient's disability indexes.

Accurate predictor-corrector skip entry guidance for low lift-to-drag ratio spacecraft

NASA Astrophysics Data System (ADS)

Enmi, Y.; Qian, W.; He, K.; Di, D.

2018-06-01

This paper develops numerical predictor-corrector skip en try guidance for vehicles with low lift-to-drag L/D ratio during the skip entry phase of a Moon return mission. The guidance method is composed of two parts: trajectory planning before entry and closed-loop gu idance during skip entry. The result of trajectory planning before entry is able to present an initial value for predictor-corrector algorithm in closed-loop guidance for fast convergence. The magnitude of bank angle, which is parameterized as a linear function of the range-to-go, is modulated to satisfy the downrange requirements. The sign of the bank ang le is determined by the bank-reversal logic. The predictor-corrector algorithm repeatedly applied onboard in each guidance cycle to realize closed-loop guidance in the skip entry phase. The effectivity of the proposed guidance is validated by simulations in nominal conditions, including skip entry, loft entry, and direct entry, as well as simulations in dispersion conditions considering the combination disturbance of the entry interface, the aerodynamic coefficients, the air density, and the mass of the vehicle.

A higher chest compression rate may be necessary for metronome-guided cardiopulmonary resuscitation.

PubMed

Chung, Tae Nyoung; Kim, Sun Wook; You, Je Sung; Cho, Young Soon; Chung, Sung Phil; Park, Incheol

2012-01-01

Metronome guidance is a simple and economical feedback system for guiding cardiopulmonary resuscitation (CPR). However, a recent study showed that metronome guidance reduced the depth of chest compression. The results of previous studies suggest that a higher chest compression rate is associated with a better CPR outcome as compared with a lower chest compression rate, irrespective of metronome use. Based on this finding, we hypothesized that a lower chest compression rate promotes a reduction in chest compression depth in the recent study rather than metronome use itself. One minute of chest compression-only CPR was performed following the metronome sound played at 1 of 4 different rates: 80, 100, 120, and 140 ticks/min. Average compression depths (ACDs) and duty cycles were compared using repeated measures analysis of variance, and the values in the absence and presence of metronome guidance were compared. Both the ACD and duty cycle increased when the metronome rate increased (P = .017, <.001). Average compression depths for the CPR procedures following the metronome rates of 80 and 100 ticks/min were significantly lower than those for the procedures without metronome guidance. The ACD and duty cyle for chest compression increase as the metronome rate increases during metronome-guided CPR. A higher rate of chest compression is necessary for metronome-guided CPR to prevent suboptimal quality of chest compression. Copyright © 2012 Elsevier Inc. All rights reserved.

Human Health Toxicity Values in Superfund Risk Assessments

EPA Pesticide Factsheets

This memorandum revises the hierarchy of human health toxicity values generally recommended for use inr isk assessments, originally presented in Risk Assessment Guidance for Superfund Volume I, Part A.

Use Of Value Engineering For Engineering And Design Of Airport Grant Projects

DOT National Transportation Integrated Search

1993-09-09

This advisory circular (AC) provides guidance for the use of value engineering : (VE) in airport projects funded under the Federal Aviation Administration's : (FAA) Airport Grant Program. Department of Transportation (DOT) Order 1395.1, : Use of Valu...

Exploring the Use of Individualized, Reflective Guidance In an Educational Multi-User Virtual Environment

NASA Astrophysics Data System (ADS)

Nelson, Brian C.

2007-02-01

This study examines the patterns of use and potential impact of individualized, reflective guidance in an educational Multi-User Virtual Environment (MUVE). A guidance system embedded within a MUVE-based scientific inquiry curriculum was implemented with a sample of middle school students in an exploratory study investigating (a) whether access to the guidance system was associated with improved learning, (b) whether students viewing more guidance messages saw greater improvement on content tests than those viewing less, and (c) whether there were any differences in guidance use among boys and girls. Initial experimental findings showed that basic access to individualized guidance used with a MUVE had no measurable impact on learning. However, post-hoc exploratory analyses indicated that increased use of the system among those with access to it was positively associated with content test score gains. In addition, differences were found in overall learning outcomes by gender and in patterns of guidance use by boys and girls, with girls outperforming boys across a spectrum of guidance system use. Based on these exploratory findings, the paper suggests design guidelines for the development of guidance systems embedded in MUVEs and outlines directions for further research.

78 FR 48173 - Guidance for Industry on Oversight of Clinical Investigations-A Risk-Based Approach to Monitoring...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-07

...] Guidance for Industry on Oversight of Clinical Investigations--A Risk-Based Approach to Monitoring... Administration (FDA) is announcing the availability of a guidance for industry entitled ``Oversight of Clinical... monitoring strategies and plans for clinical investigations of human drugs, biologics, medical devices, and...

HOW STUDENTS USE VALUES IN DECISION-MAKING.

ERIC Educational Resources Information Center

VARENHORST, BARBARA B.

HIGH SCHOOL STUDENTS ARE EXAMINING AND INTERNALIZING VALUES. THEIR FEAR OF COMMITMENT TO ANYTHING DEVIATING FROM ACCEPTED VALUES MAY HINDER THEIR CLARIFICATION OF PERSONAL GOALS AND VALUES. THE DECISION-MAKING PROCESS SHOULD BE AN IMPORTANT PART OF THE GUIDANCE PROGRAM. STANDARD QUESTIONNAIRES DO NOT PROVIDE INFORMATION ABOUT SPECIFIC FACTORS…

Assessment of an extended dataset of in vitro human dermal absorption studies on pesticides to determine default values, opportunities for read-across and influence of dilution on absorption.

PubMed

Aggarwal, M; Fisher, P; Hüser, A; Kluxen, F M; Parr-Dobrzanski, R; Soufi, M; Strupp, C; Wiemann, C; Billington, R

2015-06-01

Dermal absorption is a key parameter in non-dietary human safety assessments for agrochemicals. Conservative default values and other criteria in the EFSA guidance have substantially increased generation of product-specific in vitro data and in some cases, in vivo data. Therefore, data from 190 GLP- and OECD guideline-compliant human in vitro dermal absorption studies were published, suggesting EFSA defaults and criteria should be revised (Aggarwal et al., 2014). This follow-up article presents data from an additional 171 studies and also the combined dataset. Collectively, the data provide consistent and compelling evidence for revision of EFSA's guidance. This assessment covers 152 agrochemicals, 19 formulation types and representative ranges of spray concentrations. The analysis used EFSA's worst-case dermal absorption definition (i.e., an entire skin residue, except for surface layers of stratum corneum, is absorbed). It confirmed previously proposed default values of 6% for liquid and 2% for solid concentrates, irrespective of active substance loading, and 30% for all spray dilutions, irrespective of formulation type. For concentrates, absorption from solvent-based formulations provided reliable read-across for other formulation types, as did water-based products for solid concentrates. The combined dataset confirmed that absorption does not increase linearly beyond a 5-fold increase in dilution. Finally, despite using EFSA's worst-case definition for absorption, a rationale for routinely excluding the entire stratum corneum residue, and ideally the entire epidermal residue in in vitro studies, is presented. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Guidance and Control Architecture Design and Demonstration for Low Ballistic Coefficient Atmospheric Entry

NASA Technical Reports Server (NTRS)

Swei, Sean

2014-01-01

We propose to develop a robust guidance and control system for the ADEPT (Adaptable Deployable Entry and Placement Technology) entry vehicle. A control-centric model of ADEPT will be developed to quantify the performance of candidate guidance and control architectures for both aerocapture and precision landing missions. The evaluation will be based on recent breakthroughs in constrained controllability/reachability analysis of control systems and constrained-based energy-minimum trajectory optimization for guidance development operating in complex environments.

Guidance and New Education for Schools.

ERIC Educational Resources Information Center

Sprinthall, Norman A.

1980-01-01

Details rationale for broad-based school reform including examination of old guidance. General curriculum of schools must include psychological growth as direct object of classroom instruction. Effective guidance role can alter classroom teaching strategies and curriculum content. Guidance theory and practice should lead in seeking school reforms.…

SUPPORTING THE INDUSTRY BY DEVELOPING A DESIGN GUIDANCE FOR COMPUTER-BASED PROCEDURES FOR FIELD WORKERS

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

Oxstrand, Johanna; LeBlanc, Katya

The paper-based procedures currently used for nearly all activities in the commercial nuclear power industry have a long history of ensuring safe operation of the plants. However, there is potential to greatly increase efficiency and safety by improving how the human interacts with the procedures, which can be achieved through the use of computer-based procedures (CBPs). A CBP system offers a vast variety of improvements, such as context driven job aids, integrated human performance tools and dynamic step presentation. As a step toward the goal of improving procedure use performance, the U.S. Department of Energy Light Water Reactor Sustainability Programmore » researchers, together with the nuclear industry, have been investigating the possibility and feasibility of replacing current paper-based procedures with CBPs. The main purpose of the CBP research conducted at the Idaho National Laboratory was to provide design guidance to the nuclear industry to be used by both utilities and vendors. After studying existing design guidance for CBP systems, the researchers concluded that the majority of the existing guidance is intended for control room CBP systems, and does not necessarily address the challenges of designing CBP systems for instructions carried out in the field. Further, the guidance is often presented on a high level, which leaves the designer to interpret what is meant by the guidance and how to specifically implement it. The authors developed a design guidance to provide guidance specifically tailored to instructions that are carried out in the field based.« less

Five features of value-based insurance design plans were associated with higher rates of medication adherence.

PubMed

Choudhry, Niteesh K; Fischer, Michael A; Smith, Benjamin F; Brill, Gregory; Girdish, Charmaine; Matlin, Olga S; Brennan, Troyen A; Avorn, Jerry; Shrank, William H

2014-03-01

Value-based insurance design (VBID) plans selectively lower cost sharing to increase medication adherence. Existing plans have been structured in a variety of ways, and these variations could influence the effectiveness of VBID plans. We evaluated seventy-six plans introduced by a large pharmacy benefit manager during 2007-10. We found that after we adjusted for the other features and baseline trends, VBID plans that were more generous, targeted high-risk patients, offered wellness programs, did not offer disease management programs, and made the benefit available only for medication ordered by mail had a significantly greater impact on adherence than plans without these features. The effects were as large as 4-5 percentage points. These findings can provide guidance for the structure of future VBID plans.

Ultrasound Guidance for Botulinum Neurotoxin Chemodenervation Procedures.

PubMed

Alter, Katharine E; Karp, Barbara I

2017-12-28

Injections of botulinum neurotoxins (BoNTs) are prescribed by clinicians for a variety of disorders that cause over-activity of muscles; glands; pain and other structures. Accurately targeting the structure for injection is one of the principle goals when performing BoNTs procedures. Traditionally; injections have been guided by anatomic landmarks; palpation; range of motion; electromyography or electrical stimulation. Ultrasound (US) based imaging based guidance overcomes some of the limitations of traditional techniques. US and/or US combined with traditional guidance techniques is utilized and or recommended by many expert clinicians; authors and in practice guidelines by professional academies. This article reviews the advantages and disadvantages of available guidance techniques including US as well as technical aspects of US guidance and a focused literature review related to US guidance for chemodenervation procedures including BoNTs injection.

Dedicated cardiac rehabilitation wearable sensor and its clinical potential.

PubMed

Lee, Hooseok; Chung, Heewon; Ko, Hoon; Jeong, Changwon; Noh, Se-Eung; Kim, Chul; Lee, Jinseok

2017-01-01

We describe a wearable sensor developed for cardiac rehabilitation (CR) exercise. To effectively guide CR exercise, the dedicated CR wearable sensor (DCRW) automatically recommends the exercise intensity to the patient by comparing heart rate (HR) measured in real time with a predefined target heart rate zone (THZ) during exercise. The CR exercise includes three periods: pre-exercise, exercise with intensity guidance, and post-exercise. In the pre-exercise period, information such as THZ, exercise type, exercise stage order, and duration of each stage are set up through a smartphone application we developed for iPhones and Android devices. The set-up information is transmitted to the DCRW via Bluetooth communication. In the period of exercise with intensity guidance, the DCRW continuously estimates HR using a reflected pulse signal in the wrist. To achieve accurate HR measurements, we used multichannel photo sensors and increased the chances of acquiring a clean signal. Subsequently, we used singular value decomposition (SVD) for de-noising. For the median and variance of RMSEs in the measured HRs, our proposed method with DCRW provided lower values than those from a single channel-based method and template-based multiple-channel method for the entire exercise stage. In the post-exercise period, the DCRW transmits all the measured HR data to the smartphone application via Bluetooth communication, and the patient can monitor his/her own exercise history.

Simulating an underwater vehicle self-correcting guidance system with Simulink

NASA Astrophysics Data System (ADS)

Fan, Hui; Zhang, Yu-Wen; Li, Wen-Zhe

2008-09-01

Underwater vehicles have already adopted self-correcting directional guidance algorithms based on multi-beam self-guidance systems, not waiting for research to determine the most effective algorithms. The main challenges facing research on these guidance systems have been effective modeling of the guidance algorithm and a means to analyze the simulation results. A simulation structure based on Simulink that dealt with both issues was proposed. Initially, a mathematical model of relative motion between the vehicle and the target was developed, which was then encapsulated as a subsystem. Next, steps for constructing a model of the self-correcting guidance algorithm based on the Stateflow module were examined in detail. Finally, a 3-D model of the vehicle and target was created in VRML, and by processing mathematical results, the model was shown moving in a visual environment. This process gives more intuitive results for analyzing the simulation. The results showed that the simulation structure performs well. The simulation program heavily used modularization and encapsulation, so has broad applicability to simulations of other dynamic systems.

Design of virtual simulation experiment based on key events

NASA Astrophysics Data System (ADS)

Zhong, Zheng; Zhou, Dongbo; Song, Lingxiu

2018-06-01

Considering complex content and lacking of guidance in virtual simulation experiments, the key event technology in VR narrative theory was introduced for virtual simulation experiment to enhance fidelity and vividness process. Based on the VR narrative technology, an event transition structure was designed to meet the need of experimental operation process, and an interactive event processing model was used to generate key events in interactive scene. The experiment of" margin value of bees foraging" based on Biologic morphology was taken as an example, many objects, behaviors and other contents were reorganized. The result shows that this method can enhance the user's experience and ensure experimental process complete and effectively.

[WTP guidance technology: a comparison of payment card, single-bounded and double-bounded dichotomous formats for evaluating non-use values of Sanjiang Plain ecotourism water resources].

PubMed

Chen, Hong-Guang; Wang, Qiu-Dan; Li, Chen-Yang

2014-09-01

Contingent valuation method (CVM) is the most widespread method to assess resources and value of environmental goods and services. The guidance technology of willingness to pay (WTP) is an important means of CVM. Therefore, the study on the WTP guidance technology is an important approach to improve the reliability and validity of CVM. This article conducted comprehensive evaluation on non-use value of eco-tourism water resources in Sanjiang Plain by using payment card, single-bound dichotomous choice and double-bound dichotomous choice. Results showed that the socio-economic attributes were consistent with the willingness to pay in the three formats, and the tender value, age, educational level, annual income and the concern level had significant effect on the willingness to pay, while gender and job did not have significant influence. The WTP value was 112.46 yuan per capita with the payment card, 136.15 with the single-bound dichotomous choice, and 168.74 with the double-bound dichotomous choice. Comprehensive consideration of the nature of the investigation, investigation costs and statistical techniques, the result of double-bound dichotomous choice (47.86 x 10(8) yuan · a(-1)) was best in accordance with the reality, and could be used as non-use value of eco-tourism water resources in Sanjiang Plain. The format of questionnaire was very important to improve its validity, and made a great influence on the WTP.

Guidance Provided by Teacher and Simulation for Inquiry-Based Learning: A Case Study

ERIC Educational Resources Information Center

Lehtinen, Antti; Viiri, Jouni

2017-01-01

Current research indicates that inquiry-based learning should be guided in order to achieve optimal learning outcomes. The need for guidance is even greater when simulations are used because of their high information content and the difficulty of extracting information from them. Previous research on guidance for learning with simulations has…

Meta-Analysis of Inquiry-Based Learning: Effects of Guidance

ERIC Educational Resources Information Center

Lazonder, Ard W.; Harmsen, Ruth

2016-01-01

Research has consistently shown that inquiry-based learning can be more effective than other, more expository instructional approaches as long as students are supported adequately. But what type of guidance is adequate, and for whom? These questions are difficult to answer as most previous research has only focused on one type of guidance and one…

Maternal Knowledge and Behaviors regarding Discipline: The Effectiveness of a Hands-On Education Program in Positive Guidance

ERIC Educational Resources Information Center

Saunders, Rachel; McFarland-Piazza, Laura; Jacobvitz, Deborah; Hazen-Swann, Nancy; Burton, Rosalinda

2013-01-01

This study examined which method is most effective in supporting parents to use positive guidance techniques, a lecture-based only parent training series or a lecture-based plus hands-on parent training series. Maternal characteristics of depression, stress level, and attitudes towards positive guidance were explored as possible moderators. In…

Autonomous Guidance Strategy for Spacecraft Formations and Reconfiguration Maneuvers

NASA Astrophysics Data System (ADS)

Wahl, Theodore P.

A guidance strategy for autonomous spacecraft formation reconfiguration maneuvers is presented. The guidance strategy is presented as an algorithm that solves the linked assignment and delivery problems. The assignment problem is the task of assigning the member spacecraft of the formation to their new positions in the desired formation geometry. The guidance algorithm uses an auction process (also called an "auction algorithm''), presented in the dissertation, to solve the assignment problem. The auction uses the estimated maneuver and time of flight costs between the spacecraft and targets to create assignments which minimize a specific "expense'' function for the formation. The delivery problem is the task of delivering the spacecraft to their assigned positions, and it is addressed through one of two guidance schemes described in this work. The first is a delivery scheme based on artificial potential function (APF) guidance. APF guidance uses the relative distances between the spacecraft, targets, and any obstacles to design maneuvers based on gradients of potential fields. The second delivery scheme is based on model predictive control (MPC); this method uses a model of the system dynamics to plan a series of maneuvers designed to minimize a unique cost function. The guidance algorithm uses an analytic linearized approximation of the relative orbital dynamics, the Yamanaka-Ankersen state transition matrix, in the auction process and in both delivery methods. The proposed guidance strategy is successful, in simulations, in autonomously assigning the members of the formation to new positions and in delivering the spacecraft to these new positions safely using both delivery methods. This guidance algorithm can serve as the basis for future autonomous guidance strategies for spacecraft formation missions.

43 CFR 11.84 - Damage determination phase-implementation guidance.

Code of Federal Regulations, 2012 CFR

2012-10-01

... expected present value of the costs of restoration, rehabilitation, replacement, and/or acquisition of... be estimated in the form of an expected present value dollar amount. In order to perform this... estimate is the expected present value of uses obtained through restoration, rehabilitation, replacement...

43 CFR 11.84 - Damage determination phase-implementation guidance.

Code of Federal Regulations, 2013 CFR

2013-10-01

... expected present value of the costs of restoration, rehabilitation, replacement, and/or acquisition of... be estimated in the form of an expected present value dollar amount. In order to perform this... estimate is the expected present value of uses obtained through restoration, rehabilitation, replacement...

43 CFR 11.84 - Damage determination phase-implementation guidance.

Code of Federal Regulations, 2014 CFR

2014-10-01

... expected present value of the costs of restoration, rehabilitation, replacement, and/or acquisition of... be estimated in the form of an expected present value dollar amount. In order to perform this... estimate is the expected present value of uses obtained through restoration, rehabilitation, replacement...

Null Hypothesis Significance Testing and "p" Values

ERIC Educational Resources Information Center

Travers, Jason C.; Cook, Bryan G.; Cook, Lysandra

2017-01-01

"p" values are commonly reported in quantitative research, but are often misunderstood and misinterpreted by research consumers. Our aim in this article is to provide special educators with guidance for appropriately interpreting "p" values, with the broader goal of improving research consumers' understanding and interpretation…

SU-C-207B-03: A Geometrical Constrained Chan-Vese Based Tumor Segmentation Scheme for PET

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

Chen, L; Zhou, Z; Wang, J

Purpose: Accurate segmentation of tumor in PET is challenging when part of tumor is connected with normal organs/tissues with no difference in intensity. Conventional segmentation methods, such as thresholding or region growing, cannot generate satisfactory results in this case. We proposed a geometrical constrained Chan-Vese based scheme to segment tumor in PET for this special case by considering the similarity between two adjacent slices. Methods: The proposed scheme performs segmentation in a slice-by-slice fashion where an accurate segmentation of one slice is used as the guidance for segmentation of rest slices. For a slice that the tumor is not directlymore » connected to organs/tissues with similar intensity values, a conventional clustering-based segmentation method under user’s guidance is used to obtain an exact tumor contour. This is set as the initial contour and the Chan-Vese algorithm is applied for segmenting the tumor in the next adjacent slice by adding constraints of tumor size, position and shape information. This procedure is repeated until the last slice of PET containing tumor. The proposed geometrical constrained Chan-Vese based algorithm was implemented in Matlab and its performance was tested on several cervical cancer patients where cervix and bladder are connected with similar activity values. The positive predictive values (PPV) are calculated to characterize the segmentation accuracy of the proposed scheme. Results: Tumors were accurately segmented by the proposed method even when they are connected with bladder in the image with no difference in intensity. The average PPVs were 0.9571±0.0355 and 0.9894±0.0271 for 17 slices and 11 slices of PET from two patients, respectively. Conclusion: We have developed a new scheme to segment tumor in PET images for the special case that the tumor is quite similar to or connected to normal organs/tissues in the image. The proposed scheme can provide a reliable way for segmenting tumors.« less

Self-similarity Clustering Event Detection Based on Triggers Guidance

NASA Astrophysics Data System (ADS)

Zhang, Xianfei; Li, Bicheng; Tian, Yuxuan

Traditional method of Event Detection and Characterization (EDC) regards event detection task as classification problem. It makes words as samples to train classifier, which can lead to positive and negative samples of classifier imbalance. Meanwhile, there is data sparseness problem of this method when the corpus is small. This paper doesn't classify event using word as samples, but cluster event in judging event types. It adopts self-similarity to convergence the value of K in K-means algorithm by the guidance of event triggers, and optimizes clustering algorithm. Then, combining with named entity and its comparative position information, the new method further make sure the pinpoint type of event. The new method avoids depending on template of event in tradition methods, and its result of event detection can well be used in automatic text summarization, text retrieval, and topic detection and tracking.

Increasing the Value of Age: Guidance in Employers' Age Management Strategies. Research Paper No 44

ERIC Educational Resources Information Center

Cedefop - European Centre for the Development of Vocational Training, 2015

2015-01-01

The European active population is ageing. In the face of growing skills shortages, both national States and employers need to prolong the working lives of their most experienced workers. While enterprises strive to respond to this challenge, most still have not fully explored the potential of guidance activities in addressing age-related issues in…

The Effectiveness of Baby Books for Providing Pediatric Anticipatory Guidance to New Mothers

PubMed Central

Reich, Stephanie M.; Bickman, Leonard; Saville, Benjamin R.; Alvarez, JoAnn

2010-01-01

Objective To assess whether embedding pediatric anticipatory guidance into books read to babies is an effective way to educate low-income, first-time mothers about injury prevention and health promotion practices. Patients and Methods Primiparous women (n = 168) were randomly assigned to one of three groups; an educational book group, a non-educational book group, or a no book group. Knowledge of anticipatory guidance topics from birth to 12 months of age (e.g., injury prevention, parenting, nutrition) was assessed during the third trimester of pregnancy and again when infants were approximately 2, 4, 6, 9, 12, and 18 months of age. Results The educational book group scored consistently higher on knowledge than the other two groups. The educational book group was found to have significantly higher knowledge scores than both the non-educational book group (ES = .3, p-value < 0.001) and the no book group (ES = .3, p-value < 0.001) in the longitudinal model. Discussion Books read by mothers to babies appear to be an effective way to provide anticipatory guidance to new mothers. However, future work is needed to determine if increased knowledge translates into safer and more developmentally appropriate parenting practices. PMID:20385630

Adherence to Internet-Based Mobile-Supported Stress Management: A Pooled Analysis of Individual Participant Data From Three Randomized Controlled Trials

PubMed Central

Lehr, Dirk; Berking, Matthias; Riper, Heleen; Cuijpers, Pim; Ebert, David Daniel

2016-01-01

Background Nonadherence to treatment is a prevalent issue in Internet interventions. Guidance from health care professionals has been found to increase treatment adherence rates in Internet interventions for a range of physical and mental disorders. Evaluating different guidance formats of varying intensity is important, particularly with respect to improvement of effectiveness and cost-effectiveness. Identifying predictors of nonadherence allows for the opportunity to better adapt Internet interventions to the needs of participants especially at risk for discontinuing treatment. Objective The goal of this study was to investigate the influence of different guidance formats (content-focused guidance, adherence-focused guidance, and administrative guidance) on adherence and to identify predictors of nonadherence in an Internet-based mobile-supported stress management intervention (ie, GET.ON Stress) for employees. Methods The data from the groups who received the intervention were pooled from three randomized controlled trials (RCTs) that evaluated the efficacy of the same Internet-based mobile-supported stress management intervention (N=395). The RCTs only differed in terms of the guidance format (content-focused guidance vs waitlist control, adherence-focused guidance vs waitlist control, administrative guidance vs waitlist control). Adherence was defined by the number of completed treatment modules (0-7). An ANOVA was performed to compare the adherence rates from the different guidance formats. Multiple hierarchical linear regression analysis was conducted to evaluate predictors of nonadherence, which included gender, age, education, symptom-related factors, and hope for improvement. Results In all, 70.5% (93/132) of the content-focused guidance sample, 68.9% (91/132) of the adherence-focused guidance sample, and 42.0% (55/131) of the participants in the administrative guidance sample completed all treatment modules. Guidance had a significant effect on treatment adherence (F2,392=11.64, P<.001; ω2=.05). Participants in the content-focused guidance (mean 5.70, SD 2.32) and adherence-focused guidance samples (mean 5.58, SD 2.33) completed significantly more modules than participants in the administrative guidance sample (mean 4.36, SD 2.78; t223=4.53, P<.001; r=.29). Content-focused guidance was not significantly associated with higher adherence compared to adherence-focused guidance (t262=0.42, P=.67; r=.03). The effect size of r=.03 (95% CI –0.09 to 0.15) did not pass the equivalence margin of r=.20 and the upper bound of the 95% CI lay below the predefined margin, indicating equivalence between adherence-focused guidance and content-focused guidance. Beyond the influence of guidance, none of the predictors significantly predicted nonadherence. Conclusions Guidance has been shown to be an influential factor in promoting adherence to an Internet-based mobile-supported stress management intervention. Adherence-focused guidance, which included email reminders and feedback on demand, was equivalent to content-focused guidance with regular feedback while requiring only approximately a quarter of the coaching resources. This could be a promising discovery in terms of cost-effectiveness. However, even after considering guidance, sociodemographic, and symptom-related characteristics, most interindividual differences in nonadherence remain unexplained. Clinical Trial DRKS00004749; http://drks-neu.uniklinik-freiburg.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL _ID=DRKS00004749 (Archived by WebCite at http://www.webcitation.org/6QiDk9Zn8); DRKS00005112; http://drks-neu.uniklinik-freiburg. de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00005112 (Archived by WebCite at http://www.webcitation.org/6QiDysvev); DRKS00005384; http://drks-neu.uniklinik-freiburg.de/ drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00005384 (Archived by WebCite at http://www.webcitation.org/6QiE0xcpE) PMID:27357528

Adherence to Internet-Based Mobile-Supported Stress Management: A Pooled Analysis of Individual Participant Data From Three Randomized Controlled Trials.

PubMed

Zarski, Anna-Carlotta; Lehr, Dirk; Berking, Matthias; Riper, Heleen; Cuijpers, Pim; Ebert, David Daniel

2016-06-29

Nonadherence to treatment is a prevalent issue in Internet interventions. Guidance from health care professionals has been found to increase treatment adherence rates in Internet interventions for a range of physical and mental disorders. Evaluating different guidance formats of varying intensity is important, particularly with respect to improvement of effectiveness and cost-effectiveness. Identifying predictors of nonadherence allows for the opportunity to better adapt Internet interventions to the needs of participants especially at risk for discontinuing treatment. The goal of this study was to investigate the influence of different guidance formats (content-focused guidance, adherence-focused guidance, and administrative guidance) on adherence and to identify predictors of nonadherence in an Internet-based mobile-supported stress management intervention (ie, GET.ON Stress) for employees. The data from the groups who received the intervention were pooled from three randomized controlled trials (RCTs) that evaluated the efficacy of the same Internet-based mobile-supported stress management intervention (N=395). The RCTs only differed in terms of the guidance format (content-focused guidance vs waitlist control, adherence-focused guidance vs waitlist control, administrative guidance vs waitlist control). Adherence was defined by the number of completed treatment modules (0-7). An ANOVA was performed to compare the adherence rates from the different guidance formats. Multiple hierarchical linear regression analysis was conducted to evaluate predictors of nonadherence, which included gender, age, education, symptom-related factors, and hope for improvement. In all, 70.5% (93/132) of the content-focused guidance sample, 68.9% (91/132) of the adherence-focused guidance sample, and 42.0% (55/131) of the participants in the administrative guidance sample completed all treatment modules. Guidance had a significant effect on treatment adherence (F2,392=11.64, P<.001; ω(2)=.05). Participants in the content-focused guidance (mean 5.70, SD 2.32) and adherence-focused guidance samples (mean 5.58, SD 2.33) completed significantly more modules than participants in the administrative guidance sample (mean 4.36, SD 2.78; t223=4.53, P<.001; r=.29). Content-focused guidance was not significantly associated with higher adherence compared to adherence-focused guidance (t262=0.42, P=.67; r=.03). The effect size of r=.03 (95% CI -0.09 to 0.15) did not pass the equivalence margin of r=.20 and the upper bound of the 95% CI lay below the predefined margin, indicating equivalence between adherence-focused guidance and content-focused guidance. Beyond the influence of guidance, none of the predictors significantly predicted nonadherence. Guidance has been shown to be an influential factor in promoting adherence to an Internet-based mobile-supported stress management intervention. Adherence-focused guidance, which included email reminders and feedback on demand, was equivalent to content-focused guidance with regular feedback while requiring only approximately a quarter of the coaching resources. This could be a promising discovery in terms of cost-effectiveness. However, even after considering guidance, sociodemographic, and symptom-related characteristics, most interindividual differences in nonadherence remain unexplained. DRKS00004749; http://drks-neu.uniklinik-freiburg.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL _ID=DRKS00004749 (Archived by WebCite at http://www.webcitation.org/6QiDk9Zn8); DRKS00005112; http://drks-neu.uniklinik-freiburg. de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00005112 (Archived by WebCite at http://www.webcitation.org/6QiDysvev); DRKS00005384; http://drks-neu.uniklinik-freiburg.de/ drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00005384 (Archived by WebCite at http://www.webcitation.org/6QiE0xcpE).

Online thesis guidance management information system

NASA Astrophysics Data System (ADS)

Nasution, T. H.; Pratama, F.; Tanjung, K.; Siregar, I.; Amalia, A.

2018-03-01

The development of internet technology in education is still not maximized, especially in the process of thesis guidance between students and lecturers. Difficulties met the lecturers to help students during thesis guidance is the limited communication time and the compatibility of schedule between students and lecturer. To solve this problem, we designed an online thesis guidance management information system that helps students and lecturers to do thesis tutoring process anytime, anywhere. The system consists of a web-based admin app for usage management and an android-based app for students and lecturers.

Regulation of non-relevant metabolites of plant protection products in drinking and groundwater in the EU: Current status and way forward.

PubMed

Laabs, V; Leake, C; Botham, P; Melching-Kollmuß, S

2015-10-01

Non-relevant metabolites are defined in the EU regulation for plant protection product authorization and a detailed definition of non-relevant metabolites is given in an EU Commission DG Sanco (now DG SANTE - Health and Food Safety) guidance document. However, in water legislation at EU and member state level non-relevant metabolites of pesticides are either not specifically regulated or diverse threshold values are applied. Based on their inherent properties, non-relevant metabolites should be regulated based on substance-specific and toxicity-based limit values in drinking and groundwater like other anthropogenic chemicals. Yet, if a general limit value for non-relevant metabolites in drinking and groundwater is favored, an application of a Threshold of Toxicological Concern (TTC) concept for Cramer class III compounds leads to a threshold value of 4.5 μg L(-1). This general value is exemplarily shown to be protective for non-relevant metabolites, based on individual drinking water limit values derived for a set of 56 non-relevant metabolites. A consistent definition of non-relevant metabolites of plant protection products, as well as their uniform regulation in drinking and groundwater in the EU, is important to achieve legal clarity for all stakeholders and to establish planning security for development of plant protection products for the European market. Copyright © 2015 Elsevier Inc. All rights reserved.

Technical bases and guidance for the use of composite soil sampling for demonstrating compliance with radiological release criteria

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

Vitkus, Timothy J.

2012-04-24

This guidance provides information on methodologies and the technical bases that licensees should consider for incorporating composite sampling strategies into final status survey (FSS) plans. In addition, this guidance also includes appropriate uses of composite sampling for generating the data for other decommissioning site investigations such as characterization or other preliminary site investigations.

Mississippi Curriculum Framework for Child Care and Guidance Management and Services (Program CIP: 20.0201--Child Care & Guidance Workers and Managers). Secondary Programs.

ERIC Educational Resources Information Center

Mississippi Research and Curriculum Unit for Vocational and Technical Education, State College.

This document, which reflects Mississippi's statutory requirement that instructional programs be based on core curricula and performance-based assessment, contains outlines of the instructional units required in local instructional management plans and daily lesson plans for child care and guidance management and services I and II. Presented first…

Charging Guidance of Electric Taxis Based on Adaptive Particle Swarm Optimization

PubMed Central

Niu, Liyong; Zhang, Di

2015-01-01

Electric taxis are playing an important role in the application of electric vehicles. The actual operational data of electric taxis in Shenzhen, China, is analyzed, and, in allusion to the unbalanced time availability of the charging station equipment, the electric taxis charging guidance system is proposed basing on the charging station information and vehicle information. An electric taxis charging guidance model is established and guides the charging based on the positions of taxis and charging stations with adaptive mutation particle swarm optimization. The simulation is based on the actual data of Shenzhen charging stations, and the results show that electric taxis can be evenly distributed to the appropriate charging stations according to the charging pile numbers in charging stations after the charging guidance. The even distribution among the charging stations in the area will be achieved and the utilization of charging equipment will be improved, so the proposed charging guidance method is verified to be feasible. The improved utilization of charging equipment can save public charging infrastructure resources greatly. PMID:26236770

Charging Guidance of Electric Taxis Based on Adaptive Particle Swarm Optimization.

PubMed

Niu, Liyong; Zhang, Di

2015-01-01

Electric taxis are playing an important role in the application of electric vehicles. The actual operational data of electric taxis in Shenzhen, China, is analyzed, and, in allusion to the unbalanced time availability of the charging station equipment, the electric taxis charging guidance system is proposed basing on the charging station information and vehicle information. An electric taxis charging guidance model is established and guides the charging based on the positions of taxis and charging stations with adaptive mutation particle swarm optimization. The simulation is based on the actual data of Shenzhen charging stations, and the results show that electric taxis can be evenly distributed to the appropriate charging stations according to the charging pile numbers in charging stations after the charging guidance. The even distribution among the charging stations in the area will be achieved and the utilization of charging equipment will be improved, so the proposed charging guidance method is verified to be feasible. The improved utilization of charging equipment can save public charging infrastructure resources greatly.

Family Relational Values in the Parent-Adolescent Relationship

ERIC Educational Resources Information Center

Edgar-Smith, Susan E.; Wozniak, Robert H.

2010-01-01

This study measured the relational family values system of upper-middle-class mothers, fathers, and adolescents in the United States. Results revealed that participants shared common family values that mainly reflected the importance of individualism, equality in family relationships, family member interdependence, and parental guidance. Parent…

One Chance to Get it Right: understanding the new guidance for care of the dying person.

PubMed

Sykes, Nigel

2015-09-01

Following criticism of the Liverpool Care of the Dying Pathway (LCP), widely used to guide care of dying people in British health-care settings, the UK Government set up an independent review which in 2013 recommended that use of the LCP be discontinued. In response, the Leadership Alliance for the Care of Dying People, a coalition of a wide range of stakeholders, recently published guidance entitled One Chance to Get it Right. This guidance contains five Priorities of Care for the dying person that are intended to guide clinical staff and will inform Care Quality Commission inspections of health-care providers. This article summarizes the background to One Chance to Get it Right and the guidance it contains. One Chance to Get it Right, More Care, Less Pathway and related guidance documents. The need to improve the standard of end-of-life care in every clinical setting. The value of a pathway-based approach to end-of-life care in a context where well-implemented programmes of staff education in the subject are lacking. Public concern with, and scrutiny of, the quality of dying in the UK health-care system, particularly in hospitals but also the ability of patients to die well at home where that is their place of choice. Effective methods of teaching end of life care to all clinical staff; the effect upon families of caring for a dying relative at home; the optimum type, quantity and source of external support to informal carers that is perceived by them as adequate and enables the ill person to die well in in their own home; fuller understanding of the physiology of dying. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Motion-adapted catheter navigation with real-time instantiation and improved visualisation

PubMed Central

Kwok, Ka-Wai; Wang, Lichao; Riga, Celia; Bicknell, Colin; Cheshire, Nicholas; Yang, Guang-Zhong

2014-01-01

The improvements to catheter manipulation by the use of robot-assisted catheter navigation for endovascular procedures include increased precision, stability of motion and operator comfort. However, navigation through the vasculature under fluoroscopic guidance is still challenging, mostly due to physiological motion and when tortuous vessels are involved. In this paper, we propose a motion-adaptive catheter navigation scheme based on shape modelling to compensate for these dynamic effects, permitting predictive and dynamic navigations. This allows for timed manipulations synchronised with the vascular motion. The technical contribution of the paper includes the following two aspects. Firstly, a dynamic shape modelling and real-time instantiation scheme based on sparse data obtained intra-operatively is proposed for improved visualisation of the 3D vasculature during endovascular intervention. Secondly, a reconstructed frontal view from the catheter tip using the derived dynamic model is used as an interventional aid to user guidance. To demonstrate the practical value of the proposed framework, a simulated aortic branch cannulation procedure is used with detailed user validation to demonstrate the improvement in navigation quality and efficiency. PMID:24744817

A neural net approach to space vehicle guidance

NASA Technical Reports Server (NTRS)

Caglayan, Alper K.; Allen, Scott M.

1990-01-01

The space vehicle guidance problem is formulated using a neural network approach, and the appropriate neural net architecture for modeling optimum guidance trajectories is investigated. In particular, an investigation is made of the incorporation of prior knowledge about the characteristics of the optimal guidance solution into the neural network architecture. The online classification performance of the developed network is demonstrated using a synthesized network trained with a database of optimum guidance trajectories. Such a neural-network-based guidance approach can readily adapt to environment uncertainties such as those encountered by an AOTV during atmospheric maneuvers.

False Dawns, Bleak Sunset: The Coalition Government's Policies on Career Guidance

ERIC Educational Resources Information Center

Watts, A. G.

2013-01-01

The Coalition Government's policies on career guidance are analysed. Its rhetorical concern for career guidance provision is based largely on its support for social mobility, and its recognition of the role of career guidance in moving towards a demand-led skills system. Initial policy statements affirmed its intention to establish an all-age…

Setting nutrient thresholds to support an ecological assessment based on nutrient enrichment, potential primary production and undesirable disturbance.

PubMed

Devlin, Michelle; Painting, Suzanne; Best, Mike

2007-01-01

The EU Water Framework Directive recognises that ecological status is supported by the prevailing physico-chemical conditions in each water body. This paper describes an approach to providing guidance on setting thresholds for nutrients taking account of the biological response to nutrient enrichment evident in different types of water. Indices of pressure, state and impact are used to achieve a robust nutrient (nitrogen) threshold by considering each individual index relative to a defined standard, scale or threshold. These indices include winter nitrogen concentrations relative to a predetermined reference value; the potential of the waterbody to support phytoplankton growth (estimated as primary production); and detection of an undesirable disturbance (measured as dissolved oxygen). Proposed reference values are based on a combination of historical records, offshore (limited human influence) nutrient concentrations, literature values and modelled data. Statistical confidence is based on a number of attributes, including distance of confidence limits away from a reference threshold and how well the model is populated with real data. This evidence based approach ensures that nutrient thresholds are based on knowledge of real and measurable biological responses in transitional and coastal waters.

Institutional Guidance of Affective Bonding: Moral Values Development in Brazilian Military Education.

PubMed

Wortmeyer, Daniela Schmitz; Branco, Angela Uchoa

2016-09-01

In this article, our aim is to analyze institutional practices guided to promote the development of moral values within the context of military education of Brazilian Army combatant commissioned officers. From a cultural psychological approach, we discuss how social guidance within military culture operates at different levels of the affective-semiotic regulation of individuals, structuring complex experiences that give rise to hypergeneralized meaning fields regarding morality and military values. For this goal, we first introduce some theoretical topics related to values development, emphasizing their affective roots and role in the emergence, maintenance, amplification and attenuation of all relations between the person and the environment. Following a brief discussion on how social institutions try to promote changes in personal values, we provide an overview of values present in the military culture and socialization. Finally, the text focuses on the education of Brazilian Army combatant commissioned officers, describing how practices related to different levels of affective-semiotic experience combine in order to promote the internalization and externalization of specific moral values. We conclude suggesting issues for future investigation.

Women's views of two interventions designed to assist in the prophylactic oophorectomy decision: a qualitative pilot evaluation

PubMed Central

Bhavnani, Vanita; Clarke, Aileen; Dowie, Jack; Kennedy, Andrew; Pell, Ian

2002-01-01

Abstract Introduction  A qualitative pilot evaluation of two different decision interventions for the prophylactic oophorectomy (PO) decision: a Decision Chart and a computerized clinical guidance programme (CGP) was undertaken. The Decision Chart, representing current practice in decision interventions, presents population‐based information. The CGP elicits individual values to allow for quality‐adjusted life years to be calculated and an explicit guidance statement is given. Prophylactic oophorectomy involves removal of the ovaries as an adjunct to hysterectomy to prevent ovarian cancer. The decision is complex because the operation can affect a number of long‐term outcomes including breast cancer, coronary heart disease and osteoporosis. Methods  Both interventions were based on the evidence and were administered by a facilitator. The Decision Chart is a file, which progressively reveals information in the form of bar charts. The CGP is a decision‐analysis based program integrating the results from a cluster of Markov cycle trees. The research evidence is incorporated with woman's individual risk factors, values and preferences. A purposive sample of 19 women awaiting hysterectomy used the decision interventions (10 CGP, nine Decision Chart). In‐depth semi‐structured interviews were undertaken. Interviews were transcribed and analysed to derive themes. Results  Reactions to the different decision interventions were mixed. Both were seen as clarifying the decision. Some women found some of the tasks difficult (e.g. rating health status). Some were surprised by the ‘individualized’ guidance, which the CGP offered. The Decision Chart provided some with a sense of empowerment, although some found that it provided too much information. Conclusions  Women were able to use both decision interventions. Both provided decision clarification. Problems were evident with both interventions, which give useful pointers for future development. These included the possibility for women to see how their individual risks of different outcomes are affected in the Decision Chart and enhanced explanation of the CGP tasks. Future design and evaluation of decision aids, will need to accommodate differences between patients in the desire for amount and type of information and level of involvement in the decision‐making process. PMID:12031056

77 FR 14321 - Modifications to Minimum Present Value Requirements for Partial Annuity Distribution Options...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-09

... DEPARTMENT OF THE TREASURY Internal Revenue Service 26 CFR Part 1 [REG-110980-10] RIN 1545-BJ55 Modifications to Minimum Present Value Requirements for Partial Annuity Distribution Options Under Defined... FR 5454), providing guidance relating to the minimum present value requirements applicable to certain...

Stakeholders' Guidance Document for Consumer Analytical Devices with a Focus on Gluten and Food Allergens.

PubMed

Popping, Bert; Allred, Laura; Bourdichon, François; Brunner, Kurt; Diaz-Amigo, Carmen; Galan-Malo, Patricia; Lacorn, Markus; North, Jennifer; Parisi, Salvatore; Rogers, Adrian; Sealy-Voyksner, Jennifer; Thompson, Tricia; Yeung, Jupiter

2018-01-01

Until recently, analytical tests for food were performed primarily in laboratories, but technical developments now enable consumers to use devices to test their food at home or when dining out. Current consumer devices for food can determine nutritional values, freshness, and, most recently, the presence of food allergens and substances that cause food intolerances. The demand for such products is driven by an increase in the incidence of food allergies, as well as consumer desire for more information about what is in their food. The number and complexity of food matrixes creates an important need for properly validated testing devices with comprehensive user instructions (definitions of technical terms can be found in ISO 5725-1:1994 and the International Vocabulary of Metrology). This is especially important with food allergen determinations that can have life-threatening consequences. Stakeholders-including food regulators, food producers, and food testing kit and equipment manufacturers, as well as representatives from consumer advocacy groups-have worked to outline voluntary guidelines for consumer food allergen- and gluten-testing devices. These guidelines cover areas such as kit validation, user sampling instructions, kit performance, and interpretation of results. The recommendations are based on (1) current known technologies, (2) analytical expertise, and (3) standardized AOAC INTERNATIONAL allergen community guidance and best practices on the analysis of food allergens and gluten. The present guidance document is the first in a series of papers intended to provide general guidelines applicable to consumer devices for all food analytes. Future publications will give specific guidance and validation protocols for devices designed to detect individual allergens and gluten, as statistical analysis and review of any validation data, preferably from an independent third party, are necessary to establish a device's fitness-for-purpose. Following the recommendations of these guidance documents will help ensure that consumers are equipped with sufficient information to make an informed decision based on an analytical result from a consumer device. However, the present guidance document emphasizes that consumer devices should not be used in isolation to make a determination as to whether a food is safe to eat. As advances are made in science and technology, these recommendations will be reevaluated and revised as appropriate.

Analysis of methods to assess frontal sinus extent in osteoplastic flap surgery: transillumination versus 6-ft Caldwell versus image guidance.

PubMed

Melroy, Christopher T; Dubin, Marc G; Hardy, Stuart M; Senior, Brent A

2006-01-01

The aim of this study was to compare three common methods (transillumination, plain radiographs, and computerized tomography [CT] image guidance) for estimating the position and extent of pneumatization of the frontal sinus in osteoplastic flap surgery. Axial CT scans and 6-ft Caldwell radiographs were performed on 10 cadaver heads. For each head, soft tissue overlying the frontal bone was raised and the anticipated position and extent of the frontal sinus at four points was marked using three common methods. The silhouette of the frontal sinus from the Caldwell plain radiograph was excised and placed in position. Four points at the periphery also were made using information obtained from a passive optically guided image-guided surgery device, and transillumination via a frontal trephination also was used to estimate sinus extent. The true sinus size was measured at each point and compared with experimental values. The use of CT image guidance generated the least difference between measured and actual values (mean = 1.91 mm; SEM = 0.29); this method was found statistically superior to Caldwell (p = 0.040) and transillumination (p = 0.007). Image guidance did not overestimate the size of the sinus (0/36) and was quicker than the Caldwell approach (8.5 versus 11.5 minutes). There was no learning curve appreciated with image guidance. Accurate and precise estimation of the position and extent of the frontal sinus is crucial when performing osteoplastic flap surgery. Use of CT image guidance was statistically superior to Caldwell and transillumination methods and proved to be safe, reproducible, economic, and easy to learn.

Vision based obstacle detection and grouping for helicopter guidance

NASA Technical Reports Server (NTRS)

Sridhar, Banavar; Chatterji, Gano

1993-01-01

Electro-optical sensors can be used to compute range to objects in the flight path of a helicopter. The computation is based on the optical flow/motion at different points in the image. The motion algorithms provide a sparse set of ranges to discrete features in the image sequence as a function of azimuth and elevation. For obstacle avoidance guidance and display purposes, these discrete set of ranges, varying from a few hundreds to several thousands, need to be grouped into sets which correspond to objects in the real world. This paper presents a new method for object segmentation based on clustering the sparse range information provided by motion algorithms together with the spatial relation provided by the static image. The range values are initially grouped into clusters based on depth. Subsequently, the clusters are modified by using the K-means algorithm in the inertial horizontal plane and the minimum spanning tree algorithms in the image plane. The object grouping allows interpolation within a group and enables the creation of dense range maps. Researchers in robotics have used densely scanned sequence of laser range images to build three-dimensional representation of the outside world. Thus, modeling techniques developed for dense range images can be extended to sparse range images. The paper presents object segmentation results for a sequence of flight images.

Study design for a randomized controlled trial to increase the relative reinforcing value of vegetable consumption using incentive sensitization among obese and overweight people.

PubMed

Jahns, Lisa; Roemmich, James N

2016-09-01

In this manuscript, we present the protocol for a study that applies incentive sensitization theory to improve vegetable intake in overweight and obese adults. This 8-week, randomized, controlled, community-based feeding study with an 8-week follow-up seeks to use repeated exposure to amounts of vegetables recommended by federal guidance to increase the primary outcome of the relative reinforcing value of vegetables compared to a snack food. A community-based design is used to give participants autonomy in choosing their method of exposure. Secondary outcomes include: 1) Determine potential moderators of incentive sensitization of vegetables, including genetic polymorphisms associated with food reinforcement and obesity, 6-n-propylthiouracil tasting status, and delay discounting. 2) Determine whether adding vegetables to the diet results in participants substituting low-energy-dense vegetables for energy-dense foods or whether energy-dense food consumption is independent of vegetable consumption. 3) Determine whether reductions in adiposity are associated with substitution of vegetables in the diet. 4) Determine if markers of bone turnover change. 5) Assess changes in self-reported secondary outcomes measured by questionnaire such as self-efficacy to eat vegetables. The results of this study will provide information about the drivers of individual choice to consume recommended amounts of vegetables. The understanding gained will help increase the effectiveness and sustainability of behavior-based interventions focused on improving vegetable intake. This information may also be used to assist in setting dietary guidance targets for the amounts and types of vegetables Americans can, and should, consume. Published by Elsevier Inc.

Values Tech: The Polytechnic School of Values, Leading You to a Higher Degree of Self Awareness.

ERIC Educational Resources Information Center

Koberg, Don; Bagnall, Jim

This workbook presents lessons, workshop sessions, and laboratory exercises designed to help youth and adults clarify personal values and develop decision-making skills. The workbook (or "portable school") provides guidance in procedure and method of values clarification. The learning experiences involve users of the text in establishing criteria,…

Evaluation of relative response factor methodology for demonstrating attainment of ozone in Houston, Texas.

PubMed

Vizuete, William; Biton, Leiran; Jeffries, Harvey E; Couzo, Evan

2010-07-01

In 2007, the U.S. Environmental Protection Agency (EPA) released guidance on demonstrating attainment of the federal ozone (O3) standard. This guidance recommended a change in the use of air quality model (AQM) predictions from an absolute to a relative way. This was accomplished by using a ratio, and not the absolute difference of AQM O3 predictions from a historical year to an attainment year. This ratio of O3 concentrations, labeled the relative response factor (RRF), is multiplied by an average of observed concentrations at every monitor. In this analysis, whether the methodology used to calculate RRFs is severing the source-receptor relationship for a given monitor was investigated. Model predictions were generated with a regulatory AQM system used to support the 2004 Houston-Galveston-Brazoria State Implementation Plan. Following the procedures in the EPA guidance, an attainment demonstration was completed using regulatory AQM predictions and measurements from the Houston ground-monitoring network. Results show that the model predictions used for the RRF calculation were often based on model conditions that were geographically remote from observations and counter to wind flow. Many of the monitors used the same model predictions for an RRF, even if that O3 plume did not impact it. The RRF methodology resulted in severing the true source-receptor relationship for a monitor. This analysis also showed that model performance could influence RRF values, and values at monitoring sites appear to be sensitive to model bias. Results indicate an inverse linear correlation of RRFs with model bias at each monitor (R2 = 0.47), resulting in a change in future O3 design values up to 5 parts per billion (ppb). These results suggest that the application of RRF methodology in Houston, TX, should be changed from using all model predictions above 85 ppb to a method that removes any predictions that are not relevant to the observed source-receptor relationship.

The utility of QSARs in predicting acute fish toxicity of pesticide metabolites: A retrospective validation approach.

PubMed

Burden, Natalie; Maynard, Samuel K; Weltje, Lennart; Wheeler, James R

2016-10-01

The European Plant Protection Products Regulation 1107/2009 requires that registrants establish whether pesticide metabolites pose a risk to the environment. Fish acute toxicity assessments may be carried out to this end. Considering the total number of pesticide (re-) registrations, the number of metabolites can be considerable, and therefore this testing could use many vertebrates. EFSA's recent "Guidance on tiered risk assessment for plant protection products for aquatic organisms in edge-of-field surface waters" outlines opportunities to apply non-testing methods, such as Quantitative Structure Activity Relationship (QSAR) models. However, a scientific evidence base is necessary to support the use of QSARs in predicting acute fish toxicity of pesticide metabolites. Widespread application and subsequent regulatory acceptance of such an approach would reduce the numbers of animals used. The work presented here intends to provide this evidence base, by means of retrospective data analysis. Experimental fish LC50 values for 150 metabolites were extracted from the Pesticide Properties Database (http://sitem.herts.ac.uk/aeru/ppdb/en/atoz.htm). QSAR calculations were performed to predict fish acute toxicity values for these metabolites using the US EPA's ECOSAR software. The most conservative predicted LC50 values generated by ECOSAR were compared with experimental LC50 values. There was a significant correlation between predicted and experimental fish LC50 values (Spearman rs = 0.6304, p < 0.0001). For 62% of metabolites assessed, the QSAR predicted values are equal to or lower than their respective experimental values. Refined analysis, taking into account data quality and experimental variation considerations increases the proportion of sufficiently predictive estimates to 91%. For eight of the nine outliers, there are plausible explanation(s) for the disparity between measured and predicted LC50 values. Following detailed consideration of the robustness of this non-testing approach, it can be concluded there is a strong data driven rationale for the applicability of QSAR models in the metabolite assessment scheme recommended by EFSA. As such there is value in further refining this approach, to improve the method and enable its future incorporation into regulatory guidance and practice. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

What's the evidence that NICE guidance has been implemented? Results from a national evaluation using time series analysis, audit of patients' notes, and interviews.

PubMed

Sheldon, Trevor A; Cullum, Nicky; Dawson, Diane; Lankshear, Annette; Lowson, Karin; Watt, Ian; West, Peter; Wright, Dianne; Wright, John

2004-10-30

To assess the extent and pattern of implementation of guidance issued by the National Institute for Clinical Excellence (NICE). Interrupted time series analysis, review of case notes, survey, and interviews. Acute and primary care trusts in England and Wales. All primary care prescribing, hospital pharmacies; a random sample of 20 acute trusts, 17 mental health trusts, and 21 primary care trusts; and senior clinicians and managers from five acute trusts. Rates of prescribing and use of procedures and medical devices relative to evidence based guidance. 6308 usable patient audit forms were returned. Implementation of NICE guidance varied by trust and by topic. Prescribing of some taxanes for cancer (P < 0.002) and orlistat for obesity (P < 0.001) significantly increased in line with guidance. Prescribing of drugs for Alzheimer's disease and prophylactic extraction of wisdom teeth showed trends consistent with, but not obviously a consequence of, the guidance. Prescribing practice often did not accord with the details of the guidance. No change was apparent in the use of hearing aids, hip prostheses, implantable cardioverter defibrillators, laparoscopic hernia repair, and laparoscopic colorectal cancer surgery after NICE guidance had been issued. Implementation of NICE guidance has been variable. Guidance seems more likely to be adopted when there is strong professional support, a stable and convincing evidence base, and no increased or unfunded costs, in organisations that have established good systems for tracking guidance implementation and where the professionals involved are not isolated. Guidance needs to be clear and reflect the clinical context.

[Study on incorporation of "management and guidance of home-visiting by a pharmacist" into a care plan -observation based on a survey of care managers-].

PubMed

Nanaumi, Yoko; Onda, Mitsuko; Sakurai, Hidehiko; Tanaka, Rie; Tsubota, Kenichi; Matoba, Shunya; Mukai, Yusuke; Arakawa, Yukio; Hayase, Yukitoshi

2010-11-01

A survey of care managers ("CMs") was conducted to identify top priority issues in promoting the management and guidance of home-visiting by a pharmacist ("management and guidance") by focusing on the experience in incorporating the management and guidance into a care plan and its relevant factors. Major survey items included (1) number of years working as a CM, (2) basic occupation, (3) experience in incorporating the management and guidance into care plans, (4) understanding the management and guidance content, and (5) an awareness of the need for pharmacists' involvement in care plans. A χ² test was conducted to determine if the experience in incorporating the management and guidance into care plans caused a difference in the distribution of the number of years as a CM, the basic occupation, understanding of the management and guidance content, and an awareness of the need for pharmacists' involvement in care plans. A regression analysis was conducted to determine the degree of association between the incorporation experience and each item. The numbers of years working as a CM, the basic occupation, understanding of the management and guidance content, and an awareness of the need for pharmacists' involvement in care plans, were found to be associated with the experience in incorporating the management and guidance into care plans. Understanding of the management and guidance content was most closely associated. To promote pharmacists' management and guidance for home-based care, CMs need to deepen their understanding of this service.

The value of a statistical life: a meta-analysis with a mixed effects regression model.

PubMed

Bellavance, François; Dionne, Georges; Lebeau, Martin

2009-03-01

The value of a statistical life (VSL) is a very controversial topic, but one which is essential to the optimization of governmental decisions. We see a great variability in the values obtained from different studies. The source of this variability needs to be understood, in order to offer public decision-makers better guidance in choosing a value and to set clearer guidelines for future research on the topic. This article presents a meta-analysis based on 39 observations obtained from 37 studies (from nine different countries) which all use a hedonic wage method to calculate the VSL. Our meta-analysis is innovative in that it is the first to use the mixed effects regression model [Raudenbush, S.W., 1994. Random effects models. In: Cooper, H., Hedges, L.V. (Eds.), The Handbook of Research Synthesis. Russel Sage Foundation, New York] to analyze studies on the value of a statistical life. We conclude that the variability found in the values studied stems in large part from differences in methodologies.

Problems, Pitfalls, and Benefits of Portfolios.

ERIC Educational Resources Information Center

Stone, Bernice A.

1998-01-01

Two groups of student teachers, one school-based and one university-based, were introduced to portfolio construction. School-based students received more guidance in and time for portfolio construction. Surveys and interviews indicated that the extra time and guidance helped school-based students, who benefited more from portfolios than…

Dietary exposure and health risk assessment for 14 toxic and essential trace elements in Yaoundé: the Cameroonian total diet study.

PubMed

Gimou, Marie-Madeleine; Pouillot, Régis; Charrondiere, U Ruth; Noël, Laurent; Guérin, Thierry; Leblanc, Jean-Charles

2014-01-01

Dietary exposure to trace elements (aluminium, antimony, barium, cadmium, lead, nickel, vanadium, copper, manganese, molybdenum, germanium, lithium, strontium and tellurium) was assessed by the total diet study (TDS) method. Sixty-four pooled samples representing 96.5% of the diet in Yaoundé, Cameroon, were prepared "as consumed" before analysis. Consumption data were sourced from a households' budget survey. Dietary exposures were compared with health-based guidance or nutritional values and to worldwide TDS results. The health-based guidance value was exceeded by ≤ 0.2% of the study population for aluminium, antimony, barium, cadmium, nickel and vanadium. For lead, the observed 95th percentile of exposure (3.05 µg kg(-1) body weight day(-1)) equals the critical value considered by JECFA for cardiovascular effects; therefore, risk to health cannot be excluded for certain consumer groups. The population at risk of excess intake for manganese, copper, molybdenum and nickel was considered to be low (≤ 0.3%). The prevalence of inadequate intake was estimated at 5.9% for copper and was nil for molybdenum. Due to the lack of toxicological and/or nutritional consistent data to perform a risk assessment, dietary exposures to germanium, lithium, strontium and tellurium were provided as supplementary data. The food groups highest contributors to exposure were "tubers and starches" for aluminium (27%), lead (39%) and copper (26%), "cereals and cereal products" for cadmium (54%) and manganese (35%), "fruits, vegetables and oilseeds" for barium (34%), molybdenum (49%) and nickel (31%), "beverages" for antimony (27%) and "fish" for vanadium (43% - lower bound). Measures should be recommended to maintain low levels of exposure before the problem could become an important health or trade issue.

Research on energy stock market associated network structure based on financial indicators

NASA Astrophysics Data System (ADS)

Xi, Xian; An, Haizhong

2018-01-01

A financial market is a complex system consisting of many interacting units. In general, due to the various types of information exchange within the industry, there is a relationship between the stocks that can reveal their clear structural characteristics. Complex network methods are powerful tools for studying the internal structure and function of the stock market, which allows us to better understand the stock market. Applying complex network methodology, a stock associated network model based on financial indicators is created. Accordingly, we set threshold value and use modularity to detect the community network, and we analyze the network structure and community cluster characteristics of different threshold situations. The study finds that the threshold value of 0.7 is the abrupt change point of the network. At the same time, as the threshold value increases, the independence of the community strengthens. This study provides a method of researching stock market based on the financial indicators, exploring the structural similarity of financial indicators of stocks. Also, it provides guidance for investment and corporate financial management.

Guidance Concept for a Mars Ascent Vehicle First Stage

NASA Technical Reports Server (NTRS)

Queen, Eric M.

2000-01-01

This paper presents a guidance concept for use on the first stage of a Mars Ascent Vehicle (MAV). The guidance is based on a calculus of variations approach similar to that used for the final phase of the Apollo Earth return guidance. A three degree-of-freedom (3DOF) Monte Carlo simulation is used to evaluate performance and robustness of the algorithm.

78 FR 19495 - Draft Guidance for Industry on Scale-Up and Post-Approval Changes: Manufacturing Equipment...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-01

...-based assessment approaches and quality by design principles. These efforts will also be considered part... processes being referenced. DATES: Although you can comment on any guidance at any time (see 21 CFR 10.115(g... on the final version of the guidance and on any other part of the SUPAC guidance series, submit...

Apply an Augmented Reality in a Mobile Guidance to Increase Sense of Place for Heritage Places

ERIC Educational Resources Information Center

Chang, Yu-Lien; Hou, Huei-Tse; Pan, Chao-Yang; Sung, Yao-Ting; Chang, Kuo-En

2015-01-01

Based on the sense of place theory and the design principles of guidance and interpretation, this study developed an augmented reality mobile guidance system that used a historical geo-context-embedded visiting strategy. This tool for heritage guidance and educational activities enhanced visitor sense of place. This study consisted of 3 visitor…

Effect of flashlight guidance on manual ventilation performance in cardiopulmonary resuscitation: A randomized controlled simulation study.

PubMed

Kim, Ji Hoon; Beom, Jin Ho; You, Je Sung; Cho, Junho; Min, In Kyung; Chung, Hyun Soo

2018-01-01

Several auditory-based feedback devices have been developed to improve the quality of ventilation performance during cardiopulmonary resuscitation (CPR), but their effectiveness has not been proven in actual CPR situations. In the present study, we investigated the effectiveness of visual flashlight guidance in maintaining high-quality ventilation performance. We conducted a simulation-based, randomized, parallel trial including 121 senior medical students. All participants were randomized to perform ventilation during 2 minutes of CPR with or without flashlight guidance. For each participant, we measured mean ventilation rate as a primary outcome and ventilation volume, inspiration velocity, and ventilation interval as secondary outcomes using a computerized device system. Mean ventilation rate did not significantly differ between flashlight guidance and control groups (P = 0.159), but participants in the flashlight guidance group exhibited significantly less variation in ventilation rate than participants in the control group (P<0.001). Ventilation interval was also more regular among participants in the flashlight guidance group. Our results demonstrate that flashlight guidance is effective in maintaining a constant ventilation rate and interval. If confirmed by further studies in clinical practice, flashlight guidance could be expected to improve the quality of ventilation performed during CPR.

76 FR 78545 - Guidance Regarding Foreign Base Company Sales Income

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-19

... Regarding Foreign Base Company Sales Income AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Final... provide guidance relating to foreign base company sales income when personal property sold by a controlled... that addressed the application of the section 954(d)(2) branch rules under the foreign base company...

IRIS Summary and Supporting Documents for Methylmercury ...

EPA Pesticide Factsheets

In January 2001, U.S. EPA finalized the guidance for methylmercury in the water quality criteria for states and authorized tribes. The links below take you to the best resources for this guidance. This final Guidance for Implementing the January 2001 Methylmercury Water Quality Criterion provides technical guidance to states and authorized tribes on how they may want to use the January 2001 fish tissue-based recommended water quality criterion for methylmercury in surface water protection programs (e.g., TMDLs, NPDES permitting). The guidance addresses questions related to water quality standards adoption (e.g., site-specific criteria, variances), assessments, monitoring, TMDLs, and NPDES permitting. The guidance consolidates existing EPA guidance where relevant to mercury.

Modeling and controlling a robotic convoy using guidance laws strategies.

PubMed

Belkhouche, Fethi; Belkhouche, Boumediene

2005-08-01

This paper deals with the problem of modeling and controlling a robotic convoy. Guidance laws techniques are used to provide a mathematical formulation of the problem. The guidance laws used for this purpose are the velocity pursuit, the deviated pursuit, and the proportional navigation. The velocity pursuit equations model the robot's path under various sensors based control laws. A systematic study of the tracking problem based on this technique is undertaken. These guidance laws are applied to derive decentralized control laws for the angular and linear velocities. For the angular velocity, the control law is directly derived from the guidance laws after considering the relative kinematics equations between successive robots. The second control law maintains the distance between successive robots constant by controlling the linear velocity. This control law is derived by considering the kinematics equations between successive robots under the considered guidance law. Properties of the method are discussed and proven. Simulation results confirm the validity of our approach, as well as the validity of the properties of the method. Index Terms-Guidance laws, relative kinematics equations, robotic convoy, tracking.

Image guidance systems for minimally invasive sinus and skull base surgery in children.

PubMed

Benoit, Margo McKenna; Silvera, V Michelle; Nichollas, Richard; Jones, Dwight; McGill, Trevor; Rahbar, Reza

2009-10-01

The use of image guidance for sinonasal and skull base surgery has been well-characterized in adults but there is limited information on the use of these systems in the pediatric population, despite their widespread use. The aim of this study is to evaluate the use of image guidance systems to facilitate an endoscopic minimally invasive approach to sinonasal and skull base surgery in a pediatric population. A retrospective cohort study was performed at a tertiary pediatric hospital. Thirty-three children presented with complications of sinusitis, tumors, traumatic, or congenital lesions of the skull base and underwent endoscopic surgery using image guidance from March 2000 to April 2007. Patient variables including diagnosis, extent of disease, and complications were extracted from paper and computer charts. Additional surgical variables including set-up time, accuracy, surgeon satisfaction index and number of uses per case were also reviewed. Twenty-eight patients (85%) underwent sinonasal surgery and five (15%) underwent skull base surgery. Indications included infectious complications of acute sinusitis (N=15), neoplasms (N=12), choanal atresia (N=4), and cerebrospinal fluid leak (N=2). Thirty-one patients (94%) required only one procedure. No surgical complications were reported. Surgeon satisfaction, mean accuracy and number of uses per procedure increased over time (p<0.05). Image guidance systems are safe and effective tools that facilitate a minimally invasive approach to sinonasal and skull base surgery in children. Consistent with adult literature, usage and surgeon comfort increased with experience. The additional anatomical information obtained by image guidance systems facilitates a minimally invasive endoscopic approach for sinonasal and skull base pathologies.

Focus groups: examining a community-based group intervention for depressed Puerto Rican women.

PubMed

Stacciarini, Jeanne-Marie R

2008-07-01

Puerto Ricans manifest high rates of depression but avoid seeking treatment. The purpose of this pilot was to learn directly from Puerto Rican women how culturally appropriate they would consider a proposed community-based intervention for treating depression. Interactive activities were reviewed by two focus groups of women (N = 16), all working in community-based health programs. All activities (e.g., writing, role playing, and music) except individual drawing were deemed appropriate. Categories that emerged were family/community values, mainland/non-mainland cultural variances, communication style, religion, education/occupational variances, health beliefs, Puerto Rican traditions/customs, emotions, and coping skills. Categories provided guidance for refining a community-based intervention for treating depression in Puerto Rican women.

On the design of fuzzified trajectory shaping guidance law.

PubMed

Lin, Chun-Liang; Lin, Yu-Ping; Chen, Kai-Ming

2009-04-01

Midcourse guidance is commonly designed to save as much energy as possible so that the missile's final speed can be maximized while entering the homing stage. For this purpose, a competitive guidance design should be able to generate an admissible flight trajectory as to bring the interceptor to a superior altitude for a favorable target engagement. In this paper, a new adaptive trajectory shaping guidance scheme based on the adaptive fuzzy inference system, which is capable of generating a variety of trajectories for efficient target interception, is presented. The guidance law is developed with the aim of saving the interceptor's energy conservation while improving performance robustness. Applications of the presented approach have included a variety of mission oriented guidance, such as cruise missile guidance, anti-ballistic missile guidance, etc.

Adaptive Guidance and Control Algorithms applied to the X-38 Reentry Mission

NASA Astrophysics Data System (ADS)

Graesslin, M.; Wallner, E.; Burkhardt, J.; Schoettle, U.; Well, K. H.

International Space Station's Crew Return/Rescue Vehicle (CRV) is planned to autonomously return the complete crew of 7 astronauts back to earth in case of an emergency. As prototype of such a vehicle, the X-38, is being developed and built by NASA with European participation. The X-38 is a lifting body with a hyper- sonic lift to drag ratio of about 0.9. In comparison to the Space Shuttle Orbiter, the X-38 has less aerodynamic manoeuvring capability and less actuators. Within the German technology programme TETRA (TEchnologies for future space TRAnsportation systems) contributing to the X-38 program, guidance and control algorithms have been developed and applied to the X-38 reentry mission. The adaptive guidance concept conceived combines an on-board closed-loop predictive guidance algorithm with flight load control that temporarily overrides the attitude commands of the predictive component if the corre- sponding load constraints are violated. The predictive guidance scheme combines an optimization step and a sequence of constraint restoration cycles. In order to satisfy on-board computation limitations the complete scheme is performed only during the exo-atmospheric flight coast phase. During the controlled atmospheric flight segment the task is reduced to a repeatedly solved targeting problem based on the initial optimal solution, thus omitting in-flight constraints. To keep the flight loads - especially the heat flux, which is in fact a major concern of the X-38 reentry flight - below their maximum admissible values, a flight path controller based on quadratic minimization techniques may override the predictive guidance command for a flight along the con- straint boundary. The attitude control algorithms developed are based on dynamic inversion. This methodology enables the designer to straightforwardly devise a controller structure from the system dynamics. The main ad- vantage of this approach with regard to reentry control design lies in the fact that inversion renders a scheduled controller. Throughout the reentry, varying sets of actuators are available for control. Depending on which set is available, different inversion schemes are applied. With at least three controls effectors, decoupled control of the attitude angles can be achieved via a successive inversion which exploits the time-scale separation inherent in the attitude dynamics. However, during a flight phase where control needs to be achieved with only two body flaps, internal dynamics must be taken into account. To this end, a redefinition of the controlled variables is carried out so that the internal dynamics are stabilized while satisfactory tracking performance is achieved. The objectives of the present paper are to discuss the guidance and control approach taken, and asses the per- formance of the concepts by numerical flight simulations. For this purpose results obtained by means of a nu- merical flight simulator (CREDITS), that accurately models the characteristics of the X-38 vehicle, are presented to demonstrate the performance and effectiveness of the guidance and control design. Sensitivities to non- nominal flight conditions have been evaluated by Monte-Carlo analyses comprising motion simulations in both three and six degree of freedom. The results show that the mission requirements are met.

Characterizing chronic and acute health risks of residues of veterinary drugs in food: latest methodological developments by the joint FAO/WHO expert committee on food additives.

PubMed

Boobis, Alan; Cerniglia, Carl; Chicoine, Alan; Fattori, Vittorio; Lipp, Markus; Reuss, Rainer; Verger, Philippe; Tritscher, Angelika

2017-11-01

The risk assessment of residues of veterinary drugs in food is a field that continues to evolve. The toxicological end-points to be considered are becoming more nuanced and in light of growing concern about the development of antimicrobial resistance, detailed analysis of the antimicrobial activity of the residues of veterinary drugs in food is increasingly incorporated in the assessment. In recent years, the Joint FAO/WHO Expert Committee on Food Additives (JECFA) has refined its approaches to provide a more comprehensive and fit-for-purpose risk assessment. This publication describes in detail the consideration of acute and chronic effects, the estimation of acute and chronic dietary exposure, current approaches for including microbiological endpoints in the risk assessment, and JECFA's considerations for the potential effects of food processing on residues from veterinary drugs. JECFA now applies these approaches in the development of health-based guidance values (i.e. safe exposure levels) for residues of veterinary drugs. JECFA, thus, comprehensively addresses acute and chronic risks by using corresponding estimates for acute and chronic exposure and suitable correction for the limited bioavailability of bound residues by the Gallo-Torres model. On a case-by-case basis, JECFA also considers degradation products that occur from normal food processing of food containing veterinary drug residues. These approaches will continue to be refined to ensure the most scientifically sound basis for the establishment of health-based guidance values for veterinary drug residues.

The Effect of Haptic Guidance on Learning a Hybrid Rhythmic-Discrete Motor Task.

PubMed

Marchal-Crespo, Laura; Bannwart, Mathias; Riener, Robert; Vallery, Heike

2015-01-01

Bouncing a ball with a racket is a hybrid rhythmic-discrete motor task, combining continuous rhythmic racket movements with discrete impact events. Rhythmicity is exceptionally important in motor learning, because it underlies fundamental movements such as walking. Studies suggested that rhythmic and discrete movements are governed by different control mechanisms at different levels of the Central Nervous System. The aim of this study is to evaluate the effect of fixed/fading haptic guidance on learning to bounce a ball to a desired apex in virtual reality with varying gravity. Changing gravity changes dominance of rhythmic versus discrete control: The higher the value of gravity, the more rhythmic the task; lower values reduce the bouncing frequency and increase dwell times, eventually leading to a repetitive discrete task that requires initiation and termination, resembling target-oriented reaching. Although motor learning in the ball-bouncing task with varying gravity has been studied, the effect of haptic guidance on learning such a hybrid rhythmic-discrete motor task has not been addressed. We performed an experiment with thirty healthy subjects and found that the most effective training condition depended on the degree of rhythmicity: Haptic guidance seems to hamper learning of continuous rhythmic tasks, but it seems to promote learning for repetitive tasks that resemble discrete movements.

Interpreting REACH guidance in the determination of the derived no effect level (DNEL).

PubMed

Kreider, Marisa L; Spencer Williams, E

2010-11-01

Under the new European chemicals regulation, REACH, a new safety value, the Derived No Effect Level (DNEL) must be established for all chemicals manufactured, imported or used in the EU in quantities greater than 10 metric tonnes per year. The DNEL is to be calculated for all relevant exposure pathways, exposure populations, and endpoints of toxicity. The EU has published guidance on how to derive the DNEL, but this guidance has yet to be put into practice and is in some places not prescriptive. Using the Agency for Toxic Substances and Disease Registry (ATSDR) dataset, we have determined inhalation DNELs for styrene. In doing so, we considered what effect key decisions would have on the calculated DNEL. The resulting DNELs were then compared to existing risk criteria values or occupational exposure limits. General population DNELs were generally more conservative than analogous risk criteria (ranging from approximately 0.05 to 2.5 ppm). Worker DNELs are lower than existing occupational standards (ranging from approximately 0.4 to 20 ppm). To our knowledge, this work represents the first rigorous application and interpretation of the EU guidance for determination of a DNEL and will prove useful as a model for determination of other DNELs under REACH. Copyright © 2010 Elsevier Inc. All rights reserved.

What's the evidence that NICE guidance has been implemented? Results from a national evaluation using time series analysis, audit of patients' notes, and interviews

PubMed Central

Sheldon, Trevor A; Cullum, Nicky; Dawson, Diane; Lankshear, Annette; Lowson, Karin; Watt, Ian; West, Peter; Wright, Dianne; Wright, John

2004-01-01

Objectives To assess the extent and pattern of implementation of guidance issued by the National Institute for Clinical Excellence (NICE). Design Interrupted time series analysis, review of case notes, survey, and interviews. Setting Acute and primary care trusts in England and Wales. Participants All primary care prescribing, hospital pharmacies; a random sample of 20 acute trusts, 17 mental health trusts, and 21 primary care trusts; and senior clinicians and managers from five acute trusts. Main outcome measures Rates of prescribing and use of procedures and medical devices relative to evidence based guidance. Results 6308 usable patient audit forms were returned. Implementation of NICE guidance varied by trust and by topic. Prescribing of some taxanes for cancer (P < 0.002) and orlistat for obesity (P < 0.001) significantly increased in line with guidance. Prescribing of drugs for Alzheimer's disease and prophylactic extraction of wisdom teeth showed trends consistent with, but not obviously a consequence of, the guidance. Prescribing practice often did not accord with the details of the guidance. No change was apparent in the use of hearing aids, hip prostheses, implantable cardioverter defibrillators, laparoscopic hernia repair, and laparoscopic colorectal cancer surgery after NICE guidance had been issued. Conclusions Implementation of NICE guidance has been variable. Guidance seems more likely to be adopted when there is strong professional support, a stable and convincing evidence base, and no increased or unfunded costs, in organisations that have established good systems for tracking guidance implementation and where the professionals involved are not isolated. Guidance needs to be clear and reflect the clinical context. PMID:15514342

Opening All Options. Proceedings of the Ohio Middle School and Junior High School Career Guidance Conference (Columbus, Ohio, June 24-26, 1987).

ERIC Educational Resources Information Center

Ohio State Dept. of Education, Columbus.

This document presents the conference proceedings of a career guidance conference which focused attention on the need to develop a comprehensive career guidance program in Ohio middle and junior high schools. Papers include: (1) "Competency-Based Guidance Programs: A Model of the Future" (C. D. Johnson and Sharon Johnson); (2) "How…

Adaptive Critic Neural Network-Based Terminal Area Energy Management and Approach and Landing Guidance

NASA Technical Reports Server (NTRS)

Grantham, Katie

2003-01-01

Reusable Launch Vehicles (RLVs) have different mission requirements than the Space Shuttle, which is used for benchmark guidance design. Therefore, alternative Terminal Area Energy Management (TAEM) and Approach and Landing (A/L) Guidance schemes can be examined in the interest of cost reduction. A neural network based solution for a finite horizon trajectory optimization problem is presented in this paper. In this approach the optimal trajectory of the vehicle is produced by adaptive critic based neural networks, which were trained off-line to maintain a gradual glideslope.

Applying human rights to maternal health: UN Technical Guidance on rights-based approaches.

PubMed

Yamin, Alicia Ely

2013-05-01

In the last few years there have been several critical milestones in acknowledging the centrality of human rights to sustainably addressing the scourge of maternal death and morbidity around the world, including from the United Nations Human Rights Council. In 2012, the Council adopted a resolution welcoming a Technical Guidance on rights-based approaches to maternal mortality and morbidity, and calling for a report on its implementation in 2 years. The present paper provides an overview of the contents and significance of the Guidance. It reviews how the Guidance can assist policymakers in improving women's health and their enjoyment of rights by setting out the implications of adopting a human rights-based approach at each step of the policy cycle, from planning and budgeting, to ensuring implementation, to monitoring and evaluation, to fostering accountability mechanisms. The Guidance should also prove useful to clinicians in understanding rights frameworks as applied to maternal health. Copyright © 2013 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Comparison of Single-Stick and Double-Stick Techniques for Percutaneous Nephrostomy

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

Funaki, Brian, E-mail: bfunaki@midway.uchicago.edu; Vatakencherry, Geogi

2004-01-15

We compared single- and double-stick techniques of percutaneous nephrostomy insertion by retrospectively reviewing 140 percutaneous nephrostomy procedures in 101 patients. All procedures were performed by residents or fellows with direct attending supervision. Either the single-stick or double-stick technique was used based solely on personal attending preference. There were no significant differences in groups in terms of age, sex, or degree of hydronephrosis. In the single-stick technique, the kidney was punctured with sonographic guidance and the tract was serially dilated to accept an 8.5 Fr. nephrostomy catheter. In the double-stick technique, the kidney was punctured with sonographic guidance and a mixturemore » of air and contrast were injected into the collecting system. The affected side was then elevated and a posterior calyx was punctured using fluoroscopic guidance. Both groups were compared in terms of complications and early tube dysfunction using the chi-squared test. All procedures were successful without immediate complications. Bleeding requiring transfusion occurred in 4.7% (4/86) procedures in the single stick group and 3.7% (2/54) in the double stick group (p-value not significant). None of these patients required further interventions for bleeding. Tube dysfunction leading to premature tube exchange occurred in 3.5% (3/86) of catheters in the single stick group and 3.7% (2/54) of catheters in the double- stick group (p-value not significant). We found no significant difference between the single and double- stick methods of percutaneous nephrostomy in terms of success rates, complications, or tube function. We believe that the single-stick method should be adopted as the insertion technique of choice.« less

Framework Based Guidance Navigation and Control Flight Software Development

NASA Technical Reports Server (NTRS)

McComas, David

2007-01-01

This viewgraph presentation describes NASA's guidance navigation and control flight software development background. The contents include: 1) NASA/Goddard Guidance Navigation and Control (GN&C) Flight Software (FSW) Development Background; 2) GN&C FSW Development Improvement Concepts; and 3) GN&C FSW Application Framework.

Guidance of Nonlinear Nonminimum-Phase Dynamic Systems

NASA Technical Reports Server (NTRS)

Devasia, Santosh

1997-01-01

The first two years research work has advanced the inversion-based guidance theory for: (1) systems with non-hyperbolic internal dynamics; (2) systems with parameter jumps; (3) systems where a redesign of the output trajectory is desired; and (4) the generation of recovery guidance maneuvers.

The history and future of dietary guidance in America

USDA-ARS?s Scientific Manuscript database

Evidence-based dietary guidance in the US has progressed substantially since its inception over 100 years ago. This review describes the historical development and significance of dietary guidance in the US, including the Dietary Guidelines for Americans, and emphasizes the foundations upon which th...

Limited utility of residue masking for positive-selection inference.

PubMed

Spielman, Stephanie J; Dawson, Eric T; Wilke, Claus O

2014-09-01

Errors in multiple sequence alignments (MSAs) can reduce accuracy in positive-selection inference. Therefore, it has been suggested to filter MSAs before conducting further analyses. One widely used filter, Guidance, allows users to remove MSA positions aligned with low confidence. However, Guidance's utility in positive-selection inference has been disputed in the literature. We have conducted an extensive simulation-based study to characterize fully how Guidance impacts positive-selection inference, specifically for protein-coding sequences of realistic divergence levels. We also investigated whether novel scoring algorithms, which phylogenetically corrected confidence scores, and a new gap-penalization score-normalization scheme improved Guidance's performance. We found that no filter, including original Guidance, consistently benefitted positive-selection inferences. Moreover, all improvements detected were exceedingly minimal, and in certain circumstances, Guidance-based filters worsened inferences. © The Author 2014. Published by Oxford University Press on behalf of the Society for Molecular Biology and Evolution. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Standard Operating Procedure for Using the NAFTA Guidance to Calculate Representative Half-life Values and Characterizing Pesticide Degradation

EPA Pesticide Factsheets

Results of the degradation kinetics project and describes a general approach for calculating and selecting representative half-life values from soil and aquatic transformation studies for risk assessment and exposure modeling purposes.

ESTIMATION OF GIARDIA CT VALUES AT HIGH PH FOR THE SURFACE WATER TREATMENT RULE

EPA Science Inventory

The U.S. Environmental Protection Agency currently recommends Ct (disinfectant concentration multiplied by the exposure time) values to achieve required levels of inactivation of Giardia lamblia cysts by different disinfectants including free chlorine. Current guidance covers ina...

Health technology assessment, value-based decision making, and innovation.

PubMed

Henshall, Chris; Schuller, Tara

2013-10-01

Identifying treatments that offer value and value for money is becoming increasingly important, with interest in how health technology assessment (HTA) and decision makers can take appropriate account of what is of value to patients and to society, and in the relationship between innovation and assessments of value. This study summarizes points from an Health Technology Assessment International (HTAi) Policy Forum discussion, drawing on presentations, discussions among attendees, and background papers. Various perspectives on value were considered; most place patient health at the core of value. Wider elements of value comprise other benefits for: patients; caregivers; the health and social care systems; and society. Most decision-making systems seek to take account of similar elements of value, although they are assessed and combined in different ways. Judgment in decisions remains important and cannot be replaced by mathematical approaches. There was discussion of the value of innovation and of the effects of value assessments on innovation. Discussion also included moving toward "progressive health system decision making," an ongoing process whereby evidence-based decisions on use would be made at various stages in the technology lifecycle. Five actions are identified: (i) development of a general framework for the definition and assessment of value; development by HTA/coverage bodies and regulators of (ii) disease-specific guidance and (iii) further joint scientific advice for industry on demonstrating value; (iv) development of a framework for progressive licensing, usage, and reimbursement; and (v) promoting work to better adapt HTA, coverage, and procurement approaches to medical devices.

Synthesis of Nonlinear Guidance Laws for Missiles with Uncertain Dynamics

DTIC Science & Technology

2007-11-01

and Astronautics, Progress in Astronautics and Aeronautics, Volume 199, 2002. 2. Gurfil , M. Jodorkovsky and M. Guelman, Neoclassical Guidance for...658-666, July-August 2002. 19. P. Gurfil , “Robust Guidance for Electro-Optical Missiles,” IEEE Transactions on Aerospace and Electronic Systems, Vol...edition, Upper Saddle River, NJ: Prentice-Hall, 2002. 23. P. Gurfil , ”Zero-Miss Distance Guidance Law Based on Line-of-Sight Rate Measuremenbt Only

Limitations and opportunities for the social cost of carbon (Invited)

NASA Astrophysics Data System (ADS)

Rose, S. K.

2010-12-01

Estimates of the marginal value of carbon dioxide-the social cost of carbon (SCC)-were recently adopted by the U.S. Government in order to satisfy requirements to value estimated GHG changes of new federal regulations. However, the development and use of SCC estimates of avoided climate change impacts comes with significant challenges and controversial decisions. Fortunately, economics can provide some guidance for conceptually appropriate estimates. At the same time, economics defaults to a benefit-cost decision framework to identify socially optimal policies. However, not all current policy decisions are benefit-cost based, nor depend on monetized information, or even have the same threshold for information. While a conceptually appropriate SCC is a useful metric, how far can we take it? This talk discusses potential applications of the SCC, limitations based on the state of research and methods, as well as opportunities for among other things consistency with climate risk management and research and decision-making tools.

The need for sustainability and alignment of future support for National Immunization Technical Advisory Groups (NITAGs) in low and middle-income countries.

PubMed

Howard, Natasha; Bell, Sadie; Walls, Helen; Blanchard, Laurence; Brenzel, Logan; Jit, Mark; Mounier-Jack, Sandra

2018-02-22

National Immunisation Technical Advisory Groups (NITAGs) provide independent guidance to health ministries to support evidence-based and nationally relevant immunisation decisions. We examined NITAGs' value, sustainability, and need for support in low and middle-income countries, drawing from a mixed-methods study including 130 global and national-level key informant interviews. NITAGs were particularly valued for providing independent and nationally owned evidence-based decision-making (EBDM), but needed to be integrated within national processes to effectively balance independence and influence. Participants agreed that most NITAGs, being relatively new, would need developmental and strengthening support for at least a decade. While national governments could support NITAG functioning, external support is likely needed for requisite capacity building. This might come from Gavi mechanisms and WHO, but would require alignment among stakeholders to be effective.

Vocational and Career Guidance. The Key to Unlock the Future. A Model for Vocational and Career Guidance for Washington County School District. Manual for Implementation for Grades One through Twelve.

ERIC Educational Resources Information Center

Washington County School District, St. George, UT.

This document contains a model for vocational career education and career guidance for grades 1-12, based on a program developed in the Washington County School District (Utah). The model is based upon the premise that major educational and vocational goals have been identified over the years by many state departments of education and local school…

43. Upper level, left to rightground missile guidance system liquid ...

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

43. Upper level, left to right--ground missile guidance system liquid cooling equipment, guidance and control coupler rack, programmer group - Ellsworth Air Force Base, Delta Flight, Launch Facility, On County Road T512, south of Exit 116 off I-90, Interior, Jackson County, SD

Automated Guidance for Student Inquiry

ERIC Educational Resources Information Center

Gerard, Libby F.; Ryoo, Kihyun; McElhaney, Kevin W.; Liu, Ou Lydia; Rafferty, Anna N.; Linn, Marcia C.

2016-01-01

In 4 classroom experiments we investigated uses for technologies that automatically score student generated essays, concept diagrams, and drawings in inquiry curricula. We used the automatic scores to assign typical and research-based guidance and studied the impact of the guidance on student progress. Seven teachers and their 897 students…

Computed intraoperative navigation guidance--a preliminary report on a new technique.

PubMed

Enislidis, G; Wagner, A; Ploder, O; Ewers, R

1997-08-01

To assess the value of a computer-assisted three-dimensional guidance system (Virtual Patient System) in maxillofacial operations. Laboratory and open clinical study. Teaching Hospital, Austria. 6 patients undergoing various procedures including removal of foreign body (n=3) and biopsy, maxillary advancement, and insertion of implants (n=1 each). Storage of computed tomographic (CT) pictures on an optical disc, and imposition of intraoperative video images on to these. The resulting display is shown to the surgeon on a micromonitor in his head-up display for guidance during the operations. To improve orientation during complex or minimally invasive maxillofacial procedures and to make such operations easier and less traumatic. Successful transferral of computed navigation technology into an operation room environment and positive evaluation of the method by the surgeons involved. Computer-assisted three-dimensional guidance systems have the potential for making complex or minimally invasive procedures easier to do, thereby reducing postoperative morbidity.

Proposal for a new protein therapeutic immunogenicity titer assay cutpoint.

PubMed

Wakshull, Eric; Hendricks, Robert; Amaya, Caroline; Coleman, Daniel

2011-12-01

Generally, immunogenicity assessment strategies follow this assay triage schema: screen→confirm→titer. Each requires the determination of a threshold value (cutpoint) for decision making. No guidance documents exist for the determination of a specific titration assay cutpoint. The default practice is to use the screening assay cutpoint, frequently leading to controls or samples not reaching this cutpoint. We propose a method for determination of a titration cutpoint based upon the variance of the negative-control sample. Positive-control samples that did not cross a screening cutpoint did cross the titer cutpoint, albeit generating slightly lower titer values. Our approach is consistent with the statistical methods currently recommended for the screening and confirmatory assay cutpoints and is operationally simple and efficient.

The Effect of Lift on Entry Corridor Depth and Guidance Requirements for the Return Lunar Flight

NASA Technical Reports Server (NTRS)

Wong, Thomas J.; Slye, Robert E.

1961-01-01

Corridors for manned vehicles are defined consistent with requirements for avoiding radiation exposure and for limiting values of peak deceleration. Use of lift increases the depth of the entry corridor. Mid-course guidance requirements appear to be critical only for the flight-path angle. Increasing the energy of the transport orbit increases the required guidance accuracy for the flight-path angle. Corrective thrust applied essentially parallel to the local horizontal produces the maximum change in perigee altitude for a given increment of velocity. Energy required to effect a given change in perigee altitude varies inversely with range measured from the center of the earth.

AGARD Flight Test Instrumentation Series. Volume 1, Issue 2. Basic Principles of Flight Test Instrumentation Engineering (Introduction Generale aux Principles de Base de l’Instrumentation des Essais en Vol)

DTIC Science & Technology

1994-03-01

evaluation of its anticipated value. If the program can be accomplished using conventional techniques , this should be seriously considered. Development or...the direct frequency generating principles such as, pulse tachos, turbine flowmeters, and encoders, also Doppler and laser techniques used for...CERAMIC BLOCK Figure 5.3. The basic concepts of the laser ring gyro (LRG). The principle depends upon the guidance of two beams of laser light around an

78 FR 69693 - Draft Guidance for Industry: Recommendations for Premarket Notification (510(k)) Submissions for...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-20

...] Draft Guidance for Industry: Recommendations for Premarket Notification (510(k)) Submissions for Nucleic... ``Guidance for Industry: Recommendations for Premarket Notification (510(k)) Submissions for Nucleic Acid... submitters and FDA reviewers in preparing and reviewing 510(k) submissions for nucleic acid-based HLA test...

Student-perceived barriers and facilitators to e-learning in continuing professional development in primary care.

PubMed

Docherty, Andrea; Sandhu, Harbinder

2006-01-01

WHAT IS ALREADY KNOWN IN THIS AREA • E-learning is being increasingly used within learning and teaching including its application within healthcare education and service provision. Multiple advantages have been identified including enhanced accessibility and increased flexibility of learning. Guidance on the generic-design and development of e-learning courses has been generated. WHAT THIS WORK ADDS • This paper provides a detailed understanding of the barriers and facilitators to e-learning as perceived by students on a continuing professional development (CPD); course arid highlights its multifaceted values. In addition, the paper ṕrovides evidence-based guidance for the development of courses within CPD utilising e-learning. SUGGESTIONS FOR FUTURE RESEARCH • Future research would benefit from, focusing upon the perceptions of staff including barriers and facilitators to the implementation of e-learning and awareness of student experience to generate a balanced and informed understanding of e-learning within the context-of CPD.

Patient doses from chest radiography in Victoria.

PubMed

Cardillo, I; Boal, T J; Einsiedel, P F

1997-06-01

This survey examines doses from PA chest radiography at radiology practices, private hospitals and public hospitals throughout metropolitan and country Victoria. Data were collected from 111 individual X-ray units at 86 different practices. Entrance skin doses in air were measured for exposure factors used by the centre for a 23 cm thick male chest. A CDRH LucA1 chest phantom was used when making these measurements. About half of the centres used grid technique and half used non-grid technique. There was a factor of greater than 10 difference in the entrance dose delivered between the highest dose centre and the lowest dose centre for non-grid centres; and a factor of about 5 for centres using grids. Factors contributing to the high doses recorded at some centres were identified. Guidance levels for chest radiography based on the third quartile value of the entrance doses from this survey have been recommended and compared with guidance levels recommended in other countries.

Apollo lunar descent guidance

NASA Technical Reports Server (NTRS)

Klumpp, A. R.

1974-01-01

Apollo lunar-descent guidance transfers the Lunar Module from a near-circular orbit to touchdown, traversing a 17 deg central angle and a 15 km altitude in 11 min. A group of interactive programs in an onboard computer guide the descent, controlling altitude and the descent propulsion system throttle. A ground-based program pre-computes guidance targets. The concepts involved in this guidance are described. Explicit and implicit guidance are discussed, guidance equations are derived, and the earlier Apollo explicit equation is shown to be an inferior special case of the later implicit equation. Interactive guidance, by which the two-man crew selects a landing site in favorable terrain and directs the trajectory there, is discussed. Interactive terminal-descent guidance enables the crew to control the essentially vertical descent rate in order to land in minimum time with safe contact speed. The altitude maneuver routine uses concepts that make gimbal lock inherently impossible.

International Conference on Harmonisation; guidance on Q10 Pharmaceutical Quality System; availability. Notice.

PubMed

2009-04-08

The Food and Drug Administration (FDA) is announcing the availability of a guidance entitled "Q10 Pharmaceutical Quality System." The guidance was prepared under the auspices of the International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH). The guidance describes a model for an effective quality management system for the pharmaceutical industry, referred to as the Pharmaceutical Quality System. The guidance is intended to provide a comprehensive approach to an effective pharmaceutical quality system that is based on International Organization for Standardization (ISO) concepts, includes applicable good manufacturing practice (GMP) regulations and complements ICH guidances on "Q8 Pharmaceutical Development" and "Q9 Quality Risk Management."

Passive sampling methods for contaminated sediments: Practical guidance for selection, calibration, and implementation

PubMed Central

Ghosh, Upal; Driscoll, Susan Kane; Burgess, Robert M; Jonker, Michiel To; Reible, Danny; Gobas, Frank; Choi, Yongju; Apitz, Sabine E; Maruya, Keith A; Gala, William R; Mortimer, Munro; Beegan, Chris

2014-01-01

This article provides practical guidance on the use of passive sampling methods (PSMs) that target the freely dissolved concentration (Cfree) for improved exposure assessment of hydrophobic organic chemicals in sediments. Primary considerations for selecting a PSM for a specific application include clear delineation of measurement goals for Cfree, whether laboratory-based “ex situ” and/or field-based “in situ” application is desired, and ultimately which PSM is best-suited to fulfill the measurement objectives. Guidelines for proper calibration and validation of PSMs, including use of provisional values for polymer–water partition coefficients, determination of equilibrium status, and confirmation of nondepletive measurement conditions are defined. A hypothetical example is described to illustrate how the measurement of Cfree afforded by PSMs reduces uncertainty in assessing narcotic toxicity for sediments contaminated with polycyclic aromatic hydrocarbons. The article concludes with a discussion of future research that will improve the quality and robustness of Cfree measurements using PSMs, providing a sound scientific basis to support risk assessment and contaminated sediment management decisions. Integr Environ Assess Manag 2014;10:210–223. © 2014 The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals, Inc. on behalf of SETAC. PMID:24288273

Halon 1301 management planning guidance

NASA Astrophysics Data System (ADS)

1995-05-01

This ETL provides guidance to help the Base Civil Engineer (BCE) and other users manage inventories of Halon 1301, an ozone depleting substance used in many facility fire protection systems. This guidance will allow Halon 1301 users to develop the transition plans necessary to implement the DOD and Air Force policies on ozone depleting substances. Attachment 3 to this ETL contains detailed instructions on how to develop a Base Halon 1 301 Management Plan and comply with Air Force policies and regulations designed to minimize dependency on Halon 1301.

75 FR 13610 - Office of New Reactors; Interim Staff Guidance on Implementation of a Seismic Margin Analysis for...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-22

... Staff Guidance on Implementation of a Seismic Margin Analysis for New Reactors Based on Probabilistic... Seismic Margin Analysis for New Reactors Based on Probabilistic Risk Assessment,'' (Agencywide Documents.../COL-ISG-020 ``Implementation of a Seismic Margin Analysis for New Reactors Based on Probabilistic Risk...

Supervised guiding long-short term memory for image caption generation based on object classes

NASA Astrophysics Data System (ADS)

Wang, Jian; Cao, Zhiguo; Xiao, Yang; Qi, Xinyuan

2018-03-01

The present models of image caption generation have the problems of image visual semantic information attenuation and errors in guidance information. In order to solve these problems, we propose a supervised guiding Long Short Term Memory model based on object classes, named S-gLSTM for short. It uses the object detection results from R-FCN as supervisory information with high confidence, and updates the guidance word set by judging whether the last output matches the supervisory information. S-gLSTM learns how to extract the current interested information from the image visual se-mantic information based on guidance word set. The interested information is fed into the S-gLSTM at each iteration as guidance information, to guide the caption generation. To acquire the text-related visual semantic information, the S-gLSTM fine-tunes the weights of the network through the back-propagation of the guiding loss. Complementing guidance information at each iteration solves the problem of visual semantic information attenuation in the traditional LSTM model. Besides, the supervised guidance information in our model can reduce the impact of the mismatched words on the caption generation. We test our model on MSCOCO2014 dataset, and obtain better performance than the state-of-the- art models.

Robust approximate optimal guidance strategies for aeroassisted orbital transfer missions

NASA Astrophysics Data System (ADS)

Ilgen, Marc R.

This thesis presents the application of game theoretic and regular perturbation methods to the problem of determining robust approximate optimal guidance laws for aeroassisted orbital transfer missions with atmospheric density and navigated state uncertainties. The optimal guidance problem is reformulated as a differential game problem with the guidance law designer and Nature as opposing players. The resulting equations comprise the necessary conditions for the optimal closed loop guidance strategy in the presence of worst case parameter variations. While these equations are nonlinear and cannot be solved analytically, the presence of a small parameter in the equations of motion allows the method of regular perturbations to be used to solve the equations approximately. This thesis is divided into five parts. The first part introduces the class of problems to be considered and presents results of previous research. The second part then presents explicit semianalytical guidance law techniques for the aerodynamically dominated region of flight. These guidance techniques are applied to unconstrained and control constrained aeroassisted plane change missions and Mars aerocapture missions, all subject to significant atmospheric density variations. The third part presents a guidance technique for aeroassisted orbital transfer problems in the gravitationally dominated region of flight. Regular perturbations are used to design an implicit guidance technique similar to the second variation technique but that removes the need for numerically computing an optimal trajectory prior to flight. This methodology is then applied to a set of aeroassisted inclination change missions. In the fourth part, the explicit regular perturbation solution technique is extended to include the class of guidance laws with partial state information. This methodology is then applied to an aeroassisted plane change mission using inertial measurements and subject to uncertainties in the initial value of the flight path angle. A summary of performance results for all these guidance laws is presented in the fifth part of this thesis along with recommendations for further research.

Commissioning and quality assurance for the treatment delivery components of the AccuBoost system.

PubMed

Iftimia, Ileana; Talmadge, Mike; Ladd, Ron; Halvorsen, Per

2015-03-08

The objective for this work was to develop a commissioning methodology for the treatment delivery components of the AccuBoost system, as well as to establish a routine quality assurance program and appropriate guidance for clinical use based on the commissioning results. Various tests were developed: 1) assessment of the accuracy of the displayed separation value; 2) validation of the dwell positions within each applicator; 3) assessment of the accuracy and precision of the applicator localization system; 4) assessment of the combined dose profile of two opposed applicators to confirm that they are coaxial; 5) measurement of the absolute dose delivered with each applicator to confirm acceptable agreement with dose based on Monte Carlo modeling; 6) measurements of the skin-to-center dose ratio using optically stimulated luminescence dosimeters; and 7) assessment of the mammopad cushion's effect on the center dose. We found that the difference between the measured and the actual paddle separation is < 0.1 cm for the separation range of 3 cm to 7.5 cm. Radiochromic film measurements demonstrated that the number of dwell positions inside the applicators agree with the values from the vendor, for each applicator type and size. The shift needed for a good applicator-grid alignment was within 0.2 cm. The dry-run test using film demonstrated that the shift of the dosimetric center is within 0.15 cm. Dose measurements in water converted to polystyrene agreed within 5.0% with the Monte Carlo data in polystyrene for the same applicator type, size, and depth. A solid water-to-water (phantom) factor was obtained for each applicator, and all future annual quality assurance tests will be performed in solid water using an average value of 1.07 for the solid water-to-water factor. The skin-to-center dose ratio measurements support the Monte Carlo-based values within 5.0% agreement. For the treatment separation range of 4 cm to 8cm, the change in center dose would be < 1.0% for all applicators when using a compressed pad of 0.2 cm to 0.3 cm. The tests performed ensured that all treatment components of the AccuBoost system are functional and that a treatment plan can be delivered with acceptable accuracy. Based on the commissioning results, a quality assurance manual and guidance documents for clinical use were developed.

When paradigms collide at the road rail interface: evaluation of a sociotechnical systems theory design toolkit for cognitive work analysis.

PubMed

Read, Gemma J M; Salmon, Paul M; Lenné, Michael G

2016-09-01

The Cognitive Work Analysis Design Toolkit (CWA-DT) is a recently developed approach that provides guidance and tools to assist in applying the outputs of CWA to design processes to incorporate the values and principles of sociotechnical systems theory. In this paper, the CWA-DT is evaluated based on an application to improve safety at rail level crossings. The evaluation considered the extent to which the CWA-DT met pre-defined methodological criteria and aligned with sociotechnical values and principles. Both process and outcome measures were taken based on the ratings of workshop participants and human factors experts. Overall, workshop participants were positive about the process and indicated that it met the methodological criteria and sociotechnical values. However, expert ratings suggested that the CWA-DT achieved only limited success in producing RLX designs that fully aligned with the sociotechnical approach. Discussion about the appropriateness of the sociotechnical approach in a public safety context is provided. Practitioner Summary: Human factors and ergonomics practitioners need evidence of the effectiveness of methods. A design toolkit for cognitive work analysis, incorporating values and principles from sociotechnical systems theory, was applied to create innovative designs for rail level crossings. Evaluation results based on the application are provided and discussed.

A Design Study of Onboard Navigation and Guidance During Aerocapture at Mars. M.S. Thesis

NASA Technical Reports Server (NTRS)

Fuhry, Douglas Paul

1988-01-01

The navigation and guidance of a high lift-to-drag ratio sample return vehicle during aerocapture at Mars are investigated. Emphasis is placed on integrated systems design, with guidance algorithm synthesis and analysis based on vehicle state and atmospheric density uncertainty estimates provided by the navigation system. The latter utilizes a Kalman filter for state vector estimation, with useful update information obtained through radar altimeter measurements and density altitude measurements based on IMU-measured drag acceleration. A three-phase guidance algorithm, featuring constant bank numeric predictor/corrector atmospheric capture and exit phases and an extended constant altitude cruise phase, is developed to provide controlled capture and depletion of orbital energy, orbital plane control, and exit apoapsis control. Integrated navigation and guidance systems performance are analyzed using a four degree-of-freedom computer simulation. The simulation environment includes an atmospheric density model with spatially correlated perturbations to provide realistic variations over the vehicle trajectory. Navigation filter initial conditions for the analysis are based on planetary approach optical navigation results. Results from a selection of test cases are presented to give insight into systems performance.

International Conference on Harmonisation; guidance on Q9 Quality Risk Management; availability. Notice.

PubMed

2006-06-02

The Food and Drug Administration (FDA) is announcing the availability of a guidance entitled "Q9 Quality Risk Management."' The guidance was prepared under the auspices of the International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH). The guidance provides principles and examples of tools for quality risk management that can be applied to all aspects of pharmaceutical quality throughout the lifecycle of drug substances, drug products, and biological and biotechnological products. The guidance is intended to enable regulators and industry to make more effective and consistent risk-based decisions.

CRYPTOSPORIDIUM LOG INACTIVATION CALCULATION METHODS

EPA Science Inventory

Appendix O of the Surface Water Treatment Rule (SWTR) Guidance Manual introduces the CeffT10 (i.e., reaction zone outlet C value and T10 time) method for calculating ozone CT value and Giardia and virus log inactivation. The LT2ESWTR Pre-proposal Draft Regulatory Language for St...

Alternative radiation-free registration technique for image-guided pedicle screw placement in deformed cervico-thoracic segments.

PubMed

Kantelhardt, Sven R; Neulen, Axel; Keric, Naureen; Gutenberg, Angelika; Conrad, Jens; Giese, Alf

2017-10-01

Image-guided pedicle screw placement in the cervico-thoracic region is a commonly applied technique. In some patients with deformed cervico-thoracic segments, conventional or 3D fluoroscopy based registration of image-guidance might be difficult or impossible because of the anatomic/pathological conditions. Landmark based registration has been used as an alternative, mostly using separate registration of each vertebra. We here investigated a routine for landmark based registration of rigid spinal segments as single objects, using cranial image-guidance software. Landmark based registration of image-guidance was performed using cranial navigation software. After surgical exposure of the spinous processes, lamina and facet joints and fixation of a reference marker array, up to 26 predefined landmarks were acquired using a pointer. All pedicle screws were implanted using image guidance alone. Following image-guided screw placement all patients underwent postoperative CT scanning. Screw positions as well as intraoperative and clinical parameters were retrospectively analyzed. Thirteen patients received 73 pedicle screws at levels C6 to Th8. Registration of spinal segments, using the cranial image-guidance succeeded in all cases. Pedicle perforations were observed in 11.0%, severe perforations of >2 mm occurred in 5.4%. One patient developed a transient C8 syndrome and had to be revised for deviation of the C7 pedicle screw. No other pedicle screw-related complications were observed. In selected patients suffering from pathologies of the cervico-thoracic region, which impair intraoperative fluoroscopy or 3D C-arm imaging, landmark based registration of image-guidance using cranial software is a feasible, radiation-saving and a safe alternative.

Correlation of Condylar Guidance Determined by Panoramic Radiographs to One Determined by Conventional Methods.

PubMed

Godavarthi, A Sowjanya; Sajjan, M C Suresh; Raju, A V Rama; Rajeshkumar, P; Premalatha, Averneni; Chava, Narayana

2015-08-01

To evaluate the feasibility of using panoramic radiographs as an alternative to an interocclusal recording method for determining the condylar guidance in dentate and edentulous conditions. 20 dentulous individuals with an age range of 20-30 years and 20 edentulous patients of 40-65 years were selected. An interocclusal bite registration was done in protrusive position for all the subjects. Orthopantomographs were made for all patients in open mouth position. Hanau articulator was modified to record the angulations to the accuracy of 1°. Tracing of glenoid fossa on radiograph was done to measure the condylar guidance angles. Readings were recorded and analyzed by Freidman's test and t-test. Condylar guidance values obtained by the interocclusal method and radiographic method in dentate individuals on the right side and left side 40.55°, and 37.1°, and 40.15°, and 34.75°, respectively. In the edentulous individuals, the values on the right side and left side was 36.7° and 36.1° and 35.95° and 33.6,° respectively. The difference was statistically significant (P = < 0.001) in dentate group and was not statistically significant (P = 0.6493) in edentulous group. Panoramic radiograph can be used as an alternative to interocclusal technique only in edentulous patients. Further studies comparing panoramic radiograph to jaw tracking devices would substantiate the results of this study.

Flight demonstrations of curved, descending approaches and automatic landings using time referenced scanning beam guidance

NASA Technical Reports Server (NTRS)

White, W. F. (Compiler)

1978-01-01

The Terminal Configured Vehicle (TCV) program operates a Boeing 737 modified to include a second cockpit and a large amount of experimental navigation, guidance and control equipment for research on advanced avionics systems. Demonstration flights to include curved approaches and automatic landings were tracked by a phototheodolite system. For 50 approaches during the demonstration flights, the following results were obtained: the navigation system, using TRSB guidance, delivered the aircraft onto the 3 nautical mile final approach leg with an average overshoot of 25 feet past centerline, subjet to a 2-sigma dispersion of 90 feet. Lateral tracking data showed a mean error of 4.6 feet left of centerline at the category 1 decision height (200 feet) and 2.7 feet left of centerline at the category 2 decision height (100 feet). These values were subject to a sigma dispersion of about 10 feet. Finally, the glidepath tracking errors were 2.5 feet and 3.0 feet high at the category 1 and 2 decision heights, respectively, with a 2 sigma value of 6 feet.

EPRI/NRC-RES fire human reliability analysis guidelines.

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

Lewis, Stuart R.; Cooper, Susan E.; Najafi, Bijan

2010-03-01

During the 1990s, the Electric Power Research Institute (EPRI) developed methods for fire risk analysis to support its utility members in the preparation of responses to Generic Letter 88-20, Supplement 4, 'Individual Plant Examination - External Events' (IPEEE). This effort produced a Fire Risk Assessment methodology for operations at power that was used by the majority of U.S. nuclear power plants (NPPs) in support of the IPEEE program and several NPPs overseas. Although these methods were acceptable for accomplishing the objectives of the IPEEE, EPRI and the U.S. Nuclear Regulatory Commission (NRC) recognized that they required upgrades to support currentmore » requirements for risk-informed, performance-based (RI/PB) applications. In 2001, EPRI and the USNRC's Office of Nuclear Regulatory Research (RES) embarked on a cooperative project to improve the state-of-the-art in fire risk assessment to support a new risk-informed environment in fire protection. This project produced a consensus document, NUREG/CR-6850 (EPRI 1011989), entitled 'Fire PRA Methodology for Nuclear Power Facilities' which addressed fire risk for at power operations. NUREG/CR-6850 developed high level guidance on the process for identification and inclusion of human failure events (HFEs) into the fire PRA (FPRA), and a methodology for assigning quantitative screening values to these HFEs. It outlined the initial considerations of performance shaping factors (PSFs) and related fire effects that may need to be addressed in developing best-estimate human error probabilities (HEPs). However, NUREG/CR-6850 did not describe a methodology to develop best-estimate HEPs given the PSFs and the fire-related effects. In 2007, EPRI and RES embarked on another cooperative project to develop explicit guidance for estimating HEPs for human failure events under fire generated conditions, building upon existing human reliability analysis (HRA) methods. This document provides a methodology and guidance for conducting a fire HRA. This process includes identification and definition of post-fire human failure events, qualitative analysis, quantification, recovery, dependency, and uncertainty. This document provides three approaches to quantification: screening, scoping, and detailed HRA. Screening is based on the guidance in NUREG/CR-6850, with some additional guidance for scenarios with long time windows. Scoping is a new approach to quantification developed specifically to support the iterative nature of fire PRA quantification. Scoping is intended to provide less conservative HEPs than screening, but requires fewer resources than a detailed HRA analysis. For detailed HRA quantification, guidance has been developed on how to apply existing methods to assess post-fire fire HEPs.« less

Statistical evaluation of stability data: criteria for change-over-time and data variability.

PubMed

Bar, Raphael

2003-01-01

In a recently issued ICH Q1E guidance on evaluation of stability data of drug substances and products, the need to perform a statistical extrapolation of a shelf-life of a drug product or a retest period for a drug substance is based heavily on whether data exhibit a change-over-time and/or variability. However, this document suggests neither measures nor acceptance criteria of these two parameters. This paper demonstrates a useful application of simple statistical parameters for determining whether sets of stability data from either accelerated or long-term storage programs exhibit a change-over-time and/or variability. These parameters are all derived from a simple linear regression analysis first performed on the stability data. The p-value of the slope of the regression line is taken as a measure for change-over-time, and a value of 0.25 is suggested as a limit to insignificant change of the quantitative stability attributes monitored. The minimal process capability index, Cpk, calculated from the standard deviation of the regression line, is suggested as a measure for variability with a value of 2.5 as a limit for an insignificant variability. The usefulness of the above two parameters, p-value and Cpk, was demonstrated on stability data of a refrigerated drug product and on pooled data of three batches of a drug substance. In both cases, the determined parameters allowed characterization of the data in terms of change-over-time and variability. Consequently, complete evaluation of the stability data could be pursued according to the ICH guidance. It is believed that the application of the above two parameters with their acceptance criteria will allow a more unified evaluation of stability data.

Achieving high-quality care: a view from NICE.

PubMed

Leng, Gillian; Partridge, Gemma

2018-01-01

The National Institute for Health and Care Excellence (NICE) was established in 1999 to provide evidence-based guidance. The task of producing guidance by reviewing primary research data and using an advisory committee to develop evidence-based recommendations, is not straightforward. Guidance production is, however, less challenging than the task of putting evidence-based recommendations into practice.NICE is very sensitive to this challenge as, since 1999, over 1500 pieces of NICE guidance have been published. A number of pieces of guidance relate to heart disease, including pharmaceutical agents, new medical technologies and clinical guidelines. Examples include guidelines on acute heart failure and atrial fibrillation, and advice on technologies including edoxaban and implantable cardioverter defibrillators.The research evidence is clear that a change in practice rarely comes about as a result of simply disseminating guidance on best practice. Simple dissemination is particularly ineffective if the guidance has not been produced by a well-respected, credible organisation. It is also clear from the literature that implementation is more successful when more than one approach is taken, and when there is alignment between efforts at organisational, local and national levels.At an organisational level, there should be support from the Board for quality improvement, with ongoing measurement of progress. Resources should be provided for targeted change programmes, particularly where new guidance suggests improvements are required. A systematic process for putting change in place should include identifying barriers to change, agreeing interventions to overcome the barriers and drive forward improvement and planning for implementation and evaluation. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Online Career Guidance: Does Knowledge Equate to Power for High School Students?

ERIC Educational Resources Information Center

Galliott, Natal'ya

2017-01-01

The provision of online career information and guidance is becoming more popular among career counselling practitioners and policy makers targeting the postschool transitions of youth. Internet-based career exploration and guidance systems provide convenience and economy to both individuals confronted with career decision making as well as those…

Impact of Additional Guidance in Science Education on Primary Students' Conceptual Understanding

ERIC Educational Resources Information Center

Decristan, Jasmin; Hondrich, A. Lena; Büttner, Gerhard; Hertel, Silke; Klieme, Eckhard; Kunter, Mareike; Lühken, Arnim; Adl-Amini, Katja; Djakovic, Sanna-K.; Mannel, Susanne; Naumann, Alexander; Hardy, Ilonca

2015-01-01

A cognitive and a guidance dimension can describe the support of students' conceptual understanding in inquiry-based science education. The role of guidance for student learning has been intensively discussed. Furthermore, inquiry learning may pose particular challenges to students with low language proficiency. The present intervention in primary…

Guidance Document on Anaerobic Digester Foaming Prevention and Control Methods (WERF Report INFR1SG10a)

EPA Science Inventory

The development of this anaerobic digester (AD) foaming guidance document is based on the need for a specific detailed methodology that water resource recovery facilities (WRRF) personnel can follow and implement to manage or mitigate AD foam incidents. This guidance manual is th...

Counseling Skills Pre-Practicum Training at Guidance and Counseling Undergraduate Programs: A Qualitative Investigation

ERIC Educational Resources Information Center

Aladag, Mine

2013-01-01

This study was aimed to describe counseling skills pre-practicum training at guidance and counseling undergraduate programs in Turkey. A descriptive study was conducted based upon qualitative data. The research group of this study consisted of 11 guidance and counseling undergraduate programs voluntarily participate into study. The Survey Form…

A clinico-radiographic analysis of sagittal condylar guidance determined by protrusive interocclusal registration and panoramic radiographic images in humans

PubMed Central

Prasad, Krishna D.; Shah, Namrata; Hegde, Chethan

2012-01-01

Purpose: To evaluate the correlation between sagittal condylar guidance obtained by protrusive interocclusal records and panoramic radiograph tracing methods in human dentulous subjects. Materials and Methods: The sagittal condylar guidance was determined in 75 dentulous subjects by protrusive interocclusal records using Aluwax through a face bow transfer (HANAU™ Spring Bow, Whip Mix Corporation, USA) to a semi-adjustable articulator (HANAU™ Wide-Vue Articulator, Whip Mix Corporation, USA). In the same subjects, the sagittal outline of the articular eminence and glenoid fossa was traced in panoramic radiographs. The sagittal condylar path inclination was constructed by joining the heights of curvature in the glenoid fossa and the corresponding articular eminence. This was then related to the constructed Frankfurt's horizontal plane to determine the radiographic angle of sagittal condylar guidance. Results: A strong positive correlation existed between right and left condylar guidance by the protrusive interocclusal method (P 0.000) and similarly by the radiographic method (P 0.013). The mean difference between the condylar guidance obtained using both methods were 1.97° for the right side and 3.18° for the left side. This difference between the values by the two methods was found to be highly significant for the right (P 0.003) and left side (P 0.000), respectively. The sagittal condylar guidance obtained from both methods showed a significant positive correlation on right (P 0.000) and left side (P 0.015), respectively. Conclusion: Panoramic radiographic tracings of the sagittal condylar path guidance may be made relative to the Frankfurt's horizontal reference plane and the resulting condylar guidance angles used to set the condylar guide settings of semi-adjustable articulators. PMID:23633793

Highly Effective Photonic Cue for Repulsive Axonal Guidance

PubMed Central

Black, Bryan J.; Gu, Ling; Mohanty, Samarendra K.

2014-01-01

In vivo nerve repair requires not only the ability to regenerate damaged axons, but most importantly, the ability to guide developing or regenerating axons along paths that will result in functional connections. Furthermore, basic studies in neuroscience and neuro-electronic interface design require the ability to construct in vitro neural circuitry. Both these applications require the development of a noninvasive, highly effective tool for axonal growth-cone guidance. To date, a myriad of technologies have been introduced based on chemical, electrical, mechanical, and hybrid approaches (such as electro-chemical, optofluidic flow and photo-chemical methods). These methods are either lacking in desired spatial and temporal selectivity or require the introduction of invasive external factors. Within the last fifteen years however, several attractive guidance cues have been developed using purely light based cues to achieve axonal guidance. Here, we report a novel, purely optical repulsive guidance technique that uses low power, near infrared light, and demonstrates the guidance of primary goldfish retinal ganglion cell axons through turns of up to 120 degrees and over distances of ∼90 µm. PMID:24717339

Highly effective photonic cue for repulsive axonal guidance.

PubMed

Black, Bryan J; Gu, Ling; Mohanty, Samarendra K

2014-01-01

In vivo nerve repair requires not only the ability to regenerate damaged axons, but most importantly, the ability to guide developing or regenerating axons along paths that will result in functional connections. Furthermore, basic studies in neuroscience and neuro-electronic interface design require the ability to construct in vitro neural circuitry. Both these applications require the development of a noninvasive, highly effective tool for axonal growth-cone guidance. To date, a myriad of technologies have been introduced based on chemical, electrical, mechanical, and hybrid approaches (such as electro-chemical, optofluidic flow and photo-chemical methods). These methods are either lacking in desired spatial and temporal selectivity or require the introduction of invasive external factors. Within the last fifteen years however, several attractive guidance cues have been developed using purely light based cues to achieve axonal guidance. Here, we report a novel, purely optical repulsive guidance technique that uses low power, near infrared light, and demonstrates the guidance of primary goldfish retinal ganglion cell axons through turns of up to 120 degrees and over distances of ∼90 µm.

Estimation of skin entrance doses (SEDs) for common medical X-ray diagnostic examinations in India and proposed diagnostic reference levels (DRLs).

PubMed

Sonawane, A U; Shirva, V K; Pradhan, A S

2010-02-01

Skin entrance doses (SEDs) were estimated by carrying out measurements of air kerma from 101 X-ray machines installed in 45 major and selected hospitals in the country by using a silicon detector-based dose Test-O-Meter. 1209 number of air kerma measurements of diagnostic projections for adults have been analysed for seven types of common diagnostic examinations, viz. chest (AP, PA, LAT), lumbar spine (AP, LAT), thoracic spine (AP, LAT), abdomen (AP), pelvis (AP), hip joints (AP) and skull (PA, LAT) for different film-screen combinations. The values of estimated diagnostic reference levels (DRLs) (third quartile values of SEDs) were compared with guidance levels/DRLs of doses published by the IAEA-BSS-Safety Series No. 115, 1996; HPA (NRPB) (2000 and 2005), UK; CRCPD/CDRH (USA), European Commission and other national values. The values of DRLs obtained in this study are comparable with the values published by the IAEA-BSS-115 (1996); HPA (NRPB) (2000 and 2005) UK; EC and CRCPD/CDRH, USA including values obtained in previous studies in India.

7 CFR 4279.144 - Appraisals.

Code of Federal Regulations, 2014 CFR

2014-01-01

... servicing transactions will meet the requirements contained in the Financial Institutions Reform, Recovery... value of the collateral. For additional guidance and information concerning the completion of real...

7 CFR 4279.144 - Appraisals.

Code of Federal Regulations, 2011 CFR

2011-01-01

... servicing transactions will meet the requirements contained in the Financial Institutions Reform, Recovery... value of the collateral. For additional guidance and information concerning the completion of real...

U.S.--American Value Orientations. Cultural Monograph No. 4. Bilingual Multicultural Education Training Project for School Psychologists and Guidance Counselors.

ERIC Educational Resources Information Center

Hallman, Clemens L.; And Others

This teacher training monograph deals with value orientations of cultures in general and with specific reference to United States Culture. The first two sections discuss the conceptual issues of value orientation and give axiological definitions of the six clusters used to describe cultural orientation: self, the family, society, human nature,…

77 FR 74421 - Approval and Promulgation of Air Quality Implementation Plans for PM2.5

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-14

... calculation of future year PM 2.5 design values using the SMAT assumptions contained in the modeled guidance\\4... components. Future PM 2.5 design values at specified monitoring sites were estimated by adding the future... nonattainment area, all future site-specific PM 2.5 design values were below the concentration specified in the...

Ecological risk assessment for Mather Air Force Base, California: Phase 1, screening assessment

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

Meyers-Schoene, L.; Fischer, N.T.; Rabe, J.J.

Mather Air Force Base (AFB) is among the numerous facilities scheduled for closure under the US Air Force (USAF) Installation Restoration Program (IRP). A component of the Mather AFB IRP is to prepare risk assessments for each of the chemically contaminated sites. Because no previous ecological risk related studies have been conducted on Mather AFB, the authors proposed a phased approach to assessing ecological risks at the base. Phase 1 consisted of baseline ecological surveys that collected data over a 12-month period. In addition, benchmark screening criteria were used in conjunction with modeling results that utilized measured concentrations of chemicalmore » analytes in abiotic samples. Phase 2 may consist of the collection of more site-specific data and toxicity testing, if warranted by the Phase 1 screening analysis. This approach was in agreement with the USAF`s ecological risk assessment guidance and met the approval of the Air Force and USEPA Region 9. The authors found the use of established and derived screening values to effectively aid in the focusing of the ecological risk assessment on those chemicals most likely to be hazardous to ecological receptors at the base. Disadvantages in the use of screening values include the uncertainties associated with the conservative assumptions inherent in the derivation of benchmark values and the difficulty in extrapolating from laboratory determined benchmark values to impacts in the field.« less

Data governance and data sharing agreements for community-wide health information exchange: lessons from the beacon communities.

PubMed

Allen, Claudia; Des Jardins, Terrisca R; Heider, Arvela; Lyman, Kristin A; McWilliams, Lee; Rein, Alison L; Schachter, Abigail A; Singh, Ranjit; Sorondo, Barbara; Topper, Joan; Turske, Scott A

2014-01-01

Unprecedented efforts are underway across the United States to electronically capture and exchange health information to improve health care and population health, and reduce costs. This increased collection and sharing of electronic patient data raises several governance issues, including privacy, security, liability, and market competition. Those engaged in such efforts have had to develop data sharing agreements (DSAs) among entities involved in information exchange, many of whom are "nontraditional" health care entities and/or new partners. This paper shares lessons learned based on the experiences of six federally funded communities participating in the Beacon Community Cooperative Agreement Program, and offers guidance for navigating data governance issues and developing DSAs to facilitate community-wide health information exchange. While all entities involved in electronic data sharing must address governance issues and create DSAs accordingly, until recently little formal guidance existed for doing so - particularly for community-based initiatives. Despite this lack of guidance, together the Beacon Communities' experiences highlight promising strategies for navigating complex governance issues, which may be useful to other entities or communities initiating information exchange efforts to support delivery system transformation. For the past three years, AcademyHealth has provided technical assistance to most of the 17 Beacon Communities, 6 of whom contributed to this collaborative writing effort. Though these communities varied widely in terms of their demographics, resources, and Beacon-driven priorities, common themes emerged as they described their approaches to data governance and DSA development. The 6 Beacon Communities confirmed that DSAs are necessary to satisfy legal and market-based concerns, and they identified several specific issues, many of which have been noted by others involved in network data sharing initiatives. More importantly, these communities identified several promising approaches to timely and effective DSA development, including: stakeholder engagement; identification and effective communication of value; adoption of a parsimonious approach; attention to market-based concerns; flexibility in adapting and expanding existing agreements and partnerships; and anticipation of required time and investment.

Real-time piloted simulation of fully automatic guidance and control for rotorcraft nap-of-the-earth (NOE) flight following planned profiles

NASA Technical Reports Server (NTRS)

Clement, Warren F.; Gorder, Pater J.; Jewell, Wayne F.; Coppenbarger, Richard

1990-01-01

Developing a single-pilot all-weather NOE capability requires fully automatic NOE navigation and flight control. Innovative guidance and control concepts are being investigated to (1) organize the onboard computer-based storage and real-time updating of NOE terrain profiles and obstacles; (2) define a class of automatic anticipative pursuit guidance algorithms to follow the vertical, lateral, and longitudinal guidance commands; (3) automate a decision-making process for unexpected obstacle avoidance; and (4) provide several rapid response maneuvers. Acquired knowledge from the sensed environment is correlated with the recorded environment which is then used to determine an appropriate evasive maneuver if a nonconformity is observed. This research effort has been evaluated in both fixed-base and moving-base real-time piloted simulations thereby evaluating pilot acceptance of the automated concepts, supervisory override, manual operation, and reengagement of the automatic system.

Command generator tracker based direct model reference adaptive tracking guidance for Mars atmospheric entry

NASA Astrophysics Data System (ADS)

Li, Shuang; Peng, Yuming

2012-01-01

In order to accurately deliver an entry vehicle through the Martian atmosphere to the prescribed parachute deployment point, active Mars entry guidance is essential. This paper addresses the issue of Mars atmospheric entry guidance using the command generator tracker (CGT) based direct model reference adaptive control to reduce the adverse effect of the bounded uncertainties on atmospheric density and aerodynamic coefficients. Firstly, the nominal drag acceleration profile meeting a variety of constraints is planned off-line in the longitudinal plane as the reference model to track. Then, the CGT based direct model reference adaptive controller and the feed-forward compensator are designed to robustly track the aforementioned reference drag acceleration profile and to effectively reduce the downrange error. Afterwards, the heading alignment logic is adopted in the lateral plane to reduce the crossrange error. Finally, the validity of the guidance algorithm proposed in this paper is confirmed by Monte Carlo simulation analysis.

OFT, VBP: QED?

PubMed

Claxton, Karl

2007-06-01

The report by the Office of Fair Trading (OFT) on the UK pharmaceutical price regulation scheme (PPRS) recommends the reform of the current scheme, which is a combination of profit and price controls, to one where price is based on the health benefits offered by a pharmaceutical. On closer examination some of the more commonly expressed concerns about these proposals do not seem to be well founded. In principle, the OFT's recommendations may contribute to allocative and dynamic efficiency in the NHS. However, there are some dangers and the details of how it will be implemented are crucial. For example, value-based pricing with an inappropriate threshold for cost-effectiveness, or an inappropriate pricing structure, could lead to technologies being adopted at prices where their benefits, in terms of health outcome, do not offset the health displaced elsewhere in the NHS, a situation in which the NHS is damaged rather than improved by innovation. A failure to account for uncertainty and the value of evidence in negotiating prices and coverage could also undermine the evidence base for future NHS practice. Whatever view is taken, the OFT report will inevitably shape the scope of future policy debates about value, guidance, price and innovation.

A Critical Analysis of UNESCO's International Technical Guidance on School-Based Education for Puberty and Sexuality

ERIC Educational Resources Information Center

Goldman, Juliette D. G.

2012-01-01

Preparing children and adolescents for sexual safety and reproductive responsibility lies at the heart and purpose of puberty/sexuality education. The document of International Technical Guidance released by UNESCO in December 2009 aims to provide an evidence-based and rights-based platform offering children and adolescents vital knowledge about…

Effectiveness of Wellness-Based Classroom Guidance in Elementary School Settings: A Pilot Study

ERIC Educational Resources Information Center

Villalba, Jose A.; Myers, Jane E.

2008-01-01

A three-session, wellness-based classroom guidance unit was developed based on the Indivisible Self wellness model and presented to 55 students in 5th grade. Participants completed the Five Factor Wellness Inventory, Elementary School Version, before and after the unit. Wellness scores were significantly and positively higher at post-testing for…

4D BADA-based Trajectory Generator and 3D Guidance Algorithm

NASA Technical Reports Server (NTRS)

Palacios, Eduardo Sepulveda; Johnson, Marcus A.

2013-01-01

This paper presents a hybrid integration between aerodynamic, airline procedures and other BADA-based (Base of Aircraft Data) coefficients with a classical aircraft dynamic model. This paper also describes a three-dimensional guidance algorithm implemented in order to produce commands for the aircraft to follow a flight plan. The software chosen for this work is MATLAB.

Values: Understanding Written Language and the Mind through Brain Biology.

ERIC Educational Resources Information Center

Brand, Alice G.

Suggesting that neuroscience and the actualities of brain circuitry can provide guidance for what is misunderstood in writing education, namely, the role of subjectivity and values in the composing process, this paper argues that neuroscience provides corporeal evidence for the salience of particular brain structures and processes responsible for…

Return period adjustment for runoff coefficients based on analysis in undeveloped Texas watersheds

USGS Publications Warehouse

Dhakal, Nirajan; Fang, Xing; Asquith, William H.; Cleveland, Theodore G.; Thompson, David B.

2013-01-01

The rational method for peak discharge (Qp) estimation was introduced in the 1880s. The runoff coefficient (C) is a key parameter for the rational method that has an implicit meaning of rate proportionality, and the C has been declared a function of the annual return period by various researchers. Rate-based runoff coefficients as a function of the return period, C(T), were determined for 36 undeveloped watersheds in Texas using peak discharge frequency from previously published regional regression equations and rainfall intensity frequency for return periods T of 2, 5, 10, 25, 50, and 100 years. The C(T) values and return period adjustments C(T)/C(T=10  year) determined in this study are most applicable to undeveloped watersheds. The return period adjustments determined for the Texas watersheds in this study and those extracted from prior studies of non-Texas data exceed values from well-known literature such as design manuals and textbooks. Most importantly, the return period adjustments exceed values currently recognized in Texas Department of Transportation design guidance when T>10  years.

BENCHMARK DOSE TECHNICAL GUIDANCE DOCUMENT ...

EPA Pesticide Factsheets

The purpose of this document is to provide guidance for the Agency on the application of the benchmark dose approach in determining the point of departure (POD) for health effects data, whether a linear or nonlinear low dose extrapolation is used. The guidance includes discussion on computation of benchmark doses and benchmark concentrations (BMDs and BMCs) and their lower confidence limits, data requirements, dose-response analysis, and reporting requirements. This guidance is based on today's knowledge and understanding, and on experience gained in using this approach.

The Vocational Guidance Research Database: A Scientometric Approach

ERIC Educational Resources Information Center

Flores-Buils, Raquel; Gil-Beltran, Jose Manuel; Caballer-Miedes, Antonio; Martinez-Martinez, Miguel Angel

2012-01-01

The scientometric study of scientific output through publications in specialized journals cannot be undertaken exclusively with the databases available today. For this reason, the objective of this article is to introduce the "Base de Datos de Investigacion en Orientacion Vocacional" [Vocational Guidance Research Database], based on the…

Piloted Simulation of Various Synthetic Vision Systems Terrain Portrayal and Guidance Symbology Concepts for Low Altitude En-Route Scenario

NASA Technical Reports Server (NTRS)

Takallu, M. A.; Glaab, L. J.; Hughes, M. F.; Wong, D. T.; Bartolone, A. P.

2008-01-01

In support of the NASA Aviation Safety Program's Synthetic Vision Systems Project, a series of piloted simulations were conducted to explore and quantify the relationship between candidate Terrain Portrayal Concepts and Guidance Symbology Concepts, specific to General Aviation. The experiment scenario was based on a low altitude en route flight in Instrument Metrological Conditions in the central mountains of Alaska. A total of 18 general aviation pilots, with three levels of pilot experience, evaluated a test matrix of four terrain portrayal concepts and six guidance symbology concepts. Quantitative measures included various pilot/aircraft performance data, flight technical errors and flight control inputs. The qualitative measures included pilot comments and pilot responses to the structured questionnaires such as perceived workload, subjective situation awareness, pilot preferences, and the rare event recognition. There were statistically significant effects found from guidance symbology concepts and terrain portrayal concepts but no significant interactions between them. Lower flight technical errors and increased situation awareness were achieved using Synthetic Vision Systems displays, as compared to the baseline Pitch/Roll Flight Director and Blue Sky Brown Ground combination. Overall, those guidance symbology concepts that have both path based guidance cue and tunnel display performed better than the other guidance concepts.

Modeling guidance and recognition in categorical search: bridging human and computer object detection.

PubMed

Zelinsky, Gregory J; Peng, Yifan; Berg, Alexander C; Samaras, Dimitris

2013-10-08

Search is commonly described as a repeating cycle of guidance to target-like objects, followed by the recognition of these objects as targets or distractors. Are these indeed separate processes using different visual features? We addressed this question by comparing observer behavior to that of support vector machine (SVM) models trained on guidance and recognition tasks. Observers searched for a categorically defined teddy bear target in four-object arrays. Target-absent trials consisted of random category distractors rated in their visual similarity to teddy bears. Guidance, quantified as first-fixated objects during search, was strongest for targets, followed by target-similar, medium-similarity, and target-dissimilar distractors. False positive errors to first-fixated distractors also decreased with increasing dissimilarity to the target category. To model guidance, nine teddy bear detectors, using features ranging in biological plausibility, were trained on unblurred bears then tested on blurred versions of the same objects appearing in each search display. Guidance estimates were based on target probabilities obtained from these detectors. To model recognition, nine bear/nonbear classifiers, trained and tested on unblurred objects, were used to classify the object that would be fixated first (based on the detector estimates) as a teddy bear or a distractor. Patterns of categorical guidance and recognition accuracy were modeled almost perfectly by an HMAX model in combination with a color histogram feature. We conclude that guidance and recognition in the context of search are not separate processes mediated by different features, and that what the literature knows as guidance is really recognition performed on blurred objects viewed in the visual periphery.

Modeling guidance and recognition in categorical search: Bridging human and computer object detection

PubMed Central

Zelinsky, Gregory J.; Peng, Yifan; Berg, Alexander C.; Samaras, Dimitris

2013-01-01

Search is commonly described as a repeating cycle of guidance to target-like objects, followed by the recognition of these objects as targets or distractors. Are these indeed separate processes using different visual features? We addressed this question by comparing observer behavior to that of support vector machine (SVM) models trained on guidance and recognition tasks. Observers searched for a categorically defined teddy bear target in four-object arrays. Target-absent trials consisted of random category distractors rated in their visual similarity to teddy bears. Guidance, quantified as first-fixated objects during search, was strongest for targets, followed by target-similar, medium-similarity, and target-dissimilar distractors. False positive errors to first-fixated distractors also decreased with increasing dissimilarity to the target category. To model guidance, nine teddy bear detectors, using features ranging in biological plausibility, were trained on unblurred bears then tested on blurred versions of the same objects appearing in each search display. Guidance estimates were based on target probabilities obtained from these detectors. To model recognition, nine bear/nonbear classifiers, trained and tested on unblurred objects, were used to classify the object that would be fixated first (based on the detector estimates) as a teddy bear or a distractor. Patterns of categorical guidance and recognition accuracy were modeled almost perfectly by an HMAX model in combination with a color histogram feature. We conclude that guidance and recognition in the context of search are not separate processes mediated by different features, and that what the literature knows as guidance is really recognition performed on blurred objects viewed in the visual periphery. PMID:24105460

The acceptability of an Internet-based exposure treatment for flying phobia with and without therapist guidance: patients’ expectations, satisfaction, treatment preferences, and usability

PubMed Central

Campos, Daniel; Mira, Adriana; Bretón-López, Juana; Castilla, Diana; Botella, Cristina; Baños, Rosa Maria; Quero, Soledad

2018-01-01

Purpose Internet-based treatments have been tested for several psychological disorders. However, few studies have directly assessed the acceptability of these self-applied interventions in terms of expectations, satisfaction, treatment preferences, and usability. Moreover, no studies provide this type of data on Internet-based treatment for flying phobia (FP), with or without therapist guidance. The aim of this study was to analyze the acceptability of an Internet-based treatment for FP (NO-FEAR Airlines) that includes exposure scenarios composed of images and real sounds. A secondary aim was to compare patients’ acceptance of two ways of delivering this treatment (with or without therapist guidance). Patients and methods The sample included 46 participants from a randomized controlled trial who had received the self-applied intervention with (n = 23) or without (n = 23) therapist guidance. All participants completed an assessment protocol conducted online and by telephone at both pre- and posttreatment. Results Results showed good expectations, satisfaction, opinion, and usability, regardless of the presence of therapist guidance, including low aversiveness levels from before to after the intervention. However, participants generally preferred the therapist-supported condition. Conclusion NO-FEAR Airlines is a well-accepted Internet-based treatment that can help enhance the application of the exposure technique, improving patient acceptance and access to FP treatment. PMID:29636613

Effects of land use changes on the ecosystem service values of coastal wetlands.

PubMed

Camacho-Valdez, Vera; Ruiz-Luna, Arturo; Ghermandi, Andrea; Berlanga-Robles, César A; Nunes, Paulo A L D

2014-10-01

Changes in the coastal landscape of Southern Sinaloa (Mexico), between 2000 and 2010, were analyzed to relate spatial variations in wetlands extent with the provision and economic value of the ecosystem services (ES). Remote sensing techniques applied to Landsat TM imagery were used to evaluate land use/land cover changes while the value transfer method was used to assess the value of ES by land cover category. Five wetland types and other four land covers were found as representative of the coastal landscape. Findings reveal a 14 % decrease in the saltmarsh/forested mangrove area and a 12 % increase in the area of shrimp pond aquaculture (artificial wetland) during the study period. ES valuation shows that the total value flow increased by 9 % from $215 to $233 million (2007 USD) during the 10-year period. This increase is explained as result of the high value worldwide assigned to saltmarsh. We recognize limitations in the transfer-based approach in quantifying and mapping ES values in the region, but this method provides with value estimates spatially defined, and also provides some guidance in the preliminary screening of policies and projected development in the context of data-scarce regions.

An Innovate Robotic Endoscope Guidance System for Transnasal Sinus and Skull Base Surgery: Proof of Concept.

PubMed

Friedrich, D T; Sommer, F; Scheithauer, M O; Greve, J; Hoffmann, T K; Schuler, P J

2017-12-01

Objective  Advanced transnasal sinus and skull base surgery remains a challenging discipline for head and neck surgeons. Restricted access and space for instrumentation can impede advanced interventions. Thus, we present the combination of an innovative robotic endoscope guidance system and a specific endoscope with adjustable viewing angle to facilitate transnasal surgery in a human cadaver model. Materials and Methods  The applicability of the robotic endoscope guidance system with custom foot pedal controller was tested for advanced transnasal surgery on a fresh frozen human cadaver head. Visualization was enabled using a commercially available endoscope with adjustable viewing angle (15-90 degrees). Results  Visualization and instrumentation of all paranasal sinuses, including the anterior and middle skull base, were feasible with the presented setup. Controlling the robotic endoscope guidance system was effectively precise, and the adjustable endoscope lens extended the view in the surgical field without the common change of fixed viewing angle endoscopes. Conclusion  The combination of a robotic endoscope guidance system and an advanced endoscope with adjustable viewing angle enables bimanual surgery in transnasal interventions of the paranasal sinuses and the anterior skull base in a human cadaver model. The adjustable lens allows for the abandonment of fixed-angle endoscopes, saving time and resources, without reducing the quality of imaging.

Guidance for K-12 Administrators' Responses to Influenza

ERIC Educational Resources Information Center

Education Digest: Essential Readings Condensed for Quick Review, 2009

2009-01-01

This document provides guidance to help decrease the spread of flu among students and school staff during the 2009-2010 school year. It provides tools that school and health officials can choose from based on conditions in their area and recommends actions to take if CDC finds that the flu starts causing more severe disease. The guidance also…

Present situation and trend of precision guidance technology and its intelligence

NASA Astrophysics Data System (ADS)

Shang, Zhengguo; Liu, Tiandong

2017-11-01

This paper first introduces the basic concepts of precision guidance technology and artificial intelligence technology. Then gives a brief introduction of intelligent precision guidance technology, and with the help of development of intelligent weapon based on deep learning project in foreign: LRASM missile project, TRACE project, and BLADE project, this paper gives an overview of the current foreign precision guidance technology. Finally, the future development trend of intelligent precision guidance technology is summarized, mainly concentrated in the multi objectives, intelligent classification, weak target detection and recognition, intelligent between complex environment intelligent jamming and multi-source, multi missile cooperative fighting and other aspects.

Autonomous Control Modes and Optimized Path Guidance for Shipboard Landing in High Sea States

DTIC Science & Technology

2017-04-15

50 0 50 Singular Values Frequency (rad/s) S in g u la r V a lu e s ( d B ) controller . The non -output variables can be estimated by reliable linear...Contract # N00014-14-C-0004 Autonomous Control Modes and Optimized Path Guidance for Shipboard Landing in High Sea States Progress Report...recovery of a VTOL UAV. There is a clear need for additional levels of stability and control augmentation and, ultimately, fully autonomous landing

How high-performance work systems drive health care value: an examination of leading process improvement strategies.

PubMed

Robbins, Julie; Garman, Andrew N; Song, Paula H; McAlearney, Ann Scheck

2012-01-01

As hospitals focus on increasing health care value, process improvement strategies have proliferated, seemingly faster than the evidence base supporting them. Yet, most process improvement strategies are associated with work practices for which solid evidence does exist. Evaluating improvement strategies in the context of evidence-based work practices can provide guidance about which strategies would work best for a given health care organization. We combined a literature review with analysis of key informant interview data collected from 5 case studies of high-performance work practices (HPWPs) in health care organizations. We explored the link between an evidence-based framework for HPWP use and 3 process improvement strategies: Hardwiring Excellence, Lean/Six Sigma, and Baldrige. We found that each of these process improvement strategies has not only strengths but also important gaps with respect to incorporating HPWPs involving engaging staff, aligning leaders, acquiring and developing talent, and empowering the front line. Given differences among these strategies, our analyses suggest that some may work better than others for individual health care organizations, depending on the organizations' current management systems. In practice, most organizations implementing improvement strategies would benefit from including evidence-based HPWPs to maximize the potential for process improvement strategies to increase value in health care.

Prevocational Exploration Guidance. Competency Based Curriculum.

ERIC Educational Resources Information Center

Harrington, Fred; And Others

This competency-based curriculum for prevocational exploration in West Virginia provides experiences at grades 9 and 10 related to exploring careers and educational programs for those careers. The guidance units are designed to assist the counselor in providing activities that relate to ongoing hands-on activities in prevocational business,…

School-Based Peer Mediation Programs: A Natural Extension of Developmental Guidance Programs.

ERIC Educational Resources Information Center

Robertson, Gwendolyn

School-based peer mediation programs are natural extensions of the kindergarten-grade 12 developmental guidance programs. Peer mediation programs not only provide schools with alternatives to traditional discipline practices, but also teach students important life skills. Existing research on peer mediation is very limited, yet promising. This…

Imaging-guided and nonimaging-guided fine needle aspiration of liver lesions: experience with 406 patients.

PubMed

Edoute, Y; Tibon-Fisher, O; Ben-Haim, S A; Malberger, E

1991-12-01

The aim of the present study was to determine the diagnostic accuracy of different modes of fine needle aspiration (FNA) of liver lesions. A total of 492 FNAs were performed on 406 patients in order to confirm or to rule out focal or multifocal neoplastic disease: 29% under ultrasound (US) guidance, 3% with computed tomographic (CT) guidance, 67% preoperatively, and 1% intraoperatively without imaging guidance. Based on histologic, cytologic, and clinical findings, final diagnoses were reached in 387 patients, of whom 264 had malignant liver disease and 123 had benign liver disease. Of 321 aspirations performed in patients with malignant liver disease, the cytologic findings suggested malignancy in 225 (70.1%), suspected malignancy in 25 (7.8%), and did not reveal malignancy in 71 aspirations (22.1%). Among the 123 patients with benign liver disease, the cytologic findings were reported as benign in all but two patients, who had false-positive cytologic findings. The overall sensitivity, specificity, positive, and negative predictive values for cytologic findings were 85.6, 98.4, 99.1, and 76.1%, respectively. The overall diagnostic accuracy was 89.7%. In one patient, fatal intraperitoneal bleeding due to chronic intravascular coagulation complicated the FNA procedure. We conclude that imaging-guided FNA as well as nonguided FNA for cytologic diagnosis of liver lesions are highly accurate and only rarely may be associated with a fatal complication.

Shuttle program. MCC Level C formulation requirements: Entry guidance and entry autopilot

NASA Technical Reports Server (NTRS)

Harpold, J. C.; Hill, O.

1980-01-01

A set of preliminary entry guidance and autopilot software formulations is presented for use in the Mission Control Center (MCC) entry processor. These software formulations meet all level B requirements. Revision 2 incorporates the modifications required to functionally simulate optimal TAEM targeting capability (OTT). Implementation of this logic in the MCC must be coordinated with flight software OTT implementation and MCC TAEM guidance OTT. The entry guidance logic is based on the Orbiter avionics entry guidance software. This MCC requirements document contains a definition of coordinate systems, a list of parameter definitions for the software formulations, a description of the entry guidance detailed formulation requirements, a description of the detailed autopilot formulation requirements, a description of the targeting routine, and a set of formulation flow charts.

Enhanced Automated Guidance System for Horizontal Auger Boring Based on Image Processing

PubMed Central

Wu, Lingling; Wen, Guojun; Wang, Yudan; Huang, Lei; Zhou, Jiang

2018-01-01

Horizontal auger boring (HAB) is a widely used trenchless technology for the high-accuracy installation of gravity or pressure pipelines on line and grade. Differing from other pipeline installations, HAB requires a more precise and automated guidance system for use in a practical project. This paper proposes an economic and enhanced automated optical guidance system, based on optimization research of light-emitting diode (LED) light target and five automated image processing bore-path deviation algorithms. An LED target was optimized for many qualities, including light color, filter plate color, luminous intensity, and LED layout. The image preprocessing algorithm, feature extraction algorithm, angle measurement algorithm, deflection detection algorithm, and auto-focus algorithm, compiled in MATLAB, are used to automate image processing for deflection computing and judging. After multiple indoor experiments, this guidance system is applied in a project of hot water pipeline installation, with accuracy controlled within 2 mm in 48-m distance, providing accurate line and grade controls and verifying the feasibility and reliability of the guidance system. PMID:29462855

Helicopter Approach Capability Using the Differential Global Positioning System

NASA Technical Reports Server (NTRS)

Kaufmann, David N.

1994-01-01

The results of flight tests to determine the feasibility of using the Global Positioning System (GPS) in the Differential mode (DGPS) to provide high accuracy, precision navigation and guidance for helicopter approaches to landing are presented. The airborne DGPS receiver and associated equipment is installed in a NASA UH-60 Black Hawk helicopter. The ground-based DGPS reference receiver is located at a surveyed test site and is equipped with a real-time VHF data link to transmit correction information to the airborne DGPS receiver. The corrected airborne DGPS information, together with the preset approach geometry, is used to calculate guidance commands which are sent to the aircraft's approach guidance instruments. The use of DGPS derived guidance for helicopter approaches to landing is evaluated by comparing the DGPS data with the laser tracker truth data. The errors indicate that the helicopter position based on DGPS guidance satisfies the International Civil Aviation Organization (ICAO) Category 1 (CAT 1) lateral and vertical navigational accuracy requirements.

Enhanced Automated Guidance System for Horizontal Auger Boring Based on Image Processing.

PubMed

Wu, Lingling; Wen, Guojun; Wang, Yudan; Huang, Lei; Zhou, Jiang

2018-02-15

Horizontal auger boring (HAB) is a widely used trenchless technology for the high-accuracy installation of gravity or pressure pipelines on line and grade. Differing from other pipeline installations, HAB requires a more precise and automated guidance system for use in a practical project. This paper proposes an economic and enhanced automated optical guidance system, based on optimization research of light-emitting diode (LED) light target and five automated image processing bore-path deviation algorithms. An LED light target was optimized for many qualities, including light color, filter plate color, luminous intensity, and LED layout. The image preprocessing algorithm, direction location algorithm, angle measurement algorithm, deflection detection algorithm, and auto-focus algorithm, compiled in MATLAB, are used to automate image processing for deflection computing and judging. After multiple indoor experiments, this guidance system is applied in a project of hot water pipeline installation, with accuracy controlled within 2 mm in 48-m distance, providing accurate line and grade controls and verifying the feasibility and reliability of the guidance system.

Mars entry guidance based on an adaptive reference drag profile

NASA Astrophysics Data System (ADS)

Liang, Zixuan; Duan, Guangfei; Ren, Zhang

2017-08-01

The conventional Mars entry tracks a fixed reference drag profile (FRDP). To improve the landing precision, a novel guidance approach that utilizes an adaptive reference drag profile (ARDP) is presented. The entry flight is divided into two phases. For each phase, a family of drag profiles corresponding to various trajectory lengths is planned. Two update windows are investigated for the reference drag profile. At each window, the ARDP is selected online from the profile database according to the actual range-to-go. The tracking law for the selected drag profile is designed based on the feedback linearization. Guidance approaches using the ARDP and the FRDP are then tested and compared. Simulation results demonstrate that the proposed ARDP approach achieves much higher guidance precision than the conventional FRDP approach.

[Development process of Evidence-based "Return-to-work Guidance in Occupational Health 2017"].

PubMed

Kojimahara, Noriko; Fukumoto, Masakatsu; Yoshikawa, Etsuko; Shinada, Kayoko; Tsuiki, Hirokazu

2018-06-05

Objective"Return-to-work Guidance in Occupational Health 2017 (RTW Guidance 2017) " is the first occupational health guide in Japan that evaluates the quality of evidence and offers recommendations based on results of the systematic review of randomized controlled trials. Details of the systematic review of each review question (RQs) will be described separately. This article presents an overview of the method and process of developing the "RTW Guidance 2017."Materials and MethodsThe guidance was developed following the previously-published "Method for developing evidence based occupational health guidance," which included the composition of a highly-transparent guidance developing group as well as the recruitment and selection of RQs. Using the Cochrane Library, PubMed, and Ichushi-Web, a literature search for the six RQs was conducted in January 2016 by partly modifying the search terms of the existing systematic review. Articles were selected according to the inclusion criteria, and the quality of evidence was evaluated using the GRADE approach. Meta-analysis was conducted for RQ2 and RQ4, and a qualitative systematic review was conducted for RQ5, RQ6, and cost-effectiveness. Recommendations were subsequently made after a thorough consideration for feasibility in Japan by examining the costs and available resources.ResultsBased on a comprehensive literature search, eleven RQ2, four RQ4, one RQ5, and three RQ6 were selected. Support program for returning to work, such as "Re-work" for those who are temporarily not working due to musculoskeletal disorders or mental health disorder, was recommended based on moderate evidence (RQ2). For RQ4, the collaboration between occupational health practice and clinical practice was weakly recommended based on low evidence. For RQ5 that evaluated the usefulness of social support, intervention by the manager/co-worker was proposed as a "best practice statement" without indicating it as a recommendation. Work accommodation was weakly recommended based on low evidence in RQ6.Discussion and ConclusionFrom the result of systematic reviews, it was recommended for workers on sick leave more than four weeks regardless of sick leave and sickness absence that interventions during leave would improve work-related outcomes, such as earlier reinstatement. Although there is limited evidence regarding occupational health in Japan, it is important for many occupational health professionals to learn the method of developing guidance and to identify issues for future studies with priority in Japan.

Optical coherence tomography compared with intravascular ultrasound and with angiography to guide coronary stent implantation (ILUMIEN III: OPTIMIZE PCI): a randomised controlled trial.

PubMed

Ali, Ziad A; Maehara, Akiko; Généreux, Philippe; Shlofmitz, Richard A; Fabbiocchi, Franco; Nazif, Tamim M; Guagliumi, Giulio; Meraj, Perwaiz M; Alfonso, Fernando; Samady, Habib; Akasaka, Takashi; Carlson, Eric B; Leesar, Massoud A; Matsumura, Mitsuaki; Ozan, Melek Ozgu; Mintz, Gary S; Ben-Yehuda, Ori; Stone, Gregg W

2016-11-26

Percutaneous coronary intervention (PCI) is most commonly guided by angiography alone. Intravascular ultrasound (IVUS) guidance has been shown to reduce major adverse cardiovascular events (MACE) after PCI, principally by resulting in a larger postprocedure lumen than with angiographic guidance. Optical coherence tomography (OCT) provides higher resolution imaging than does IVUS, although findings from some studies suggest that it might lead to smaller luminal diameters after stent implantation. We sought to establish whether or not a novel OCT-based stent sizing strategy would result in a minimum stent area similar to or better than that achieved with IVUS guidance and better than that achieved with angiography guidance alone. In this randomised controlled trial, we recruited patients aged 18 years or older undergoing PCI from 29 hospitals in eight countries. Eligible patients had one or more target lesions located in a native coronary artery with a visually estimated reference vessel diameter of 2·25-3·50 mm and a length of less than 40 mm. We excluded patients with left main or ostial right coronary artery stenoses, bypass graft stenoses, chronic total occlusions, planned two-stent bifurcations, and in-stent restenosis. Participants were randomly assigned (1:1:1; with use of an interactive web-based system in block sizes of three, stratified by site) to OCT guidance, IVUS guidance, or angiography-guided stent implantation. We did OCT-guided PCI using a specific protocol to establish stent length, diameter, and expansion according to reference segment external elastic lamina measurements. All patients underwent final OCT imaging (operators in the IVUS and angiography groups were masked to the OCT images). The primary efficacy endpoint was post-PCI minimum stent area, measured by OCT at a masked independent core laboratory at completion of enrolment, in all randomly allocated participants who had primary outcome data. The primary safety endpoint was procedural MACE. We tested non-inferiority of OCT guidance to IVUS guidance (with a non-inferiority margin of 1·0 mm 2 ), superiority of OCT guidance to angiography guidance, and superiority of OCT guidance to IVUS guidance, in a hierarchical manner. This trial is registered with ClinicalTrials.gov, number NCT02471586. Between May 13, 2015, and April 5, 2016, we randomly allocated 450 patients (158 [35%] to OCT, 146 [32%] to IVUS, and 146 [32%] to angiography), with 415 final OCT acquisitions analysed for the primary endpoint (140 [34%] in the OCT group, 135 [33%] in the IVUS group, and 140 [34%] in the angiography group). The final median minimum stent area was 5·79 mm 2 (IQR 4·54-7·34) with OCT guidance, 5·89 mm 2 (4·67-7·80) with IVUS guidance, and 5·49 mm 2 (4·39-6·59) with angiography guidance. OCT guidance was non-inferior to IVUS guidance (one-sided 97·5% lower CI -0·70 mm 2 ; p=0·001), but not superior (p=0·42). OCT guidance was also not superior to angiography guidance (p=0·12). We noted procedural MACE in four (3%) of 158 patients in the OCT group, one (1%) of 146 in the IVUS group, and one (1%) of 146 in the angiography group (OCT vs IVUS p=0·37; OCT vs angiography p=0·37). OCT-guided PCI using a specific reference segment external elastic lamina-based stent optimisation strategy was safe and resulted in similar minimum stent area to that of IVUS-guided PCI. These data warrant a large-scale randomised trial to establish whether or not OCT guidance results in superior clinical outcomes to angiography guidance. St Jude Medical. Copyright © 2016 Elsevier Ltd. All rights reserved.

In-App Reflection Guidance: Lessons Learned Across Four Field Trials at the Workplace

ERIC Educational Resources Information Center

Fessl, Angela; Wesiak, Gudrun; Rivera-Pelayo, Verónica; Feyertag, Sandra; Pammer, Viktoria

2017-01-01

This paper presents a concept for in-app reflection guidance and its evaluation in four work-related field trials. By synthesizing across four field trials, we can show that computer-based reflection guidance can function in the workplace, in the sense of being accepted as technology, being perceived as useful and leading to reflective learning.…

Vocational Guidance for the Deaf; A Classified Guide to the Basic Requirements for Occupations Open to the Profoundly Deaf.

ERIC Educational Resources Information Center

Montgomery, G.W.G.

Published in Britain for use by counselors and placement officials, the book offers a systematic attack on occupational placement problems of the prelingually deaf. The system is based on a vocational guidance profile, which is developed from intelligence and achievement test scores. The vocational guidance profile is explained, and occupational…

Echocardiographic and Fluoroscopic Fusion Imaging for Procedural Guidance: An Overview and Early Clinical Experience.

PubMed

Thaden, Jeremy J; Sanon, Saurabh; Geske, Jeffrey B; Eleid, Mackram F; Nijhof, Niels; Malouf, Joseph F; Rihal, Charanjit S; Bruce, Charles J

2016-06-01

There has been significant growth in the volume and complexity of percutaneous structural heart procedures in the past decade. Increasing procedural complexity and accompanying reliance on multimodality imaging have fueled the development of fusion imaging to facilitate procedural guidance. The first clinically available system capable of echocardiographic and fluoroscopic fusion for real-time guidance of structural heart procedures was approved by the US Food and Drug Administration in 2012. Echocardiographic-fluoroscopic fusion imaging combines the precise catheter and device visualization of fluoroscopy with the soft tissue anatomy and color flow Doppler information afforded by echocardiography in a single image. This allows the interventionalist to perform precise catheter manipulations under fluoroscopy guidance while visualizing critical tissue anatomy provided by echocardiography. However, there are few data available addressing this technology's strengths and limitations in routine clinical practice. The authors provide a critical review of currently available echocardiographic-fluoroscopic fusion imaging for guidance of structural heart interventions to highlight its strengths, limitations, and potential clinical applications and to guide further research into value of this emerging technology. Copyright © 2016 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.

Ultrasound Imaging in Radiation Therapy: From Interfractional to Intrafractional Guidance

PubMed Central

Western, Craig; Hristov, Dimitre

2015-01-01

External beam radiation therapy (EBRT) is included in the treatment regimen of the majority of cancer patients. With the proliferation of hypofractionated radiotherapy treatment regimens, such as stereotactic body radiation therapy (SBRT), interfractional and intrafractional imaging technologies are becoming increasingly critical to ensure safe and effective treatment delivery. Ultrasound (US)-based image guidance systems offer real-time, markerless, volumetric imaging with excellent soft tissue contrast, overcoming the limitations of traditional X-ray or computed tomography (CT)-based guidance for abdominal and pelvic cancer sites, such as the liver and prostate. Interfractional US guidance systems have been commercially adopted for patient positioning but suffer from systematic positioning errors induced by probe pressure. More recently, several research groups have introduced concepts for intrafractional US guidance systems leveraging robotic probe placement technology and real-time soft tissue tracking software. This paper reviews various commercial and research-level US guidance systems used in radiation therapy, with an emphasis on hardware and software technologies that enable the deployment of US imaging within the radiotherapy environment and workflow. Previously unpublished material on tissue tracking systems and robotic probe manipulators under development by our group is also included. PMID:26180704

Guidance and Navigation Requirements for Unmanned Flyby and Swingby Missions to the Outer Planets. Volume 3; Low Thrust Missions, Phase B

NASA Technical Reports Server (NTRS)

1970-01-01

The guidance and navigation requirements for unmanned missions to the outer planets, assuming constant, low thrust, ion propulsion are discussed. The navigational capability of the ground based Deep Space Network is compared to the improvements in navigational capability brought about by the addition of guidance and navigation related onboard sensors. Relevant onboard sensors include: (1) the optical onboard navigation sensor, (2) the attitude reference sensors, and (3) highly sensitive accelerometers. The totally ground based, and the combination ground based and onboard sensor systems are compared by means of the estimated errors in target planet ephemeris, and the spacecraft position with respect to the planet.

Deriving Criteria-supporting Benchmark Values from Empirical Response Relationships: Comparison of Statistical Techniques and Effect of Log-transforming the Nutrient Variable

EPA Science Inventory

In analyses supporting the development of numeric nutrient criteria, multiple statistical techniques can be used to extract critical values from stressor response relationships. However there is little guidance for choosing among techniques, and the extent to which log-transfor...

40 CFR 132.4 - State adoption and application of methodologies, policies and procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

.... (2) The chronic water quality criteria and values for the protection of aquatic life, or site... AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY GUIDANCE FOR THE GREAT LAKES SYSTEM § 132.4 State...) The Methodologies for Development of Aquatic Life Criteria and Values in appendix A of this part; (3...

40 CFR 132.4 - State adoption and application of methodologies, policies and procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

.... (2) The chronic water quality criteria and values for the protection of aquatic life, or site... AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY GUIDANCE FOR THE GREAT LAKES SYSTEM § 132.4 State...) The Methodologies for Development of Aquatic Life Criteria and Values in appendix A of this part; (3...

40 CFR 132.4 - State adoption and application of methodologies, policies and procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

.... (2) The chronic water quality criteria and values for the protection of aquatic life, or site... AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY GUIDANCE FOR THE GREAT LAKES SYSTEM § 132.4 State...) The Methodologies for Development of Aquatic Life Criteria and Values in appendix A of this part; (3...

40 CFR 132.4 - State adoption and application of methodologies, policies and procedures.

Code of Federal Regulations, 2012 CFR

2012-07-01

.... (2) The chronic water quality criteria and values for the protection of aquatic life, or site... AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY GUIDANCE FOR THE GREAT LAKES SYSTEM § 132.4 State...) The Methodologies for Development of Aquatic Life Criteria and Values in appendix A of this part; (3...

40 CFR 132.4 - State adoption and application of methodologies, policies and procedures.

Code of Federal Regulations, 2013 CFR

2013-07-01

.... (2) The chronic water quality criteria and values for the protection of aquatic life, or site... AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY GUIDANCE FOR THE GREAT LAKES SYSTEM § 132.4 State...) The Methodologies for Development of Aquatic Life Criteria and Values in appendix A of this part; (3...

Codes of Ethics in Australian Education: Towards a National Perspective

ERIC Educational Resources Information Center

Forster, Daniella J.

2012-01-01

Teachers have a dual moral responsibility as both values educators and moral agents representing the integrity of the profession. Codes of ethics and conduct in teaching articulate shared professional values and aim to provide some guidance for action around recognised issues special to the profession but are also instruments of regulation which…

49 CFR Appendix C to Part 195 - Guidance for Implementation of an Integrity Management Program

Code of Federal Regulations, 2014 CFR

2014-10-01

... get this information from topographical maps such as U.S. Geological Survey quadrangle maps. (2... risk.)—Risk Value=3 Close interval survey: (yes/no)—no—Risk Value =5 Internal Inspection tool used..., including a summary of performance improvements, both qualitative and quantitative, to an operator's...

49 CFR Appendix C to Part 195 - Guidance for Implementation of an Integrity Management Program

Code of Federal Regulations, 2011 CFR

2011-10-01

... get this information from topographical maps such as U.S. Geological Survey quadrangle maps. (2... risk.)—Risk Value=3 Close interval survey: (yes/no)—no—Risk Value =5 Internal Inspection tool used..., including a summary of performance improvements, both qualitative and quantitative, to an operator's...

49 CFR Appendix C to Part 195 - Guidance for Implementation of an Integrity Management Program

Code of Federal Regulations, 2012 CFR

2012-10-01

... get this information from topographical maps such as U.S. Geological Survey quadrangle maps. (2... risk.)—Risk Value=3 Close interval survey: (yes/no)—no—Risk Value =5 Internal Inspection tool used..., including a summary of performance improvements, both qualitative and quantitative, to an operator's...

49 CFR Appendix C to Part 195 - Guidance for Implementation of an Integrity Management Program

Code of Federal Regulations, 2013 CFR

2013-10-01

... get this information from topographical maps such as U.S. Geological Survey quadrangle maps. (2... risk.)—Risk Value=3 Close interval survey: (yes/no)—no—Risk Value =5 Internal Inspection tool used..., including a summary of performance improvements, both qualitative and quantitative, to an operator's...

Value Engineering. Technical Manual. School Facilities Development Procedures Manual.

ERIC Educational Resources Information Center

Washington Office of the State Superintendent of Public Instruction, Olympia.

Value Engineering (VE) is a cost-optimizing technique used to analyze design quality and cost-effectiveness. The application of VE procedures to the design and construction of school facilities has been adopted by the state of Washington. This technical manual provides guidance in developing the scope and applicability of VE to school projects; in…

A community-based, interdisciplinary rehabilitation engineering course.

PubMed

Lundy, Mary; Aceros, Juan

2016-08-01

A novel, community-based course was created through collaboration between the School of Engineering and the Physical Therapy program at the University of North Florida. This course offers a hands-on, interdisciplinary training experience for undergraduate engineering students through team-based design projects where engineering students are partnered with physical therapy students. Students learn the process of design, fabrication and testing of low-tech and high-tech rehabilitation technology for children with disabilities, and are exposed to a clinical experience under the guidance of licensed therapists. This course was taught in two consecutive years and pre-test/post-test data evaluating the impact of this interprofessional education experience on the students is presented using the Public Service Motivation Scale, Civic Actions Scale, Civic Attitudes Scale, and the Interprofessional Socialization and Valuing Scale.

Mechanisms of value-learning in the guidance of spatial attention.

PubMed

Anderson, Brian A; Kim, Haena

2018-05-11

The role of associative reward learning in the guidance of feature-based attention is well established. The extent to which reward learning can modulate spatial attention has been much more controversial. At least one demonstration of a persistent spatial attention bias following space-based associative reward learning has been reported. At the same time, multiple other experiments have been published failing to demonstrate enduring attentional biases towards locations at which a target, if found, yields high reward. This is in spite of evidence that participants use reward structures to inform their decisions where to search, leading some to suggest that, unlike feature-based attention, spatial attention may be impervious to the influence of learning from reward structures. Here, we demonstrate a robust bias towards regions of a scene that participants were previously rewarded for selecting. This spatial bias relies on representations that are anchored to the configuration of objects within a scene. The observed bias appears to be driven specifically by reinforcement learning, and can be observed with equal strength following non-reward corrective feedback. The time course of the bias is consistent with a transient shift of attention, rather than a strategic search pattern, and is evident in eye movement patterns during free viewing. Taken together, our findings reconcile previously conflicting reports and offer an integrative account of how learning from feedback shapes the spatial attention system. Copyright © 2018 Elsevier B.V. All rights reserved.

Evaluation of low-dose limits in 3D-2D rigid registration for surgical guidance

NASA Astrophysics Data System (ADS)

Uneri, A.; Wang, A. S.; Otake, Y.; Kleinszig, G.; Vogt, S.; Khanna, A. J.; Gallia, G. L.; Gokaslan, Z. L.; Siewerdsen, J. H.

2014-09-01

An algorithm for intensity-based 3D-2D registration of CT and C-arm fluoroscopy is evaluated for use in surgical guidance, specifically considering the low-dose limits of the fluoroscopic x-ray projections. The registration method is based on a framework using the covariance matrix adaptation evolution strategy (CMA-ES) to identify the 3D patient pose that maximizes the gradient information similarity metric. Registration performance was evaluated in an anthropomorphic head phantom emulating intracranial neurosurgery, using target registration error (TRE) to characterize accuracy and robustness in terms of 95% confidence upper bound in comparison to that of an infrared surgical tracking system. Three clinical scenarios were considered: (1) single-view image + guidance, wherein a single x-ray projection is used for visualization and 3D-2D guidance; (2) dual-view image + guidance, wherein one projection is acquired for visualization, combined with a second (lower-dose) projection acquired at a different C-arm angle for 3D-2D guidance; and (3) dual-view guidance, wherein both projections are acquired at low dose for the purpose of 3D-2D guidance alone (not visualization). In each case, registration accuracy was evaluated as a function of the entrance surface dose associated with the projection view(s). Results indicate that images acquired at a dose as low as 4 μGy (approximately one-tenth the dose of a typical fluoroscopic frame) were sufficient to provide TRE comparable or superior to that of conventional surgical tracking, allowing 3D-2D guidance at a level of dose that is at most 10% greater than conventional fluoroscopy (scenario #2) and potentially reducing the dose to approximately 20% of the level in a conventional fluoroscopically guided procedure (scenario #3).

Correlation of Condylar Guidance Determined by Panoramic Radiographs to One Determined by Conventional Methods

PubMed Central

Godavarthi, A Sowjanya; Sajjan, M C Suresh; Raju, A V Rama; Rajeshkumar, P; Premalatha, Averneni; Chava, Narayana

2015-01-01

Background: To evaluate the feasibility of using panoramic radiographs as an alternative to an interocclusal recording method for determining the condylar guidance in dentate and edentulous conditions. Materials and Methods: 20 dentulous individuals with an age range of 20-30 years and 20 edentulous patients of 40-65 years were selected. An interocclusal bite registration was done in protrusive position for all the subjects. Orthopantomographs were made for all patients in open mouth position. Hanau articulator was modified to record the angulations to the accuracy of 1°. Tracing of glenoid fossa on radiograph was done to measure the condylar guidance angles. Readings were recorded and analyzed by Freidman’s test and t-test. Results: Condylar guidance values obtained by the interocclusal method and radiographic method in dentate individuals on the right side and left side 40.55°, and 37.1°, and 40.15°, and 34.75°, respectively. In the edentulous individuals, the values on the right side and left side was 36.7° and 36.1° and 35.95° and 33.6,° respectively. The difference was statistically significant (P = < 0.001) in dentate group and was not statistically significant (P = 0.6493) in edentulous group. Conclusion: Panoramic radiograph can be used as an alternative to interocclusal technique only in edentulous patients. Further studies comparing panoramic radiograph to jaw tracking devices would substantiate the results of this study. PMID:26464554

EPA guidance on cultural competence training.

PubMed

Schouler-Ocak, Meryam; Graef-Calliess, Iris T; Tarricone, Ilaria; Qureshi, Adil; Kastrup, Marianne C; Bhugra, Dinesh

2015-03-01

The stress of migration as well as social factors and changes related to the receiving society may lead to the manifestation of psychiatric disorders in vulnerable individuals after migration. The diversity of cultures, ethnicities, races and reasons for migration poses a challenge for those seeking to understand how illness is experienced by immigrants whose backgrounds differ significantly from their clinicians. Cultural competence represents good clinical practice and can be defined as such that a clinician regards each patient in the context of the patient's own culture as well as from the perspective of the clinician's cultural values and prejudices. The EPA Guidance on cultural competence training outlines some of the key issues related to cultural competence and how to deal with these. It points out that cultural competence represents a comprehensive response to the mental health care needs of immigrant patients and requires knowledge, skills and attitudes which can improve the effectiveness of psychiatric treatment. To reach these aims, both individual and organizational competence are needed, as well as teaching competence in terms of educational leadership. The WPA Guidance on Mental Health and Mental Health Care for Migrants and the EPA Guidance on Mental Health Care for Migrants list a series of recommendations for policy makers, service providers and clinicians; these are aimed at improving mental health care for immigrants. The authors of this paper would like to underline these recommendations and, focusing on cultural competency and training, believe that they will be of positive value. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Adaptation Guidance for Evidence-Based Teen Pregnancy and STI/HIV Prevention Curricula: From Development to Practice

ERIC Educational Resources Information Center

Rolleri, Lori A.; Fuller, Taleria R.; Firpo-Triplett, Regina; Lesesne, Catherine A.; Moore, Claire; Leeks, Kimberly D.

2014-01-01

Evidence-based interventions (EBIs) are effective in preventing adolescent pregnancy and sexually transmitted infections; however, prevention practitioners are challenged when selecting and adapting the most appropriate programs. While there are existing adaptation frameworks, there is little practical guidance in applying research in the field.…

The Role of Guidance in Computer-Based Problem Solving for the Development of Concepts of Logic.

ERIC Educational Resources Information Center

Eysink, Tessa H. S.; Dijkstra, Sanne; Kuper, Jan

2002-01-01

Describes a study at the University of Twente (Netherlands) that investigated the effect of two instructional variables, manipulation of objects and guidance, in learning to use the logical connective, conditional with a computer-based learning environment, Tarski's World, designed to teach first-order logic. Discusses results of…

Guidance for Schools Selecting Antibullying Approaches: Translating Evidence-Based Strategies to Contemporary Implementation Realities

ERIC Educational Resources Information Center

Ansary, Nadia S.; Elias, Maurice J.; Greene, Michael B.; Green, Stuart

2015-01-01

This article synthesizes the current research on bullying prevention and intervention in order to provide guidance to schools seeking to select and implement antibullying strategies. Evidence-based best practices that are shared across generally effective antibullying approaches are elucidated, and these strategies are grounded in examples…

Flexible Multi agent Algorithm for Distributed Decision Making

DTIC Science & Technology

2015-01-01

How, J. P. Consensus - Based Auction Approaches for Decentralized task Assignment. Proceedings of the AIAA Guidance, Navigation, and Control...G. ; Kim, Y. Market- based Decentralized Task Assignment for Cooperative UA V Mission Including Rendezvous. Proceedings of the AIAA Guidance...scalable and adaptable to a variety of specific mission tasks . Additionally, the algorithm could easily be adapted for use on land or sea- based systems

Accounting for parameter uncertainty in the definition of parametric distributions used to describe individual patient variation in health economic models.

PubMed

Degeling, Koen; IJzerman, Maarten J; Koopman, Miriam; Koffijberg, Hendrik

2017-12-15

Parametric distributions based on individual patient data can be used to represent both stochastic and parameter uncertainty. Although general guidance is available on how parameter uncertainty should be accounted for in probabilistic sensitivity analysis, there is no comprehensive guidance on reflecting parameter uncertainty in the (correlated) parameters of distributions used to represent stochastic uncertainty in patient-level models. This study aims to provide this guidance by proposing appropriate methods and illustrating the impact of this uncertainty on modeling outcomes. Two approaches, 1) using non-parametric bootstrapping and 2) using multivariate Normal distributions, were applied in a simulation and case study. The approaches were compared based on point-estimates and distributions of time-to-event and health economic outcomes. To assess sample size impact on the uncertainty in these outcomes, sample size was varied in the simulation study and subgroup analyses were performed for the case-study. Accounting for parameter uncertainty in distributions that reflect stochastic uncertainty substantially increased the uncertainty surrounding health economic outcomes, illustrated by larger confidence ellipses surrounding the cost-effectiveness point-estimates and different cost-effectiveness acceptability curves. Although both approaches performed similar for larger sample sizes (i.e. n = 500), the second approach was more sensitive to extreme values for small sample sizes (i.e. n = 25), yielding infeasible modeling outcomes. Modelers should be aware that parameter uncertainty in distributions used to describe stochastic uncertainty needs to be reflected in probabilistic sensitivity analysis, as it could substantially impact the total amount of uncertainty surrounding health economic outcomes. If feasible, the bootstrap approach is recommended to account for this uncertainty.

Water Infrastructure Finance and Innovation Act

EPA Pesticide Factsheets

How WIFIA works, program implementation, program guidance, how potential recipients can obtain funding, and project eligibility. WIFIA works with State Revolving Funds to provide subsidized financing for large dollar-value projects.

An alternative approach to account for patient organ doses from imaging guidance procedures.

PubMed

Nelson, Alan P; Ding, George X

2014-07-01

To investigate the feasibility of an alternative method of accounting for additional organ doses resulting from image guidance procedures during patient treatment planning through tabulated values based on scan protocol and scan site. Patient-specific imaging dose to 30 patients resulting from Varian OBI kV-CBCT scans using the Standard Head (17 patients), Low-dose Thorax (8 patients), and Pelvic (5 patients) scan protocols were retrospectively calculated using Monte Carlo methods. Dose dependence on scan location and patient geometry was explored. Patient organ doses were analyzed by using dose-volume histograms and expressed by the mean, minimum dose delivered to 50% of the organ volume, D50. The reported doses are dose-to-medium instead of dose-to-water. The organ doses from all patient-specific calculations show predictable and limited ranges across patients. For brain isocenters using Standard Head Scans: Bone: 0.7-1.1 cGy, Brain: 0.2-0.3 cGy, Brainstem: 0.2-0.3 cGy, Skin: 0.3-0.4 cGy, Eye: 0.03-0.3 cGy. For head and neck patients using the Standard Head Scan: Bone: 0.3-0.6 cGy, Parotids: 0.3-0.4 cGy, Spinal Cord: 0.15-0.25 cGy, Thyroid: 0.1-0.25 cGy, Skin: 0.2-0.3 cGy, Trachea-Esophagus: 0.1-0.2 cGy. For chest using Thorax Scans: Bone: 1.1-1.8 cGy, Soft tissue organs (Bowel, Lung, Heart, Kidney, Esophagus, and Spinal Cord): 0.3-0.6 cGy. For abdominal site using Pelvic Scans: Bone: 3.2-4.2 cGy. Soft tissue organs (Bladder, Bowel, Rectum, Prostate, and Skin) D50s fell between 1.2 and 2.2 cGy. Femoral Heads: 2.5-3.4 cGy. It is adequate to estimate and account for organ dose by using tabulated values based on scan procedure and site because organ doses from imaging procedures are only modestly dependent upon scan location and body size. Considering the dose variation and magnitude of dose from each scan protocol in comparison to therapeutic doses, this approach provides a simple alternative to account for additional imaging guidance doses during patient treatment planning. Clinicians can use these tabulated values to make informed decisions in selecting the appropriate imaging procedures and imaging frequency during radiotherapy treatment. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Effects of a Velocity-Vector Based Command Augmentation System and Synthetic Vision System Terrain Portrayal and Guidance Symbology Concepts on Single-Pilot Performance

NASA Technical Reports Server (NTRS)

Liu, Dahai; Goodrich, Kenneth H.; Peak, Bob

2010-01-01

This study investigated the effects of synthetic vision system (SVS) concepts and advanced flight controls on the performance of pilots flying a light, single-engine general aviation airplane. We evaluated the effects and interactions of two levels of terrain portrayal, guidance symbology, and flight control response type on pilot performance during the conduct of a relatively complex instrument approach procedure. The terrain and guidance presentations were evaluated as elements of an integrated primary flight display system. The approach procedure used in the study included a steeply descending, curved segment as might be encountered in emerging, required navigation performance (RNP) based procedures. Pilot performance measures consisted of flight technical performance, perceived workload, perceived situational awareness and subjective preference. The results revealed that an elevation based generic terrain portrayal significantly improved perceived situation awareness without adversely affecting flight technical performance or workload. Other factors (pilot instrument rating, control response type, and guidance symbology) were not found to significantly affect the performance measures.

Technical note: real-time web-based wireless visual guidance system for radiotherapy.

PubMed

Lee, Danny; Kim, Siyong; Palta, Jatinder R; Kim, Taeho

2017-06-01

Describe a Web-based wireless visual guidance system that mitigates issues associated with hard-wired audio-visual aided patient interactive motion management systems that are cumbersome to use in routine clinical practice. Web-based wireless visual display duplicates an existing visual display of a respiratory-motion management system for visual guidance. The visual display of the existing system is sent to legacy Web clients over a private wireless network, thereby allowing a wireless setting for real-time visual guidance. In this study, active breathing coordinator (ABC) trace was used as an input for visual display, which captured and transmitted to Web clients. Virtual reality goggles require two (left and right eye view) images for visual display. We investigated the performance of Web-based wireless visual guidance by quantifying (1) the network latency of visual displays between an ABC computer display and Web clients of a laptop, an iPad mini 2 and an iPhone 6, and (2) the frame rate of visual display on the Web clients in frames per second (fps). The network latency of visual display between the ABC computer and Web clients was about 100 ms and the frame rate was 14.0 fps (laptop), 9.2 fps (iPad mini 2) and 11.2 fps (iPhone 6). In addition, visual display for virtual reality goggles was successfully shown on the iPhone 6 with 100 ms and 11.2 fps. A high network security was maintained by utilizing the private network configuration. This study demonstrated that a Web-based wireless visual guidance can be a promising technique for clinical motion management systems, which require real-time visual display of their outputs. Based on the results of this study, our approach has the potential to reduce clutter associated with wired-systems, reduce space requirements, and extend the use of medical devices from static usage to interactive and dynamic usage in a radiotherapy treatment vault.

Evolution of chemical-specific adjustment factors (CSAF) based on recent international experience; increasing utility and facilitating regulatory acceptance.

PubMed

Bhat, Virunya S; Meek, M E Bette; Valcke, Mathieu; English, Caroline; Boobis, Alan; Brown, Richard

2017-10-01

The application of chemical-specific toxicokinetic or toxicodynamic data to address interspecies differences and human variability in the quantification of hazard has potential to reduce uncertainty and better characterize variability compared with the use of traditional default or categorically-based uncertainty factors. The present review summarizes the state-of-the-science since the introduction of the World Health Organization/International Programme on Chemical Safety (WHO/IPCS) guidance on chemical-specific adjustment factors (CSAF) in 2005 and the availability of recent applicable guidance including the WHO/IPCS guidance on physiologically-based pharmacokinetic (PBPK) modeling in 2010 as well as the U.S. EPA guidance on data-derived extrapolation factors in 2014. A summary of lessons learned from an analysis of more than 100 case studies from global regulators or published literature illustrates the utility and evolution of CSAF in regulatory decisions. Challenges in CSAF development related to the adequacy of, or confidence in, the supporting data, including verification or validation of PBPK models. The analysis also identified issues related to adequacy of CSAF documentation, such as inconsistent terminology and often limited and/or inconsistent reporting, of both supporting data and/or risk assessment context. Based on this analysis, recommendations for standardized terminology, documentation and relevant interdisciplinary research and engagement are included to facilitate the continuing evolution of CSAF development and guidance.

Utility of Left Atrial Expansion Index and Stroke Volume in Management of Chronic Systolic Heart Failure.

PubMed

Hsiao, Shih-Hung; Lin, Shih-Kai; Chiou, Yi-Ran; Cheng, Chin-Chang; Hwang, Hwong-Ru; Chiou, Kuan-Rau

2018-06-01

Titration of evidence-based medications, important for treating heart failure (HF), is often underdosed by symptom-guided treatment. The aim of this study was to investigate, using echocardiographic parameters, stroke volume and left ventricular (LV) filling pressure to guide up-titration of medications, increasing prognostic benefits. A total of 765 patients with chronic HF and severely reduced LV ejection fractions (<35%), referred from 2008 to 2016, were prospectively studied. Echocardiographic guidance was performed in 149 patients. LV filling pressure was assessed by left atrial expansion index, and stroke volume was estimated from diameter and time-velocity integral in the LV outflow tract. Up-titration of evidence-based medications and adjustment for side effects or worsening clinical conditions according to those parameters were performed. Propensity score matching was used to match pairs of patients with (n = 110) or without (n = 110) echocardiographic guidance. End points were 4-year frequencies of HF hospitalization and all-cause mortality. During a mean follow-up time of 4.1 years, rates of adverse events were 58 (52.7%) with no echocardiographic guidance and 36 (32.7%) with echocardiographic guidance (P < .0001). Echocardiography provided effective guidance to reduce prescribing frequency and dose of diuretics and to promote evidence-based medication prescription. It reduced HF rehospitalization and all-cause mortality. By multivariate analysis, prognostic improvement was associated with up-titration of medications with echocardiographic guidance. There was a statistically significant difference in long-term prognosis between propensity score-matched pairs of patients with chronic severe HF with and without echocardiographic guidance. These findings need further validation in large prospective clinical trials. Copyright © 2018 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.

CT fluoroscopy-assisted puncture of thoracic and abdominal masses: a randomized trial.

PubMed

Kirchner, Johannes; Kickuth, Ralph; Laufer, Ulf; Schilling, Esther Maria; Adams, Stephan; Liermann, Dieter

2002-03-01

We investigated the benefit of real-time guidance of interventional punctures by means of computed tomography fluoroscopy (CTF) compared with the conventional sequential acquisition guidance. In a prospective randomized trial, 75 patients underwent either CTF-guided (group A, n = 50) or sequential CT-guided (group B, n = 25) punctures of thoracic (n = 29) or abdominal (n = 46) masses. CTF was performed on the CT machine (Somatom Plus 4 Power, Siemens Corp., Forchheim, Germany) equipped with the C.A.R.E. Vision application (tube voltage 120 kV, tube current 50 mA, rotational time 0.75 s, slice thickness 10 mm, 8 frames/s). The average procedure time showed a statistically significant difference between the two study groups (group A: 564 s, group B 795 s, P = 0.0032). The mean total mAs was 7089 mAs for the CTF and 4856 mAs for the sequential image-guided intervention, respectively. The sensitivity was 71% specificity 100% positive predictive value 100% and negative predictive value 60% for the CTF-guided puncture, and 68, 100, 100 and 50% for sequential CT, respectively. CTF guidance realizes a time-saving but increases the radiation exposure dosage.

A gold standard method for the evaluation of antibody-based materials functionality: Approach to forced degradation studies.

PubMed

Coussot, Gaëlle; Le Postollec, Aurélie; Faye, Clément; Dobrijevic, Michel

2018-04-15

The scope of this paper is to present a gold standard method to evaluate functional activity of antibody (Ab)-based materials during the different phases of their development, after their exposure to forced degradations or even during routine quality control. Ab-based materials play a central role in the development of diagnostic devices, for example, for screening or therapeutic target characterization, in formulation development, and in novel micro(nano)technology approaches to develop immunosensors useful for the analysis of trace substances in pharmaceutical and food industries, clinical and environmental fields. A very important aspect in diagnostic device development is the construction of its biofunctional surfaces. These Ab surfaces require biocompatibility, homogeneity, stability, specificity and functionality. Thus, this work describes the validation and applications of a unique ligand binding assay to directly perform the quantitative measurement of functional Ab binding sites immobilized on the solid surfaces. The method called Antibody Anti-HorseRadish Peroxidase (A2HRP) method, uses a covalently coated anti-HRP antibody (anti-HRP Ab) and does not need for a secondary Ab during the detection step. The A2HRP method was validated and gave reliable results over a wide range of absorbance values. Analyzed validation criteria were fulfilled as requested by the food and drug administration (FDA) and European Medicines Agency (EMA) guidance for the validation of bioanalytical methods with 1) an accuracy mean value within +15% of the nominal value; 2) the within-assay precision less than 7.1%, and 3) the inter-day variability under 12.1%. With the A2HRP method, it is then possible to quantify from 0.04 × 10 12 to 2.98 × 10 12 functional Ab binding sites immobilized on the solid surfaces. A2HRP method was validated according to FDA and EMA guidance, allowing the creation of a gold standard method to evaluate Ab surfaces for their resistance under laboratory constraints. Stability testing was described through forced degradation studies after exposure of Ab-surfaces to storage, pH and aqueous-organic solvent mixture stresses. Copyright © 2018 Elsevier B.V. All rights reserved.

Examination of the "Theory of Guidance" in the View of 'Ali Ibn Abi Talib (A): An Exploration into the Nahj Al-Balaghah

ERIC Educational Resources Information Center

Rostami-Nasab, Abas Ali; Tajedini, Oranus; Sadatmoosavi, Ali

2016-01-01

This study examines the "Theory of Guidance" according to 'Ali ibn Abi Talib (a). This theory is based on three divine covenants or fundamentals in guidance including the divine Prophet, the divine Book, and the divine human nature ("fitrat"). Research in this regard seems essential because this theory has not been previously…

26 CFR 1.861-8 - Computation of taxable income from sources within the United States and from other sources and...

Code of Federal Regulations, 2010 CFR

2010-04-01

... income. [Reserved]. For guidance, see § 1.861-8T(c)(1). (2) Apportionment based on assets. [Reserved.... [Reserved]. For guidance, see § 1.861-8T(d)(2). (e) Allocation and apportionment of certain deductions—(1... section. (2) Interest. [Reserved]. For guidance, see § 1.861-8T(e)(2). (3) Research and experimental...

78 FR 66936 - Issuance of Final Guidance Publication

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-07

... Immediately Dangerous to Life or Health (IDLH) Values'' [NIOSH 2014-100]. ADDRESSES: This document may be.... Scott Dotson, Ph.D. CIH, NIOSH Education and Information Division, Taft Laboratories Building, 4676...

Anti-Obesity Agents and the US Food and Drug Administration.

PubMed

Casey, Martin F; Mechanick, Jeffrey I

2014-09-01

Despite the growing market for obesity care, the US Food and Drug Administration (FDA) has approved only two new pharmaceutical agents-lorcaserin and combination phentermine/topiramate-for weight reduction since 2000, while removing three agents from the market in the same time period. This article explores the FDA's history and role in the approval of anti-obesity medications within the context of a public health model of obesity. Through the review of obesity literature and FDA approval documents, we identified two major barriers preventing fair evaluation of anti-obesity agents including: (1) methodological pitfalls in clinical trials and (2) misaligned values in the assessment of anti-obesity agents. Specific recommendations include the use of adaptive (Bayesian) design protocols, value-based analyses of risks and benefits, and regulatory guidance based on a comprehensive, multi-platform obesity disease model. Positively addressing barriers in the FDA approval process of anti-obesity agents may have many beneficial effects within an obesity disease model.

Investigation of a Macromechanical Approach to Analyzing Triaxially-Braided Polymer Composites

NASA Technical Reports Server (NTRS)

Goldberg, Robert K.; Blinzler, Brina J.; Binienda, Wieslaw K.

2010-01-01

A macro level finite element-based model has been developed to simulate the mechanical and impact response of triaxially-braided polymer matrix composites. In the analytical model, the triaxial braid architecture is simulated by using four parallel shell elements, each of which is modeled as a laminated composite. The commercial transient dynamic finite element code LS-DYNA is used to conduct the simulations, and a continuum damage mechanics model internal to LS-DYNA is used as the material constitutive model. The material stiffness and strength values required for the constitutive model are determined based on coupon level tests on the braided composite. Simulations of quasi-static coupon tests of a representative braided composite are conducted. Varying the strength values that are input to the material model is found to have a significant influence on the effective material response predicted by the finite element analysis, sometimes in ways that at first glance appear non-intuitive. A parametric study involving the input strength parameters provides guidance on how the analysis model can be improved.

VTOL shipboard letdown guidance system analysis

NASA Technical Reports Server (NTRS)

Phatak, A. V.; Karmali, M. S.

1983-01-01

Alternative letdown guidance strategies are examined for landing of a VTOL aircraft onboard a small aviation ship under adverse environmental conditions. Off line computer simulation of shipboard landing task is utilized for assessing the relative merits of the proposed guidance schemes. The touchdown performance of a nominal constant rate of descent (CROD) letdown strategy serves as a benchmark for ranking the performance of the alternative letdown schemes. Analysis of ship motion time histories indicates the existence of an alternating sequence of quiescent and rough motions called lulls and swells. A real time algorithms lull/swell classification based upon ship motion pattern features is developed. The classification algorithm is used to command a go/no go signal to indicate the initiation and termination of an acceptable landing window. Simulation results show that such a go/no go pattern based letdown guidance strategy improves touchdown performance.

Fully automatic guidance and control for rotorcraft nap-of-the-Earth flight following planned profiles. Volume 1: Real-time piloted simulation

NASA Technical Reports Server (NTRS)

Clement, Warren F.; Gorder, Peter J.; Jewell, Wayne F.

1991-01-01

Developing a single-pilot, all-weather nap-of-the-earth (NOE) capability requires fully automatic NOE (ANOE) navigation and flight control. Innovative guidance and control concepts are investigated in a four-fold research effort that: (1) organizes the on-board computer-based storage and real-time updating of NOE terrain profiles and obstacles in course-oriented coordinates indexed to the mission flight plan; (2) defines a class of automatic anticipative pursuit guidance algorithms and necessary data preview requirements to follow the vertical, lateral, and longitudinal guidance commands dictated by the updated flight profiles; (3) automates a decision-making process for unexpected obstacle avoidance; and (4) provides several rapid response maneuvers. Acquired knowledge from the sensed environment is correlated with the forehand knowledge of the recorded environment (terrain, cultural features, threats, and targets), which is then used to determine an appropriate evasive maneuver if a nonconformity of the sensed and recorded environments is observed. This four-fold research effort was evaluated in both fixed-based and moving-based real-time piloted simulations, thereby, providing a practical demonstration for evaluating pilot acceptance of the automated concepts, supervisory override, manual operation, and re-engagement of the automatic system. Volume one describes the major components of the guidance and control laws as well as the results of the piloted simulations. Volume two describes the complete mathematical model of the fully automatic guidance system for rotorcraft NOE flight following planned flight profiles.

Fully Automatic Guidance and Control for Rotorcraft Nap-of-the-earth Flight Following Planned Profiles. Volume 2: Mathematical Model

NASA Technical Reports Server (NTRS)

Clement, Warren F.; Gorder, Peter J.; Jewell, Wayne F.

1991-01-01

Developing a single-pilot, all-weather nap-of-the-earth (NOE) capability requires fully automatic NOE (ANOE) navigation and flight control. Innovative guidance and control concepts are investigated in a four-fold research effort that: (1) organizes the on-board computer-based storage and real-time updating of NOE terrain profiles and obstacles in course-oriented coordinates indexed to the mission flight plan; (2) defines a class of automatic anticipative pursuit guidance algorithms and necessary data preview requirements to follow the vertical, lateral, and longitudinal guidance commands dictated by the updated flight profiles; (3) automates a decision-making process for unexpected obstacle avoidance; and (4) provides several rapid response maneuvers. Acquired knowledge from the sensed environment is correlated with the forehand knowledge of the recorded environment (terrain, cultural features, threats, and targets), which is then used to determine an appropriate evasive maneuver if a nonconformity of the sensed and recorded environments is observed. This four-fold research effort was evaluated in both fixed-base and moving-base real-time piloted simulations; thereby, providing a practical demonstration for evaluating pilot acceptance of the automated concepts, supervisory override, manual operation, and re-engagement of the automatic system. Volume one describes the major components of the guidance and control laws as well as the results of the piloted simulations. Volume two describes the complete mathematical model of the fully automatic guidance system for rotorcraft NOE flight following planned flight profiles.

Using prediction uncertainty analysis to design hydrologic monitoring networks: Example applications from the Great Lakes water availability pilot project

USGS Publications Warehouse

Fienen, Michael N.; Doherty, John E.; Hunt, Randall J.; Reeves, Howard W.

2010-01-01

The importance of monitoring networks for resource-management decisions is becoming more recognized, in both theory and application. Quantitative computer models provide a science-based framework to evaluate the efficacy and efficiency of existing and possible future monitoring networks. In the study described herein, two suites of tools were used to evaluate the worth of new data for specific predictions, which in turn can support efficient use of resources needed to construct a monitoring network. The approach evaluates the uncertainty of a model prediction and, by using linear propagation of uncertainty, estimates how much uncertainty could be reduced if the model were calibrated with addition information (increased a priori knowledge of parameter values or new observations). The theoretical underpinnings of the two suites of tools addressing this technique are compared, and their application to a hypothetical model based on a local model inset into the Great Lakes Water Availability Pilot model are described. Results show that meaningful guidance for monitoring network design can be obtained by using the methods explored. The validity of this guidance depends substantially on the parameterization as well; hence, parameterization must be considered not only when designing the parameter-estimation paradigm but also-importantly-when designing the prediction-uncertainty paradigm.

Latency in Visionic Systems: Test Methods and Requirements

NASA Technical Reports Server (NTRS)

Bailey, Randall E.; Arthur, J. J., III; Williams, Steven P.; Kramer, Lynda J.

2005-01-01

A visionics device creates a pictorial representation of the external scene for the pilot. The ultimate objective of these systems may be to electronically generate a form of Visual Meteorological Conditions (VMC) to eliminate weather or time-of-day as an operational constraint and provide enhancement over actual visual conditions where eye-limiting resolution may be a limiting factor. Empirical evidence has shown that the total system delays or latencies including the imaging sensors and display systems, can critically degrade their utility, usability, and acceptability. Definitions and measurement techniques are offered herein as common test and evaluation methods for latency testing in visionics device applications. Based upon available data, very different latency requirements are indicated based upon the piloting task, the role in which the visionics device is used in this task, and the characteristics of the visionics cockpit display device including its resolution, field-of-regard, and field-of-view. The least stringent latency requirements will involve Head-Up Display (HUD) applications, where the visionics imagery provides situational information as a supplement to symbology guidance and command information. Conversely, the visionics system latency requirement for a large field-of-view Head-Worn Display application, providing a Virtual-VMC capability from which the pilot will derive visual guidance, will be the most stringent, having a value as low as 20 msec.

Management of allergy to penicillins and other beta-lactams.

PubMed

Mirakian, R; Leech, S C; Krishna, M T; Richter, A G; Huber, P A J; Farooque, S; Khan, N; Pirmohamed, M; Clark, A T; Nasser, S M

2015-02-01

The Standards of Care Committee of the British Society for Allergy and Clinical Immunology (BSACI) and an expert panel have prepared this guidance for the management of immediate and non-immediate allergic reactions to penicillins and other beta-lactams. The guideline is intended for UK specialists in both adult and paediatric allergy and for other clinicians practising allergy in secondary and tertiary care. The recommendations are evidence based, but where evidence is lacking, the panel reached consensus. During the development of the guideline, all BSACI members were consulted using a Web-based process and all comments carefully considered. Included in the guideline are epidemiology of allergic reactions to beta-lactams, molecular structure, formulations available in the UK and a description of known beta-lactam antigenic determinants. Sections on the value and limitations of clinical history, skin testing and laboratory investigations for both penicillins and cephalosporins are included. Cross-reactivity between penicillins and cephalosporins is discussed in detail. Recommendations on oral provocation and desensitization procedures have been made. Guidance for beta-lactam allergy in children is given in a separate section. An algorithm to help the clinician in the diagnosis of patients with a history of penicillin allergy has also been included. © 2015 John Wiley & Sons Ltd.

The Nutrient Density of Snacks

PubMed Central

Hess, Julie; Rao, Goutham; Slavin, Joanne

2017-01-01

Background: Although Americans receive almost a quarter of their daily energy from snacks, snacking remains a poorly defined and understood eating occasion. However, there is little dietary guidance about choosing snacks. Families, clinicians, and researchers need a comprehensive approach to assessing their nutritional value. Objective: To quantify and compare the nutrient density of commonly consumed snacks by their overall nutrient profiles using the Nutrient-Rich Foods (NRF) Index 10.3. Methods: NRF Index scores were calculated for the top 3 selling products (based on 2014 market research data) in different snack categories. These NRF scores were averaged to provide an overall nutrient-density score for each category. Results: Based on NRF scores, yogurt (55.3), milk (52.5), and fruit (30.1) emerged as the most nutrient-dense snacks. Ice cream (−4.4), pies and cakes (−11.1), and carbonated soft drinks (−17.2) emerged as the most nutrient-poor snacks. Conclusions: The NRF Index is a useful tool for assessing the overall nutritional value of snacks based on nutrients to limit and nutrients to encourage. PMID:28491924

Infrared dim-small target tracking via singular value decomposition and improved Kernelized correlation filter

NASA Astrophysics Data System (ADS)

Qian, Kun; Zhou, Huixin; Rong, Shenghui; Wang, Bingjian; Cheng, Kuanhong

2017-05-01

Infrared small target tracking plays an important role in applications including military reconnaissance, early warning and terminal guidance. In this paper, an effective algorithm based on the Singular Value Decomposition (SVD) and the improved Kernelized Correlation Filter (KCF) is presented for infrared small target tracking. Firstly, the super performance of the SVD-based algorithm is that it takes advantage of the target's global information and obtains a background estimation of an infrared image. A dim target is enhanced by subtracting the corresponding estimated background with update from the original image. Secondly, the KCF algorithm is combined with Gaussian Curvature Filter (GCF) to eliminate the excursion problem. The GCF technology is adopted to preserve the edge and eliminate the noise of the base sample in the KCF algorithm, helping to calculate the classifier parameter for a small target. At last, the target position is estimated with a response map, which is obtained via the kernelized classifier. Experimental results demonstrate that the presented algorithm performs favorably in terms of efficiency and accuracy, compared with several state-of-the-art algorithms.

The Nutrient Density of Snacks: A Comparison of Nutrient Profiles of Popular Snack Foods Using the Nutrient-Rich Foods Index.

PubMed

Hess, Julie; Rao, Goutham; Slavin, Joanne

2017-01-01

Background: Although Americans receive almost a quarter of their daily energy from snacks, snacking remains a poorly defined and understood eating occasion. However, there is little dietary guidance about choosing snacks. Families, clinicians, and researchers need a comprehensive approach to assessing their nutritional value. Objective: To quantify and compare the nutrient density of commonly consumed snacks by their overall nutrient profiles using the Nutrient-Rich Foods (NRF) Index 10.3. Methods: NRF Index scores were calculated for the top 3 selling products (based on 2014 market research data) in different snack categories. These NRF scores were averaged to provide an overall nutrient-density score for each category. Results: Based on NRF scores, yogurt (55.3), milk (52.5), and fruit (30.1) emerged as the most nutrient-dense snacks. Ice cream (-4.4), pies and cakes (-11.1), and carbonated soft drinks (-17.2) emerged as the most nutrient-poor snacks. Conclusions: The NRF Index is a useful tool for assessing the overall nutritional value of snacks based on nutrients to limit and nutrients to encourage.

Ethics Review for a Multi-Site Project Involving Tribal Nations in the Northern Plains.

PubMed

Angal, Jyoti; Petersen, Julie M; Tobacco, Deborah; Elliott, Amy J

2016-04-01

Increasingly, Tribal Nations are forming ethics review panels, which function separately from institutional review boards (IRBs). The emergence of strong community representation coincides with a widespread effort supported by the U.S. Department of Health & Human Services and other federal agencies to establish a single IRB for all multi-site research. This article underscores the value of a tribal ethics review board and describes the tribal oversight for the Safe Passage Study-a multi-site, community-based project in the Northern Plains. Our experience demonstrates the benefits of tribal ethics review and makes a strong argument for including tribal oversight in future regulatory guidance for multi-site, community-based research. © The Author(s) 2016.

Orion Powered Flight Guidance Burn Options for Near Term Exploration

NASA Technical Reports Server (NTRS)

Fill, Tom; Goodman, John; Robinson, Shane

2018-01-01

NASA's Orion exploration spacecraft will fly more demanding mission profiles than previous NASA human flight spacecraft. Missions currently under development are destined for cislunar space. The EM-1 mission will fly unmanned to a Distant Retrograde Orbit (DRO) around the Moon. EM-2 will fly astronauts on a mission to the lunar vicinity. To fly these missions, Orion requires powered flight guidance that is more sophisticated than the orbital guidance flown on Apollo and the Space Shuttle. Orion's powered flight guidance software contains five burn guidance options. These five options are integrated into an architecture based on a proven shuttle heritage design, with a simple closed-loop guidance strategy. The architecture provides modularity, simplicity, versatility, and adaptability to future, yet-to-be-defined, exploration mission profiles. This paper provides a summary of the executive guidance architecture and details the five burn options to support both the nominal and abort profiles for the EM-1 and EM-2 missions.

Orion's Powered Flight Guidance Burn Options for Near Term Exploration Missions

NASA Technical Reports Server (NTRS)

Fill, Thomas; Goodman, John; Robinson, Shane

2018-01-01

NASA's Orion exploration spacecraft will fly more demanding mission profiles than previous NASA human flight spacecraft. Missions currently under development are destined for cislunar space. The EM-1 mission will fly unmanned to a Distant Retrograde Orbit (DRO) around the Moon. EM-2 will fly astronauts on a mission to the lunar vicinity. To fly these missions, Orion requires powered flight guidance that is more sophisticated than the orbital guidance flown on Apollo and the Space Shuttle. Orion's powered flight guidance software contains five burn guidance options. These five options are integrated into an architecture based on a proven shuttle heritage design, with a simple closed-loop guidance strategy. The architecture provides modularity, simplicity, versatility, and adaptability to future, yet-to-be-defined, exploration mission profiles. This paper provides a summary of the executive guidance architecture and details the five burn options to support both the nominal and abort profiles for the EM-1 and EM-2 missions.

An investigation of automatic guidance concepts to steer a VTOL aircraft to a small aviation facility ship

NASA Technical Reports Server (NTRS)

Sorensen, J. A.; Goka, T.; Phatak, A. V.; Schmidt, S. F.

1980-01-01

A detailed system model of a VTOL aircraft approaching a small aviation facility ship was developed and used to investigate several approach guidance concepts. A preliminary anaysis of the aircraft-vessel landing guidance requirements was conducted. The various subelements and constraints of the flight system are described including the landing scenario, lift fan aircraft, state rate feedback flight control, MLS-based navigation, sea state induced ship motion, and wake turbulence due to wind-over-deck effects. These elements are integrated into a systems model with various guidance concepts. Guidance is described in terms of lateral, vertical, and longitudinal axes steering modes and approach and landing phases divided by a nominal hover (or stationkeeping) point defined with respect to the landing pad. The approach guidance methods are evaluated, and the two better steering concepts are studied by both single pass and Monte Carlo statistical simulation runs. Four different guidance concepts are defined for further analysis for the landing phase of flight.

Bias estimates used in lieu of validation of fission products and minor actinides in MCNP K eff calculations for PWR burnup credit casks

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

Mueller, Don E.; Marshall, William J.; Wagner, John C.

The U.S. Nuclear Regulatory Commission (NRC) Division of Spent Fuel Storage and Transportation recently issued Interim Staff Guidance (ISG) 8, Revision 3. This ISG provides guidance for burnup credit (BUC) analyses supporting transport and storage of PWR pressurized water reactor (PWR) fuel in casks. Revision 3 includes guidance for addressing validation of criticality (k eff) calculations crediting the presence of a limited set of fission products and minor actinides (FP&MA). Based on previous work documented in NUREG/CR-7109, recommendation 4 of ISG-8, Rev. 3, includes a recommendation to use 1.5 or 3% of the FP&MA worth to conservatively cover the biasmore » due to the specified FP&MAs. This bias is supplementary to the bias and bias uncertainty resulting from validation of k eff calculations for the major actinides in SNF and does not address extension to actinides and fission products beyond those identified herein. The work described in this report involves comparison of FP&MA worths calculated using SCALE and MCNP with ENDF/B-V, -VI, and -VII based nuclear data and supports use of the 1.5% FP&MA worth bias when either SCALE or MCNP codes are used for criticality calculations, provided the other conditions of the recommendation 4 are met. The method used in this report may also be applied to demonstrate the applicability of the 1.5% FP&MA worth bias to other codes using ENDF/B V, VI or VII based nuclear data. The method involves use of the applicant s computational method to generate FP&MA worths for a reference SNF cask model using specified spent fuel compositions. The applicant s FP&MA worths are then compared to reference values provided in this report. The applicants FP&MA worths should not exceed the reference results by more than 1.5% of the reference FP&MA worths.« less

Recent Experiences of the NASA Engineering and Safety Center (NESC) Guidance Navigation and Control (GN and C) Technical Discipline Team (TDT)

NASA Technical Reports Server (NTRS)

Dennehy, Cornelius J.

2011-01-01

The NASA Engineering and Safety Center (NESC) is an independently funded NASA Program whose dedicated team of technical experts provides objective engineering and safety assessments of critical, high risk projects. NESC's strength is rooted in the diverse perspectives and broad knowledge base that add value to its products, affording customers a responsive, alternate path for assessing and preventing technical problems while protecting vital human and national resources. The Guidance Navigation and Control (GN&C) Technical Discipline Team (TDT) is one of fifteen such discipline-focused teams within the NESC organization. The TDT membership is composed of GN&C specialists from across NASA and its partner organizations in other government agencies, industry, national laboratories, and universities. This paper will briefly define the vision, mission, and purpose of the NESC organization. The role of the GN&C TDT will then be described in detail along with an overview of how this team operates and engages in its objective engineering and safety assessments of critical NASA.

Possible Health Benefits From Reducing Occupational Magnetic Fields

PubMed Central

Bowman, Joseph D.; Ray, Tapas K.; Park, Robert M.

2015-01-01

Background Magnetic fields (MF) from AC electricity are a Possible Human Carcinogen, based on limited epidemiologic evidence from exposures far below occupational health limits. Methods To help formulate government guidance on occupational MF, the cancer cases prevented and the monetary benefits accruing to society by reducing workplace exposures were determined. Life-table methods produced Disability Adjusted Life Years, which were converted to monetary values. Results Adjusted for probabilities of causality, the expected increase in a worker’s disability-free life are 0.04 year (2 weeks) from a 1 microtesla (μT) MF reduction in average worklife exposure, which is equivalent to $5,100/worker/μT in year 2010 U.S. dollars (95% confidence interval $1,000–$9,000/worker/μT). Where nine electrosteel workers had 13.8 μT exposures, for example, moving them to ambient MFs would provide $600,000 in benefits to society (uncertainty interval $0–$1,000,000). Conclusions When combined with the costs of controls, this analysis provides guidance for precautionary recommendations for managing occupational MF exposures. PMID:23129537

Possible health benefits from reducing occupational magnetic fields.

PubMed

Bowman, Joseph D; Ray, Tapas K; Park, Robert M

2013-07-01

Magnetic fields (MF) from AC electricity are a Possible Human Carcinogen, based on limited epidemiologic evidence from exposures far below occupational health limits. To help formulate government guidance on occupational MF, the cancer cases prevented and the monetary benefits accruing to society by reducing workplace exposures were determined. Life-table methods produced Disability Adjusted Life Years, which were converted to monetary values. Adjusted for probabilities of causality, the expected increase in a worker's disability-free life are 0.04 year (2 weeks) from a 1 microtesla (µT) MF reduction in average worklife exposure, which is equivalent to $5,100/worker/µT in year 2010 U.S. dollars (95% confidence interval $1,000-$9,000/worker/µT). Where nine electrosteel workers had 13.8 µT exposures, for example, moving them to ambient MFs would provide $600,000 in benefits to society (uncertainty interval $0-$1,000,000). When combined with the costs of controls, this analysis provides guidance for precautionary recommendations for managing occupational MF exposures. Copyright © 2012 Wiley Periodicals, Inc.

Guidebook for value for money assessment.

DOT National Transportation Integrated Search

2013-12-01

The Federal Highway Administrations (FHWA) Office of Innovative Program Delivery (OIPD) has developed a Public-Private Partnership (P3) Toolkit comprising tools and guidance documents to assist in educating public sector policymakers, legislative ...

Experience-Based Career Education. High School Level Demonstration Project. Final Report (October 1, 1976 to July 30, 1979).

ERIC Educational Resources Information Center

Greenville County School District, Greenville, SC.

An Experience-Based Career Education (EBCE) exemplary project was conducted for three years in four high schools in Greenville County, South Carolina, and then evaluated for this final program report. Guidance and community components made up the program's major strengths. A third component (academic) proved nonessential. The guidance component…

Career Guidance in India Based on O*NET and Cultural Variables

ERIC Educational Resources Information Center

Bhatnagar, Mohit

2018-01-01

The Occupational Information Network (O*NET) is the primary source of occupational information in the United States (US). In this study, I review O*NET's usage for career guidance in India and conceive a career intervention based on it. In an empirical evaluation adopting a posttest-only experimental design with post-graduate management students…

Missile Guidance Law Based on Robust Model Predictive Control Using Neural-Network Optimization.

PubMed

Li, Zhijun; Xia, Yuanqing; Su, Chun-Yi; Deng, Jun; Fu, Jun; He, Wei

2015-08-01

In this brief, the utilization of robust model-based predictive control is investigated for the problem of missile interception. Treating the target acceleration as a bounded disturbance, novel guidance law using model predictive control is developed by incorporating missile inside constraints. The combined model predictive approach could be transformed as a constrained quadratic programming (QP) problem, which may be solved using a linear variational inequality-based primal-dual neural network over a finite receding horizon. Online solutions to multiple parametric QP problems are used so that constrained optimal control decisions can be made in real time. Simulation studies are conducted to illustrate the effectiveness and performance of the proposed guidance control law for missile interception.

75 FR 64162 - Determination of Attainment for PM10

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-19

... AQS as a special event due to a volcanic eruption. Under EPA's 1994 guidance,\\4\\ data may be excluded... 1992-1994 period (all in 1992), these values were flagged by ADEC as special events due to a volcanic eruption. EPA concurred on the flagged exceedances in a May 24, 1995, letter to ADEC and thus these values...

MARLAP

EPA Science Inventory

MARLAP is being developed as a multi-agency guidance manual for project managers and radioanalytical laboratories. The document uses a performance based approach and will provide guidance and a framework to assure that laboratory radioanalytical data meets the specific project or...

Optimal guidance for the space shuttle transition

NASA Technical Reports Server (NTRS)

Stengel, R. F.

1972-01-01

A guidance method for the space shuttle's transition from hypersonic entry to subsonic cruising flight is presented. The method evolves from a numerical trajectory optimization technique in which kinetic energy and total energy (per unit weight) replace velocity and time in the dynamic equations. This allows the open end-time problem to be transformed to one of fixed terminal energy. In its ultimate form, E-Guidance obtains energy balance (including dynamic-pressure-rate damping) and path length control by angle-of-attack modulation and cross-range control by roll angle modulation. The guidance functions also form the basis for a pilot display of instantaneous maneuver limits and destination. Numerical results illustrate the E-Guidance concept and the optimal trajectories on which it is based.

The AMCP Format for Formulary Submissions: Welcome to Version 4.0.

PubMed

2016-05-01

Managed care pharmacists are increasingly presented with complex considerations related to prescription drug formulary management. As prescription drug spending soars, and new effective, but expensive drugs rush to the market, pharmacists and other health care decision makers must evaluate a myriad of important clinical and economic considerations in determining the relative value and, subsequently, the appropriate placement of a product within a formulary. The AMCP Format for Formulary Submissions, Version 4.0, is the next iteration of the Format, which was first released in 2000. Version 4.0, developed by pharmacists from health plan, manufacturer, and academic perspectives, provides updated recommendations on acquiring and evaluating clinical and economic evidence to inform formulary and medical policy decisions. It also includes new guidance related to emerging special topic considerations such as biosimilars, specialty pharmacy products, and companion diagnostic tests. Version 4.0 has been modified to improve the usability of the Format, with clarifying guidance related to logistical considerations such as a recommended time frame for implementation of Version 4.0, as well as dossier updates and ongoing communication between manufacturers and health care decision makers. The Format should be used as a framework for ongoing evidence-based dialogue between manufacturers and payers. The evolving health care landscape will require new levels of collaboration and communication among key stakeholders to successfully navigate the challenges of this new environment. The Format provides a framework to support these critical interactions related to product value by facilitating an evidence-based, transparent approach. This document was prepared by Jeff Lee, PharmD, FCCP, on behalf of the AMCP Format Executive Committee. Committee members reviewed and provided feedback on the final draft. No conflicts of interest, financial or otherwise, were reported.

The process of developing evidence-based guidance in medicine and public health: a qualitative study of views from the inside

PubMed Central

2013-01-01

Background There has been significant investment in developing guidelines to improve clinical and public health practice. Though much is known about the processes of evidence synthesis and evidence-based guidelines implementation, we know little about how evidence presented to advisory groups is interpreted and used to form practice recommendations or what happens where evidence is lacking. This study investigates how members of advisory groups of NICE (National Institute of Health and Clinical Excellence) conceptualize evidence and experience the process. Methods Members of three advisory groups for acute physical, mental and public health were interviewed at the beginning and end of the life of the group. Seventeen were interviewed at both time points; five were interviewed just once at time one; and 17 were interviewed only once after guidance completion. Using thematic and content analysis, interview transcripts were analysed to identify the main themes. Results Three themes were identified: 1. What is the task? Different members conceptualized the task differently; some emphasized the importance of evidence at the top of the quality hierarchy while others emphasized the importance of personal experience. 2. Who gets heard? Managing the diversity of opinion and vested interests was a challenge for the groups; service users were valued and as was the importance of fostering good working relationships between group members. 3. What is the process? Group members valued debate and recognized the need to marshal discussion; most members were satisfied with the process and output. Conclusions Evidence doesn’t form recommendations on its own, but requires human judgement. Diversity of opinion within advisory groups was seen as key to making well-informed judgments relevant to forming recommendations. However, that diversity can bring tensions in the evaluation of evidence and its translation into practice recommendations. PMID:24006933

Tier 3 Toxicity Value White Paper

EPA Pesticide Factsheets

The purpose of this white paper is to articulate the issues pertaining to Tier 3 toxicity values and provide recommendations on processes that will improve the transparency and consistency of identifying, evaluating, selecting, and documenting Tier 3 toxicity values for use in the Superfund and Resource Conservation and Recovery Act (RCRA) programs. This white paper will be used to assist regional risk assessors in selecting Tier 3 toxicity values as well as provide the foundation for future regional and national efforts to improve guidance and policy on Tier 3 toxicity values.

Laser beam riding artillery missiles guidance device is designed

NASA Astrophysics Data System (ADS)

Yan, Mingliang; Huo, Zhicheng; Chen, Wei

2014-09-01

Laser driving gun missile guidance type beam of laser information field formed by any link failure or reduced stability will directly lead to ballistic or miss out of control, and based on this, this paper designed the driving beam of laser guided missile guidance beam type forming device modulation and zoom mechanism, in order to make the missile can recognize its position in the laser beam, laser beam gun missile, by means of spatial encoding of the laser beam laser beam into information after forming device, a surface to achieve the purpose of precision guidance.

Study on the Reduced Traffic Congestion Method Based on Dynamic Guidance Information

NASA Astrophysics Data System (ADS)

Li, Shu-Bin; Wang, Guang-Min; Wang, Tao; Ren, Hua-Ling; Zhang, Lin

2018-05-01

This paper studies how to generate the reasonable information of travelers’ decision in real network. This problem is very complex because the travelers’ decision is constrained by different human behavior. The network conditions can be predicted by using the advanced dynamic OD (Origin-Destination, OD) estimation techniques. Based on the improved mesoscopic traffic model, the predictable dynamic traffic guidance information can be obtained accurately. A consistency algorithm is designed to investigate the travelers’ decision by simulating the dynamic response to guidance information. The simulation results show that the proposed method can provide the best guidance information. Further, a case study is conducted to verify the theoretical results and to draw managerial insights into the potential of dynamic guidance strategy in improving traffic performance. Supported by National Natural Science Foundation of China under Grant Nos. 71471104, 71771019, 71571109, and 71471167; The University Science and Technology Program Funding Projects of Shandong Province under Grant No. J17KA211; The Project of Public Security Department of Shandong Province under Grant No. GATHT2015-236; The Major Social and Livelihood Special Project of Jinan under Grant No. 20150905

How Does the Degree of Guidance Support Students' Metacognitive and Problem Solving Skills in Educational Robotics?

NASA Astrophysics Data System (ADS)

Atmatzidou, Soumela; Demetriadis, Stavros; Nika, Panagiota

2018-02-01

Educational robotics (ER) is an innovative learning tool that offers students opportunities to develop higher-order thinking skills. This study investigates the development of students' metacognitive (MC) and problem-solving (PS) skills in the context of ER activities, implementing different modes of guidance in two student groups (11-12 years old, N1 = 30, and 15-16 years old, N2 = 22). The students of each age group were involved in an 18-h group-based activity after being randomly distributed in two conditions: "minimal" (with minimal MC and PS guidance) and "strong" (with strong MC and PS guidance). Evaluations were based on the Metacognitive Awareness Inventory measuring students' metacognitive awareness and on a think-aloud protocol asking students to describe the process they would follow to solve a certain robot-programming task. The results suggest that (a) strong guidance in solving problems can have a positive impact on students' MC and PS skills and (b) students reach eventually the same level of MC and PS skills development independently of their age and gender.

Towards an Integrated Approach to Sexual Health Services: The Contribution of NICE Guidance on One-to-One Interventions to Prevent STIs and under 18 Conceptions

ERIC Educational Resources Information Center

Killoran, Amanda; McCormick, Geraldine

2010-01-01

Objective: To describe the development of the National Institute for Health and Clinical Excellence (NICE) evidence-based guidance on one-to-one interventions for prevention of STIs and under 18 conceptions, as a focus for an integrated approach to sexual health services. Method: Documentation of the process for developing NICE guidance that is…

Non-invasive continuous blood pressure measurement based on mean impact value method, BP neural network, and genetic algorithm.

PubMed

Tan, Xia; Ji, Zhong; Zhang, Yadan

2018-04-25

Non-invasive continuous blood pressure monitoring can provide an important reference and guidance for doctors wishing to analyze the physiological and pathological status of patients and to prevent and diagnose cardiovascular diseases in the clinical setting. Therefore, it is very important to explore a more accurate method of non-invasive continuous blood pressure measurement. To address the shortcomings of existing blood pressure measurement models based on pulse wave transit time or pulse wave parameters, a new method of non-invasive continuous blood pressure measurement - the GA-MIV-BP neural network model - is presented. The mean impact value (MIV) method is used to select the factors that greatly influence blood pressure from the extracted pulse wave transit time and pulse wave parameters. These factors are used as inputs, and the actual blood pressure values as outputs, to train the BP neural network model. The individual parameters are then optimized using a genetic algorithm (GA) to establish the GA-MIV-BP neural network model. Bland-Altman consistency analysis indicated that the measured and predicted blood pressure values were consistent and interchangeable. Therefore, this algorithm is of great significance to promote the clinical application of a non-invasive continuous blood pressure monitoring method.

Seeking Optimal Region-Of-Interest (ROI) Single-Value Summary Measures for fMRI Studies in Imaging Genetics

PubMed Central

Tong, Yunxia; Chen, Qiang; Nichols, Thomas E.; Rasetti, Roberta; Callicott, Joseph H.; Berman, Karen F.; Weinberger, Daniel R.; Mattay, Venkata S.

2016-01-01

A data-driven hypothesis-free genome-wide association (GWA) approach in imaging genetics studies allows screening the entire genome to discover novel genes that modulate brain structure, chemistry, and function. However, a whole brain voxel-wise analysis approach in such genome-wide based imaging genetic studies can be computationally intense and also likely has low statistical power since a stringent multiple comparisons correction is needed for searching over the entire genome and brain. In imaging genetics with functional magnetic resonance imaging (fMRI) phenotypes, since many experimental paradigms activate focal regions that can be pre-specified based on a priori knowledge, reducing the voxel-wise search to single-value summary measures within a priori ROIs could prove efficient and promising. The goal of this investigation is to evaluate the sensitivity and reliability of different single-value ROI summary measures and provide guidance in future work. Four different fMRI databases were tested and comparisons across different groups (patients with schizophrenia, their siblings, vs. normal control subjects; across genotype groups) were conducted. Our results show that four of these measures, particularly those that represent values from the top most-activated voxels within an ROI are more powerful at reliably detecting group differences and generating greater effect sizes than the others. PMID:26974435

Commissioning and quality assurance for the treatment delivery components of the AccuBoost system

PubMed Central

Talmadge, Mike; Ladd, Ron; Halvorsen, Per

2015-01-01

The objective for this work was to develop a commissioning methodology for the treatment delivery components of the AccuBoost system, as well as to establish a routine quality assurance program and appropriate guidance for clinical use based on the commissioning results. Various tests were developed: 1) assessment of the accuracy of the displayed separation value; 2) validation of the dwell positions within each applicator; 3) assessment of the accuracy and precision of the applicator localization system; 4) assessment of the combined dose profile of two opposed applicators to confirm that they are coaxial; 5) measurement of the absolute dose delivered with each applicator to confirm acceptable agreement with dose based on Monte Carlo modeling; 6) measurements of the skin‐to‐center dose ratio using optically stimulated luminescence dosimeters; and 7) assessment of the mammopad cushion's effect on the center dose. We found that the difference between the measured and the actual paddle separation is <0.1 cm for the separation range of 3 cm to 7.5 cm. Radiochromic film measurements demonstrated that the number of dwell positions inside the applicators agree with the values from the vendor, for each applicator type and size. The shift needed for a good applicator‐grid alignment was within 0.2 cm. The dry‐run test using film demonstrated that the shift of the dosimetric center is within 0.15 cm. Dose measurements in water converted to polystyrene agreed within 5.0% with the Monte Carlo data in polystyrene for the same applicator type, size, and depth. A solid water‐to‐water (phantom) factor was obtained for each applicator, and all future annual quality assurance tests will be performed in solid water using an average value of 1.07 for the solid water‐to‐water factor. The skin‐to‐center dose ratio measurements support the Monte Carlo‐based values within 5.0% agreement. For the treatment separation range of 4 cm to 8 cm, the change in center dose would be <1.0% for all applicators when using a compressed pad of 0.2 cm to 0.3 cm. The tests performed ensured that all treatment components of the AccuBoost system are functional and that a treatment plan can be delivered with acceptable accuracy. Based on the commissioning results, a quality assurance manual and guidance documents for clinical use were developed. PACS numbers: 87.55.Qr, 87.56.Da, 87.90.+y PMID:26103184

How Many Batches Are Needed for Process Validation under the New FDA Guidance?

PubMed

Yang, Harry

2013-01-01

The newly updated FDA Guidance for Industry on Process Validation: General Principles and Practices ushers in a life cycle approach to process validation. While the guidance no longer considers the use of traditional three-batch validation appropriate, it does not prescribe the number of validation batches for a prospective validation protocol, nor does it provide specific methods to determine it. This potentially could leave manufacturers in a quandary. In this paper, I develop a Bayesian method to address the issue. By combining process knowledge gained from Stage 1 Process Design (PD) with expected outcomes of Stage 2 Process Performance Qualification (PPQ), the number of validation batches for PPQ is determined to provide a high level of assurance that the process will consistently produce future batches meeting quality standards. Several examples based on simulated data are presented to illustrate the use of the Bayesian method in helping manufacturers make risk-based decisions for Stage 2 PPQ, and they highlight the advantages of the method over traditional Frequentist approaches. The discussions in the paper lend support for a life cycle and risk-based approach to process validation recommended in the new FDA guidance. The newly updated FDA Guidance for Industry on Process Validation: General Principles and Practices ushers in a life cycle approach to process validation. While the guidance no longer considers the use of traditional three-batch validation appropriate, it does not prescribe the number of validation batches for a prospective validation protocol, nor does it provide specific methods to determine it. This potentially could leave manufacturers in a quandary. In this paper, I develop a Bayesian method to address the issue. By combining process knowledge gained from Stage 1 Process Design (PD) with expected outcomes of Stage 2 Process Performance Qualification (PPQ), the number of validation batches for PPQ is determined to provide a high level of assurance that the process will consistently produce future batches meeting quality standards. Several examples based on simulated data are presented to illustrate the use of the Bayesian method in helping manufacturers make risk-based decisions for Stage 2 PPQ, and THEY highlight the advantages of the method over traditional Frequentist approaches. The discussions in the paper lend support for a life cycle and risk-based approach to process validation recommended in the new FDA guidance.

Use of Preoperative Testing and Physicians' Response to Professional Society Guidance.

PubMed

Sigmund, Alana E; Stevens, Elizabeth R; Blitz, Jeanna D; Ladapo, Joseph A

2015-08-01

The value of routine preoperative testing before most surgical procedures is widely considered to be low. To improve the quality of preoperative care and reduce waste, 2 professional societies released guidance on use of routine preoperative testing in 2002, but researchers and policymakers remain concerned about the health and cost burden of low-value care in the preoperative setting. To examine the long-term national effect of the 2002 professional guidance from the American College of Cardiology/American Heart Association and the American Society of Anesthesiologists on physicians' use of routine preoperative testing. Retrospective analysis of nationally representative data from the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey to examine adults in the United States who were evaluated during preoperative visits from January 1, 1997, through December 31, 2010. A quasiexperimental, difference-in-difference (DID) approach evaluated whether the publication of professional guidance in 2002 was associated with changes in preoperative testing patterns, adjusting for temporal trends in routine testing, as captured by testing patterns in general medical examinations. Physician orders for outpatient plain radiography, hematocrit, urinalysis, electrocardiogram, and cardiac stress testing. During the 14-year period, the average annual number of preoperative visits in the United States increased from 6.8 million in 1997-1999 to 9.8 million in 2002-2004 and 14.3 million in 2008-2010. After accounting for temporal trends in routine testing, we found no statistically significant overall changes in the use of plain radiography (11.3% in 1997-2002 to 9.9% in 2003-2010; DID, -1.0 per 100 visits; 95% CI, -4.1 to 2.2), hematocrit (9.4% in 1997-2002 to 4.1% in 2003-2010; DID, 1.2 per 100 visits; 95% CI, -2.2 to 4.7), urinalysis (12.2% in 1997-2002 to 8.9% in 2003-2010; DID, 2.7 per 100 visits; 95% CI, -1.7 to 7.1), or cardiac stress testing (1.0% in 1997-2002 to 2.0% in 2003-2010; DID, 0.7 per 100 visits; 95% CI, -0.1 to 1.5) after the publication of professional guidance. However, the rate of electrocardiogram testing fell (19.4% in 1997-2002 to 14.3% in 2003-2010; DID, -6.7 per 100 visits; 95% CI, -10.6 to -2.7) in the period after the publication of guidance. The release of the 2002 guidance on routine preoperative testing was associated with a reduced incidence of routine electrocardiogram testing but not of plain radiography, hematocrit, urinalysis, or cardiac stress testing. Because routine preoperative testing is generally considered to provide low incremental value, more concerted efforts to understand physician behavior and remove barriers to guideline adherence may improve health care quality and reduce costs.

The Marketisation of Guidance Services in Germany, France and Britain.

ERIC Educational Resources Information Center

Rees, Teresa; Bartlett, Will; Watts, A. G.

1999-01-01

Compares developments in Britain, France, and Germany, focusing on the trends toward marketing adult career guidance services. Describes how Germany's centralized system and the quasi-market based system in France might apply in Britain. (JOW)

Image registration assessment in radiotherapy image guidance based on control chart monitoring.

PubMed

Xia, Wenyao; Breen, Stephen L

2018-04-01

Image guidance with cone beam computed tomography in radiotherapy can guarantee the precision and accuracy of patient positioning prior to treatment delivery. During the image guidance process, operators need to take great effort to evaluate the image guidance quality before correcting a patient's position. This work proposes an image registration assessment method based on control chart monitoring to reduce the effort taken by the operator. According to the control chart plotted by daily registration scores of each patient, the proposed method can quickly detect both alignment errors and image quality inconsistency. Therefore, the proposed method can provide a clear guideline for the operators to identify unacceptable image quality and unacceptable image registration with minimal effort. Experimental results demonstrate that by using control charts from a clinical database of 10 patients undergoing prostate radiotherapy, the proposed method can quickly identify out-of-control signals and find special cause of out-of-control registration events.

New Hypervelocity Terminal Intercept Guidance Systems for Deflecting/Disrupting Hazardous Asteroids

NASA Astrophysics Data System (ADS)

Lyzhoft, Joshua Richard

Computational modeling and simulations of visual and infrared (IR) sensors are investigated for a new hypervelocity terminal guidance system of intercepting small asteroids (50 to 150 meters in diameter). Computational software tools for signal-to-noise ratio estimation of visual and IR sensors, estimation of minimum and maximum ranges of target detection, and GPU (Graphics Processing Units)-accelerated simulations of the IR-based terminal intercept guidance systems are developed. Scaled polyhedron models of known objects, such as the Rosetta mission's Comet 67P/C-G, NASA's OSIRIS-REx Bennu, and asteroid 433 Eros, are utilized in developing a GPU-based simulation tool for the IR-based terminal intercept guidance systems. A parallelized-ray tracing algorithm for simulating realistic surface-to-surface shadowing of irregular-shaped asteroids or comets is developed. Polyhedron solid-angle approximation is also considered. Using these computational models, digital image processing is investigated to determine single or multiple impact locations to assess the technical feasibility of new planetary defense mission concepts of utilizing a Hypervelocity Asteroid Intercept Vehicle (HAIV) or a Multiple Kinetic-energy Interceptor Vehicle (MKIV). Study results indicate that the IR-based guidance system outperforms the visual-based system in asteroid detection and tracking. When using an IR sensor, predicting impact locations from filtered images resulted in less jittery spacecraft control accelerations than conducting missions with a visual sensor. Infrared sensors have also the possibility to detect asteroids at greater distances, and if properly used, can aid in terminal phase guidance for proper impact location determination for the MKIV system. Emerging new topics of the Minimum Orbit Intersection Distance (MOID) estimation and the Full-Two-Body Problem (F2BP) formulation are also investigated to assess a potential near-Earth object collision risk and the proximity gravity effects of an irregular-shaped binary-asteroid target on a standoff nuclear explosion mission.

A theoretical introduction to "combinatory SYBRGreen qPCR screening", a matrix-based approach for the detection of materials derived from genetically modified plants.

PubMed

Van den Bulcke, Marc; Lievens, Antoon; Barbau-Piednoir, Elodie; MbongoloMbella, Guillaume; Roosens, Nancy; Sneyers, Myriam; Casi, Amaya Leunda

2010-03-01

The detection of genetically modified (GM) materials in food and feed products is a complex multi-step analytical process invoking screening, identification, and often quantification of the genetically modified organisms (GMO) present in a sample. "Combinatory qPCR SYBRGreen screening" (CoSYPS) is a matrix-based approach for determining the presence of GM plant materials in products. The CoSYPS decision-support system (DSS) interprets the analytical results of SYBRGREEN qPCR analysis based on four values: the C(t)- and T(m) values and the LOD and LOQ for each method. A theoretical explanation of the different concepts applied in CoSYPS analysis is given (GMO Universe, "Prime number tracing", matrix/combinatory approach) and documented using the RoundUp Ready soy GTS40-3-2 as an example. By applying a limited set of SYBRGREEN qPCR methods and through application of a newly developed "prime number"-based algorithm, the nature of subsets of corresponding GMO in a sample can be determined. Together, these analyses provide guidance for semi-quantitative estimation of GMO presence in a food and feed product.

The Impact of Activity-Based Oral Expression Course on Speech Self-Efficacy of Students

ERIC Educational Resources Information Center

Altunkaya, Hatice

2018-01-01

The objective of the present study was to examine the effect of the activity-based oral expression course on the speech self-efficacy of psychological counseling and guidance students. The study group included 80 freshmen students in the Psychological Counseling and Guidance Department in the Faculty of Education of a university located in western…

INPRO Assessment of an INS in the Area of Safety of Fuel Cycle Installations

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

Raj, B.; Busurin, Y.; Depisch, F.

2006-07-01

INPRO has defined requirements organized in a hierarchy of Basic Principles, User Requirements and Criteria (consisting of an indicator and an acceptance limit) to be met by innovative nuclear reactor systems (INS) in six areas, namely: economics, safety, waste management, environment, proliferation resistance, and infrastructure. If an INS meets all requirements in all areas it represents a sustainable system for the supply of energy, capable of making a significant contribution to meeting the energy needs of the 21. century. Draft manuals have been developed, for each INPRO area, to provide guidance for performing an assessment of whether an INS meetsmore » the INPRO requirements in a given area. The manuals set out the information that needs to be assembled to perform an assessment and provide guidance on selecting the acceptance limits and, for a given INS, for determining the value of the indicators for comparison with the associated acceptance limits. Each manual also includes an example of a specific assessment to illustrate the guidance. This paper discusses the manual for performing an INPRO assessment in the area of safety of fuel cycle installations. The example, chosen solely for the purpose of illustrating the INPRO methodology, describes an assessment of an MOX fuel fabrication plant based on sol-gel technology and illustrates an assessment performed for an INS at an early stage of development. The safety issues and the assessment steps are presented in detail in the paper. (authors)« less

A quantitative comparison of the safety margins in the european indicative occupational exposure limits and the derived no-effect levels for workers under REACH.

PubMed

Schenk, Linda; Johanson, Gunnar

2011-06-01

The new European Union (EU) REACH legislation requires derived no-effect levels (DNELs) to be calculated for substances produced in quantities above 10 tonnes/year. Meanwhile, the setting of occupational exposure limits (OELs) continues both at the member state and the EU levels. According to REACH, indicative OEL values (IOELVs) from the Commission may under some circumstances be used as worker-DNELs. On the other hand, worker-DNELs will be derived for several thousand substances, far more than the approximately 100 substances for which IOELVs have been established. Thus, the procedure to set health-based OELs may become influential on that of DNELs and vice versa. In this study, we compare the safety margins of 88 Scientific Committee on OELs (SCOEL) recommendations with those of the corresponding worker-DNELs, derived according to the default approach as described in the REACH guidance document. Overall, the REACH safety margins were approximately six times higher than those derived from the SCOEL documentation but varied widely with REACH/SCOEL safety margin ratios ranging by two orders of magnitude, from 0.3 to 58 (n = 88). The discrepancies may create confusion in terms of legal compliance, risk management, and risk communication. We also found that the REACH guidance document, although encompassing detailed advice on many issues, including default assessment factors for species and route extrapolation, gives little quantitative guidance on when and how to depart from defaults.

The development of regulatory expectations for computer-based safety systems for the UK nuclear programme

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

Hughes, P. J.; Westwood, R.N; Mark, R. T.

2006-07-01

The Nuclear Installations Inspectorate (NII) of the UK's Health and Safety Executive (HSE) has completed a review of their Safety Assessment Principles (SAPs) for Nuclear Installations recently. During the period of the SAPs review in 2004-2005 the designers of future UK naval reactor plant were optioneering the control and protection systems that might be implemented. Because there was insufficient regulatory guidance available in the naval sector to support this activity the Defence Nuclear Safety Regulator (DNSR) invited the NII to collaborate with the production of a guidance document that provides clarity of regulatory expectations for the production of safety casesmore » for computer based safety systems. A key part of producing regulatory expectations was identifying the relevant extant standards and sector guidance that reflect good practice. The three principal sources of such good practice were: IAEA Safety Guide NS-G-1.1 (Software for Computer Based Systems Important to Safety in Nuclear Power Plants), European Commission consensus document (Common Position of European Nuclear Regulators for the Licensing of Safety Critical Software for Nuclear Reactors) and IEC nuclear sector standards such as IEC60880. A common understanding has been achieved between the NII and DNSR and regulatory guidance developed which will be used by both NII and DNSR in the assessment of computer-based safety systems and in the further development of more detailed joint technical assessment guidance for both regulatory organisations. (authors)« less

Visual search guidance is best after a short delay

PubMed Central

Schmidt, Joseph; Zelinsky, Gregory J.

2011-01-01

Search displays are typically presented immediately after a target cue, but in the real-world, delays often exist between target designation and search. Experiments 1 and 2 asked how search guidance changes with delay. Targets were cued using a picture or text label, each for 3000ms, followed by a delay up to 9000ms before the search display. Search stimuli were realistic objects, and guidance was quantified using multiple eye movement measures. Text-based cues showed a non-significant trend towards greater guidance following any delay relative to a no-delay condition. However, guidance from a pictorial cue increased sharply 300–600 msec after preview offset. Experiment 3 replicated this guidance enhancement using shorter preview durations while equating the time from cue onset to search onset, demonstrating that the guidance benefit is linked to preview offset rather than a more complete encoding of the target. Experiment 4 showed that enhanced guidance persists even with a mask flashed at preview offset, suggesting an explanation other than visual priming. We interpret our findings as evidence for the rapid consolidation of target information into a guiding representation, which attains its maximum effectiveness shortly after preview offset. PMID:21295053

Visual search guidance is best after a short delay.

PubMed

Schmidt, Joseph; Zelinsky, Gregory J

2011-03-25

Search displays are typically presented immediately after a target cue, but in the real-world, delays often exist between target designation and search. Experiments 1 and 2 asked how search guidance changes with delay. Targets were cued using a picture or text label, each for 3000ms, followed by a delay up to 9000ms before the search display. Search stimuli were realistic objects, and guidance was quantified using multiple eye movement measures. Text-based cues showed a non-significant trend towards greater guidance following any delay relative to a no-delay condition. However, guidance from a pictorial cue increased sharply 300-600ms after preview offset. Experiment 3 replicated this guidance enhancement using shorter preview durations while equating the time from cue onset to search onset, demonstrating that the guidance benefit is linked to preview offset rather than a more complete encoding of the target. Experiment 4 showed that enhanced guidance persists even with a mask flashed at preview offset, suggesting an explanation other than visual priming. We interpret our findings as evidence for the rapid consolidation of target information into a guiding representation, which attains its maximum effectiveness shortly after preview offset. Copyright © 2011 Elsevier Ltd. All rights reserved.

Using the New Postacute Care Quality Measures to Demonstrate the Value of Occupational Therapy.

PubMed

Sandhu, Sharmila; Furniss, Jeremy; Metzler, Christina

As the health care system continues to evolve toward one based on quality not quantity, demonstrating the value of occupational therapy has never been more important. Providing high-quality services, achieving optimal outcomes, and identifying and promoting occupational therapy's distinct value are the responsibilities of all practitioners. In relation to the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014, the Centers for Medicare and Medicaid Services (CMS) is implementing new functional items and related outcome performance measures across postacute care (PAC) settings. Practitioners can demonstrate the role and value of occupational therapy services through their participation in data collection and the interpretation of the resulting performance measures. In this column, we review the objectives of the IMPACT Act, introduce the new self-care and mobility items and outcome performance measures being implemented in PAC settings, and describe ways to use these new data to advocate for occupational therapy. We also discuss American Occupational Therapy Association initiatives to provide materials and guidance for occupational therapy practitioners to contribute to PAC data collection. Copyright © 2018 by the American Occupational Therapy Association, Inc.

Innovative use of global navigation satellite systems for flight inspection

NASA Astrophysics Data System (ADS)

Kim, Eui-Ho

The International Civil Aviation Organization (ICAO) mandates flight inspection in every country to provide safety during flight operations. Among many criteria of flight inspection, airborne inspection of Instrument Landing Systems (ILS) is very important because the ILS is the primary landing guidance system worldwide. During flight inspection of the ILS, accuracy in ILS landing guidance is checked by using a Flight Inspection System (FIS). Therefore, a flight inspection system must have high accuracy in its positioning capability to detect any deviation so that accurate guidance of the ILS can be maintained. Currently, there are two Automated Flight Inspection Systems (AFIS). One is called Inertial-based AFIS, and the other one is called Differential GPS-based (DGPS-based) AFIS. The Inertial-based AFIS enables efficient flight inspection procedures, but its drawback is high cost because it requires a navigation-grade Inertial Navigation System (INS). On the other hand, the DGPS-based AFIS has relatively low cost, but flight inspection procedures require landing and setting up a reference receiver. Most countries use either one of the systems based on their own preferences. There are around 1200 ILS in the U.S., and each ILS must be inspected every 6 to 9 months. Therefore, it is important to manage the airborne inspection of the ILS in a very efficient manner. For this reason, the Federal Aviation Administration (FAA) mainly uses the Inertial-based AFIS, which has better efficiency than the DGPS-based AFIS in spite of its high cost. Obviously, the FAA spends tremendous resources on flight inspection. This thesis investigates the value of GPS and the FAA's augmentation to GPS for civil aviation called the Wide Area Augmentation System (or WAAS) for flight inspection. Because standard GPS or WAAS position outputs cannot meet the required accuracy for flight inspection, in this thesis, various algorithms are developed to improve the positioning ability of Flight Inspection Systems (FIS) by using GPS and WAAS in novel manners. The algorithms include Adaptive Carrier Smoothing (ACS), optimizing WAAS accuracy and stability, and reference point-based precise relative positioning for real-time and near-real-time applications. The developed systems are WAAS-aided FIS, WAAS-based FIS, and stand-alone GPS-based FIS. These systems offer both high efficiency and low cost, and they have different advantages over one another in terms of accuracy, integrity, and worldwide availability. The performance of each system is tested with experimental flight test data and shown to have accuracy that is sufficient for flight inspection and superior to the current Inertial-based AFIS.

CDC Guidance for State and Local Public Health Officials and School Administrators for School (K-12) Responses to Influenza during the 2009-2010 School Year

ERIC Educational Resources Information Center

Centers for Disease Control and Prevention, 2009

2009-01-01

This document provides guidance to help decrease the spread of flu among students and school staff during the 2009-2010 school year. This document expands upon earlier school guidance documents by providing a menu of tools that school and health officials can choose from based on conditions in their area. It recommends actions to take this school…

Training Aide: Research and Guidance for Effective Training User Guide

DTIC Science & Technology

2013-12-01

Research Product 2014-02 Training Aide: Research and Guidance for Effective Training User Guide Beth Plott Shaun...Effective Training User Guide 5a. CONTRACT OR GRANT NUMBER W91WAW-07-C-0081 5b. PROGRAM ELEMENT NUMBER 611102 6. AUTHOR(S) Beth Plott...Representative and Subject Matter POC: Karin A. Orvis 14. ABSTRACT: This is a user guide for the web-based tool called Training Aide: Research and Guidance

Development of a Design Flexibility Toolkit : [Technical Summary

DOT National Transportation Integrated Search

2012-01-01

The American Association of State Highway and Transportation : Officials (AASHTO) publication titled A Policy : on Geometric Design of Highways and Streets (Green : Book) provides guidance to the designer by referencing : a recommended range of value...

Development of a Design Flexibility Toolkit

DOT National Transportation Integrated Search

2012-09-01

The American Association of State Highway and Transportation Officials (AASHTO) publication titled A Policy on Geometric Design of : Highways and Streets (Green Book) provides guidance to the designer by referencing a recommended range of values for ...

INHALATION EXPOSURE-RESPONSE METHODOLOGY

EPA Science Inventory

The Inhalation Exposure-Response Analysis Methodology Document is expected to provide guidance on the development of the basic toxicological foundations for deriving reference values for human health effects, focusing on the hazard identification and dose-response aspects of the ...

Methods and approaches in the topology-based analysis of biological pathways

PubMed Central

Mitrea, Cristina; Taghavi, Zeinab; Bokanizad, Behzad; Hanoudi, Samer; Tagett, Rebecca; Donato, Michele; Voichiţa, Călin; Drăghici, Sorin

2013-01-01

The goal of pathway analysis is to identify the pathways significantly impacted in a given phenotype. Many current methods are based on algorithms that consider pathways as simple gene lists, dramatically under-utilizing the knowledge that such pathways are meant to capture. During the past few years, a plethora of methods claiming to incorporate various aspects of the pathway topology have been proposed. These topology-based methods, sometimes referred to as “third generation,” have the potential to better model the phenomena described by pathways. Although there is now a large variety of approaches used for this purpose, no review is currently available to offer guidance for potential users and developers. This review covers 22 such topology-based pathway analysis methods published in the last decade. We compare these methods based on: type of pathways analyzed (e.g., signaling or metabolic), input (subset of genes, all genes, fold changes, gene p-values, etc.), mathematical models, pathway scoring approaches, output (one or more pathway scores, p-values, etc.) and implementation (web-based, standalone, etc.). We identify and discuss challenges, arising both in methodology and in pathway representation, including inconsistent terminology, different data formats, lack of meaningful benchmarks, and the lack of tissue and condition specificity. PMID:24133454

Heuristic approach to the development of ratings and tactics applicable to the one-on-one aerial combat (dogfight) encounter

NASA Technical Reports Server (NTRS)

Hague, D. S.

1977-01-01

Computer simulations of the one-on-one aerial combat encounter are generated under the control of specified guidance laws. Given an initial state, the vehicle and atmospheric characteristics, and the guidance laws, the aerial combat encounter is simulated by forward integration of the two vehicles' motions. The development of a combat guidance law which converts positional advantage into an improved firing opportunity is reported. A combination of lag, line of sight, and lead pursuit steering paths are followed in the guidance law. The law is based on steering error, target angle-off and the relative velocities. It readily is automated either as an onboard aid to manned aircraft pilots or as a combat guidance law for unmanned vehicles.

Nonlinear feedback guidance law for aero-assisted orbit transfer maneuvers

NASA Technical Reports Server (NTRS)

Menon, P. K. A.

1992-01-01

Aero-assisted orbit transfer vehicles have the potential for significantly reducing the fuel requirements in certain classes of orbit transfer operations. Development of a nonlinear feedback guidance law for performing aero-assisted maneuvers that accomplish simultaneous change of all the orbital elements with least vehicle acceleration magnitude is discussed. The analysis is based on a sixth order nonlinear point-mass vehicle model with lift, bank angle, thrust and drag modulation as the control variables. The guidance law uses detailed vehicle aerodynamic and the atmosphere models in the feedback loop. Higher-order gravitational harmonics, planetary atmosphere rotation and ambient winds are included in the formulation. Due to modest computational requirements, the guidance law is implementable on-board an orbit transfer vehicle. The guidance performance is illustrated for three sets of boundary conditions.

Improvement of single detector proton radiography by incorporating intensity of time-resolved dose rate functions

NASA Astrophysics Data System (ADS)

Zhang, Rongxiao; Jee, Kyung-Wook; Cascio, Ethan; Sharp, Gregory C.; Flanz, Jacob B.; Lu, Hsiao-Ming

2018-01-01

Proton radiography, which images patients with the same type of particles as those with which they are to be treated, is a promising approach to image guidance and water equivalent path length (WEPL) verification in proton radiation therapy. We have shown recently that proton radiographs could be obtained by measuring time-resolved dose rate functions (DRFs) using an x-ray amorphous silicon flat panel. The WEPL values were derived solely from the root-mean-square (RMS) of DRFs, while the intensity information in the DRFs was filtered out. In this work, we explored the use of such intensity information for potential improvement in WEPL accuracy and imaging quality. Three WEPL derivation methods based on, respectively, the RMS only, the intensity only, and the intensity-weighted RMS were tested and compared in terms of the quality of obtained radiograph images and the accuracy of WEPL values. A Gammex CT calibration phantom containing inserts made of various tissue substitute materials with independently measured relative stopping powers (RSP) was used to assess the imaging performances. Improved image quality with enhanced interfaces was achieved while preserving the accuracy by using intensity information in the calibration. Other objects, including an anthropomorphic head phantom, a proton therapy range compensator, a frozen lamb’s head and an ‘image quality phantom’ were also imaged. Both the RMS only and the intensity-weighted RMS methods derived RSPs within  ±  1% for most of the Gammex phantom inserts, with a mean absolute percentage error of 0.66% for all inserts. In the case of the insert with a titanium rod, the method based on RMS completely failed, whereas that based on the intensity-weighted RMS was qualitatively valid. The use of intensity greatly enhanced the interfaces between different materials in the obtained WEPL images, suggesting the potential for image guidance in areas such as patient positioning and tumor tracking by proton radiography.

Augmented reality-based electrode guidance system for reliable electroencephalography.

PubMed

Song, Chanho; Jeon, Sangseo; Lee, Seongpung; Ha, Ho-Gun; Kim, Jonghyun; Hong, Jaesung

2018-05-24

In longitudinal electroencephalography (EEG) studies, repeatable electrode positioning is essential for reliable EEG assessment. Conventional methods use anatomical landmarks as fiducial locations for the electrode placement. Since the landmarks are manually identified, the EEG assessment is inevitably unreliable because of individual variations among the subjects and the examiners. To overcome this unreliability, an augmented reality (AR) visualization-based electrode guidance system was proposed. The proposed electrode guidance system is based on AR visualization to replace the manual electrode positioning. After scanning and registration of the facial surface of a subject by an RGB-D camera, the AR of the initial electrode positions as reference positions is overlapped with the current electrode positions in real time. Thus, it can guide the position of the subsequently placed electrodes with high repeatability. The experimental results with the phantom show that the repeatability of the electrode positioning was improved compared to that of the conventional 10-20 positioning system. The proposed AR guidance system improves the electrode positioning performance with a cost-effective system, which uses only RGB-D camera. This system can be used as an alternative to the international 10-20 system.

Providing guidance for genomics-based cancer treatment decisions: insights from stakeholder engagement for post-prostatectomy radiation therapy.

PubMed

Abe, James; Lobo, Jennifer M; Trifiletti, Daniel M; Showalter, Timothy N

2017-08-24

Despite the emergence of genomics-based risk prediction tools in oncology, there is not yet an established framework for communication of test results to cancer patients to support shared decision-making. We report findings from a stakeholder engagement program that aimed to develop a framework for using Markov models with individualized model inputs, including genomics-based estimates of cancer recurrence probability, to generate personalized decision aids for prostate cancer patients faced with radiation therapy treatment decisions after prostatectomy. We engaged a total of 22 stakeholders, including: prostate cancer patients, urological surgeons, radiation oncologists, genomic testing industry representatives, and biomedical informatics faculty. Slides were at each meeting to provide background information regarding the analytical framework. Participants were invited to provide feedback during the meeting, including revising the overall project aims. Stakeholder meeting content was reviewed and summarized by stakeholder group and by theme. The majority of stakeholder suggestions focused on aspects of decision aid design and formatting. Stakeholders were enthusiastic about the potential value of using decision analysis modeling with personalized model inputs for cancer recurrence risk, as well as competing risks from age and comorbidities, to generate a patient-centered tool to assist decision-making. Stakeholders did not view privacy considerations as a major barrier to the proposed decision aid program. A common theme was that decision aids should be portable across multiple platforms (electronic and paper), should allow for interaction by the user to adjust model inputs iteratively, and available to patients both before and during consult appointments. Emphasis was placed on the challenge of explaining the model's composite result of quality-adjusted life years. A range of stakeholders provided valuable insights regarding the design of a personalized decision aid program, based upon Markov modeling with individualized model inputs, to provide a patient-centered framework to support for genomic-based treatment decisions for cancer patients. The guidance provided by our stakeholders may be broadly applicable to the communication of genomic test results to patients in a patient-centered fashion that supports effective shared decision-making that represents a spectrum of personal factors such as age, medical comorbidities, and individual priorities and values.

The Value of Business Education: Perceptions of High School Guidance Counselors, Principals, and Boards of Education

ERIC Educational Resources Information Center

Railsback, Barbara; Hite, Nancy Groneman

2008-01-01

The purpose of this study was to determine the value of business education at the secondary school level as perceived by three groups of people who have great impact on course offerings, student advisement, and teacher hiring decisions. Specifically, high school counselors, high school principals, and local board of education presidents in a…

Designing occupancy studies when false-positive detections occur

USGS Publications Warehouse

Clement, Matthew

2016-01-01

1.Recently, estimators have been developed to estimate occupancy probabilities when false-positive detections occur during presence-absence surveys. Some of these estimators combine different types of survey data to improve estimates of occupancy. With these estimators, there is a tradeoff between the number of sample units surveyed, and the number and type of surveys at each sample unit. Guidance on efficient design of studies when false positives occur is unavailable. 2.For a range of scenarios, I identified survey designs that minimized the mean square error of the estimate of occupancy. I considered an approach that uses one survey method and two observation states and an approach that uses two survey methods. For each approach, I used numerical methods to identify optimal survey designs when model assumptions were met and parameter values were correctly anticipated, when parameter values were not correctly anticipated, and when the assumption of no unmodelled detection heterogeneity was violated. 3.Under the approach with two observation states, false positive detections increased the number of recommended surveys, relative to standard occupancy models. If parameter values could not be anticipated, pessimism about detection probabilities avoided poor designs. Detection heterogeneity could require more or fewer repeat surveys, depending on parameter values. If model assumptions were met, the approach with two survey methods was inefficient. However, with poor anticipation of parameter values, with detection heterogeneity, or with removal sampling schemes, combining two survey methods could improve estimates of occupancy. 4.Ignoring false positives can yield biased parameter estimates, yet false positives greatly complicate the design of occupancy studies. Specific guidance for major types of false-positive occupancy models, and for two assumption violations common in field data, can conserve survey resources. This guidance can be used to design efficient monitoring programs and studies of species occurrence, species distribution, or habitat selection, when false positives occur during surveys.

Data Governance and Data Sharing Agreements for Community-Wide Health Information Exchange: Lessons from the Beacon Communities

PubMed Central

Allen, Claudia; Des Jardins, Terrisca R.; Heider, Arvela; Lyman, Kristin A.; McWilliams, Lee; Rein, Alison L.; Schachter, Abigail A.; Singh, Ranjit; Sorondo, Barbara; Topper, Joan; Turske, Scott A.

2014-01-01

Purpose: Unprecedented efforts are underway across the United States to electronically capture and exchange health information to improve health care and population health, and reduce costs. This increased collection and sharing of electronic patient data raises several governance issues, including privacy, security, liability, and market competition. Those engaged in such efforts have had to develop data sharing agreements (DSAs) among entities involved in information exchange, many of whom are “nontraditional” health care entities and/or new partners. This paper shares lessons learned based on the experiences of six federally funded communities participating in the Beacon Community Cooperative Agreement Program, and offers guidance for navigating data governance issues and developing DSAs to facilitate community-wide health information exchange. Innovation: While all entities involved in electronic data sharing must address governance issues and create DSAs accordingly, until recently little formal guidance existed for doing so – particularly for community-based initiatives. Despite this lack of guidance, together the Beacon Communities’ experiences highlight promising strategies for navigating complex governance issues, which may be useful to other entities or communities initiating information exchange efforts to support delivery system transformation. Credibility: For the past three years, AcademyHealth has provided technical assistance to most of the 17 Beacon Communities, 6 of whom contributed to this collaborative writing effort. Though these communities varied widely in terms of their demographics, resources, and Beacon-driven priorities, common themes emerged as they described their approaches to data governance and DSA development. Conclusions: The 6 Beacon Communities confirmed that DSAs are necessary to satisfy legal and market-based concerns, and they identified several specific issues, many of which have been noted by others involved in network data sharing initiatives. More importantly, these communities identified several promising approaches to timely and effective DSA development, including: stakeholder engagement; identification and effective communication of value; adoption of a parsimonious approach; attention to market-based concerns; flexibility in adapting and expanding existing agreements and partnerships; and anticipation of required time and investment. PMID:25848589

WODA Technical Guidance on Underwater Sound from Dredging.

PubMed

Thomsen, Frank; Borsani, Fabrizio; Clarke, Douglas; de Jong, Christ; de Wit, Pim; Goethals, Fredrik; Holtkamp, Martine; Martin, Elena San; Spadaro, Philip; van Raalte, Gerard; Victor, George Yesu Vedha; Jensen, Anders

2016-01-01

The World Organization of Dredging Associations (WODA) has identified underwater sound as an environmental issue that needs further consideration. A WODA Expert Group on Underwater Sound (WEGUS) prepared a guidance paper in 2013 on dredging sound, including a summary of potential impacts on aquatic biota and advice on underwater sound monitoring procedures. The paper follows a risk-based approach and provides guidance for standardization of acoustic terminology and methods for data collection and analysis. Furthermore, the literature on dredging-related sounds and the effects of dredging sounds on marine life is surveyed and guidance on the management of dredging-related sound risks is provided.

Study on the techniques of valuation of ecosystem services based on remote sensing in Anxin County

NASA Astrophysics Data System (ADS)

Wang, Hongyan; Li, Zengyuan; Gao, Zhihai; Wang, Bengyu; Bai, Lina; Wu, Junjun; Sun, Bin; Wang, Zhibo

2014-05-01

The farmland ecosystem is an important component of terrestrial ecosystems and has a fundamental role in the human life. The wetland is an unique and versatile ecological system. It is important for rational development and sustainable utilization of farmland and wetland resources to study on the measurement of valuation of farmland and wetland ecosystem services. It also has important significance for improving productivity. With the rapid development of remote sensing technology, it has become a powerful tool for evaluation of the value of ecosystem services. The land cover types in Anxin County mainly was farmland and wetland, the indicator system for ecosystem services valuation was brought up based on the remote sensing data of high spatial resolution ratio(Landsat-5 TM data and SPOT-5 data), the technology system for measurement of ecosystem services value was established. The study results show that the total ecosystem services value in 2009 in Anxin was 4.216 billion yuan, and the unit area value was between 8489 yuan/hm2 and 329535 yuan/hm2. The value of natural resources, water conservation value in farmland ecosystem and eco-tourism value in wetland ecosystem were higher than the other, total of the three values reached 2.858 billion yuan, and the percentage of the total ecosystem services values in Anxin was 67.79%. Through the statistics in the nine towns and three villages of Anxin County, the juantou town has the highest services value, reached 0.736 billion yuan. Scientific and comprehensive evaluation of the ecosystem services can conducive to promoting the understanding of the importance of the ecosystem. The research results had significance to ensure the sustainable use of wetland resources and the guidance of ecological construction in Anxin County.

Guidance for Reviewing OCSPP 850.2100 Avian Oral Toxicity Studies Conducted with Passerine Birds

EPA Pesticide Factsheets

Guidance based on comparison of results from the TG223 validation studies to results from avian acute oral studies previously submitted to EPA for two test chemicals following EPA's 850.2100 (public draft) guidelines.

SAMPLING-BASED APPROACH TO INVESTIGATING VAPOR INTRUSION

EPA Science Inventory

Vapor intrusion is defined as the migration of volatile organic compounds (VOCs) into occupied buildings from contaminated soil or ground water. EPA recently developed guidance to facilitate assessment of vapor intrusion at sites regulated by RCRA and CERCLA. The EPA guidance e...

Perspectives on driver preferences for dynamic route guidance systems

DOT National Transportation Integrated Search

1997-01-01

Insights about the design of route guidance systems based on the needs and desires of drivers who are familiar with the travel network are provided. Results from the ADVANCE Intelligent Transportation System operational test, in which more than 100 d...

Guidance for Use When Regurgitation is Observed in Avian Acute Toxicity Studies with Passerine Species

EPA Pesticide Factsheets

Guidance based on comparison of results from the TG223 validation studies to results from avian acute oral studies previously submitted to EPA for two test chemicals following EPA's 850.2100 (public draft) guidelines.

Cost review template and guidance for project officers grants Under 40 CFR Part 35 Subpart A

EPA Pesticide Factsheets

EPA will base its review of requested personnel costs on the previous application request. Costs within 10 of the previous application request will be deemed necessary and reasonable. Cost review template and Guidance.

Age- and Parkinson's disease-related evaluation of gait by General Tau Theory.

PubMed

Zhang, Shutao; Qian, Jinwu; Zhang, Zhen; Shen, Linyong; Wu, Xi; Hu, Xiaowu

2016-10-01

The degeneration of postural control in the elderly and patients with Parkinson's disease (PD) can be debilitating and may lead to increased fall risk. This study evaluated the changes in postural control during gait affected by PD and aging using a new method based on the General Tau Theory. Fifteen patients with PD, 11 healthy old adults (HOs), and 15 healthy young adults (HYs) were recruited. Foot trajectories of each participant were monitored during walking by a three-camera Optotrak Certus(®) motion capture system. The anteroposterior direction of foot movement during stepping was analyzed by tau-G and tau-J guidance strategies. Two linear regression analyses suggested that the tau of the step-gap was strongly coupled onto the tau-J guidance during walking. The regression slope K could estimate the coupling ratio in the tau-coupling equation which reflects the performance of postural control during gait. The mean K value for the PD group, which was highest among the three groups, was approximately 0.5. Therefore, participants in the PD group walked with the poorest postural control and exhibited a relatively hard contact with the endpoint during stepping when compared with those in the HO and HY groups. The HY and HO groups obtained mean K values significantly lower than 0.5, which indicated that the gait was well controlled and ended at low speed with low deceleration. However, the HO group showed a decreased tendency for postural control, in which the mean K value was significantly higher than that of the HY group. The K value was moderately positively correlated with the double support time and negatively correlated with the stride length and walking speed. The tau-J coupling ratio can provide additional insight into gait disturbances and may serve as a reliable, objective, and quantitative tool to evaluate dynamic postural control during walking.

Can podcasts for assessment guidance and feedback promote self-efficacy among undergraduate nursing students? A qualitative study.

PubMed

McSwiggan, Linda C; Campbell, Maureen

2017-02-01

Improving assessment guidance and feedback for students has become an international priority within higher education. Podcasts have been proposed as a tool for enhancing teaching, learning and assessment. However, a stronger theory-based rationale for using podcasts, particularly as a means of facilitating assessment guidance and feedback, is required. To explore students' experiences of using podcasts for assessment guidance and feedback. To consider how these podcasts shaped beliefs about their ability to successfully engage with, and act on, assessment guidance and feedback Design Exploratory qualitative study. Setting Higher education institution in North-East Scotland. Participants Eighteen third year undergraduate nursing students who had utilised podcasts for assessment guidance and feedback within their current programme of study. Participants took part in one of four focus groups, conducted between July and September 2013. Purposive sampling was utilised to recruit participants of different ages, gender, levels of self-assessed information technology skills and levels of academic achievement. Data analysis was guided by the framework approach. Thematic analysis highlighted similarities and differences in terms of students' experiences of using podcasts for assessment guidance and feedback. Further analysis revealed that Self-Efficacy Theory provided deeper theoretical insights into how the content, structure and delivery of podcasts can be shaped to promote more successful engagement with assessment guidance and feedback from students. The structured, logical approach of assessment guidance podcasts appeared to strengthen self-efficacy by providing readily accessible support and by helping students convert intentions into action. Students with high self-efficacy in relation to tasks associated with assessment were more likely to engage with feedback, whereas those with low self-efficacy tended to overlook opportunities to access feedback due to feelings of helplessness and futility. Adopting well-structured podcasts as an educational tool, based around the four major sources of information (performance accomplishments, vicarious experience, social persuasion, and physiological and emotional states), has potential to promote self efficacy for individuals, as well as groups of students, in terms of assessment guidance and feedback. Copyright © 2016 Elsevier Ltd. All rights reserved.

Mass Casualty Decontamination Guidance and Psychosocial Aspects of CBRN Incident Management: A Review and Synthesis

PubMed Central

Carter, Holly; Amlôt, Richard

2016-01-01

Introduction: Mass casualty decontamination is an intervention employed by first responders at the scene of an incident involving noxious contaminants.  Many countries have sought to address the challenge of decontaminating large numbers of affected casualties through the provision of rapidly deployable temporary showering structures, with accompanying decontamination protocols.  In this paper we review decontamination guidance for emergency responders and associated research evidence, in order to establish to what extent psychosocial aspects of casualty management have been considered within these documents. The review focuses on five psychosocial aspects of incident management: likely public behaviour; responder management style; communication strategy; privacy/ modesty concerns; and vulnerable groups. Methods: Two structured literature reviews were carried out; one to identify decontamination guidance documents for first responders, and another to identify evidence which is relevant to the understanding of the psychosocial aspects of mass decontamination.  The guidance documents and relevant research were reviewed to identify whether the guidance documents contain information relating to psychosocial issues and where it exists, that the guidance is consistent with the existing evidence-base. Results: Psychosocial aspects of incident management receive limited attention in current decontamination guidance.  In addition, our review has identified a number of gaps and inconsistencies between guidance and research evidence.  For each of the five areas we identify: what is currently presented in guidance documents, to what extent this is consistent with the existing research evidence and where it diverges.  We present a series of evidence-based recommendations for updating decontamination guidance to address the psychosocial aspects of mass decontamination. Conclusions: Effective communication and respect for casualties’ needs are critical in ensuring decontamination is completed quickly and effectively.  We identify a number of areas requiring further research including: identifying effective methods for communicating in an emergency; better understanding of the needs of vulnerable groups during decontamination; effective training for emergency responders on psychosocial issues, and pre-incident public education for incidents involving emergency decontamination.  It is essential that the psychosocial aspects of mass decontamination are not neglected in the pursuit of solely technical solutions. PMID:27790383

Accuracy of percutaneous soft-tissue interventions using a multi-axis, C-arm CT system and 3D laser guidance.

PubMed

Kostrzewa, Michael; Rathmann, Nils; Kara, Kerim; Schoenberg, Stefan O; Diehl, Steffen J

2015-10-01

Purpose of this phantom study was to compare the accuracy of needle placement using a multi-axis, C-arm-based, flat-panel, cone-beam computed tomography system (CBCT guidance) with that under multi-detector computed tomography guidance (MDCT guidance). In an abdominal phantom, eight lesions (six lesions in the liver and two in the renal pelvises, respectively) were each punctured in-plane and off-plane with a 20G needle under CBCT and MDCT guidance. Access paths were initially defined and reproduced identically on the two systems. In total, 32 interventions were conducted. CBCT and MDCT guidance was compared prospectively with respect to technical success, accuracy, and overall procedural time. All 32 interventions were technically successful in that it was possible to hit the respective lesion in each procedure. When comparing the accuracy of MDCT to CBCT guidance there was no significant difference in absolute, angular, and longitudinal deviation for either in- or off-plane interventions. Overall procedural duration was significantly longer under CBCT guidance for in-plane interventions (888 vs 527s, p=0.00005), whereas, for off-plane procedures there was no significant difference between CBCT and MDCT guidance (920 vs 701s, p=0.08). Off-plane interventions took significantly longer than in-plane interventions under MDCT guidance (701 vs 527s, p=0.03), whereas under CBCT guidance no significant difference could be found between off- and in-plane procedures (920 vs. 888s, p=0.2). In this phantom study, we could show that percutaneous soft-tissue interventions under CBCT guidance can be conducted with an accuracy comparable to that under MDCT guidance. Although overall procedural duration is in general shorter using MDCT guidance, CBCT-guided interventions offer the advantage of more degrees of freedom, which is of particular importance for off-plane procedures. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Air Force Technical Objective Document FY 87

DTIC Science & Technology

1985-12-01

Air Force Systems Command Edwards Air Force Base. Cal ifornia 93523-5000 NOTICES THIS DOCUMENT IS FOR INFORMATION AND GUIDANCE ONL Y This...acquisition of Air Foree weapon systems . Each Air Foree laboratory annually formulates Q Research and Technology (R& T) Pion in response to available...guidance based on USAF requirements, the identification of scientific and technological opportunities, and the needs of present and projected systems

A Practical Protocol for Situating Evidence-Based Mental Health Programs and Practices within School-Wide Positive Behavioral Interventions and Supports

ERIC Educational Resources Information Center

Runge, Timothy J.; Knoster, Timothy P.; Moerer, Deanna; Breinich, Todd; Palmiero, James

2017-01-01

Schools have limited experience and little guidance to identify and install evidence-based and promising programs and practices/interventions (EBPs) within advanced tiers of School-Wide Positive Behavioral Intervention and Supports (SWPBIS). One form of guidance is the Hexagon Tool which can be used to ensure a match between the EBP and student…

Guidance and Control Aspects of Tactical Air-Launched Missiles

DTIC Science & Technology

1980-10-01

information; - Continuously stimulating advances in the aerospace sciences relevant to strengthening the common defence pusture; -- Improving the co...Symposium on Precision Delivery Systems was held at Eglin Air Force Base , Florida. USA. Many important advances in guidance sensor technology, control system...paper concentrates primarily or the US Army Missile Command’s technology base for development of the precision pointing and tracking or fire control

Surface target-tracking guidance by self-organizing formation flight of fixed-wing UAV

NASA Astrophysics Data System (ADS)

Regina, N.; Zanzi, M.

This paper presents a new concept of ground target surveillance based on a formation flight of two Unmanned Aerial Vehicles (UAVs) of fixed-wing type. Each UAV considered in this work has its own guidance law specifically designed for two different aims. A self organizing non-symmetric collaborative surveying scheme has been developed based on pursuers with different roles: the close-up-pursuer and the distance-pursuer. The close-up-pursuer behaves according to a guidance law which takes it to continually over-fly the target, also optimizing flight endurance. On the other hand, the distancepursuer behaves so as to circle around the target by flying at a certain distance and altitude from it; moreover, its motion ensures the maximum “ seeability” of the ground based target. In addition, the guidance law designed for the distance-pursuer also implements a collision avoidance feature in order to prevent possible risks of collision with the close-up-pursuer during the tracking maneuvers. The surveying scheme is non-symmetric in the sense that the collision avoidance feature is accomplished by a guidance law implemented only on one of the two pursuers; moreover, it is collaborative because the surveying is performed by different tasks of two UAVs and is self-organizing because, due to the collision avoidance feature, target tracking does not require pre-planned collision-risk-free trajectories but trajectories are generated in real time.

Study of automatic and manual terminal guidance and control systems for space shuttle vehicles. Volume 2: Section 4 through appendix B

NASA Technical Reports Server (NTRS)

Osder, S.; Keller, R.

1971-01-01

Guidance and control design studies that were performed for three specific space shuttle candidate vehicles are described. Three types of simulation were considered. The manual control investigations and pilot evaluations of the automatic system performance is presented. Recommendations for systems and equipment, both airborne and ground-based, necessary to flight test the guidance and control concepts for shuttlecraft terminal approach and landing are reported.

Progress in Guidance and Control Research for Space Access and Hypersonic Vehicles (Preprint)

DTIC Science & Technology

2006-09-01

affect range capabilities. In 2003 an integrated adaptive guidance control and trajectory re- shaping algorithm was flight demonstrated using in-flight...21] which tied for the best scores as well as a Linear Quadratic Regulator[22], Predictor - Corrector [23], and Shuttle-like entry[24] guidance method...Accurate knowledge of mass, center- of-gravity and moments of inertia improves the perfor- mance of not only IAG& C algorithms but also model based

Exploratory studies to decide whether and how to proceed with full-scale evaluations of public health interventions: a systematic review of guidance.

PubMed

Hallingberg, Britt; Turley, Ruth; Segrott, Jeremy; Wight, Daniel; Craig, Peter; Moore, Laurence; Murphy, Simon; Robling, Michael; Simpson, Sharon Anne; Moore, Graham

2018-01-01

Evaluations of complex interventions in public health are frequently undermined by problems that can be identified before the effectiveness study stage. Exploratory studies, often termed pilot and feasibility studies, are a key step in assessing the feasibility and value of progressing to an effectiveness study. Such studies can provide vital information to support more robust evaluations, thereby reducing costs and minimising potential harms of the intervention. This systematic review forms the first phase of a wider project to address the need for stand-alone guidance for public health researchers on designing and conducting exploratory studies. The review objectives were to identify and examine existing recommendations concerning when such studies should be undertaken, questions they should answer, suitable methods, criteria for deciding whether to progress to an effectiveness study and appropriate reporting. We searched for published and unpublished guidance reported between January 2000 and November 2016 via bibliographic databases, websites, citation tracking and expert recommendations. Included papers were thematically synthesized. The search retrieved 4095 unique records. Thirty papers were included, representing 25 unique sources of guidance/recommendations. Eight themes were identified: pre-requisites for conducting an exploratory study, nomenclature, guidance for intervention assessment, guidance surrounding any future evaluation study design, flexible versus fixed design, progression criteria to a future evaluation study, stakeholder involvement and reporting of exploratory studies. Exploratory studies were described as being concerned with the intervention content, the future evaluation design or both. However, the nomenclature and endorsed methods underpinning these aims were inconsistent across papers. There was little guidance on what should precede or follow an exploratory study and decision-making surrounding this. Existing recommendations are inconsistent concerning the aims, designs and conduct of exploratory studies, and guidance is lacking on the evidence needed to inform when to proceed to an effectiveness study. PROSPERO 2016, CRD42016047843.

Limited variance control in statistical low thrust guidance analysis. [stochastic algorithm for SEP comet Encke flyby mission

NASA Technical Reports Server (NTRS)

Jacobson, R. A.

1975-01-01

Difficulties arise in guiding a solar electric propulsion spacecraft due to nongravitational accelerations caused by random fluctuations in the magnitude and direction of the thrust vector. These difficulties may be handled by using a low thrust guidance law based on the linear-quadratic-Gaussian problem of stochastic control theory with a minimum terminal miss performance criterion. Explicit constraints are imposed on the variances of the control parameters, and an algorithm based on the Hilbert space extension of a parameter optimization method is presented for calculation of gains in the guidance law. The terminal navigation of a 1980 flyby mission to the comet Encke is used as an example.

Uncertainty Analysis of Thermal Comfort Parameters

NASA Astrophysics Data System (ADS)

Ribeiro, A. Silva; Alves e Sousa, J.; Cox, Maurice G.; Forbes, Alistair B.; Matias, L. Cordeiro; Martins, L. Lages

2015-08-01

International Standard ISO 7730:2005 defines thermal comfort as that condition of mind that expresses the degree of satisfaction with the thermal environment. Although this definition is inevitably subjective, the Standard gives formulae for two thermal comfort indices, predicted mean vote ( PMV) and predicted percentage dissatisfied ( PPD). The PMV formula is based on principles of heat balance and experimental data collected in a controlled climate chamber under steady-state conditions. The PPD formula depends only on PMV. Although these formulae are widely recognized and adopted, little has been done to establish measurement uncertainties associated with their use, bearing in mind that the formulae depend on measured values and tabulated values given to limited numerical accuracy. Knowledge of these uncertainties are invaluable when values provided by the formulae are used in making decisions in various health and civil engineering situations. This paper examines these formulae, giving a general mechanism for evaluating the uncertainties associated with values of the quantities on which the formulae depend. Further, consideration is given to the propagation of these uncertainties through the formulae to provide uncertainties associated with the values obtained for the indices. Current international guidance on uncertainty evaluation is utilized.

[Evaluation of ecosystem service value and strategies for ecological design in land consolidation: a case of land consolidation project in Da'an City, Jilin Province, China].

PubMed

Wang, Jun; Yan, Shen-Chun; Yu, Li; Zhang, Ya-Nan

2014-04-01

Land consolidation, as one of the major driving forces for the changes of land use/cover, has significant impacts on landscape patterns, ecological functions, and ecosystem services. In this paper, a land consolidation project conducted in Da'an City, Jinlin Province, China, was selected to evaluate the ecosystem service values before and after land consolidation at three spatial scales, i. e., village, town, and county. The results indicated that the land consolidation with the goal to increase the area of cultivated land might cause the decrease of the saline and alkaline land, grassland, and wetland. In addition, land consolidation resulted in the reduction of the total ecosystem service values at varying degree at the three scales. Compared to the pre-consolidation status, the total post-consolidation ecosystem service values at the village, town and county scales were 7.96, 843.01 and 1205.86 million yuan, and reduced by 10.5%, 14.2% and 33.1%, respectively. Based on the evaluation of ecosystem service value, strategies of landscape ecological design were discussed to improve the ecological functions and to provide the guidance for the sustainable development of land consolidation.

Implementing the Freight Transportation Data Architecture : Data Element Dictionary

DOT National Transportation Integrated Search

2015-01-01

NCFRP Report 9: Guidance for Developing a Freight Data Architecture articulates the value of establishing architecture for linking data across modes, subjects, and levels of geography to obtain essential information for decision making. Central to th...

Robot-assisted endoscope guidance versus manual endoscope guidance in functional endonasal sinus surgery (FESS).

PubMed

Eichhorn, Klaus Wolfgang; Westphal, Ralf; Rilk, Markus; Last, Carsten; Bootz, Friedrich; Wahl, Friedrich; Jakob, Mark; Send, Thorsten

2017-10-01

Having one hand occupied with the endoscope is the major disadvantage for the surgeon when it comes to functional endoscopic sinus surgery (FESS). Only the other hand is free to use the surgical instruments. Tiredness or frequent instrument changes can thus lead to shaky endoscopic images. We collected the pose data (position and orientation) of the rigid 0° endoscope and all the instruments used in 16 FESS procedures with manual endoscope guidance as well as robot-assisted endoscope guidance. In combination with the DICOM CT data, we tracked the endoscope poses and workspaces using self-developed tracking markers. All surgeries were performed once with the robot and once with the surgeon holding the endoscope. Looking at the durations required, we observed a decrease in the operating time because one surgeon doing all the procedures and so a learning curve occurred what we expected. The visual inspection of the specimens showed no damages to any of the structures outside the paranasal sinuses. Robot-assisted endoscope guidance in sinus surgery is possible. Further CT data, however, are desirable for the surgical analysis of a tracker-based navigation within the anatomic borders. Our marker-based tracking of the endoscope as well as the instruments makes an automated endoscope guidance feasible. On the subjective side, we see that RASS brings a relief for the surgeon.

The use of evidence-based guidance to enable reliable and accurate measurements of the home environment

PubMed Central

Atwal, Anita; McIntyre, Anne

2017-01-01

Introduction High quality guidance in home strategies is needed to enable older people to measure their home environment and become involved in the provision of assistive devices and to promote consistency among professionals. This study aims to investigate the reliability of such guidance and its ability to promote accuracy of results when measurements are taken by both older people and professionals. Method Twenty-five health professionals and 26 older people participated in a within-group design to test the accuracy of measurements taken (that is, person’s popliteal height, baths, toilets, beds, stairs and chairs). Data were analysed with descriptive analysis and the Wilcoxon test. The intra-rater reliability was assessed by correlating measurements taken at two different times with guidance use. Results The intra-rater reliability analysis revealed statistical significance (P < 0.05) for all measurements except for the bath internal width. The guidance enabled participants to take 90% of measurements that they were not able to complete otherwise, 80.55% of which lay within the acceptable suggested margin of variation. Accuracy was supported by the significant reduction in the standard deviation of the actual measurements and accuracy scores. Conclusion This evidence-based guidance can be used in its current format by older people and professionals to facilitate appropriate measurements. Yet, some users might need help from carers or specialists depending on their impairments. PMID:29386701

The use of evidence-based guidance to enable reliable and accurate measurements of the home environment.

PubMed

Spiliotopoulou, Georgia; Atwal, Anita; McIntyre, Anne

2018-01-01

High quality guidance in home strategies is needed to enable older people to measure their home environment and become involved in the provision of assistive devices and to promote consistency among professionals. This study aims to investigate the reliability of such guidance and its ability to promote accuracy of results when measurements are taken by both older people and professionals. Twenty-five health professionals and 26 older people participated in a within-group design to test the accuracy of measurements taken (that is, person's popliteal height, baths, toilets, beds, stairs and chairs). Data were analysed with descriptive analysis and the Wilcoxon test. The intra-rater reliability was assessed by correlating measurements taken at two different times with guidance use. The intra-rater reliability analysis revealed statistical significance ( P  < 0.05) for all measurements except for the bath internal width. The guidance enabled participants to take 90% of measurements that they were not able to complete otherwise, 80.55% of which lay within the acceptable suggested margin of variation. Accuracy was supported by the significant reduction in the standard deviation of the actual measurements and accuracy scores. This evidence-based guidance can be used in its current format by older people and professionals to facilitate appropriate measurements. Yet, some users might need help from carers or specialists depending on their impairments.

Extending FDA guidance to include consumer medication information (CMI) delivery on mobile devices.

PubMed

Sage, Adam; Blalock, Susan J; Carpenter, Delesha

This paper describes the current state of consumer-focused mobile health application use and the current U.S. Food and Drug Administration (FDA) guidance on the distribution of consumer medication information (CMI), and discusses recommendations and considerations for the FDA to expand CMI guidance to include CMI in mobile applications. Smartphone-based health interventions have been linked to increased medication adherence and improved health outcomes. Trends in smartphone ownership present opportunities to more effectively communicate and disseminate medication information; however, current FDA guidance for CMI does not outline how to effectively communicate CMI on a mobile platform, particularly in regards to user-centered design and information sourcing. As evidence supporting the potential effectiveness of mobile communication in health care continues to increase, CMI developers, regulating entities, and researchers should take note. Although mobile-based CMI offers an innovative mechanism to deliver medication information, caution should be exercised. Specifically, considerations for developing mobile CMI include consumers' digital literacy, user experience (e.g., usability), and the quality and accuracy of new widely used sources of information (e.g., crowd-sourced reviews and ratings). Recommended changes to FDA guidance for CMI include altering the language about scientific accuracy to address more novel methods of information gathering (e.g., anecdotal experiences and Google Consumer Surveys) and including guidance for usability testing of mobile health applications. Copyright © 2016 Elsevier Inc. All rights reserved.

78 FR 66366 - Draft Guidance for Industry: Use of Donor Screening Tests To Test Donors of Human Cells, Tissues...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-05

...The Food and Drug Administration (FDA) is announcing the availability of a draft document entitled ``Guidance for Industry: Use of Donor Screening Tests to Test Donors of Human Cells, Tissues, and Cellular and Tissue-Based Products (HCT/Ps) for Infection with Treponema pallidum (Syphilis),'' dated October 2013. The draft guidance document provides establishments that make donor eligibility determinations for donors of HCT/Ps (HCT/P Establishments), with updated recommendations concerning donor testing for evidence of Treponema pallidum (T. pallidum) infection, the etiologic agent of syphilis. HCT/P Establishments must, as required under Federal regulations, test a donor specimen for evidence of T. pallidum infection using appropriate FDA-licensed, approved, or cleared donor screening tests, in accordance with the manufacturer's instructions, unless an exception to this requirement applies. The draft guidance clarifies that FDA does not consider diagnostic tests or pre-amendment devices (which have not been licensed, approved, or cleared) to be adequate for use in donor testing for T. pallidum infection under the criteria specified in Federal regulations. The recommendations in this guidance, when finalized, will supersede those recommendations for testing HCT/P donors for evidence of T. pallidum infection contained in the document entitled ``Guidance for Industry: Eligibility Determination for Donors of Human Cells, Tissues, and Cellular and Tissue-Based Products (HCT/Ps),'' dated August 2007.

Vocational guidance during the Depression: phrenology versus applied psychology.

PubMed

Risse, G B

1976-04-01

The paper describes the design and use of a machine, the "Psychograph," which automatically measured the size and shape of the skull and provided evaluations of mental traits according to phrenological principles. Developed in 1930, the psychograph was billed as a diagnostic tool capable of providing suitable vocational guidance to the thousands of unemployed as a result of the Depression. Its appearance prompted a vigorous opposition from the Psychology Department at the University of Minnesota, especially in the person of Donald L. Paterson. Subsequently, the psychograph was merely exploited for its entertainment value and disappeared after the 1933 World's Fair in Chicago.

Global Sensitivity Analysis of Environmental Models: Convergence, Robustness and Validation

NASA Astrophysics Data System (ADS)

Sarrazin, Fanny; Pianosi, Francesca; Khorashadi Zadeh, Farkhondeh; Van Griensven, Ann; Wagener, Thorsten

2015-04-01

Global Sensitivity Analysis aims to characterize the impact that variations in model input factors (e.g. the parameters) have on the model output (e.g. simulated streamflow). In sampling-based Global Sensitivity Analysis, the sample size has to be chosen carefully in order to obtain reliable sensitivity estimates while spending computational resources efficiently. Furthermore, insensitive parameters are typically identified through the definition of a screening threshold: the theoretical value of their sensitivity index is zero but in a sampling-base framework they regularly take non-zero values. There is little guidance available for these two steps in environmental modelling though. The objective of the present study is to support modellers in making appropriate choices, regarding both sample size and screening threshold, so that a robust sensitivity analysis can be implemented. We performed sensitivity analysis for the parameters of three hydrological models with increasing level of complexity (Hymod, HBV and SWAT), and tested three widely used sensitivity analysis methods (Elementary Effect Test or method of Morris, Regional Sensitivity Analysis, and Variance-Based Sensitivity Analysis). We defined criteria based on a bootstrap approach to assess three different types of convergence: the convergence of the value of the sensitivity indices, of the ranking (the ordering among the parameters) and of the screening (the identification of the insensitive parameters). We investigated the screening threshold through the definition of a validation procedure. The results showed that full convergence of the value of the sensitivity indices is not necessarily needed to rank or to screen the model input factors. Furthermore, typical values of the sample sizes that are reported in the literature can be well below the sample sizes that actually ensure convergence of ranking and screening.

Mirror, mirror on the wall--evaluating Fair Market Value for manufacturer-physician consulting arrangements.

PubMed

Eaton, Fred; Reid, Jaimee

2010-01-01

Pharmaceutical and medical device manufacturers contract with thousands of physicians each year, and struggle to comply with the Fair Market Value requirements of the Anti-Kickback Statute's "personal services" safe harbor. Consultant arrangements between physicians and manufactures have come under increasing scrutiny by regulators. In 2007, the five leading Hip & Knee manufacturers entered into settlement agreements related to their contract practices with physician consultants. Government sources do not provide guidance for calculating Fair Market Value; however, this article recommends four principles to use when evaluating Fair Market Value methodologies.

Ultrasonography-guided percutaneous nephrolithotomy with Chinese one-shot tract dilation technique based on stimulated diuresis: A report of 67 cases.

PubMed

Shi, Ying; Liang, Hua-Geng; Yang, Xiong; Hai, Bo; Wang, Liang; Xing, Yi-Fei; Ju, Wen; Zeng, Fu-Qing; Zhang, Xiao-Ping; Li, Wen-Cheng

2016-12-01

The safety and effectiveness of a novel Chinese one-shot dilation technique based on stimulated diuresis for percutaneous nephrolithotomy (PCNL) were investigated. After the feasibility of the Chinese one-shot dilation based on stimulated diuresis was verified by an animal study, this technique was applied in the clinical practice. A total of 67 patients in our department underwent the modified PCNL from July 2014 to June 2015. After the renal infundibulum was distended by stimulated diuresis, the kidney was punctured under the ultrasonographic guidance via the fornix of the target calyx. The working channel was dilated using a special designed pencil-shaped fascial dilator. The successful access rate, nephrostomy tract creation time, pre- and postoperative hemoglobin values and serum creatinine concentrations, stone-free rate and complications were recorded and analyzed. The renal infundibulum was successfully distended in all of the patients by the diuresis treatment. Under the ultrasonographic guidance, the successful access rate was 100% and the mean tract creation time was 2.0 min (range: 1.5-5.0 min). The stone-free rate right after surgery was 91.0%. Although the postoperative hemoglobin was significantly reduced (P<0.01), transfusion was not clinically necessary. There was no significant difference in serum creatinine concentrations before and after operation (P>0.05). No severe complication occurred during or after the PCNL. It was suggested that this Chinese one-shot dilation technique based on stimulated diuresis is an efficient and safe innovation for PCNL, and is even helpful for those patients with non-dilated pelvicaliceal systems.

New era in drug interaction evaluation: US Food and Drug Administration update on CYP enzymes, transporters, and the guidance process.

PubMed

Huang, Shiew-Mei; Strong, John M; Zhang, Lei; Reynolds, Kellie S; Nallani, Srikanth; Temple, Robert; Abraham, Sophia; Habet, Sayed Al; Baweja, Raman K; Burckart, Gilbert J; Chung, Sang; Colangelo, Philip; Frucht, David; Green, Martin D; Hepp, Paul; Karnaukhova, Elena; Ko, Hon-Sum; Lee, Jang-Ik; Marroum, Patrick J; Norden, Janet M; Qiu, Wei; Rahman, Atiqur; Sobel, Solomon; Stifano, Toni; Thummel, Kenneth; Wei, Xiao-Xiong; Yasuda, Sally; Zheng, Jenny H; Zhao, Hong; Lesko, Lawrence J

2008-06-01

Predicting clinically significant drug interactions during drug development is a challenge for the pharmaceutical industry and regulatory agencies. Since the publication of the US Food and Drug Administration's (FDA's) first in vitro and in vivo drug interaction guidance documents in 1997 and 1999, researchers and clinicians have gained a better understanding of drug interactions. This knowledge has enabled the FDA and the industry to progress and begin to overcome these challenges. The FDA has continued its efforts to evaluate methodologies to study drug interactions and communicate recommendations regarding the conduct of drug interaction studies, particularly for CYP-based and transporter-based drug interactions, to the pharmaceutical industry. A drug interaction Web site was established to document the FDA's current understanding of drug interactions (http://www.fda.gov/cder/drug/drugInteractions/default.htm). This report provides an overview of the evolution of the drug interaction guidances, includes a synopsis of the steps taken by the FDA to revise the original drug interaction guidance documents, and summarizes and highlights updated sections in the current guidance document, Drug Interaction Studies-Study Design, Data Analysis, and Implications for Dosing and Labeling.

Development of Velocity Guidance Assistance System by Haptic Accelerator Pedal Reaction Force Control

NASA Astrophysics Data System (ADS)

Yin, Feilong; Hayashi, Ryuzo; Raksincharoensak, Pongsathorn; Nagai, Masao

This research proposes a haptic velocity guidance assistance system for realizing eco-driving as well as enhancing traffic capacity by cooperating with ITS (Intelligent Transportation Systems). The proposed guidance system generates the desired accelerator pedal (abbreviated as pedal) stroke with respect to the desired velocity obtained from ITS considering vehicle dynamics, and provides the desired pedal stroke to the driver via a haptic pedal whose reaction force is controllable and guides the driver in order to trace the desired velocity in real time. The main purpose of this paper is to discuss the feasibility of the haptic velocity guidance. A haptic velocity guidance system for research is developed on the Driving Simulator of TUAT (DS), by attaching a low-inertia, low-friction motor to the pedal, which does not change the original characteristics of the original pedal when it is not operated, implementing an algorithm regarding the desired pedal stroke calculation and the reaction force controller. The haptic guidance maneuver is designed based on human pedal stepping experiments. A simple velocity profile with acceleration, deceleration and cruising is synthesized according to naturalistic driving for testing the proposed system. The experiment result of 9 drivers shows that the haptic guidance provides high accuracy and quick response in velocity tracking. These results prove that the haptic guidance is a promising velocity guidance method from the viewpoint of HMI (Human Machine Interface).

Virtual and augmented medical imaging environments: enabling technology for minimally invasive cardiac interventional guidance.

PubMed

Linte, Cristian A; White, James; Eagleson, Roy; Guiraudon, Gérard M; Peters, Terry M

2010-01-01

Virtual and augmented reality environments have been adopted in medicine as a means to enhance the clinician's view of the anatomy and facilitate the performance of minimally invasive procedures. Their value is truly appreciated during interventions where the surgeon cannot directly visualize the targets to be treated, such as during cardiac procedures performed on the beating heart. These environments must accurately represent the real surgical field and require seamless integration of pre- and intra-operative imaging, surgical tracking, and visualization technology in a common framework centered around the patient. This review begins with an overview of minimally invasive cardiac interventions, describes the architecture of a typical surgical guidance platform including imaging, tracking, registration and visualization, highlights both clinical and engineering accuracy limitations in cardiac image guidance, and discusses the translation of the work from the laboratory into the operating room together with typically encountered challenges.

Guidance for feasibility analysis of candidate sites : handbook.

DOT National Transportation Integrated Search

2009-09-30

The purpose of this handbook is to provide guidance in determining whether or not speed : harmonization and peak period shoulder is feasible for a given site or set of sites. The content of : this handbook is based on the analysis conducted for this ...

USDOT guidance summary for connected vehicle pilot site deployments: security operational concept : final report.

DOT National Transportation Integrated Search

2016-07-01

This document provides guidance material in regards to security for the CV Pilots Deployment Concept Development Phase. An approach for developing the security operational concept is presented based on identifying the impacts of security breaches reg...

A hybrid approach to near-optimal launch vehicle guidance

NASA Technical Reports Server (NTRS)

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

1992-01-01

This paper evaluates a proposed hybrid analytical/numerical approach to launch-vehicle guidance for ascent to orbit injection. The feedback-guidance approach is based on a piecewise nearly analytic zero-order solution evaluated using a collocation method. The zero-order solution is then improved through a regular perturbation analysis, wherein the neglected dynamics are corrected in the first-order term. For real-time implementation, the guidance approach requires solving a set of small dimension nonlinear algebraic equations and performing quadrature. Assessment of performance and reliability are carried out through closed-loop simulation for a vertically launched 2-stage heavy-lift capacity vehicle to a low earth orbit. The solutions are compared with optimal solutions generated from a multiple shooting code. In the example the guidance approach delivers over 99.9 percent of optimal performance and terminal constraint accuracy.

Effectiveness of respiratory-gated radiotherapy with audio-visual biofeedback for synchrotron-based scanned heavy-ion beam delivery

NASA Astrophysics Data System (ADS)

He, Pengbo; Li, Qiang; Zhao, Ting; Liu, Xinguo; Dai, Zhongying; Ma, Yuanyuan

2016-12-01

A synchrotron-based heavy-ion accelerator operates in pulse mode at a low repetition rate that is comparable to a patient’s breathing rate. To overcome inefficiencies and interplay effects between the residual motion of the target and the scanned heavy-ion beam delivery process for conventional free breathing (FB)-based gating therapy, a novel respiratory guidance method was developed to help patients synchronize their breathing patterns with the synchrotron excitation patterns by performing short breath holds with the aid of personalized audio-visual biofeedback (BFB) system. The purpose of this study was to evaluate the treatment precision, efficiency and reproducibility of the respiratory guidance method in scanned heavy-ion beam delivery mode. Using 96 breathing traces from eight healthy volunteers who were asked to breathe freely and guided to perform short breath holds with the aid of BFB, a series of dedicated four-dimensional dose calculations (4DDC) were performed on a geometric model which was developed assuming a linear relationship between external surrogate and internal tumor motions. The outcome of the 4DDCs was quantified in terms of the treatment time, dose-volume histograms (DVH) and dose homogeneity index. Our results show that with the respiratory guidance method the treatment efficiency increased by a factor of 2.23-3.94 compared with FB gating, depending on the duty cycle settings. The magnitude of dose inhomogeneity for the respiratory guidance methods was 7.5 times less than that of the non-gated irradiation, and good reproducibility of breathing guidance among different fractions was achieved. Thus, our study indicates that the respiratory guidance method not only improved the overall treatment efficiency of respiratory-gated scanned heavy-ion beam delivery, but also had the advantages of lower dose uncertainty and better reproducibility among fractions.

A Value-Based Case Study to Increasing Community Mentoring in STEM for Hispanic Students

NASA Astrophysics Data System (ADS)

Moreno, Gilberto

This case study investigates the implementation of a unique community-driven mentoring pilot program (PASOS2) forging stronger community and K-12 partnerships. Focused on surfacing what matters most in engaging community mentors, this case study explores a civic organization's quest to impact, expand, and bring value via mentoring to Hispanic students' pursuit of post-secondary studies with emphasis in STEM careers. A major stumbling block faced by many underprivileged students is the lack of mentorship vital to expanding their social capital support system. This innovative mentoring approach provides students with critical access to STEM community empowerment agents supporting aspiring students' dreams. Analytical methods and principles of case study research focus on how community mentor choices impact community mentorship value. The study examines whether or not a formal mentoring system with a value-driven mentoring curriculum matters in attracting, preparing, and sustaining community mentors to advocate for STEM careers to Hispanic students. A mentor value equation is introduced correlating mentor capacity to build student relationships, demystify STEM, deliver career guidance, and fortify student readiness. A formal mentor development training program integrates a technology-based 'grit' software platform to enhance student awareness, understanding, and commitment to considering a STEM career. Through the investigation of a formal mentoring experience, the study reveals what best practices, tools, and techniques influence community mentor engagement. The findings of this case study underscore the value in preparing community mentor capacity and competency. The very nature of the PASOS2 project being civic community-based informs other communities on how their investments can fortify Hispanic student social capital in their successful pursuit of STEM careers.

Modeling Color Difference for Visualization Design.

PubMed

Szafir, Danielle Albers

2018-01-01

Color is frequently used to encode values in visualizations. For color encodings to be effective, the mapping between colors and values must preserve important differences in the data. However, most guidelines for effective color choice in visualization are based on either color perceptions measured using large, uniform fields in optimal viewing environments or on qualitative intuitions. These limitations may cause data misinterpretation in visualizations, which frequently use small, elongated marks. Our goal is to develop quantitative metrics to help people use color more effectively in visualizations. We present a series of crowdsourced studies measuring color difference perceptions for three common mark types: points, bars, and lines. Our results indicate that peoples' abilities to perceive color differences varies significantly across mark types. Probabilistic models constructed from the resulting data can provide objective guidance for designers, allowing them to anticipate viewer perceptions in order to inform effective encoding design.

Raman spectroscopic sensing of carbonate intercalation in breast microcalcifications at stereotactic biopsy

PubMed Central

Sathyavathi, R.; Saha, Anushree; Soares, Jaqueline S.; Spegazzini, Nicolas; McGee, Sasha; Rao Dasari, Ramachandra; Fitzmaurice, Maryann; Barman, Ishan

2015-01-01

Microcalcifications are an early mammographic sign of breast cancer and frequent target for stereotactic biopsy. Despite their indisputable value, microcalcifications, particularly of the type II variety that are comprised of calcium hydroxyapatite deposits, remain one of the least understood disease markers. Here we employed Raman spectroscopy to elucidate the relationship between pathogenicity of breast lesions in fresh biopsy cores and composition of type II microcalcifications. Using a chemometric model of chemical-morphological constituents, acquired Raman spectra were translated to characterize chemical makeup of the lesions. We find that increase in carbonate intercalation in the hydroxyapatite lattice can be reliably employed to differentiate benign from malignant lesions, with algorithms based only on carbonate and cytoplasmic protein content exhibiting excellent negative predictive value (93–98%). Our findings highlight the importance of calcium carbonate, an underrated constituent of microcalcifications, as a spectroscopic marker in breast pathology evaluation and pave the way for improved biopsy guidance. PMID:25927331

Exposure Factors Handbook - 2009 Update (External Review ...

EPA Pesticide Factsheets

The mission of National Center for Environmental Assessment (NCEA) of EPA's Office of Research and Development is to provide guidance and risk assessments aimed at protecting human health and the environment. To accomplish this mission, NCEA works to develop and improve the models, databases, tools, assumptions, and extrapolations used in risk assessments. This handbook is a tool developed by NCEA aimed at refining the assumptions used in exposure assessments and reducing uncertainty. This handbook was first published in 1989 and updated in 1997 to provide statistical data on the various human factors used in assessing exposure. This revised version of the handbook provides the up-to-date data on these exposure factors. The recommended values are based solely on our interpretations of the available data. In many situations different values may be appropriate to use in consideration of policy, precedent or other factors. External Review Draft

Raman spectroscopic sensing of carbonate intercalation in breast microcalcifications at stereotactic biopsy

NASA Astrophysics Data System (ADS)

Sathyavathi, R.; Saha, Anushree; Soares, Jaqueline S.; Spegazzini, Nicolas; McGee, Sasha; Rao Dasari, Ramachandra; Fitzmaurice, Maryann; Barman, Ishan

2015-04-01

Microcalcifications are an early mammographic sign of breast cancer and frequent target for stereotactic biopsy. Despite their indisputable value, microcalcifications, particularly of the type II variety that are comprised of calcium hydroxyapatite deposits, remain one of the least understood disease markers. Here we employed Raman spectroscopy to elucidate the relationship between pathogenicity of breast lesions in fresh biopsy cores and composition of type II microcalcifications. Using a chemometric model of chemical-morphological constituents, acquired Raman spectra were translated to characterize chemical makeup of the lesions. We find that increase in carbonate intercalation in the hydroxyapatite lattice can be reliably employed to differentiate benign from malignant lesions, with algorithms based only on carbonate and cytoplasmic protein content exhibiting excellent negative predictive value (93-98%). Our findings highlight the importance of calcium carbonate, an underrated constituent of microcalcifications, as a spectroscopic marker in breast pathology evaluation and pave the way for improved biopsy guidance.

Raman spectroscopic sensing of carbonate intercalation in breast microcalcifications at stereotactic biopsy.

PubMed

Sathyavathi, R; Saha, Anushree; Soares, Jaqueline S; Spegazzini, Nicolas; McGee, Sasha; Rao Dasari, Ramachandra; Fitzmaurice, Maryann; Barman, Ishan

2015-04-30

Microcalcifications are an early mammographic sign of breast cancer and frequent target for stereotactic biopsy. Despite their indisputable value, microcalcifications, particularly of the type II variety that are comprised of calcium hydroxyapatite deposits, remain one of the least understood disease markers. Here we employed Raman spectroscopy to elucidate the relationship between pathogenicity of breast lesions in fresh biopsy cores and composition of type II microcalcifications. Using a chemometric model of chemical-morphological constituents, acquired Raman spectra were translated to characterize chemical makeup of the lesions. We find that increase in carbonate intercalation in the hydroxyapatite lattice can be reliably employed to differentiate benign from malignant lesions, with algorithms based only on carbonate and cytoplasmic protein content exhibiting excellent negative predictive value (93-98%). Our findings highlight the importance of calcium carbonate, an underrated constituent of microcalcifications, as a spectroscopic marker in breast pathology evaluation and pave the way for improved biopsy guidance.

Accommodating non-market values in evaluation of wildfire management in the United States: Challenges and opportunities

Treesearch

Tyron J. Venn; David E. Calkin

2011-01-01

Forests in the United States generate many non-market benefits for society that can be enhanced and diminished by wildfire and wildfire management. The Federal Wildland Fire Management Policy (1995, updated 2001), and subsequent Guidance to the Implementation of that policy provided in 2009, require fire management priorities be set on the basis of values to be...

The role of benefit transfer in ecosystem service valuation

USGS Publications Warehouse

Richardson, Leslie A.; Loomis, John; Kroeger, Timm; Casey, Frank

2015-01-01

The demand for timely monetary estimates of the economic value of nonmarket ecosystem goods and services has steadily increased over the last few decades. This article describes the use of benefit transfer to generate monetary value estimates of ecosystem services specifically. The article provides guidance for conducting such benefit transfers and summarizes advancements in benefit transfer methods, databases and analysis tools designed to facilitate its application.

GUIDANCE FOR STATISTICAL DETERMINATION OF APPROPRIATE PERCENT MINORITY AND PERCENT POVERTY DISTRIBUTIONAL CUTOFF VALUES USING CENSUS DATA FOR AND EPA REGION II ENVIRONMENTAL JUSTICE PROJECT

EPA Science Inventory

The purpose of this report is to assist Region H by providing a statistical analysis identifying the areas with minority and below poverty populations known as "Community of Concern" (COC). The aim was to find a cutoff value as a threshold to identify a COC using demographic data...

The Seated Soldier Study: Posture and Body Shape in Vehicle Seats

DTIC Science & Technology

2014-01-28

vehicle interior layout Current design guidance is based on outdated anthropometry Previous studies of seated anthropometry have not included the...personal protective equipment (PPE) for seat and vehicle interior layout • Current design guidance is based on outdated anthropometry • Previous...studies of seated anthropometry have not included the effects of PPE on posture and body shape • Detailed anthropometric data needed for the design

Toward Developing a Universal Code of Ethics for Adult Educators.

ERIC Educational Resources Information Center

Siegel, Irwin H.

2000-01-01

Presents conflicting viewpoints on a universal code of ethics for adult educators. Suggests objectives of a code (guidance for practice, policymaking direction, common reference point, shared values). Outlines content and methods for implementing a code. (SK)

77 FR 41334 - Request for Comments: Customer Due Diligence Requirements for Financial Institutions; Public Hearing

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-13

... domestic or foreign entity, (2) regulated or unregulated for anti-money laundering purposes, etc.), (ii... little to no independent economic value. See FinCEN Guidance, FIN-2006-G014, ``Potential Money Laundering...

17 CFR Appendix A to Part 39 - Application Guidance and Compliance With Core Principles

Code of Federal Regulations, 2010 CFR

2010-04-01

... management tools such as stress testing and value at risk calculations; and c. What contingency plans the... informal, which the clearing organization views as appropriate and applicable to its operations. 2. How...

Effects on radionuclide concentrations by cement/ground-water interactions in support of performance assessment of low-level radioactive waste disposal facilities

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

Krupka, K.M.; Serne, R.J.

The US Nuclear Regulatory Commission is developing a technical position document that provides guidance regarding the performance assessment of low-level radioactive waste disposal facilities. This guidance considers the effects that the chemistry of the vault disposal system may have on radionuclide release. The geochemistry of pore waters buffered by cementitious materials in the disposal system will be different from the local ground water. Therefore, the cement-buffered environment needs to be considered within the source term calculations if credit is taken for solubility limits and/or sorption of dissolved radionuclides within disposal units. A literature review was conducted on methods to modelmore » pore-water compositions resulting from reactions with cement, experimental studies of cement/water systems, natural analogue studies of cement and concrete, and radionuclide solubilities experimentally determined in cement pore waters. Based on this review, geochemical modeling was used to calculate maximum concentrations for americium, neptunium, nickel, plutonium, radium, strontium, thorium, and uranium for pore-water compositions buffered by cement and local ground-water. Another literature review was completed on radionuclide sorption behavior onto fresh cement/concrete where the pore water pH will be greater than or equal 10. Based on this review, a database was developed of preferred minimum distribution coefficient values for these radionuclides in cement/concrete environments.« less

The use of a Colapinto TIPS Needle under cone-beam computed tomography guidance for true lumen re-entry in subintimal recanalization of chronic iliac artery occlusion.

PubMed

Liang, Huei-Lung; Li, Ming-Feng; Chiang, Chia-Ling; Chen, Matt Chiung-Yu; Wu, Chieh-Jen; Pan, Huay-Ben

2017-06-01

To report the technique and clinical outcome of subintimal re-entry in chronic iliac artery occlusion by using a Colapinto transjugular intrahepatic portosystemic shunt (TIPS) needle under rotational angiography (cone-beam computed tomography; CT) imaging guidance. Patients with chronic iliac artery occlusion with earlier failed attempts at conventional percutaneous recanalization during the past 5 years were enrolled in our study. In these patients, an ipsilateral femoral access route was routinely utilized in a retrograde fashion. A Colapinto TIPS Needle was used to aid the true lumen re-entry after failed conventional intraluminal or subintimal guidewire and catheter-based techniques. The puncture was directed under rotational angiography cone-beam CT guidance to re-enter the abdominal aorta. Bare metallic stents 8-10 mm in diameter were deployed in the common iliac artery, and followed by balloon dilation. Ten patients (9 male; median age, 75 years) were included in our investigation. The average occlusion length was 10.2 cm (range, 4-15 cm). According to the Trans-Atlantic Inter-Society Consensus (TASC) II classification, there were five patients each with Class B and D lesions. Successful re-entry was achieved in all patients without procedure-related complications. The ankle-brachial index (ABI) values increased from 0.38-0.79 to 0.75-1.28 after the procedure. Imaging follow-up (> 6 months) was available in six patients with patency of all stented iliac artery. Thereafter, no complaints of recurrent clinical symptoms occurred during the follow-up period. The use of Colapinto TIPS needle, especially under cone-beam CT image guidance, appears to be safe and effective to re-enter the true lumen in a subintimal angioplasty for a difficult chronic total iliac occlusion. Copyright © 2017. Published by Elsevier Taiwan LLC.

Make Change Happen at the Program or Institutional Scale: Converting Community Expertise into Practical Guidance

NASA Astrophysics Data System (ADS)

McDaris, J. R.; Manduca, C. A.; Orr, C. H.

2016-12-01

As geoscience and STEM programs address common challenges like increasing the diversity of graduates or implementing active learning pedagogies, it is important to learn from the experiences of others in the community. Individual faculty members embody a wealth of experience on these topics but distilling that experience into practical guidance that has value for a broad audience is not as simple as knowing exactly what one person did. Context is important, not only because activities used in similar contexts are easier to adapt, but also because activities that work across multiple contexts are more robust. The development of any best practices guidance benefits from the engagement of a community. Synthesizing across multiple viewpoints leads to a consensus that builds on the diversity of individual experiences. The Science Education Resource Center (SERC) at Carleton College has had success generating such resources in geoscience and STEM education. Working with different groups of educators, we have helped develop content around making change happen at the program or institutional levels, increasing the diversity of students graduating in geoscience and STEM, fostering interdisciplinary learning, translating the results of education research into practice, and several others. These resources draw out common practices, situate them in the education research base, and highlight examples of their use in the real world but also communicate the different ways individuals or institutions have adapted these practices for their particular situation. These resources were developed through a group synthesis process involving the contribution of individual or group expertise, a face-to-face meeting of teams working on themes drawn from the contributed work, and asynchronous group revision and review following the meeting. The materials developed via this process provide reliable and adaptable guidance firmly rooted in the community's experience. This presentation will showcase these materials and describe the development process in detail. The materials that have been developed are being added to SERC's For Higher Ed portal (serc.carleton.edu/highered/index.html).

Effective translation of current dietary guidance: understanding and communicating the concepts of minimal and optimal levels of dietary protein.

PubMed

Rodriguez, Nancy R; Miller, Sharon L

2015-04-29

Dietitians and health care providers have critical roles in the translation of the dietary guidance to practice. The protein content of diets for adults can be based on the Recommended Dietary Allowance (RDA) of 0.80 g/kg per day. Alternatively, the most recent Dietary Reference Intakes (DRIs) for macronutrients reflect expanded guidance for assessing protein needs and consider the relative relation of absolute amounts of protein, carbohydrate, and fat to total energy intake in the context of chronic disease prevention. The Acceptable Macronutrient Distribution Range (AMDR) reflects the interrelation between the macronutrients and affords dietitians and clinicians additional flexibility in diet planning. Accounting for the caloric value of RDAs for carbohydrate and fat, "flexible calories" emerge as an opportunity to create varied eating plans that provide for protein intakes in excess of the RDA but within the AMDR. Protein Summit 2.0 highlighted the growing body of scientific evidence documenting the benefits of higher protein intakes at amounts approximating twice the RDA, which include promotion of healthy body weight and preservation of lean body mass and functional ability with age. The essential amino acid (EAA) density of a food also emerged as a novel concept analogous to "nutrient density," which can enable the practitioner to calculate the caloric cost associated with a specific protein source to attain the daily requirement of EAAs to accomplish various health outcomes because these indispensable nutrients have a significant role in protein utilization and metabolic regulation. Tailoring recommendations unique to an individual's varying goals and needs remains a challenge. However, flexibility within the application of DRIs to include consideration of the AMDR provides a sound framework to guide practitioners in effective translation of current dietary guidance with a specific regard for the documented benefits of higher protein intakes. © 2015 American Society for Nutrition.

An Automated Method to Compute Orbital Re-entry Trajectories with Heating Constraints

NASA Technical Reports Server (NTRS)

Zimmerman, Curtis; Dukeman, Greg; Hanson, John; Fogle, Frank R. (Technical Monitor)

2002-01-01

Determining how to properly manipulate the controls of a re-entering re-usable launch vehicle (RLV) so that it is able to safely return to Earth and land involves the solution of a two-point boundary value problem (TPBVP). This problem, which can be quite difficult, is traditionally solved on the ground prior to flight. If necessary, a nearly unlimited amount of time is available to find the 'best' solution using a variety of trajectory design and optimization tools. The role of entry guidance during flight is to follow the pre- determined reference solution while correcting for any errors encountered along the way. This guidance method is both highly reliable and very efficient in terms of onboard computer resources. There is a growing interest in a style of entry guidance that places the responsibility of solving the TPBVP in the actual entry guidance flight software. Here there is very limited computer time. The powerful, but finicky, mathematical tools used by trajectory designers on the ground cannot in general be converted to do the job. Non-convergence or slow convergence can result in disaster. The challenges of designing such an algorithm are numerous and difficult. Yet the payoff (in the form of decreased operational costs and increased safety) can be substantiaL This paper presents an algorithm that incorporates features of both types of guidance strategies. It takes an initial RLV orbital re-entry state and finds a trajectory that will safely transport the vehicle to Earth. During actual flight, the computed trajectory is used as the reference to be flown by a more traditional guidance method.

Guidance for Classifying Studies Conducted Using the OECD Test Guideline 223 (TG223) (Acute Avian Oral Sequential Dose Study)

EPA Pesticide Factsheets

Guidance based on comparison of results from the TG223 validation studies to results from avian acute oral studies previously submitted to EPA for two test chemicals following EPA's 850.2100 (public draft) guidelines.

Issuance of Final Guidance: Ecological Risk Assessment and Risk Management Principles for Superfund Sites, October 7, 1999

EPA Pesticide Factsheets

This guidance is intended to help Superfund risk managers make ecological risk management decisions that are based on sound science, consistent across Regions, and present a characterization of site risks that is transparent to the public.

Developing a web-based forecasting tool for nutrient management

USDA-ARS?s Scientific Manuscript database

Modern nutrient management planning tools provide strategic guidance that, in the best cases, educates farmers and others involved in nutrient management to make prudent management decisions. The strategic guidance provided by nutrient management plans does not provide the day-to-day support require...

An investigation of microwave landing guidance system signal requirements for conventionally equipped civilian aircraft.

DOT National Transportation Integrated Search

1971-06-01

The report describes efforts leading to the determination of minimum suitable scan rates for the azimuth and Elevation functions of the microwave Landing Guidance System (LGS) proposed by RTCA SC-117, based on performance requirements of two conventi...

Development of a unified guidance system for geocentric transfer. [for solar electric propulsion spacecraft

NASA Technical Reports Server (NTRS)

Cake, J. E.; Regetz, J. D., Jr.

1975-01-01

A method is presented for open loop guidance of a solar electric propulsion spacecraft to geosynchronous orbit. The method consists of determining the thrust vector profiles on the ground with an optimization computer program, and performing updates based on the difference between the actual trajectory and that predicted with a precision simulation computer program. The motivation for performing the guidance analysis during the mission planning phase is discussed, and a spacecraft design option that employs attitude orientation constraints is presented. The improvements required in both the optimization program and simulation program are set forth, together with the efforts to integrate the programs into the ground support software for the guidance system.

Development of a unified guidance system for geocentric transfer. [solar electric propulsion spacecraft

NASA Technical Reports Server (NTRS)

Cake, J. E.; Regetz, J. D., Jr.

1975-01-01

A method is presented for open loop guidance of a solar electric propulsion spacecraft to geosynchronsus orbit. The method consists of determining the thrust vector profiles on the ground with an optimization computer program, and performing updates based on the difference between the actual trajectory and that predicted with a precision simulation computer program. The motivation for performing the guidance analysis during the mission planning phase is discussed, and a spacecraft design option that employs attitude orientation constraints is presented. The improvements required in both the optimization program and simulation program are set forth, together with the efforts to integrate the programs into the ground support software for the guidance system.

Approach trajectory planning system for maximum concealment

NASA Technical Reports Server (NTRS)

Warner, David N., Jr.

1986-01-01

A computer-simulation study was undertaken to investigate a maximum concealment guidance technique (pop-up maneuver), which military aircraft may use to capture a glide path from masked, low-altitude flight typical of terrain following/terrain avoidance flight enroute. The guidance system applied to this problem is the Fuel Conservative Guidance System. Previous studies using this system have concentrated on the saving of fuel in basically conventional land and ship-based operations. Because this system is based on energy-management concepts, it also has direct application to the pop-up approach which exploits aircraft performance. Although the algorithm was initially designed to reduce fuel consumption, the commanded deceleration is at its upper limit during the pop-up and, therefore, is a good approximation of a minimum-time solution. Using the model of a powered-lift aircraft, the results of the study demonstrated that guidance commands generated by the system are well within the capability of an automatic flight-control system. Results for several initial approach conditions are presented.

Vision 20/20: Molecular-guided surgical oncology based upon tumor metabolism or immunologic phenotype: Technological pathways for point of care imaging and intervention

PubMed Central

Paulsen, Keith D.; Samkoe, Kimberley S.; Elliott, Jonathan T.; Hasan, Tayyaba; Strong, Theresa V.; Draney, Daniel R.; Feldwisch, Joachim

2016-01-01

Surgical guidance with fluorescence has been demonstrated in individual clinical trials for decades, but the scientific and commercial conditions exist today for a dramatic increase in clinical value. In the past decade, increased use of indocyanine green based visualization of vascular flow, biliary function, and tissue perfusion has spawned a robust growth in commercial systems that have near-infrared emission imaging and video display capabilities. This recent history combined with major preclinical innovations in fluorescent-labeled molecular probes, has the potential for a shift in surgical practice toward resection guidance based upon molecular information in addition to conventional visual and palpable cues. Most surgical subspecialties already have treatment management decisions partially based upon the immunohistochemical phenotype of the cancer, as assessed from molecular pathology of the biopsy tissue. This phenotyping can inform the surgical resection process by spatial mapping of these features. Further integration of the diagnostic and therapeutic value of tumor metabolism sensing molecules or immune binding agents directly into the surgical process can help this field mature. Maximal value to the patient would come from identifying the spatial patterns of molecular expression in vivo that are well known to exist. However, as each molecular agent is advanced into trials, the performance of the imaging system can have a critical impact on the success. For example, use of pre-existing commercial imaging systems are not well suited to image receptor targeted fluorophores because of the lower concentrations expected, requiring orders of magnitude more sensitivity. Additionally the imaging system needs the appropriate dynamic range and image processing features to view molecular probes or therapeutics that may have nonspecific uptake or pharmacokinetic issues which lead to limitations in contrast. Imaging systems need to be chosen based upon objective performance criteria, and issues around calibration, validation, and interpretation need to be established before a clinical trial starts. Finally, as early phase trials become more established, the costs associated with failures can be crippling to the field, and so judicious use of phase 0 trials with microdose levels of agents is one viable paradigm to help the field advance, but this places high sensitivity requirements on the imaging systems used. Molecular-guided surgery has truly transformative potential, and several key challenges are outlined here with the goal of seeing efficient advancement with ideal choices. The focus of this vision 20/20 paper is on the technological aspects that are needed to be paired with these agents. PMID:27277060

Vision 20/20: Molecular-guided surgical oncology based upon tumor metabolism or immunologic phenotype: Technological pathways for point of care imaging and intervention.

PubMed

Pogue, Brian W; Paulsen, Keith D; Samkoe, Kimberley S; Elliott, Jonathan T; Hasan, Tayyaba; Strong, Theresa V; Draney, Daniel R; Feldwisch, Joachim

2016-06-01

Surgical guidance with fluorescence has been demonstrated in individual clinical trials for decades, but the scientific and commercial conditions exist today for a dramatic increase in clinical value. In the past decade, increased use of indocyanine green based visualization of vascular flow, biliary function, and tissue perfusion has spawned a robust growth in commercial systems that have near-infrared emission imaging and video display capabilities. This recent history combined with major preclinical innovations in fluorescent-labeled molecular probes, has the potential for a shift in surgical practice toward resection guidance based upon molecular information in addition to conventional visual and palpable cues. Most surgical subspecialties already have treatment management decisions partially based upon the immunohistochemical phenotype of the cancer, as assessed from molecular pathology of the biopsy tissue. This phenotyping can inform the surgical resection process by spatial mapping of these features. Further integration of the diagnostic and therapeutic value of tumor metabolism sensing molecules or immune binding agents directly into the surgical process can help this field mature. Maximal value to the patient would come from identifying the spatial patterns of molecular expression in vivo that are well known to exist. However, as each molecular agent is advanced into trials, the performance of the imaging system can have a critical impact on the success. For example, use of pre-existing commercial imaging systems are not well suited to image receptor targeted fluorophores because of the lower concentrations expected, requiring orders of magnitude more sensitivity. Additionally the imaging system needs the appropriate dynamic range and image processing features to view molecular probes or therapeutics that may have nonspecific uptake or pharmacokinetic issues which lead to limitations in contrast. Imaging systems need to be chosen based upon objective performance criteria, and issues around calibration, validation, and interpretation need to be established before a clinical trial starts. Finally, as early phase trials become more established, the costs associated with failures can be crippling to the field, and so judicious use of phase 0 trials with microdose levels of agents is one viable paradigm to help the field advance, but this places high sensitivity requirements on the imaging systems used. Molecular-guided surgery has truly transformative potential, and several key challenges are outlined here with the goal of seeing efficient advancement with ideal choices. The focus of this vision 20/20 paper is on the technological aspects that are needed to be paired with these agents.

Percutaneous imaging-guided interventions for acute biliary disorders in high surgical risk patients

PubMed Central

Donkol, Ragab Hani; Latif, Nahed Abdel; Moghazy, Khaled

2010-01-01

AIM: To evaluate the efficacy of percutaneous imaging-guided biliary interventions in the management of acute biliary disorders in high surgical risk patients. METHODS: One hundred and twenty two patients underwent 139 percutaneous imaging-guided biliary interventions during the period between January 2007 to December 2009. The patients included 73 women and 49 men with a mean age of 61 years (range 35-90 years). Fifty nine patients had acute biliary obstruction, 26 patients had acute biliary infection and 37 patients had abnormal collections. The procedures were performed under computed tomography (CT)- (73 patients), sonographic- (41 patients), and fluoroscopic-guidance (25 patients). Success rates and complications were determined. The χ2 test with Yates’ correction for continuity was applied to compare between these procedures. A P value < 0.05 was considered significant. RESULTS: The success rates for draining acute biliary obstruction under CT- , fluoroscopy- or ultrasound-guidance were 93.3%, 62.5% and 46.1%, respectively with significant P values (P = 0.026 and 0.002, respectively). In acute biliary infection, successful drainage was achieved in 22 patients (84.6%). The success rates in patients drained under ultrasound- and CT-guidance were 46.1% and 88.8%, respectively and drainage under CT-guidance was significantly higher (P = 0.0293). In 13 patients with bilomas, percutaneous drainage was successful in 11 patients (84.6%). Ten out of 12 cases with hepatic abscesses were drained with a success rate of 83.3%. In addition, the success rate of drainage in 12 cases with pancreatic pseudocysts was 83.3%. The reported complications were two deaths, four major and seven minor complications. CONCLUSION: Percutaneous imaging-guided biliary interventions help to promptly diagnose and effectively treat acute biliary disorders. They either cure the disorders or relieve sepsis and jaundice before operations. PMID:21160698

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

Sailer, Anna M., E-mail: anni.sailer@mumc.nl; Haan, Michiel W. de, E-mail: m.de.haan@mumc.nl; Graaf, Rick de, E-mail: r.de.graaf@mumc.nl

PurposeThis study was designed to evaluate the feasibility of endovascular guidance by means of live fluoroscopy fusion with magnetic resonance angiography (MRA) and computed tomography angiography (CTA).MethodsFusion guidance was evaluated in 20 endovascular peripheral artery interventions in 17 patients. Fifteen patients had received preinterventional diagnostic MRA and two patients had undergone CTA. Time for fluoroscopy with MRA/CTA coregistration was recorded. Feasibility of fusion guidance was evaluated according to the following criteria: for every procedure the executing interventional radiologists recorded whether 3D road-mapping provided added value (yes vs. no) and whether PTA and/or stenting could be performed relying on the fusionmore » road-map without need for diagnostic contrast-enhanced angiogram series (CEAS) (yes vs. no). Precision of the fusion road-map was evaluated by recording maximum differences between the position of the vasculature on the virtual CTA/MRA images and conventional angiography.ResultsAverage time needed for image coregistration was 5 ± 2 min. Three-dimensional road-map added value was experienced in 15 procedures in 12 patients. In half of the patients (8/17), intervention was performed relying on the fusion road-map only, without diagnostic CEAS. In two patients, MRA roadmap showed a false-positive lesion. Excluding three patients with inordinate movements, mean difference in position of vasculature on angiography and MRA/CTA road-map was 1.86 ± 0.95 mm, implying that approximately 95 % of differences were between 0 and 3.72 mm (2 ± 1.96 standard deviation).ConclusionsFluoroscopy with MRA/CTA fusion guidance for peripheral artery interventions is feasible. By reducing the number of CEAS, this technology may contribute to enhance procedural safety.« less

Action levels for airborne uranium in the workplace: chemical and radiological assessments.

PubMed

Leggett, R W; Meck, R A

2018-06-01

A method is described for deriving two levels of action-an investigation level (IL) and an immediate action level (IAL)-for different forms and mixtures of the natural uranium (U) isotopes 234 U, 235 U, and 238 U in air in the workplace. An IL indicates the need to confirm the validity of moderately elevated measurements of airborne U and adequacy of confinement controls and determine whether work limitations are appropriate. An IAL indicates that safeguards should be put into place immediately, including removal of workers from further exposure until conditions are acceptable. Derivations of ILs and IALs are based on latest radiation protection guidance, information on chemical toxicity of U, and biokinetic models for U. An action level (IL or IAL) is the more restrictive of two derived values, the action level based on U as a chemical hazard and the action level based on U as a radiation hazard.

Endovascular MR-guided Renal Embolization by Using a Magnetically Assisted Remote-controlled Catheter System

PubMed Central

Lillaney, Prasheel V.; Yang, Jeffrey K.; Losey, Aaron D.; Martin, Alastair J.; Cooke, Daniel L.; Thorne, Bradford R. H.; Barry, David C.; Chu, Andrew; Stillson, Carol; Do, Loi; Arenson, Ronald L.; Saeed, Maythem; Wilson, Mark W.

2016-01-01

Purpose To assess the feasibility of a magnetically assisted remote-controlled (MARC) catheter system under magnetic resonance (MR) imaging guidance for performing a simple endovascular procedure (ie, renal artery embolization) in vivo and to compare with x-ray guidance to determine the value of MR imaging guidance and the specific areas where the MARC system can be improved. Materials and Methods In concordance with the Institutional Animal Care and Use Committee protocol, in vivo renal artery navigation and embolization were tested in three farm pigs (mean weight 43 kg ± 2 [standard deviation]) under real-time MR imaging at 1.5 T. The MARC catheter device was constructed by using an intramural copper-braided catheter connected to a laser-lithographed saddle coil at the distal tip. Interventionalists controlled an in-room cart that delivered electrical current to deflect the catheter in the MR imager. Contralateral kidneys were similarly embolized under x-ray guidance by using standard clinical catheters and guidewires. Changes in renal artery flow and perfusion were measured before and after embolization by using velocity-encoded and perfusion MR imaging. Catheter navigation times, renal parenchymal perfusion, and renal artery flow rates were measured for MR-guided and x-ray–guided embolization procedures and are presented as means ± standard deviation in this pilot study. Results Embolization was successful in all six kidneys under both x-ray and MR imaging guidance. Mean catheterization time with MR guidance was 93 seconds ± 56, compared with 60 seconds ± 22 for x-ray guidance. Mean changes in perfusion rates were 4.9 au/sec ± 0.8 versus 4.6 au/sec ± 0.6, and mean changes in renal flow rate were 2.1 mL/min/g ± 0.2 versus 1.9 mL/min/g ± 0.2 with MR imaging and x-ray guidance, respectively. Conclusion The MARC catheter system is feasible for renal artery catheterization and embolization under real-time MR imaging in vivo, and quantitative physiologic measures under MR imaging guidance were similar to those measured under x-ray guidance, suggesting that the MARC catheter system could be used for endovascular procedures with interventional MR imaging. © RSNA, 2016 PMID:27019290

Endovascular MR-guided Renal Embolization by Using a Magnetically Assisted Remote-controlled Catheter System.

PubMed

Lillaney, Prasheel V; Yang, Jeffrey K; Losey, Aaron D; Martin, Alastair J; Cooke, Daniel L; Thorne, Bradford R H; Barry, David C; Chu, Andrew; Stillson, Carol; Do, Loi; Arenson, Ronald L; Saeed, Maythem; Wilson, Mark W; Hetts, Steven W

2016-10-01

Purpose To assess the feasibility of a magnetically assisted remote-controlled (MARC) catheter system under magnetic resonance (MR) imaging guidance for performing a simple endovascular procedure (ie, renal artery embolization) in vivo and to compare with x-ray guidance to determine the value of MR imaging guidance and the specific areas where the MARC system can be improved. Materials and Methods In concordance with the Institutional Animal Care and Use Committee protocol, in vivo renal artery navigation and embolization were tested in three farm pigs (mean weight 43 kg ± 2 [standard deviation]) under real-time MR imaging at 1.5 T. The MARC catheter device was constructed by using an intramural copper-braided catheter connected to a laser-lithographed saddle coil at the distal tip. Interventionalists controlled an in-room cart that delivered electrical current to deflect the catheter in the MR imager. Contralateral kidneys were similarly embolized under x-ray guidance by using standard clinical catheters and guidewires. Changes in renal artery flow and perfusion were measured before and after embolization by using velocity-encoded and perfusion MR imaging. Catheter navigation times, renal parenchymal perfusion, and renal artery flow rates were measured for MR-guided and x-ray-guided embolization procedures and are presented as means ± standard deviation in this pilot study. Results Embolization was successful in all six kidneys under both x-ray and MR imaging guidance. Mean catheterization time with MR guidance was 93 seconds ± 56, compared with 60 seconds ± 22 for x-ray guidance. Mean changes in perfusion rates were 4.9 au/sec ± 0.8 versus 4.6 au/sec ± 0.6, and mean changes in renal flow rate were 2.1 mL/min/g ± 0.2 versus 1.9 mL/min/g ± 0.2 with MR imaging and x-ray guidance, respectively. Conclusion The MARC catheter system is feasible for renal artery catheterization and embolization under real-time MR imaging in vivo, and quantitative physiologic measures under MR imaging guidance were similar to those measured under x-ray guidance, suggesting that the MARC catheter system could be used for endovascular procedures with interventional MR imaging. (©) RSNA, 2016.

Web-Based Learning for Emergency Airway Management in Anesthesia Residency Training

PubMed Central

Hindle, Ada; Cheng, Ji; Thabane, Lehana; Wong, Anne

2015-01-01

Introduction. Web-based learning (WBL) is increasingly used in medical education; however, residency training programs often lack guidance on its implementation. We describe how the use of feasibility studies can guide the use of WBL in anesthesia residency training. Methods. Two case-based WBL emergency airway management modules were developed for self-directed use by anesthesia residents. The feasibility of using this educational modality was assessed using a single cohort pretest/posttest design. Outcome measures included user recruitment and retention rate, perceptions of educational value, and knowledge improvement. The differences between pre- and postmodule test scores and survey Likert scores were analysed using the paired t test. Results. Recruitment and retention rates were 90% and 65%, respectively. User-friendliness of the modules was rated highly. There was a significant improvement in perceptions of the value of WBL in the postsurvey. There was a significant knowledge improvement of 29% in the postmodule test. Conclusions. Feasibility studies can help guide appropriate use of WBL in curricula. While our study supported the potential feasibility of emergency airway management modules for training, collaboration with other anesthesia residency programs may enable more efficient development, implementation, and evaluation of this resource-intensive modality in anesthesia education and practice. PMID:26788056

Web-Based Learning for Emergency Airway Management in Anesthesia Residency Training.

PubMed

Hindle, Ada; Cheng, Ji; Thabane, Lehana; Wong, Anne

2015-01-01

Introduction. Web-based learning (WBL) is increasingly used in medical education; however, residency training programs often lack guidance on its implementation. We describe how the use of feasibility studies can guide the use of WBL in anesthesia residency training. Methods. Two case-based WBL emergency airway management modules were developed for self-directed use by anesthesia residents. The feasibility of using this educational modality was assessed using a single cohort pretest/posttest design. Outcome measures included user recruitment and retention rate, perceptions of educational value, and knowledge improvement. The differences between pre- and postmodule test scores and survey Likert scores were analysed using the paired t test. Results. Recruitment and retention rates were 90% and 65%, respectively. User-friendliness of the modules was rated highly. There was a significant improvement in perceptions of the value of WBL in the postsurvey. There was a significant knowledge improvement of 29% in the postmodule test. Conclusions. Feasibility studies can help guide appropriate use of WBL in curricula. While our study supported the potential feasibility of emergency airway management modules for training, collaboration with other anesthesia residency programs may enable more efficient development, implementation, and evaluation of this resource-intensive modality in anesthesia education and practice.

Variations in guideline use and practice relating to diagnosis and management of infection in paediatric burns services in England and Wales: A national survey.

PubMed

Davies, Anna; Spickett-Jones, Francesca; Brock, Paula; Coy, Karen; Young, Amber

2017-02-01

Wound infection causes morbidity and mortality in burns. UK National Burns Care Standards state that guidance should be used to diagnose and treat burn wound infection. However, surveys of senior staff about standard operating procedures or guidance in UK burns services indicate that they are infrequently available (Papini et al., 1995; Lymperopoulos et al., 2015). Staff may have differing views and experiences of guidance use according to their role. This survey investigated the extent to which guidance is available, and current practices used for diagnosis and treatment of burn wound infection, both within and between paediatric burns services. Staff from paediatric burns services in England and Wales were individually interviewed by two nurses about guidance and practices around antibiotic prophylaxis, diagnosis and management of burn wound infection and toxic shock syndrome, and antibiotic use. In each service staff from three categories were interviewed: lead consultant/burns specialist nurse, junior doctor/senior nurse, ward based nurse. Data were subjected to content analysis and reliably coded by two researchers using a coding frame. Guidance documents were also requested. Thirteen services took part. Staff in fewer than half of services reported that they had guidance for antibiotic prophylaxis, diagnosis, and management of burn wound infection. In nine services at least one staff member reported that they had guidance for antibiotic use. Guidance was available for diagnosis and management of toxic shock syndrome in ten services, and staff in five were consistently aware of it. One service routinely used antibiotic prophylaxis, but had no written guidance for it. In five services where at least one member of staff reported that they had guidance for diagnosing infection, at least one interviewed staff member was unaware of it. Swabbing practice varied between and within services, with 10 staff across six services cleaning before swabbing, and four staff in three services cleaning after swabbing. Staff from fewer than half of burns services report that they have guidance for diagnosing and managing burn wound infection, and there is variation between and within services relating to staff awareness of available guidance. There are some consistencies in practice; the majority of services do not use antibiotic prophylaxis, and there is consistent prescribing for suspected infection and tests used for infection diagnosis. Swabbing practices are less consistent. This survey indicates a need for evidence-based guidelines to be developed in order to meet national burns care standards, and for staff to be made aware of them and trained in their use. Guidelines do not need to replace clinical judgement and should be developed with the involvement of those who will implement them. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Factors influencing behavior guidance: a survey of practicing pediatric dentists.

PubMed

Juntgen, Laura M; Sanders, Brian J; Walker, Laquia A; Jones, James E; Weddell, James A; Tomlin, Angela M; Eckert, George; Maupome, Gerardo

2013-01-01

The purpose of this study was to identify factors influencing behavior guidance technique utilization among practicing pediatric dentists and explore potential barriers to the incorporation of previously unused techniques. The data for this study were obtained from a web-based survey containing 15 multiple choice questions concerning the practitioners' past, current, and anticipated future behavior guidance technique utilization. Most respondents received hands-on training in 10 of the American Academy of Pediatric Dentistry behavior guidance techniques. The type of training was associated with the practitioners' level of comfort using a given technique upon graduation and with the current frequency of technique utilization. Residency type impacted hands-on behavior guidance training, with 39 percent of respondents reporting no intravenous sedation training. The type of practice was associated with the frequency of behavior guidance technique utilization, as was graduation decade. Currently practicing dentists cited legal concerns, parental acceptance to change, and limited resources as perceived obstacles in the incorporation of new techniques. Behavior guidance technique selection and utilization among practicing pediatric dentists was influenced by multiple factors, including advanced education training, residency type, graduation decade, and practice type. Obstacles to the incorporation of previously unused techniques appear to be multifactorial.

Initial contact guidance during cell spreading is contractility-independent.

PubMed

Sales, Adrià; Holle, Andrew W; Kemkemer, Ralf

2017-08-02

A wide variety of cell types exhibit substrate topography-based behavior, also known as contact guidance. However, the precise cellular mechanisms underlying this process are still unknown. In this study, we investigated contact guidance by studying the reaction of human endothelial cells (ECs) to well-defined microgroove topographies, both during and after initial cell spreading. As the cytoskeleton plays a major role in cellular adaptation to topographical features, two methods were used to perturb cytoskeletal structures. Inhibition of actomyosin contractility with the chemical inhibitor blebbistatatin demonstrated that initial contact guidance events are independent of traction force generation. However, cell alignment to the grooved substrate was altered at later time points, suggesting an initial 'passive' phase of contact guidance, followed by a contractility-dependent 'active' phase that relies on mechanosensitive feedback. The actin cytoskeleton was also perturbed in an indirect manner by culturing cells upside down, resulting in decreased levels of contact guidance and suggesting that a possible loss of contact between the actin cytoskeleton and the substrate could lead to cytoskeleton impairment. The process of contact guidance at the microscale was found to be primarily lamellipodia driven, as no bias in filopodia extension was observed on micron-scale grooves.

Effect-based trigger values for in vitro bioassays: Reading across from existing water quality guideline values.

PubMed

Escher, Beate I; Neale, Peta A; Leusch, Frederic D L

2015-09-15

Cell-based bioassays are becoming increasingly popular in water quality assessment. The new generations of reporter-gene assays are very sensitive and effects are often detected in very clean water types such as drinking water and recycled water. For monitoring applications it is therefore imperative to derive trigger values that differentiate between acceptable and unacceptable effect levels. In this proof-of-concept paper, we propose a statistical method to read directly across from chemical guideline values to trigger values without the need to perform in vitro to in vivo extrapolations. The derivation is based on matching effect concentrations with existing chemical guideline values and filtering out appropriate chemicals that are responsive in the given bioassays at concentrations in the range of the guideline values. To account for the mixture effects of many chemicals acting together in a complex water sample, we propose bioanalytical equivalents that integrate the effects of groups of chemicals with the same mode of action that act in a concentration-additive manner. Statistical distribution methods are proposed to derive a specific effect-based trigger bioanalytical equivalent concentration (EBT-BEQ) for each bioassay of environmental interest that targets receptor-mediated toxicity. Even bioassays that are indicative of the same mode of action have slightly different numeric trigger values due to differences in their inherent sensitivity. The algorithm was applied to 18 cell-based bioassays and 11 provisional effect-based trigger bioanalytical equivalents were derived as an illustrative example using the 349 chemical guideline values protective for human health of the Australian Guidelines for Water Recycling. We illustrate the applicability using the example of a diverse set of water samples including recycled water. Most recycled water samples were compliant with the proposed triggers while wastewater effluent would not have been compliant with a few. The approach is readily adaptable to any water type and guideline or regulatory framework and can be expanded from the protection goal of human health to environmental protection targets. While this work constitutes a proof of principle, the applicability remains limited at present due to insufficient experimental bioassay data on individual regulated chemicals and the derived effect-based trigger values are of course only provisional. Once the experimental database is expanded and made more robust, the proposed effect-based trigger values may provide guidance in a regulatory context. Copyright © 2015 Elsevier Ltd. All rights reserved.

Guidelines for Assessment of Gait and Reference Values for Spatiotemporal Gait Parameters in Older Adults: The Biomathics and Canadian Gait Consortiums Initiative

PubMed Central

Beauchet, Olivier; Allali, Gilles; Sekhon, Harmehr; Verghese, Joe; Guilain, Sylvie; Steinmetz, Jean-Paul; Kressig, Reto W.; Barden, John M.; Szturm, Tony; Launay, Cyrille P.; Grenier, Sébastien; Bherer, Louis; Liu-Ambrose, Teresa; Chester, Vicky L.; Callisaya, Michele L.; Srikanth, Velandai; Léonard, Guillaume; De Cock, Anne-Marie; Sawa, Ryuichi; Duque, Gustavo; Camicioli, Richard; Helbostad, Jorunn L.

2017-01-01

Background: Gait disorders, a highly prevalent condition in older adults, are associated with several adverse health consequences. Gait analysis allows qualitative and quantitative assessments of gait that improves the understanding of mechanisms of gait disorders and the choice of interventions. This manuscript aims (1) to give consensus guidance for clinical and spatiotemporal gait analysis based on the recorded footfalls in older adults aged 65 years and over, and (2) to provide reference values for spatiotemporal gait parameters based on the recorded footfalls in healthy older adults free of cognitive impairment and multi-morbidities. Methods: International experts working in a network of two different consortiums (i.e., Biomathics and Canadian Gait Consortium) participated in this initiative. First, they identified items of standardized information following the usual procedure of formulation of consensus findings. Second, they merged databases including spatiotemporal gait assessments with GAITRite® system and clinical information from the “Gait, cOgnitiOn & Decline” (GOOD) initiative and the Generation 100 (Gen 100) study. Only healthy—free of cognitive impairment and multi-morbidities (i.e., ≤ 3 therapeutics taken daily)—participants aged 65 and older were selected. Age, sex, body mass index, mean values, and coefficients of variation (CoV) of gait parameters were used for the analyses. Results: Standardized systematic assessment of three categories of items, which were demographics and clinical information, and gait characteristics (clinical and spatiotemporal gait analysis based on the recorded footfalls), were selected for the proposed guidelines. Two complementary sets of items were distinguished: a minimal data set and a full data set. In addition, a total of 954 participants (mean age 72.8 ± 4.8 years, 45.8% women) were recruited to establish the reference values. Performance of spatiotemporal gait parameters based on the recorded footfalls declined with increasing age (mean values and CoV) and demonstrated sex differences (mean values). Conclusions: Based on an international multicenter collaboration, we propose consensus guidelines for gait assessment and spatiotemporal gait analysis based on the recorded footfalls, and reference values for healthy older adults. PMID:28824393

Observability-Based Guidance and Sensor Placement

NASA Astrophysics Data System (ADS)

Hinson, Brian T.

Control system performance is highly dependent on the quality of sensor information available. In a growing number of applications, however, the control task must be accomplished with limited sensing capabilities. This thesis addresses these types of problems from a control-theoretic point-of-view, leveraging system nonlinearities to improve sensing performance. Using measures of observability as an information quality metric, guidance trajectories and sensor distributions are designed to improve the quality of sensor information. An observability-based sensor placement algorithm is developed to compute optimal sensor configurations for a general nonlinear system. The algorithm utilizes a simulation of the nonlinear system as the source of input data, and convex optimization provides a scalable solution method. The sensor placement algorithm is applied to a study of gyroscopic sensing in insect wings. The sensor placement algorithm reveals information-rich areas on flexible insect wings, and a comparison to biological data suggests that insect wings are capable of acting as gyroscopic sensors. An observability-based guidance framework is developed for robotic navigation with limited inertial sensing. Guidance trajectories and algorithms are developed for range-only and bearing-only navigation that improve navigation accuracy. Simulations and experiments with an underwater vehicle demonstrate that the observability measure allows tuning of the navigation uncertainty.

A open loop guidance architecture for navigationally robust on-orbit docking

NASA Technical Reports Server (NTRS)

Chern, Hung-Sheng

1995-01-01

The development of an open-hop guidance architecture is outlined for autonomous rendezvous and docking (AR&D) missions to determine whether the Global Positioning System (GPS) can be used in place of optical sensors for relative initial position determination of the chase vehicle. Feasible command trajectories for one, two, and three impulse AR&D maneuvers are determined using constrained trajectory optimization. Early AR&D command trajectory results suggest that docking accuracies are most sensitive to vertical position errors at the initial conduction of the chase vehicle. Thus, a feasible command trajectory is based on maximizing the size of the locus of initial vertical positions for which a fixed sequence of impulses will translate the chase vehicle into the target while satisfying docking accuracy requirements. Documented accuracies are used to determine whether relative GPS can achieve the vertical position error requirements of the impulsive command trajectories. Preliminary development of a thruster management system for the Cargo Transfer Vehicle (CTV) based on optimal throttle settings is presented to complete the guidance architecture. Results show that a guidance architecture based on a two impulse maneuvers generated the best performance in terms of initial position error and total velocity change for the chase vehicle.

A mapping review of international guidance on the management and care of amyotrophic lateral sclerosis (ALS).

PubMed

Janssens, Astrid I W A; Ruytings, Marijke; Al-Chalabi, Ammar; Chio, Adriano; Hardiman, Orla; Mcdermott, Christopher J; Meyer, Thomas; Mora, Gabriele; Van Damme, Philip; Van Den Berg, Leonard H; Vanhaecht, Kris; Winkler, Andrea S; Sermeus, Walter

2016-01-01

Management of ALS is suboptimal. Consequently, quality improvement interventions are needed to improve ALS care. An evidence-based insight into how patients should be managed is essential when developing quality improvement interventions. Therefore, this study aimed to map, categorize and summarize international guidance on the management and care of ALS and to identify gaps in this guidance by means of a mapping review. Literature was searched for clinical practice guidelines, quality indicators and evidence-based clinical summaries. A content analysis and meta-synthesis of the included literature was performed. Interventions and outcomes used in the management and care of ALS were identified and categorized. Furthermore, the amount of guidance underpinning these interventions and outcomes was analysed. Six clinical practice guidelines, one set of quality indicators and three evidence-based clinical summaries were identified. The results demonstrated that certain domains in ALS care, mainly disease-specific domains such as breathing and swallowing, are extensively addressed in the literature whereas other subjects, such as care coordination, receive little attention. In conclusion, this mapping review provides a scientific basis for targeting and developing the clinical content of a quality improvement intervention for the management of ALS.

Is goal-directed attentional guidance just intertrial priming? A review.

PubMed

Lamy, Dominique F; Kristjánsson, Arni

2013-07-01

According to most models of selective visual attention, our goals at any given moment and saliency in the visual field determine attentional priority. But selection is not carried out in isolation--we typically track objects through space and time. This is not well captured within the distinction between goal-directed and saliency-based attentional guidance. Recent studies have shown that selection is strongly facilitated when the characteristics of the objects to be attended and of those to be ignored remain constant between consecutive selections. These studies have generated the proposal that goal-directed or top-down effects are best understood as intertrial priming effects. Here, we provide a detailed overview and critical appraisal of the arguments, experimental strategies, and findings that have been used to promote this idea, along with a review of studies providing potential counterarguments. We divide this review according to different types of attentional control settings that observers are thought to adopt during visual search: feature-based settings, dimension-based settings, and singleton detection mode. We conclude that priming accounts for considerable portions of effects attributed to top-down guidance, but that top-down guidance can be independent of intertrial priming.

Geometrically confined ultrasmall gadolinium oxide nanoparticles boost the T1 contrast ability

NASA Astrophysics Data System (ADS)

Ni, Kaiyuan; Zhao, Zhenghuan; Zhang, Zongjun; Zhou, Zijian; Yang, Li; Wang, Lirong; Ai, Hua; Gao, Jinhao

2016-02-01

High-performance magnetic resonance imaging (MRI) contrast agents and novel contrast enhancement strategies are urgently needed for sensitive and accurate diagnosis. Here we report a strategy to construct a new T1 contrast agent based on the Solomon-Bloembergen-Morgan (SBM) theory. We loaded the ultrasmall gadolinium oxide nanoparticles into worm-like interior channels of mesoporous silica nanospheres (Gd2O3@MSN nanocomposites). This unique structure endows the nanocomposites with geometrical confinement, high molecular tumbling time, and a large coordinated number of water molecules, which results in a significant enhancement of the T1 contrast with longitudinal proton relaxivity (r1) as high as 45.08 mM-1 s-1. Such a high r1 value of Gd2O3@MSN, compared to those of ultrasmall Gd2O3 nanoparticles and gadolinium-based clinical contrast agents, is mainly attributed to the strong geometrical confinement effect. This strategy provides new guidance for developing various high-performance T1 contrast agents for sensitive imaging and disease diagnosis.High-performance magnetic resonance imaging (MRI) contrast agents and novel contrast enhancement strategies are urgently needed for sensitive and accurate diagnosis. Here we report a strategy to construct a new T1 contrast agent based on the Solomon-Bloembergen-Morgan (SBM) theory. We loaded the ultrasmall gadolinium oxide nanoparticles into worm-like interior channels of mesoporous silica nanospheres (Gd2O3@MSN nanocomposites). This unique structure endows the nanocomposites with geometrical confinement, high molecular tumbling time, and a large coordinated number of water molecules, which results in a significant enhancement of the T1 contrast with longitudinal proton relaxivity (r1) as high as 45.08 mM-1 s-1. Such a high r1 value of Gd2O3@MSN, compared to those of ultrasmall Gd2O3 nanoparticles and gadolinium-based clinical contrast agents, is mainly attributed to the strong geometrical confinement effect. This strategy provides new guidance for developing various high-performance T1 contrast agents for sensitive imaging and disease diagnosis. Electronic supplementary information (ESI) available: Supplementary Fig. S1-S6. See DOI: 10.1039/c5nr08402d

Twelve recommendations for integrating existing systematic reviews into new reviews: EPC guidance.

PubMed

Robinson, Karen A; Chou, Roger; Berkman, Nancy D; Newberry, Sydne J; Fu, Rongwei; Hartling, Lisa; Dryden, Donna; Butler, Mary; Foisy, Michelle; Anderson, Johanna; Motu'apuaka, Makalapua; Relevo, Rose; Guise, Jeanne-Marie; Chang, Stephanie

2016-02-01

As time and cost constraints in the conduct of systematic reviews increase, the need to consider the use of existing systematic reviews also increases. We developed guidance on the integration of systematic reviews into new reviews. A workgroup of methodologists from Evidence-based Practice Centers developed consensus-based recommendations. Discussions were informed by a literature scan and by interviews with organizations that conduct systematic reviews. Twelve recommendations were developed addressing selecting reviews, assessing risk of bias, qualitative and quantitative synthesis, and summarizing and assessing body of evidence. We provide preliminary guidance for an efficient and unbiased approach to integrating existing systematic reviews with primary studies in a new review. Copyright © 2016 Elsevier Inc. All rights reserved.

Object-based target templates guide attention during visual search.

PubMed

Berggren, Nick; Eimer, Martin

2018-05-03

During visual search, attention is believed to be controlled in a strictly feature-based fashion, without any guidance by object-based target representations. To challenge this received view, we measured electrophysiological markers of attentional selection (N2pc component) and working memory (sustained posterior contralateral negativity; SPCN) in search tasks where two possible targets were defined by feature conjunctions (e.g., blue circles and green squares). Critically, some search displays also contained nontargets with two target features (incorrect conjunction objects, e.g., blue squares). Because feature-based guidance cannot distinguish these objects from targets, any selective bias for targets will reflect object-based attentional control. In Experiment 1, where search displays always contained only one object with target-matching features, targets and incorrect conjunction objects elicited identical N2pc and SPCN components, demonstrating that attentional guidance was entirely feature-based. In Experiment 2, where targets and incorrect conjunction objects could appear in the same display, clear evidence for object-based attentional control was found. The target N2pc became larger than the N2pc to incorrect conjunction objects from 250 ms poststimulus, and only targets elicited SPCN components. This demonstrates that after an initial feature-based guidance phase, object-based templates are activated when they are required to distinguish target and nontarget objects. These templates modulate visual processing and control access to working memory, and their activation may coincide with the start of feature integration processes. Results also suggest that while multiple feature templates can be activated concurrently, only a single object-based target template can guide attention at any given time. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Application and assessment of a regular environmental monitoring of the antineoplastic drug contamination level in pharmacies - the MEWIP project.

PubMed

Kiffmeyer, Thekla K; Tuerk, Jochen; Hahn, Moritz; Stuetzer, Hartmut; Hadtstein, Claudia; Heinemann, André; Eickmann, Udo

2013-05-01

A large-scale study was carried out in order to determine the contamination level of antineoplastic drugs in pharmacies and to investigate the suitability and effects of wipe sample monitoring at regular intervals. A specific study design was developed. The 130 participating pharmacies were divided into a study and a control group, carrying out five and two wipe sampling cycles, respectively. The work practice was analyzed using questionnaires to identify factors that influence the contamination level. From 1269 wipe samples, 774 (61%) were contaminated with at least one of the analyzed cytotoxic drugs: cyclophosphamide, docetaxel, etoposide, 5-fluorouracil, gemcitabine, ifosfamide, methotrexate, and paclitaxel. A significant decrease of the contamination with cyclophosphamide and 5-fluorouracil was observed in the study group. The Monitoring-Effect Study of Wipe Sampling in Pharmacies method has proven to be a reliable and affordable tool for contamination control. Based on the 90th percentile of the contamination values, a substance-independent performance-based guidance value of 0.1ng cm(-2) has been derived.

Development of guidance laws for a variable-speed missile

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

Gazit, R.; Gutman, S.

1991-05-01

The most used guidance law for short-range homing missiles is proportional navigation (PN). In PN, the acceleration command is proportional to the line-of-sight (LOS) angular velocity. Indeed, if a missile and a target move on a collision course with constant speeds, the LOS rate is zero. The speed of a highly maneuverable modern missile varies considerably during flight. The performance of PN is far from being satisfactory in that case. In this article the collision course for a variable-speed missile is analyzed and a guidance law that steers the heading of the missile to the collision course is defined. Guidancemore » laws based on optimal control and differential game formulations are developed, and note that both optimal laws coincide with the Guidance to Collision law at impact. The performance improvement of the missile using the new guidance law as compared to PN is demonstrated. 19 refs.« less

A novel guidance law using fast terminal sliding mode control with impact angle constraints.

PubMed

Sun, Lianghua; Wang, Weihong; Yi, Ran; Xiong, Shaofeng

2016-09-01

This paper is concerned with the question of, for a missile interception with impact angle constraints, how to design a guidance law. Firstly, missile interception with impact angle constraints is modeled; secondly, a novel guidance law using fast terminal sliding mode control based on extended state observer is proposed to optimize the trajectory and time of interception; finally, for stationary targets, constant velocity targets and maneuvering targets, the guidance law and the stability of the closed loop system is analyzed and the stability of the closed loop system is analyzed, respectively. Simulation results show that when missile and target are on a collision course, the novel guidance law using fast terminal sliding mode control with extended state observer has more optimized trajectory and effectively reduces the time of interception which has a great significance in modern warfare. Copyright © 2016 ISA. Published by Elsevier Ltd. All rights reserved.

GUIDANCE ON SELECTING AGE GROUPS FOR MONITORING AND ASSESSING CHILDHOOD EXPOSURES TO ENVIRONMENTAL CONTAMINANTS

EPA Science Inventory

This guidance document provides a set of early-lifestage age groups for Environmental Protection Agency scientists to consider when assessing children’s exposure to environmental contaminants and the resultant potential dose. These recommended age groups are based on current und...

Community-Based Career Guidance Practices. Vol. III--Postsecondary Level.

ERIC Educational Resources Information Center

Manatee Junior Coll., Bradenton, FL.

This collection of sixty postsecondary-level career guidance practices contains the following nine types of activities: novel practices such as games and role enactment, volunteering, field trips, special career emphases, intern/extern practices, work experience and exploration practices, exchanges, mobile practices, and educator inservices. A…

A Multi-level Fuzzy Evaluation Method for Smart Distribution Network Based on Entropy Weight

NASA Astrophysics Data System (ADS)

Li, Jianfang; Song, Xiaohui; Gao, Fei; Zhang, Yu

2017-05-01

Smart distribution network is considered as the future trend of distribution network. In order to comprehensive evaluate smart distribution construction level and give guidance to the practice of smart distribution construction, a multi-level fuzzy evaluation method based on entropy weight is proposed. Firstly, focus on both the conventional characteristics of distribution network and new characteristics of smart distribution network such as self-healing and interaction, a multi-level evaluation index system which contains power supply capability, power quality, economy, reliability and interaction is established. Then, a combination weighting method based on Delphi method and entropy weight method is put forward, which take into account not only the importance of the evaluation index in the experts’ subjective view, but also the objective and different information from the index values. Thirdly, a multi-level evaluation method based on fuzzy theory is put forward. Lastly, an example is conducted based on the statistical data of some cites’ distribution network and the evaluation method is proved effective and rational.

Evaluation of all African clinical practice guidelines for hypertension: Quality and opportunities for improvement.

PubMed

Okwen, Patrick Mbah; Maweu, Irene; Grimmer, Karen; Margarita Dizon, Janine

2018-06-14

Good-quality clinical practice guidelines (CPGs) provide recommendations based on current best-evidence summaries. Hypertension is a prevalent noncommunicable disease in Africa, with disastrous sequelae (stroke, heart, and kidney disease). Its effective management relies on good quality, current, locally relevant evidence. This paper reports on an all African review of the guidance documents currently informing hypertension management. Attempts were made to contact 62 African countries for formal guidance documents used nationally to inform diagnosis and management of hypertension. Their quality was assessed by using Appraisal of Guidelines for Research & Evaluation (AGREE) II, scored by 2 independent reviewers. Differences in domain scores were compared between documents written prior to 2011 and 2011 onward. Findings were compared with earlier African CPG reviews. Guidelines and protocols were provided by 26 countries. Six used country-specific stand-alone hypertension guidelines, and 10 used protocols embedded in Standard Treatment Guidelines for multiple conditions. Six used guidelines developed by the World Health Organization, and 4 indicated ad hoc use of international guidance (US, Portugal, and Brazil). Only 1 guidance document met CPG construction criteria, and none scored well on all AGREE domain scores. The lowest-scoring domain was rigour of development. There was no significant quality difference between pre-2011 and post-2011 guidance documents, and there were variable AGREE II scores for the same CPGs when comparing the African reviews. The quality of hypertension guidance used by African nations could be improved. The need for so many guidance documents is questioned. Adopting a common evidence base from international good-quality CPGs and layering it with local contexts offer 1 way to efficiently improve African hypertension CPG quality and implementation. © 2018 John Wiley & Sons, Ltd.

UPMC's blueprint for BuILDing a high-value health care system.

PubMed

Keyser, Donna; Kogan, Jane; McGowan, Marion; Peele, Pamela; Holder, Diane; Shrank, William

2018-03-30

National-level demonstration projects and real-world studies continue to inform health care transformation efforts and catalyze implementation of value-based service delivery and payment models, though evidence generation and diffusion of learnings often occurs at a relatively slow pace. Rapid-cycle learning models, however, can help individual organizations to more quickly adapt health care innovations to meet the challenges and demands of a rapidly changing health care landscape. Integrated delivery and financing systems (IDFSs) offer a unique platform for rapid-cycle learning and innovation. Since both the provider and payer benefit from delivering care that enhances the patient experience, improves quality, and reduces cost, incentives are aligned to experiment with value-based models, enhance learning about what works and why, and contribute to solutions that can accelerate transformation. In this article, we describe how the UPMC Insurance Services Division, as part of a large IDFS, uses its Business, Innovation, Learning, and Dissemination (BuILD) model to prioritize, design, test, and refine health care innovations and accelerate learning. We provide examples of how the BuILD model offers an approach for quickly assessing the impact and value of health care transformation efforts. Lessons learned through the BuILD process will offer insights and guidance for a wide range of stakeholders whether an IDFS or independent payer-provider collaborators. Copyright © 2018 Elsevier Inc. All rights reserved.

Cardiovascular medicine at face value: a qualitative pilot study on clinical axiology.

PubMed

de Hoyos, Adalberto; Nava-Diosdado, Rodrigo; Mendez, Jorge; Ricco, Sergio; Serrano, Ana; Flores Cisneros, Carmen; Macías-Ojeda, Carlos; Cisneros, Héctor; Bialostozky, David; Altamirano-Bustamante, Nelly; Altamirano-Bustamante, Myriam M

2013-03-27

Cardiology is characterized by its state-of-the-art biomedical technology and the predominance of Evidence-Based Medicine. This predominance makes it difficult for healthcare professionals to deal with the ethical dilemmas that emerge in this subspecialty. This paper is a first endeavor to empirically investigate the axiological foundations of the healthcare professionals in a cardiology hospital. Our pilot study selected, as the target population, cardiology personnel not only because of their difficult ethical deliberations but also because of the stringent conditions in which they have to make them. Therefore, there is an urgent need to reconsider clinical ethics and Value-Based Medicine. This study proposes a qualitative analysis of the values and the virtues of healthcare professionals in a cardiology hospital in order to establish how the former impact upon the medical and ethical decisions made by the latter. We point out the need for strengthening the roles of healthcare personnel as educators and guidance counselors in order to meet the ends of medicine, as well as the need for an ethical discernment that is compatible with our results, namely, that the ethical values developed by healthcare professionals stem from their life history as well as their professional education. We establish the kind of actions, communication skills and empathy that are required to build a stronger patient-healthcare professional relationship, which at the same time improves prognosis, treatment efficiency and therapeutic adhesion.

The confusing world of dietary sugars: definitions, intakes, food sources and international dietary recommendations.

PubMed

Hess, Jennifer; Latulippe, Marie E; Ayoob, Keith; Slavin, Joanne

2012-05-01

Government and health organizations worldwide have issued dietary guidelines for sugars. These guidelines vary considerably in the recommended or suggested intakes and the types of sugars specified. Despite access to the same published literature, recommendations vary greatly and create confusion for nutrition practitioners who offer dietary guidance. Some of the confusion in this field is linked to differences in definitions for sugar and methods to measure total sugars. Additionally, although dietary guidance typically recommends foods high in sugar, fruits and dairy products, other advice suggests strict limits on intake of "added sugar". Added sugar cannot be analytically determined and must be calculated so nutrient databases generally contain values for total sugar and do not differentiate between sugars naturally occurring in foods and those added in processing. This review defines sugars, provides the sugar content of major food sources, summarizes health concerns about dietary sugars, and compiles dietary guidelines for sugars issued by various organizations. Dietary recommendations from various health organizations are based on different means of assessment, and thus vary considerably. In general, the use of added sugars is cautioned, especially when it contributes to calories in excess of needs for an individual.

Energy management of three-dimensional minimum-time intercept. [for aircraft flight optimization

NASA Technical Reports Server (NTRS)

Kelley, H. J.; Cliff, E. M.; Visser, H. G.

1985-01-01

A real-time computer algorithm to control and optimize aircraft flight profiles is described and applied to a three-dimensional minimum-time intercept mission. The proposed scheme has roots in two well known techniques: singular perturbations and neighboring-optimal guidance. Use of singular-perturbation ideas is made in terms of the assumed trajectory-family structure. A heading/energy family of prestored point-mass-model state-Euler solutions is used as the baseline in this scheme. The next step is to generate a near-optimal guidance law that will transfer the aircraft to the vicinity of this reference family. The control commands fed to the autopilot (bank angle and load factor) consist of the reference controls plus correction terms which are linear combinations of the altitude and path-angle deviations from reference values, weighted by a set of precalculated gains. In this respect the proposed scheme resembles neighboring-optimal guidance. However, in contrast to the neighboring-optimal guidance scheme, the reference control and state variables as well as the feedback gains are stored as functions of energy and heading in the present approach. Some numerical results comparing open-loop optimal and approximate feedback solutions are presented.

Some data processing requirements for precision Nap-Of-the-Earth (NOE) guidance and control of rotorcraft

NASA Technical Reports Server (NTRS)

Clement, Warren F.; Mcruer, Duane T.; Magdeleno, Raymond E.

1987-01-01

Nap-Of-the-Earth (NOE) flight in a conventional helicopter is extremely taxing for two pilots under visual conditions. Developing a single pilot all-weather NOE capability will require a fully automatic NOE navigation and flight control capability for which innovative guidance and control concepts were examined. Constrained time-optimality provides a validated criterion for automatically controlled NOE maneuvers if the pilot is to have confidence in the automated maneuvering technique. A second focus was to organize the storage and real-time updating of NOE terrain profiles and obstacles in course-oriented coordinates indexed to the mission flight plan. A method is presented for using pre-flight geodetic parameter identification to establish guidance commands for planned flight profiles and alternates. A method is then suggested for interpolating this guidance command information with the aid of forward and side looking sensors within the resolution of the stored data base, enriching the data content with real-time display, guidance, and control purposes. A third focus defined a class of automatic anticipative guidance algorithms and necessary data preview requirements to follow the vertical, lateral, and longitudinal guidance commands dictated by the updated flight profiles and to address the effects of processing delays in digital guidance and control system candidates. The results of this three-fold research effort offer promising alternatives designed to gain pilot acceptance for automatic guidance and control of rotorcraft in NOE operations.

Nice Work if You Can Get Them To Do It.

ERIC Educational Resources Information Center

Fish, Stanley

2000-01-01

Discusses the value for administrators of guidance offered by (1) the tenets of poststructuralism; (2) the book "An Uncertain Glory: Letters of Cautious but Sound Advice to Stanley, a Dean-in-Waiting"; and (3) Machiavelli's "Il Principe." (NH)

Futureprint Counseling Design.

ERIC Educational Resources Information Center

Guillen, Mary A.

A junior high school level program combines reading instruction with guidance counseling. Students become aware of their personal dignity, worth, and responsibility. An introduction to the rationale of classroom counseling precedes 6 sections of course materials and techniques. A section on values clarification contains exercises examining…

7 CFR 4279.144 - Appraisals.

Code of Federal Regulations, 2010 CFR

2010-01-01

... value of the collateral. For additional guidance and information concerning the completion of real... Questionnaire” and “Phase I Environmental Site Assessment,” both published by the American Society of Testing... Regulations of the Department of Agriculture (Continued) RURAL BUSINESS-COOPERATIVE SERVICE AND RURAL...

Structuring modeling and simulation analysis for evacuation planning and operations.

DOT National Transportation Integrated Search

2009-06-01

This document is intended to provide guidance to decision-makers at agencies and jurisdictions considering the role of analytical tools in evacuation planning and operations. It is often unclear what kind of analytical approach may be of most value, ...

Added Value of Contrast-Enhanced Ultrasound on Biopsies of Focal Hepatic Lesions Invisible on Fusion Imaging Guidance.

PubMed

Kang, Tae Wook; Lee, Min Woo; Song, Kyoung Doo; Kim, Mimi; Kim, Seung Soo; Kim, Seong Hyun; Ha, Sang Yun

2017-01-01

To assess whether contrast-enhanced ultrasonography (CEUS) with Sonazoid can improve the lesion conspicuity and feasibility of percutaneous biopsies for focal hepatic lesions invisible on fusion imaging of real-time ultrasonography (US) with computed tomography/magnetic resonance images, and evaluate its impact on clinical decision making. The Institutional Review Board approved this retrospective study. Between June 2013 and January 2015, 711 US-guided percutaneous biopsies were performed for focal hepatic lesions. Biopsies were performed using CEUS for guidance if lesions were invisible on fusion imaging. We retrospectively evaluated the number of target lesions initially invisible on fusion imaging that became visible after applying CEUS, using a 4-point scale. Technical success rates of biopsies were evaluated based on histopathological results. In addition, the occurrence of changes in clinical decision making was assessed. Among 711 patients, 16 patients (2.3%) were included in the study. The median size of target lesions was 1.1 cm (range, 0.5-1.9 cm) in pre-procedural imaging. After CEUS, 15 of 16 (93.8%) focal hepatic lesions were visualized. The conspicuity score was significantly increased after adding CEUS, as compared to that on fusion imaging (p < 0.001). The technical success rate of biopsy was 87.6% (14/16). After biopsy, there were changes in clinical decision making for 11 of 16 patients (68.8%). The addition of CEUS could improve the conspicuity of focal hepatic lesions invisible on fusion imaging. This dual guidance using CEUS and fusion imaging may affect patient management via changes in clinical decision-making.

Cycle water chemistry based on film forming amines at power plants: evaluation of technical guidance documents

NASA Astrophysics Data System (ADS)

Dyachenko, F. V.; Petrova, T. I.

2017-11-01

Efficiency and reliability of the equipment in fossil power plants as well as in combined cycle power plants depend on the corrosion processes and deposit formation in steam/water circuit. In order to decrease these processes different water chemistries are used. Today the great attention is being attracted to the application of film forming amines and film forming amine products. The International Association for the Properties of Water and Steam (IAPWS) consolidated the information from all over the World, and based on the research studies and operating experience of researchers and engineers from 21 countries, developed and authorized the Technical Guidance Document: “Application of Film Forming Amines in Fossil, Combined Cycle, and Biomass Power Plants” in 2016. This article describe Russian and International technical guidance documents for the cycle water chemistries based on film forming amines at fossil and combined cycle power plants.

Using patient values and preferences to inform the importance of health outcomes in practice guideline development following the GRADE approach.

PubMed

Zhang, Yuan; Coello, Pablo Alonso; Brożek, Jan; Wiercioch, Wojtek; Etxeandia-Ikobaltzeta, Itziar; Akl, Elie A; Meerpohl, Joerg J; Alhazzani, Waleed; Carrasco-Labra, Alonso; Morgan, Rebecca L; Mustafa, Reem A; Riva, John J; Moore, Ainsley; Yepes-Nuñez, Juan José; Cuello-Garcia, Carlos; AlRayees, Zulfa; Manja, Veena; Falavigna, Maicon; Neumann, Ignacio; Brignardello-Petersen, Romina; Santesso, Nancy; Rochwerg, Bram; Darzi, Andrea; Rojas, Maria Ximena; Adi, Yaser; Bollig, Claudia; Waziry, Reem; Schünemann, Holger J

2017-05-02

There are diverse opinions and confusion about defining and including patient values and preferences (i.e. the importance people place on the health outcomes) in the guideline development processes. This article aims to provide an overview of a process for systematically incorporating values and preferences in guideline development. In 2013 and 2014, we followed the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to adopt, adapt and develop 226 recommendations in 22 guidelines for the Ministry of Health of the Kingdom of Saudi Arabia. To collect context-specific values and preferences for each recommendation, we performed systematic reviews, asked clinical experts to provide feedback according to their clinical experience, and consulted patient representatives. We found several types of studies addressing the importance of outcomes, including those reporting utilities, non-utility measures of health states based on structured questionnaires or scales, and qualitative studies. Guideline panels used the relative importance of outcomes based on values and preferences to weigh the balance of desirable and undesirable consequences of alternative intervention options. However, we found few studies addressing local values and preferences. Currently there are different but no firmly established processes for integrating patient values and preferences in healthcare decision-making of practice guideline development. With GRADE Evidence-to-Decision (EtD) frameworks, we provide an empirical strategy to find and incorporate values and preferences in guidelines by performing systematic reviews and eliciting information from guideline panel members and patient representatives. However, more research and practical guidance are needed on how to search for relevant studies and grey literature, assess the certainty of this evidence, and best summarize and present the findings.

MADM-based smart parking guidance algorithm

PubMed Central

Li, Bo; Pei, Yijian; Wu, Hao; Huang, Dijiang

2017-01-01

In smart parking environments, how to choose suitable parking facilities with various attributes to satisfy certain criteria is an important decision issue. Based on the multiple attributes decision making (MADM) theory, this study proposed a smart parking guidance algorithm by considering three representative decision factors (i.e., walk duration, parking fee, and the number of vacant parking spaces) and various preferences of drivers. In this paper, the expected number of vacant parking spaces is regarded as an important attribute to reflect the difficulty degree of finding available parking spaces, and a queueing theory-based theoretical method was proposed to estimate this expected number for candidate parking facilities with different capacities, arrival rates, and service rates. The effectiveness of the MADM-based parking guidance algorithm was investigated and compared with a blind search-based approach in comprehensive scenarios with various distributions of parking facilities, traffic intensities, and user preferences. Experimental results show that the proposed MADM-based algorithm is effective to choose suitable parking resources to satisfy users’ preferences. Furthermore, it has also been observed that this newly proposed Markov Chain-based availability attribute is more effective to represent the availability of parking spaces than the arrival rate-based availability attribute proposed in existing research. PMID:29236698

Developing a vision and strategic action plan for future community-based residency training.

PubMed

Skelton, Jann B; Owen, James A

2016-01-01

The Community Pharmacy Residency Program (CPRP) Planning Committee convened to develop a vision and a strategic action plan for the advancement of community pharmacy residency training. Aligned with the profession's efforts to achieve provider status and expand access to care, the Future Vision and Action Plan for Community-based Residency Training will provide guidance, direction, and a strategic action plan for community-based residency training to ensure that the future needs of community-based pharmacist practitioners are met. National thought leaders, selected because of their leadership in pharmacy practice, academia, and residency training, served on the planning committee. The committee conducted a series of conference calls and an in-person strategic planning meeting held on January 13-14, 2015. Outcomes from the discussions were supplemented with related information from the literature. Results of a survey of CPRP directors and preceptors also informed the planning process. The vision and strategic action plan for community-based residency training is intended to advance training to meet the emerging needs of patients in communities that are served by the pharmacy profession. The group anticipated the advanced skills required of pharmacists serving as community-based pharmacist practitioners and the likely education, training and competencies required by future residency graduates in order to deliver these services. The vision reflects a transformation of community residency training, from CPRPs to community-based residency training, and embodies the concept that residency training should be primarily focused on training the individual pharmacist practitioner based on the needs of patients served within the community, and not on the physical location where pharmacy services are provided. The development of a vision statement, core values statements, and strategic action plan will provide support, guidance, and direction to the profession of pharmacy to continue the advancement and expansion of community-based residency training. Published by Elsevier Inc.

76 FR 46819 - Agency Information Collection Activities; Proposed Collection; Comment Request; Guidance for...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-03

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No.FDA-2011-N-0535] Agency Information Collection Activities; Proposed Collection; Comment Request; Guidance for Industry: Notification of a Health Claim or Nutrient Content Claim Based on an Authoritative Statement of a Scientific...

The Dance of Elementary School Classroom Management

ERIC Educational Resources Information Center

Powell, Pamela

2014-01-01

At times, classroom management and guidance elude even the most seasoned teachers. Yet, students need guidance and practice in self-regulatory skills to assist in the learning that occurs in classrooms. Teachers need both practical and research-based classroom management strategies that benefit the environment and help create a space conducive to…

Automated Guidance for Thermodynamics Essays: Critiquing versus Revisiting

ERIC Educational Resources Information Center

Donnelly, Dermot F.; Vitale, Jonathan M.; Linn, Marcia C.

2015-01-01

Middle school students struggle to explain thermodynamics concepts. In this study, to help students succeed, we use a natural language processing program to analyze their essays explaining the aspects of thermodynamics and provide guidance based on the automated score. The 346 sixth-grade students were assigned to either the critique condition…

THE ROLE OF GUIDANCE SERVICES IN COMMUNITY ACTION PROGRAMS COMBATING POVERTY.

ERIC Educational Resources Information Center

GUIDANCE OBJECTIVES TO BE INCLUDED IN A COMMUNITY ACTION PROGRAM COMBATING PROVERTY ARE PRESENTED. THE OBJECTIVES INCLUDE EARLY ADJUSTMENT OF STUDENTS, EARLY IDENTIFICATION AND INTERPRETATION OF ABILITIES, EDUCATIONAL AND CAREER PLANS BASED ON ABILITIES AND SKILLS, PARENT UNDERSTANDING OF OPPORTUNITIES, ENCOURAGEMENT OF REALISTIC GOALS IN LINE…

77 FR 3779 - Guidance for Industry on Product Name Placement, Size, and Prominence in Advertising and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-25

...), broadcast media promotion (e.g., television advertisements, radio advertisements), and electronic and computer-based promotional labeling and advertisements, such as Internet promotion, social media, emails... guidance pertain to product names in traditional print media promotion (e.g., journal ads, detail aids...

Radon Reduction Techniques in Schools: Interim Technical Guidance.

ERIC Educational Resources Information Center

Environmental Protection Agency, Washington, DC.

This technical document is intended to assist school facilities maintenance personnel in the selection, design, and operation of radon reduction systems in schools. The guidance contained in this document is based largely on research conducted in 1987 and 1988 in schools located in Maryland and Virginia. Researchers from the United States…

Community-Based Career Guidance Practices. Vol. II--Secondary Level.

ERIC Educational Resources Information Center

Manatee Junior Coll., Bradenton, FL.

This collection of eighty-six secondary level career guidance practices contains the following nine types of activities: novel practices such as games and role enactments, volunteering, field trips, special career emphases, intern/extern practices, work experience and exploration practices, exchanges, mobile practices, and educator in-services. A…

Prevention and management of foot problems in diabetes: A Summary Guidance for Daily Practice 2015, based on the IWGDF guidance documents.

PubMed

Schaper, N C; Van Netten, J J; Apelqvist, J; Lipsky, B A; Bakker, K

2017-02-01

Foot problems complicating diabetes are a source of major patient suffering and societal costs. To prevent, or at least reduce, the adverse effects of foot problems in diabetes, the International Working Group on the Diabetic Foot (IWGDF; www.iwgdf.org) was founded in 1996, consisting of experts from almost all the disciplines involved in the care of patients with diabetes and foot problems. An important output of the IWGDF is the international consensus guidance, continuously updated since 1999. To date, the publications have been translated into 26 languages, and more than 100,000 copies have been distributed globally. The "Summary Guidance for Daily Practice" summarises the essentials of prevention and management of foot problems in persons with diabetes for clinicians who work with these patients on a daily basis. This guidance is the result of a long and careful process that started with the empaneling in 2013 of five working groups consisting of 49 international experts. These experts performed seven targeted systematic reviews to provide the evidence supporting the five chapters of the IWGDF Guidance on prevention; footwear and offloading; diagnosis, prognosis and management of peripheral artery disease; diagnosis and management of foot infections; interventions to enhance healing. In total almost 80,000 studies were detected by our literature review. After review of the title and abstract the reviewers of the different working groups selected only studies that fulfilled a minimal set of quality criteria and ended up with 429 articles for complete quality analysis. The GRADE system was used to translate the evidence from the studies into recommendations for daily clinical practice. The rating of each recommendation takes into account both the strength and the quality of the evidence. The IWGDF Guidance 2015 makes a total of 77 recommendations on prevention and management of foot problems in diabetes. These recommendations were condensed by the editorial board into this "Summary Guidance". Encouraging and aiding clinicians to follow the evidence-based recommendations of the IWGDF Guidance 2015, and in particular the principles outlined in the "Summary Guidance", will likely result in a worldwide reduction in, and better outcomes of, foot problems in persons with diabetes, helping to reduce the morbidity and mortality associated with this major health problem. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Ready! Aim! Fire! targeting the right medical science journal.

PubMed

Hardman, Timothy C; Serginson, James M

2017-09-01

Inadvertently submitting a paper to a journal that is unlikely to publish it is a waste of resources and ultimately delays dissemination of one's research. A high proportion of manuscripts are rejected by their author's first-choice journal. The aim of the present work was to review guidance provided within the literature for journal selection that might minimize the chance of manuscript rejection. We also consider papers that encompass more than one main medical science and describe the selection process that we used with a paper that was published in Cardiovascular Endocrinology . A database search (Embase, PubMed and Medworm) was performed for all articles published in the scientific literature providing guidance on journal selection. Articles were identified that either had journal selection as their principal topic or included journal selection as part of a broader discussion of publishing. The relative performance of four free-to-use, web-based applications that claim to provide guidance on journal selection was compared. The searches identified 286 hits, of which 249 were in English. Of these papers, 16 discussed journal selection and a further 10 articles were identified from citations within the original 16 articles. Only one article described a comprehensive model for submission decision-making. Identification of appropriate candidate journals by various web-based applications was erratic, with the Jane database providing the most robust suggestions. Our work suggests that little attention has been focused in the scientific literature on the mechanisms that authors use to select a journal for their work. Nevertheless, scientists for the most part seem to have a good sense of where their papers are most likely to be accepted. Beyond ensuring that a manuscript fulfils all the target journal's requirements, the literature suggests that it is important to have an objective view of the scientific contribution or 'value' of your work.