GENESI-DR - A single access point to Earth Science data

NASA Astrophysics Data System (ADS)

Cossu, R.; Goncalves, P.; Pacini, F.

2009-04-01

.) and will adhere to a common set of standards / policies / interfaces. The end-users will be provided with a virtual collection of digital Earth Science data, irrespectively of their location in the various single federated repositories. GENESI-DR objectives have lead to the identification of the basic GENESI-DR infrastructure requirements: • Capability, for Earth Science users, to discover data from different European Earth Science Digital Repositories through the same interface in a transparent and homogeneous way; • Easiness and speed of access to large volumes of coherently maintained distributed data in an effective and timely way; • Capability, for DR owners, to easily make available their data to a significantly increased audience with no need to duplicate them in a different storage system. Data discovery is based on a Central Discovery Service, which allows users and applications to easily query information about data collections and products existing in heterogeneous catalogues, at federated DR sites. This service can be accessed by users via web interface, the GENESI-DR Web Portal, or by external applications via open standardized interfaces exposed by the system. The Central Discovery Service identifies the DRs providing products complying with the user search criteria and returns the corresponding access points to the requester. By taking into consideration different and efficient data transfer technologies such as HTTPS, GridFTP and BitTorrent, the infrastructure provides easiness and speed of access. Conversely, for data publishing GENESI-DR provides several mechanisms to assist DR owners in producing a metadata catalogues. In order to reach its objectives, the GENESI-DR e-Infrastructure will be validated against user needs for accessing and sharing Earth Science data. Initially, four specific applications in the land, atmosphere and marine domains have been selected, including: • Near real time orthorectification for agricultural crops

15. Credit JTL: Detail, oblique view of central panel point ...

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

15. Credit JTL: Detail, oblique view of central panel point connection at top chord; note recess in chord bar to right of joint, and missing third (central) vertical tie rod - Reading-Halls Station Bridge, U.S. Route 220, spanning railroad near Halls Station, Muncy, Lycoming County, PA

Contextual view of Point Bonita Ridge, showing Bonita Ridge access ...

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

Contextual view of Point Bonita Ridge, showing Bonita Ridge access road retaining wall and location of Signal Corps Radar (S.C.R.) 296 Station 5 Transmitter Building foundation (see stake at center left), camera facing north - Fort Barry, Signal Corps Radar 296, Station 5, Transmitter Building Foundation, Point Bonita, Marin Headlands, Sausalito, Marin County, CA

Centralized light-source optical access network based on polarization multiplexing.

PubMed

Grassi, Fulvio; Mora, José; Ortega, Beatriz; Capmany, José

2010-03-01

This paper presents and demonstrates a centralized light source optical access network based on optical polarization multiplexing technique. By using two optical sources emitting light orthogonally polarized in the Central Node for downstream and upstream operations, the Remote Node is kept source-free. EVM values below telecommunication standard requirements have been measured experimentally when bidirectional digital signals have been transmitted over 10 km of SMF employing subcarrier multiplexing technique in the electrical domain.

32 CFR 242.6 - Central point of contact.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 2 2013-07-01 2013-07-01 false Central point of contact. 242.6 Section 242.6 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) MISCELLANEOUS ADMISSION POLICIES AND PROCEDURES FOR THE SCHOOL OF MEDICINE, UNIFORMED SERVICES UNIVERSITY OF THE...

32 CFR 242.6 - Central point of contact.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 2 2010-07-01 2010-07-01 false Central point of contact. 242.6 Section 242.6 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) MISCELLANEOUS ADMISSION POLICIES AND PROCEDURES FOR THE SCHOOL OF MEDICINE, UNIFORMED SERVICES UNIVERSITY OF THE...

32 CFR 242.6 - Central point of contact.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 2 2014-07-01 2014-07-01 false Central point of contact. 242.6 Section 242.6 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) MISCELLANEOUS ADMISSION POLICIES AND PROCEDURES FOR THE SCHOOL OF MEDICINE, UNIFORMED SERVICES UNIVERSITY OF THE...

32 CFR 242.6 - Central point of contact.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 2 2012-07-01 2012-07-01 false Central point of contact. 242.6 Section 242.6 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) MISCELLANEOUS ADMISSION POLICIES AND PROCEDURES FOR THE SCHOOL OF MEDICINE, UNIFORMED SERVICES UNIVERSITY OF THE...

32 CFR 242.6 - Central point of contact.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 2 2011-07-01 2011-07-01 false Central point of contact. 242.6 Section 242.6 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) MISCELLANEOUS ADMISSION POLICIES AND PROCEDURES FOR THE SCHOOL OF MEDICINE, UNIFORMED SERVICES UNIVERSITY OF THE...

Accessing the exceptional points of parity-time symmetric acoustics

PubMed Central

Shi, Chengzhi; Dubois, Marc; Chen, Yun; Cheng, Lei; Ramezani, Hamidreza; Wang, Yuan; Zhang, Xiang

2016-01-01

Parity-time (PT) symmetric systems experience phase transition between PT exact and broken phases at exceptional point. These PT phase transitions contribute significantly to the design of single mode lasers, coherent perfect absorbers, isolators, and diodes. However, such exceptional points are extremely difficult to access in practice because of the dispersive behaviour of most loss and gain materials required in PT symmetric systems. Here we introduce a method to systematically tame these exceptional points and control PT phases. Our experimental demonstration hinges on an active acoustic element that realizes a complex-valued potential and simultaneously controls the multiple interference in the structure. The manipulation of exceptional points offers new routes to broaden applications for PT symmetric physics in acoustics, optics, microwaves and electronics, which are essential for sensing, communication and imaging. PMID:27025443

75 FR 13705 - Inmate Access to Inmate Central File: PSRs and SORs

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-23

... DEPARTMENT OF JUSTICE Bureau of Prisons 28 CFR Part 513 [BOP Docket No. 1157-P] RIN 1120-AB57 Inmate Access to Inmate Central File: PSRs and SORs AGENCY: Bureau of Prisons, Justice. ACTION: Proposed rule. SUMMARY: The Bureau of Prisons (Bureau) proposes to amend regulations regarding inmate access to...

Intravascular thrombosis as a result of central venous access.

PubMed

Biernacka, Jadwiga; Nestorowicz, Andrzej; Wach, Małgorzata

2002-01-01

Central venous access represents one of the most basic therapeutic procedures in modern medicine. Unfortunately, numerous advantages that result from maintaining a central venous line are accompanied by some complications among which the venous thrombosis is the most significant clinically. The study was designed to assess frequency and natural history of this complication in the setting at a multi profile clinical hospital. Central venous cannulation was performed by a fully qualified anaesthesiologist in every case. There were 887 cannulations and only 5 patients with clinically significant venous thrombosis. The analysis of the collected data allowed us to state that the frequency of intravascular thrombosis is low, but this complication is often associated with extensive impairment of patency of the central veins. Full recanalization is not always achieved regardless of the treatment applied. Pulmonary embolism in the course of central venous thrombosis was diagnosed in one patient only and appeared as a multiple and fine X-ray infiltrates. It seems that in the presence of permanent or even life threatening complications of central venous thrombosis their risk should be minimized by frequent examination of the cannulation site and early initiation of antithrombotic treatment.

Interactive access to forest inventory data for the South Central United States

Treesearch

William H. McWilliams

1990-01-01

On-line access to USDA, Forest Service successive forest inventory data for the South Central United States is provided by two computer systems. The Easy Access to Forest Inventory and Analysis Tables program (EZTAB) produces a set of tables for specific geographic areas. The Interactive Graphics and Retrieval System (INGRES) is a database management system that...

Introducing a Fresh Cadaver Model for Ultrasound-guided Central Venous Access Training in Undergraduate Medical Education

PubMed Central

Miller, Ryan; Ho, Hang; Ng, Vivienne; Tran, Melissa; Rappaport, Douglas; Rappaport, William J.A.; Dandorf, Stewart J.; Dunleavy, James; Viscusi, Rebecca; Amini, Richard

2016-01-01

Introduction Over the past decade, medical students have witnessed a decline in the opportunities to perform technical skills during their clinical years. Ultrasound-guided central venous access (USG-CVA) is a critical procedure commonly performed by emergency medicine, anesthesia, and general surgery residents, often during their first month of residency. However, the acquisition of skills required to safely perform this procedure is often deficient upon graduation from medical school. To ameliorate this lack of technical proficiency, ultrasound simulation models have been introduced into undergraduate medical education to train venous access skills. Criticisms of simulation models are the innate lack of realistic tactile qualities, as well as the lack of anatomical variances when compared to living patients. The purpose of our investigation was to design and evaluate a life-like and reproducible training model for USG-CVA using a fresh cadaver. Methods This was a cross-sectional study at an urban academic medical center. An 18-point procedural knowledge tool and an 18-point procedural skill evaluation tool were administered during a cadaver lab at the beginning and end of the surgical clerkship. During the fresh cadaver lab, procedure naïve third-year medical students were trained on how to perform ultrasound-guided central venous access of the femoral and internal jugular vessels. Preparation of the fresh cadaver model involved placement of a thin-walled latex tubing in the anatomic location of the femoral and internal jugular vein respectively. Results Fifty-six third-year medical students participated in this study during their surgical clerkship. The fresh cadaver model provided high quality and lifelike ultrasound images despite numerous cannulation attempts. Technical skill scores improved from an average score of 3 to 12 (p<0.001) and procedural knowledge scores improved from an average score of 4 to 8 (p<0.001). Conclusion The use of this novel cadaver

Introducing a Fresh Cadaver Model for Ultrasound-guided Central Venous Access Training in Undergraduate Medical Education.

PubMed

Miller, Ryan; Ho, Hang; Ng, Vivienne; Tran, Melissa; Rappaport, Douglas; Rappaport, William J A; Dandorf, Stewart J; Dunleavy, James; Viscusi, Rebecca; Amini, Richard

2016-05-01

Over the past decade, medical students have witnessed a decline in the opportunities to perform technical skills during their clinical years. Ultrasound-guided central venous access (USG-CVA) is a critical procedure commonly performed by emergency medicine, anesthesia, and general surgery residents, often during their first month of residency. However, the acquisition of skills required to safely perform this procedure is often deficient upon graduation from medical school. To ameliorate this lack of technical proficiency, ultrasound simulation models have been introduced into undergraduate medical education to train venous access skills. Criticisms of simulation models are the innate lack of realistic tactile qualities, as well as the lack of anatomical variances when compared to living patients. The purpose of our investigation was to design and evaluate a life-like and reproducible training model for USG-CVA using a fresh cadaver. This was a cross-sectional study at an urban academic medical center. An 18-point procedural knowledge tool and an 18-point procedural skill evaluation tool were administered during a cadaver lab at the beginning and end of the surgical clerkship. During the fresh cadaver lab, procedure naïve third-year medical students were trained on how to perform ultrasound-guided central venous access of the femoral and internal jugular vessels. Preparation of the fresh cadaver model involved placement of a thin-walled latex tubing in the anatomic location of the femoral and internal jugular vein respectively. Fifty-six third-year medical students participated in this study during their surgical clerkship. The fresh cadaver model provided high quality and lifelike ultrasound images despite numerous cannulation attempts. Technical skill scores improved from an average score of 3 to 12 (p<0.001) and procedural knowledge scores improved from an average score of 4 to 8 (p<0.001). The use of this novel cadaver model prevented extravasation of fluid

Generation-based memory synchronization in a multiprocessor system with weakly consistent memory accesses

DOEpatents

Ohmacht, Martin

2017-08-15

In a multiprocessor system, a central memory synchronization module coordinates memory synchronization requests responsive to memory access requests in flight, a generation counter, and a reclaim pointer. The central module communicates via point-to-point communication. The module includes a global OR reduce tree for each memory access requesting device, for detecting memory access requests in flight. An interface unit is implemented associated with each processor requesting synchronization. The interface unit includes multiple generation completion detectors. The generation count and reclaim pointer do not pass one another.

Generation-based memory synchronization in a multiprocessor system with weakly consistent memory accesses

DOEpatents

Ohmacht, Martin

2014-09-09

In a multiprocessor system, a central memory synchronization module coordinates memory synchronization requests responsive to memory access requests in flight, a generation counter, and a reclaim pointer. The central module communicates via point-to-point communication. The module includes a global OR reduce tree for each memory access requesting device, for detecting memory access requests in flight. An interface unit is implemented associated with each processor requesting synchronization. The interface unit includes multiple generation completion detectors. The generation count and reclaim pointer do not pass one another.

Managing Inadvertent Arterial Catheterization During Central Venous Access Procedures

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

Nicholson, Tony, E-mail: Tony.Nicholson@leedsth.nhs.uk; Ettles, Duncan; Robinson, Graham

2004-01-15

Purpose: Approximately 200,000 central venous catheterizations are carried out annually in the National Health Service in the United Kingdom. Inadvertent arterial puncture occurs in up to 3.7%. Significant morbidity and death has been reported. We report on our experience in the endovascular treatment of this iatrogenic complication. Methods: Retrospective analysis was carried out of 9 cases referred for endovascular treatment of inadvertent arterial puncture during central venous catheterization over a 5 year period. Results: It was not possible to obtain accurate figures on the numbers of central venous catheterizations carried out during the time period. Five patients were referred withmore » carotid or subclavian pseudoaneurysms and hemothorax following inadvertent arterial catheter insertion and subsequent removal. These patients all underwent percutaneous balloon tamponade and/or stent-graft insertion. More recently 4 patients were referred with the catheter still in situ and were successfully treated with a percutaneous closure device. Conclusion: If inadvertent arterial catheterization during central venous access procedures is recognized and catheters removed, sequelae can be treated percutaneously. However, once the complication is recognized it is better to leave the catheter in situ and seal the artery percutaneously with a closure device.« less

Van Allen Probes Science Gateway: A Centralized Data Access Point

NASA Astrophysics Data System (ADS)

Romeo, G.; Barnes, R. J.; Ukhorskiy, A. Y.; Sotirelis, T.; Stephens, G. K.; Kessel, R.; Potter, M.

2015-12-01

The Van Allen Probes Science Gateway acts a centralized interface to the instrument Science Operation Centers (SOCs), provides mission planning tools, and hosts a number of science related activities such as the mission bibliography. Most importantly, the Gateway acts as the primary site for processing and delivering the Van Allen Probes Space Weather data to users. Over the past years, the web-site has been completely redesigned with the focus on easier navigation and improvements of the existing tools such as the orbit plotter, position calculator and magnetic footprint tool. In addition, a new data plotting facility has been added. Based on HTML5, which allows users to interactively plot Van Allen Probes science and space weather data. The user can tailor the tool to display exactly the plot they wish to see and then share this with other users via either a URL or by QR code. Various types of plots can be created, including, simple time series, data plotted as a function of orbital location, and time versus L-Shell, capability of visualizing data from both probes (A & B) on the same plot. In cooperation with all Van Allen Probes Instrument SOCs, the Science Gateway will soon be able to serve higher level data products (Level 3), and to visualize them via the above mentioned HTML5 interface. Users will also be able to create customized CDF files on the fly.

Help Central: Creating a Help Desk and Knowledge Portal in SharePoint

ERIC Educational Resources Information Center

Ennis, Lisa A.; Tims, Randy S.

2012-01-01

This article discusses the authors' implementation of Help Central, a site within the Lister Hill Library Collection on the University of Alabama-Birmingham's SharePoint server. Initially, Help Central was designed to address the inadequacies in the library's old, static HTML web-based support system, including haphazard issue reporting by staff…

Management of end-stage central venous access in children referred for possible small bowel transplantation.

PubMed

Rodrigues, A F; van Mourik, I D M; Sharif, K; Barron, D J; de Giovanni, J V; Bennett, J; Bromley, P; Protheroe, S; John, P; de Ville de Goyet, J; Beath, S V

2006-04-01

The 3-year survival after small bowel transplantation (SBTx) has improved to between 73% and 88%. Impaired venous access for parenteral nutrition can be an indication for SBTx in children with chronic intestinal failure. To report our experience in management of children with extreme end-stage venous access. The study consisted of 6 children (all boys), median age of assessment 27 months (range, 13-52 months), diagnosed with total intestinal aganglionosis (1), protracted diarrhea (1), and short bowel syndrome (4), of which gastroschisis (2) and malrotation with midgut volvulus (2) were the causes. All had a documented history of more than 10 central venous catheter insertions previously. All had venograms, and 1 child additionally had a magnetic resonance angiogram to evaluate venous access. Five of 6 presented with thrombosis of the superior vena cava (SVC) and/or inferior vena cava. Venous access was reestablished as follows: transhepatic venous catheters (5), direct intra-atrial catheter via midline sternotomy (4), azygous venous catheters (2), dilatation of left subclavian vein after passage of a guide wire and then placing a catheter to reach the right atrium (1), radiological recanalization of the SVC and placement of a central venous catheter in situ (1), and direct puncture of SVC stump(1). Complications included serous pleural effusion after direct intra-atrial line insertion, which resolved after chest drain insertion (1), displacement of transhepatic catheter needing repositioning (2), and SVC stent narrowing requiring repeated balloon dilatation. Four children with permanent intestinal failure on assessment were offered SBTx, 3 of which were transplanted and were established on full enteral nutrition; the family of 1 child declined the procedure. In the remaining 2 children in whom bowel adaptation was still a possibility, attempts were made to provide adequate central venous access as feeds and drug manipulations were undertaken. One of them received

A study comparing centralized CD-ROM and decentralized intranet access to MEDLINE

PubMed Central

Darmoni, Stefan J.; Benichou, Jacques; Thirion, Benoit; Hellot, Marie France; Fuss, Jacques

2000-01-01

Objective: The purpose of this study was to evaluate the efficacy of a decentralized intranet access in each medical department as opposed to centralized unique MEDLINE access in the medical library. Design: A two-phase questionnaire to evaluate MEDLINE use was given to junior and senior physicians at Rouen University Hospital (RUH). Phase I (August–October 1996) corresponded to a time period when centralized access was the only means of access available and phase II (August–October 1997) to a time period following the introduction of decentralized intranet access. Results: A total of 168 physicians filled out at least one phase of the questionnaire, among whom 123 (73%) filled out both phases. Use of MEDLINE significantly increased in 1997 (average of 10.2 ± 1.1 searches in three months) versus 1996 (average of 4.9 ± 0.7 searches in three months, P < 0.0001). The aim of searches changed, becoming significantly more care oriented in phase II (P < 0.0001). The number of searches performed by the physicians alone increased (P < 0.0001) and searches performed by the librarian decreased (P < 0.0001) in phase II. The method of searches also changed, as searches by author (P < 0.0001), by journal (P = 0.0042), and by free word (P = 0.0027) increased in phase II. Knowledge of the following concepts of MEDLINE significantly increased: explosion (P < 0.0001), scope note (P < 0.0001), Abridged Index Medicus (AIM) journals (P < 0.0001), Medical Subject Headings (MeSH) qualifier (P < 0.0001), and focus (P < 0.0001). Conclusion: A decentralized intranet access to MEDLINE increased the number of searches and knowledge of this bibliographic database. MEDLINE intranet access modified the purpose and the methods of searching. PMID:10783970

Open Access, Retention and Throughput at the Central University of Technology

ERIC Educational Resources Information Center

de Beer, K. J.

2006-01-01

The most debatable question in higher education today is: Why first "open access" to promote massafication and now "capping" to restrict learner intake? (cf. SA Media Information 2004). Concerning the managing of this difficult and extremely sensitive issue, the Central University of Technology, Free State (CUT) has come a long…

Central intake to improve access to physiotherapy for children with complex needs: a mixed methods case report.

PubMed

Wittmeier, Kristy D M; Restall, Gayle; Mulder, Kathy; Dufault, Brenden; Paterson, Marie; Thiessen, Matthew; Lix, Lisa M

2016-08-31

Children with complex needs can face barriers to system access and navigation related to their need for multiple services and healthcare providers. Central intake for pediatric rehabilitation was developed and implemented in 2008 in Winnipeg Manitoba Canada as a means to enhance service coordination and access for children and their families. This study evaluates the process and impact of implementing a central intake system, using pediatric physiotherapy as a case example. A mixed methods instrumental case study design was used. Interviews were completed with 9 individuals. Data was transcribed and analyzed for themes. Quantitative data (wait times, referral volume and caregiver satisfaction) was collected for children referred to physiotherapy with complex needs (n = 1399), and a comparison group of children referred for orthopedic concerns (n = 3901). Wait times were analyzed using the Kruskal-Wallis test, caregiver satisfaction was analyzed using Fisher exact test and change point modeling was applied to examine referral volume over the study period. Interview participants described central intake implementation as creating more streamlined processes. Factors that facilitated successful implementation included 1) agreement among stakeholders, 2) hiring of a central intake coordinator, 3) a financial commitment from the government and 4) leadership at the individual and organization level. Mean (sd) wait times improved for children with complex needs (12.3(13.1) to 8.0(6.9) days from referral to contact with family, p < 0.0001; 29.8(17.9) to 24.3(17.0) days from referral to appointment, p < 0.0001) while referral volumes remained consistent. A small but significant increase in wait times was observed for the comparison group (9.6(8.6) to 10.1(6.6) days from referral to contact with family, p < 0.001; 20.4(14.3) to 22.1(13.1) days from referral to appointment, p < 0.0001), accompanied by an increasing referral volume for this group

Not just a drop in the bucket: expanding access to point-of-use water treatment systems.

PubMed

Mintz, E; Bartram, J; Lochery, P; Wegelin, M

2001-10-01

Since 1990, the number of people without access to safe water sources has remained constant at approximately 1.1 billion, of whom approximately 2.2 million die of waterborne disease each year. In developing countries, population growth and migrations strain existing water and sanitary infrastructure and complicate planning and construction of new infrastructure. Providing safe water for all is a long-term goal; however, relying only on time- and resource-intensive centralized solutions such as piped, treated water will leave hundreds of millions of people without safe water far into the future. Self-sustaining, decentralized approaches to making drinking water safe, including point-of-use chemical and solar disinfection, safe water storage, and behavioral change, have been widely field-tested. These options target the most affected, enhance health, contribute to development and productivity, and merit far greater priority for rapid implementation.

Not Just a Drop in the Bucket: Expanding Access to Point-of-Use Water Treatment Systems

PubMed Central

Mintz, Eric; Bartram, Jamie; Lochery, Peter; Wegelin, Martin

2001-01-01

Since 1990, the number of people without access to safe water sources has remained constant at approximately 1.1 billion, of whom approximately 2.2 million die of waterborne disease each year. In developing countries, population growth and migrations strain existing water and sanitary infrastructure and complicate planning and construction of new infrastructure. Providing safe water for all is a long-term goal; however, relying only on time- and resource-intensive centralized solutions such as piped, treated water will leave hundreds of millions of people without safe water far into the future. Self-sustaining, decentralized approaches to making drinking water safe, including point-of-use chemical and solar disinfection, safe water storage, and behavioral change, have been widely field-tested. These options target the most affected, enhance health, contribute to development and productivity, and merit far greater priority for rapid implementation. PMID:11574307

Divergent neuronal circuitries underlying acute orexigenic effects of peripheral or central ghrelin: critical role of brain accessibility

PubMed Central

Cabral, Agustina; Valdivia, Spring; Fernandez, Gimena; Reynaldo, Mirta; Perello, Mario

2014-01-01

Ghrelin is an octanoylated peptide hormone that potently and rapidly increases food intake. The orexigenic action of ghrelin involves the hypothalamic arcuate nucleus (ARC), which is accessible to plasma ghrelin and expresses high levels of the ghrelin receptor. Local administration of ghrelin in a variety of other brain nuclei also increases food intake. It is currently unclear, however, if these non-ARC ghrelin brain targets are impacted by physiological increases of plasma ghrelin. Thus, the current study was designed to clarify which ghrelin brain targets participate in the short-term orexigenic actions of ghrelin. First, c-Fos induction into mouse brains centrally or peripherally treated with ghrelin was analyzed. It was confirmed that peripherally administered ghrelin dose dependently increases food intake and mainly activates c-Fos in ARC neurons. In contrast, centrally administered ghrelin activates c-Fos in a larger number of brain nuclei. To determine which nuclei are directly accessible to ghrelin, mice were centrally or peripherally injected with a fluorescent ghrelin tracer. It was found that peripherally injected tracer mainly accesses the ARC while centrally injected tracer reaches most brain areas known to express ghrelin receptors. Following that, ghrelin effects in ARC-ablated mice were tested and it was found that these mice failed to increase food intake in response to peripherally administered ghrelin but fully responded to centrally administered ghrelin. ARC-ablated mice showed similar patterns of ghrelin-induced c-Fos expression as seen in control mice with the exception of the ARC, where no c-Fos was found. Thus, peripheral ghrelin mainly accesses the ARC, which is required for the orexigenic effects of the hormone. Central ghrelin accesses a variety of nuclei, which can mediate the orexigenic effects of the hormone even in the absence of an intact ARC. PMID:24888783

Incidence and risk factors for central venous access port-related infection in Chinese cancer patients.

PubMed

Wang, Ting-Yao; Lee, Kuan-Der; Chen, Ping-Tsung; Chen, Min-Chi; Chen, Yi-Yang; Huang, Cih-En; Kuan, Feng-Che; Chen, Chih-Cheng; Lu, Chang Hsien

2015-11-01

Cytotoxic chemotherapy via central venous access ports is an important part of the standard treatment for most cancers, but it is accompanied with the risk of infections. This study aimed to analyze the incidence and risk factors for central venous access port-related infection (CPI) among Chinese patients receiving cytotoxic chemotherapy. Between January 1, 2002 and December 31, 2005 a total of 1391 cancer patients with 1449 totally implantable central venous access ports were evaluated. The log-rank test and Cox proportional hazards model were used for the analyses of risk factors. The overall CPI incidence rate was 0.21 per 1000 catheter-days. Hematological malignancies and head and neck cancer were associated with an increased risk of CPI (hazard ratio 4.00 and 4.11, respectively, both p < 0.001) and less infection-free catheter longevity (p < 0.001) compared with other cancer types. Chemotherapy in an adjuvant setting was associated with a lower risk of infection than for patients in a nonadjuvant setting (p < 0.001). The most common pathogens isolated from CPI were Pseudomonas aeruginosa and Candida. Infection remains to be a challenging issue for totally implantable central venous ports. Implementation of an insertion bundle for the prevention of central line-associated bloodstream infections is warranted, especially for those patients with hematological and head and neck cancers, as well as for patients receiving chemotherapy in the metastatic settings. Copyright © 2015. Published by Elsevier B.V.

A Point to Share: Streamlining Access Services Workflow through Online Collaboration, Communication, and Storage with Microsoft SharePoint

ERIC Educational Resources Information Center

Diffin, Jennifer; Chirombo, Fanuel; Nangle, Dennis; de Jong, Mark

2010-01-01

This article explains how the document management team (circulation and interlibrary loan) at the University of Maryland University College implemented Microsoft's SharePoint product to create a central hub for online collaboration, communication, and storage. Enhancing the team's efficiency, organization, and cooperation was the primary goal.…

Development of Curie point switching for thin film, random access, memory device

NASA Technical Reports Server (NTRS)

Lewicki, G. W.; Tchernev, D. I.

1967-01-01

Managanese bismuthide films are used in the development of a random access memory device of high packing density and nondestructive readout capability. Memory entry is by Curie point switching using a laser beam. Readout is accomplished by microoptical or micromagnetic scanning.

Creating a Web-accessible, point-of-care, team-based information system (PointTIS): the librarian as publisher.

PubMed

Burrows, S C; Moore, K M; Lemkau, H L

2001-04-01

The Internet has created new opportunities for librarians to develop information systems that are readily accessible at the point of care. This paper describes the multiyear process used to justify, fund, design, develop, promote, and evaluate a rehabilitation prototype of a point-of-care, team-based information system (PoinTIS) and train health care providers to use this prototype for their spinal cord injury and traumatic brain injury patient care and education activities. PoinTIS is a successful model for librarians in the twenty-first century to serve as publishers of information created or used by their parent organizations and to respond to the opportunities for information dissemination provided by recent technological advances.

46 CFR 188.10-56 - Pilot boarding equipment and point of access.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 7 2014-10-01 2014-10-01 false Pilot boarding equipment and point of access. 188.10-56 Section 188.10-56 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) OCEANOGRAPHIC RESEARCH VESSELS GENERAL PROVISIONS Definition of Terms Used in This Subchapter § 188.10-56 Pilot boarding...

46 CFR 188.10-56 - Pilot boarding equipment and point of access.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 7 2011-10-01 2011-10-01 false Pilot boarding equipment and point of access. 188.10-56 Section 188.10-56 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) OCEANOGRAPHIC RESEARCH VESSELS GENERAL PROVISIONS Definition of Terms Used in This Subchapter § 188.10-56 Pilot boarding...

46 CFR 188.10-56 - Pilot boarding equipment and point of access.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 7 2013-10-01 2013-10-01 false Pilot boarding equipment and point of access. 188.10-56 Section 188.10-56 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) OCEANOGRAPHIC RESEARCH VESSELS GENERAL PROVISIONS Definition of Terms Used in This Subchapter § 188.10-56 Pilot boarding...

46 CFR 188.10-56 - Pilot boarding equipment and point of access.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 7 2012-10-01 2012-10-01 false Pilot boarding equipment and point of access. 188.10-56 Section 188.10-56 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) OCEANOGRAPHIC RESEARCH VESSELS GENERAL PROVISIONS Definition of Terms Used in This Subchapter § 188.10-56 Pilot boarding...

ScienceCentral: open access full-text archive of scientific journals based on Journal Article Tag Suite regardless of their languages

PubMed Central

Huh, Sun

2013-01-01

ScienceCentral, a free or open access, full-text archive of scientific journal literature at the Korean Federation of Science and Technology Societies, was under test in September 2013. Since it is a Journal Article Tag Suite-based full text database, extensible markup language files of all languages can be presented, according to Unicode Transformation Format 8-bit encoding. It is comparable to PubMed Central: however, there are two distinct differences. First, its scope comprises all science fields; second, it accepts all language journals. Launching ScienceCentral is the first step for free access or open access academic scientific journals of all languages to leap to the world, including scientific journals from Croatia. PMID:24266292

ScienceCentral: open access full-text archive of scientific journals based on Journal Article Tag Suite regardless of their languages.

PubMed

Huh, Sun

2013-01-01

ScienceCentral, a free or open access, full-text archive of scientific journal literature at the Korean Federation of Science and Technology Societies, was under test in September 2013. Since it is a Journal Article Tag Suite-based full text database, extensible markup language files of all languages can be presented, according to Unicode Transformation Format 8-bit encoding. It is comparable to PubMed Central: however, there are two distinct differences. First, its scope comprises all science fields; second, it accepts all language journals. Launching ScienceCentral is the first step for free access or open access academic scientific journals of all languages to leap to the world, including scientific journals from Croatia.

Synthetic Minor NSR Permit: Red Cedar Gathering Company - South Ignacio Central Delivery Point

EPA Pesticide Factsheets

This page contains the final synthetic minor NSR permit for the Red Cedar Gathering Company, South Ignacio Central Delivery Point, located on the Southern Ute Indian Reservation in La Plata County, CO.

Access Point Selection for Multi-Rate IEEE 802.11 Wireless LANs

DTIC Science & Technology

2014-05-16

Mobile Systems, Applications and Services, 2006. [2] S . Vasudevan, K. Papagiannaki, C . Diot, J. Kurose, and D. Towsley, “Facilitating Access Point...LANs 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR( S ) 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7...PERFORMING ORGANIZATION NAME( S ) AND ADDRESS(ES) University of California at Berkeley,Electrical Engineering and Computer Sciences,Berkeley,CA,94720 8

Accessing care summaries at point-of-care:Implementation of mobile devices for personal carers in aged care.

PubMed

Brimelow, Rachel E; Gibney, Annie; Meakin, Suzanne; Wollin, Judy A

2017-04-01

Continued development of mobile technology now allows access to information at the point-of-care. This study was conducted to evaluate the use of one such tool on a mobile device, from the carer perspective. Caregivers across 12 aged-care facilities were supplied mobile devices to access a Picture Care Plan (PCP), a specific tool designed around the role of the personal carer. An anonymous questionnaire was subsequently completed by 85 carers with questions relating to participants' experience. Perceived helpfulness of the PCP at the point-of-care was high (87%). A significant number of participants believed the use of the PCP increased resident safety and quality of care (76%). Practical components related to the carrying of the device, network speed and the requirement to maintain communication with senior members of staff to ascertain updates were also expressed by participants. Findings suggest that staff are receptive to adoption of mobile devices to access care directives at the point-of-care and that the technology is useful.

Creating a mobile subject guide to improve access to point-of-care resources for medical students: a case study.

PubMed

Boruff, Jill T; Bilodeau, Edward

2012-01-01

Can a mobile optimized subject guide facilitate medical student access to mobile point-of-care tools? The guide was created at a library at a research-intensive university with six teaching hospital sites. The team created a guide facilitating medical student access to point-of-care tools directly on mobile devices to provide information allowing them to access and set up resources with little assistance. Two librarians designed a mobile optimized subject guide for medicine and conducted a survey to test its usefulness. Web analytics and survey results demonstrate that the guide is used and the students are satisfied. The library will continue to use the subject guide as its primary means of supporting mobile devices. It remains to be seen if the mobile guide facilitates access for those who do not need assistance and want direct access to the resources. Internet access in the hospitals remains an issue.

Constrained Inclusion: Access and Persistence Among Undocumented Community College Students in California's Central Valley

ERIC Educational Resources Information Center

Negrón-Gonzales, Genevieve

2017-01-01

This article examines the ways in which citizenship status uniquely shapes both the access and persistence of undocumented community college students in the Central Valley of California. Drawing on more than 2 years of qualitative fieldwork, it is argued that undocumented community college students navigate an institutional landscape of…

Synthetic Minor NSR Permit: BP America Production Company - Salvador I/II Central Delivery Point

EPA Pesticide Factsheets

This page contains the final synthetic minor NSR permit for the BP America Production Company, Salvador I/II Central Delivery Point, located on the Southern Ute Indian Reservation in La Plata County, CO.

Experiences of registered nurses with regard to accessing health information at the point-of-care via mobile computing devices.

PubMed

Ricks, Esmeralda; Benjamin, Valencia; Williams, Margaret

2015-11-19

The volume of health information necessary to provide competent health care today has become overwhelming. Mobile computing devices are fast becoming an essential clinical tool for accessing health information at the point-of-care of patients. This study explored and described how registered nurses experienced accessing information at the point-of-care via mobile computing devices (MCDs). A qualitative, exploratory, descriptive and contextual design was used. Ten in-depth interviews were conducted with purposively sampled registered nurses employed by a state hospital in the Nelson Mandela Bay Municipality (NMBM). Interviews were recorded, transcribed verbatim and analysed using Tesch's data analysis technique. Ethical principles were adhered to throughout the study. Guba's model of trustworthiness was used to confirm integrity of the study. Four themes emerged which revealed that the registered nurses benefited from the training they received by enabling them to develop, and improve, their computer literacy levels. Emphasis was placed on the benefits that the accessed information had for educational purposes for patients and the public, for colleagues and students. Furthermore the ability to access information at the point-of-care was considered by registered nurses as valuable to improve patient care because of the wide range of accurate and readily accessible information available via the mobile computing device. The registered nurses in this study felt that being able to access information at the point-of-care increased their confidence and facilitated the provision of quality care because it assisted them in being accurate and sure of what they were doing.

Creating a mobile subject guide to improve access to point-of-care resources for medical students: a case study

PubMed Central

Boruff, Jill T; Bilodeau, Edward

2012-01-01

Question: Can a mobile optimized subject guide facilitate medical student access to mobile point-of-care tools? Setting: The guide was created at a library at a research-intensive university with six teaching hospital sites. Objectives: The team created a guide facilitating medical student access to point-of-care tools directly on mobile devices to provide information allowing them to access and set up resources with little assistance. Methods: Two librarians designed a mobile optimized subject guide for medicine and conducted a survey to test its usefulness. Results: Web analytics and survey results demonstrate that the guide is used and the students are satisfied. Conclusion: The library will continue to use the subject guide as its primary means of supporting mobile devices. It remains to be seen if the mobile guide facilitates access for those who do not need assistance and want direct access to the resources. Internet access in the hospitals remains an issue. PMID:22272160

Accessibility Considerations for e-Learning in Ghana

ERIC Educational Resources Information Center

Boateng, John Kwame

2016-01-01

This paper reports on a study that explored the best ways to design e-learning in order to provide better access for adult learners with disabilities. Two districts from the Central Region of Ghana were selected and two major research questions guided the study. The five-point Likert scale was employed between May and August of 2014. The two…

Substantial harm associated with failure of chronic paediatric central venous access devices.

PubMed

Ullman, Amanda J; Kleidon, Tricia; Cooke, Marie; Rickard, Claire M

2017-07-06

Central venous access devices (CVADs) form an important component of modern paediatric healthcare, especially for children with chronic health conditions such as cancer or gastrointestinal disorders. However device failure and complications rates are high.Over 2½ years, a child requiring parenteral nutrition and associated vascular access dependency due to 'short gut syndrome' (intestinal failure secondary to gastroschisis and resultant significant bowel resection) had ten CVADs inserted, with ninesubsequently failing. This resulted in multiple anaesthetics, invasive procedures, injuries, vascular depletion, interrupted nutrition, delayed treatment and substantial healthcare costs. A conservative estimate of the institutional costs for each insertion, or rewiring, of her tunnelled CVAD was $A10 253 (2016 Australian dollars).These complications and device failures had significant negative impact on the child and her family. Considering the commonality of conditions requiring prolonged vascular access, these failures also have a significant impact on international health service costs. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

[Port device central venous access in children with chronic renal disease--personal experience].

PubMed

Szczepańska, Maria; Szprynger, Krystyna; Stoksik, Piotr; Morawiec-Knysak, Aurelia; Adamczyk, Piotr; Ziora, Katarzyna; Oswiecimska, Joanna

2006-01-01

The application of central venous lines in children has been widely accepted in the case of pediatric cancer treatment. This is of particular importance when the treatment must be continued during the long period of time. The indication to long-term application of central venous lines became significantly frequent within last years. They are necessary in the treatment of chronic pediatric patients, in whom the central venous line allows continuous access for medication, parenteral rehydration, nutrition and frequent blood sampling. In the current study authors present their experience in subcutaneous port devices application in children with kidney disease. The case history data obtained from 8 children were retrospectively analysed. In these children subcutaneous port devices were applied for mean 26.7 months (totally 9 port devices). The mean age at the time of implantation was 2.2 years, and the mean body weight--10.6 kg. Peripheral venous access in all children was bad. In one child during the time of implantation the hematoma of coli and chest was present. Infectious complications connected with implanted port device were not detected. Thrombotic complications were present in 6 children with chronic renal failure--in 5 the lumen of port device has been successfully recanalysed, in 3 cases even several times. In 1 child the thrombus on the tip of central venous line was detected. In 2 children the removal of port device was necessary because of breakage of venous line and in the second case because of port device thrombosis. Two children died with functioning port device. The cause of death was not connected with implanted port device. The application of subcutaneous port devices definitely improved the comfort of treatment but was significantly associated with thrombotic complications. Infectious complications were not detected as compared to hematological group of patients.

Morphological diversity of cassava accessions of the south-central mesoregion of the State of Mato Grosso, Brazil.

PubMed

Zago, B W; Barelli, M A A; Hoogerheide, E S S; Corrêa, C L; Delforno, G I S; da Silva, C J

2017-08-17

Genetic variability of cassava (Manihot esculenta Crantz) in Brazil is wide, being this the result of natural and cultural selection during pre- and post-domestication of the species in different environments. Given the number of species of the genus found in the region (38 of a total of 98 species), the central region of Brazil was defined as the primary center of cassava diversity. Therefore, genetic diversity characterization of cassava accessions is fundamental, both for farmers and for plant breeders, because it allows the organization of genetic resources and better utilization of available genetic diversity. This research aims to assess genetic divergence of cassava accessions from the south-central region of the State of Mato Grosso, based on multi-categorical morphological traits. For this purpose, 38 qualitative and quantitative morphological descriptors were used. Genetic diversity was expressed by the genetic similarity index, with subsequent clustering of accessions by the modified Tocher's procedure and UPGMA. Of 38 descriptors, only growth habit of stem showed no variability. Tocher and UPGMA methods were efficient and corroborated on group composition. Both methods were able to group accessions of different localities in distinct group consistency.

Does the preference of peripheral versus central venous access in peripheral blood stem cell collection/yield change stem cell kinetics in autologous stem cell transplantation?

PubMed

Dogu, Mehmet Hilmi; Kaya, Ali Hakan; Berber, Ilhami; Sari, İsmail; Tekgündüz, Emre; Erkurt, Mehmet Ali; Iskender, Dicle; Kayıkçı, Ömur; Kuku, Irfan; Kaya, Emin; Keskin, Ali; Altuntaş, Fevzi

2016-02-01

Central venous access is often used during apheresis procedure in stem cell collection. The aim of the present study was to evaluate whether central or peripheral venous access has an effect on stem cell yield and the kinetics of the procedure and the product in patients undergoing ASCT after high dose therapy. A total of 327 patients were retrospectively reviewed. The use of peripheral venous access for stem cell yield was significantly more frequent in males compared to females (p = 0.005). Total volume of the product was significantly lower in central venous access group (p = 0.046). As being a less invasive procedure, peripheral venous access can be used for stem cell yield in eligible selected patients. Copyright © 2016 Elsevier Ltd. All rights reserved.

An antenna-pointing mechanism for the ETS-6 K-band Single Access (KSA) antenna

NASA Technical Reports Server (NTRS)

Takada, Noboru; Amano, Takahiro; Ohhashi, Toshiro; Wachi, Shigeo

1991-01-01

Both the design philosophy for the Antenna Pointing Mechanism (APM) to be used for the K-band Single Access (KSA) antenna system and experimental results of the APM Engineering Model (EM) tests are described. The KSA antenna system will be flown on the Engineering Test Satellite 6 (ETS-6).

Public Internet Access Points (PIAPs) and Their Social Impact: A Case Study from Turkey

ERIC Educational Resources Information Center

Afacan, Gulgun; Er, Erkan; Arifoglu, Ali

2013-01-01

Building public Internet access points (PIAPs) is a significant contribution of governments towards achieving an information society. While many developing countries are investing great amounts to establish PIAPs today, people may not use PIAPs effectively. Yet, the successful implementation of PIAPs is the result of citizens' acceptance to use…

An Experimental Performance Measurement of Implemented Wireless Access Point for Interworking Wi-Fi and HSDPA Networks

NASA Astrophysics Data System (ADS)

Byun, Tae-Young

This paper presents a prototype of WAP(Wireless Access Point) that provides the wireless Internet access anywhere. Implemented WAP can be equipped with various wireless WAN interfaces such as WCDMA and HSDPA. WAP in the IP mechanism has to process connection setup procedure to one wireless WAN. Also, WAP can provide connection management procedures to reconnect interrupted connection automatically. By using WAP, several mobile devices such as netbook, UMPC and smart-phone in a moving vehicle can access to HSDPA network simultaneously. So, it has more convenient for using the WAP when there are needs to access wireless Internet more than two mobile devices in restricted spaces such as car, train and ship.

Synthetic Minor NSR Permit: BP America Production Company - Treating Site #8 Central Delivery Point

EPA Pesticide Factsheets

This page contains the response to public comments and the final synthetic minor NSR permit for the BP America Production Company, Treating Site #8 Central Delivery Point, located on the Southern Ute Indian Reservation in La Plata County, CO.

Do open access data policies inhibit innovation?

USGS Publications Warehouse

Katzner, Todd E.

2015-01-01

There has been a great deal of attention paid recently to the idea of data sharing (Van Noorden 2014, Beardsley 2015, Nature Publishing Group2015, www.copdess.com). However, the vast majority of these arguments are in agreement and present as fait accompli the idea that data are a public good and that therefore, once published, they should become open access. In fact, although there are many good reasons for data sharing, there also are a number of cogent and coherent cases to be made against open-access policies (e.g., Fenichel and Skelly 2015). The goal of this piece is not to debate the relevance or accuracy of the points made in favor of data sharing but to elevate the discussion by pointing out key problems with open-access policies and to identify central issues that, if solved, will enhance the utility of data sharing to science and society.

Biological therapy in inflammatory bowel diseases: Access in Central and Eastern Europe

PubMed Central

Rencz, Fanni; Péntek, Márta; Bortlik, Martin; Zagorowicz, Edyta; Hlavaty, Tibor; Śliwczyński, Andrzej; Diculescu, Mihai M; Kupcinskas, Limas; Gecse, Krisztina B; Gulácsi, László; Lakatos, Peter L

2015-01-01

Biological drugs opened up new horizons in the management of inflammatory bowel diseases (IBD). This study focuses on access to biological therapy in IBD patients across 9 selected Central and Eastern European (CEE) countries, namely Bulgaria, the Czech Republic, Estonia, Hungary, Latvia, Lithuania, Poland, Romania and Slovakia. Literature data on the epidemiology and disease burden of IBD in CEE countries was systematically reviewed. Moreover, we provide an estimation on prevalence of IBD as well as biological treatment rates. In all countries with the exception of Romania, lower biological treatment rates were observed in ulcerative colitis (UC) compared to Crohn’s disease despite the higher prevalence of UC. Great heterogeneity (up to 96-fold) was found in access to biologicals across the CEE countries. Poland, Bulgaria, Romania and the Baltic States are lagging behind Hungary, Slovakia and the Czech Republic in their access to biologicals. Variations of reimbursement policy may be one of the factors explaining the differences to a certain extent in Bulgaria, Latvia, Lithuania, and Poland, but association with other possible determinants (differences in prevalence and incidence, price of biologicals, total expenditure on health, geographical access, and cost-effectiveness results) was not proven. We assume, nevertheless, that health deterioration linked to IBD might be valued differently against other systemic inflammatory conditions in distinct countries and which may contribute to the immense diversity in the utilization of biological drugs for IBD. In conclusion, access to biologicals varies widely among CEE countries and this difference cannot be explained by epidemiological factors, drug prices or total health expenditure. Changes in reimbursement policy could contribute to better access to biologicals in some countries. PMID:25684937

Access Barriers to Distance Education in Secondary Career and Technical Education Programs in Central Virginia

ERIC Educational Resources Information Center

Goodwyn, Patrell Vachyi

2010-01-01

The qualitative phenomenological study explored the perceived institutional access barriers to distance education at comprehensive high schools with secondary career and technical education programs in central Virginia. Semi-structured interviews were conducted to gather data via email, telephone, and face-to-face. A purposive sample of 24…

Central Asian mountain Rhithrogenini (Ephemeroptera: Heptageniidae) with pointed and ephemeropteroid claws in the winged stages.

PubMed

Kluge, Nikita J

2015-08-03

Among mountain species of Heptageniidae from Central Asia, six species belonging to the taxa Cinygmula McDunnough 1933, Himalogena Kluge 2004 and Caucasiron Kluge 1997 have all claws of the winged stages (subimago and imago) pointed. In this area Cinygmula is represented by two species: C. hutchinsoni (Traver 1939) (with pointed claws) and C. joosti Braasch 1977 (with the more typical ephemeropteroid claws); for both species all stages of both sexes associated by rearing are redescribed. The Central Asian mountain taxon Himalogena includes seven species: Rhithrogena (Himalogena) tianshanica Brodsky 1930, Rh. (H.) pamirica sp. n., Rh. (H.) carnivora sp. n., Rh. (H.) semicarnivora sp. n., Rh. (H.) stackelbergi Sinitshenkova 1973, Rh. (H.) gunti sp. n. and Rh. (H.) nepalensis Braasch 1984; for five of them, all stages of both sexes associated by rearing are redescribed; Rh. (H.) semicarnivora is known as male imagoes reared from larvae; Rh. (H.) nepalensis formerly known only as larvae, is redescribed based on an anomalous female imago (with gynandromorphism caused by helminth in abdomen) reared from the larval stage. Among these species, Rh. (H.) tianshanica, Rh. (H.) pamirica, Rh. (H.) carnivora and Rh. (H.) semicarnivora have mandibles and the labrum modified for carnivorism, while the other three species have the usual Rhithrogena mouth apparatus. Imagoes and subimagoes of Rh. (H.) pamirica, Rh. (H.) carnivora, Rh. (H.) gunti and Rh. (H.) nepalensis, have both claws of each leg pointed, while the other species have ephemeropteroid claws. Corrections to the description of Rh. minima Sinitshenkova 1973 claw denticulation and to original figure references are given. The taxon Ironopsis/g1 is represented by two species in the Central Asian mountains: Epeorus (Caucasiron) guttatus (Braasch & Soldán 1979) (with pointed claws) and Epeorus (Ironopsis) rheophilus (Brodsky 1930) (with ephemeropteroid claws); for both species all stages of both sexes associated by rearing

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

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

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

1996-05-15

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

Genetic diversity analysis of cultivated and wild grapevine (Vitis vinifera L.) accessions around the Mediterranean basin and Central Asia.

PubMed

Riaz, Summaira; De Lorenzis, Gabriella; Velasco, Dianne; Koehmstedt, Anne; Maghradze, David; Bobokashvili, Zviad; Musayev, Mirza; Zdunic, Goran; Laucou, Valerie; Andrew Walker, M; Failla, Osvaldo; Preece, John E; Aradhya, Mallikarjuna; Arroyo-Garcia, Rosa

2018-06-27

The mountainous region between the Caucasus and China is considered to be the center of domestication for grapevine. Despite the importance of Central Asia in the history of grape growing, information about the extent and distribution of grape genetic variation in this region is limited in comparison to wild and cultivated grapevines from around the Mediterranean basin. The principal goal of this work was to survey the genetic diversity and relationships among wild and cultivated grape germplasm from the Caucasus, Central Asia, and the Mediterranean basin collectively to understand gene flow, possible domestication events and adaptive introgression. A total of 1378 wild and cultivated grapevines collected around the Mediterranean basin and from Central Asia were tested with a set of 20 nuclear SSR markers. Genetic data were analyzed (Cluster analysis, Principal Coordinate Analysis and STRUCTURE) to identify groups, and the results were validated by Nei's genetic distance, pairwise F ST analysis and assignment tests. All of these analyses identified three genetic groups: G1, wild accessions from Croatia, France, Italy and Spain; G2, wild accessions from Armenia, Azerbaijan and Georgia; and G3, cultivars from Spain, France, Italy, Georgia, Iran, Pakistan and Turkmenistan, which included a small group of wild accessions from Georgia and Croatia. Wild accessions from Georgia clustered with cultivated grape from the same area (proles pontica), but also with Western Europe (proles occidentalis), supporting Georgia as the ancient center of grapevine domestication. In addition, cluster analysis indicated that Western European wild grapes grouped with cultivated grapes from the same area, suggesting that the cultivated proles occidentalis contributed more to the early development of wine grapes than the wild vines from Eastern Europe. The analysis of genetic relationships among the tested genotypes provided evidence of genetic relationships between wild and cultivated

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

NASA Astrophysics Data System (ADS)

Ma, Jianxin; Wang, Zhao; Zheng, Guoli

2014-04-01

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

The use of a policy dialogue to facilitate evidence-informed policy development for improved access to care: the case of the Winnipeg Central Intake Service (WCIS).

PubMed

Damani, Zaheed; MacKean, Gail; Bohm, Eric; DeMone, Brie; Wright, Brock; Noseworthy, Tom; Holroyd-Leduc, Jayna; Marshall, Deborah A

2016-10-18

Policy dialogues are critical for developing responsive, effective, sustainable, evidence-informed policy. Our multidisciplinary team, including researchers, physicians and senior decision-makers, comprehensively evaluated The Winnipeg Central Intake Service, a single-entry model in Winnipeg, Manitoba, to improve patient access to hip/knee replacement surgery. We used the evaluation findings to develop five evidence-informed policy directions to help improve access to scheduled clinical services across Manitoba. Using guiding principles of public participation processes, we hosted a policy roundtable meeting to engage stakeholders and use their input to refine the policy directions. Here, we report on the use and input of a policy roundtable meeting and its role in contributing to the development of evidence-informed policy. Our evidence-informed policy directions focused on formal measurement/monitoring of quality, central intake as a preferred model for service delivery, provincial scope, transparent processes/performance indicators, and patient choice of provider. We held a policy roundtable meeting and used outcomes of facilitated discussions to refine these directions. Individuals from our team and six stakeholder groups across Manitoba participated (n = 44), including patients, family physicians, orthopaedic surgeons, surgical office assistants, Winnipeg Central Intake team, and administrators/managers. We developed evaluation forms to assess the meeting process, and collected decision-maker partners' perspectives on the value of the policy roundtable meeting and use of policy directions to improve access to scheduled clinical services after the meeting, and again 15 months later. We analyzed roundtable and evaluation data using thematic analysis to identify key themes. Four key findings emerged. First, participants supported all policy directions, with revisions and key implementation considerations identified. Second, participants felt the policy roundtable

Subject Access Points in the MARC Record and Archival Finding Aid: Enough or Too Many?

ERIC Educational Resources Information Center

Cox, Elizabeth; Czechowski, Leslie

2007-01-01

In this research project, the authors set out to discover the current practice in both the archival and cataloging worlds for usage of access points in descriptive records and to learn how archival descriptive practices fit into long-established library cataloging procedures and practices. A sample of archival finding aids and MARC records at 123…

Making metabolism accessible and meaningful: is the definition of a central metabolic dogma within reach?

PubMed

LaRossa, Robert A

2015-04-01

Intermediary metabolism, a dominant research area before the emergence of molecular biology, is attracting renewed interest for fundamental and applied reasons as documented here. Nonetheless, the field may appear to be a thicket precluding entry to all but the most determined. Here we present a metabolic overview that makes this important and fascinating area accessible to a broad range of the molecular biological and biotechnological communities that are being attracted to biological problems crying out for metabolic solutions. This is accomplished by identifying seven key concepts, a so-called metabolic central dogma, that provide a core understanding analogous to the "Central Dogma of Molecular Biology" which focused upon maintenance and flow of genetic information.

Accessible Earth: Enhancing diversity in the Geosciences through accessible course design

NASA Astrophysics Data System (ADS)

Bennett, R. A.; Lamb, D. A.

2017-12-01

The tradition of field-based instruction in the geoscience curriculum, which culminates in a capstone geological field camp, presents an insurmountable barrier to many disabled students who might otherwise choose to pursue geoscience careers. There is a widespread perception that success as a practicing geoscientist requires direct access to outcrops and vantage points available only to those able to traverse inaccessible terrain. Yet many modern geoscience activities are based on remotely sensed geophysical data, data analysis, and computation that take place entirely from within the laboratory. To challenge the perception of geoscience as a career option only for the non-disabled, we have created the capstone Accessible Earth Study Abroad Program, an alternative to geologic field camp for all students, with a focus on modern geophysical observation systems, computational thinking, data science, and professional development.In this presentation, we will review common pedagogical approaches in geosciences and current efforts to make the field more inclusive. We will review curricular access and inclusivity relative to a wide range of learners and provide examples of accessible course design based on our experiences in teaching a study abroad course in central Italy, and our plans for ongoing assessment, refinement, and dissemination of the effectiveness of our efforts.

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

DOT National Transportation Integrated Search

2014-04-01

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

Pan European Phenological database (PEP725): a single point of access for European data.

PubMed

Templ, Barbara; Koch, Elisabeth; Bolmgren, Kjell; Ungersböck, Markus; Paul, Anita; Scheifinger, Helfried; Rutishauser, This; Busto, Montserrat; Chmielewski, Frank-M; Hájková, Lenka; Hodzić, Sabina; Kaspar, Frank; Pietragalla, Barbara; Romero-Fresneda, Ramiro; Tolvanen, Anne; Vučetič, Višnja; Zimmermann, Kirsten; Zust, Ana

2018-06-01

The Pan European Phenology (PEP) project is a European infrastructure to promote and facilitate phenological research, education, and environmental monitoring. The main objective is to maintain and develop a Pan European Phenological database (PEP725) with an open, unrestricted data access for science and education. PEP725 is the successor of the database developed through the COST action 725 "Establishing a European phenological data platform for climatological applications" working as a single access point for European-wide plant phenological data. So far, 32 European meteorological services and project partners from across Europe have joined and supplied data collected by volunteers from 1868 to the present for the PEP725 database. Most of the partners actively provide data on a regular basis. The database presently holds almost 12 million records, about 46 growing stages and 265 plant species (including cultivars), and can be accessed via http://www.pep725.eu/ . Users of the PEP725 database have studied a diversity of topics ranging from climate change impact, plant physiological question, phenological modeling, and remote sensing of vegetation to ecosystem productivity.

Pan European Phenological database (PEP725): a single point of access for European data

NASA Astrophysics Data System (ADS)

Templ, Barbara; Koch, Elisabeth; Bolmgren, Kjell; Ungersböck, Markus; Paul, Anita; Scheifinger, Helfried; Rutishauser, This; Busto, Montserrat; Chmielewski, Frank-M.; Hájková, Lenka; Hodzić, Sabina; Kaspar, Frank; Pietragalla, Barbara; Romero-Fresneda, Ramiro; Tolvanen, Anne; Vučetič, Višnja; Zimmermann, Kirsten; Zust, Ana

2018-02-01

The Pan European Phenology (PEP) project is a European infrastructure to promote and facilitate phenological research, education, and environmental monitoring. The main objective is to maintain and develop a Pan European Phenological database (PEP725) with an open, unrestricted data access for science and education. PEP725 is the successor of the database developed through the COST action 725 "Establishing a European phenological data platform for climatological applications" working as a single access point for European-wide plant phenological data. So far, 32 European meteorological services and project partners from across Europe have joined and supplied data collected by volunteers from 1868 to the present for the PEP725 database. Most of the partners actively provide data on a regular basis. The database presently holds almost 12 million records, about 46 growing stages and 265 plant species (including cultivars), and can be accessed via http://www.pep725.eu/. Users of the PEP725 database have studied a diversity of topics ranging from climate change impact, plant physiological question, phenological modeling, and remote sensing of vegetation to ecosystem productivity.

Access to point-of-care tests reduces the prescription of antibiotics among antibiotic-requesting subjects with respiratory tract infections.

PubMed

Llor, Carl; Bjerrum, Lars; Munck, Anders; Cots, Josep M; Hernández, Silvia; Moragas, Ana

2014-12-01

General practitioners (GPs) often feel uncomfortable when patients request an antibiotic when there is likely little benefit. This study evaluates the effect of access to point-of-care tests on decreasing the prescription of antibiotics in respiratory tract infections in subjects who explicitly requested an antibiotic prescription. Spanish GPs registered all cases of respiratory tract infections over a 3-week period before and after an intervention undertaken in 2008 and 2009. Patients with acute sinusitis, pneumonia, and exacerbations of COPD were excluded. Two types of interventions were performed: the full intervention group received prescriber feedback with discussion of the results of the first registry, courses for GPs, guidelines, patient information leaflets, workshops, and access to point-of-care tests (rapid streptococcal antigen detection test and C-reactive protein test); and the partial intervention group underwent all of the above interventions except for the workshop and access to point-of-care tests. A total of 210 GPs were assigned to the full intervention group and 71 to the partial intervention group. A total of 25,479 subjects with respiratory tract infections were included, of whom 344 (1.4%) requested antibiotic prescribing. Antibiotics were more frequently prescribed to subjects requesting them compared with those who did not (49.1% vs 18.5%, P < .001). In the group of GPs assigned to the partial intervention group, 53.1% of subjects requesting antibiotics received a prescription before and 60% after the intervention, without statistical differences being observed. In the group of GPs assigned to the full intervention group, the percentages were 55.1% and 36.2%, respectively, with a difference of 18.9% (95% CI: 6.4%-30.6%, P < .05). Access to point-of-care tests reduces antibiotic use in subjects who explicitly request an antibiotic prescription. Copyright © 2014 by Daedalus Enterprises.

Access point selection game with mobile users using correlated equilibrium.

PubMed

Sohn, Insoo

2015-01-01

One of the most important issues in wireless local area network (WLAN) systems with multiple access points (APs) is the AP selection problem. Game theory is a mathematical tool used to analyze the interactions in multiplayer systems and has been applied to various problems in wireless networks. Correlated equilibrium (CE) is one of the powerful game theory solution concepts, which is more general than the Nash equilibrium for analyzing the interactions in multiplayer mixed strategy games. A game-theoretic formulation of the AP selection problem with mobile users is presented using a novel scheme based on a regret-based learning procedure. Through convergence analysis, we show that the joint actions based on the proposed algorithm achieve CE. Simulation results illustrate that the proposed algorithm is effective in a realistic WLAN environment with user mobility and achieves maximum system throughput based on the game-theoretic formulation.

Access Point Selection Game with Mobile Users Using Correlated Equilibrium

PubMed Central

Sohn, Insoo

2015-01-01

One of the most important issues in wireless local area network (WLAN) systems with multiple access points (APs) is the AP selection problem. Game theory is a mathematical tool used to analyze the interactions in multiplayer systems and has been applied to various problems in wireless networks. Correlated equilibrium (CE) is one of the powerful game theory solution concepts, which is more general than the Nash equilibrium for analyzing the interactions in multiplayer mixed strategy games. A game-theoretic formulation of the AP selection problem with mobile users is presented using a novel scheme based on a regret-based learning procedure. Through convergence analysis, we show that the joint actions based on the proposed algorithm achieve CE. Simulation results illustrate that the proposed algorithm is effective in a realistic WLAN environment with user mobility and achieves maximum system throughput based on the game-theoretic formulation. PMID:25785726

Access and Quality of HIV-Related Point-of-Care Diagnostic Testing in Global Health Programs.

PubMed

Fonjungo, Peter N; Boeras, Debrah I; Zeh, Clement; Alexander, Heather; Parekh, Bharat S; Nkengasong, John N

2016-02-01

Access to point-of-care testing (POCT) improves patient care, especially in resource-limited settings where laboratory infrastructure is poor and the bulk of the population lives in rural settings. However, because of challenges in rolling out the technology and weak quality assurance measures, the promise of human immunodeficiency virus (HIV)-related POCT in resource-limited settings has not been fully exploited to improve patient care and impact public health. Because of these challenges, the Joint United Nations Programme on HIV/AIDS (UNAIDS), in partnership with other organizations, recently launched the Diagnostics Access Initiative. Expanding HIV programs, including the "test and treat" strategies and the newly established UNAIDS 90-90-90 targets, will require increased access to reliable and accurate POCT results. In this review, we examine various components that could improve access and uptake of quality-assured POC tests to ensure coverage and public health impact. These components include evaluation, policy, regulation, and innovative approaches to strengthen the quality of POCT. © The Author 2015. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

Effect of central obscuration on the LDR point spread function

NASA Technical Reports Server (NTRS)

Vanzyl, Jakob J.

1988-01-01

It is well known that Gaussian apodization of an aperture reduces the sidelobe levels of its point spread function (PSF). In the limit where the standard deviation of the Gaussian function is much smaller than the diameter of the aperture, the sidelobes completely disappear. However, when Gaussian apodization is applied to the Large Deployable Reflector (LDR) array consisting of 84 hexagonal panels, it is found that the sidelobe level only decreases by about 2.5 dB. The reason for this is explained. The PSF is shown for an array consisting of 91 uniformly illuminated hexagonal apertures; this array is identical to the LDR array, except that the central hole in the LDR array is filled with seven additional panels. For comparison, the PSF of the uniformly illuminated LDR array is shown. Notice that it is already evident that the sidelobe structure of the LDR array is different from that of the full array of 91 panels. The PSF's of the same two arrays are shown, but with the illumination apodized with a Gaussian function to have 20 dB tapering at the edges of the arrays. While the sidelobes of the full array have decreased dramatically, those of the LDR array changed in structure, but stayed at almost the same level. This result is not completely surprising, since the Gaussian apodization tends to emphasize the contributions from the central portion of the array; exactly where the hole in the LDR array is located. The two most important conclusions are: the size of the central hole should be minimized, and a simple Gaussian apodization scheme to suppress the sidelobes in the PSF should not be used. A more suitable apodization scheme would be a Gaussian annular ring.

Pan European Phenological database (PEP725): a single point of access for European data

NASA Astrophysics Data System (ADS)

Templ, Barbara; Koch, Elisabeth; Bolmgren, Kjell; Ungersböck, Markus; Paul, Anita; Scheifinger, Helfried; Rutishauser, This; Busto, Montserrat; Chmielewski, Frank-M.; Hájková, Lenka; Hodzić, Sabina; Kaspar, Frank; Pietragalla, Barbara; Romero-Fresneda, Ramiro; Tolvanen, Anne; Vučetič, Višnja; Zimmermann, Kirsten; Zust, Ana

2018-06-01

The Pan European Phenology (PEP) project is a European infrastructure to promote and facilitate phenological research, education, and environmental monitoring. The main objective is to maintain and develop a Pan European Phenological database (PEP725) with an open, unrestricted data access for science and education. PEP725 is the successor of the database developed through the COST action 725 "Establishing a European phenological data platform for climatological applications" working as a single access point for European-wide plant phenological data. So far, 32 European meteorological services and project partners from across Europe have joined and supplied data collected by volunteers from 1868 to the present for the PEP725 database. Most of the partners actively provide data on a regular basis. The database presently holds almost 12 million records, about 46 growing stages and 265 plant species (including cultivars), and can be accessed via http://www.pep725.eu/ . Users of the PEP725 database have studied a diversity of topics ranging from climate change impact, plant physiological question, phenological modeling, and remote sensing of vegetation to ecosystem productivity.

Achievable Rate Estimation of IEEE 802.11ad Visual Big-Data Uplink Access in Cloud-Enabled Surveillance Applications.

PubMed

Kim, Joongheon; Kim, Jong-Kook

2016-01-01

This paper addresses the computation procedures for estimating the impact of interference in 60 GHz IEEE 802.11ad uplink access in order to construct visual big-data database from randomly deployed surveillance camera sensing devices. The acquired large-scale massive visual information from surveillance camera devices will be used for organizing big-data database, i.e., this estimation is essential for constructing centralized cloud-enabled surveillance database. This performance estimation study captures interference impacts on the target cloud access points from multiple interference components generated by the 60 GHz wireless transmissions from nearby surveillance camera devices to their associated cloud access points. With this uplink interference scenario, the interference impacts on the main wireless transmission from a target surveillance camera device to its associated target cloud access point with a number of settings are measured and estimated under the consideration of 60 GHz radiation characteristics and antenna radiation pattern models.

Public accessibility of biomedical articles from PubMed Central reduces journal readership--retrospective cohort analysis.

PubMed

Davis, Philip M

2013-07-01

Does PubMed Central--a government-run digital archive of biomedical articles--compete with scientific society journals? A longitudinal, retrospective cohort analysis of 13,223 articles (5999 treatment, 7224 control) published in 14 society-run biomedical research journals in nutrition, experimental biology, physiology, and radiology between February 2008 and January 2011 reveals a 21.4% reduction in full-text hypertext markup language (HTML) article downloads and a 13.8% reduction in portable document format (PDF) article downloads from the journals' websites when U.S. National Institutes of Health-sponsored articles (treatment) become freely available from the PubMed Central repository. In addition, the effect of PubMed Central on reducing PDF article downloads is increasing over time, growing at a rate of 1.6% per year. There was no longitudinal effect for full-text HTML downloads. While PubMed Central may be providing complementary access to readers traditionally underserved by scientific journals, the loss of article readership from the journal website may weaken the ability of the journal to build communities of interest around research papers, impede the communication of news and events to scientific society members and journal readers, and reduce the perceived value of the journal to institutional subscribers.

Percutaneous retrieval of centrally embolized fragments of central venous access devices or knotted Swan-Ganz catheters. Clinical report of 14 retrievals with detailed angiographic analysis and review of procedural aspects

PubMed Central

Chmielak, Zbigniew; Dębski, Artur; Kępka, Cezary; Rudziński, Piotr N.; Bujak, Sebastian; Skwarek, Mirosław; Kurowski, Andrzej; Dzielińska, Zofia; Demkow, Marcin

2016-01-01

Introduction Totally implantable venous access systems (TIVAS), Swan-Ganz (SG) and central venous catheters (CVC) allow easy and repetitive entry to the central cardiovascular system. Fragments of them may be released inadvertently into the cardiovascular system during their insertion or as a result of mechanical complications encountered during long-term utilization. Aim To present results of percutaneous retrieval of embolized fragments of central venous devices or knotted SG and review the procedural aspects with a series of detailed angiographies. Material and methods Between January 2003 and December 2012 there were 14 (~0.025%) successful retrievals in 13 patients (44 ±16 years, 15% females) of embolized fragments of TIVAS (n = 10) or CVC (n = 1) or of dislodged guide-wires (n = 2) or knotted SG (n = 1). Results Foreign bodies with the forward end located in the right ventricle (RV), as well as those found in the pulmonary artery (PA), often required repositioning with a pigtail catheter as compared to those catheter fragments which were located in the right atrium (RA) and/or great vein and possessed an accessible free end allowing their direct ensnarement with the loop snare (57.0% (4/7) vs. 66.7% (2/3) vs. 0.0% (0/3); p = 0.074 respectively). Procedure duration was 2–3 times longer among catheters retrieved from the PA than among those with the forward edge located in the RV or RA (30 (18–68) vs. 13.5 (11–37) vs. 8 min (8–13); p = 0.054 respectively). The SG catheter knotted in the vena cava superior (VCS) was encircled with the loop snare introduced transfemorally, subsequently cut at its skin entrance and then pulled down inside the 14 Fr vascular sheath. Conclusions By using the pigtail catheter and the loop snare, it is feasible to retrieve centrally embolized fragments or knotted central venous access devices. PMID:27279874

Role-based access control permissions

DOEpatents

Staggs, Kevin P.; Markham, Thomas R.; Hull Roskos, Julie J.; Chernoguzov, Alexander

2017-04-25

Devices, systems, and methods for role-based access control permissions are disclosed. One method includes a policy decision point that receives up-to-date security context information from one or more outside sources to determine whether to grant access for a data client to a portion of the system and creates an access vector including the determination; receiving, via a policy agent, a request by the data client for access to the portion of the computing system by the data client, wherein the policy agent checks to ensure there is a session established with communications and user/application enforcement points; receiving, via communications policy enforcement point, the request from the policy agent, wherein the communications policy enforcement point determines whether the data client is an authorized node, based upon the access vector received from the policy decision point; and receiving, via the user/application policy enforcement point, the request from the communications policy enforcement point.

Central venous access and handwashing: variability in policies and practices.

PubMed

Galway, Robyn; Harrod, Mary Ellen; Crisp, Jackie; Donnellan, Robyn; Hardy, Jan; Harvey, Alice; Maurice, Lucy; Petty, Sheila; Senner, Anne

2003-12-01

This study examined variability in handwashing policy between hospitals, variability in handwashing practices in nurses and how practice differed from policy in tertiary paediatric hospitals in Australia and New Zealand. Eight of the possible nine major paediatric hospitals provided a copy of their handwashing and/or central venous access device (CVAD) policies, and 67 nurses completed a survey on their handwashing practices associated with CVAD management. A high degree of variability was found in relation to all the questions posed in the study. There was little consistency between policies and little agreement between policies and clinical practice, with many nurses washing for longer than required by policy. Rigour of handwashing also varied according to the procedure undertaken and the type of CVAD with activities undertaken farther from the insertion site of the device more likely to be performed using a clean rather than an aseptic handwashing technique. As both patients and nursing staff move within and between hospitals, a uniform and evidence-based approach to handwashing is highly desirable.

Measurements of the Received Signal Level and Service Coverage Area at the IEEE 802.11 Access Point in the Building

NASA Astrophysics Data System (ADS)

Gunantara, N.; Sudiarta, P. K.; Prasetya, AAN A. I.; Dharma, A.; Gde Antara, I. N.

2018-04-01

Access point (AP) is part of a Wireless Local Access Network (WLAN) with its communications using WiFi. AP is used to transmit and receive data to users/clients. The ability of AP to serve users/clients depends on many factors. Moreover, if AP is applied in conditions inside the building. In this study, AP is installed at two points inside the building and then measured in the form of the received signal level (RSL) and service coverage area. One AP measured its performance by 26 measurement points and the other AP measured its performance by 20 measurement points. When AP has measured its performance then another AP position is switched off. Based on the measurement result, the received signal level value is the highest value is about -47 dBm at a distance of 3.2 m, while the lowest is about -79 dBm at a 9.21 m because it is on barrier 2 walls. While based on service coverage area, the area which is far away from the AP then the quality of service becomes bad because the transmitted signal is weakening caused by the distance and the loss of the wall.

Low coverage of central point vaccination against dog rabies in Bamako, Mali.

PubMed

Muthiani, Yvonne; Traoré, Abdallah; Mauti, Stephanie; Zinsstag, Jakob; Hattendorf, Jan

2015-06-15

Canine rabies remains an important public-health problem in Africa. Dog mass vaccination is the recommended method for rabies control and elimination. We report on the first small-scale mass dog vaccination campaign trial in Bamako, Mali. Our objective was to estimate coverage of the vaccination campaign and to quantify determinants of intervention effectiveness. In September 2013, a central point vaccination campaign--free of cost for dog owners--was carried out in 17 posts on three consecutive days within Bamako's Commune 1. Vaccination coverage and the proportion of ownerless dogs were estimated by combining mark-recapture household and transect surveys using Bayesian modeling. The estimated vaccination coverage was 17.6% (95% Credibility Interval, CI: 14.4-22.1%) which is far below the World Health Organization (WHO) recommended vaccination coverage of 70%. The Bayesian estimate for the owned dog population of Commune 1 was 3459 dogs (95% CI: 2786-4131) and the proportion of ownerless dogs was about 8%. The low coverage observed is primarily attributed to low participation by dog owners. Dog owners reported several reasons for not bringing their dogs to the vaccination posts. The most frequently reported reasons for non-attendance were lack of information (25%) and the inability to handle the dog (16%). For 37% of respondents, no clear reason was given for non-vaccination. Despite low coverage, the vaccination campaign in Bamako was relatively easy to implement, both in terms of logistics and organization. Almost half of the participating dog owners brought their pets on the first day of the campaign. Participatory stakeholder processes involving communities and local authorities are needed to identify effective communication channels and locally adapted vaccination strategies, which could include both central-point and door-to-door vaccination. Copyright © 2015 Elsevier B.V. All rights reserved.

Water Quality vs. Sanitation Accessibility: What is the most effective intervention point for preventing cholera in Dhaka, Bangladesh?

NASA Astrophysics Data System (ADS)

Majumder, M. S.; Gute, D.; Faruque, A. S.

2011-12-01

Every year, 3 to 5 million individuals contract cholera, an acute diarrheal infection that is caused by the ingestion of food or water containing the Vibrio cholerae bacterium. Because cholera is a waterborne disease, it can be transmitted quickly in environments with inadequate water and sanitation systems where infected waste can easily pollute drinking water. Today, Bangladesh continues to struggle with endemic cholera. Donor organizations address water and sanitation via localized initiatives, including the installation of community water collection sites (i.e. tubewells; water-boiling points; etc.). At this small-scale level, water quality and sanitation accessibility can be improved independently of one another, and when resources are limited, donors must invest in the most effective disease prevention options. This study used laboratory-confirmed cholera incidence data (2000-2009) collected by the International Centre of Diarrheal Disease Research, Bangladesh at their on-site hospital to compare the efficacy of interventions addressing water quality versus sanitation accessibility in Dhaka, Bangladesh. Data regarding use of sanitary latrines and boiling of drinking water were extracted from sequential patient interviews conducted at the Dhaka facility and used as surrogate variables for sanitation accessibility and water quality respectively. Our analysis indicates that boiling water is 10 times more effective at preventing cholera than the use of a sanitary latrine. This finding suggests that regulating water quality is perhaps more critical to cholera prevention than increasing sanitation accessibility in an urban environment like that of Dhaka. At present, WaterAid - one of Bangladesh's most significant water and sanitation donor organizations - invests the majority of its budget on improving sanitation accessibility. The World Health Organization and the United Nations Millennium Development Goals also prioritize sanitation accessibility. However, in

Model-Atmosphere Spectra of Central Stars of Planetary Nebulae - Access via the Virtual Observatory Service TheoSSA

NASA Astrophysics Data System (ADS)

Rauch, T.; Reindl, N.

2014-04-01

In the framework of the Virtual Observatory (VO), the German Astrophysical Virtual Observatory GAVO project provides easy access to theoretical spectral energy distributions (SEDs) within the registered GAVO service TheoSSA (http://dc.g-vo.org/theossa). TheoSSA is based on the well established Tübingen NLTE Model-Atmosphere Package (TMAP) for hot, compact stars. This includes central stars of planetary nebulae. We show examples of TheoSSA in operation.

[Venous access in oncology].

PubMed

Lesimple, T; Béguec, J F; Levêque, J M

1998-10-31

Many treatments administered to cancer patients require venous access either via a peripheral vein or a larger central vein at the risk of local or systemic infection, thrombus formation or venous occlusion and dysfunction. Insertion of a central catheter is an invasive procedure which must be conducted under conditions of rigorous asepsia. Strict rules based on well-defined protocols must be applied throughout its use. Local or systemic infectious complications account for 18 to 25% of all nosocomial infections and are often related to colonisation of the puncture site by a Gram positive germ. In case of infection, ablation of the central catheter is not mandatory for diagnosis or antibiotic treatment. Reported at varying frequencies in the literature from 4 to 42%, thrombus formation is unpredictable and often difficult to diagnose. Anticoagulants or fibrolytic agents are indicated but it may also be necessary to withdraw the catheter. Displacement, rupture, obstruction and extravasation are frequent complications. Back flow must be checked in all venous accesses and free flow carefully verified. The access must remain patent throughout the period of use, guaranteed by a standard heparinization and rinsing protocol. This complications must not mask the important progress achieved with the use of central venous access for specific and symptomatic treatment in cancer patients.

Trends in Education Access and Financing during the Transition in Central And Eastern Europe. Social Challenges of Transition Series.

ERIC Educational Resources Information Center

Laporte, Bruno; Ringold, Dena

This paper is one in a series of reports based upon data from the "Social Challenges of Transition (SCT)" database. This cross-country study examines empirical trends in access to and financing of education in nine Central and East European countries. The study substantially improves the understanding of the impact of transition on…

The Point Sal–Point Piedras Blancas correlation and the problem of slip on the San Gregorio–Hosgri fault, central California Coast Ranges

USGS Publications Warehouse

Colgan, Joseph P.; Stanley, Richard G.

2016-01-01

Existing models for large-magnitude, right-lateral slip on the San Gregorio–Hosgri fault system imply much more deformation of the onshore block in the Santa Maria basin than is supported by geologic data. This problem is resolved by a model in which dextral slip on this fault system increases gradually from 0–10 km near Point Arguello to ∼150 km at Cape San Martin, but such a model requires abandoning the cross-fault tie between Point Sal and Point Piedras Blancas, which requires 90–100 km of right-lateral slip on the southern Hosgri fault. We collected stratigraphic and detrital zircon data from Miocene clastic rocks overlying Jurassic basement at both localities to determine if either section contained unique characteristics that could establish how far apart they were in the early Miocene. Our data indicate that these basins formed in the early Miocene during a period of widespread transtensional basin formation in the central Coast Ranges, and they filled with sediment derived from nearby pre-Cenozoic basement rocks. Although detrital zircon data do not indicate a unique source component in either section, they establish the maximum depositional age of the previously undated Point Piedras Blancas section to be 18 Ma. We also show that detrital zircon trace-element data can be used to discriminate between zircons of oceanic crust and arc affinity of the same age, a potentially useful tool in future studies of the California Coast Ranges. Overall, we find no characteristics in the stratigraphy and provenance of the Point Sal and Point Piedras Blancas sections that are sufficiently unique to prove whether they were far apart or close together in the early Miocene, making them of questionable utility as piercing points.

Recent Advances in Point-of-Access Water Quality Monitoring

NASA Astrophysics Data System (ADS)

Korostynska, O.; Arshak, K.; Velusamy, V.; Arshak, A.; Vaseashta, Ashok

Clean water is one of our most valuable natural resources. In addition to providing safe drinking water it assures functional ecosystems that support fisheries and recreation. Human population growth and its associated increased demands on water pose risks to maintaining acceptable water quality. It is vital to assess source waters and the aquatic systems that receive inputs from industrial waste and sewage treatment plants, storm water systems, and runoff from urban and agricultural lands. Rapid and confident assessments of aquatic resources form the basis for sound environmental management. Current methods engaged in tracing the presence of various bacteria in water employ bulky laboratory equipment and are time consuming. Thus, real-time water quality monitoring is essential for National and International Health and Safety. Environmental water monitoring includes measurements of physical characteristics (e.g. pH, temperature, conductivity), chemical parameters (e.g. oxygen, alkalinity, nitrogen and phosphorus compounds), and abundance of certain biological taxa. Monitoring could also include assays of biological activity such as alkaline phosphatase, tests for toxins such as microcystins and direct measurements of pollutants such as heavy metals or hydrocarbons. Real time detection can significantly reduce the level of damage and also the cost to remedy the problem. This paper presents overview of state-of-the-art methods and devices used for point-of-access water quality monitoring and suggest further developments in this area.

Point-of-care lactate and creatinine analysis for sick obstetric patients at Queen Elizabeth Central Hospital in Blantyre, Malawi: A feasibility study.

PubMed

Glasmacher, S A; Bonongwe, P; Stones, W

2016-03-01

To achieve good outcomes in critically ill obstetric patients, it is necessary to identify organ dysfunction rapidly so that life-saving interventions can be appropriately commenced. However, timely access to clinical chemistry results is problematic, even in referral institutions, in the sub-Saharan African region. Reliable point-of-care tests licensed for clinical use are now available for lactate and creatinine. We aimed to assess whether implementation of point-of-care testing for lactate and creatinine is feasible in the obstetric unit at the Queen Elizabeth Central Hospital (QECH) in Blantyre, Malawi, by obtaining the opinions of clinical staff on the use of these tests in practice. During a two-month evaluation period nurse-midwives, medical interns, clinical officers, registrars, and consultants were given the opportunity to use StatStrip® and StatSensor® (Nova Biomedical, Waltham, USA) devices, for lactate and creatinine estimation, as part of their routine clinical practice in the obstetric unit. They were subsequently asked to complete a short questionnaire. Thirty-seven questionnaires were returned by participants: 22 from nurse-midwives and the remainder from clinicians. The mean satisfaction score for the devices was 7.6/10 amongst clinicians and 8.0/10 amongst nurse-midwives. The majority of participants stated that the obstetric high dependency unit (HDU) was the most suitable location for the devices. For lactate, 31 participants strongly agreed that testing should be continued and 24 strongly agreed that it would influence patient management. For creatinine, 29 strongly agreed that testing should be continued and 28 strongly agreed that it would influence their patient management. Twenty participants strongly agreed that they trust point-of-care devices. Point-of-care clinical chemistry testing was feasible, practical, and well received by staff, and was considered to have a useful role to play in the clinical care of sick obstetric patients at

Current use of ultrasound for central vascular access in children and infants in the Nordic countries--a cross-sectional study.

PubMed

Olsen, Thomas C Risom; Rimstad, Ivan Jonassen; Tarpgaard, Mona; Holmberg, Svante; Hallas, Peter

2015-01-01

The use of ultrasound (US) guidance for central vascular access in children has been advocated as a safer approach compared to traditional landmark techniques. We therefore collected data on the current use of US for central vascular access in children and infants in the Nordic countries. A cross-sectional survey using an online questionnaire was distributed to one anaesthesiologist at every hospital in the Nordic countries; a total of 177 anaesthesiologists were contacted from July till August 2012. The use of US for placing central venous catheters (CVCs) seems widespread across the Nordic countries. Close to 80% of respondents were using it "almost always" or "frequently" across all paediatric age groups for internal jugular vein cannulation. US was least frequently used when catheterizing the subclavian vein. The two most common reasons given when not using US were lack of training followed by lack of equipment. We found no difference in the use of US between high-volume centres and low-volume centres. (High-volume centres placed paediatric CVCs at least weekly.). US was commonly used for cannulation of the internal jugular vein but infrequently for the subclavian vein. A lack of training seems to be a barrier for further increasing the use of US. Establishing standardized training programmes based on current evidence should alleviate this.

Vascular Access Tracking System: a Web-Based Clinical Tracking Tool for Identifying Catheter Related Blood Stream Infections in Interventional Radiology Placed Central Venous Catheters.

PubMed

Morrison, James; Kaufman, John

2016-12-01

Vascular access is invaluable in the treatment of hospitalized patients. Central venous catheters provide a durable and long-term solution while saving patients from repeated needle sticks for peripheral IVs and blood draws. The initial catheter placement procedure and long-term catheter usage place patients at risk for infection. The goal of this project was to develop a system to track and evaluate central line-associated blood stream infections related to interventional radiology placement of central venous catheters. A customized web-based clinical database was developed via open-source tools to provide a dashboard for data mining and analysis of the catheter placement and infection information. Preliminary results were gathered over a 4-month period confirming the utility of the system. The tools and methodology employed to develop the vascular access tracking system could be easily tailored to other clinical scenarios to assist in quality control and improvement programs.

Performance evaluation of modulation and multiple access schemes in ultraviolet optical wireless connections for two atmosphere thickness cases.

PubMed

Raptis, Nikos; Pikasis, Evangelos; Syvridis, Dimitris

2016-08-01

The exploitation of optical wireless communication channels in a non-line-of-sight regime is studied for point-to-point and networking configurations considering the use of light-emitting diodes. Two environments with different scattering center densities are considered, assuming operation at 265 nm. The bit error rate performance of both pulsed and multicarrier modulation schemes is examined, using numerical approaches. In the networking scenario, a central node only receives data, one node transmits useful data, and the rest of them act as interferers. The performance of the desirable node's transmissions is evaluated. The access to the medium is controlled by a code division multiple access scheme.

Central venous access devices: an investigation of oncology nurses' troubleshooting techniques.

PubMed

Mason, Tina M; Ferrall, Sheila M; Boyington, Alice R; Reich, Richard R

2014-08-01

Experienced oncology nurses use different troubleshooting techniques for clearing occluded central venous access devices (CVADs) with varying degrees of success. The purpose of this study was to explore troubleshooting techniques used for clearing occluded CVADs by experienced oncology RNs and identify the perceived effectiveness of each technique. An invitation for a web-based survey was sent to select RN members of the Oncology Nursing Society. All nurses (N = 224) reported asking patients to raise and/or move their arm. Most nurses asked patients to lie down, cough, and take deep breaths. Respondents considered instilling a thrombolytic agent to be the most effective technique. No associations were found between techniques and respondents' years in oncology nursing, work setting, certification, or academic degree. The findings contribute to knowledge about care of patients with occluded devices and will help formulate direction for additional investigation of CVADs. Establishing the appropriateness of practice-related troubleshooting techniques may eliminate unnecessary steps and save nursing time. Educating nurses on the topic will also help reduce techniques that are not expected to yield results or are contraindicated.

Central venous access: techniques and indications in oncology.

PubMed

Marcy, Pierre-Yves

2008-10-01

Long lines can be inserted centrally or peripherally through patent veins into the central venous system down to the atrial caval junction. Traditionally surgeons, anesthetists, cardiologists and more recently interventional radiologists have been placing them using vein cutdown or percutaneous needle puncture techniques. Typical candidates for implanted venous catheters are cancer patients undergoing long-term chemotherapy. The most important issues, in addition to the patency of central veins and the history of previous indwelling catheters, pacewires or venous thrombosis, are the patient's performance status, body mass index, medical history and respiratory status, and the relevant technique. The present article will give an overview of the radiological and surgical implantation techniques and will highlight the impact of imaging means on the technical feasibility, assessment and treatment of device-related complications.

Apollo: Giving application developers a single point of access to public health models using structured vocabularies and Web services

PubMed Central

Wagner, Michael M.; Levander, John D.; Brown, Shawn; Hogan, William R.; Millett, Nicholas; Hanna, Josh

2013-01-01

This paper describes the Apollo Web Services and Apollo-SV, its related ontology. The Apollo Web Services give an end-user application a single point of access to multiple epidemic simulators. An end user can specify an analytic problem—which we define as a configuration and a query of results—exactly once and submit it to multiple epidemic simulators. The end user represents the analytic problem using a standard syntax and vocabulary, not the native languages of the simulators. We have demonstrated the feasibility of this design by implementing a set of Apollo services that provide access to two epidemic simulators and two visualizer services. PMID:24551417

Apollo: giving application developers a single point of access to public health models using structured vocabularies and Web services.

PubMed

Wagner, Michael M; Levander, John D; Brown, Shawn; Hogan, William R; Millett, Nicholas; Hanna, Josh

2013-01-01

This paper describes the Apollo Web Services and Apollo-SV, its related ontology. The Apollo Web Services give an end-user application a single point of access to multiple epidemic simulators. An end user can specify an analytic problem-which we define as a configuration and a query of results-exactly once and submit it to multiple epidemic simulators. The end user represents the analytic problem using a standard syntax and vocabulary, not the native languages of the simulators. We have demonstrated the feasibility of this design by implementing a set of Apollo services that provide access to two epidemic simulators and two visualizer services.

How does electronic cigarette access affect adolescent smoking?

PubMed

Friedman, Abigail S

2015-12-01

Understanding electronic cigarettes' effect on tobacco smoking is a central economic and policy issue. This paper examines the causal impact of e-cigarette access on conventional cigarette use by adolescents. Regression analyses consider how state bans on e-cigarette sales to minors influence smoking rates among 12 to 17 year olds. Such bans yield a statistically significant 0.9 percentage point increase in recent smoking in this age group, relative to states without such bans. Results are robust to multiple specifications as well as several falsification and placebo checks. This effect is both consistent with e-cigarette access reducing smoking among minors, and large: banning electronic cigarette sales to minors counteracts 70 percent of the downward pre-trend in teen cigarette smoking for a given two-year period. Copyright © 2015 Elsevier B.V. All rights reserved.

A Randomized Controlled Comparison of the Internal Jugular Vein and the Subclavian Vein as Access Sites for Central Venous Catheterization in Pediatric Cardiac Surgery.

PubMed

Camkiran Firat, Aynur; Zeyneloglu, Pinar; Ozkan, Murat; Pirat, Arash

2016-09-01

To compare internal jugular vein and subclavian vein access for central venous catheterization in terms of success rate and complications. A 1:1 randomized controlled trial. Baskent University Medical Center. Pediatric patients scheduled for cardiac surgery. Two hundred and eighty children undergoing central venous catheterization were randomly allocated to the internal jugular vein or subclavian vein group during a period of 18 months. The primary outcome was the first-attempt success rate of central venous catheterization through either approach. The secondary outcomes were the rates of infectious and mechanical complications. The central venous catheterization success rate at the first attempt was not significantly different between the subclavian vein (69%) and internal jugular vein (64%) groups (p = 0.448). However, the overall success rate was significantly higher through the subclavian vein (91%) than the internal jugular vein (82%) (p = 0.037). The overall frequency of mechanical complications was not significantly different between the internal jugular vein (25%) and subclavian vein (31%) (p = 0.456). However, the rate of arterial puncture was significantly higher with internal jugular vein (8% vs 2%; p = 0.03) and that of catheter malposition was significantly higher with subclavian vein (17% vs 1%; p < 0.001). The rates per 1,000 catheter days for both positive catheter-tip cultures (26.1% vs 3.6%; p < 0.001) and central-line bloodstream infection (6.9 vs 0; p < 0.001) were significantly higher with internal jugular vein. There were no significant differences between the groups in the length of ICU and hospital stays or in-hospital mortality rates (p > 0.05 for all). Central venous catheterization through the internal jugular vein and subclavian vein was not significantly different in terms of success at the first attempt. Although the types of mechanical complications were different, the overall rate was similar between internal jugular vein and

Management of Central Venous Access Device-Associated Skin Impairment: An Evidence-Based Algorithm.

PubMed

Broadhurst, Daphne; Moureau, Nancy; Ullman, Amanda J

Patients relying on central venous access devices (CVADs) for treatment are frequently complex. Many have multiple comorbid conditions, including renal impairment, nutritional deficiencies, hematologic disorders, or cancer. These conditions can impair the skin surrounding the CVAD insertion site, resulting in an increased likelihood of skin damage when standard CVAD management practices are employed. Supported by the World Congress of Vascular Access (WoCoVA), developed an evidence- and consensus-based algorithm to improve CVAD-associated skin impairment (CASI) identification and diagnosis, guide clinical decision-making, and improve clinician confidence in managing CASI. A scoping review of relevant literature surrounding CASI management was undertaken March 2014, and results were distributed to an international advisory panel. A CASI algorithm was developed by an international advisory panel of clinicians with expertise in wounds, vascular access, pediatrics, geriatric care, home care, intensive care, infection control and acute care, using a 2-phase, modified Delphi technique. The algorithm focuses on identification and treatment of skin injury, exit site infection, noninfectious exudate, and skin irritation/contact dermatitis. It comprised 3 domains: assessment, skin protection, and patient comfort. External validation of the algorithm was achieved by prospective pre- and posttest design, using clinical scenarios and self-reported clinician confidence (Likert scale), and incorporating algorithm feasibility and face validity endpoints. The CASI algorithm was found to significantly increase participants' confidence in the assessment and management of skin injury (P = .002), skin irritation/contact dermatitis (P = .001), and noninfectious exudate (P < .01). A majority of participants reported the algorithm as easy to understand (24/25; 96%), containing all necessary information (24/25; 96%). Twenty-four of 25 (96%) stated that they would recommend the tool to

Utilizing Fission Technology to Enable Rapid and Affordable Access to any Point in the Solar System

NASA Technical Reports Server (NTRS)

Houts, Mike; Bonometti, Joe; Morton, Jeff; Hrbud, Ivana; Bitteker, Leo; VanDyke, Melissa; Godfroy, T.; Pedersen, K.; Dobson, C.; Patton, B.;

Vascular Access Guidelines: Summary, Rationale, and Controversies.

PubMed

Sequeira, Adrian; Naljayan, Mihran; Vachharajani, Tushar J

2017-03-01

Dialysis vascular access management in the United States changed significantly after National Kidney Foundation-Kidney Disease Outcome Quality Initiative (NKF-KDOQI) clinical practice guidelines were first published in 1997. The Centers for Medicare and Medicaid Service adopted these guidelines and in collaboration with the End-Stage Renal Disease Networks established the Fistula First Breakthrough Initiative (FFBI) in 2003 to improve the rate of arteriovenous fistula use over arteriovenous graft and central venous catheter in the dialysis population. The implementation of guidelines and FFBI has led to a significant increase in the arteriovenous fistula use in the prevalent dialysis population. The guidelines are criticized for being opinion based and often impractical. Over the past 2 decades, the patient population undergoing dialysis has become older with complex comorbidities and challenges for creating an ideal vascular access. Advancing knowledge about access pathophysiology, improved treatment options, and improved process of care with team approach model point toward diminishing relevance of few of the existing guidelines. Moreover, several guidelines remain controversial and may be leading to clinical decisions that may be unfavorable to the patients. The review discusses the historical aspect of vascular access care in the United States and evolution of current practice standards and controversies surrounding few of these guidelines in the current time. Published by Elsevier Inc.

Access to Strong Opioid Analgesics in the Context of Legal and Regulatory Barriers in Eleven Central and Eastern European Countries.

PubMed

Vranken, Marjolein J M; Mantel-Teeuwisse, Aukje K; Schutjens, Marie-Hélène D B; Scholten, Willem K; Jünger, Saskia; Medic, Dr Rer; Leufkens, Hubert G M

2018-04-06

In 2011-2013, >95% of the global opioid analgesics consumption occurred in three regions, accounting for 15% of the world population. Despite abundant literature on barriers to access, little is known on the correlation between actual access to opioid analgesics and barriers to access, including legal and regulatory barriers. This study aimed to evaluate the correlation between access to strong opioid analgesics and barriers to access in national legislation and regulations in 11 central and eastern European countries that participated in the Access to Opioid Medication in Europe (ATOME) project. Two variables were contrasted to assess their correlation: the country level of access to strong opioid analgesics indicated by the Adequacy of Consumption Measure (ACM) and the number of potential legal and regulatory barriers identified by an external review of legislation and regulations. A linear correlation was evaluated using a squared linear correlation coefficient. Evaluation of the correlation between the ACM and the number of potential barriers produces an R 2 value of 0.023 and a correlation plot trend line gradient of -0.075, indicating no correlation between access to strong opioid analgesics and the number of potential barriers in national legislation and regulations in the countries studied. No correlation was found, which indicates that other factors besides potential legal and regulatory barriers play a critical role in withholding prescribers and patients essential pain medication in the studied countries. More research is needed toward better understanding of the complex interplay of factors that determine access to strong opioid analgesics.

Point Cloud Storage and Access on a Global Scale

DTIC Science & Technology

2015-01-01

coordinates. These Geodetic values are appended to the list of parameters and are re-projected into WGS84 Geocentric (ECEF X,Y,Z), replacing the original...Append Lon,Lat,Alt to point parameters Re-project point with Proj.4 from Geodetic (Lon,Lat,Alt) -> Geocentric (X,Y,Z) Insert point into

Mental Health and Migration: Depression, Alcohol Abuse, and Access to Health Care among Migrants in Central Asia

PubMed Central

Ismayilova, Leyla; Lee, Hae Nim; Shaw, Stacey; El-Bassel, Nabila; Gilbert, Louisa; Terlikbayeva, Assel; Rozental, Yelena

2014-01-01

Background One fifth of Kazakhstan’s population is labor migrants working in poor conditions with limited legal rights. This paper examines self-rated health, mental health and access to health care among migrant workers. Methods Using geo-mapping, a random sample of internal and external migrant market workers was selected in Almaty (N=450). We used survey logistic regression adjusted for clustering of workers within stalls. Results Almost half of participants described their health as fair or poor and reported not seeing a doctor when needed, 6.2% had clinical depression and 8.7% met criteria for alcohol abuse. Female external migrants were at higher risk for poor health and underutilization of health services. High mobility was associated with depression among internal migrants and with alcohol abuse among female migrant workers. Conclusions This study demonstrates the urgent need to address health and mental health needs and improve access to health care among labor migrants in Central Asia. PMID:24186359

Mental health and migration: depression, alcohol abuse, and access to health care among migrants in Central Asia.

PubMed

Ismayilova, Leyla; Lee, Hae Nim; Shaw, Stacey; El-Bassel, Nabila; Gilbert, Louisa; Terlikbayeva, Assel; Rozental, Yelena

2014-12-01

One-fifth of Kazakhstan's population is labor migrants working in poor conditions with limited legal rights. This paper examines self-rated health, mental health and access to health care among migrant workers. Using geo-mapping, a random sample of internal and external migrant market workers was selected in Almaty (N = 450). We used survey logistic regression adjusted for clustering of workers within stalls. Almost half of participants described their health as fair or poor and reported not seeing a doctor when needed, 6.2% had clinical depression and 8.7% met criteria for alcohol abuse. Female external migrants were at higher risk for poor health and underutilization of health services. High mobility was associated with depression among internal migrants and with alcohol abuse among female migrant workers. This study demonstrates the urgent need to address health and mental health needs and improve access to health care among labor migrants in Central Asia.

Single-stick tunneled central venous access using the jugular veins in infants weighing less than 5 kg.

PubMed

Lindquester, Will S; Hawkins, C Matthew; Monroe, Eric J; Gill, Anne E; Shivaram, Giridhar M; Seidel, F Glen; Lungren, Matthew P

2017-11-01

Despite the demonstrated feasibility of the single-stick technique in the femoral vein, its use in neonates and infants for placing central lines in internal and external jugular veins has not been reported. Describe and assess the safety and efficacy of tunneled jugular central venous catheter placement performed under ultrasound (US) and fluoroscopic guidance in neonates and infants weighing <5 kg using the single-stick technique at three tertiary pediatric hospitals. Thirty-three children weighing less than 5 kg received tunneled central venous access in either internal or external jugular veins using the single-stick technique. Patient history, procedural records and clinical follow-up documents were retrospectively reviewed. Complication rates were compared to those of 41 patients receiving single-stick femoral central lines. Technical complications occurred during one (3.0%) jugular placement with the patient having a failed right-side attempt with subsequent successful left-side placement. The catheters did not last the entire course of treatment in three (9.1%) patients with jugular lines. One patient had the catheter removed due to concern for infection, one catheter was accidentally removed during dressing changes, and one catheter was displaced and subsequently exchanged. Of patients receiving femoral central lines, 1 (2.4%) had a technical complication and 5 catheters (12.2%) did not last the entire course of treatment. The placement of tunneled central venous catheters in neonates/infants <5 kg is safe and technically feasible using the internal/external jugular vein via the single-stick technique. By theoretically reducing the risks of catheter infection by avoiding the diaper area and thrombosis by using larger veins, it may be preferable in certain patient populations.

Nurse-delivered universal point-of-care testing for HIV in an open-access returning traveller clinic.

PubMed

Herbert, R; Ashraf, A N; Yates, T A; Spriggs, K; Malinnag, M; Durward-Brown, E; Phillips, D; Mewse, E; Daniel, A; Armstrong, M; Kidd, I M; Waite, J; Wilks, P; Burns, F; Bailey, R; Brown, M

2012-09-01

Early diagnosis of HIV infection reduces morbidity and mortality associated with late presentation. Despite UK guidelines, the HIV testing rate has not increased. We have introduced universal HIV screening in an open-access returning traveller clinic. Data were prospectively recorded for all patients attending the open-access returning traveller clinic between August 2008 and December 2010. HIV testing was offered to all patients from May 2009; initially testing with laboratory samples (phase 1) and subsequently a point-of-care test (POCT) (phase 2). A total of 4965 patients attended the clinic; 1342 in phase 0, 792 in phase 1 and 2831 in phase 2. Testing rates for HIV increased significantly from 2% (38 of 1342) in phase 0 to 23.1% (183 of 792) in phase 1 and further increased to 44.5% (1261 of 2831) during phase 2 (P < 0.0001). Two new diagnoses of HIV-1 were identified in phase 1 (1.1% of tested); seven patients had a reactive POCT test in phase 2, of whom five (0.4% of those tested) were confirmed in a 4th generation assay. The patients with false reactive tests had a concurrent Plasmodium falciparum infection. Patients travelling to the Middle East and Europe were less likely to accept an HIV test with POCT. A nurse-delivered universal point-of-care HIV testing service has been successfully introduced and sustained in an acute medical clinic in a low-prevalence country. Caution is required in communicating reactive results in low-prevalence settings where there may be alternative diagnoses or a low population prevalence of HIV infection. © 2012 British HIV Association.

Genetic and Chemical Profiling of Gymnema sylvestre Accessions from Central India: Its Implication for Quality Control and Therapeutic Potential of Plant.

PubMed

Verma, Ashutosh Kumar; Dhawan, Sunita Singh; Singh, Seema; Bharati, Kumar Avinash; Jyotsana

2016-07-01

Gymnema sylvestre , a vulnerable plant species, is mentioned in Indian Pharmacopeia as an antidiabetic drug. Study of genetic and chemical diversity and its implications in accessions of G. sylvestre . Fourteen accessions of G. sylvestre collected from Central India and assessment of their genetic and chemical diversity were carried out using ISSR (inter simple sequence repeat) and HPLC (high performance liquid chromatography) fingerprinting methods. Among the screened 40 ISSR primers, 15 were found polymorphic and collectively produced nine unique accession-specific bands. The maximum and minimum numbers of amplicones were noted for ISSR-15 and ISSR-11, respectively. The ISSR -11 and ISSR-13 revealed 100% polymorphism. HPLC chromatograms showed that accessions possess the secondary metabolites of mid-polarity with considerable variability. Unknown peaks with retention time 2.63, 3.41, 23.83, 24.50, and 44.67 were found universal type. Comparative hierarchical clustering analysis based on foresaid fingerprints indicates that both techniques have equal potential to discriminate accessions according to percentage gymnemic acid in their leaf tissue. Second approach was noted more efficiently for separation of accessions according to their agro-climatic/collection site. Highly polymorphic ISSRs could be utilized as molecular probes for further selection of high gymnemic acid yielding accessions. Observed accession specific bands may be used as a descriptor for plant accessions protection and converted into sequence tagged sites markers. Identified five universal type peaks could be helpful in identification of G. sylvestre -based various herbal preparations. Nine accession specific unique bandsFive marker peaks for G. sylvestre .Suitability of genetic and chemical fingerprinting Abbreviations used: HPLC: High Performance Liquid Chromatography, ISSR: Inter Simple Sequence Repeats, CTAB: Cetyl Trimethylammonium Bromide, DNTP: Deoxynucleotide Triphosphates.

A Systematic Content Analysis of Policy Barriers Impeding Access to Opioid Medication in Central and Eastern Europe: Results of ATOME.

PubMed

Larjow, Eugenia; Papavasiliou, Evangelia; Payne, Sheila; Scholten, Willem; Radbruch, Lukas

2016-01-01

Reliable access to opioid medication is critical to delivering effective pain management, adequate treatment of opioid dependence, and quality palliative care. However, more than 80% of the world population is estimated to be inadequately treated for pain because of difficulties in accessing opioids. Although barriers to opioid access are primarily associated with restrictive laws, regulations, and licensing requirements, a key problem that significantly limits opioid access relates to policy constraints. To identify and explore policy barriers to opioid access in 12 Eastern and Central European countries involved in the Access to Opioid Medication in Europe project, funded by the European Community's Seventh Framework (FP7/2007-2013, no. 222994) Programme. A systematic content analysis of texts retrieved from documents (e.g., protocols of national problem analyses, strategic planning worksheets, and executive summaries) compiled, reviewed, approved, and submitted by either the Access to Opioid Medication in Europe consortium or the national country teams (comprising experts in pain management, harm reduction, and palliative care) between September 2011 and April 2014 was performed. Twenty-five policy barriers were identified (e.g., economic crisis, bureaucratic issues, lack of training initiatives, stigma, and discrimination), classified under four predetermined categories (financial/economic aspects and governmental support, formularies, education and training, and societal attitudes). Key barriers related to issues of funding allocation, affordability, knowledge, and fears associated with opioids. Reducing barriers and improving access to opioids require policy reform at the governmental level with a set of action plans being formulated and concurrently implemented and aimed at different levels of social, education, and economic policy change. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Outlook for modern cooking energy access in Central America

PubMed Central

2018-01-01

The Central American nations of Guatemala, Honduras and Nicaragua are among the poorest in the Americas. While the fraction of population dependent on solid fuels has declined in these nations over the last 25 years, the number of people using them has risen. Here, we first assess current patterns of cooking energy use in these nations. We then apply a discrete model of household cooking choices and demand to simulate future pathways of clean cooking uptake and the outlook for achieving target 7.1 of the Sustainable Development Goals (SDG), which aims to ensure universal access to affordable, reliable and modern energy services by 2030. We find that by 2030, ensuing income growth is likely to enable 90% of urban populations in these nations to switch to using modern cooking energy services. However, without supporting policies, between 40% to 50% of rural Guatemalans and Hondurans, while over two-thirds of rural Nicaraguans, are likely to find clean fuels or stoves unaffordable in 2030. A targeted subsidy on modern fuels, like liquid petroleum gas (LPG), is the most effective policy mechanism we studied that could provide such support. A 50% subsidy policy on LPG targeted to the rural and urban poor population could, by 2030, make cooking with LPG affordable to an additional 7.3 million people in these countries. We estimate that such a policy would cost about $250 million per year and would have negligible greenhouse gas emissions impacts. Such a policy could also have significant health benefits, preventing about 8,890 premature deaths annually from reduced exposure to cooking-related household pollution in 2030. PMID:29883457

Efficacy of losartan and carvedilol on central hemodynamics in hypertensives: a prospective, randomized, open, blinded end point, multicenter study.

PubMed

Kim, Eung Ju; Song, Woo-Hyuk; Lee, Jae Ung; Shin, Mi-Seung; Lee, Sahng; Kim, Byeong-Ok; Hong, Kyeong-Sun; Han, Seong Woo; Park, Chang Gyu; Seo, Hong Seog

2014-01-01

Renin-angiotensin system (RAS) blockers have shown clinical outcomes superior to those of the beta (β)-blocker atenolol, despite similar reductions in the peripheral blood pressure (BP), perhaps because of different impacts on central hemodynamics. However, few comparative studies of RAS blockers and newer vasodilating β-blockers have been performed. We compared the central hemodynamic effects of losartan and carvedilol in a prospective, randomized, open, blinded end point study. Of the 201 hypertensive patients enrolled, 182 (49.6±9.9 years, losartan group=88 and carvedilol group=94) were analyzed. Carotid-femoral pulse wave velocity (cfPWV), aortic augmentation index (AIx), AIx corrected for a heart rate (HR) of 75 beats per minute (AIx@HR75) and central BP were measured noninvasively at baseline and after a 24-week treatment regimen with losartan or carvedilol. After 24 weeks, there were no between-group differences in the brachial BP, cfPWV, AIx@HR75 or central BP changes, except for a more favorable AIx effect with losartan. The changes in all measured metabolic and inflammatory parameters were also not significantly different between the two groups, except for uric acid. Losartan and carvedilol showed generally comparable effects on central hemodynamic indices, metabolic profile, inflammatory parameters and peripheral arterial pressure with a 24-week treatment.

Evidence-Based Practice Point-of-Care Resources: A Quantitative Evaluation of Quality, Rigor, and Content.

PubMed

Campbell, Jared M; Umapathysivam, Kandiah; Xue, Yifan; Lockwood, Craig

2015-12-01

Clinicians and other healthcare professionals need access to summaries of evidence-based information in order to provide effective care to their patients at the point-of-care. Evidence-based practice (EBP) point-of-care resources have been developed and are available online to meet this need. This study aimed to develop a comprehensive list of available EBP point-of-care resources and evaluate their processes and policies for the development of content, in order to provide a critical analysis based upon rigor, transparency and measures of editorial quality to inform healthcare providers and promote quality improvement amongst publishers of EBP resources. A comprehensive and systematic search (Pubmed, CINAHL, and Cochrane Central) was undertaken to identify available EBP point-of-care resources, defined as "web-based medical compendia specifically designed to deliver predigested, rapidly accessible, comprehensive, periodically updated, and evidence-based information (and possibly also guidance) to clinicians." A pair of investigators independently extracted information on general characteristics, content presentation, editorial quality, evidence-based methodology, and breadth and volume. Twenty-seven summary resources were identified, of which 22 met the predefined inclusion criteria for EBP point-of-care resources, and 20 could be accessed for description and assessment. Overall, the upper quartile of EBP point-of-care providers was assessed to be UpToDate, Nursing Reference Centre, Mosby's Nursing Consult, BMJ Best Practice, and JBI COnNECT+. The choice of which EBP point-of-care resources are suitable for an organization is a decision that depends heavily on the unique requirements of that organization and the resources it has available. However, the results presented in this study should enable healthcare providers to make that assessment in a clear, evidence-based manner, and provide a comprehensive list of the available options. © 2015 Sigma Theta Tau

Accessibility Considerations for Hybrid Courses

ERIC Educational Resources Information Center

Behling, Kirsten

2017-01-01

This chapter explores the central questions and issues that faculty and administrators need to consider when designing and implementing hybrid courses to ensure that all students, including those with disabilities, have equal access. The author offers resources on faculty development programs, accessibility checklists, and online resources on…

Ultrasound-guided central venous access using Google Glass.

PubMed

Wu, Teresa S; Dameff, Christian J; Tully, Jeffrey L

2014-12-01

The use of ultrasound during invasive bedside procedures is quickly becoming the standard of care. Ultrasound machine placement during procedures often requires the practitioner to turn their head during the procedure to view the screen. Such turning has been implicated in unintentional hand movements in novices. Google Glass is a head-mounted computer with a specialized screen capable of projecting images and video into the view of the wearer. Such technology may help decrease unintentional hand movements. Our aim was to evaluate whether or not medical practitioners at various levels of training could use Google Glass to perform an ultrasound-guided procedure, and to explore potential advantages of this technology. Forty participants of varying training levels were randomized into two groups. One group used Google Glass to perform an ultrasound-guided central line. The other group used traditional ultrasound during the procedure. Video recordings of eye and hand movements were analyzed. All participants from both groups were able to complete the procedure without difficulty. Google Glass wearers took longer to perform the procedure at all training levels (medical student year 1 [MS1]: 193 s vs. 77 s, p > 0.5; MS4: 197s vs. 91s, p ≤ 0.05; postgraduate year 1 [PGY1]: 288s vs. 125 s, p > 0.5; PGY3: 151 s vs. 52 s, p ≤ 0.05), and required more needle redirections (MS1: 4.4 vs. 2.0, p > 0.5; MS4: 4.8 vs. 2.8, p > 0.5; PGY1: 4.4 vs. 2.8, p > 0.5; PGY3: 2.0 vs. 1.0, p > 0.5). In this study, it was possible to perform ultrasound-guided procedures with Google Glass. Google Glass wearers, on average, took longer to gain access, and had more needle redirections, but less head movements were noted. Copyright © 2014 Elsevier Inc. All rights reserved.

Bee venom acupuncture point injection for central post stroke pain: a preliminary single-blind randomized controlled trial.

PubMed

Cho, Seung-Yeon; Park, Joo-Young; Jung, Woo-Sang; Moon, Sang-Kwan; Park, Jung-Mi; Ko, Chang-Nam; Park, Seong-Uk

2013-06-01

We investigated apipuncture, or acupuncture point injection with diluted bee venom, as a promising new treatment for central post stroke pain (CPSP). Bee venom, diluted to 0.005% in normal saline, was administered to the treatment group, and normal saline given to control group as twice-weekly injections for three weeks. The points were LI15, GB21, LI11, GB31, ST36 and GB39 of the affected side and the amount of injection was 0.05 ml at each point. Eight patients in each group were included in the analysis. After three weeks there were significant decreases in visual analogue pain scores compared with baseline in both groups and the treatment group improved more significantly than the control group (p = 0.009). Apipuncture significantly improved CPSP in this pilot trial. Further studies of its mechanisms and a larger and long-term follow-up trial will be needed to determine more definitely the efficacy of apipuncture and to elucidate duration of improvement. Copyright © 2013 Elsevier Ltd. All rights reserved.

Energy challenges in optical access and aggregation networks.

PubMed

Kilper, Daniel C; Rastegarfar, Houman

2016-03-06

Scalability is a critical issue for access and aggregation networks as they must support the growth in both the size of data capacity demands and the multiplicity of access points. The number of connected devices, the Internet of Things, is growing to the tens of billions. Prevailing communication paradigms are reaching physical limitations that make continued growth problematic. Challenges are emerging in electronic and optical systems and energy increasingly plays a central role. With the spectral efficiency of optical systems approaching the Shannon limit, increasing parallelism is required to support higher capacities. For electronic systems, as the density and speed increases, the total system energy, thermal density and energy per bit are moving into regimes that become impractical to support-for example requiring single-chip processor powers above the 100 W limit common today. We examine communication network scaling and energy use from the Internet core down to the computer processor core and consider implications for optical networks. Optical switching in data centres is identified as a potential model from which scalable access and aggregation networks for the future Internet, with the application of integrated photonic devices and intelligent hybrid networking, will emerge. © 2016 The Author(s).

Upper limb grafts for hemodialysis access.

PubMed

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

2015-01-01

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

Improving the Accessibility and Efficiency of Point-of-Care Diagnostics Services in Low- and Middle-Income Countries: Lean and Agile Supply Chain Management.

PubMed

Kuupiel, Desmond; Bawontuo, Vitalis; Mashamba-Thompson, Tivani P

2017-11-29

Access to point-of-care (POC) diagnostics services is essential for ensuring rapid disease diagnosis, management, control, and surveillance. POC testing services can improve access to healthcare especially where healthcare infrastructure is weak and access to quality and timely medical care is a challenge. Improving the accessibility and efficiency of POC diagnostics services, particularly in resource-limited settings, may be a promising route to improving healthcare outcomes. In this review, the accessibility of POC testing is defined as the distance/proximity to the nearest healthcare facility for POC diagnostics service. This review provides an overview of the impact of POC diagnostics on healthcare outcomes in low- and middle-income countries (LMICs) and factors contributing to the accessibility of POC testing services in LMICs, focusing on characteristics of the supply chain management and quality systems management, characteristics of the geographical location, health infrastructure, and an enabling policy framework for POC diagnostics services. Barriers and challenges related to the accessibility of POC diagnostics in LMICs were also discussed. Bearing in mind the reported barriers and challenges as well as the disease epidemiology in LMICs, we propose a lean and agile supply chain management framework for improving the accessibility and efficiency of POC diagnostics services in these settings.

Improving the Accessibility and Efficiency of Point-of-Care Diagnostics Services in Low- and Middle-Income Countries: Lean and Agile Supply Chain Management

PubMed Central

Kuupiel, Desmond; Bawontuo, Vitalis

2017-01-01

Access to point-of-care (POC) diagnostics services is essential for ensuring rapid disease diagnosis, management, control, and surveillance. POC testing services can improve access to healthcare especially where healthcare infrastructure is weak and access to quality and timely medical care is a challenge. Improving the accessibility and efficiency of POC diagnostics services, particularly in resource-limited settings, may be a promising route to improving healthcare outcomes. In this review, the accessibility of POC testing is defined as the distance/proximity to the nearest healthcare facility for POC diagnostics service. This review provides an overview of the impact of POC diagnostics on healthcare outcomes in low- and middle-income countries (LMICs) and factors contributing to the accessibility of POC testing services in LMICs, focusing on characteristics of the supply chain management and quality systems management, characteristics of the geographical location, health infrastructure, and an enabling policy framework for POC diagnostics services. Barriers and challenges related to the accessibility of POC diagnostics in LMICs were also discussed. Bearing in mind the reported barriers and challenges as well as the disease epidemiology in LMICs, we propose a lean and agile supply chain management framework for improving the accessibility and efficiency of POC diagnostics services in these settings. PMID:29186013

Genetic and Chemical Profiling of Gymnema sylvestre Accessions from Central India: Its Implication for Quality Control and Therapeutic Potential of Plant

PubMed Central

Verma, Ashutosh Kumar; Dhawan, Sunita Singh; Singh, Seema; Bharati, Kumar Avinash; Jyotsana

2016-01-01

Background: Gymnema sylvestre, a vulnerable plant species, is mentioned in Indian Pharmacopeia as an antidiabetic drug Objective: Study of genetic and chemical diversity and its implications in accessions of G. sylvestre Materials and Methods: Fourteen accessions of G. sylvestre collected from Central India and assessment of their genetic and chemical diversity were carried out using ISSR (inter simple sequence repeat) and HPLC (high performance liquid chromatography) fingerprinting methods Results: Among the screened 40 ISSR primers, 15 were found polymorphic and collectively produced nine unique accession-specific bands. The maximum and minimum numbers of amplicones were noted for ISSR-15 and ISSR-11, respectively. The ISSR -11 and ISSR-13 revealed 100% polymorphism. HPLC chromatograms showed that accessions possess the secondary metabolites of mid-polarity with considerable variability. Unknown peaks with retention time 2.63, 3.41, 23.83, 24.50, and 44.67 were found universal type. Comparative hierarchical clustering analysis based on foresaid fingerprints indicates that both techniques have equal potential to discriminate accessions according to percentage gymnemic acid in their leaf tissue. Second approach was noted more efficiently for separation of accessions according to their agro-climatic/collection site Conclusion: Highly polymorphic ISSRs could be utilized as molecular probes for further selection of high gymnemic acid yielding accessions. Observed accession specific bands may be used as a descriptor for plant accessions protection and converted into sequence tagged sites markers. Identified five universal type peaks could be helpful in identification of G. sylvestre-based various herbal preparations. SUMMARY Nine accession specific unique bandsFive marker peaks for G. sylvestre.Suitability of genetic and chemical fingerprinting Abbreviations used: HPLC: High Performance Liquid Chromatography, ISSR: Inter Simple Sequence Repeats, CTAB: Cetyl

Mars Science Laboratory Frame Manager for Centralized Frame Tree Database and Target Pointing

NASA Technical Reports Server (NTRS)

Kim, Won S.; Leger, Chris; Peters, Stephen; Carsten, Joseph; Diaz-Calderon, Antonio

2013-01-01

The FM (Frame Manager) flight software module is responsible for maintaining the frame tree database containing coordinate transforms between frames. The frame tree is a proper tree structure of directed links, consisting of surface and rover subtrees. Actual frame transforms are updated by their owner. FM updates site and saved frames for the surface tree. As the rover drives to a new area, a new site frame with an incremented site index can be created. Several clients including ARM and RSM (Remote Sensing Mast) update their related rover frames that they own. Through the onboard centralized FM frame tree database, client modules can query transforms between any two frames. Important applications include target image pointing for RSM-mounted cameras and frame-referenced arm moves. The use of frame tree eliminates cumbersome, error-prone calculations of coordinate entries for commands and thus simplifies flight operations significantly.

Overall satisfaction of health care users with the quality of and access to health care services: a cross-sectional study in six Central and Eastern European countries.

PubMed

Stepurko, Tetiana; Pavlova, Milena; Groot, Wim

2016-08-02

The measurement of consumer satisfaction is an essential part of the assessment of health care services in terms of service quality and health care system responsiveness. Studies across Europe have described various strategies health care users employ to secure services with good quality and quick access. In Central and Eastern European countries, such strategies also include informal payments to health care providers. This paper analyzes the satisfaction of health care users with the quality of and access to health care services. The study focuses on six Central and Eastern European countries (Bulgaria, Hungary, Lithuania, Poland, Romania and Ukraine). We use data on past experience with health care use collected in 2010 through uniform national surveys in these countries. Based on these data, we carry out a multi-country analysis to investigate factors associated with the satisfaction of health care users in the six countries. The results indicate that about 10-14 % of the service users are not satisfied with the quality of, or access to health care services they used in the preceding year. However, significant differences across countries and services are observed, e.g. the highest level of dissatisfaction with access to outpatient services (16.4 %) is observed among patients in Lithuania, while in Poland, the level of dissatisfaction with quality of outpatient and inpatient services are much lower than dissatisfaction with access. The study also analyses the association of users' satisfaction with factors such as making informal payments, inability to pay and relative importance of service attributes stated by the service users. These multi-country findings provide evidence for health policy making in the Central and Eastern European countries. Although the average rates of satisfactions per country are relatively high, the results suggest that there is ample room for improvements. Specifically, many service-users still report dissatisfaction especially those

Initial Experience Performing In-office Ultrasound-guided Transperineal Prostate Biopsy Under Local Anesthesia Using the PrecisionPoint Transperineal Access System.

PubMed

Meyer, Alexa R; Joice, Gregory A; Schwen, Zeyad R; Partin, Alan W; Allaf, Mohamad E; Gorin, Michael A

2018-05-01

To describe our procedural technique and initial outcomes performing in-office transperineal prostate biopsies using the PrecisionPoint Transperineal Access System (Perineologic, Cumberland, MD). Following institutional review board approval, we retrospectively reviewed the records of men who underwent an in-office transperineal prostate biopsy using the PrecisionPoint device. Records were reviewed for baseline characteristics, biopsy results, and postbiopsy complications. Between January 4, 2017 and August 23, 2017, 43 men underwent an in-office transperineal prostate biopsy using the PrecisionPoint Transperineal Access System. Patients had a median serum prostate specific antigen level of 6.1 ng/mL (range 0.8-32.9). Of the 43 biopsies, 12 (27.9%) were performed for active surveillance of low-risk prostate cancer and 31 (72.1%) were performed for cancer screening. Overall, 21 (48.8%) men were found to have prostate cancer. Among those on active surveillance, cancer was detected in 8 of 12 (66.7%) patients, with 2 of 12 (16.7%) found to have Gleason ≥3 + 4 = 7 prostate cancer. Additionally, cancer was detected in 13 of 31 (41.9%) patients undergoing a biopsy for prostate cancer screening, with 5 (16.1%) found to have Gleason ≥3 + 4 = 7 disease. In total, 3 (7.0%) patients experienced a postbiopsy complication: 2 (4.7%) with urinary retention and 1 (2.3%) with gross hematuria requiring catheterization. No patient experienced an infectious complication despite omission of periprocedural antibiotics in all cases. The PrecisionPoint device allowed for the successful performance of in-office transperineal prostate biopsies under local anesthesia without the need for periprocedural antibiotics. We observed an acceptable cancer detection rate with no infectious complications. Copyright © 2018 Elsevier Inc. All rights reserved.

On Ramps: Options and Issues in Accessing the Internet.

ERIC Educational Resources Information Center

Bocher, Bob

1995-01-01

Outlines the basic options that schools and libraries have for accessing the Internet, focusing on four models: direct connection; dial access using SLIP/PPP (Serial Line Internet Protocol/Point-to-Point Protocol); dial-up using terminal emulation mode; and dial access through commercial online services. Discusses access option issues such as…

Decreasing dialysis catheter rates by creating a multidisciplinary dialysis access program.

PubMed

Rosenberry, Patricia M; Niederhaus, Silke V; Schweitzer, Eugene J; Leeser, David B

2018-03-01

Centers for Medicare and Medicaid Services have determined that chronic dialysis units should have <12% of their patients utilizing central venous catheters for hemodialysis treatments. On the Eastern Shore of Maryland, the central venous catheter rates in the dialysis units averaged >45%. A multidisciplinary program was established with goals of decreasing catheter rates in order to decrease central line-associated bloodstream infections, decrease mortality associated with central line-associated bloodstream infection, decrease hospital days, and provide savings to the healthcare system. We collected the catheter rates within three dialysis centers served over a 5-year period. Using published data surrounding the incidence and related costs of central line-associated bloodstream infection and mortality per catheter day, the number of central line-associated bloodstream infection events, the costs, and the related mortality could be determined prior to and after the initiation of the dialysis access program. An organized dialysis access program resulted in a 82% decrease in the number of central venous catheter days which lead to a concurrent reduction in central line-associated bloodstream infection and deaths. As a result of creating an access program, central venous catheter rates decreased from an average rate of 45% to 8%. The cost savings related to the program was calculated to be over US$5 million. The decrease in the number of mortalities is estimated to be between 13 and 27 patients. We conclude that a formalized access program decreases catheter rates, central line-associated bloodstream infection, and the resultant hospitalizations, mortality, and costs. Areas with high hemodialysis catheter rates should develop access programs to better serve their patient population.

Point-to-point people with purpose—Exploring the possibility of a commercial traveler market for point-to-point suborbital space transportation

NASA Astrophysics Data System (ADS)

Webber, Derek

2013-12-01

An argument was made at the First Arcachon Conference on Private Human Access to Space in 2008 [1] that some systematic market research should be conducted into potential market segments for point-to-point suborbital space transportation (PtP), in order to understand whether a commercial market exists which might augment possible government use for such a vehicle. The cargo market potential was subsequently addressed via desk research, and the results, which resulted in a pessimistic business case outlook, were presented in [2]. The same desk research approach is now used in this paper to address the potential business and wealthy individual passenger traveler market segment ("point-to-point people with purpose"). The results, with the assumed ticket pricing, are not encouraging.

Endovascular interventions for central vein stenosis.

PubMed

Agarwal, Anil K

2015-12-01

Central vein stenosis is common because of the placement of venous access and cardiac intravascular devices and compromises vascular access for dialysis. Endovascular intervention with angioplasty and/or stent placement is the preferred approach, but the results are suboptimal and limited. Primary patency after angioplasty alone is poor, but secondary patency can be maintained with repeated angioplasty. Stent placement is recommended for quick recurrence or elastic recoil of stenosis. Primary patency of stents is also poor, though covered stents have recently shown better patency than bare metal stents. Secondary patency requires repeated intervention. Recanalization of occluded central veins is tedious and not always successful. Placement of hybrid graft-catheter with a combined endovascular surgical approach can maintain patency in many cases. In the presence of debilitating symptoms, palliative approach with endovascular banding or occlusion of the access may be necessary. Prevention of central vein stenosis is the most desirable strategy.

Epidemiology and natural history of central venous access device use and infusion pump function in the NO16966 trial.

PubMed

Chu, E; Haller, D; Cartwright, T; Twelves, C; Cassidy, J; Sun, W; Saif, M W; McKenna, E; Lee, S; Schmoll, H-J

2014-03-18

Central venous access devices in fluoropyrimidine therapy are associated with complications; however, reliable data are lacking regarding their natural history, associated complications and infusion pump performance in patients with metastatic colorectal cancer. We assessed device placement, use during treatment, associated clinical outcomes and infusion pump performance in the NO16966 trial. Device replacement was more common with FOLFOX-4 (5-fluorouracil (5-FU)+oxaliplatin) than XELOX (capecitabine+oxaliplatin) (14.1% vs 5.1%). Baseline device-associated events and post-baseline removal-/placement-related events occurred more frequently with FOLFOX-4 than XELOX (11.5% vs 2.4% and 8.5% vs 2.1%). Pump malfunctions, primarily infusion accelerations in 16% of patients, occurred within 1.6-4.3% of cycles. Fluoropyrimidine-associated grade 3/4 toxicity was increased in FOLFOX-4-treated patients experiencing a malfunction compared with those who did not (97 out of 155 vs 452 out of 825 patients), predominantly with increased grade 3/4 neutropenia (53.5% vs 39.8%). Febrile neutropenia rates were comparable between patient cohorts±malfunction. Efficacy outcomes were similar in patient cohorts±malfunction. Central venous access device removal or replacement was common and more frequent in patients receiving FOLFOX-4. Pump malfunctions were also common and were associated with increased rates of grade 3/4 haematological adverse events. Oral fluoropyrimidine-based regimens may be preferable to infusional 5-FU based on these findings.

Use of peripherally inserted central catheters as an alternative to central catheters in neurocritical care units.

PubMed

DeLemos, Christi; Abi-Nader, Judy; Akins, Paul T

2011-04-01

Patients in neurological critical care units often have lengthy stays that require extended vascular access and invasive hemodynamic monitoring. The traditional approach for these patients has relied heavily on central venous and pulmonary artery catheters. The aim of this study was to evaluate peripherally inserted central catheters as an alternative to central venous catheters in neurocritical care settings. Data on 35 patients who had peripherally inserted central catheters rather than central venous or pulmonary artery catheters for intravascular access and monitoring were collected from a prospective registry of neurological critical care admissions. These data were cross-referenced with information from hospital-based data registries for peripherally inserted central catheters and subarachnoid hemorrhage. Complete data were available on 33 patients with Hunt-Hess grade IV-V aneurysmal subarachnoid hemorrhage. Catheters remained in place a total of 649 days (mean, 19 days; range, 4-64 days). One patient (3%) had deep vein thrombosis in an upper extremity. In 2 patients, central venous pressure measured with a peripherally inserted catheter was higher than pressure measured concurrently with a central venous catheter. None of the 33 patients had a central catheter bloodstream infection or persistent insertion-related complications. CONCLUSIONS Use of peripherally inserted central catheters rather than central venous catheters or pulmonary artery catheters in the neurocritical care unit reduced procedural and infection risk without compromising patient management.

The intracavitary ECG method for positioning the tip of central venous access devices in pediatric patients: results of an Italian multicenter study.

PubMed

Rossetti, Francesca; Pittiruti, Mauro; Lamperti, Massimo; Graziano, Ugo; Celentano, Davide; Capozzoli, Giuseppe

2015-01-01

The Italian Group for Venous Access Devices (GAVeCeLT) has carried out a multicenter study investigating the safety and accuracy of intracavitary electrocardiography (IC-ECG) in pediatric patients. We enrolled 309 patients (age 1 month-18 years) candidate to different central venous access devices (VAD) - 56 peripherally inserted central catheters (PICC), 178 short term centrally inserted central catheters (CICC), 65 long term VADs, 10 VADs for dialysis - in five Italian Hospitals. Three age groups were considered: A (<4 years, n = 157), B (4-11 years, n = 119), and C (12-18 years, n = 31). IC-ECG was applicable in 307 cases. The increase of the P wave on IC-ECG was detected in all cases but two. The tip of the catheter was positioned at the cavo-atrial junction (CAJ) (i.e., at the maximal height of the P wave on IC-ECG) and the position was checked during the procedure by fluoroscopy or chest x-ray, considering the CAJ at 1-2 cm (group A), 1.5-3 cm (group B), or 2-4 cm (group C) below the carina. There were no complications related to IC-ECG. The overall match between IC-ECG and x-ray was 95.8% (96.2% in group A, 95% in group B, and 96.8% in group C). In 95 cases, the IC-ECG was performed with a dedicated ECG monitor, specifically designed for IC-ECG (Nautilus, Romedex): in this group, the match between IC-ECG and x-ray was 98.8%. We conclude that the IC-ECG method is safe and accurate in the pediatric patients. The applicability of the method is 99.4% and its feasibility is 99.4%. The accuracy is 95.8% and even higher (98.8%) when using a dedicated ECG monitor.

A universal data access and protocol integration mechanism for smart home

NASA Astrophysics Data System (ADS)

Shao, Pengfei; Yang, Qi; Zhang, Xuan

2013-03-01

With the lack of standardized or completely missing communication interfaces in home electronics, there is no perfect solution to address every aspect in smart homes based on existing protocols and technologies. In addition, the central control unit (CCU) of smart home system working point-to-point between the multiple application interfaces and the underlying hardware interfaces leads to its complicated architecture and unpleasant performance. A flexible data access and protocol integration mechanism is required. The current paper offers a universal, comprehensive data access and protocol integration mechanism for a smart home. The universal mechanism works as a middleware adapter with unified agreements of the communication interfaces and protocols, offers an abstraction of the application level from the hardware specific and decoupling the hardware interface modules from the application level. Further abstraction for the application interfaces and the underlying hardware interfaces are executed based on adaption layer to provide unified interfaces for more flexible user applications and hardware protocol integration. This new universal mechanism fundamentally changes the architecture of the smart home and in some way meets the practical requirement of smart homes more flexible and desirable.

elevatr: Access Elevation Data from Various APIs

EPA Science Inventory

Several web services are available that provide access to elevation data. This package provides access to several of those services and returns elevation data either as a SpatialPointsDataFrame from point elevation services or as a raster object from raster elevation services. ...

Robotic percutaneous access to the kidney: comparison with standard manual access.

PubMed

Su, Li-Ming; Stoianovici, Dan; Jarrett, Thomas W; Patriciu, Alexandru; Roberts, William W; Cadeddu, Jeffrey A; Ramakumar, Sanjay; Solomon, Stephen B; Kavoussi, Louis R

2002-09-01

To evaluate the efficiency, accuracy, and safety of robotic percutaneous access to the kidney (PAKY) for percutaneous nephrolithotomy in comparison with conventional manual techniques. We compared the intraoperative access variables (number of access attempts, time to successful access, estimated blood loss, complications) of 23 patients who underwent robotic PAKY with the remote center of motion device (PAKY-RCM) with the same data from a contemporaneous series of 23 patients who underwent conventional manual percutaneous access to the kidney. The PAKY-RCM incorporates a robotic arm and a friction transmission with axial loading system to accurately position and insert a standard 18-gauge needle percutaneously into the kidney. The blood loss during percutaneous access was estimated on a four-point scale (1 = minimal to 4 = large). The color of effluent urine was graded on a four-point scale (1 = clear to 4 = red). The mean target calix width was 13.5 +/- 9.2 mm in the robotic group and 12.2 +/- 4.5 mm in the manual group (P = 0.57). When comparing PAKY-RCM with standard manual techniques, the mean number of attempts was 2.2 +/- 1.6 v 3.2 +/- 2.5 (P = 0.14), time to access was 10.4 +/- 6.5 minutes v 15.1 +/- 8.8 minutes (P = 0.06), estimated blood loss score was 1.3 +/- 0.49 v 1.7 +/- 0.66 (P = 0.14), and color of effluent urine following access was 2.0 +/- 0.90 v 2.1 +/- 0.7 (P = 0.82). The PAKY-RCM was successful in obtaining access in 87% (20 of 23) of cases. The other three patients (13%) required conversion to manual techniques. There were no major intraoperative complications in either group. Robotic PAKY is a feasible, safe, and efficacious method of obtaining renal access for nephrolithotomy. The number of attempts and time to access were comparable to those of standard manual percutaneous access techniques. These findings provide the groundwork for the development of a completely automated robot-assisted percutaneous renal access device.

Barriers to accessing adequate maternal care in Central and Eastern European countries: A systematic literature review.

PubMed

Miteniece, Elina; Pavlova, Milena; Rechel, Bernd; Groot, Wim

2017-03-01

Maternal health outcomes in Central and Eastern Europe (CEE) compare unfavorable with those in Western Europe, despite macro-indicators that suggest well-designed maternal care systems. However, macro-indicators at the system level only capture capacity, funding and utilization of care and not the actual allocation of financial and human resources, the quality of care and access to it. It is these latter which are problematic in the CEE region. In this study service-related indicators of access to maternal care in CEE are examined. These include availability, appropriateness, affordability, approachability and acceptability of maternal care. This study uses a qualitative systematic literature review, analyzing information of peer-reviewed articles published since 2004. Other inclusion criteria included language, setting and publication purpose. The included articles were analyzed using a framework analysis technique and quality was assessed using standardized evaluation checklists. Results indicate improvements in maternal care. However, availability of care is limited by outdated equipment and training curricula, and the lack of professionals and pharmaceuticals. Geographical distance to healthcare institutions, inappropriate communication of providers and waiting times are the main approachability barriers. Some mothers are unaware of the importance of care or are discouraged to utilize healthcare services because of cultural aspects. Finally, a major barrier in accessing maternal care in the CEE is the inability to pay for it. Our findings indicate that major gaps in evidence exist and that more representative and better quality data should be collected. Governments in CEE countries need to establish a reliable system for measuring and monitoring a suitable set of indicators, as well as deal with the general social and economic problem of informality. Medical curricula in the CEE region need to be overhauled and there should be a focus on improving the

Remifentanil for the insertion and removal of long-term central venous access during monitored anesthesia care.

PubMed

Burlacu, Crina L; McKeating, Kevin; McShane, Alan J

2011-06-01

To determine the analgesic efficacy of three different rates of remifentanil infusion in patients undergoing insertion or removal of long-term central venous access devices during monitored anesthesia care and local anesthetic field infiltration. Double-blinded, randomized, controlled study. Operating theatre of an University hospital. 44 unpremedicated, ASA physical status 1 and 2 patients, aged 18-65 years, undergoing insertion or removal of a Port-a-Cath or Hickman catheter. Patients sedated with a propofol target-controlled infusion were randomly allocated to three groups: Group R25 (n = 14), Group R50 (n = 15), and Group R75 (n = 15), to receive remifentanil 0.025, 0.05, and 0.075 μg/kg/min, respectively. Rescue remifentanil 0.5 μg/kg was administered for pain scores > 3. The remifentanil infusion rate was maintained constant unless respiratory and/or cardiovascular unwanted events occurred, whereupon the rate was adjusted in 0.01 μg/kg/min decrements as necessary. Pain scores (primary outcome), sedation, and movement scores (secondary outcomes) were assessed during local anesthetic infiltration of the anterior chest wall and 5 other procedural steps. All infusion rates had equal analgesic efficacy, as shown by comparable pain scores, number of rescue boluses, and number of patients requiring rescue analgesia. Excessive sedation was associated with the highest remifentanil rate such that Group R75 patients were significantly more sedated than Groups R25 or R50 at selective procedural steps (P < 0.05). More Group R75 patients (6/15) required remifentanil rate reduction than did patients from Group R50 (1/15) or Group R25 (0/14), P < 0.01, most commonly because of respiratory depression. For the insertion or removal of long-term central venous access devices, all three remifentanil infusion rates proved to be equally analgesic-efficient. However, the excessive sedation and tendency to respiratory and cardiovascular events associated with the highest

Sea-floor geology in central Rhode Island Sound south of Sakonnet Point, Rhode Island

USGS Publications Warehouse

McMullen, K.Y.; Poppe, L.J.; Ackerman, S.D.; Worley, C.R.; Nadeau, M.A.; Van Hoy, M. V.

2012-01-01

The U.S. Geological Survey (USGS) and the National Oceanic and Atmospheric Administration (NOAA) are working together to study the sea floor along the northeastern coast of the United States. NOAA collected multibeam-echosounder data during hydrographic survey H11995 in a 63-square-kilometer area in central Rhode Island Sound, south of Sakonnet Point, Rhode Island. The USGS collected sediment samples, bottom video, and still photographs from 27 stations in this study area to verify an interpretation of the bathymetric data. Collected data are used to map areas of scour depressions and erosional outliers, megaripples, boulders, and relatively undisturbed modern marine sediments. In general, much of the eastern part of the study area, a submerged segment of the Harbor Hill-Roanoke Point-Charlestown-Buzzards Bay moraine, is bouldery. Bottom photography shows boulders are generally encrusted with hydrozoans, algae, and anemone. Scour depressions, presumably formed by long-period storm waves, and erosional outliers of Holocene sediments dominate the western part of the study area and several large areas in the east. The scour depressions tend to have coarser grained sediment than intervening erosional outliers. The coarseness likely creates turbulence in the water over these areas, which prevents fine-grained sediment deposition. Several small areas of megaripples are visible in the bathymetry data in the west. Other sandy areas are typically rippled, with burrows, worm tubes, and starfish present.

48 CFR 18.102 - Central contractor registration.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Central contractor... Central contractor registration. Contractors are not required to be registered in the Central Contractor.... (See 4.1102). However, contractors are required to register with CCR in order to gain access to the...

A mixed-reality part-task trainer for subclavian venous access.

PubMed

Robinson, Albert R; Gravenstein, Nikolaus; Cooper, Lou Ann; Lizdas, David; Luria, Isaac; Lampotang, Samsun

2014-02-01

Mixed-reality (MR) procedural simulators combine virtual and physical components and visualization software that can be used for debriefing and offer an alternative to learn subclavian central venous access (SCVA). We present a SCVA MR simulator, a part-task trainer, which can assist in the training of medical personnel. Sixty-five participants were involved in the following: (1) a simulation trial 1; (2) a teaching intervention followed by trial 2 (with the simulator's visualization software); and (3) trial 3, a final simulation assessment. The main test parameters were time to complete SCVA and the SCVA score, a composite of efficiency and safety metrics generated by the simulator's scoring algorithm. Residents and faculty completed questionnaires presimulation and postsimulation that assessed their confidence in obtaining access and learner satisfaction questions, for example, realism of the simulator. The average SCVA score was improved by 24.5 (n=65). Repeated-measures analysis of variance showed significant reductions in average time (F=31.94, P<0.0001), number of attempts (F=10.56, P<0.0001), and score (F=18.59, P<0.0001). After the teaching intervention and practice with the MR simulator, the results no longer showed a difference in performance between the faculty and residents. On a 5-point scale (5=strongly agree), participants agreed that the SCVA simulator was realistic (M=4.3) and strongly agreed that it should be used as an educational tool (M=4.9). An SCVA mixed simulator offers a realistic representation of subclavian central venous access and offers new debriefing capabilities.

Evaluation of generic medical information accessed via mobile phones at the point of care in resource-limited settings

PubMed Central

Goldbach, Hayley; Chang, Aileen Y; Kyer, Andrea; Ketshogileng, Dineo; Taylor, Lynne; Chandra, Amit; Dacso, Matthew; Kung, Shiang-Ju; Rijken, Taatske; Fontelo, Paul; Littman-Quinn, Ryan; Seymour, Anne K; Kovarik, Carrie L

2014-01-01

Objective Many mobile phone resources have been developed to increase access to health education in the developing world, yet few studies have compared these resources or quantified their performance in a resource-limited setting. This study aims to compare the performance of resident physicians in answering clinical scenarios using PubMed abstracts accessed via the PubMed for Handhelds (PubMed4Hh) website versus medical/drug reference applications (Medical Apps) accessed via software on the mobile phone. Methods A two-arm comparative study with crossover design was conducted. Subjects, who were resident physicians at the University of Botswana, completed eight scenarios, each with multi-part questions. The primary outcome was a grade for each question. The primary independent variable was the intervention arm and other independent variables included residency and question. Results Within each question type there were significant differences in ‘percentage correct’ between Medical Apps and PubMed4Hh for three of the six types of questions: drug-related, diagnosis/definitions, and treatment/management. Within each of these question types, Medical Apps had a higher percentage of fully correct responses than PubMed4Hh (63% vs 13%, 33% vs 12%, and 41% vs 13%, respectively). PubMed4Hh performed better for epidemiologic questions. Conclusions While mobile access to primary literature remains important and serves an information niche, mobile applications with condensed content may be more appropriate for point-of-care information needs. Further research is required to examine the specific information needs of clinicians in resource-limited settings and to evaluate the appropriateness of current resources in bridging location- and context-specific information gaps. PMID:23535665

Neighborhood Socioeconomic Status and Primary Health Care: Usual Points of Access and Temporal Trends in a Major US Urban Area.

PubMed

Hussein, Mustafa; Diez Roux, Ana V; Field, Robert I

2016-12-01

Neighborhood socioeconomic status (SES), an overall marker of neighborhood conditions, may determine residents' access to health care, independently of their own individual characteristics. It remains unclear, however, how the distinct settings where individuals seek care vary by neighborhood SES, particularly in US urban areas. With existing literature being relatively old, revealing how these associations might have changed in recent years is also timely in this US health care reform era. Using data on the Philadelphia region from 2002 to 2012, we performed multilevel analysis to examine the associations of neighborhood SES (measured as census tract median household income) with access to usual sources of primary care (physician offices, community health centers, and hospital outpatient clinics). We found no evidence that residence in a low-income (versus high-income) neighborhood was associated with poorer overall access. However, low-income neighborhood residence was associated with less reliance on physician offices [-4.40 percentage points; 95 % confidence intervals (CI) -5.80, -3.00] and greater reliance on the safety net provided by health centers [2.08; 95 % CI 1.42, 2.75] and outpatient clinics [1.61; 95 % CI 0.97, 2.26]. These patterns largely persisted over the 10 years investigated. These findings suggest that safety-net providers have continued to play an important role in ensuring access to primary care in urban, low-income communities, further underscoring the importance of supporting a strong safety net to ensure equitable access to care regardless of place of residence.

Using a geographic information system to enhance patient access to point-of-care diagnostics in a limited-resource setting.

PubMed

Ferguson, William J; Kemp, Karen; Kost, Gerald

2016-03-01

Rapid and accurate diagnosis drives evidence-based care in health. Point-of-care testing (POCT) aids diagnosis by bringing advanced technologies closer to patients. Health small-world networks are constrained by natural connectivity in the interactions between geography of resources and social forces. Using a geographic information system (GIS) we can understand how populations utilize their health networks, visualize their inefficiencies, and compare alternatives. This project focuses on cardiac care resource in rural Isaan, Thailand. A health care access analysis was created using ArcGIS Network Analyst 10.1 from data representing aggregated population, roads, health resource facilities, and diagnostic technologies. The analysis quantified cardiac health care access and identified ways to improve it using both widespread and resource-limited strategies. Results indicated that having diagnostic technologies closer to populations streamlines critical care paths. GIS allowed us to compare the effectiveness of the implementation strategies and put into perspective the benefits of adopting rapid POCT within health networks. Geospatial analyses derive high impact by improving alternative diagnostic placement strategies in limited-resource settings and by revealing deficiencies in health care access pathways. Additionally, the GIS provides a platform for comparing relative costs, assessing benefits, and improving outcomes. This approach can be implemented effectively by health ministries seeking to enhance cardiac care despite limited resources.

How To Modify a Trailer for Accessibility (Up to a Point) [and] Accessibility Considerations for Home Buyers. Key Notes.

ERIC Educational Resources Information Center

Access Group, Atlanta, GA.

Two brief fact sheets for people with disabilities provide information on: (1) modifying a trailer to make it accessible for persons with mobility impairments, especially those in wheelchairs, and (2) accessibility considerations for home buyers or home owners with mobility impairments. The first fact sheet identifies inherent problems in…

Central Venous Occlusion in the Hemodialysis Patient.

PubMed

Krishna, Vinay Narasimha; Eason, Joseph B; Allon, Michael

2016-11-01

Central venous stenosis (CVS) is encountered frequently among hemodialysis patients. Prior ipsilateral central venous catheterization and cardiac rhythm device insertions are common risk factors, but CVS can also occur in the absence of this history. Chronic CVS can cause thrombosis with partial or complete occlusion of the central vein at the site of stenosis. CVS is frequently asymptomatic and identified as an incidental finding during imaging studies. Symptomatic CVS presents most commonly as an upper- or lower-extremity edema ipsilateral to the CVS. Previously unsuspected CVS may become symptomatic after placement of an ipsilateral vascular access. The likelihood of symptomatic CVS may be affected by the central venous catheter (CVC) location; CVC side; duration of CVC dependence; type, location, and blood flow of the ipsilateral access; and extent of collateral veins. Venous angiography is the gold standard for diagnosis. Percutaneous transluminal angioplasty and stent placement can improve the stenosis and alleviate symptoms, but CVS typically recurs frequently, requiring repeated interventions. Refractory symptomatic CVS may require ligation of the ipsilateral vascular access. Because no available treatment option is curative, the goal should be to prevent CVS by minimizing catheters and central vein instrumentation in patients with chronic kidney disease and dialysis patients. Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Access to Educational Opportunity in Rural Communities: Alternative Patterns of Delivering Vocational Education in Sparsely Populated Areas. Volume 4: The Interdistrict Cooperative Center: A Centralized Center.

ERIC Educational Resources Information Center

Peterson, Roland L.; And Others

The centralized secondary center pattern of inter-school district cooperation is examined in this third of four case studies addressing access of rural students to vocational education. The report identifies essential features of this form of cooperation, details factors facilitating/impeding the operation/maintenance of the cooperative…

Dry needling — peripheral and central considerations

PubMed Central

Dommerholt, Jan

2011-01-01

Dry needling is a common treatment technique in orthopedic manual physical therapy. Although various dry needling approaches exist, the more common and best supported approach targets myofascial trigger points. This article aims to place trigger point dry needling within the context of pain sciences. From a pain science perspective, trigger points are constant sources of peripheral nociceptive input leading to peripheral and central sensitization. Dry needling cannot only reverse some aspects of central sensitization, it reduces local and referred pain, improves range of motion and muscle activation pattern, and alters the chemical environment of trigger points. Trigger point dry needling should be based on a thorough understanding of the scientific background of trigger points, the differences and similarities between active and latent trigger points, motor adaptation, and central sensitize application. Several outcome studies are included, as well as comments on dry needling and acupuncture. PMID:23115475

Central venous access by trainees: a systematic review and meta-analysis of the use of simulation to improve success rate on patients.

PubMed

Madenci, Arin L; Solis, Carolina V; de Moya, Marc A

2014-02-01

Simulation training for invasive procedures may improve patient safety by enabling efficient training. This study is a meta-analysis with rigorous inclusion and exclusion criteria designed to assess the real patient procedural success of simulation training for central venous access. Published randomized controlled trials and prospective 2-group cohort studies that used simulation for the training of procedures involving central venous access were identified. The quality of each study was assessed. The primary outcome was the proportion of trainees who demonstrated the ability to successfully complete the procedure. Secondary outcomes included the mean number of attempts to procedural success and periprocedural adverse events. Proportions were compared between groups using risk ratios (RRs), whereas continuous variables were compared using weighted mean differences. Random-effects analysis was used to determine pooled effect sizes. We identified 550 studies, of which 5 (3 randomized controlled trials, 2 prospective 2-group cohort studies) studies of central venous catheter (CVC) insertion were included in the meta-analysis, composed of 407 medical trainees. The simulation group had a significantly larger proportion of trainees who successfully placed CVCs (RR, 1.09; 95% confidence interval [CI], 1.03-1.16, P<0.01). In addition, the simulation group had significantly fewer mean attempts to CVC insertion (weighted mean difference, -1.42; 95% CI, -2.34 to -0.49, P<0.01). There was no significant difference in the rate of adverse events between the groups (RR, 0.50; 95% CI, 0.19-1.29; P=0.15). Training programs should consider adopting simulation training for CVC insertion to improve the real patient procedural success of trainees.

Risk factors for central line-associated bloodstream infection in pediatric oncology patients with a totally implantable venous access port: A cohort study.

PubMed

Viana Taveira, Michelle Ribeiro; Lima, Luciana Santana; de Araújo, Cláudia Corrêa; de Mello, Maria Júlia Gonçalves

2017-02-01

Totally implantable venous access ports (TIVAPs) are used for prolonged central venous access, allowing the infusion of chemotherapy and other fluids and improving the quality of life of children with cancer. TIVAPs were developed to reduce the infection rates associated with central venous catheters; however, infectious events remain common and have not been fully investigated in pediatric oncology patients. A retrospective cohort was formed to investigate risk factors for central line-associated bloodstream infection (CLABSI) in pediatric cancer patients. Sociodemographic, clinical, and TIVAP insertion-related variables were evaluated, with the endpoint being the first CLABSI. A Kaplan-Meier analysis was performed to determine CLABSI-free catheter survival. Overall, 188 children were evaluated over 77,541 catheter days, with 94 being diagnosed with CLABSI (50%). Although coagulase-negative staphylococci were the pathogens most commonly isolated, Gram-negative microorganisms (46.8%) were also prevalent. In the multivariate analysis, factors that increased the risk for CLABSI were TIVAP insertion prior to chemotherapy (risk ratio [RR] = 1.56; P < 0.01), white blood cell count less than 1,000 mm -3 on the day of implantation (RR = 1.64; P < 0.01), and chronic malnutrition (RR = 1.41; P < 0.05). Median time without CLABSI following TIVAP insertion was 74.5 days. Risk factors for CLABSI in pediatric cancer patients with a TIVAP may be related to the severity of the child's condition at catheter insertion. Insertion of the catheter before chemotherapy and unfavorable conditions such as malnutrition and bone marrow aplasia can increase the risk of CLABSI. Protocols must be revised and surveillance increased over the first 10 weeks of treatment. © 2016 Wiley Periodicals, Inc.

Considerations on private human access to space from an institutional point of view

NASA Astrophysics Data System (ADS)

Hufenbach, Bernhard

2013-12-01

Private human access to space as discussed in this article addresses two market segments: suborbital flight and crew flights to Low Earth Orbit. The role of entrepreneurs, the technical complexity, the customers, the market conditions as well as the time to market in these two segments differ significantly. Space agencies take currently a very different approach towards private human access to space in both segments. Analysing the outcome of broader inter-agency deliberations on the future of human spaceflight and exploration, performed e.g. in the framework of the International Space Exploration Coordination Group, enables to derive some common general views on this topic. Various documents developed by inter-agency working groups recognise the general strategic importance for enabling private human access to space for ensuring a sustainable future of human spaceflight, although the specific definition of private human access and approaches vary. ESA has performed some reflections on this subject throughout the last 5 years. While it gained through these reflections a good understanding on the opportunities and implications resulting from the development of capabilities and markets for Private Human Access, limited concrete activities have been initiated in relation to this topic as of today.

elevatr: Access Elevation Data from Various APIs | Science ...

EPA Pesticide Factsheets

Several web services are available that provide access to elevation data. This package provides access to several of those services and returns elevation data either as a SpatialPointsDataFrame from point elevation services or as a raster object from raster elevation services. Currently, the package supports access to the Mapzen Elevation Service, Mapzen Terrain Service, and the USGS Elevation Point Query Service. The R language for statistical computing is increasingly used for spatial data analysis . This R package, elevatr, is in response to this and provides access to elevation data from various sources directly in R. The impact of `elevatr` is that it will 1) facilitate spatial analysis in R by providing access to foundational dataset for many types of analyses (e.g. hydrology, limnology) 2) open up a new set of users and uses for APIs widely used outside of R, and 3) provide an excellent example federal open source development as promoted by the Federal Source Code Policy (https://sourcecode.cio.gov/).

[Vascular access guidelines for hemodialysis].

PubMed

Rodríguez Hernández, J A; González Parra, E; Julián Gutiérrez, J M; Segarra Medrano, A; Almirante, B; Martínez, M T; Arrieta, J; Fernández Rivera, C; Galera, A; Gallego Beuter, J; Górriz, J L; Herrero, J A; López Menchero, R; Ochando, A; Pérez Bañasco, V; Polo, J R; Pueyo, J; Ruiz, Camps I; Segura Iglesias, R

2005-01-01

Quality of vascular access (VA) has a remarkable influence in hemodialysis patients outcomes. Dysfunction of VA represents a capital cause of morbi-mortality of these patients as well an increase in economical. Spanish Society of Neprhology, aware of the problem, has decided to carry out a revision of the issue with the aim of providing help in comprehensión and treatment related with VA problems, and achieving an homogenization of practices in three mayor aspects: to increase arteriovenous fistula utilization as first vascular access, to increment vascular access monitoring practice and rationalise central catheters use. We present a consensus document elaborated by a multidisciplinar group composed by nephrologists, vascular surgeons, interventional radiologysts, infectious diseases specialists and nephrological nurses. Along six chapters that cover patient education, creation of VA, care, monitoring, complications and central catheters, we present the state of the art and propose guidelines for the best practice, according different evidence based degrees, with the intention to provide help at the professionals in order to make aproppiate decissions. Several quality standars are also included.

Increasing equity of access to point-of-use water treatment products through social marketing and entrepreneurship: a case study in western Kenya.

PubMed

Freeman, Matthew C; Quick, Robert E; Abbott, Daniel P; Ogutu, Paul; Rheingans, Richard

2009-09-01

Point-of-use water chlorination reduces diarrhoea risk by 25-85%. Social marketing has expanded access to inexpensive sodium hypochlorite for water treatment, at a cost of less than US$0.01 per day, in Kenya. To increase product access, women's groups in western Kenya were trained to educate neighbours and sell health products to generate income. We evaluated this programme's impact on equity of access to water treatment products in a cross-sectional survey. We surveyed 487 randomly selected households in eight communities served by the women's groups. Overall, 20% (range 5-39%) of households in eight communities purchased and used chlorine, as confirmed by residual chlorine observed in stored water. Multivariate models using illiteracy and the poorest socioeconomic status as a referent showed that persons with at least some primary education (OR 2.5, 95% CI 1.8, 3.5) or secondary education (OR 5.4, 95% CI 1.6, 17.5) and persons in the four wealthiest quintiles (OR 2.5, 95% CI 1.0, 6.0) were more likely to chlorinate stored water. While this implementation model was associated with good product penetration and use, barriers to access to inexpensive water treatment remained among the very poor and less educated.

Open Access to Data - Central Role for Geoinformatics

NASA Astrophysics Data System (ADS)

Snyder, W. S.

2006-12-01

The open access to scientific information has become a contentious issue. In the United States there are calls to make all published literature available for free within 6 months of publication, the notion being that this will promote better science and policy decisions based on science. Here, I argue that this is the incorrect approach to the issue of open access to scientific information. A fundamental problem raised by the call for open access to government-supported research results is the viability of our not-for-profit professional scientific societies. These societies provide the base level framework for the exchange of scientific ideas, and hence the very core of how we do science and how scientific knowledge is advanced. Why should a scientist subscribe to a journal if they can read the article for free in six months? A large portion of a society's operational costs come from these subscriptions and the sale of specialized books, all of which contain the results of federally-funded research. Without revenue from journal subscriptions and book sales, not only will these publications disappear, but many of societies may as well. Without a broad venue to publish and in which to interact, our science suffers - many subdisciplines may fade or even die - those that don't "sell well." Very popular publications such as "Nature", "Science", "Tectonics", and "Geology" will continue to thrive, but what about the more specialized journals such as "Journal of Paleontology"? They are costly to publish yet fill a very critical niche for our science. Many will still pay for reading the Nature/Science/Tectonics/Geology article, but where do we publish the mainstream science paper? We have to guard against becoming a "Hollywood Science" - where only the glitzy gets published because those are the articles that sell. We must have peer-reviewed, independent publications and viable professional societies, or our science will severely suffer. We can better approach the need for

Implementation of a written protocol for management of central venous access devices: a theoretical and practical education, including bedside examinations.

PubMed

Ahlin, Catharina; Klang-Söderkvist, Birgitta; Brundin, Seija; Hellström, Birgitta; Pettersson, Karin; Johansson, Eva

2006-01-01

The objectives of this study were to evaluate registered nurses' (RN) compliance with a local clinical central venous access device (CVAD) protocol after completing an educational program and to determine RNs' perception of the program. Seventy-five RNs working in hematology participated in the educational part of the program. Sixty-eight RNs were examined while changing CVAD dressings or placing a Huber needle into a port on actual patients. Sixty percent of the RNs passed the examination and reported that the program increased their knowledge. The results indicated that the educational program could be recommended for use when implementing a new clinical protocol.

Association of State Access Standards With Accessibility to Specialists for Medicaid Managed Care Enrollees.

PubMed

Ndumele, Chima D; Cohen, Michael S; Cleary, Paul D

2017-10-01

Medicaid recipients have consistently reported less timely access to specialists than patients with other types of coverage. By 2018, state Medicaid agencies will be required by the Center for Medicare and Medicaid Services (CMS) to enact time and distance standards for managed care organizations to ensure an adequate supply of specialist physicians for enrollees; however, there have been no published studies of whether these policies have significant effects on access to specialty care. To compare ratings of access to specialists for adult Medicaid and commercial enrollees before and after the implementation of specialty access standards. We used Consumer Assessment of Healthcare Providers and Systems survey data to conduct a quasiexperimental difference-in-differences (DID) analysis of 20 163 nonelderly adult Medicaid managed care (MMC) enrollees and 54 465 commercially insured enrollees in 5 states adopting access standards, and 37 290 MMC enrollees in 5 matched states that previously adopted access standards. Reported access to specialty care in the previous 6 months. Seven thousand six hundred ninety-eight (69%) Medicaid enrollees and 28 423 (75%) commercial enrollees reported that it was always or usually easy to get an appointment with a specialist before the policy implementation (or at baseline) compared with 11 889 (67%) of Medicaid enrollees in states that had previously implemented access standards. Overall, there was no significant improvement in timely access to specialty services for MMC enrollees in the period following implementation of standard(s) (adjusted difference-in-differences, -1.2 percentage points; 95% CI, -2.7 to 0.1), nor was there any impact of access standards on insurance-based disparities in access (0.6 percentage points; 95% CI, -4.3 to 5.4). There was heterogeneity across states, with 1 state that implemented both time and distance standards demonstrating significant improvements in access and reductions in disparities

MyOcean Central Information System - Achievements and Perspectives

NASA Astrophysics Data System (ADS)

de Dianous, Rémi; Jolibois, Tony; Besnard, Sophie

2015-04-01

MyOcean (http://www.myocean.eu) is providing a pre-operational service, for forecasts, analysis and expertise on ocean currents, temperature, salinity, sea level, primary ecosystems and ice coverage. Since 2009, three successive projects (MyOcean-I, MyOcean-II and MyOcean-Follow-on) have been designed to prepare and to lead the demonstration phases of the future Copernicus Marine Environment Monitoring Service. The main goal of these projects was to build a system of systems offering the users a unique access point to European oceanographic data. Reaching this goal at European level with 59 partners from 28 different countries was a real challenge: initially, each local system had its own human processes and methodology, its own interfaces for production and dissemination. At the end of MyOcean Follow-on, any user can connect to one web portal, browse an interactive catalogue of products and services, use one login to access all data disseminated through harmonized interfaces in a common format and contact a unique centralized service desk. In this organization the central information system plays a key role. The production of observation and forecasting data is done by 48 Production Units (PU). Product download and visualisation are hosted by 26 Dissemination Units (DU). All these products and associated services are gathered in a single system hiding the intricate distributed organization of PUs and DUs. This central system will be presented in detail, including notably the technical choices in architecture and technologies which have been made and why, and the lessons learned during these years of real life of the system, taking into account internal and external feedbacks. Then, perspectives will be presented to sketch the future of such system in the next Marine Copernicus Service which is meant to be fully operational from 2015 onwards.

Fixed-Rate Compressed Floating-Point Arrays.

PubMed

Lindstrom, Peter

2014-12-01

Current compression schemes for floating-point data commonly take fixed-precision values and compress them to a variable-length bit stream, complicating memory management and random access. We present a fixed-rate, near-lossless compression scheme that maps small blocks of 4(d) values in d dimensions to a fixed, user-specified number of bits per block, thereby allowing read and write random access to compressed floating-point data at block granularity. Our approach is inspired by fixed-rate texture compression methods widely adopted in graphics hardware, but has been tailored to the high dynamic range and precision demands of scientific applications. Our compressor is based on a new, lifted, orthogonal block transform and embedded coding, allowing each per-block bit stream to be truncated at any point if desired, thus facilitating bit rate selection using a single compression scheme. To avoid compression or decompression upon every data access, we employ a software write-back cache of uncompressed blocks. Our compressor has been designed with computational simplicity and speed in mind to allow for the possibility of a hardware implementation, and uses only a small number of fixed-point arithmetic operations per compressed value. We demonstrate the viability and benefits of lossy compression in several applications, including visualization, quantitative data analysis, and numerical simulation.

Control Points To Reduce Movement of Central Nervous System Tissue during Beef Slaughter.

PubMed

Aalhus, J L; Thacker, R D; Larsen, I L; Roberts, J C; Price, M A; Juárez, M

2017-02-01

Consumption of central nervous system tissue (CNST) from cattle with bovine spongiform encephalopathy (BSE) is thought to cause the human neurological disease, variant Creutzfeldt-Jacob disease. To identify points of cross-contamination of beef carcasses with CNST, 55 young beef cattle were slaughtered and processed through a federally inspected multispecies abattoir. The objectives of this study were to evaluate CNST spread following the placement of a plug in the penetration site of the skull after captive bolt stunning, to evaluate cross-contamination of carcasses before and after splitting, to compare the effects of hot water pasteurization (84°C for 10 s) versus cold water wash (10°C for 30 s) for reducing CNST on the carcass, and to examine other possible sources of cross-contamination in the abattoir. Results indicated that the use of a plastic plug reduced CNST contamination near the bolt penetration site. This study also confirmed that carcass splitting resulted in an increase in CNST contamination at various areas of the carcass. Hot water pasteurization appeared to be an effective means of removing CNST contamination from carcasses in most of the areas sampled.

XNAT Central: Open sourcing imaging research data.

PubMed

Herrick, Rick; Horton, William; Olsen, Timothy; McKay, Michael; Archie, Kevin A; Marcus, Daniel S

2016-01-01

XNAT Central is a publicly accessible medical imaging data repository based on the XNAT open-source imaging informatics platform. It hosts a wide variety of research imaging data sets. The primary motivation for creating XNAT Central was to provide a central repository to host and provide access to a wide variety of neuroimaging data. In this capacity, XNAT Central hosts a number of data sets from research labs and investigative efforts from around the world, including the OASIS Brains imaging studies, the NUSDAST study of schizophrenia, and more. Over time, XNAT Central has expanded to include imaging data from many different fields of research, including oncology, orthopedics, cardiology, and animal studies, but continues to emphasize neuroimaging data. Through the use of XNAT's DICOM metadata extraction capabilities, XNAT Central provides a searchable repository of imaging data that can be referenced by groups, labs, or individuals working in many different areas of research. The future development of XNAT Central will be geared towards greater ease of use as a reference library of heterogeneous neuroimaging data and associated synthetic data. It will also become a tool for making data available supporting published research and academic articles. Copyright © 2015 Elsevier Inc. All rights reserved.

Advanced access appointments

PubMed Central

Hudec, John C.; MacDougall, Steven; Rankin, Elaine

2010-01-01

ABSTRACT OBJECTIVE To examine the effects of advanced access (same-day physician appointments) on patient and provider satisfaction and to determine its association with other variables such as physician income and patient emergency department use. DESIGN Patient satisfaction survey and semistructured interviews with physicians and support staff; analysis of physician medical insurance billings and patient emergency department visits. SETTING Cape Breton, NS. PARTICIPANTS Patients, physicians, and support staff of 3 comparable family physician practices that had not implemented advanced access and an established advanced access practice. MAIN OUTCOME MEASURES Self-reported provider and patient satisfaction, physician office income, and patients’ emergency department use. RESULTS The key benefits of implementation of advanced access were an increase in provider and patient satisfaction levels, same or greater physician office income, and fewer less urgent (triage level 4) and nonurgent (triage level 5) emergency department visits by patients. CONCLUSION Currently within the Central Cape Breton Region, 33% of patients wait 4 or more days for urgent appointments. Findings from this study can be used to enhance primary care physician practice redesign. This research supports many benefits of transitioning to an advanced access model of patient booking. PMID:20944024

Maintaining the Access Mission: Open Access Universities and the Challenges of Performance-Based Funding

ERIC Educational Resources Information Center

Mathuews, Katy; Pulcini, Brad

2017-01-01

For the purposes of this article, open access universities are defined as bachelor's degree-granting institutions that do not restrict admission on the basis of ACT/SAT scores, high school grade point average, and the like. Typically, the mission of an open access university is to provide all students with the opportunity to pursue a degree. The…

Pinch-off syndrome: transection of implantable central venous access device.

PubMed

Sugimoto, Takuya; Nagata, Hiroshi; Hayashi, Ken; Kano, Nobuyasu

2012-11-30

As the population of people with cancer increases so does the number of patients who take chemotherapy. Majority of them are administered parentally continuously. Implantable central venous catheter device is a good choice for those patients; however, severe complication would occur concerning the devices. Pinch-off syndrome is one of the most severe complications. The authors report a severe case of pinch-off syndrome. The patient with the implantable central venous device could not take chemotherapy because the device occluded. Further examination revealed the transection of the catheter. The transected fragment of the catheter in the heart was successfully removed by using a loop snare placed through the right femoral vein.

Peripherally inserted central catheter - insertion

MedlinePlus

... ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 26. Smith SF, Duell DJ, Martin BC, Gonzalez L, Aebersold M. Central vascular access devices. In: Smith SF, Duell DJ, Martin BC, Gonzalez L, Aebersold ...

Motorcycles entering from access points and merging with traffic on primary roads in Malaysia: behavioral and road environment influence on the occurrence of traffic conflicts.

PubMed

Abdul Manan, Muhammad Marizwan

2014-09-01

This paper uses data from an observational study, conducted at access points in straight sections of primary roads in Malaysia in 2012, to investigate the effects of motorcyclists' behavior and road environment attributes on the occurrence of serious traffic conflicts involving motorcyclists entering primary roads via access points. In order to handle the unobserved heterogeneity in the small sample data size, this study applies mixed effects logistic regression with multilevel bootstrapping. Two statistically significant models (Model 2 and Model 3) are produced, with 2 levels of random effect parameters, i.e. motorcyclists' attributes and behavior at Level 1, and road environment attributes at Level 2. Among all the road environment attributes tested, the traffic volume and the speed limit are found to be statistically significant, only contributing to 26-29% of the variations affecting the traffic conflict outcome. The implication is that 71-74% of the unmeasured or undescribed attributes and behavior of motorcyclists still have an importance in predicting the outcome: a serious traffic conflict. As for the fixed effect parameters, both models show that the risk of motorcyclists being involved in a serious traffic conflict is 2-4 times more likely if they accept a shorter gap to a single approaching vehicle (time lag <4s) and in between two vehicles (time gap <4s) when entering the primary road from the access point. A road environment factor, such as a narrow lane (seen in Model 2), and a behavioral factor, such as stopping at the stop line (seen in Model 3), also influence the occurrence of a serious traffic conflict compared to those entering into a wider lane road and without stopping at the stop line, respectively. A discussion of the possible reasons for this seemingly strange result, including a recommendation for further research, concludes the paper. Copyright © 2014 Elsevier Ltd. All rights reserved.

Access to and Accessibility of Education: An Analytic and Conceptual Approach to a Multidimensional Issue

ERIC Educational Resources Information Center

Stauber, Barbara; Parreira do Amaral, Marcelo

2015-01-01

This article presents analytical considerations for the discussion of issues of access to education and inequality. It first sharpens the concept of access and inequality by pointing to the interplay of structure and agency as well as to processes of social differentiation in which differences are constructed. This implies a critical view on…

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

PubMed

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

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

Access control mechanism of wireless gateway based on open flow

NASA Astrophysics Data System (ADS)

Peng, Rong; Ding, Lei

2017-08-01

In order to realize the access control of wireless gateway and improve the access control of wireless gateway devices, an access control mechanism of SDN architecture which is based on Open vSwitch is proposed. The mechanism utilizes the features of the controller--centralized control and programmable. Controller send access control flow table based on the business logic. Open vSwitch helps achieve a specific access control strategy based on the flow table.

The Lagrange Points

ERIC Educational Resources Information Center

Lovell, M.S.

2007-01-01

This paper presents a derivation of all five Lagrange points by methods accessible to sixth-form students, and provides a further opportunity to match Newtonian gravity with centripetal force. The predictive powers of good scientific theories are also discussed with regard to the philosophy of science. Methods for calculating the positions of the…

PubMed Central Canada: Beyond an Open Access Repository?

ERIC Educational Resources Information Center

Nariani, Rajiv

2013-01-01

PubMed Central Canada (PMC Canada) represents a partnership between the Canadian Institutes of Health Research (CIHR), the National Research Council's Canada Institute for Scientific and Technical Information (NRC-CISTI), and the National Library of Medicine of the US. The present study was done to gauge faculty awareness about the CIHR Policy on…

Indexing the medical open access literature for textual and content-based visual retrieval.

PubMed

Eggel, Ivan; Müller, Henning

2010-01-01

Over the past few years an increasing amount of scientific journals have been created in an open access format. Particularly in the medical field the number of openly accessible journals is enormous making a wide body of knowledge available for analysis and retrieval. Part of the trend towards open access publications can be linked to funding bodies such as the NIH¹ (National Institutes of Health) and the Swiss National Science Foundation (SNF²) requiring funded projects to make all articles of funded research available publicly. This article describes an approach to make part of the knowledge of open access journals available for retrieval including the textual information but also the images contained in the articles. For this goal all articles of 24 journals related to medical informatics and medical imaging were crawled from the web pages of BioMed Central. Text and images of the PDF (Portable Document Format) files were indexed separately and a web-based retrieval interface allows for searching via keyword queries or by visual similarity queries. Starting point for a visual similarity query can be an image on the local hard disk that is uploaded or any image found via the textual search. Search for similar documents is also possible.

Poor Linkage to Care Despite Significant Improvement in Access to Early cART in Central Poland - Data from Test and Keep in Care (TAK) Project.

PubMed

Kowalska, Justyna D; Shepherd, Leah; Ankiersztejn-Bartczak, Magdalena; Cybula, Aneta; Czeszko-Paprocka, Hanna; Firląg-Burkacka, Ewa; Mocroft, Amanda; Horban, Andrzej

2016-01-01

The main objective of the TAK project is investigating barriers in accessing HIV care after HIV-diagnosis at the CBVCTs of central Poland. Here we describe factors associated with and changes over time in linkage to care and access to cART. Data collected in 2010-2013 in CBVCTs were linked with HIV clinics records using unique identifiers. Individuals were followed from the day of CBVCTs visit until first clinical visit or 4/06/2014. Cox-proportional hazard models were used to identify factors associated with being linked to care and starting cART. In total 232 persons were diagnosed HIV-positive and 144 (62.1% 95%CI: 55.5-68.3) persons were linked to care. There was no change over time in linkage to care (p = 0.48), while time to starting cART decreased (p = 0.02). Multivariate factors associated with a lower rate of linkage to care were hetero/bisexual sexual orientation, lower education, not having an HIV-positive partner and not using condoms in a stable relationship. Multivariate factors associated with starting cART were lower education, recent year of linked to care, and first HIV RNA and CD4 cell count. Benefits of linkage to care, measured by access to early treatment, steadily improved in recent years. However at least 1 in 3 persons aware of their HIV status in central Poland remained outside professional healthcare. Persons at higher risk of remaining outside care, thus target population for future interventions, are bi/heterosexuals and those with lower levels of education.

Globalizing Higher Education Access in South-West Nigeria

ERIC Educational Resources Information Center

Olayiwola, Mohammed Mubashiru; Kolawole, Oladipupo Fatai; Moyosore, Onabanjo Florence

2013-01-01

Education is central to national interest and cannot be solely determined by market forces. Thus, the role of the state in making education policy and funding education to embrace access cannot be overemphasized. The influence of globalization on Higher Education access in Southwest Nigeria as it affects policy making was investigated through the…

Access to electronic health knowledge in five countries in Africa: a descriptive study.

PubMed

Smith, Helen; Bukirwa, Hasifa; Mukasa, Oscar; Snell, Paul; Adeh-Nsoh, Sylvester; Mbuyita, Selemani; Honorati, Masanja; Orji, Bright; Garner, Paul

2007-05-17

Access to medical literature in developing countries is helped by open access publishing and initiatives to allow free access to subscription only journals. The effectiveness of these initiatives in Africa has not been assessed. This study describes awareness, reported use and factors influencing use of on-line medical literature via free access initiatives. Descriptive study in four teaching hospitals in Cameroon, Nigeria, Tanzania and Uganda plus one externally funded research institution in The Gambia. Survey with postgraduate doctors and research scientists to determine Internet access patterns, reported awareness of on-line medical information and free access initiatives; semi structured interviews with a sub-sample of survey participants to explore factors influencing use. In the four African teaching hospitals, 70% of the 305 postgraduate doctors reported textbooks as their main source of information; 66% had used the Internet for health information in the last week. In two hospitals, Internet cafés were the main Internet access point. For researchers at the externally-funded research institution, electronic resources were their main source, and almost all had used the Internet in the last week. Across all 333 respondents, 90% had heard of PubMed, 78% of BMJ on line, 49% the Cochrane Library, 47% HINARI, and 19% BioMedCentral. HINARI use correlates with accessing the Internet on computers located in institutions. Qualitative data suggested there are difficulties logging into HINARI and that sometimes it is librarians that limit access to passwords. Text books remain an important resource for postgraduate doctors in training. Internet use is common, but awareness of free-access initiatives is limited. HINARI and other initiatives could be more effective with strong institutional endorsement and management to promote and ensure access.

Case report: Unilateral conduction hearing loss due to central venous occlusion.

PubMed

Ribeiro, Phillip; Patel, Swetal; Qazi, Rizwan A

2016-05-07

Central venous stenosis is a well-known complication in patients with vascular access for hemodialysis. We report two cases involving patients on hemodialysis with arteriovenous fistulas who developed reversible unilateral conductive hearing loss secondary to critical stenosis of central veins draining the arteriovenous dialysis access. A proposed mechanism for the patients' reversible unilateral hearing loss is pterygoid venous plexus congestion leading to decreased Eustachian tube patency. Endovascular therapy was conducted to treat the stenosis and the hearing loss of both patients was returned to near normal after successful central venous angioplasty.

Incidence of Central Vein Stenosis and Occlusion Following Upper Extremity PICC and Port Placement

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

Gonsalves, Carin F., E-mail: Carin.Gonsalves@mail.tju.edu; Eschelman, David J.; Sullivan, Kevin L.

2003-04-15

The purpose of this study was to determine the incidence of central vein stenosis and occlusion following upper extremity placement of peripherally inserted central venous catheters(PICCs) and venous ports. One hundred fifty-four patients who underwent venography of the ipsilateral central veins prior to initial and subsequent venous access device insertion were retrospectively identified. All follow-up venograms were interpreted at the time of catheter placement by one interventional radiologist over a 5-year period and compared to the findings on initial venography. For patients with central vein abnormalities, hospital and home infusion service records and radiology reports were reviewed to determine cathetermore » dwelltime and potential alternative etiologies of central vein stenosis or occlusion. The effect of catheter caliber and dwell time on development of central vein abnormalities was evaluated. Venography performed prior to initial catheter placement showed that 150 patients had normal central veins. Three patients had central vein stenosis, and one had central vein occlusion. Subsequent venograms (n = 154)at the time of additional venous access device placement demonstrated 8 patients with occlusions and 10 with stenoses. Three of the 18 patients with abnormal follow-up venograms were found to have potential alternative causes of central vein abnormalities. Excluding these 3 patients and the 4 patients with abnormal initial venograms, a 7% incidence of central vein stenosis or occlusion was found in patients with prior indwelling catheters and normal initial venograms. Catheter caliber showed no effect on the subsequent development of central vein abnormalities. Patients who developed new or worsened central vein stenosis or occlusion had significantly (p =0.03) longer catheter dwell times than patients without central vein abnormalities. New central vein stenosis or occlusion occurred in 7% of patients following upper arm placement of venous access

The Central American Network for Disaster and Health Information.

PubMed

Arnesen, Stacey J; Cid, Victor H; Scott, John C; Perez, Ricardo; Zervaas, Dave

2007-07-01

This paper describes an international outreach program to support rebuilding Central America's health information infrastructure after several natural disasters in the region, including Hurricane Mitch in 1998 and two major earthquakes in 2001. The National Library of Medicine joined forces with the Pan American Health Organization/World Health Organization, the United Nations International Strategy for Disaster Reduction, and the Regional Center of Disaster Information for Latin America and the Caribbean (CRID) to strengthen libraries and information centers in Central America and improve the availability of and access to health and disaster information in the region by developing the Central American Network for Disaster and Health Information (CANDHI). Through CRID, the program created ten disaster health information centers in medical libraries and disaster-related organizations in six countries. This project served as a catalyst for the modernization of several medical libraries in Central America. The resulting CANDHI provides much needed electronic access to public health "gray literature" on disasters, as well as access to numerous health information resources. CANDHI members assist their institutions and countries in a variety of disaster preparedness activities through collecting and disseminating information.

The Central American Network for Disaster and Health Information

PubMed Central

Arnesen, Stacey J.; Cid, Victor H.; Scott, John C.; Perez, Ricardo; Zervaas, Dave

2007-01-01

Purpose: This paper describes an international outreach program to support rebuilding Central America's health information infrastructure after several natural disasters in the region, including Hurricane Mitch in 1998 and two major earthquakes in 2001. Setting, Participants, and Description: The National Library of Medicine joined forces with the Pan American Health Organization/World Health Organization, the United Nations International Strategy for Disaster Reduction, and the Regional Center of Disaster Information for Latin America and the Caribbean (CRID) to strengthen libraries and information centers in Central America and improve the availability of and access to health and disaster information in the region by developing the Central American Network for Disaster and Health Information (CANDHI). Through CRID, the program created ten disaster health information centers in medical libraries and disaster-related organizations in six countries. Results/Outcome: This project served as a catalyst for the modernization of several medical libraries in Central America. The resulting CANDHI provides much needed electronic access to public health “gray literature” on disasters, as well as access to numerous health information resources. CANDHI members assist their institutions and countries in a variety of disaster preparedness activities through collecting and disseminating information. PMID:17641767

Management of hemodialysis access infections.

PubMed

Ryan, Sean V; Calligaro, Keith D; Dougherty, Matthew J

2004-03-01

Management of hemodialysis (HD) access infection is one of the most challenging and most common problems faced by surgeons, interventional radiologists, and nephrologists. The goal to eradicate infection is often at odds with the need to maintain access. Patients on HD are immunocompromised and typically have significant comorbid conditions placing them at high risk for the occurrence of access infection. Infection is most common with central-vein catheter access, followed by prosthetic arteriovenous grafts (AVG) and is rare with autogenous fistulas. The diagnosis is usually evident on physical exam, but it is not uncommon for these patients to present with atypical symptoms and lack of clinical findings. Although Staphylococcal species are the most common organism to cause infection, early empiric antimicrobial therapy should also include coverage for Gram-negative organisms. Management of central-vein catheter infection includes removal and delayed replacement or, in patients with mild clinical symptoms, catheter exchange over a guide wire. Our management of AVG infection includes total graft excision when patients present with sepsis or the entire graft is bathed in pus, subtotal graft excision when all of the graft is removed except a small oversewn cuff of prosthetic material on an underlying patent artery, and partial graft excision when only a limited infected portion of the graft is removed and a new graft is rerouted in adjacent sterile tissue to maintain patency of the original graft. This strategy has proven to be highly successful in the management of these complicated cases.

Browsing for the Best Internet Access Provider?

ERIC Educational Resources Information Center

Weil, Marty

1996-01-01

Highlights points to consider when choosing an Internet Service Provider. Serial Line Internet Protocol (SLIP) and Point to Point Protocol (PPP) are compared regarding price, performance, bandwidth, speed, and technical support. Obtaining access via local, national, consumer online, and telephone-company providers is discussed. A pricing chart and…

Open Access Publishing - Strengths and Strategies

NASA Astrophysics Data System (ADS)

Rasmussen, Martin

2010-05-01

The journal crisis and the demand for free accessibility to the results of publicly funded research were the main drivers of the Open Access movement since the late 1990's. Besides many academic institutions that support the different ways of Open Access publishing, there is a growing number of publishing houses that are specialized on this new access and business model of scholarly literature. The lecture provides an overview of the different kinds of Open Access publishing, discusses the variety of underlying business models, names the advantages and potentials for researches and the public, and overcomes some objections against Open Access. Besides the increased visibility and information supply, the topic of copyrights and exploitation rights will be discussed. Furthermore, it is a central aim of the presentation to show that Open Access does not only support full peer-review, but also provides the potential for even enhanced quality assurance. The financing of business models based on open accessible literature is another important part to be outlined in the lecture.

Dialysis access: an increasingly important clinical issue.

PubMed

Gallieni, Maurizio; Martini, Alma; Mezzina, Nicoletta

2009-12-01

Dialysis access, including vascular access for hemodialysis and peritoneal access for peritoneal dialysis, is critical in the clinical care of patients with end-stage renal disease. It is associated with increases in morbidity, mortality, and health care costs. A number of problematic issues are involved, some of which are addressed in this paper with reference to the most recent publications, including: the inappropriately low prevalence of peritoneal dialysis in Western countries, which is relevant to access placement in the pre-dialysis stage; the excessively high use of central venous catheters in incident and prevalent dialysis patients; the diagnosis and treatment of steal syndrome; the advantages and limitations of antiplatelet therapy; and finally, the correct pre-operative evaluation and subsequent surveillance of the vascular access.

Research on an uplink carrier sense multiple access algorithm of large indoor visible light communication networks based on an optical hard core point process.

PubMed

Nan, Zhufen; Chi, Xuefen

2016-12-20

The IEEE 802.15.7 protocol suggests that it could coordinate the channel access process based on the competitive method of carrier sensing. However, the directionality of light and randomness of diffuse reflection would give rise to a serious imperfect carrier sense (ICS) problem [e.g., hidden node (HN) problem and exposed node (EN) problem], which brings great challenges in realizing the optical carrier sense multiple access (CSMA) mechanism. In this paper, the carrier sense process implemented by diffuse reflection light is modeled as the choice of independent sets. We establish an ICS model with the presence of ENs and HNs for the multi-point to multi-point visible light communication (VLC) uplink communications system. Considering the severe optical ICS problem, an optical hard core point process (OHCPP) is developed, which characterizes the optical CSMA for the indoor VLC uplink communications system. Due to the limited coverage of the transmitted optical signal, in our OHCPP, the ENs within the transmitters' carrier sense region could be retained provided that they could not corrupt the ongoing communications. Moreover, because of the directionality of both light emitting diode (LED) transmitters and receivers, theoretical analysis of the HN problem becomes difficult. In this paper, we derive the closed-form expression for approximating the outage probability and transmission capacity of VLC networks with the presence of HNs and ENs. Simulation results validate the analysis and also show the existence of an optimal physical carrier-sensing threshold that maximizes the transmission capacity for a given emission angle of LED.

Variability in alignment of central venous pressure transducer to physiologic reference point in the intensive care unit-A descriptive and correlational study.

PubMed

Sjödin, Carl; Sondergaard, Soren; Johansson, Lotta

2018-06-01

The phlebostatic axis is the most commonly used anatomical external reference point for central venous pressure measurements. Deviation in the central venous pressure transducer alignment from the phlebostatic axis causes inadequate pressure readings, which may affect treatment decisions for critically ill patients in intensive care units. The primary aim of the study was to assess the variability in central venous pressure transducer levelling in the intensive care unit. We also assessed whether patient characteristics impacted on central venous pressure transducer alignment deviation. A sample of 61 critical care nurses was recruited and asked to place a transducer at the appropriate level for central venous pressure measurement. The measurements were performed in the intensive care unit on critically ill patients in supine and Fowler's positions. The variability among the participants using eyeball levelling and a laser levelling device was calculated in both sessions and adjusted for patient characteristics. A significant variation was found among critical care nurses in the horizontal levelling of the pressure transducer placement when measuring central venous pressure in the intensive care unit. Using a laser levelling device did not reduce the deviation from the phlebostatic axis. Patient characteristics had little impact on the deviation in the measurements. The anatomical external landmark for the phlebostatic axis varied between critical care nurses, as the variation in the central venous pressure transducer placement was not reduced with a laser levelling device. Standardisation of a zero-level for vascular pressures should be considered to reduce the variability in vascular pressure readings in the intensive care unit to improve patient treatment decisions. Further studies are needed to evaluate critical care nurses' knowledge and use of central venous pressure monitoring and whether assistive tools and/or routines can improve the accuracy in vascular

Lymphatic Leak Complicating Central Venous Catheter Insertion

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

Barnacle, Alex M., E-mail: alexbarnacle@yahoo.co.uk; Kleidon, Tricia M.

2005-12-15

Many of the risks associated with central venous access are well recognized. We report a case of inadvertent lymphatic disruption during the insertion of a tunneled central venous catheter in a patient with raised left and right atrial pressures and severe pulmonary hypertension, which led to significant hemodynamic instability. To our knowledge, this rare complication is previously unreported.

An operational data access infrastructure for accessing integrated environmental and socio-economic data from the Dutch Wadden Sea

NASA Astrophysics Data System (ADS)

De Bruin, T.

2012-12-01

The Wadden Sea, an UNESCO World Heritage Site along the Northern coasts of The Netherlands, Germany and Denmark, is a very valuable, yet also highly vulnerable tidal flats area. Knowledge is key to the sustainable management of the Wadden Sea. This knowledge should be reliable, founded on promptly accessible information and sufficiently broad to integrate both ecological and economic analyses. The knowledge is gained from extensive monotoring of both ecological and socio-economic parameters. Even though many organisations, research institutes, government agencies and NGOs carry out monitoring, there is no central overview of monitoring activities, nor easy access to the resulting data. The 'Wadden Sea Long-Term Ecosystem Research' (WaLTER) project (2011-2015) aims to set-up an integrated monitoring plan for the main environmental and management issues relevant to the Wadden Sea, such as sea-level rise, fisheries management, recreation and industry activities. The WaLTER data access infrastructure will be a distributed system of data providers, with a centralized data access portal. It is based on and makes use of the existing data access infrastructure of the Netherlands National Oceanographic Data Committee (NL-NODC), which has been operational since early 2009. The NL-NODC system is identical to and in fact developed by the European SeaDataNet project, furthering standardisation on a pan-European scale. The presentation will focus on the use of a distributed data access infrastructure to address the needs of different user groups such as policy makers, scientists and the general public.

Centralized mouse repositories.

PubMed

Donahue, Leah Rae; Hrabe de Angelis, Martin; Hagn, Michael; Franklin, Craig; Lloyd, K C Kent; Magnuson, Terry; McKerlie, Colin; Nakagata, Naomi; Obata, Yuichi; Read, Stuart; Wurst, Wolfgang; Hörlein, Andreas; Davisson, Muriel T

2012-10-01

Because the mouse is used so widely for biomedical research and the number of mouse models being generated is increasing rapidly, centralized repositories are essential if the valuable mouse strains and models that have been developed are to be securely preserved and fully exploited. Ensuring the ongoing availability of these mouse strains preserves the investment made in creating and characterizing them and creates a global resource of enormous value. The establishment of centralized mouse repositories around the world for distributing and archiving these resources has provided critical access to and preservation of these strains. This article describes the common and specialized activities provided by major mouse repositories around the world.

Global access to surgical care: a modelling study.

PubMed

Alkire, Blake C; Raykar, Nakul P; Shrime, Mark G; Weiser, Thomas G; Bickler, Stephen W; Rose, John A; Nutt, Cameron T; Greenberg, Sarah L M; Kotagal, Meera; Riesel, Johanna N; Esquivel, Micaela; Uribe-Leitz, Tarsicio; Molina, George; Roy, Nobhojit; Meara, John G; Farmer, Paul E

2015-06-01

More than 2 billion people are unable to receive surgical care based on operating theatre density alone. The vision of the Lancet Commission on Global Surgery is universal access to safe, affordable surgical and anaesthesia care when needed. We aimed to estimate the number of individuals worldwide without access to surgical services as defined by the Commission's vision. We modelled access to surgical services in 196 countries with respect to four dimensions: timeliness, surgical capacity, safety, and affordability. We built a chance tree for each country to model the probability of surgical access with respect to each dimension, and from this we constructed a statistical model to estimate the proportion of the population in each country that does not have access to surgical services. We accounted for uncertainty with one-way sensitivity analyses, multiple imputation for missing data, and probabilistic sensitivity analysis. At least 4·8 billion people (95% posterior credible interval 4·6-5·0 [67%, 64-70]) of the world's population do not have access to surgery. The proportion of the population without access varied widely when stratified by epidemiological region: greater than 95% of the population in south Asia and central, eastern, and western sub-Saharan Africa do not have access to care, whereas less than 5% of the population in Australasia, high-income North America, and western Europe lack access. Most of the world's population does not have access to surgical care, and access is inequitably distributed. The near absence of access in many low-income and middle-income countries represents a crisis, and as the global health community continues to support the advancement of universal health coverage, increasing access to surgical services will play a central role in ensuring health care for all. None. Copyright © 2015 Alkire et al. Open Access article distributed under the terms of CC BY. Published by Elsevier Ltd.. All rights reserved.

Point prevalence of access block and overcrowding in New Zealand emergency departments in 2010 and their relationship to the 'Shorter Stays in ED' target.

PubMed

Jones, Peter G; Olsen, Sarah

2011-10-01

To document the extent of access block and ED overcrowding in New Zealand in 2010 and to determine whether these were linked to the hospital's ability to meet the Shorter Stays in ED target. Surveys of all New Zealand EDs were undertaken at two points in time in 2010 to determine ED occupancy. Data on target achievement during corresponding time periods were obtained from the Ministry of Health. In tertiary and secondary hospitals, respectively, access block was seen in 64% versus 23% (P= 0.05) and overcrowding was seen in 57.1% versus 39% (P= 0.45). No hospital with access block met the 'Shorter Stays' target, compared with 60% without access block (P= 0.001). Twenty-three per cent of hospitals with ED overcrowding met the target compared with 43% without ED overcrowding (P= 0.42). The number of patients experiencing ≥8 h delay to admission were 25 in May and 59 in August (P= 0.04). This represented 45.5% and 79.7% of patients waiting for admission, respectively (P= 0.08). Hospital access block was seen more often in larger hospitals and significantly associated with failure to meet the 'Shorter Stays in ED' health target, whereas ED overcrowding was seen in both small and large hospitals, but not associated with failure to meet the target. © 2011 The Authors. EMA © 2011 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Investigations of Multiple Swirl-Venturi Fuel Injector Concepts: Recent Experimental Optical Measurement Results for 1-Point, 7-Point, and 9-Point Configurations

NASA Technical Reports Server (NTRS)

Hicks, Yolanda R.; Anderson, Robert C.; Tedder, Sarah A.; Tacina, Kathleen M.

2015-01-01

This paper presents results obtained during testing in optically-accessible, JP8-fueled, flame tube combustors using swirl-venturi lean direct injection (LDI) research hardware. The baseline LDI geometry has 9 fuel/air mixers arranged in a 3 x 3 array within a square chamber. 2-D results from this 9-element array are compared to results obtained in a cylindrical combustor using a 7-element array and a single element. In each case, the baseline element size remains the same. The effect of air swirler angle, and element arrangement on the presence of a central recirculation zone are presented. Only the highest swirl number air swirler produced a central recirculation zone for the single element swirl-venturi LDI and the 9-element LDI, but that same swirler did not produce a central recirculation zone for the 7-element LDI, possibly because of strong interactions due to element spacing within the array.

Point Positioning Service for Natural Hazard Monitoring

NASA Astrophysics Data System (ADS)

Bar-Sever, Y. E.

2014-12-01

In an effort to improve natural hazard monitoring, JPL has invested in updating and enlarging its global real-time GNSS tracking network, and has launched a unique service - real-time precise positioning for natural hazard monitoring, entitled GREAT Alert (GNSS Real-Time Earthquake and Tsunami Alert). GREAT Alert leverages the full technological and operational capability of the JPL's Global Differential GPS System [www.gdgps.net] to offer owners of real-time dual-frequency GNSS receivers: Sub-5 cm (3D RMS) real-time, absolute positioning in ITRF08, regardless of location Under 5 seconds turnaround time Full covariance information Estimates of ancillary parameters (such as troposphere) optionally provided This service enables GNSS networks operators to instantly have access to the most accurate and reliable real-time positioning solutions for their sites, and also to the hundreds of participating sites globally, assuring inter-consistency and uniformity across all solutions. Local authorities with limited technical and financial resources can now access to the best technology, and share environmental data to the benefit of the entire pacific region. We will describe the specialized precise point positioning techniques employed by the GREAT Alert service optimized for natural hazard monitoring, and in particular Earthquake monitoring. We address three fundamental aspects of these applications: 1) small and infrequent motion, 2) the availability of data at a central location, and 3) the need for refined solutions at several time scales

Trends in Radical Prostatectomy: Centralization, Robotics, and Access to Urologic Cancer Care

PubMed Central

Stitzenberg, Karyn B.; Wong, Yu-Ning; Nielsen, Matthew E.; Egleston, Brian L.; Uzzo, Robert G.

2011-01-01

Background Robotic surgery has been widely adopted for radical prostatectomy. We hypothesize that this change is rapidly shifting procedures away from hospitals that do not offer robotics and consequently increasing patient travel. Methods A population-based observational study of all prostatectomies for cancer in NY, NJ, and PA from 2000–2009 was performed using hospital discharge data. Hospital procedure volume was defined as the number of prostatectomies performed for cancer in a given year. Straight-line travel distance to treating hospital was calculated for each case. Hospitals were contacted to determine year of acquisition of first robot. Results From 2000–2009, the total number of prostatectomies performed annually increased substantially. The increase occurred almost entirely at the very high volume centers (≥106 prostatectomies/year). The number of hospitals performing prostatectomy fell 37% from 2000–2009. By 2009, the 9% (21/244) of hospitals that had very high volume performed 57% of all prostatectomies, and the 35% (86/244) of hospitals with a robot performed 85% of all prostatectomies. Median travel increased 54% from 2000–2009, p<0.001. The proportion of patients traveling ≥15 miles increased from 24% to 40%, p<0.001. Conclusions Over the past decade, the number of radical prostatectomies performed has risen substantially. These procedures have been increasingly centralized at high volume centers, leading to longer patient travel distances. Few prostatectomies are now performed at hospitals that do not offer robotic surgery. Future work should focus on the impact of these trends on cancer control, functional outcomes, access to care and cost. PMID:21717436

Development of key performance indicators to evaluate centralized intake for patients with osteoarthritis and rheumatoid arthritis.

PubMed

Barber, Claire E; Patel, Jatin N; Woodhouse, Linda; Smith, Christopher; Weiss, Stephen; Homik, Joanne; LeClercq, Sharon; Mosher, Dianne; Christiansen, Tanya; Howden, Jane Squire; Wasylak, Tracy; Greenwood-Lee, James; Emrick, Andrea; Suter, Esther; Kathol, Barb; Khodyakov, Dmitry; Grant, Sean; Campbell-Scherer, Denise; Phillips, Leah; Hendricks, Jennifer; Marshall, Deborah A

2015-11-14

Centralized intake is integral to healthcare systems to support timely access to appropriate health services. The aim of this study was to develop key performance indicators (KPIs) to evaluate centralized intake systems for patients with osteoarthritis (OA) and rheumatoid arthritis (RA). Phase 1 involved stakeholder meetings including healthcare providers, managers, researchers and patients to obtain input on candidate KPIs, aligned along six quality dimensions: appropriateness, accessibility, acceptability, efficiency, effectiveness, and safety. Phase 2 involved literature reviews to ensure KPIs were based on best practices and harmonized with existing measures. Phase 3 involved a three-round, online modified Delphi panel to finalize the KPIs. The panel consisted of two rounds of rating and a round of online and in-person discussions. KPIs rated as valid and important (≥7 on a 9-point Likert scale) were included in the final set. Twenty-five KPIs identified and substantiated during Phases 1 and 2 were submitted to 27 panellists including healthcare providers, managers, researchers, and patients in Phase 3. After the in-person meeting, three KPIs were removed and six were suggested. The final set includes 9 OA KPIs, 10 RA KPIs and 9 relating to centralized intake processes for both conditions. All 28 KPIs were rated as valid and important. Arthritis stakeholders have proposed 28 KPIs that should be used in quality improvement efforts when evaluating centralized intake for OA and RA. The KPIs measure five of the six dimensions of quality and are relevant to patients, practitioners and health systems.

Non-Gimbaled Antenna Pointing

NASA Technical Reports Server (NTRS)

Vigil, Jeannine S.

1997-01-01

The small satellite community has been interested in accessing fixed ground stations for means of space-to-ground transmissions, although a problem arises from the limited global coverage. There is a growing interest for using the Space Network (SN) or Tracking and Data Relay Satellites (TDRS) as the primary support for communications because of the coverage it provides. This thesis will address the potential for satellite access of the Space Network with a non-gimbaled antenna configuration and low-power, coded transmission. The non-gimbaled antenna and the TDRS satellites, TDRS-East, TDRS-West, and TDRS-Zone of Exclusion, were configured in an orbital analysis software package called Satellite Tool Kit to emulate the three-dimensional position of the satellites. The access potential, which is the average number of contacts per day and the average time per contact, were obtained through simulations run over a 30-day period to gain all the possible orientations. The orbital altitude was varied from 600 km through 1200 km with the results being a function of orbital inclination angles varying from 20 deg through 100 deg and pointing half-angles of I0 deg through 40 deg. To compare the validity of the simulations, Jet Propulsion Laboratory granted the use of the TOPEX satellite. The TOPEX satellite was configured to emulate a spin-stabilized antenna with its communications antenna stowed in the zenith-pointing direction. This mimicked the antenna pointing spin-stabilized satellite in the simulations. To make valid comparisons, the TOPEX orbital parameters were entered into Satellite Tool Kit and simulated over five test times provided by Jet Propulsion Laboratory.

Resident training in point-of-care testing.

PubMed

Campbell, Sheldon; Howanitz, Peter J

2007-06-01

Although central laboratory testing has been the norm for the last few decades and point-of-care testing (POCT) is considered an emerging area, physicians were performing POCT long before the existence of central laboratory testing. As medical directors of POCT programs, pathologists need the basic knowledge and skills associated with directing laboratory-based testing programs as well as additional knowledge and skills about testing at the point of care. Although the essential elements of quality testing are the same for laboratory-based and POCT, the enormous variety of settings, technologies, and workers involved present unique challenges.

Spatial access to residential care resources in Beijing, China

PubMed Central

2012-01-01

Background As the population is ageing rapidly in Beijing, the residential care sector is in a fast expansion process with the support of the municipal government. Understanding spatial accessibility to residential care resources by older people supports the need for rational allocation of care resources in future planning. Methods Based on population data and data on residential care resources, this study uses two Geographic Information System (GIS) based methods – shortest path analysis and a two-step floating catchment area (2SFCA) method to analyse spatial accessibility to residential care resources. Results Spatial accessibility varies as the methods and considered factors change. When only time distance is considered, residential care resources are more accessible in the central city than in suburban and exurban areas. If care resources are considered in addition to time distance, spatial accessibility is relatively poor in the central city compared to the northeast to southeast side of the suburban and exurban areas. The resources in the northwest to southwest side of the city are the least accessible, even though several hotspots of residential care resources are located in these areas. Conclusions For policy making, it may require combining various methods for a comprehensive analysis. The methods used in this study provide tools for identifying underserved areas in order to improve equity in access to and efficiency in allocation of residential care resources in future planning. PMID:22877360

Grey-Markov prediction model based on background value optimization and central-point triangular whitenization weight function

NASA Astrophysics Data System (ADS)

Ye, Jing; Dang, Yaoguo; Li, Bingjun

2018-01-01

Grey-Markov forecasting model is a combination of grey prediction model and Markov chain which show obvious optimization effects for data sequences with characteristics of non-stationary and volatility. However, the state division process in traditional Grey-Markov forecasting model is mostly based on subjective real numbers that immediately affects the accuracy of forecasting values. To seek the solution, this paper introduces the central-point triangular whitenization weight function in state division to calculate possibilities of research values in each state which reflect preference degrees in different states in an objective way. On the other hand, background value optimization is applied in the traditional grey model to generate better fitting data. By this means, the improved Grey-Markov forecasting model is built. Finally, taking the grain production in Henan Province as an example, it verifies this model's validity by comparing with GM(1,1) based on background value optimization and the traditional Grey-Markov forecasting model.

32 CFR 1906.149 - Program accessibility: Discrimination prohibited.

Code of Federal Regulations, 2011 CFR

2011-07-01

... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.149 Program accessibility: Discrimination prohibited...

32 CFR 1906.149 - Program accessibility: Discrimination prohibited.

Code of Federal Regulations, 2013 CFR

2013-07-01

... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.149 Program accessibility: Discrimination prohibited...

32 CFR 1906.149 - Program accessibility: Discrimination prohibited.

Code of Federal Regulations, 2012 CFR

2012-07-01

... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.149 Program accessibility: Discrimination prohibited...

32 CFR 1906.149 - Program accessibility: Discrimination prohibited.

Code of Federal Regulations, 2010 CFR

2010-07-01

... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.149 Program accessibility: Discrimination prohibited...

32 CFR 1906.149 - Program accessibility: Discrimination prohibited.

Code of Federal Regulations, 2014 CFR

2014-07-01

... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.149 Program accessibility: Discrimination prohibited...

Accessibility benchmarks: interpretive programs and services in north central California

Treesearch

Laura J. McLachlin; Emilyn A. Sheffield; Donald A. Penland; Charles W. Nelson

1995-01-01

The Heritage Corridors Project was a unique partnership between the California Department of Parks and Recreation, the California State University, and the Across California Conservancy. The purpose of the project was to develop a map of selected northern California outdoor recreation and heritage sites. Data about facility accessibility improvements (restrooms, clear...

Can developing countries leapfrog the centralized electrification paradigm?

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

Levin, Todd; Thomas, Valerie M.

Due to the rapidly decreasing costs of small renewable electricity generation 'systems, centralized power systems are no longer a necessary condition of universal access to modern energy services. Developing countries, where centralized electricity infrastructures are less developed, may be able to adopt these new technologies more quickly. We first review the costs of grid extension and distributed solar home systems (SHSs) as reported by a number of different studies. We then present a general analytic framework for analyzing the choice between extending the grid and implementing distributed solar home systems. Drawing upon reported grid expansion cost data for three specificmore » regions, we demonstrate this framework by determining the electricity consumption levels at which the costs of provision through centralized and decentralized approaches are equivalent in these regions. We then calculate SHS capital costs that are necessary for these technologies provide each of five tiers of energy access, as defined by the United Nations Sustainable Energy for All initiative. Our results suggest that solar home systems can play an important role in achieving universal access to basic energy services. The extent of this role depends on three primary factors: SHS costs, grid expansion costs, and centralized generation costs. Given current technology costs, centralized systems will still be required to enable higher levels of consumption; however, cost reduction trends have the potential to disrupt this paradigm. By looking ahead rather than replicating older infrastructure styles, developing countries can leapfrog to a more distributed electricity service model. (C) 2016 International Energy Initiative. Published by Elsevier Inc. All rights reserved.« less

Can developing countries leapfrog the centralized electrification paradigm?

DOE PAGES

Levin, Todd; Thomas, Valerie M.

2016-02-04

Due to the rapidly decreasing costs of small renewable electricity generation systems, centralized power systems are no longer a necessary condition of universal access to modern energy services. Developing countries, where centralized electricity infrastructures are less developed, may be able to adopt these new technologies more quickly. We first review the costs of grid extension and distributed solar home systems (SHSs) as reported by a number of different studies. We then present a general analytic framework for analyzing the choice between extending the grid and implementing distributed solar home systems. Drawing upon reported grid expansion cost data for three specificmore » regions, we demonstrate this framework by determining the electricity consumption levels at which the costs of provision through centralized and decentralized approaches are equivalent in these regions. We then calculate SHS capital costs that are necessary for these technologies provide each of five tiers of energy access, as defined by the United Nations Sustainable Energy for All initiative. Our results suggest that solar home systems can play an important role in achieving universal access to basic energy services. The extent of this role depends on three primary factors: SHS costs, grid expansion costs, and centralized generation costs. Given current technology costs, centralized systems will still be required to enable higher levels of consumption; however, cost reduction trends have the potential to disrupt this paradigm. Furthermore, by looking ahead rather than replicating older infrastructure styles, developing countries can leapfrog to a more distributed electricity service model.« less

32 CFR 1906.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2012 CFR

2012-07-01

... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.150 Program accessibility: Existing facilities. (a...

32 CFR 1906.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2013 CFR

2013-07-01

... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.150 Program accessibility: Existing facilities. (a...

32 CFR 1906.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2014 CFR

2014-07-01

... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.150 Program accessibility: Existing facilities. (a...

32 CFR 1906.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2011 CFR

2011-07-01

... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.150 Program accessibility: Existing facilities. (a...

32 CFR 1906.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.150 Program accessibility: Existing facilities. (a...

Seattle Central Questions: Institutional and Educational Effectiveness, 2001.

ERIC Educational Resources Information Center

Bystrom, Valerie, Ed.; Kempen, Laurie, Ed.

2001-01-01

The aim of this newsletter, published twice a year by the office of Institutional Planning and Research at Seattle Central Community College (Washington), is to help Seattle Central faculty and staff gain access to the institutional data they need, and to help them link and integrate their various planning and assessment activities without…

Measurement of Cardiac Index by Transpulmonary Thermodilution Using an Implanted Central Venous Access Port: A Prospective Study in Patients Scheduled for Oncologic High-Risk Surgery

PubMed Central

Suria, Stéphanie; Wyniecki, Anne; Eghiaian, Alexandre; Monnet, Xavier; Weil, Grégoire

2014-01-01

Background Transpulmonary thermodilution allows the measurement of cardiac index for high risk surgical patients. Oncologic patients often have a central venous access (port-a-catheter) for chronic treatment. The validity of the measurement by a port-a-catheter of the absolute cardiac index and the detection of changes in cardiac index induced by fluid challenge are unknown. Methods We conducted a monocentric prospective study. 27 patients were enrolled. 250 ml colloid volume expansions for fluid challenge were performed during ovarian cytoreductive surgery. The volume expansion-induced changes in cardiac index measured by transpulmonary thermodilution by a central venous access (CIcvc) and by a port-a-catheter (CIport) were recorded. Results 23 patients were analyzed with 123 pairs of measurements. Using a Bland and Altman for repeated measurements, the bias (lower and upper limits of agreement) between CIport and CIcvc was 0.14 (−0.59 to 0.88) L/min/m2. The percentage error was 22%. The concordance between the changes in CIport and CIcvc observed during volume expansion was 92% with an r = 0.7 (with exclusion zone). No complications (included sepsis) were observed during the follow up period. Conclusions The transpulmonary thermodilution by a port-a-catheter is reliable for absolute values estimation of cardiac index and for measurement of the variation after fluid challenge. Trial Registration clinicaltrials.gov NCT02063009 PMID:25136951

Measurement of cardiac index by transpulmonary thermodilution using an implanted central venous access port: a prospective study in patients scheduled for oncologic high-risk surgery.

PubMed

Suria, Stéphanie; Wyniecki, Anne; Eghiaian, Alexandre; Monnet, Xavier; Weil, Grégoire

2014-01-01

Transpulmonary thermodilution allows the measurement of cardiac index for high risk surgical patients. Oncologic patients often have a central venous access (port-a-catheter) for chronic treatment. The validity of the measurement by a port-a-catheter of the absolute cardiac index and the detection of changes in cardiac index induced by fluid challenge are unknown. We conducted a monocentric prospective study. 27 patients were enrolled. 250 ml colloid volume expansions for fluid challenge were performed during ovarian cytoreductive surgery. The volume expansion-induced changes in cardiac index measured by transpulmonary thermodilution by a central venous access (CIcvc) and by a port-a-catheter (CIport) were recorded. 23 patients were analyzed with 123 pairs of measurements. Using a Bland and Altman for repeated measurements, the bias (lower and upper limits of agreement) between CIport and CIcvc was 0.14 (-0.59 to 0.88) L/min/m2. The percentage error was 22%. The concordance between the changes in CIport and CIcvc observed during volume expansion was 92% with an r = 0.7 (with exclusion zone). No complications (included sepsis) were observed during the follow up period. The transpulmonary thermodilution by a port-a-catheter is reliable for absolute values estimation of cardiac index and for measurement of the variation after fluid challenge. clinicaltrials.gov NCT02063009.

Nature of the Diffuse Source and Its Central Point-like Source in SNR 0509–67.5

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

Litke, Katrina C.; Chu, You-Hua; Holmes, Abigail

We examine a diffuse emission region near the center of SNR 0509−67.5 to determine its nature. Within this diffuse region we observe a point-like source that is bright in the near-IR, but is not visible in the B and V bands. We consider an emission line observed at 6766 Å and the possibilities that it is Ly α , H α , and [O ii] λ 3727. We examine the spectral energy distribution (SED) of the source, comprised of Hubble Space Telescope B , V , I , J , and H bands in addition to Spitzer /IRAC 3.6, 4.5,more » 5.8, and 8 μ m bands. The peak of the SED is consistent with a background galaxy at z ≈ 0.8 ± 0.2 and a possible Balmer jump places the galaxy at z ≈ 0.9 ± 0.3. These SED considerations support the emission line’s identification as [O ii] λ 3727. We conclude that the diffuse source in SNR 0509−67.5 is a background galaxy at z ≈ 0.82. Furthermore, we identify the point-like source superposed near the center of the galaxy as its central bulge. Finally, we find no evidence for a surviving companion star, indicating a double-degenerate origin for SNR 0509−67.5.« less

76 FR 64237 - Access by Historical Researchers and Certain Former Government Personnel; Correction

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-18

... CENTRAL INTELLIGENCE AGENCY 32 CFR Part 1909 Access by Historical Researchers and Certain Former Government Personnel; Correction AGENCY: Central Intelligence Agency. ACTION: Final rule; correction. SUMMARY: On September 23, 2011, the Central Intelligence Agency published a final rule resulting from a review...

Centralized Mouse Repositories

PubMed Central

Donahue, Leah Rae; de Angelis, Martin Hrabe; Hagn, Michael; Franklin, Craig; Lloyd, K. C. Kent; Magnuson, Terry; McKerlie, Colin; Nakagata, Naomi; Obata, Yuichi; Read, Stuart; Wurst, Wolfgang; Hörlein, Andreas; Davisson, Muriel T.

2013-01-01

Because the mouse is used so widely for biomedical research and the number of mouse models being generated is increasing rapidly, centralized repositories are essential if the valuable mouse strains and models that have been developed are to be securely preserved and fully exploited. Ensuring the ongoing availability of these mouse strains preserves the investment made in creating and characterizing them and creates a global resource of enormous value. The establishment of centralized mouse repositories around the world for distributing and archiving these resources has provided critical access to and preservation of these strains. This article describes the common and specialized activities provided by major mouse repositories around the world. PMID:22945696

Access to Liver Transplantation in Different ABO-Blood Groups and "Exceptions Points" in a Model for End-Stage Liver Disease Allocation System: A Brazilian Single-Center Study.

PubMed

Martino, R B; Waisberg, D R; Dias, A P M; Inoue, V B S; Arantes, R M; Haddad, L B P; Rocha-Santos, V; Pinheiro, R S N; Nacif, L S; D'Albuquerque, L A C

2018-04-01

In the Model for End-Stage Liver Disease (MELD) system, patients with "MELD exceptions" points may have unfair privilege in the competition for liver grafts. Furthermore, organ distribution following identical ABO blood types may also result in unjust organ allocation. The aim of this study was to investigate access to liver transplantation in a tertiary Brazilian center, regarding "MELD exceptions" situations and among ABO-blood groups. A total of 465 adult patients on the liver waitlist from August 2015 to August 2016 were followed up until August 2017. Patients were divided into groups according to ABO-blood type and presence of "exceptions points." No differences in outcomes were observed among ABO-blood groups. However, patients from B and AB blood types spent less time on the list than patients from A and O groups (median, 46, 176, 415, and 401 days, respectively; P = .03). "Exceptions points" were granted for 141 patients (30.1%), hepatocellular carcinoma being the most common reason (52.4%). Patients with "exceptions points" showed higher transplantation rate, lower mortality on the list, and lower delta-MELD than non-exceptions patients (56.7% vs 19.1% [P < .01]; 18.4% vs 38.5% [P < .01], and 2.0 ± 2.6 vs 6.9 ± 7.0 [P < .01], respectively). Patients with refractory ascites had a higher mortality rate than those with other "exceptions" or without (48%). The MELD system provides equal access to liver transplantation among ABO-blood types, despite shorter time on the waitlist for AB and B groups. The current MELD exception system provides advantages for candidates with "exception points," resulting in superior outcomes compared with those without exceptions. Copyright © 2018 Elsevier Inc. All rights reserved.

State Medicaid Coverage, ESRD Incidence, and Access to Care

PubMed Central

Goldstein, Benjamin A.; Hall, Yoshio N.; Mitani, Aya A.; Winkelmayer, Wolfgang C.

2014-01-01

The proportion of low-income nonelderly adults covered by Medicaid varies widely by state. We sought to determine whether broader state Medicaid coverage, defined as the proportion of each state’s low-income nonelderly adult population covered by Medicaid, associates with lower state-level incidence of ESRD and greater access to care. The main outcomes were incidence of ESRD and five indicators of access to care. We identified 408,535 adults aged 20–64 years, who developed ESRD between January 1, 2001, and December 31, 2008. Medicaid coverage among low-income nonelderly adults ranged from 12.2% to 66.0% (median 32.5%). For each additional 10% of the low-income nonelderly population covered by Medicaid, there was a 1.8% (95% confidence interval, 1.0% to 2.6%) decrease in ESRD incidence. Among nonelderly adults with ESRD, gaps in access to care between those with private insurance and those with Medicaid were narrower in states with broader coverage. For a 50-year-old white woman, the access gap to the kidney transplant waiting list between Medicaid and private insurance decreased by 7.7 percentage points in high (>45%) versus low (<25%) Medicaid coverage states. Similarly, the access gap to transplantation decreased by 4.0 percentage points and the access gap to peritoneal dialysis decreased by 3.8 percentage points in high Medicaid coverage states. In conclusion, states with broader Medicaid coverage had a lower incidence of ESRD and smaller insurance-related access gaps. PMID:24652791

Intellectual property and access to medicines: an analysis of legislation in Central America.

PubMed

Cerón, Alejandro; Godoy, Angelina Snodgrass

2009-10-01

Globalization of intellectual property (IP) protection for medicines has been advancing during the past decade. Countries are obliged to adapt their legislation as a requirement of their membership to the World Trade Organization or as a condition of being part of international trade agreements. There is a growing recognition that, in low-income countries, stronger IP protection is a barrier to access to medicines. At the same time, the number of low-income countries writing national legislation to protect IP for pharmaceutical products is growing worldwide, but little research has been done on the ways in which this process is happening at the national level. This paper aims to contribute to the understanding of the implementation of IP legislation at the national level by providing a comparative analysis of the countries that are part of the United States-Dominican Republic-Central America Free Trade Agreement (DR-CAFTA). The analysis shows three trends. First, countries have often implemented stronger IP protection than required by trade agreements. Second, some countries have adopted IP protection before signing the trade agreements. Third, the process of ratification of DR-CAFTA increased public debate around these issues, which in some cases led to IP legislation that considers public health needs. These trends suggest that industrialized countries and the pharmaceutical industry are using more tactics than just trade agreements to push for increased IP protection and that the process of national legislation is a valid arena for confronting public health needs to those of the industry.

Intellectual property and access to medicines: an analysis of legislation in Central America

PubMed Central

Cerón, Alejandro

2009-01-01

Abstract Globalization of intellectual property (IP) protection for medicines has been advancing during the past decade. Countries are obliged to adapt their legislation as a requirement of their membership to the World Trade Organization or as a condition of being part of international trade agreements. There is a growing recognition that, in low-income countries, stronger IP protection is a barrier to access to medicines. At the same time, the number of low-income countries writing national legislation to protect IP for pharmaceutical products is growing worldwide, but little research has been done on the ways in which this process is happening at the national level. This paper aims to contribute to the understanding of the implementation of IP legislation at the national level by providing a comparative analysis of the countries that are part of the United States–Dominican Republic–Central America Free Trade Agreement (DR-CAFTA). The analysis shows three trends. First, countries have often implemented stronger IP protection than required by trade agreements. Second, some countries have adopted IP protection before signing the trade agreements. Third, the process of ratification of DR-CAFTA increased public debate around these issues, which in some cases led to IP legislation that considers public health needs. These trends suggest that industrialized countries and the pharmaceutical industry are using more tactics than just trade agreements to push for increased IP protection and that the process of national legislation is a valid arena for confronting public health needs to those of the industry. PMID:19876546

Funding free and universal access to Journal of Neuroinflammation.

PubMed

Mrak, Robert E; Griffin, W Sue T

2004-10-14

Journal of Neuroinflammation is an Open Access, online journal published by BioMed Central. Open Access publishing provides instant and universal availability of published work to any potential reader, worldwide, completely free of subscriptions, passwords, and charges. Further, authors retain copyright for their work, facilitating its dissemination. Open Access publishing is made possible by article-processing charges assessed "on the front end" to authors, their institutions, or their funding agencies. Beginning November 1, 2004, the Journal of Neuroinflammation will introduce article-processing charges of around US$525 for accepted articles. This charge will be waived for authors from institutions that are BioMed Central members, and in additional cases for reasons of genuine financial hardship. These article-processing charges pay for an electronic submission process that facilitates efficient and thorough peer review, for publication costs involved in providing the article freely and universally accessible in various formats online, and for the processes required for the article's inclusion in PubMed and its archiving in PubMed Central, e-Depot, Potsdam and INIST. There is no remuneration of any kind provided to the Editors-in-Chief, to any members of the Editorial Board, or to peer reviewers; all of whose work is entirely voluntary. Our article-processing charge is less than charges frequently levied by traditional journals: the Journal of Neuroinflammation does not levy any additional page or color charges on top of this fee, and there are no reprint costs as publication-quality pdf files are provided, free, for distribution in lieu of reprints. Our article-processing charge will enable full, immediate, and continued Open Access for all work published in Journal of Neuroinflammation. The benefits from such Open Access will accrue to readers, through unrestricted access; to authors, through the widest possible dissemination of their work; and to science and

Spatial point analysis based on dengue surveys at household level in central Brazil

PubMed Central

Siqueira-Junior, João B; Maciel, Ivan J; Barcellos, Christovam; Souza, Wayner V; Carvalho, Marilia S; Nascimento, Nazareth E; Oliveira, Renato M; Morais-Neto, Otaliba; Martelli, Celina MT

2008-01-01

Background Dengue virus (DENV) affects nonimunne human populations in tropical and subtropical regions. In the Americas, dengue has drastically increased in the last two decades and Brazil is considered one of the most affected countries. The high frequency of asymptomatic infection makes difficult to estimate prevalence of infection using registered cases and to locate high risk intra-urban area at population level. The goal of this spatial point analysis was to identify potential high-risk intra-urban areas of dengue, using data collected at household level from surveys. Methods Two household surveys took place in the city of Goiania (~1.1 million population), Central Brazil in the year 2001 and 2002. First survey screened 1,586 asymptomatic individuals older than 5 years of age. Second survey 2,906 asymptomatic volunteers, same age-groups, were selected by multistage sampling (census tracts; blocks; households) using available digital maps. Sera from participants were tested by dengue virus-specific IgM/IgG by EIA. A Generalized Additive Model (GAM) was used to detect the spatial varying risk over the region. Initially without any fixed covariates, to depict the overall risk map, followed by a model including the main covariates and the year, where the resulting maps show the risk associated with living place, controlled for the individual risk factors. This method has the advantage to generate smoothed risk factors maps, adjusted by socio-demographic covariates. Results The prevalence of antibody against dengue infection was 37.3% (95%CI [35.5–39.1]) in the year 2002; 7.8% increase in one-year interval. The spatial variation in risk of dengue infection significantly changed when comparing 2001 with 2002, (ORadjusted = 1.35; p < 0.001), while controlling for potential confounders using GAM model. Also increasing age and low education levels were associated with dengue infection. Conclusion This study showed spatial heterogeneity in the risk areas of dengue

Assured Access/Mobile Computing Initiatives on Five University Campuses.

ERIC Educational Resources Information Center

Blurton, Craig; Chee, Yam San; Long, Phillip D.; Resmer, Mark; Runde, Craig

Mobile computing and assured access are becoming popular terms to describe a growing number of university programs which take advantage of ubiquitous network access points and the portability of notebook computers to ensure all students have access to digital tools and resources. However, the implementation of such programs varies widely from…

Genome-Wide Association Study in Arabidopsis thaliana of Natural Variation in Seed Oil Melting Point: A Widespread Adaptive Trait in Plants.

PubMed

Branham, Sandra E; Wright, Sara J; Reba, Aaron; Morrison, Ginnie D; Linder, C Randal

2016-05-01

Seed oil melting point is an adaptive, quantitative trait determined by the relative proportions of the fatty acids that compose the oil. Micro- and macro-evolutionary evidence suggests selection has changed the melting point of seed oils to covary with germination temperatures because of a trade-off between total energy stores and the rate of energy acquisition during germination under competition. The seed oil compositions of 391 natural accessions of Arabidopsis thaliana, grown under common-garden conditions, were used to assess whether seed oil melting point within a species varied with germination temperature. In support of the adaptive explanation, long-term monthly spring and fall field temperatures of the accession collection sites significantly predicted their seed oil melting points. In addition, a genome-wide association study (GWAS) was performed to determine which genes were most likely responsible for the natural variation in seed oil melting point. The GWAS found a single highly significant association within the coding region of FAD2, which encodes a fatty acid desaturase central to the oil biosynthesis pathway. In a separate analysis of 15 a priori oil synthesis candidate genes, 2 (FAD2 and FATB) were located near significant SNPs associated with seed oil melting point. These results comport with others' molecular work showing that lines with alterations in these genes affect seed oil melting point as expected. Our results suggest natural selection has acted on a small number of loci to alter a quantitative trait in response to local environmental conditions. © The American Genetic Association. 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Associations of centrally acting ACE inhibitors with cognitive decline and survival in Alzheimer's disease.

PubMed

Fazal, Karim; Perera, Gayan; Khondoker, Mizanur; Howard, Robert; Stewart, Robert

2017-07-01

Cognitive improvement has been reported in patients receiving centrally acting angiotensin-converting enzyme inhibitors (C-ACEIs). To compare cognitive decline and survival after diagnosis of Alzheimer's disease between people receiving C-ACEIs, non-centrally acting angiotensin-converting enzyme inhibitors (NC-ACEIs), and neither. Routine Mini-Mental State Examination (MMSE) scores were extracted in 5260 patients receiving acetylcholinesterase inhibitors and analysed against C-/NC-ACEI exposure at the time of Alzheimer's disease diagnosis. In the 9 months after Alzheimer's disease diagnosis, MMSE scores significantly increased by 0.72 and 0.19 points per year in patients on C-ACEIs and neither respectively, but deteriorated by 0.61 points per year in those on NC-ACEIs. There were no significant group differences in score trajectories from 9 to 36 months and no differences in survival. In people with Alzheimer's disease receiving acetylcholinesterase inhibitors, those also taking C-ACEIs had stronger initial improvement in cognitive function, but there was no evidence of longer-lasting influence on dementia progression. R.S. has received research funding from Pfizer, Lundbeck, Roche, Janssen and GlaxoSmithKline. © The Royal College of Psychiatrists 2017. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license.

The AAS Working Group on Accessibility and Disability (WGAD): progress, current projects, and prospects for making astronomy accessible to all

NASA Astrophysics Data System (ADS)

Aarnio, Alicia; Diaz-Merced, Wanda; Monkiewicz, Jacqueline; Knierman, Karen; AAS WGAD

2018-01-01

Representation of astronomers with disabilities is low at the earliest career stages and losses compound with career stage thereafter; single-digit and lower percentage representation statistics are in large part due to systemic barriers to access and failure to accommodate the needs of users of a wide range of abilities. In this presentation, we discuss the barriers currently inhibiting broad access to astronomical publications, databases, and conferences. The WGAD was formed in January of 2016 to work toward removal of these barriers to make our field inclusive of astronomers with disabilities at all career stages. We have productively engaged with publishers and accessibility audits have been performed. Database accessibility evaluation is underway, and we are working with the AAS and other professional organizations on conference accessibility. We are keeping users centrally focused via surveys and user test groups, and holding paramount the overarching idea that meeting present accessibility standards is a necessary but insufficient condition for full access.

Solar-terrestrial data access distribution and archiving

NASA Technical Reports Server (NTRS)

1984-01-01

It is recommended that a central data catalog and data access network (CDC/DAN) for solar-terrestrial research be established, initially as a NASA pilot program. The system is envisioned to be flexible and to evolve as funds permit, starting from a catalog to an access network for high-resolution data. The report describes the various functional requirements for the CDC/DAN, but does not specify the hardware and software architectures as these are constantly evolving. The importance of a steering committee, working with the CDC/DAN organization, to provide scientific guidelines for the data catalog and for data storage, access, and distribution is also stressed.

Performance of FORTRAN floating-point operations on the Flex/32 multicomputer

NASA Technical Reports Server (NTRS)

Crockett, Thomas W.

1987-01-01

A series of experiments has been run to examine the floating-point performance of FORTRAN programs on the Flex/32 (Trademark) computer. The experiments are described, and the timing results are presented. The time required to execute a floating-point operation is found to vary considerbaly depending on a number of factors. One factor of particular interest from an algorithm design standpoint is the difference in speed between common memory accesses and local memory accesses. Common memory accesses were found to be slower, and guidelines are given for determinig when it may be cost effective to copy data from common to local memory.

Internet Access and Online Cancer Information Seeking Among Latino Immigrants From Safety Net Clinics

PubMed Central

SELSKY, CLAIRE; LUTA, GEORGE; NOONE, ANNE-MICHELLE; HUERTA, ELMER E.; MANDELBLATT, JEANNE S.

2013-01-01

Internet use is widespread, but little is known about Internet use for cancer information among Latinos, especially those who rely on safety net clinics. The authors investigated access to and intended use of the Internet for cancer information among low income, immigrant Latinos predominately from Central and South America. A cross-sectional study of 1,273 Latinos 21 years and older attending safety net clinics or health fairs was conducted from June 2007 to November 2008. The authors used logistic regression models to evaluate associations of age, acculturation, psychosocial factors and other covariates with Internet access and intended use of the Internet for cancer information among those with access. Of the sample, 44% reported Internet access. Higher information self-efficacy and greater trust in the Internet were independently associated with Internet access (p= .05 and p < .001, respectively). Among those with access, 53.8% reported they intended to seek cancer help online if they needed information. Those with younger age and higher acculturation, education and self-efficacy had higher odds of intended Internet use for cancer information, considering covariates. In addition, those with high (vs. low) perceived risk of cancer (OR = 1.76; 95% CI [1.14, 2.73]; p = .01) and higher levels of trust in online health information (OR = 1.47 per one-point increase; 95% [CI 1.19, 1.82]; p = .0004) were more likely to intend to seek cancer information online. These findings that Internet access is fairly high in the immigrant Latino population and that the Internet is a trusted source of cancer information suggest that the Internet may be a channel for cancer control interventions. PMID:23066874

Retail Food Store Access in Rural Appalachia: A Mixed Methods Study.

PubMed

Thatcher, Esther; Johnson, Cassandra; Zenk, Shannon N; Kulbok, Pamela

2017-05-01

To describe how characteristics of food retail stores (potential access) and other factors influence self-reported food shopping behavior (realized food access) among low-income, rural Central Appalachian women. Cross-sectional descriptive. Potential access was assessed through store mapping and in-store food audits. Factors influencing consumers' realized access were assessed through in-depth interviews. Results were merged using a convergent parallel mixed methods approach. Food stores (n = 50) and adult women (n = 9) in a rural Central Appalachian county. Potential and realized food access were described across five dimensions: availability, accessibility, affordability, acceptability, and accommodation. Supermarkets had better availability of healthful foods, followed by grocery stores, dollar stores, and convenience stores. On average, participants lived within 10 miles of 3.9 supermarkets or grocery stores, and traveled 7.5 miles for major food shopping. Participants generally shopped at the closest store that met their expectations for food availability, price, service, and atmosphere. Participants' perceptions of stores diverged from each other and from in-store audit findings. Findings from this study can help public health nurses engage with communities to make affordable, healthy foods more accessible. Recommendations are made for educating low-income consumers and partnering with food stores. © 2016 Wiley Periodicals, Inc.

Central venous stenosis among hemodialysis patients is often not associated with previous central venous catheters.

PubMed

Kotoda, Atsushi; Akimoto, Tetsu; Kato, Maki; Kanazawa, Hidenori; Nakata, Manabu; Sugase, Taro; Ogura, Manabu; Ito, Chiharu; Sugimoto, Hideharu; Muto, Shigeaki; Kusano, Eiji

2011-01-01

It is widely assumed that central venous stenosis (CVS) is most commonly associated with previous central venous catheterization among the chronic hemodialysis (HD) patients. We evaluated the validity of this assumption in this retrospective study. The clinical records from 2,856 consecutive HD patients with vascular access failure during a 5-year period were reviewed, and a total of 26 patients with symptomatic CVS were identified. Combined with radiological findings, their clinical characteristics were examined. Only seven patients had a history of internal jugular dialysis catheterization. Diagnostic multidetector row computed tomography angiography showed that 7 of the 19 patients with no history of catheterization had left innominate vein stenosis due to extrinsic compression between the sternum and arch vessels. These patients had a shorter period from the time of creation of the vascular access to the initial referral (9.2 ± 7.6 months) than the rest of the patients (35.5 ± 18.6 months, p = 0.0017). Our findings suggest that cases without a history of central venous catheterization may not be rare among the HD patients with symptomatic CVS. However, those still need to be confirm by larger prospective studies of overall chronic HD patients with symptomatic CVS.

[Self-referrals at Emergency Care Access Points and triage by General Practitioner Cooperatives].

PubMed

Smits, M; Rutten, M; Schepers, L; Giesen, P

2017-01-01

There is a trend for General Practitioner Cooperatives (GPCs) to co-locate with emergency departments (EDs) of hospitals at Emergency Care Access Points (ECAPs), where the GPCs generally conduct triage and treat a large part of self-referrals who would have gone to the ED by themselves in the past. We have examined patient and care characteristics of self-referrals at ECAPs where triage was conducted by GPCs, also to determine the percentage of self-referrals being referred to the ED. Retrospective cross-sectional observational study. Descriptive analyses of routine registration data from self-referrals of five ECAPs (n = 20.451). Patient age, gender, arrival time, urgency, diagnosis and referral were analysed. Of the self-referrals, 57.9% was male and the mean age was 32.7 years. The number of self-referrals per hour was highest during weekends, particularly between 11 a.m. and 5 p.m. On weekdays, there was a peak between 5 and 9 p.m. Self-referrals were mostly assigned a low-urgency grade (35.7% - U4 or U5) or a mid-urgency grade (49% - U3). Almost half of the self-referrals had trauma of the locomotor system (28%) or the skin (27.3%). In total, 23% of the patients was referred to the ED. Self-referred patients at GPCs are typically young, male and have low- to mid-urgency trauma-related problems. Many self-referrals present themselves on weekend days or early weekday evenings. Over three quarters of these patients can be treated by the GPCs, without referral to the ED. This reduces the workload at the ED.

Semantically Enriched Data Access Policies in eHealth.

PubMed

Drozdowicz, Michał; Ganzha, Maria; Paprzycki, Marcin

2016-11-01

Internet of Things (IoT) requires novel solutions to facilitate autonomous, though controlled, resource access. Access policies have to facilitate interactions between heterogeneous entities (devices and humans). Here, we focus our attention on access control in eHealth. We propose an approach based on enriching policies, based on well-known and widely-used eXtensible Access Control Markup Language, with semantics. In the paper we describe an implementation of a Policy Information Point integrated with the HL7 Security and Privacy Ontology.

Placement of a Port Catheter Through Collateral Veins in a Patient with Central Venous Occlusion

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

Teichgraeber, Ulf Karl-Martin, E-mail: ulf.teichgraeber@charite.de; Streitparth, Florian, E-mail: florian.streitparth@charite.d; Gebauer, Bernhard, E-mail: bernhard.gebauer@charite.d

Long-term utilization of central venous catheters (CVCs) for parenteral nutrition has a high incidence of central venous complications including infections, occlusions, and stenosis. We report the case of a 31-year-old woman presenting with a malabsorption caused by short gut syndrome due to congenital aganglionic megacolon. The patient developed a chronic occlusion of all central neck and femoral veins due to long-term use of multiple CVCs over more than 20 years. In patients with central venous occlusion and venous transformation, the implantation of a totally implanted port system by accessing collateral veins is an option to continue long-term parenteral nutrition whenmore » required. A 0.014-in. Whisper guidewire (Terumo, Tokyo) with high flexibility and steerability was chosen to maneuver and pass through the collateral veins. We suggest this approach to avoid unfavorable translumbar or transhepatic central venous access and to conserve the anatomically limited number of percutaneous access sites.« less

Evaluating the accessibility and utility of HIV-related point-of-care diagnostics for maternal health in rural South Africa: a study protocol

PubMed Central

Mashamba-Thompson, T P; Drain, P K; Sartorius, B

2016-01-01

Introduction Poor healthcare access is a major barrier to receiving antenatal care and a cause of high maternal mortality in South Africa (SA). ‘Point-of-care’ (POC) diagnostics is a powerful emerging healthcare approach to improve healthcare access. This study focuses on evaluating the accessibility and utility of POC diagnostics for maternal health in rural SA primary healthcare (PHC) clinics in order to generate a model framework of implementation of POC diagnostics in rural South African clinics. Method and analyses We will use several research methods, including a systematic review, quasi-experiments, survey, key informant interviews and audits. We will conduct a systematic review and experimental study to determine the impact of POC diagnostics on maternal health. We will perform a cross-sectional case study of 100 randomly selected rural primary healthcare clinics in KwaZulu-Natal to measure the context and patterns of POC diagnostics access and usage by maternal health providers and patients. We will conduct interviews with relevant key stakeholders to determine the reasons for POC deficiencies regarding accessibility and utility of HIV-related POC diagnostics for maternal health. We will also conduct a vertical audit to investigate all the quality aspects of POC diagnostic services including diagnostic accuracy in a select number of clinics. On the basis of information gathered, we will propose a model framework for improved implementation of POC diagnostics in rural South African public healthcare clinics. Statistical (Stata-13) and thematic (NVIVO) data analysis will be used in this study. Ethics and dissemination The study protocol was approved by the Ethics Committee of the University of KwaZulu-Natal (BE 484/14) and the KwaZulu-Natal Department of Health based on the Helsinki Declaration (HRKM 40/15). Findings of this study will be disseminated electronically and in print. They will be presented to conferences related to HIV/AIDS, diagnostics

Web Accessibility and Guidelines

NASA Astrophysics Data System (ADS)

Harper, Simon; Yesilada, Yeliz

Access to, and movement around, complex online environments, of which the World Wide Web (Web) is the most popular example, has long been considered an important and major issue in the Web design and usability field. The commonly used slang phrase ‘surfing the Web’ implies rapid and free access, pointing to its importance among designers and users alike. It has also been long established that this potentially complex and difficult access is further complicated, and becomes neither rapid nor free, if the user is disabled. There are millions of people who have disabilities that affect their use of the Web. Web accessibility aims to help these people to perceive, understand, navigate, and interact with, as well as contribute to, the Web, and thereby the society in general. This accessibility is, in part, facilitated by the Web Content Accessibility Guidelines (WCAG) currently moving from version one to two. These guidelines are intended to encourage designers to make sure their sites conform to specifications, and in that conformance enable the assistive technologies of disabled users to better interact with the page content. In this way, it was hoped that accessibility could be supported. While this is in part true, guidelines do not solve all problems and the new WCAG version two guidelines are surrounded by controversy and intrigue. This chapter aims to establish the published literature related to Web accessibility and Web accessibility guidelines, and discuss limitations of the current guidelines and future directions.

High-resolution seismic-reflection and marine-magnetic data from offshore central California--San Gregorio to Point Sur

USGS Publications Warehouse

Sliter, Ray W.; Johnson, Samuel Y.; Watt, Janet T.; Scheirer, Daniel S.; Allwardt, Parker; Triezenberg, Peter J.

2013-01-01

The U.S. Geological Survey collected high-resolution seismic-reflection data on four surveys (S-N1-09-MB, S-15-10-NC, S-06-11-MB, and S-04-12-MB) and marine-magnetic data on one survey (S-06-11-MB) between 2009 and 2012, offshore of central California between San Gregorio and Point Sur. This work was supported in part by the California Seafloor Mapping Program. The survey areas span about 120 km of California's coast (including Monterey Bay). Most data were collected aboard the U.S. Geological Survey R/V Parke Snavely. Cumulatively, approximately 1,410 km of single-channel seismic-reflection data were acquired, mainly using a SIG 2mille minisparker. About 44 km of data were collected simultaneously using an EdgeTech Chirp 512. Subbottom acoustic penetration spanned tens to several hundreds of meters, variable by location. Marine magnetic data were collected on approximately 460 km of track lines (mainly in southern Monterey Bay) using a Geometrics G882 cesium-vapor marine magnetometer. This report includes maps and navigation files of the surveyed transects, linked to Google Earth™ software, as well as digital data files showing images of each transect in SEG-Y and JPEG formats. The images of bedrock, sediment deposits, and tectonic structure provide geologic information that is essential to hazard assessment, regional sediment management, and coastal and marine spatial planning at Federal, State and local levels, as well as to future research on the geomorphic, sedimentary, tectonic, and climatic record of central California.

Child Health and Access to Medical Care

ERIC Educational Resources Information Center

Leininger, Lindsey; Levy, Helen

2015-01-01

It might seem strange to ask whether increasing access to medical care can improve children's health. Yet Lindsey Leininger and Helen Levy begin by pointing out that access to care plays a smaller role than we might think, and that many other factors, such as those discussed elsewhere in this issue, strongly influence children's health.…

Safety Benefits of Access Spacing

DOT National Transportation Integrated Search

1997-01-01

The spacing of driveways and streets is an important element in roadway planning, design, and operation. Access points are the main source of accidents and congestion. Their location and spacing affects the safety and functional integrity of streets ...

Patient-centred access to health care: conceptualising access at the interface of health systems and populations

PubMed Central

2013-01-01

Background Access is central to the performance of health care systems around the world. However, access to health care remains a complex notion as exemplified in the variety of interpretations of the concept across authors. The aim of this paper is to suggest a conceptualisation of access to health care describing broad dimensions and determinants that integrate demand and supply-side-factors and enabling the operationalisation of access to health care all along the process of obtaining care and benefiting from the services. Methods A synthesis of the published literature on the conceptualisation of access has been performed. The most cited frameworks served as a basis to develop a revised conceptual framework. Results Here, we view access as the opportunity to identify healthcare needs, to seek healthcare services, to reach, to obtain or use health care services, and to actually have a need for services fulfilled. We conceptualise five dimensions of accessibility: 1) Approachability; 2) Acceptability; 3) Availability and accommodation; 4) Affordability; 5) Appropriateness. In this framework, five corresponding abilities of populations interact with the dimensions of accessibility to generate access. Five corollary dimensions of abilities include: 1) Ability to perceive; 2) Ability to seek; 3) Ability to reach; 4) Ability to pay; and 5) Ability to engage. Conclusions This paper explains the comprehensiveness and dynamic nature of this conceptualisation of access to care and identifies relevant determinants that can have an impact on access from a multilevel perspective where factors related to health systems, institutions, organisations and providers are considered with factors at the individual, household, community, and population levels. PMID:23496984

On-line access to geoscience bibliographic citations

USGS Publications Warehouse

Wild, Emily C.

2012-01-01

On-line geoscience bibliographic citations and access points to citations are exponentially increasing as commercial, non-profit, and government agencies worldwide publish materials electronically. On-line bibliographic tools capture cited works, and open access content allows for freely obtained citations and documents. For this newsletter, citations from the numerous journals and books listed in the "Recent Papers" section of the EXPLORE newsletters from 2008-2011 were used to provide freely-accessible web sites to determine the availability of bibliographic information.

D Central Line Extraction of Fossil Oyster Shells

NASA Astrophysics Data System (ADS)

Djuricic, A.; Puttonen, E.; Harzhauser, M.; Mandic, O.; Székely, B.; Pfeifer, N.

2016-06-01

Photogrammetry provides a powerful tool to digitally document protected, inaccessible, and rare fossils. This saves manpower in relation to current documentation practice and makes the fragile specimens more available for paleontological analysis and public education. In this study, high resolution orthophoto (0.5 mm) and digital surface models (1 mm) are used to define fossil boundaries that are then used as an input to automatically extract fossil length information via central lines. In general, central lines are widely used in geosciences as they ease observation, monitoring and evaluation of object dimensions. Here, the 3D central lines are used in a novel paleontological context to study fossilized oyster shells with photogrammetric and LiDAR-obtained 3D point cloud data. 3D central lines of 1121 Crassostrea gryphoides oysters of various shapes and sizes were computed in the study. Central line calculation included: i) Delaunay triangulation between the fossil shell boundary points and formation of the Voronoi diagram; ii) extraction of Voronoi vertices and construction of a connected graph tree from them; iii) reduction of the graph to the longest possible central line via Dijkstra's algorithm; iv) extension of longest central line to the shell boundary and smoothing by an adjustment of cubic spline curve; and v) integration of the central line into the corresponding 3D point cloud. The resulting longest path estimate for the 3D central line is a size parameter that can be applied in oyster shell age determination both in paleontological and biological applications. Our investigation evaluates ability and performance of the central line method to measure shell sizes accurately by comparing automatically extracted central lines with manually collected reference data used in paleontological analysis. Our results show that the automatically obtained central line length overestimated the manually collected reference by 1.5% in the test set, which is deemed

Trends in cancer mortality in the European Union and accession countries, 1980-2000.

PubMed

Levi, F; Lucchini, F; Negri, E; Zatonski, W; Boyle, P; La Vecchia, C

2004-09-01

Cancer mortality rates and trends over the period 1980-2000 for accession countries to the European Union (EU) in May 2004, which include a total of 75 million inhabitants, were abstracted from the World Health Organization (WHO) database, together with, for comparative purposes, those of the current EU. Total cancer mortality for men was 166/100,000 in the EU, but ranged between 195 (Lithuania) and 269/100,000 (Hungary) in central and eastern European accession countries. This excess related to most cancer sites, including lung and other tobacco-related neoplasms, but also stomach, intestines and liver, and a few neoplasms amenable to treatment, such as testis, Hodgkin's disease and leukaemias. Overall cancer mortality for women was 95/100,000 in the EU, and ranged between 100 and 110/100,000 in several central and eastern European countries, and up to 120/100,000 in the Czech Republic and 138/100,000 in Hungary. The latter two countries had a substantial excess in female mortality for lung cancer, but also for several other sites. Furthermore, for stomach and especially (cervix) uteri, female rates were substantially higher in central and eastern European accession countries. Over the last two decades, trends in mortality were systematically less favourable in accession countries than in the EU. Most of the unfavourable patterns and trends in cancer mortality in accession countries are due to recognised, and hence potentially avoidable, causes of cancer, including tobacco, alcohol, dietary habits, pollution and hepatitis B, plus inadequate screening, diagnosis and treatment. Consequently, the application of available knowledge on cancer prevention, diagnosis and treatment may substantially reduce the disadvantage now registered in the cancer mortality of central and eastern European accession countries.

Accessibility to health care facilities in Montreal Island: an application of relative accessibility indicators from the perspective of senior and non-senior residents.

PubMed

Paez, Antonio; Mercado, Ruben G; Farber, Steven; Morency, Catherine; Roorda, Matthew

2010-10-25

Geographical access to health care facilities is known to influence health services usage. As societies age, accessibility to health care becomes an increasingly acute public health concern. It is known that seniors tend to have lower mobility levels, and it is possible that this may negatively affect their ability to reach facilities and services. Therefore, it becomes important to examine the mobility situation of seniors vis-a-vis the spatial distribution of health care facilities, to identify areas where accessibility is low and interventions may be required. Accessibility is implemented using a cumulative opportunities measure. Instead of assuming a fixed bandwidth (i.e. a distance threshold) for measuring accessibility, in this paper the bandwidth is defined using model-based estimates of average trip length. Average trip length is an all-purpose indicator of individual mobility and geographical reach. Adoption of a spatial modelling approach allows us to tailor these estimates of travel behaviour to specific locations and person profiles. Replacing a fixed bandwidth with these estimates permits us to calculate customized location- and person-based accessibility measures that allow inter-personal as well as geographical comparisons. The case study is Montreal Island. Geo-coded travel behaviour data, specifically average trip length, and relevant traveller's attributes are obtained from the Montreal Household Travel Survey. These data are complemented with information from the Census. Health care facilities, also geo-coded, are extracted from a comprehensive business point database. Health care facilities are selected based on Standard Industrial Classification codes 8011-21 (Medical Doctors and Dentists). Model-based estimates of average trip length show that travel behaviour varies widely across space. With the exception of seniors in the downtown area, older residents of Montreal Island tend to be significantly less mobile than people of other age cohorts

Interior-Point Methods for Linear Programming: A Review

ERIC Educational Resources Information Center

Singh, J. N.; Singh, D.

2002-01-01

The paper reviews some recent advances in interior-point methods for linear programming and indicates directions in which future progress can be made. Most of the interior-point methods belong to any of three categories: affine-scaling methods, potential reduction methods and central path methods. These methods are discussed together with…

General and Central Obesity in Two Iranian Ethnic Groups Living in Urmia, West Azerbaijan, Iran: Effect of the Neighborhood Environment

PubMed Central

Rezazadeh, Arezoo; Omidvar, Nasrin; Eini-Zinab, Hassan; Ghazi-Tabatabaie, Mahmoud; Majdzadeh, Reza; Ghavamzadeh, Saeid; Nouri-Saeidlou, Sakineh

2016-01-01

Background Emerging evidence suggests that neighborhood characteristics can have direct and indirect effects on the weight status of the residents. Objectives To assess the relationship between general and central obesity and the neighborhood environment in two ethnic groups (Azeri Turks and Kurds) living in Urmia city, Northwestern Iran. Patients and Methods In this cross-sectional study, 723 participants (427 women and 296 men) aged 20 - 64 years from two ethnic groups (Azeri Turks, n = 445; Kurds, n = 278) were selected from 38 neighborhoods using a combination of cluster, random, and systematic sampling methods. Neighborhood characteristics were obtained by a validated 22-item neighborhood and a health observational checklist. General and central obesity were measured and evaluated using standard methods. Principal component analysis (PCA) was used to define the dominant neighborhood environment. The association of neighborhood characteristics with general and central obesity was analyzed by a logistic regression model. Results Three common neighborhood environments were identified: 1) modern-affluent, 2) central-high access and 3) marginal. These three factors explained 73.2% of the total variance. Overall, the participants living in a higher tertile of the central-high access neighborhoods had an increased chance of central obesity (OR = 1.63, 95% CI: 1.13 - 2.34). Azeri Turks living in the highest tertile of the modern-affluent neighborhoods had a significantly higher likelihood of having general obesity (OR = 2.49, 95% CI: 1.37 - 4.01). Adjustment for age, gender, marital status, socioeconomic status (SES), energy intake, and physical activity did not change the results. However, after adjustment for educational level, the association was not significant. Conclusions The findings point to a relationship between neighborhood characteristics and obesity only in the Azeri Turks. However, educational level was more important than neighborhood quality in

Laser Recanalization of Central Venous Occlusion to Salvage a Threatened Arteriovenous Fistula.

PubMed

Rambhia, Sagar; Janko, Matthew; Hacker, Robert I

2018-07-01

Central venous occlusion is conventionally managed with balloon angioplasty, stent extension, or sharp recanalization. Here, we describe recanalization of a chronically occluded innominate vein using excimer laser after conventional techniques were unsuccessful. Patient clinical improvement and fistula patency have been sustained 2 years postintervention. This technique may provide new hemodialysis access options for patients who would not otherwise be candidates for hemodialysis access on the ipsilateral side of a central venous occlusion. Copyright © 2018 Elsevier Inc. All rights reserved.

Starting Point: Pedagogic Resources for Teaching and Learning Economics

ERIC Educational Resources Information Center

Maier, Mark H.; McGoldrick, KimMarie; Simkins, Scott P.

2012-01-01

This article describes Starting Point: Teaching and Learning Economics, a Web-based portal that makes innovative pedagogic resources and effective teaching practices easily accessible to economists. Starting Point introduces economists to teaching innovations through 16 online modules, each containing a general description of a specific pedagogic…

Central New York Library Resources Council CLRC Regional Digitization Plan. Final Report for the Preparing Central New York History for the Future LSTA Project.

ERIC Educational Resources Information Center

Sywetz, Betsy

The primary goal for digitization projects sponsored by the Central New York Library Resources Council (CLRC) is enhanced access for the people of the region to digital resources created from collections in Central New York's libraries, archives and museums. The CLRC Digitization Plan provides a framework for the support of digitization activities…

Context-aware access control for pervasive access to process-based healthcare systems.

PubMed

Koufi, Vassiliki; Vassilacopoulos, George

2008-01-01

Healthcare is an increasingly collaborative enterprise involving a broad range of healthcare services provided by many individuals and organizations. Grid technology has been widely recognized as a means for integrating disparate computing resources in the healthcare field. Moreover, Grid portal applications can be developed on a wireless and mobile infrastructure to execute healthcare processes which, in turn, can provide remote access to Grid database services. Such an environment provides ubiquitous and pervasive access to integrated healthcare services at the point of care, thus improving healthcare quality. In such environments, the ability to provide an effective access control mechanism that meets the requirement of the least privilege principle is essential. Adherence to the least privilege principle requires continuous adjustments of user permissions in order to adapt to the current situation. This paper presents a context-aware access control mechanism for HDGPortal, a Grid portal application which provides access to workflow-based healthcare processes using wireless Personal Digital Assistants. The proposed mechanism builds upon and enhances security mechanisms provided by the Grid Security Infrastructure. It provides tight, just-in-time permissions so that authorized users get access to specific objects according to the current context. These permissions are subject to continuous adjustments triggered by the changing context. Thus, the risk of compromising information integrity during task executions is reduced.

AccessScope project: Accessible light microscope for users with upper limb mobility or visual impairments.

PubMed

Mansoor, Awais; Ahmed, Wamiq M; Samarapungavan, Ala; Cirillo, John; Schwarte, David; Robinson, J Paul; Duerstock, Bradley S

2010-01-01

A web-based application was developed to remotely view slide specimens and control all functions of a research-level light microscopy workstation, called AccessScope. Students and scientists with upper limb mobility and visual impairments are often unable to use a light microscope by themselves and must depend on others in its operation. Users with upper limb mobility impairments and low vision were recruited to assist in the design process of the AccessScope personal computer (PC) user interface. Participants with these disabilities were evaluated in their ability to use AccessScope to perform microscopical tasks. AccessScope usage was compared with inspecting prescanned slide images by grading participants' identification and understanding of histological features and knowledge of microscope operation. With AccessScope subjects were able to independently perform common light microscopy functions through an Internet browser by employing different PC pointing devices or accessibility software according to individual abilities. Subjects answered more histology and microscope usage questions correctly after first participating in an AccessScope test session. AccessScope allowed users with upper limb or visual impairments to successfully perform light microscopy without assistance. This unprecedented capability is crucial for students and scientists with disabilities to perform laboratory coursework or microscope-based research and pursue science, technology, engineering, and mathematics fields.

Pin routability and pin access analysis on standard cells for layout optimization

NASA Astrophysics Data System (ADS)

Chen, Jian; Wang, Jun; Zhu, ChengYu; Xu, Wei; Li, Shuai; Lin, Eason; Ou, Odie; Lai, Ya-Chieh; Qu, Shengrui

2018-03-01

At advanced process nodes, especially at sub-28nm technology, pin accessibility and routability of standard cells has become one of the most challenging design issues due to the limited router tracks and the increased pin density. If this issue can't be found and resolved during the cell design stage, the pin access problem will be very difficult to be fixed in implementation stage and will make the low efficiency for routing. In this paper, we will introduce a holistic approach for the pin accessibility scoring and routability analysis. For accessibility, the systematic calculator which assigns score for each pin will search the available access points, consider the surrounded router layers, basic design rule and allowed via geometry. Based on the score, the "bad" pins can be found and modified. On pin routability analysis, critical pin points (placing via on this point would lead to failed via insertion) will be searched out for either layout optimization guide or set as OBS for via insertion blocking. By using this pin routability and pin access analysis flow, we are able to improve the library quality and performance.

Risk of infection due to medical interventions via central venous catheters or implantable venous access port systems at the middle port of a three-way cock: luer lock cap vs. luer access split septum system (Q-Syte).

PubMed

Pohl, Fabian; Hartmann, Werner; Holzmann, Thomas; Gensicke, Sandra; Kölbl, Oliver; Hautmann, Matthias G

2014-01-25

Many cancer patients receive a central venous catheter or port system prior to therapy to assure correct drug administration. Even appropriate hygienic intervention maintenance carries the risk of contaminating the middle port (C-port) of a three-way cock (TWC), a risk that increases with the number of medical interventions. Because of the complexity of the cleaning procedure with disconnection and reconnection of the standard luer lock cap (referred as "intervention"), we compared luer lock caps with a "closed access system" consisting of a luer access split septum system with regard to process optimization (work simplification, process time), efficiency (costs) and hygiene (patient safety). For determination of process optimization the workflow of an intervention according to the usual practice and risks was depicted in a process diagram. For determining the actual process costs, we analyzed use of material and time parameters per intervention and used the process parameters for programming the process into a simulation run (n = 1000) to determine the process costs as well as their differences (ACTUAL vs. NOMINAL) within the framework of a discrete event simulation.Additionally cultures were carried out at the TWC C-ports to evaluate possible contamination. With the closed access system, the mean working time of 5.5 minutes could be reduced to 2.97 minutes. The results for average process costs (labour and material costs per use) were 3.92 € for luer lock caps and 2.55 € for the closed access system. The hypothesis test (2-sample t-test, CI 0.95, p-value<0.05) confirmed the significance of the result.In 50 reviewed samples (TWC's), the contamination rate for the luer lock cap was 8% (4 out of 50 samples were positive), the contamination rate of the 50 samples with the closed access system was 0%.Possible hygienic risks (related to material, surroundings, staff handling) could be reduced by 65.38%. In the present research, the closed access system with a

Evaluation of cost-effectiveness from the funding body's point of view of ultrasound-guided central venous catheter insertion compared with the conventional technique.

PubMed

Noritomi, Danilo Teixeira; Zigaib, Rogério; Ranzani, Otavio T; Teich, Vanessa

2016-01-01

To evaluate the cost-effectiveness, from the funding body's point of view, of real-time ultrasound-guided central venous catheter insertion compared to the traditional method, which is based on the external anatomical landmark technique. A theoretical simulation based on international literature data was applied to the Brazilian context, i.e., the Unified Health System (Sistema Único de Saúde - SUS). A decision tree was constructed that showed the two central venous catheter insertion techniques: real-time ultrasonography versus external anatomical landmarks. The probabilities of failure and complications were extracted from a search on the PubMed and Embase databases, and values associated with the procedure and with complications were taken from market research and the Department of Information Technology of the Unified Health System (DATASUS). Each central venous catheter insertion alternative had a cost that could be calculated by following each of the possible paths on the decision tree. The incremental cost-effectiveness ratio was calculated by dividing the mean incremental cost of real-time ultrasound compared to the external anatomical landmark technique by the mean incremental benefit, in terms of avoided complications. When considering the incorporation of real-time ultrasound and the concomitant lower cost due to the reduced number of complications, the decision tree revealed a final mean cost for the external anatomical landmark technique of 262.27 Brazilian reals (R$) and for real-time ultrasound of R$187.94. The final incremental cost of the real-time ultrasound-guided technique was -R$74.33 per central venous catheter. The incremental cost-effectiveness ratio was -R$2,494.34 due to the pneumothorax avoided. Real-time ultrasound-guided central venous catheter insertion was associated with decreased failure and complication rates and hypothetically reduced costs from the view of the funding body, which in this case was the SUS.

Visitor and community survey results for Kilauea Point National Wildlife Refuge and Lighthouse: Completion report

USGS Publications Warehouse

Sexton, Natalie; Gillette, Shana C.; Koontz, Lynne; Stewart, Susan C.; Loomis, John; Wundrock, Katherine D.

2005-01-01

The U.S. Fish and Wildlife Service (USFWS) and the Central Federal Lands Highway Division of the Federal Highway Administration, U.S. Department of Transportation are currently pursuing the planning and potential design of an alternative transportation system (ATS) for Kilauea Point National Wildlife Refuge (Refuge or Kilauea Point NWR). The USFWS and CFLHD seek an alternative transportation solution that provides the highest quality visitor experience and is sensitive to biological and cultural resources and the needs of the local community. In planning the alternative transportation system, managers need to consider how an ATS would change factors such as visitor access, visitor experience, visitor willingness to pay, and visitor net economic benefits. The Policy Analysis and Science Assistance branch (PASA) at the U.S. Geological Survey Fort Collins Science Center is dedicated to studying relations between humans and the environment. The objective of PASA is to conduct studies to understand how humans are affected by environmental management decisions and how human activities impact use and conservation of natural resources.

32 CFR 1906.151 - Program accessibility: New construction and alterations.

Code of Federal Regulations, 2013 CFR

2013-07-01

... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.151 Program accessibility: New construction and...

32 CFR 1906.151 - Program accessibility: New construction and alterations.

Code of Federal Regulations, 2011 CFR

2011-07-01

... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.151 Program accessibility: New construction and...

32 CFR 1906.151 - Program accessibility: New construction and alterations.

Code of Federal Regulations, 2014 CFR

2014-07-01

... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.151 Program accessibility: New construction and...

32 CFR 1906.151 - Program accessibility: New construction and alterations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.151 Program accessibility: New construction and...

32 CFR 1906.151 - Program accessibility: New construction and alterations.

Code of Federal Regulations, 2012 CFR

2012-07-01

... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.151 Program accessibility: New construction and...

Accessibility to editorial information in Oral and Maxillofacial Surgery journals: The authors' point of view.

PubMed

Castelo-Baz, Pablo; Leira-Feijoo, Yago; Seoane-Romero, Juan Manuel; Varela-Centelles, Pablo; Seoane, Juan

2015-09-01

To evaluate the accessibility to editorial information in Oral & Maxillofacial Surgery journals. A cross-sectional study using the WOS-Web of Science database in three categories: "Surgery," "Otorhinolaryngology," and "Dentistry, Oral Surgery & Medicine" was designed. Journals were filtered by title and classified under three headings: OMFS specialty; OMFS subspecialty and related sciences; and multidisciplinary journals. Specialty scope (OMFS vs. other); impact factor; path for the manuscript; blinding policy; accessibility to reviewers' criteria; and percentage of acceptance. Only 46 of 330 journals met the inclusion criteria. All OMFS journals provided comprehensive information about the review process, compared to 5 of 27 (18.5%) of Oral Surgery and related sciences periodicals. Most specialty journals do not inform about the blind review mode used (20 of 33; 60.6%). Generally, information about the reviewers' assessment criteria is scarce, but is available from all OMFS journals, which also state the percentage of manuscript acceptance (100% vs. 14.8%). OMFS JCR journals provide adequate information about their editorial process in terms of path for the manuscript, accessibility to reviewers' criteria, and percentage of acceptance. Additional efforts are needed to increase accessibility to information about blinding policy and average time from submission to acceptance. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Analysis of Airport Access - A Methods Review and Research Program

DOT National Transportation Integrated Search

1971-10-01

The report points up the differences and similarities between airport access travel and general urban trip making. Models and surveys developed for, or applicable, to airport access planning are reviewed. A research proram is proposed which would gen...

Enhancing access to reports of randomized trials published world-wide – the contribution of EMBASE records to the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library

PubMed Central

Lefebvre, Carol; Eisinga, Anne; McDonald, Steve; Paul, Nina

2008-01-01

Background Randomized trials are essential in assessing the effects of healthcare interventions and are a key component in systematic reviews of effectiveness. Searching for reports of randomized trials in databases is problematic due to the absence of appropriate indexing terms until the 1990s and inconsistent application of these indexing terms thereafter. Objectives The objectives of this study are to devise a search strategy for identifying reports of randomized trials in EMBASE which are not already indexed as trials in MEDLINE and to make these reports easily accessible by including them in the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, with the permission of Elsevier, the publishers of EMBASE. Methods A highly sensitive search strategy was designed for EMBASE based on free-text and thesaurus terms which occurred frequently in the titles, abstracts, EMTREE terms (or some combination of these) of reports of trials indexed in EMBASE. This search strategy was run against EMBASE from 1980 to 2005 (1974 to 2005 for four of the terms) and records retrieved by the search, which were not already indexed as randomized trials in MEDLINE, were downloaded from EMBASE, printed and read. An analysis of the language of publication was conducted for the reports of trials published in 2005 (the most recent year completed at the time of this study). Results Twenty-two search terms were used (including nine which were later rejected due to poor cumulative precision). More than a third of a million records were downloaded and scanned and approximately 80,000 reports of trials were identified which were not already indexed as randomized trials in MEDLINE. These are now easily identifiable in CENTRAL, in The Cochrane Library. Cumulative sensitivity ranged from 0.1% to 60% and cumulative precision ranged from 8% to 61%. The truncated term 'random$' identified 60% of the total number of reports of trials but only 35% of the more than 130

The International Mouse Phenotyping Consortium Web Portal, a unified point of access for knockout mice and related phenotyping data

PubMed Central

Koscielny, Gautier; Yaikhom, Gagarine; Iyer, Vivek; Meehan, Terrence F.; Morgan, Hugh; Atienza-Herrero, Julian; Blake, Andrew; Chen, Chao-Kung; Easty, Richard; Di Fenza, Armida; Fiegel, Tanja; Grifiths, Mark; Horne, Alan; Karp, Natasha A.; Kurbatova, Natalja; Mason, Jeremy C.; Matthews, Peter; Oakley, Darren J.; Qazi, Asfand; Regnart, Jack; Retha, Ahmad; Santos, Luis A.; Sneddon, Duncan J.; Warren, Jonathan; Westerberg, Henrik; Wilson, Robert J.; Melvin, David G.; Smedley, Damian; Brown, Steve D. M.; Flicek, Paul; Skarnes, William C.; Mallon, Ann-Marie; Parkinson, Helen

2014-01-01

The International Mouse Phenotyping Consortium (IMPC) web portal (http://www.mousephenotype.org) provides the biomedical community with a unified point of access to mutant mice and rich collection of related emerging and existing mouse phenotype data. IMPC mouse clinics worldwide follow rigorous highly structured and standardized protocols for the experimentation, collection and dissemination of data. Dedicated ‘data wranglers’ work with each phenotyping center to collate data and perform quality control of data. An automated statistical analysis pipeline has been developed to identify knockout strains with a significant change in the phenotype parameters. Annotation with biomedical ontologies allows biologists and clinicians to easily find mouse strains with phenotypic traits relevant to their research. Data integration with other resources will provide insights into mammalian gene function and human disease. As phenotype data become available for every gene in the mouse, the IMPC web portal will become an invaluable tool for researchers studying the genetic contributions of genes to human diseases. PMID:24194600

Cross-point-type spin-transfer-torque magnetoresistive random access memory cell with multi-pillar vertical body channel MOSFET

NASA Astrophysics Data System (ADS)

Sasaki, Taro; Endoh, Tetsuo

2018-04-01

In this paper, from the viewpoint of cell size and sensing margin, the impact of a novel cross-point-type one transistor and one magnetic tunnel junction (1T–1MTJ) spin-transfer-torque magnetoresistive random access memory (STT-MRAM) cell with a multi-pillar vertical body channel (BC) MOSFET is shown for high density and wide sensing margin STT-MRAM, with a 10 ns writing period and 1.2 V V DD. For that purpose, all combinations of n/p-type MOSFETs and bottom/top-pin MTJs are compared, where the diameter of MTJ (D MTJ) is scaled down from 55 to 15 nm and the tunnel magnetoresistance (TMR) ratio is increased from 100 to 200%. The results show that, benefiting from the proposed STT-MRAM cell with no back bias effect, the MTJ with a high TMR ratio (200%) can be used in the design of smaller STT-MRAM cells (over 72.6% cell size reduction), which is a difficult task for conventional planar MOSFET based design.

The NCAR Research Data Archive's Hybrid Approach for Data Discovery and Access

NASA Astrophysics Data System (ADS)

Schuster, D.; Worley, S. J.

2013-12-01

The NCAR Research Data Archive (RDA http://rda.ucar.edu) maintains a variety of data discovery and access capabilities for it's 600+ dataset collections to support the varying needs of a diverse user community. In-house developed and standards-based community tools offer services to more than 10,000 users annually. By number of users the largest group is external and access the RDA through web based protocols; the internal NCAR HPC users are fewer in number, but typically access more data volume. This paper will detail the data discovery and access services maintained by the RDA to support both user groups, and show metrics that illustrate how the community is using the services. The distributed search capability enabled by standards-based community tools, such as Geoportal and an OAI-PMH access point that serves multiple metadata standards, provide pathways for external users to initially discover RDA holdings. From here, in-house developed web interfaces leverage primary discovery level metadata databases that support keyword and faceted searches. Internal NCAR HPC users, or those familiar with the RDA, may go directly to the dataset collection of interest and refine their search based on rich file collection metadata. Multiple levels of metadata have proven to be invaluable for discovery within terabyte-sized archives composed of many atmospheric or oceanic levels, hundreds of parameters, and often numerous grid and time resolutions. Once users find the data they want, their access needs may vary as well. A THREDDS data server running on targeted dataset collections enables remote file access through OPENDAP and other web based protocols primarily for external users. In-house developed tools give all users the capability to submit data subset extraction and format conversion requests through scalable, HPC based delayed mode batch processing. Users can monitor their RDA-based data processing progress and receive instructions on how to access the data when it is

Central venous recanalization in patients with short gut syndrome: restoration of candidacy for intestinal and multivisceral transplantation.

PubMed

Lang, Elvira V; Reyes, Jorge; Faintuch, Salomao; Smith, Amy; Abu-Elmagd, Kareem

2005-09-01

To assess feasibility and success of venous recanalization in patients with short gut syndrome who have lost their traditional central venous access and required intestinal or multivisceral transplantation. Twelve patients between the ages of 7 and 55 years with short gut syndrome and long-standing total parenteral nutrition (TPN) dependency and/or hypercoagulability were treated. All had extensive chronic central venous occlusions and survival was dependent on restoration of access and planned transplantation. Central venous recanalizations were obtained via sharp needle recanalization techniques, venous reconstructions with stents, and/or extraanatomic access to the central venous system for placement of central venous tunneled catheters. Central venous access was restored in all patients without operative-related mortality. Three major hemodynamic perioperative technical complications were recorded and successfully treated. There were three self-limited early infectious complications. With a mean follow-up of 22 months, eight of the 12 patients were alive with successful small bowel or multivisceral transplantation; six of those became independent of TPN. The remaining four patients died of complications related to TPN (n = 3) or transplantation (n = 1). With a mean follow-up of 20 months, all but two of the recanalized venous accesses were maintained, for a success rate of 83%. Recanalizations of extensive chronic vein occlusions are feasible but associated with high risk. The technique is life-saving for TPN-dependent patients and can restore candidacy for intestinal and multivisceral transplantation. This approach is likely to be increasingly requested because of the current clinical availability of the transplant procedure.

PyCDT: A Python toolkit for modeling point defects in semiconductors and insulators

DOE PAGES

Broberg, Danny; Medasani, Bharat; Zimmermann, Nils E. R.; ...

2018-02-13

Point defects have a strong impact on the performance of semiconductor and insulator materials used in technological applications, spanning microelectronics to energy conversion and storage. The nature of the dominant defect types, how they vary with processing conditions, and their impact on materials properties are central aspects that determine the performance of a material in a certain application. This information is, however, difficult to access directly from experimental measurements. Consequently, computational methods, based on electronic density functional theory (DFT), have found widespread use in the calculation of point-defect properties. Here we have developed the Python Charged Defect Toolkit (PyCDT) tomore » expedite the setup and post-processing of defect calculations with widely used DFT software. PyCDT has a user-friendly command-line interface and provides a direct interface with the Materials Project database. This allows for setting up many charged defect calculations for any material of interest, as well as post-processing and applying state-of-the-art electrostatic correction terms. Our paper serves as a documentation for PyCDT, and demonstrates its use in an application to the well-studied GaAs compound semiconductor. As a result, we anticipate that the PyCDT code will be useful as a framework for undertaking readily reproducible calculations of charged point-defect properties, and that it will provide a foundation for automated, high-throughput calculations.« less

PyCDT: A Python toolkit for modeling point defects in semiconductors and insulators

NASA Astrophysics Data System (ADS)

Broberg, Danny; Medasani, Bharat; Zimmermann, Nils E. R.; Yu, Guodong; Canning, Andrew; Haranczyk, Maciej; Asta, Mark; Hautier, Geoffroy

2018-05-01

Point defects have a strong impact on the performance of semiconductor and insulator materials used in technological applications, spanning microelectronics to energy conversion and storage. The nature of the dominant defect types, how they vary with processing conditions, and their impact on materials properties are central aspects that determine the performance of a material in a certain application. This information is, however, difficult to access directly from experimental measurements. Consequently, computational methods, based on electronic density functional theory (DFT), have found widespread use in the calculation of point-defect properties. Here we have developed the Python Charged Defect Toolkit (PyCDT) to expedite the setup and post-processing of defect calculations with widely used DFT software. PyCDT has a user-friendly command-line interface and provides a direct interface with the Materials Project database. This allows for setting up many charged defect calculations for any material of interest, as well as post-processing and applying state-of-the-art electrostatic correction terms. Our paper serves as a documentation for PyCDT, and demonstrates its use in an application to the well-studied GaAs compound semiconductor. We anticipate that the PyCDT code will be useful as a framework for undertaking readily reproducible calculations of charged point-defect properties, and that it will provide a foundation for automated, high-throughput calculations.

PyCDT: A Python toolkit for modeling point defects in semiconductors and insulators

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

Broberg, Danny; Medasani, Bharat; Zimmermann, Nils E. R.

Point defects have a strong impact on the performance of semiconductor and insulator materials used in technological applications, spanning microelectronics to energy conversion and storage. The nature of the dominant defect types, how they vary with processing conditions, and their impact on materials properties are central aspects that determine the performance of a material in a certain application. This information is, however, difficult to access directly from experimental measurements. Consequently, computational methods, based on electronic density functional theory DFT), have found widespread use in the calculation of point defect properties. Here we have developed the Python Charged Defect Toolkit (PyCDT)more » to expedite the setup and post-processing of defect calculations with widely used DFT software. PyCDT has a user-friendly command-line interface and provides a direct interface with the Materials Project database. This allows for setting up many charged defect calculations for any material of interest, as well as post-processing and applying state-of-the-art electrostatic correction terms. Our paper serves as a documentation for PyCDT, and demonstrates its use in an application to the well-studied GaAs compound semiconductor. We anticipate that the PyCDT code will be useful as a framework for undertaking readily reproducible calculations of charged point-defect properties, and that it will provide a foundation for automated, high-throughput calculations.« less

PyCDT: A Python toolkit for modeling point defects in semiconductors and insulators

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

Broberg, Danny; Medasani, Bharat; Zimmermann, Nils E. R.

Point defects have a strong impact on the performance of semiconductor and insulator materials used in technological applications, spanning microelectronics to energy conversion and storage. The nature of the dominant defect types, how they vary with processing conditions, and their impact on materials properties are central aspects that determine the performance of a material in a certain application. This information is, however, difficult to access directly from experimental measurements. Consequently, computational methods, based on electronic density functional theory (DFT), have found widespread use in the calculation of point-defect properties. Here we have developed the Python Charged Defect Toolkit (PyCDT) tomore » expedite the setup and post-processing of defect calculations with widely used DFT software. PyCDT has a user-friendly command-line interface and provides a direct interface with the Materials Project database. This allows for setting up many charged defect calculations for any material of interest, as well as post-processing and applying state-of-the-art electrostatic correction terms. Our paper serves as a documentation for PyCDT, and demonstrates its use in an application to the well-studied GaAs compound semiconductor. As a result, we anticipate that the PyCDT code will be useful as a framework for undertaking readily reproducible calculations of charged point-defect properties, and that it will provide a foundation for automated, high-throughput calculations.« less

Delivering free healthcare to rural Central Appalachia population: the case of the Health Wagon.

PubMed

Gardner, T; Gavaza, P; Meade, P; Adkins, D M

2012-01-01

Central Appalachia residents present unique healthcare challenges. This vulnerable population faces poor health status and low access to health care. 'The Health Wagon' was established to innovatively enhance access to health care for the poor and marginalized rural population of Central Appalachia. This article describes the operations of the Health Wagon, a full mobile medical clinic, in delivering free health care to those in rural Southwest Virginia in Central Appalachia. The Health Wagon provides a wide range of comprehensive healthcare services, such as acute and chronic disease management, laboratory and diagnostic services, medication assistance, dental and eye care and specialty clinics for marginalized, poor and disenfranchised patients living in the mountains of that region. In 2009, a total of 157 clinics were provided and 2900 patients were seen (3165 patient encounters) in addition to 268 telemedicine specialty consultations at no cost to the patients. The work of the Health Wagon has broken down a financial barrier to healthcare access and offers unique and profound opportunities to improve health and expand health care in rural Central Appalachia.

Understanding and improving access to prompt and effective malaria treatment and care in rural Tanzania: the ACCESS Programme.

PubMed

Hetzel, Manuel W; Iteba, Nelly; Makemba, Ahmed; Mshana, Christopher; Lengeler, Christian; Obrist, Brigit; Schulze, Alexander; Nathan, Rose; Dillip, Angel; Alba, Sandra; Mayumana, Iddy; Khatib, Rashid A; Njau, Joseph D; Mshinda, Hassan

2007-06-29

Prompt access to effective treatment is central in the fight against malaria. However, a variety of interlinked factors at household and health system level influence access to timely and appropriate treatment and care. Furthermore, access may be influenced by global and national health policies. As a consequence, many malaria episodes in highly endemic countries are not treated appropriately. The ACCESS Programme aims at understanding and improving access to prompt and effective malaria treatment and care in a rural Tanzanian setting. The programme's strategy is based on a set of integrated interventions, including social marketing for improved care seeking at community level as well as strengthening of quality of care at health facilities. This is complemented by a project that aims to improve the performance of drug stores. The interventions are accompanied by a comprehensive set of monitoring and evaluation activities measuring the programme's performance and (health) impact. Baseline data demonstrated heterogeneity in the availability of malaria treatment, unavailability of medicines and treatment providers in certain areas as well as quality problems with regard to drugs and services. The ACCESS Programme is a combination of multiple complementary interventions with a strong evaluation component. With this approach, ACCESS aims to contribute to the development of a more comprehensive access framework and to inform and support public health professionals and policy-makers in the delivery of improved health services.

Understanding and improving access to prompt and effective malaria treatment and care in rural Tanzania: the ACCESS Programme

PubMed Central

Hetzel, Manuel W; Iteba, Nelly; Makemba, Ahmed; Mshana, Christopher; Lengeler, Christian; Obrist, Brigit; Schulze, Alexander; Nathan, Rose; Dillip, Angel; Alba, Sandra; Mayumana, Iddy; Khatib, Rashid A; Njau, Joseph D; Mshinda, Hassan

2007-01-01

Background Prompt access to effective treatment is central in the fight against malaria. However, a variety of interlinked factors at household and health system level influence access to timely and appropriate treatment and care. Furthermore, access may be influenced by global and national health policies. As a consequence, many malaria episodes in highly endemic countries are not treated appropriately. Project The ACCESS Programme aims at understanding and improving access to prompt and effective malaria treatment and care in a rural Tanzanian setting. The programme's strategy is based on a set of integrated interventions, including social marketing for improved care seeking at community level as well as strengthening of quality of care at health facilities. This is complemented by a project that aims to improve the performance of drug stores. The interventions are accompanied by a comprehensive set of monitoring and evaluation activities measuring the programme's performance and (health) impact. Baseline data demonstrated heterogeneity in the availability of malaria treatment, unavailability of medicines and treatment providers in certain areas as well as quality problems with regard to drugs and services. Conclusion The ACCESS Programme is a combination of multiple complementary interventions with a strong evaluation component. With this approach, ACCESS aims to contribute to the development of a more comprehensive access framework and to inform and support public health professionals and policy-makers in the delivery of improved health services. PMID:17603898

High level of molecular and phenotypic biodiversity in Jatropha curcas from Central America compared to Africa, Asia and South America

PubMed Central

2014-01-01

Background The main bottleneck to elevate jatropha (Jatropha curcas L.) from a wild species to a profitable biodiesel crop is the low genetic and phenotypic variation found in different regions of the world, hampering efficient plant breeding for productivity traits. In this study, 182 accessions from Asia (91), Africa (35), South America (9) and Central America (47) were evaluated at genetic and phenotypic level to find genetic variation and important traits for oilseed production. Results Genetic variation was assessed with SSR (Simple Sequence Repeat), TRAP (Target Region Amplification Polymorphism) and AFLP (Amplified fragment length polymorphism) techniques. Phenotypic variation included seed morphological characteristics, seed oil content and fatty acid composition and early growth traits. Jaccard’s similarity and cluster analysis by UPGM (Unweighted Paired Group Method) with arithmetic mean and PCA (Principle Component Analysis) indicated higher variability in Central American accessions compared to Asian, African and South American accessions. Polymorphism Information Content (PIC) values ranged from 0 to 0.65. In the set of Central American accessions. PIC values were higher than in other regions. Accessions from the Central American population contain alleles that were not found in the accessions from other populations. Analysis of Molecular Variance (AMOVA; P < 0.0001) indicated high genetic variation within regions (81.7%) and low variation across regions (18.3%). A high level of genetic variation was found on early growth traits and on components of the relative growth rate (specific leaf area, leaf weight, leaf weight ratio and net assimilation rate) as indicated by significant differences between accessions and by the high heritability values (50–88%). The fatty acid composition of jatropha oil significantly differed (P < 0.05) between regions. Conclusions The pool of Central American accessions showed very large genetic variation as

Deficits in Young Men's Knowledge about Accessing Sexual and Reproductive Health Services

ERIC Educational Resources Information Center

Bersamin, Melina; Fisher, Deborah A.; Marcell, Arik V.; Finan, Laura J.

2017-01-01

Objective: The current study aimed to examine (1) gender differences in college students' knowledge of sexual and reproductive health care (K-SRHC) service access points, and (2) the relationship between demographic and psychosocial factors and college students' overall K-SRHC service access points. Methods and Participants: Self-report online…

Central vein stenosis: current concepts.

PubMed

Agarwal, Anil K

2009-09-01

Central vein stenosis (CVS) is a common complication of the central venous catheter (CVC) placement. The prevalence of CVS has mostly been studied in those who present with symptoms such as swelling of the extremity, neck and breast. CVS compromises arteriovenous access and can be resistant to treatment. A previous history of CVC placement is the most important risk factor for the development of CVS later. Pacemaker and defibrillator wires are associated with a high incidence of CVS. Increasingly liberal use of peripherally inserted central catheters (PICC) is likely to increase the incidence of CVS. The trauma and inflammation related to the catheter placement is thought to result in microthrombi formation, intimal hyperplasia and fibrotic response, with development of CVS. Treatment of CVS by endovascular procedures involves angioplasty of the stenosis. An elastic or recurrent stenosis may require a stent placement. The long-term benefits of the endovascular procedures, although improved with newer technology, remain modest. Surgical options are usually limited. Future studies to explore the pathogenesis and the use of novel therapies to prevent and treat CVS are needed. The key to reducing the prevalence of CVS is in reducing CVC placement and placement of arteriovenous accesses prior to initiating dialysis. Early referral of the patients to the nephrologists by the primary care physicians is important. Timely vein mapping and referral to the surgeon for fistula creation can obviate the need for a CVC and decrease incidence of CVS.

The Unicellular State as a Point Source in a Quantum Biological System

PubMed Central

Torday, John S.; Miller, William B.

2016-01-01

A point source is the central and most important point or place for any group of cohering phenomena. Evolutionary development presumes that biological processes are sequentially linked, but neither directed from, nor centralized within, any specific biologic structure or stage. However, such an epigenomic entity exists and its transforming effects can be understood through the obligatory recapitulation of all eukaryotic lifeforms through a zygotic unicellular phase. This requisite biological conjunction can now be properly assessed as the focal point of reconciliation between biology and quantum phenomena, illustrated by deconvoluting complex physiologic traits back to their unicellular origins. PMID:27240413

[Difference and distance between the central and thinnest points of the cornea: impact of refractive state, age and ocular side].

PubMed

Steinberg, J; Kohl, C; Katz, T; Richard, G; Linke, S J

2014-04-01

The aim of the study was to quantify the difference in corneal thickness between the central and thinnest points (∆PachyZ-PachyD), the distance between the center of the cornea and its thinnest point (vector length PachyD) and to explore the impact of refractive state, age and ocular side. This was a multicenter, retrospective, cross-sectional study and medical records of 16,872 eyes were reviewed. The Orbscan® (Bausch and Lomb) procedure was used for pachymetry and keratometry. The results showed that ∆PachyZ-PachyD and vector length PachyD were higher in hyperopic eyes (∆PachyZ-PachyD: 11.99 ± 12.08 µm, vector length PachyD: 0.85 ± 0.44 mm) compared to myopic eyes (∆PachyZ-PachyD: 9.2 ± 7.86 µm, vector length PachyD: 0.7 ± 0.37 mm; p < 0.001). Refractive state, age and ocular side demonstrated an independent, statistically significant impact on ∆PachyZ-PachyD and vector length PachyD. As a result of the significant impact of refractive state, age and ocular side on ∆PachyZ-PachyD and vector length PachyD, these variables should be considered in a normative data collection.

BioMart Central Portal: an open database network for the biological community

PubMed Central

Guberman, Jonathan M.; Ai, J.; Arnaiz, O.; Baran, Joachim; Blake, Andrew; Baldock, Richard; Chelala, Claude; Croft, David; Cros, Anthony; Cutts, Rosalind J.; Di Génova, A.; Forbes, Simon; Fujisawa, T.; Gadaleta, E.; Goodstein, D. M.; Gundem, Gunes; Haggarty, Bernard; Haider, Syed; Hall, Matthew; Harris, Todd; Haw, Robin; Hu, S.; Hubbard, Simon; Hsu, Jack; Iyer, Vivek; Jones, Philip; Katayama, Toshiaki; Kinsella, R.; Kong, Lei; Lawson, Daniel; Liang, Yong; Lopez-Bigas, Nuria; Luo, J.; Lush, Michael; Mason, Jeremy; Moreews, Francois; Ndegwa, Nelson; Oakley, Darren; Perez-Llamas, Christian; Primig, Michael; Rivkin, Elena; Rosanoff, S.; Shepherd, Rebecca; Simon, Reinhard; Skarnes, B.; Smedley, Damian; Sperling, Linda; Spooner, William; Stevenson, Peter; Stone, Kevin; Teague, J.; Wang, Jun; Wang, Jianxin; Whitty, Brett; Wong, D. T.; Wong-Erasmus, Marie; Yao, L.; Youens-Clark, Ken; Yung, Christina; Zhang, Junjun; Kasprzyk, Arek

2011-01-01

BioMart Central Portal is a first of its kind, community-driven effort to provide unified access to dozens of biological databases spanning genomics, proteomics, model organisms, cancer data, ontology information and more. Anybody can contribute an independently maintained resource to the Central Portal, allowing it to be exposed to and shared with the research community, and linking it with the other resources in the portal. Users can take advantage of the common interface to quickly utilize different sources without learning a new system for each. The system also simplifies cross-database searches that might otherwise require several complicated steps. Several integrated tools streamline common tasks, such as converting between ID formats and retrieving sequences. The combination of a wide variety of databases, an easy-to-use interface, robust programmatic access and the array of tools make Central Portal a one-stop shop for biological data querying. Here, we describe the structure of Central Portal and show example queries to demonstrate its capabilities. Database URL: http://central.biomart.org. PMID:21930507

Associations of centrally acting ACE inhibitors with cognitive decline and survival in Alzheimer’s disease

PubMed Central

Fazal, Karim; Khondoker, Mizanur; Howard, Robert; Stewart, Robert

2017-01-01

Background Cognitive improvement has been reported in patients receiving centrally acting angiotensin-converting enzyme inhibitors (C-ACEIs). Aims To compare cognitive decline and survival after diagnosis of Alzheimer’s disease between people receiving C-ACEIs, non-centrally acting angiotensin-converting enzyme inhibitors (NC-ACEIs), and neither. Method Routine Mini-Mental State Examination (MMSE) scores were extracted in 5260 patients receiving acetylcholinesterase inhibitors and analysed against C-/NC-ACEI exposure at the time of Alzheimer’s disease diagnosis. Results In the 9 months after Alzheimer’s disease diagnosis, MMSE scores significantly increased by 0.72 and 0.19 points per year in patients on C-ACEIs and neither respectively, but deteriorated by 0.61 points per year in those on NC-ACEIs. There were no significant group differences in score trajectories from 9 to 36 months and no differences in survival. Conclusions In people with Alzheimer’s disease receiving acetylcholinesterase inhibitors, those also taking C-ACEIs had stronger initial improvement in cognitive function, but there was no evidence of longer-lasting influence on dementia progression. Declaration of interest R.S. has received research funding from Pfizer, Lundbeck, Roche, Janssen and GlaxoSmithKline. Copyright and usage © The Royal College of Psychiatrists 2017. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license. PMID:28713585

The effect of centralization of health care services on travel time and its equality.

PubMed

Kobayashi, Daisuke; Otsubo, Tetsuya; Imanaka, Yuichi

2015-03-01

To analyze the regional variations in travel time between patient residences and medical facilities for the treatment of ischemic heart disease and breast cancer, and to simulate the effects of health care services centralization on travel time and equality of access. We used medical insurance claims data for inpatients and outpatients for the two target diseases that had been filed between September 2008 and May 2009 in Kyoto Prefecture, Japan. Using a geographical information system, patient travel times were calculated based on the driving distance between patient residences and hospitals via highways and toll roads. Locations of residences and hospital locations were identified using postal codes. We then conducted a simulation analysis of centralization of health care services to designated regional core hospitals. The simulated changes in potential spatial access to care were examined. Inequalities in access to care were examined using Gini coefficients, which ranged from 0.4109 to 0.4574. Simulations of health care services centralization showed reduced travel time for most patients and overall improvements in equality of access, except in breast cancer outpatients. Our findings may contribute to the decision-making process in policies aimed at improving the potential spatial access to health care services. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Authomatization of Digital Collection Access Using Mobile and Wireless Data Terminals

NASA Astrophysics Data System (ADS)

Leontiev, I. V.

Information technologies become vital due to information processing needs, database access, data analysis and decision support. Currently, a lot of scientific projects are oriented on database integration of heterogeneous systems. The problem of on-line and rapid access to large integrated systems of digital collections is also very important. Usually users move between different locations, either at work or at home. In most cases users need an efficient and remote access to information, stored in integrated data collections. Desktop computers are unable to fulfill the needs, so mobile and wireless devices become helpful. Handhelds and data terminals are nessessary in medical assistance (they store detailed information about each patient, and helpful for nurses), immediate access to data collections is used in a Highway patrol services (databanks of cars, owners, driver licences). Using mobile access, warehouse operations can be validated. Library and museum items cyclecounting will speed up using online barcode-scanning and central database access. That's why mobile devices - cell phones, PDA, handheld computers with wireless access, WindowsCE and PalmOS terminals become popular. Generally, mobile devices have a relatively slow processor, and limited display capabilities, but they are effective for storing and displaying textual data, recognize user hand-writing with stylus, support GUI. Users can perform operations on handheld terminal, and exchange data with the main system (using immediate radio access, or offline access during syncronization process) for update. In our report, we give an approach for mobile access to data collections, which raises an efficiency of data processing in a book library, helps to control available books, books in stock, validate service charges, eliminate staff mistakes, generate requests for book delivery. Our system uses mobile devices Symbol RF (with radio-channel access), and data terminals Symbol Palm Terminal for batch

Online shopping interface components: relative importance as peripheral and central cues.

PubMed

Warden, Clyde A; Wu, Wann-Yih; Tsai, Dungchun

2006-06-01

The Elaboration Likelihood Model (ELM) uses central (more thoughtful) and peripheral (less thoughtful) routes of persuasion to maximize communication effectiveness. This research implements ELM to investigate the relative importance of different aspects of the user experience in online shopping. Of all the issues surrounding online shopping, convenience, access to information, and trust were found to be the most important. These were implemented in an online conjoint shopping task. Respondents were found to use the central route of the ELM on marketing messages that involved issues of minimizing travel, information access, and assurances of system security. Users employed the peripheral ELM route when considering usability, price comparison, and personal information protection. A descriptive model of Web-based marketing components, their roles in the central and peripheral routes, and their relative importance to online consumer segments was developed.

Totally implantable central venous access port infections in patients with digestive cancer: incidence and risk factors.

PubMed

Touré, Abdoulaye; Vanhems, Philippe; Lombard-Bohas, Catherine; Cassier, Philippe; Péré-Vergé, Denis; Souquet, Jean-Christophe; Ecochard, René; Chambrier, Cécile

2012-12-01

Central venous access port-related bloodstream infection (CVAP-BSI) is associated with morbidity and mortality in patients with cancer. This study examined the incidence rates and risk factors for CVAP-BSI in adult patients with digestive cancer. This prospective observational cohort study was performed from 2007 to 2011 in 2 oncology units of a university hospital. Incidence rate was expressed as number of CVAP-BSI per 1,000 catheter-days. A Cox regression model was used to identify risk factors for CVAP-BSI. A total of 315 patients were included. CVAP-BSI occurred in 41 patients (13.0%). The overall incidence rate was 0.76/1,000 catheter-days. The rate was higher in patients with esophageal cancer (1.28. P = .05) and pancreatic cancer (1.24; P = .007). Risk factors independently associated with CVAP-BSI were World Health Organization performance status between 2 and 4, catheter utilization-days in the previous month, pancreatic cancer, and parenteral nutrition. Coagulase-negative Staphylococci and enterobacteria were the main microorganisms isolated. In adult patients with digestive cancer, pancreatic cancer, cumulative catheter utilization-days, World Health Organization performance status, and parenteral nutrition were identified as independent risk factors for CVAP-BSI. Patients with any of these risk factors could be candidates for preventive strategies. Copyright © 2012 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Globalization, global health, and access to healthcare.

PubMed

Collins, Téa

2003-01-01

It is now commonly realized that the globalization of the world economy is shaping the patterns of global health, and that associated morbidity and mortality is affecting countries' ability to achieve economic growth. The globalization of public health has important implications for access to essential healthcare. The rise of inequalities among and within countries negatively affects access to healthcare. Poor people use healthcare services less frequently when sick than do the rich. The negative impact of globalization on access to healthcare is particularly well demonstrated in countries of transitional economies. No longer protected by a centralized health sector that provided free universal access to services for everyone, large segments of the populations in the transition period found themselves denied even the most basic medical services. Only countries where regulatory institutions are strong, domestic markets are competitive and social safety nets are in place, have a good chance to enjoy the health benefits of globalization.

Comparison of apical centring ability between incisal-shifted access and traditional lingual access for maxillary anterior teeth.

PubMed

Yahata, Yoshio; Masuda, Yoshiko; Komabayashi, Takashi

2017-12-01

The aim of this study was to compare the apical centring ability of incisal-shifted access (ISA) with that of traditional lingual access (TLA). Fifteen three-dimensional printed resin models were prepared from the computed tomography data for a human maxillary central incisor and divided into ISA (n = 7), TLA (n = 7) and control (n = 1) groups. After access preparation, these models were shaped to the working length using K-files up to #40, followed by step-back procedures. An apical portion of the model was removed at 0.5 mm coronal to the working length. Microscopic images of each cutting surface were taken to measure the preparation area and the distance of transportation. TLA created a larger preparation area than ISA (P < 0.05). The distance of transportation (mean ± standard deviation) was 0.4 ± 0.1 mm for ISA and 0.7 ± 0.1 mm for TLA (P < 0.05). Access cavity preparation has a significant effect on apical centring ability. ISA is beneficial to maintaining apical configuration. © 2017 Australian Society of Endodontology Inc.

Barriers to access to opioid medicines for patients with opioid dependence: a review of legislation and regulations in eleven central and eastern European countries.

PubMed

Vranken, Marjolein J M; Mantel-Teeuwisse, Aukje K; Jünger, Saskia; Radbruch, Lukas; Scholten, Willem; Lisman, John A; Subataite, Marija; Schutjens, Marie-Hélène D B

2017-06-01

Barriers linked to drug control systems are considered to contribute to inequitable access to controlled medicines, leaving millions of people in pain and suffering. Most studies focus on access to opioids for the treatment of severe (cancer) pain. This study aims to identify specific access barriers for patients with opioid dependence in legislation and regulations of 11 central and eastern European countries. This study builds on a previous analysis of legislation and regulations as part of the EU 7th Framework Access To Opioid Medication in Europe (ATOME) project. An in-depth analysis was undertaken to determine specific barriers for patients with opioid dependence in need of opioid analgesics or opioid agonist therapy (OAT). For each country, the number and nature of specific potential barriers for these patients were assessed according to eight categories: prescribing; dispensing; manufacturing; usage; trade and distribution; affordability; penalties; and other. An additional keyword search was conducted to minimize the omission of barriers. Barriers in an additional category, language, were recorded qualitatively. Countries included Bulgaria, Cyprus, Estonia, Greece, Hungary, Latvia, Lithuania, Serbia, Slovakia, Slovenia and Turkey. Ten of the 11 countries (all except Estonia) showed specific potential barriers in their legislation and regulations. The total number of barriers varied from two (Slovenia) to 46 (Lithuania); the number of categories varied from one (Slovenia) to five (Lithuania). Most specific potential barriers were shown in the categories 'prescribing', 'usage' and 'other'. The total number in a single category varied from one to 18 (Lithuania, prescribing). Individual differences between countries in the same specific potential barrier were shown; for example, variation in minimum age criteria for admission to OAT ranging from 15 (Lithuania, in special cases) to 20 years (Greece). All countries had stigmatizing language in their legislation

Programmable Direct-Memory-Access Controller

NASA Technical Reports Server (NTRS)

Hendry, David F.

1990-01-01

Proposed programmable direct-memory-access controller (DMAC) operates with computer systems of 32000 series, which have 32-bit data buses and use addresses of 24 (or potentially 32) bits. Controller functions with or without help of central processing unit (CPU) and starts itself. Includes such advanced features as ability to compare two blocks of memory for equality and to search block of memory for specific value. Made as single very-large-scale integrated-circuit chip.

PynPoint code for exoplanet imaging

NASA Astrophysics Data System (ADS)

Amara, A.; Quanz, S. P.; Akeret, J.

2015-04-01

We announce the public release of PynPoint, a Python package that we have developed for analysing exoplanet data taken with the angular differential imaging observing technique. In particular, PynPoint is designed to model the point spread function of the central star and to subtract its flux contribution to reveal nearby faint companion planets. The current version of the package does this correction by using a principal component analysis method to build a basis set for modelling the point spread function of the observations. We demonstrate the performance of the package by reanalysing publicly available data on the exoplanet β Pictoris b, which consists of close to 24,000 individual image frames. We show that PynPoint is able to analyse this typical data in roughly 1.5 min on a Mac Pro, when the number of images is reduced by co-adding in sets of 5. The main computational work, the calculation of the Singular-Value-Decomposition, parallelises well as a result of a reliance on the SciPy and NumPy packages. For this calculation the peak memory load is 6 GB, which can be run comfortably on most workstations. A simpler calculation, by co-adding over 50, takes 3 s with a peak memory usage of 600 MB. This can be performed easily on a laptop. In developing the package we have modularised the code so that we will be able to extend functionality in future releases, through the inclusion of more modules, without it affecting the users application programming interface. We distribute the PynPoint package under GPLv3 licence through the central PyPI server, and the documentation is available online (http://pynpoint.ethz.ch).

Student Standpoints about Access Programs in Higher Education

ERIC Educational Resources Information Center

Lundell, Dana B., Ed.; Higbee, Jeanne L., Ed.; Duranczyk, Irene M., Ed.; Goff, Emily, Ed.

2007-01-01

This monograph consists of 13 chapters featuring a diverse range of perspectives centralizing student standpoints about their experiences in higher education and access programs. Chapter 1, "Student Perspectives on College Readiness" (Jeanne L. Higbee), provides the results of a survey of developmental education students regarding college…

Centralized Authorization Using a Direct Service, Part II

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

Wachsmann, A

Authorization is the process of deciding if entity X is allowed to have access to resource Y. Determining the identity of X is the job of the authentication process. One task of authorization in computer networks is to define and determine which user has access to which computers in the network. On Linux, the tendency exists to create a local account for each single user who should be allowed to logon to a computer. This is typically the case because a user not only needs login privileges to a computer but also additional resources like a home directory to actuallymore » do some work. Creating a local account on every computer takes care of all this. The problem with this approach is that these local accounts can be inconsistent with each other. The same user name could have a different user ID and/or group ID on different computers. Even more problematic is when two different accounts share the same user ID and group ID on different computers: User joe on computer1 could have user ID 1234 and group ID 56 and user jane on computer2 could have the same user ID 1234 and group ID 56. This is a big security risk in case shared resources like NFS are used. These two different accounts are the same for an NFS server so that these users can wipe out each other's files. The solution to this inconsistency problem is to have only one central, authoritative data source for this kind of information and a means of providing all your computers with access to this central source. This is what a ''Directory Service'' is. The two directory services most widely used for centralizing authorization data are the Network Information Service (NIS, formerly known as Yellow Pages or YP) and Lightweight Directory Access Protocol (LDAP).« less

Privacy Impact Assessment for the Central Data Exchange

EPA Pesticide Factsheets

The Central Data Exchange collects personally identifiable information, including personal answers to security questions. Learn how this data will be collected in the system, how it will be used, access to the data, and the purpose of data collection.

The power of PowerPoint.

PubMed

Niamtu , J

2001-08-01

Carousel slide presentations have been used for academic and clinical presentations since the late 1950s. However, advances in computer technology have caused a paradigm shift, and digital presentations are quickly becoming standard for clinical presentations. The advantages of digital presentations include cost savings; portability; easy updating capability; Internet access; multimedia functions, such as animation, pictures, video, and sound; and customization to augment audience interest and attention. Microsoft PowerPoint has emerged as the most popular digital presentation software and is currently used by many practitioners with and without significant computer expertise. The user-friendly platform of PowerPoint enables even the novice presenter to incorporate digital presentations into his or her profession. PowerPoint offers many advanced options that, with a minimal investment of time, can be used to create more interactive and professional presentations for lectures, patient education, and marketing. Examples of advanced PowerPoint applications are presented in a stepwise manner to unveil the full power of PowerPoint. By incorporating these techniques, medical practitioners can easily personalize, customize, and enhance their PowerPoint presentations. Complications, pitfalls, and caveats are discussed to detour and prevent misadventures in digital presentations. Relevant Web sites are listed to further update, customize, and communicate PowerPoint techniques.

Central venous stenosis in haemodialysis patients without a previous history of catheter placement.

PubMed

Oguzkurt, Levent; Tercan, Fahri; Yildirim, Sedat; Torun, Dilek

2005-08-01

To evaluate dialysis history, imaging findings and outcome of endovascular treatment in six patients with central venous stenosis without a history of previous catheter placement. Between April 2000 and June 2004, six (10%) of 57 haemodialysis patients had stenosis of a central vein without a previous central catheter placement. Venography findings and outcome of endovascular treatment in these six patients were retrospectively evaluated. Patients were three women (50%) and three men aged 32-60 years (mean age: 45 years) and all had massive arm swelling as the main complaint. The vascular accesses were located at the elbow in five patients and at the wrist in one patient. Three patients had stenosis of the left subclavian vein and three patients had stenosis of the left brachiocephalic vein. The mean duration of the vascular accesses from the time of creation was 25.1 months. Flow volumes of the vascular access were very high in four patients who had flow volume measurement. The mean flow volume was 2347 ml/min. One of three patients with brachiocephalic vein stenosis had compression of the vein by the brachiocephalic artery. All the lesions were first treated with balloon angioplasty and two patients required stent placement on long term. Number of interventions ranged from 1 to 4 (mean: 2.1). Symptoms resolved in five patients and improved in one patient who had a stent placed in the left BCV. Central venous stenosis in haemodialysis patients without a history of central venous catheterization tends to occur or be manifested in patients with a proximal permanent vascular access with high flow rates. Balloon angioplasty with or without stent placement offers good secondary patency rates in mid-term.

BioMart Central Portal: an open database network for the biological community.

PubMed

Guberman, Jonathan M; Ai, J; Arnaiz, O; Baran, Joachim; Blake, Andrew; Baldock, Richard; Chelala, Claude; Croft, David; Cros, Anthony; Cutts, Rosalind J; Di Génova, A; Forbes, Simon; Fujisawa, T; Gadaleta, E; Goodstein, D M; Gundem, Gunes; Haggarty, Bernard; Haider, Syed; Hall, Matthew; Harris, Todd; Haw, Robin; Hu, S; Hubbard, Simon; Hsu, Jack; Iyer, Vivek; Jones, Philip; Katayama, Toshiaki; Kinsella, R; Kong, Lei; Lawson, Daniel; Liang, Yong; Lopez-Bigas, Nuria; Luo, J; Lush, Michael; Mason, Jeremy; Moreews, Francois; Ndegwa, Nelson; Oakley, Darren; Perez-Llamas, Christian; Primig, Michael; Rivkin, Elena; Rosanoff, S; Shepherd, Rebecca; Simon, Reinhard; Skarnes, B; Smedley, Damian; Sperling, Linda; Spooner, William; Stevenson, Peter; Stone, Kevin; Teague, J; Wang, Jun; Wang, Jianxin; Whitty, Brett; Wong, D T; Wong-Erasmus, Marie; Yao, L; Youens-Clark, Ken; Yung, Christina; Zhang, Junjun; Kasprzyk, Arek

2011-01-01

BioMart Central Portal is a first of its kind, community-driven effort to provide unified access to dozens of biological databases spanning genomics, proteomics, model organisms, cancer data, ontology information and more. Anybody can contribute an independently maintained resource to the Central Portal, allowing it to be exposed to and shared with the research community, and linking it with the other resources in the portal. Users can take advantage of the common interface to quickly utilize different sources without learning a new system for each. The system also simplifies cross-database searches that might otherwise require several complicated steps. Several integrated tools streamline common tasks, such as converting between ID formats and retrieving sequences. The combination of a wide variety of databases, an easy-to-use interface, robust programmatic access and the array of tools make Central Portal a one-stop shop for biological data querying. Here, we describe the structure of Central Portal and show example queries to demonstrate its capabilities.

[Access to government-funded psychotherapy: Comparing the point of view of psychologists and psychotherapists].

PubMed

Bradley, Stacy; Doucet, Rachelle; Kohler, Erich; Drapeau, Martin

Objectives Within the Quebec context, as well as the larger Canadian and International context, increasing access to mental health care treatment has become a major health care priority (see Peachey, Hicks, & Adams, 2013). Initiatives to increase access through government-funded psychotherapy have been successfully implemented in Australia and the United Kingdom. The current study sought to document how licensed psychologists and psychotherapists in Quebec differ in their attitudes about the components of these government-funded psychotherapy programs and increasing access to psychotherapy treatment.Methods The target population for the study included both psychologists and psychotherapists whom were licensed to practice psychotherapy with the Ordre of Psychologists of Quebec. Participants (N = 1 275) were recruited by email to participate in an online questionnaire focusing on components such as the services that should be offered in a new government-funded psychotherapy model (eg., individual therapy, family therapy; including employment and debt counselling), the choice and autonomy clinicians have in their treatment interventions, the role of the referring General Practitioner (GP), the fees per psychotherapy hour, the hiring structure (e.g., in the public sector versus reimbursing private psychotherapy services), among others.Results The results indicated that psychotherapists were more in favour of including family and couple therapy, and employment/vocational counselling than psychologists. Psychologists were more in favour of using evidence-based practices as well as tracking treatment outcomes using validated measures, and publishing treatment satisfaction ratings to the public. Psychotherapists were more in favour of being paid on a session-to-session basis as opposed to be being hired on a salaried basis to offer government-funded psychotherapy.Conclusions Given that psychologists and psychotherapists differ in their training background and have

Surgical management of insertional calcific achilles tendinosis with a central tendon splitting approach.

PubMed

Johnson, Keith W; Zalavras, Charalampos; Thordarson, David B

2006-04-01

Insertional calcific Achilles tendinosis is a painful, frequently disabling condition. Numerous operative approaches for this problem have been described. This study evaluated the outcome of a central tendon splitting approach. Twenty-two patients were evaluated after a central tendon splitting approach for persistent insertional calcific Achilles tendinosis. Followup averaged 34 (11 to 64) months. Suture anchors were routinely used to augment the tendon insertion after debridement. An American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score, shoewear comfort, and return to work were evaluated. A paired t-test was used to evaluate the results. Pain significantly improved from 7 points preoperatively to 33 points postoperatively (p < 0.001). Function improved significantly from 36 points to 46 points (p < 0.001). The ankle-hindfoot score improved from 53 points to 89 points (p < 0.001). Age older or younger than 50 years did not affect outcome. A central tendon splitting approach yielded good relief of pain with improved function, shoewear, and ability to work without painful postoperative scars.

Publishing Accessible Materials on the Web and CD-ROM.

ERIC Educational Resources Information Center

Federal Resource Center for Special Education, Washington, DC.

While it is generally simple to make electronic content accessible, it is also easy inadvertently to make it inaccessible. This guide covers the many formats of electronic documents and points out what to keep in mind and what procedures to follow to make documents accessible to all when disseminating information via the World Wide Web and on…

Using a participatory action strategic approach to enhance accessibility and participation in arts and cultural events: results of four focus groups.

PubMed

Milligan, Nancy Vandewiele; Nieuwenhuijsen, Els R; Grawi, Carolyn L

2014-01-01

Cultural events are abundant in a midwestern college town; however, individuals with disabilities have expressed concerns about their accessibility. Policymakers, business owners, and managers often ignore disability-related issues. Research shows accessibility is the main environmental barrier to participation in arts and cultural events. Individuals with disabilities are disconnected from managers of cultural organizations and city leaders. The lack of awareness about accessibility, including access to the built environment, impedes participation in cultural events in this college town. To encourage the participation of people with disabilities in cultural events in a midwestern college town, a bold strategic project was initiated to conduct a community-based needs assessment as a foundation for an action plan. Participation in arts and culture was selected as a unique focal point for exploring ways to enhance accessibility. Thirty-nine stakeholders participated in four different focus groups: individuals with disabilities, managers of cultural organizations, caregivers and health care providers, and other stakeholders including politicians. Critical problem areas identified were mapped onto the environmental factors in the International Classification of Functioning, Disability, and Health (ICF). Three themes emerged: 1) limited awareness about accessibility among the residents with disabilities and a lack of awareness about disability-related issues and accessibility among the managers of cultural organizations; 2) the need for a "central information clearinghouse" to share, provide, and retrieve information; 3) the need for inclusive city-level policies. Raising awareness about disabilities and accessibility, providing a clearinghouse for information sharing and implementing inclusive policies are crucial to strengthen participation in community life. Copyright © 2014 Elsevier Inc. All rights reserved.

Planning Multitechnology Access Networks with Performance Constraints

NASA Astrophysics Data System (ADS)

Chamberland, Steven

Considering the number of access network technologies and the investment needed for the “last mile” of a solution, in today’s highly competitive markets, planning tools are crucial for the service providers to optimize the network costs and accelerate the planning process. In this paper, we propose to tackle the problem of planning access networks composed of four technologies/architectures: the digital subscriber line (xDSL) technologies deployed directly from the central office (CO), the fiber-to-the-node (FTTN), the fiber-to-the-micro-node (FTTn) and the fiber-to-the-premises (FTTP). A mathematical programming model is proposed for this planning problem that is solved using a commercial implementation of the branch-and-bound algorithm. Next, a detailed access network planning example is presented followed by a systematic set of experiments designed to assess the performance of the proposed approach.

Wheelchair accessibility to public buildings in Istanbul.

PubMed

Evcil, A Nilay

2009-03-01

Accessibility to public environment is the human right and basic need of each citizen and is one of the fundamental considerations for urban planning. The aim of this study is to determine the compliance of public buildings in central business districts (CBD) of Istanbul, Turkey, to wheelchair accessibility to the guidelines of the instrument and identify architectural barriers faced by wheelchair users. This is a descriptive study of 26 public buildings in CBD of Istanbul. The instrument used is the adapted Useh, Moyo and Munyonga questionnaire to collect the data from direct observation and measurement. Descriptive statistics of simple percentages and means are used to explain the compliance to the guidelines of the instrument and wheelchair accessibility. The descriptive survey results indicate that wheelchair users experience many accessibility problems in public environment of the most urbanised city (cultural capital of Europe in 2010) in a developing country. It is found that the major architectural barrier is the public transportation items with the lowest mean compliance (25%). Beside this, the most compliant to the instrument is entrance to building items with 79% as mean percentage. It is also found that there is an intention to improve accessibility when building construction period is investigated. This article describes the example of the compliance of public buildings accessibility when the country has legislation, but lacking regulations about accessibility for the wheelchair users.

Does improved access to water supply by rural households enhance the concept of safe water at the point of use? A case study from deep rural South Africa.

PubMed

Jagals, P

2006-01-01

The concept of safe water is defined by three principles: the health-related quality must be suitable, the supply/source must be accessible and the water must constantly be available in quantities sufficient for the intended use. If any one (or more) of these three elements is missing from a water services improvement programme, providing safe water is not successfully achieved. A study in a deep rural area in South Africa showed that providing small communities, using untreated river water as their only water source, with good quality water through a piped distribution system and accessible at communal taps did not fall within our parameters of safe water. The parameters for measuring the three principles were: absence of Escherichia coli in drinking water samples; accessibility by improving tap distances to within 200 m from each household; availability by assessing whether households have at least 25 L per person per day. Results show that although E. coli levels were reduced significantly, households were still consuming water with E. coli numbers at non-compliant levels. Access (distance) was improved from an average of 750 m from households to river source to an average of 120 m to new on-tap source points. This did not result in significant increases in household quantities, which on average remained around 18 L per person per day.

Role of centrality for the identification of influential spreaders in complex networks.

PubMed

de Arruda, Guilherme Ferraz; Barbieri, André Luiz; Rodríguez, Pablo Martín; Rodrigues, Francisco A; Moreno, Yamir; Costa, Luciano da Fontoura

2014-09-01

The identification of the most influential spreaders in networks is important to control and understand the spreading capabilities of the system as well as to ensure an efficient information diffusion such as in rumorlike dynamics. Recent works have suggested that the identification of influential spreaders is not independent of the dynamics being studied. For instance, the key disease spreaders might not necessarily be so important when it comes to analyzing social contagion or rumor propagation. Additionally, it has been shown that different metrics (degree, coreness, etc.) might identify different influential nodes even for the same dynamical processes with diverse degrees of accuracy. In this paper, we investigate how nine centrality measures correlate with the disease and rumor spreading capabilities of the nodes in different synthetic and real-world (both spatial and nonspatial) networks. We also propose a generalization of the random walk accessibility as a new centrality measure and derive analytical expressions for the latter measure for simple network configurations. Our results show that for nonspatial networks, the k-core and degree centralities are the most correlated to epidemic spreading, whereas the average neighborhood degree, the closeness centrality, and accessibility are the most related to rumor dynamics. On the contrary, for spatial networks, the accessibility measure outperforms the rest of the centrality metrics in almost all cases regardless of the kind of dynamics considered. Therefore, an important consequence of our analysis is that previous studies performed in synthetic random networks cannot be generalized to the case of spatial networks.

Early cannulation prosthetic graft (Acuseal) for arteriovenous access: a useful option to provide a personal vascular access solution.

PubMed

Aitken, Emma L; Jackson, Andrew J; Kingsmore, David B

2014-01-01

Early cannulation arteriovenous grafts (ecAVGs), such as the GORE Acuseal, have "low bleed" properties permitting cannulation within 24 hours of insertion. They may provide an alternative to tunneled central venous catheters (and associated line complications) in patients requiring urgent vascular access. We present our early experience of 37 patients treated with the GORE Acuseal ecAVG. A total of 11 upper limb, 24 lower limb and 2 complex graft procedures were performed. Indications for ecAVG were as follows: bridge to transplantation (21.6%); bridge to arteriovenous fistula (AVF) maturation (8.1%); AVF salvage (8.1%); no native options (67.6%, including 17 patients with bilateral central vein stenosis); 36 AVGs (97.3%) were successfully cannulated. Mean time to first cannulation: 30.4±23.4 hours (range: 2-192). Primary and secondary patency rates at 3, 6 and 12 months were 64.9%, 48.6%, 32.4% and 70.2%, 59.4%, 40.5% respectively. The systemic bacteremia rate was 0.2 per 1,000 access days. There was one perioperative death. Other complications included hematoma at cannulation sites (n=9), pseudoaneurysm (n=3) and local infection at graft site (n=6). A total of 26 of 37 patients (70.6%) achieved a "personal vascular access solution": bridge to transplantation (n=8), bridge to functioning AVF/interposition AVG (n=5), maintenance hemodialysis via ecAVG (n=13); death with functioning AVG (n=1). Early experience with the GORE Acuseal is encouraging. Patency and bacteremia rates are at least comparable to standard polytetrafluoroethylene grafts. ecAVGs have permitted cannulation within 24 hours of insertion and line avoidance in the majority of patients. Nearly three-quarters of patients achieved a definitive "personal vascular access solution" from their ecAVG.

Cost- and reliability-oriented aggregation point association in long-term evolution and passive optical network hybrid access infrastructure for smart grid neighborhood area network

NASA Astrophysics Data System (ADS)

Cheng, Xiao; Feng, Lei; Zhou, Fanqin; Wei, Lei; Yu, Peng; Li, Wenjing

2018-02-01

With the rapid development of the smart grid, the data aggregation point (AP) in the neighborhood area network (NAN) is becoming increasingly important for forwarding the information between the home area network and wide area network. Due to limited budget, it is unable to use one-single access technology to meet the ongoing requirements on AP coverage. This paper first introduces the wired and wireless hybrid access network with the integration of long-term evolution (LTE) and passive optical network (PON) system for NAN, which allows a good trade-off among cost, flexibility, and reliability. Then, based on the already existing wireless LTE network, an AP association optimization model is proposed to make the PON serve as many APs as possible, considering both the economic efficiency and network reliability. Moreover, since the features of the constraints and variables of this NP-hard problem, a hybrid intelligent optimization algorithm is proposed, which is achieved by the mixture of the genetic, ant colony and dynamic greedy algorithm. By comparing with other published methods, simulation results verify the performance of the proposed method in improving the AP coverage and the performance of the proposed algorithm in terms of convergence.

Simultaneous Iliac Vein Bovine Pericardial Patch Venoplasty and Creation of PTFE Lower Limb Arteriovenous Fistula Graft for Rescue Vascular Access.

PubMed

Meecham, Lewis; Fisher, Owain; Kirby, George; Evans, Richard; Buxton, Pauline; Legge, Jocelyn; Rajagopalan, Sriram; Asquith, John; Pherwani, Arun

2016-10-01

We present a case of external iliac vein patch venoplasty to accommodate rescue vascular access via a polytetrafluoroethylene loop arteriovenous fistula graft (AVG) for a patient with multiple central venous stenoses. A 35-year-old female with anti-glomerular basement membrane antibody disease required rescue vascular access for hemodialysis. Repeated occlusion and/or thrombosis of long-term central venous access cannulae, to facilitate dialysis, had caused stenosis of brachiocephalic veins: right external iliac vein and occlusion of the left common iliac vein. A previous right brachiobasilic fistula had occluded within 1 year. No other upper limb options for arteriovenous fistula (AVF) were available. A right external iliac vein bovine patch angioplasty concurrently with a polytetrafluoroethylene AV graft between common femoral artery and common femoral vein was performed to restore venous patency and allow rescue dialysis access. At 3-year follow-up, the fistula remains widely patent with 2 L/min flow rates and no recurrent stenosis to the treated iliac vein. She has not required any further surgical or interventional radiological procedures to maintain fistula or central venous patency. Central venous stenosis or occlusion is common for patients requiring dialysis, especially those with multiple previous long-term central venous cannulations. If restriction of outflow is present, AVF may fail. Venous patch angioplasty in these cases is a successful technique, allowing AVF formation and long-term patency. Central venous stenosis can be treated successfully with patch venoplasty to accommodate AVF/AVG formation for rescue vascular access; this is a potentially lifesaving intervention for patients requiring dialysis. Copyright © 2016 Elsevier Inc. All rights reserved.

Use of PTFE Stent Grafts for Hemodialysis-related Central Venous Occlusions: Intermediate-Term Results

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

Kundu, Sanjoy, E-mail: sanjoy_kundu40@hotmail.com; Modabber, Milad; You, John M.

2011-10-15

Purpose: To assess the safety and effectiveness of a polytetrafluoroethylene (PTFE) encapsulated nitinol stents (Bard Peripheral Vascular, Tempe, AZ) for treatment of hemodialysis-related central venous occlusions. Materials and Methods: Study design was a single-center nonrandomized retrospective cohort of patients from May 2004 to August 2009 for a total of 64 months. There were 14 patients (mean age 60 years, range 50-83 years; 13 male, 1 female). All patients had autogenous fistulas. All 14 patients had central venous occlusions and presented with clinical symptoms of the following: extremity swelling (14%, 2 of 14), extremity and face swelling (72%, 10 of 14),more » and face swelling/edema (14%, 2 of 14). There was evidence of access dysfunction with decreased access flow in 36% (5 of 14) patients. There were prior interventions or previous line placement at the site of the central venous lesion in all 14 patients. Results were assessed by recurrence of clinical symptoms and function of the access circuit (National Kidney Foundation recommended criteria). Results: Sixteen consecutive straight stent grafts were implanted in 14 patients. Average treated lesion length was 5.0 cm (range, 0.9-7 cm). All 14 patients had complete central venous occlusion (100% stenosis). The central venous occlusions were located as follows: right subclavian and brachiocephalic vein (21%, 3 of 14), right brachiocephalic vein (36%, 5 of 14), left brachiocephalic vein (36%, 5 of 14), and bilateral brachiocephalic vein (7%, 1 of 14). A total of 16 PTFE stent grafts were placed. Ten- or 12-mm-diameter PTFE stent grafts were placed. The average stent length was 6.1 cm (range, 4-8 cm). Technical (deployment), anatomic (<30% residual stenosis), clinical (resolution of symptoms), and hemodynamic (resolution of access dysfunction) success were 100%. At 3, 6, and 9 months, primary patency of the treated area and access circuit were 100% (14 of 14). Conclusions: This PTFE encapsulated stent

Survey of Airport Access Analysis Techniques - Models, Data and a Research Program

DOT National Transportation Integrated Search

1972-06-01

The report points up the differences and similarities between airport access travel and general urban trip making. Models and surveys developed for, or applicable, to airport access planning are reviewed. A research program is proposed which would ge...

Multi-tool accessibility assessment of government department websites:a case-study with JKGAD.

PubMed

Ismail, Abid; Kuppusamy, K S; Nengroo, Ab Shakoor

2017-08-02

Nature of being accessible to all categories of users is one of the primary factors for enabling the wider reach of the resources published through World Wide Web. The accessibility of websites has been analyzed through W3C guidelines with the help of various tools. This paper presents a multi-tool accessibility assessment of government department websites belonging to the Indian state of Jammu and Kashmir. A comparative analysis of six accessibility tools is also presented with 14 different parameters. The accessibility analysis tools used in this study for analysis are aChecker, Cynthia Says, Tenon, wave, Mauve, and Hera. These tools provide us the results of selected websites accessibility status on Web Content Accessibility Guidelines (WCAG) 1.0 and 2.0. It was found that there are variations in accessibility analysis results when using different accessibility metrics to measure the accessibility of websites. In addition to this, we have identified the guidelines which have frequently been violated. It was observed that there is a need for incorporating the accessibility component features among the selected websites. This paper presents a set of suggestions to improve the accessibility status of these sites so that the information and services provided by these sites shall reach a wider spectrum of audience without any barrier. Implications for rehabilitation The following points indicates that this case study of JKGAD websites comes under Rehabilitation focused on Visually Impaired users. Due to the universal nature of web, it should be accessible to all according to WCAG guidelines framed by World Wide Web Consortium. In this paper we have identified multiple accessibility barriers for persons with visual impairment while browsing the Jammu and Kashmir Government websites. Multi-tool analysis has been done to pin-point the potential barriers for persons with visually Impaired. Usability analysis has been performed to check whether these websites are suitable

Dynamic access control model for privacy preserving personalized healthcare in cloud environment.

PubMed

Son, Jiseong; Kim, Jeong-Dong; Na, Hong-Seok; Baik, Doo-Kwon

2015-01-01

When sharing and storing healthcare data in a cloud environment, access control is a central issue for preserving data privacy as a patient's personal health data may be accessed without permission from many stakeholders. Specifically, dynamic authorization for the access of data is required because personal health data is stored in cloud storage via wearable devices. Therefore, we propose a dynamic access control model for preserving the privacy of personal healthcare data in a cloud environment. The proposed model considers context information for dynamic access. According to the proposed model, access control can be dynamically determined by changing the context information; this means that even for a subject with the same role in the cloud, access permission is defined differently depending on the context information and access condition. Furthermore, we experiment the ability of the proposed model to provide correct responses by representing a dynamic access decision with real-life personalized healthcare system scenarios.

Endovascular treatment of central venous stenosis and obstruction in hemodialysis patients.

PubMed

Shi, Ya-xue; Ye, Meng; Liang, Wei; Zhang, Hao; Zhao, Yi-ping; Zhang, Ji-wei

2013-02-01

Central venous stenosis and obstruction (CVD) is a serious and prevalent challenge to both resolve the venous hypertension symptoms and maintain the pantency of the ipsilateral hemodialysis access in hemodialysis patients. This study aimed to summarize our experience of the endovascular management of the central venous stenosis or obstruction in hemodialysis patients. Twenty-four haemodialysis cases of central vein stenosis or obstruction with ipsilateral functional vascular access in our hospital between July 2006 and February 2012 were treated by interventional therapy and the data were analyzed retrospectively. Eighteen males and six females with mean age of (66.4 ± 13.8) years and manifesting with arm swelling and venous hypertension were enrolled; 62.5% of them had a history of catheterization. Venography showed stenotic lesion in 10 cases including eight cases of brachiocephalic vein stenosis and two cases of subclavian vein stenosis and 14 cases of obstruction lesions including seven cases of short brachiocephalic obstruction and seven cases of long segment obstruction. Interventional therapy was performed and the technique success rate was 83.3%. Percutaneous transluminal angioplasty (PTA) was performed in nine cases and stent was performed in 11 cases firstly. The symptoms of venous hypertension were resolved after intervention in all the cases. There was no major complication and death perioperatively. During follow-up, reintervention was done, the primary patency rates were (88.9 ± 10.5)%, (64.8 ± 10.5)% and (48.6 ± 18.7)% at 3 months, 6 months and 1 year after treatment in the PTA group; (90.0 ± 9.5)% and (77.1 ± 14.4)% at 6 months and 1 year after treatment in the stent group, respectively. The secondary patency rates were (48.6 ± 18.7)% in the PTA group and (83.3 ± 15.2)% in the stent group 1 year after treatment, respectively. There was no significant difference between the two groups (primary patency, P = 0.20; secondary patency, P = 0

Attitude Accessibility as a Function of Emotionality.

PubMed

Rocklage, Matthew D; Fazio, Russell H

2018-04-01

Despite the centrality of both attitude accessibility and attitude basis to the last 30 years of theoretical and empirical work concerning attitudes, little work has systematically investigated their relation. The research that does exist provides conflicting results and is not at all conclusive given the methodology that has been used. The current research uses recent advances in statistical modeling and attitude measurement to provide the most systematic examination of the relation between attitude accessibility and basis to date. Specifically, we use mixed-effects modeling which accounts for variation across individuals and attitude objects in conjunction with the Evaluative Lexicon (EL)-a linguistic approach that allows for the simultaneous measurement of an attitude's valence, extremity, and emotionality. We demonstrate across four studies, over 10,000 attitudes, and nearly 50 attitude objects that attitudes based on emotion tend to be more accessible in memory, particularly if the attitude is positive.

Access to Mars from Earth-Moon Libration Point Orbits:. [Manifold and Direct Options

NASA Technical Reports Server (NTRS)

Kakoi, Masaki; Howell, Kathleen C.; Folta, David

2014-01-01

This investigation is focused specifically on transfers from Earth-Moon L(sub 1)/L(sub 2) libration point orbits to Mars. Initially, the analysis is based in the circular restricted three-body problem to utilize the framework of the invariant manifolds. Various departure scenarios are compared, including arcs that leverage manifolds associated with the Sun-Earth L(sub 2) orbits as well as non-manifold trajectories. For the manifold options, ballistic transfers from Earth-Moon L(sub 2) libration point orbits to Sun-Earth L(sub 1)/L(sub 2) halo orbits are first computed. This autonomous procedure applies to both departure and arrival between the Earth-Moon and Sun-Earth systems. Departure times in the lunar cycle, amplitudes and types of libration point orbits, manifold selection, and the orientation/location of the surface of section all contribute to produce a variety of options. As the destination planet, the ephemeris position for Mars is employed throughout the analysis. The complete transfer is transitioned to the ephemeris model after the initial design phase. Results for multiple departure/arrival scenarios are compared.

A SITELLE view of M31's central region - I. Calibrations and radial velocity catalogue of nearly 800 emission-line point-like sources

NASA Astrophysics Data System (ADS)

Martin, Thomas B.; Drissen, Laurent; Melchior, Anne-Laure

2018-01-01

We present a detailed description of the wavelength, astrometric and photometric calibration plan for SITELLE, the imaging Fourier transform spectrometer attached to the Canada-France-Hawaii telescope, based on observations of a red (647-685 nm) data cube of the central region (11 arcmin × 11 arcmin) of M 31. The first application, presented in this paper is a radial-velocity catalogue (with uncertainties of ∼2-6 km s-1) of nearly 800 emission-line point-like sources, including ∼450 new discoveries. Most of the sources are likely planetary nebulae, although we also detect five novae (having erupted in the first eight months of 2016) and one new supernova remnant candidate.

Accessing northern California earthquake data via Internet

NASA Astrophysics Data System (ADS)

Romanowicz, Barbara; Neuhauser, Douglas; Bogaert, Barbara; Oppenheimer, David

The Northern California Earthquake Data Center (NCEDC) provides easy access to central and northern California digital earthquake data. It is located at the University of California, Berkeley, and is operated jointly with the U.S. Geological Survey (USGS) in Menlo Park, Calif., and funded by the University of California and the National Earthquake Hazard Reduction Program. It has been accessible to users in the scientific community through Internet since mid-1992.The data center provides an on-line archive for parametric and waveform data from two regional networks: the Northern California Seismic Network (NCSN) operated by the USGS and the Berkeley Digital Seismic Network (BDSN) operated by the Seismographic Station at the University of California, Berkeley.

Transforming Personnel Accessions: Recruiting in the E-Business World

DTIC Science & Technology

2002-04-09

levels of PC-ownership and online access. Finally, the 1999 report found that poor rural households had replaced poor central city households as the...digital divide clearly impacts any transformation to an eBusiness, eEnterprise, and eCommerce etc. model for recruiting. This research will not assume the

Central Venous Catheter-related Fungemia Caused by Rhodotorula glutinis.

PubMed

Miglietta, Fabio; Letizia Faneschi, Maria; Braione, Adele; Palumbo, Claudio; Rizzo, Adriana; Lobreglio, Giambattista; Pizzolante, Maria

2015-01-01

Bloodstream infection due to Rhodotorula glutinis is extremely rare and mostly associated with underlying immunosuppression or cancer. Vascular access devices provide the necessary surfaces for biofilm formation and are currently responsible for a significant percentage of human infections. In this work, we describe a rare case of central venous catheter-related Rhodotorula glutinis fungemia in a female patient with acute myelogenous leukemia in remission. The timely removal of central venous catheter was an essential element for overcoming this CVC-related Rhodotorula fungemia.

Surficial geology of the sea floor in Central Rhode Island Sound Southeast of Point Judith, Rhode Island

USGS Publications Warehouse

McMullen, K.Y.; Poppe, L.J.; Ackerman, S.D.; Blackwood, D.S.; Schaer, J.D.; Nadeau, M.A.; Wood, D.A.

2011-01-01

The U.S. Geological Survey (USGS) and the National Oceanic and Atmospheric Administration (NOAA) are working together to study sea-floor environments off the northeast coast of the United States. During 2008, NOAA survey H11996 collected multibeam echosounder data in a 65-square kilometer area in central Rhode Island Sound, southeast of Point Judith, Rhode Island. During 2010, the USGS collected bottom photographs and sediment samples from 25 stations in this study area. The bathymetry, photography, and sediment data are used to interpret sea-floor features including scour depressions, sand waves, trawl marks, and dredge spoils. Scour depressions cover the bathymetric highs in much of the study area. Sand waves are located mostly in the southwest, and trawl marks tend to be in the northern regions. Dredge spoils are located at a disposal site in a bathymetric low in the western end of the study area. Most stations have a sea-floor surface of sand or silty sand, but eight of the stations have boulders to pea-sized gravel or gravelly sediment on the surface. Photographs show sandy areas typically have scattered burrows, shells, amphipod communities, and worm tubes. Boulders and cobbles are commonly overgrown with hydrozoans and anemones.

Automated Computer Access Request System

NASA Technical Reports Server (NTRS)

Snook, Bryan E.

2010-01-01

The Automated Computer Access Request (AutoCAR) system is a Web-based account provisioning application that replaces the time-consuming paper-based computer-access request process at Johnson Space Center (JSC). Auto- CAR combines rules-based and role-based functionality in one application to provide a centralized system that is easily and widely accessible. The system features a work-flow engine that facilitates request routing, a user registration directory containing contact information and user metadata, an access request submission and tracking process, and a system administrator account management component. This provides full, end-to-end disposition approval chain accountability from the moment a request is submitted. By blending both rules-based and rolebased functionality, AutoCAR has the flexibility to route requests based on a user s nationality, JSC affiliation status, and other export-control requirements, while ensuring a user s request is addressed by either a primary or backup approver. All user accounts that are tracked in AutoCAR are recorded and mapped to the native operating system schema on the target platform where user accounts reside. This allows for future extensibility for supporting creation, deletion, and account management directly on the target platforms by way of AutoCAR. The system s directory-based lookup and day-today change analysis of directory information determines personnel moves, deletions, and additions, and automatically notifies a user via e-mail to revalidate his/her account access as a result of such changes. AutoCAR is a Microsoft classic active server page (ASP) application hosted on a Microsoft Internet Information Server (IIS).

Innovative dressing and securement of tunneled central venous access devices in pediatrics: a pilot randomized controlled trial.

PubMed

Ullman, Amanda J; Kleidon, Tricia; Gibson, Victoria; McBride, Craig A; Mihala, Gabor; Cooke, Marie; Rickard, Claire M

2017-08-30

Central venous access device (CVAD) associated complications are a preventable source of patient harm, frequently resulting in morbidity and delays to vital treatment. Dressing and securement products are used to prevent infectious and mechanical complications, however current complication rates suggest customary practices are inadequate. The aim of this study was to evaluate the feasibility of launching a full-scale randomized controlled efficacy trial of innovative dressing and securement products for pediatric tunneled CVAD to prevent complication and failure. An external, pilot, four-group randomized controlled trial of standard care (bordered polyurethane dressing and suture), in comparison to integrated securement-dressing, suture-less securement device, and tissue adhesive was undertaken across two large, tertiary referral pediatric hospitals in Australia. Forty-eight pediatric participants with newly inserted tunneled CVADs were consecutively recruited. The primary outcome of study feasibility was established by elements of eligibility, recruitment, attrition, protocol adherence, missing data, parent and healthcare staff satisfaction and acceptability, and effect size estimates for CVAD failure (cessation of function prior to completion of treatment) and complication (associated bloodstream infection, thrombosis, breakage, dislodgement or occlusion). Dressing integrity, product costs and site complications were also examined. Protocol feasibility was established. CVAD failure was: 17% (2/12) integrated securement-dressing; 8% (1/13) suture-less securement device; 0% tissue adhesive (0/12); and, 0% standard care (0/11). CVAD complications were: 15% (2/13) suture-less securement device (CVAD associated bloodstream infection, and occlusion and partial dislodgement); 8% (1/12) integrated securement-dressing (partial dislodgement); 0% tissue adhesive (0/12); and, 0% standard care (0/11). One CVAD-associated bloodstream infection occurred, within the suture

Access is Not Enough: Characteristics of Physicians Who Treat Medicaid Patients.

PubMed

Geissler, Kimberley H; Lubin, Benjamin; Marzilli Ericson, Keith M

2016-04-01

Access to physicians is a major concern for Medicaid programs. However, little is known about relationships between physician participation in Medicaid and the individual-level and practice-level characteristics of physicians. We used the 2011 Massachusetts All Payer Claims Database, containing all commercial and Medicaid claims; we linked with data on physician characteristics. We measured Medicaid participation intensity (fraction of the physician's patient panel with Medicaid) for primary care physicians (PCPs) and medical specialists. We measured influence of physicians within a patient referral network using eigenvector centrality. We used regression models to associate Medicaid intensity with physician individual-level and practice-level characteristics. About 92.6% of physicians treated at least 1 Medicaid patient, but the median physician's panel contained only 5.7% Medicaid patients. Medicaid intensity was associated with physician training and influence for PCPs and specialists. For medical specialists, a 1 percentage point increase in Medicaid intensity was associated with a lower probability of being board certified (-0.22 percentage points; 95% CI, -0.30, -0.14), lower probability of attending a domestic medical school (-0.14 percentage points; 95% CI, -0.22, -0.05), having attended a less well-ranked domestic medical school (0.23 ranks; 95% CI, 0.15, 0.30), and having slightly less influence in the referral network. PCPs displayed similar results but high Medicaid intensity physicians had substantially less influence in the referral network. Medicaid participation intensity shows substantial variation across physicians, indicating limits of binary participation measures. Physicians with more Medicaid patients had characteristics often perceived by patients to be of lower quality.

The Impact of the Collapse of Communism and EU Accession on Language Education Policy and Practice in Central and Eastern Europe: Two Case-Studies Focussing on English and Russian as Foreign Languages in Hungary and Eastern Germany

ERIC Educational Resources Information Center

Bruen, Jennifer; Sheridan, Vera

2016-01-01

This paper considers the impact of geopolitical factors, and in particular the collapse of Communism and EU accession, on language education policy and practice in Central and Eastern Europe (CEE). CEE is understood here as referring to the former soviet-controlled, eastern bloc counties of Bulgaria, the Czech Republic, East Germany, Hungary,…

Spud Point Marina Breakwater, Bodega Bay, Sonoma County, California.

DTIC Science & Technology

1991-07-01

AD-A240 319 ~ MONITORING COMPLETED COASTAL PROJECTS PROGRAM MISCELLANEOUS PAPER CERC-91-5 0SPUD POINT MARINA BREAKWATER, BODEGA BAY SONOMA COUNTY , CALIFORNIA...SUBTITLE S. FUNDING NUMBERS Spud Point Marina Breakwater, Bodega Bay, Sonoma County , WU 22123 California 6. AUTHOR(S) Jonathan W. Lott 7. PERFORMING...of the harbor are also shown. The marina docks and shoreside facilities are oper- ated by Sonoma County . The breakwater and access channel are main

The Viability of Hearing Protection Device Fit-Testing at Navy and Marine Corps Accession Points

PubMed Central

Federman, Jeremy; Duhon, Christon

2016-01-01

feel when inserted correctly, they were able to properly replicate the procedure with similar results to the expert fit suggesting “ear canal muscle memory” may be a viable training strategy concomitant with HPD verification. Fit-test duration was also measured to examine the tradeoff between results accuracy and time required to complete each protocol. Discussion: Results from this study showed the critical importance of initial selection and fitting of HPDs followed by verification (i.e., fit-testing) at Navy and Marine Corps accession points. Achieving adequate protection from an HPD is fundamentally dependent on obtaining proper fit of the issued HPD as well as the quality of training recruits receive regarding HPD use. PMID:27991461

Point Counts Modifications and Breeding Bird Abundances in Central Appalachian Forests

Treesearch

J. Edwards Gates

1995-01-01

The effects of point count duration and radius on detection of breeding birds were compared by recording all birds seen or heard within two consecutive 5-minute intervals and for fixed-radius (within 30 m) or unlimited radius counts. Counts were conducted on Green Ridge State Forest (GRSF) and Savage River State Forest (SRSF) in western Maryland. More than 70 percent...

Central Configurations of the Curved N-Body Problem

NASA Astrophysics Data System (ADS)

Diacu, Florin; Stoica, Cristina; Zhu, Shuqiang

2018-06-01

We consider the N-body problem of celestial mechanics in spaces of nonzero constant curvature. Using the concept of effective potential, we define the moment of inertia for systems moving on spheres and hyperbolic spheres and show that we can recover the classical definition in the Euclidean case. After proving some criteria for the existence of relative equilibria, we find a natural way to define the concept of central configuration in curved spaces using the moment of inertia and show that our definition is formally similar to the one that governs the classical problem. We prove that, for any given point masses on spheres and hyperbolic spheres, central configurations always exist. We end with results concerning the number of central configurations that lie on the same geodesic, thus extending the celebrated theorem of Moulton to hyperbolic spheres and pointing out that it has no straightforward generalization to spheres, where the count gets complicated even for two bodies.

Topographic and location map of Bonita Point Coast Guard and ...

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

Topographic and location map of Bonita Point Coast Guard and lighthouse station, June 1940, this drawing shows the Bonita Ridge access road retaining wall and general conditions at Fort Barry and Bonita Ridge (upper left) before the construction of Signal Corps Radar (S.C.R.) 296 Station 5 - Fort Barry, Signal Corps Radar 296, Station 5, Transmitter Building Foundation, Point Bonita, Marin Headlands, Sausalito, Marin County, CA

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

NASA Astrophysics Data System (ADS)

Tu, J. J.; Yin, Z. D.

2017-07-01

With the development of electronic, more and more distributed generations (DGs) access into grid and cause the research fever of direct current (DC) distribution network. Considering distributed generation (DG) location and capacity have great impacts on voltage profile, so use IEEE9 and IEEE33 typical circuit as examples, with DGs access in centralized and decentralized mode, to compare voltage profile in alternating and direct current (AC/DC) distribution network. Introducing the voltage change ratio as an evaluation index, so gets the general results on voltage profile of DC distributed network with DG access. Simulation shows that, in the premise of reasonable location and capacity, DC distribution network is more suitable for DG access.

Vaccine production, distribution, access and uptake

PubMed Central

Smith, Jon; Lipsitch, Marc; Almond, Jeffrey W.

2011-01-01

Making human vaccines available on a global scale requires the use of complex production methods, meticulous quality control and reliable distribution channels that ensure the products are potent and effective at their point of use. The technologies involved in manufacturing different types of vaccines may strongly influence vaccine cost, ease of industrial scale-up, stability and ultimately world-wide availability. Manufacturing complexity is compounded by the need for different formulations for different countries and age groups. Reliable vaccine production in appropriate quantities and at affordable prices is the cornerstone of developing global vaccination policies. However, ensuring optimal access and uptake also requires strong partnerships between private manufacturers, regulatory authorities and national and international public health services. For vaccines whose supplies are limited, either due to rapidly emerging diseases or longer-term mismatch of supply and demand, prioritizing target groups can increase vaccine impact. Focusing on influenza vaccines as an example that well illustrates many of the relevant points, this article considers current production, distribution, access and other factors that ultimately impact on vaccine uptake and population-level effectiveness. PMID:21664680

Point-of-Care Versus Central Laboratory Measurements of Hemoglobin, Hematocrit, Glucose, Bicarbonate and Electrolytes: A Prospective Observational Study in Critically Ill Patients.

PubMed

Allardet-Servent, Jérôme; Lebsir, Melissa; Dubroca, Christian; Fabrigoule, Martine; Jordana, Sylvie; Signouret, Thomas; Castanier, Matthias; Thomas, Guillemette; Soundaravelou, Rettinavelou; Lepidi, Anne; Delapierre, Laurence; Penaranda, Guillaume; Halfon, Philippe; Seghboyan, Jean-Marie

2017-01-01

Rapid detection of abnormal biological values using point-of-care (POC) testing allows clinicians to promptly initiate therapy; however, there are concerns regarding the reliability of POC measurements. We investigated the agreement between the latest generation blood gas analyzer and central laboratory measurements of electrolytes, bicarbonate, hemoglobin, hematocrit, and glucose. 314 paired samples were collected prospectively from 51 critically ill patients. All samples were drawn simultaneously in the morning from an arterial line. BD Vacutainer tubes were analyzed in the central laboratory using Beckman Coulter analyzers (AU 5800 and DxH 800). BD Preset 3 ml heparinized-syringes were analyzed immediately in the ICU using the POC Siemens RAPIDPoint 500 blood gas system. We used CLIA proficiency testing criteria to define acceptable analytical performance and interchangeability. Biases, limits of agreement (±1.96 SD) and coefficients of correlation were respectively: 1.3 (-2.2 to 4.8 mmol/L, r = 0.936) for sodium; 0.2 (-0.2 to 0.6 mmol/L, r = 0.944) for potassium; -0.9 (-3.7 to 2 mmol/L, r = 0.967) for chloride; 0.8 (-1.9 to 3.4 mmol/L, r = 0.968) for bicarbonate; -11 (-30 to 9 mg/dL, r = 0.972) for glucose; -0.8 (-1.4 to -0.2 g/dL, r = 0.985) for hemoglobin; and -1.1 (-2.9 to 0.7%, r = 0.981) for hematocrit. All differences were below CLIA cut-off values, except for hemoglobin. Compared to central Laboratory analyzers, the POC Siemens RAPIDPoint 500 blood gas system satisfied the CLIA criteria of interchangeability for all tested parameters, except for hemoglobin. These results are warranted for our own procedures and devices. Bearing these restrictions, we recommend clinicians to initiate an appropriate therapy based on POC testing without awaiting a control measurement.

Point-of-Care Versus Central Laboratory Measurements of Hemoglobin, Hematocrit, Glucose, Bicarbonate and Electrolytes: A Prospective Observational Study in Critically Ill Patients

PubMed Central

Lebsir, Melissa; Dubroca, Christian; Fabrigoule, Martine; Jordana, Sylvie; Signouret, Thomas; Castanier, Matthias; Thomas, Guillemette; Soundaravelou, Rettinavelou; Lepidi, Anne; Delapierre, Laurence; Penaranda, Guillaume; Halfon, Philippe; Seghboyan, Jean-Marie

2017-01-01

Introduction Rapid detection of abnormal biological values using point-of-care (POC) testing allows clinicians to promptly initiate therapy; however, there are concerns regarding the reliability of POC measurements. We investigated the agreement between the latest generation blood gas analyzer and central laboratory measurements of electrolytes, bicarbonate, hemoglobin, hematocrit, and glucose. Methods 314 paired samples were collected prospectively from 51 critically ill patients. All samples were drawn simultaneously in the morning from an arterial line. BD Vacutainer tubes were analyzed in the central laboratory using Beckman Coulter analyzers (AU 5800 and DxH 800). BD Preset 3 ml heparinized-syringes were analyzed immediately in the ICU using the POC Siemens RAPIDPoint 500 blood gas system. We used CLIA proficiency testing criteria to define acceptable analytical performance and interchangeability. Results Biases, limits of agreement (±1.96 SD) and coefficients of correlation were respectively: 1.3 (-2.2 to 4.8 mmol/L, r = 0.936) for sodium; 0.2 (-0.2 to 0.6 mmol/L, r = 0.944) for potassium; -0.9 (-3.7 to 2 mmol/L, r = 0.967) for chloride; 0.8 (-1.9 to 3.4 mmol/L, r = 0.968) for bicarbonate; -11 (-30 to 9 mg/dL, r = 0.972) for glucose; -0.8 (-1.4 to -0.2 g/dL, r = 0.985) for hemoglobin; and -1.1 (-2.9 to 0.7%, r = 0.981) for hematocrit. All differences were below CLIA cut-off values, except for hemoglobin. Conclusions Compared to central Laboratory analyzers, the POC Siemens RAPIDPoint 500 blood gas system satisfied the CLIA criteria of interchangeability for all tested parameters, except for hemoglobin. These results are warranted for our own procedures and devices. Bearing these restrictions, we recommend clinicians to initiate an appropriate therapy based on POC testing without awaiting a control measurement. PMID:28072822

Accessibility Guidelines for Astronomy and Astrophysics Meetings

NASA Astrophysics Data System (ADS)

Monkiewicz, Jacqueline; Murphy, Nicholas; Diaz-Merced, Wanda Liz; Aarnio, Alicia; Knierman, Karen; AAS Working Group for Accessibility and Disability

2018-01-01

Attendance at meetings and conferences is a critical component of an astronomer's professional life, providing opportunities for presenting one's work, staying current in the field, career networking, and scientific collaboration. Exclusion from these gatherings due to lack of accessibility and accommodation failure is a reality for disabled astronomers, and contributes substantially to low levels of representation in the senior-most levels of the field. We present a preview of the AAS Working Group for Accessibility and Disability's best practice recommendations for meetings accessibility. Applying the principles of universal access and barrier-free design, we model a paradigm of anticipating and removing accessibility barriers in advance, rather than putting the burden of requesting accommodation solely on disabled astronomers and students. We cite several professional and nonprofessional societies identified as meetings accessibility exemplars, and model our guidelines on their best practices. We establish standards for accessibility budgeting, venue choice, publication of policies online, designating point persons, and identifying barriers. We make recommendations for oral and poster presentations, event registration, receptions and banquets, excursions, and other typical conference activities. For meetings which are constrained by fixed budgets and venue choice, we identify a number of low cost/high reward accessibility steps which might still have a large beneficial impact. We likewise provide adapted recommendations for low budget meetings. THIS IS A POSTER LOCATED IN THE AAS BOOTH

Renewal of Central Higher Education: Issues and Challenges.

ERIC Educational Resources Information Center

Cerych, Ladislav

1991-01-01

The heritage of the past 50 years is the greatest challenge facing higher education in central Europe. Issues to be addressed include the traditional separation of teaching and research, low enrollment and labor market needs, diversification, access, the role of the government, and the economic context and impact of higher education. (MSE)

A MAP fixed-point, packing-unpacking routine for the IBM 7094 computer

Treesearch

Robert S. Helfman

1966-01-01

Two MAP (Macro Assembly Program) computer routines for packing and unpacking fixed point data are described. Use of these routines with Fortran IV Programs provides speedy access to quantities of data which far exceed the normal storage capacity of IBM 7000-series computers. Many problems that could not be attempted because of the slow access-speed of tape...

Seeing Central African forests through their largest trees

PubMed Central

Bastin, J.-F.; Barbier, N.; Réjou-Méchain, M.; Fayolle, A.; Gourlet-Fleury, S.; Maniatis, D.; de Haulleville, T.; Baya, F.; Beeckman, H.; Beina, D.; Couteron, P.; Chuyong, G.; Dauby, G.; Doucet, J.-L.; Droissart, V.; Dufrêne, M.; Ewango, C.; Gillet, J.F.; Gonmadje, C.H.; Hart, T.; Kavali, T.; Kenfack, D.; Libalah, M.; Malhi, Y.; Makana, J.-R.; Pélissier, R.; Ploton, P.; Serckx, A.; Sonké, B.; Stevart, T.; Thomas, D.W.; De Cannière, C.; Bogaert, J.

2015-01-01

Large tropical trees and a few dominant species were recently identified as the main structuring elements of tropical forests. However, such result did not translate yet into quantitative approaches which are essential to understand, predict and monitor forest functions and composition over large, often poorly accessible territories. Here we show that the above-ground biomass (AGB) of the whole forest can be predicted from a few large trees and that the relationship is proved strikingly stable in 175 1-ha plots investigated across 8 sites spanning Central Africa. We designed a generic model predicting AGB with an error of 14% when based on only 5% of the stems, which points to universality in forest structural properties. For the first time in Africa, we identified some dominant species that disproportionally contribute to forest AGB with 1.5% of recorded species accounting for over 50% of the stock of AGB. Consequently, focusing on large trees and dominant species provides precise information on the whole forest stand. This offers new perspectives for understanding the functioning of tropical forests and opens new doors for the development of innovative monitoring strategies. PMID:26279193

Seeing Central African forests through their largest trees.

PubMed

Bastin, J-F; Barbier, N; Réjou-Méchain, M; Fayolle, A; Gourlet-Fleury, S; Maniatis, D; de Haulleville, T; Baya, F; Beeckman, H; Beina, D; Couteron, P; Chuyong, G; Dauby, G; Doucet, J-L; Droissart, V; Dufrêne, M; Ewango, C; Gillet, J F; Gonmadje, C H; Hart, T; Kavali, T; Kenfack, D; Libalah, M; Malhi, Y; Makana, J-R; Pélissier, R; Ploton, P; Serckx, A; Sonké, B; Stevart, T; Thomas, D W; De Cannière, C; Bogaert, J

2015-08-17

Large tropical trees and a few dominant species were recently identified as the main structuring elements of tropical forests. However, such result did not translate yet into quantitative approaches which are essential to understand, predict and monitor forest functions and composition over large, often poorly accessible territories. Here we show that the above-ground biomass (AGB) of the whole forest can be predicted from a few large trees and that the relationship is proved strikingly stable in 175 1-ha plots investigated across 8 sites spanning Central Africa. We designed a generic model predicting AGB with an error of 14% when based on only 5% of the stems, which points to universality in forest structural properties. For the first time in Africa, we identified some dominant species that disproportionally contribute to forest AGB with 1.5% of recorded species accounting for over 50% of the stock of AGB. Consequently, focusing on large trees and dominant species provides precise information on the whole forest stand. This offers new perspectives for understanding the functioning of tropical forests and opens new doors for the development of innovative monitoring strategies.

An Optically Accessible Pyrolysis Microreactor

NASA Astrophysics Data System (ADS)

Baraban, Joshua H.; David, Donald E.; Ellison, Barney; Daily, John W.

2016-06-01

We report an optically accessible pyrolysis micro-reactor suitable for in situ laser spectroscopic measurements. A radiative heating design allows for completely unobstructed views of the micro-reactor along two axes. The maximum temperature demonstrated here is only 1300 K (as opposed to 1700 K for the usual SiC micro-reactor) because of the melting point of fused silica, but alternative transparent materials will allow for higher temperatures. Laser induced fluorescence measurements on nitric oxide are presented as a proof of principle for spectroscopic characterization of pyrolysis conditions. (This work has been published in J. H. Baraban, D. E. David, G. B. Ellison, and J. W. Daily. An Optically Accessible Pyrolysis Micro-Reactor. Review of Scientific Instruments, 87(1):014101, 2016.)

Community College Selective Enrollment and the Challenge to Open Access

ERIC Educational Resources Information Center

Morris, David Brian

2012-01-01

The open access mission is central to the community college role and mission in higher education. Although initially implemented by four-year colleges and universities, adoption of formal enrollment management initiatives in community colleges is on the increase. Admission, matriculation, retention, and persistence are affected by enrollment…

Three-dimensional contrast-enhanced magnetic resonance angiography (3-D CE-MRA) in the evaluation of hemodialysis access complications, and the condition of central veins in patients who are candidates for hemodialysis access.

PubMed

Paksoy, Yahya; Gormus, Niyazi; Tercan, Mehmet Akif

2004-01-01

Arteriovenous (AV) fistulas are crucial in patients requiring long-term hemodialysis (HD). Dysfunctions of these fistulas are the most common causes of recurrent hospitalizations. This study aimed to evaluate the feasibility, safety and usefulness of contrast-enhanced magnetic resonance angiography (CE-MRA) in the evaluation of HD fistulas complications, and the condition of the central veins before HD access. This study comprised 30 consecutive patients (15 females, 15 males; age range 25-66 yrs, mean +/- SD 51.2 +/- 9.9 yrs). Of 30 patients, 26 had native AV fistulas and the remaining four patients, who had a history of previous subclavian vein catheterization, were candidates for HD fistulas. Nine patients had a radiocephalic fistula, 15 had a brachiobasilic fistula, one had a saphenous vein graft, and one had brachiobasilic vein transposition. To observe the fistula complications in these cases, three-dimensional (3-D) CE-MRA using gadolinium was performed. The results were considered normal in three patients (10%), who were candidates for AV fistula construction; one patient had central vein occlusion due to previous catheterization. Thirteen patients (43.3%) had venous stenosis or occlusion; three of them (10%) had low CE arteries distal to fistula region, leading to ischemic complications, and six (20%) had stenosis at the fistula region. Seven patients (23.3%) had venous pseudoaneurysms, whereas two of them had both pseudoaneurysms and fistula region stenosis, and one had both venous stenosis and pseudoaneurysm. There were no adverse or allergic-like reactions or heat and taste sensations observed in our series. 3-D CE-MRA is a useful, safe and a practical imaging modality in complicated fistula diagnosis with fewer complications and side-effects in comparison to fistulography.

REVIEW: Widespread access to predictive models in the motor system: a short review

NASA Astrophysics Data System (ADS)

Davidson, Paul R.; Wolpert, Daniel M.

2005-09-01

Recent behavioural and computational studies suggest that access to internal predictive models of arm and object dynamics is widespread in the sensorimotor system. Several systems, including those responsible for oculomotor and skeletomotor control, perceptual processing, postural control and mental imagery, are able to access predictions of the motion of the arm. A capacity to make and use predictions of object dynamics is similarly widespread. Here, we review recent studies looking at the predictive capacity of the central nervous system which reveal pervasive access to forward models of the environment.

Access to Complex Abortion Care Service and Planning Improved through a Toll-Free Telephone Resource Line

PubMed Central

Norman, Wendy V.; Hestrin, Barbara; Dueck, Royce

2014-01-01

Background. Providing equitable access to the full range of reproductive health services over wide geographic areas presents significant challenges to any health system. We present a review of a service provision model which has provided improved access to abortion care; support for complex issues experienced by women seeking nonjudgmental family planning health services; and a mechanism to collect information on access barriers. The toll-free pregnancy options service (POS) of British Columbia Women's Hospital and Health Centre sought to improve access to services and overcome barriers experienced by women seeking abortion. Methods. We describe the development and implementation of a province-wide toll-free telephone counseling and access facilitation service, including establishment of a provincial network of local abortion service providers in the Canadian province of British Columbia from 1998 to 2010. Results. Over 2000 women annually access service via the POS line, networks of care providers are established and linked to central support, and central program planners receive timely information on new service gaps and access barriers. Conclusion. This novel service has been successful in addressing inequities and access barriers identified as priorities before service establishment. The service provided unanticipated benefits to health care planning and monitoring of provincial health care related service delivery and gaps. This model for low cost health service delivery may realize similar benefits when applied to other health care systems where access and referral barriers exist. PMID:24693291

Transcript abundance on its own cannot be used to infer fluxes in central metabolism

DOE PAGES

Schwender, Jorg; Konig, Christina; Klapperstuck, Matthias; ...

2014-11-28

An attempt has been made to define the extent to which metabolic flux in central plant metabolism is reflected by changes in the transcriptome and metabolome, based on an analysis of in vitro cultured immature embryos of two oilseed rape (Brassica napus) accessions which contrast for seed lipid accumulation. Metabolic flux analysis (MFA) was used to constrain a flux balance metabolic model which included 671 biochemical and transport reactions within the central metabolism. This highly confident flux information was eventually used for comparative analysis of flux vs. transcript (metabolite). Metabolite profiling succeeded in identifying 79 intermediates within the central metabolism,more » some of which differed quantitatively between the two accessions and displayed a significant shift corresponding to flux. An RNA-Seq based transcriptome analysis revealed a large number of genes which were differentially transcribed in the two accessions, including some enzymes/proteins active in major metabolic pathways. With a few exceptions, differential activity in the major pathways (glycolysis, TCA cycle, amino acid, and fatty acid synthesis) was not reflected in contrasting abundances of the relevant transcripts. The conclusion was that transcript abundance on its own cannot be used to infer metabolic activity/fluxes in central plant metabolism. Lastly, this limitation needs to be borne in mind in evaluating transcriptome data and designing metabolic engineering experiments.« less

Access to Schooling in a Post-Apartheid South Africa: Linking Concepts to Context

NASA Astrophysics Data System (ADS)

Fataar, Aslam

1997-07-01

This paper focuses on the policy issue of expanding schooling in a post-apartheid South Africa. The Project of placing about two million children of school-going age in school is viewed as central to the rebuilding of South Africa. The paper argues that this project should be located within the peculiar history of this country's educational underdevelopment. Challenging the constraining influence of the New Right context should be central in conceptualising the provision of expanded school access. Access policy should be based on a notion of educational development that is linked to the overall socioeconomic development of this society. The view is promoted in this paper that a policy of quantitative expansion of schooling should not ignore the quality of such schooling.

Peripheral Venous Access Ports: Outcomes Analysis in 109 Patients

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

Bodner, Leonard J.; Nosher, John L.; Patel, Kaushik M.

Purpose: To perform a retrospective outcomes analysis of central venous catheters with peripheral venous access ports, with comparison to published data.Methods: One hundred and twelve central venous catheters with peripherally placed access ports were placed under sonographic guidance in 109 patients over a 4-year period. Ports were placed for the administration of chemotherapy, hyperalimentation, long-term antibiotic therapy, gamma-globulin therapy, and frequent blood sampling. A vein in the upper arm was accessed in each case and the catheter was passed to the superior vena cava or right atrium. Povidone iodine skin preparation was used in the first 65 port insertions. Amore » combination of Iodophor solution and povidone iodine solution was used in the last 47 port insertions. Forty patients received low-dose (1 mg) warfarin sodium beginning the day after port insertion. Three patients received higher doses of warfarin sodium for preexistent venous thrombosis. Catheter performance and complications were assessed and compared with published data.Results: Access into the basilic or brachial veins was obtained in all cases. Ports remained functional for a total of 28,936 patient days. The port functioned in 50% of patients until completion of therapy, or the patient's expiration. Ports were removed prior to completion of therapy in 18% of patients. Eleven patients (9.9% of ports placed) suffered an infectious complication (0.38 per thousand catheter-days)-in nine, at the port implantation site, in two along the catheter. In all 11 instances the port was removed. Port pocket infection in the early postoperative period occurred in three patients (4.7%) receiving a Betadine prep vs two patients (4.2%) receiving a standard O.R. prep. This difference was not statistically significant (p = 0.9). Venous thrombosis occurred in three patients (6.8%) receiving warfarin sodium and in two patients (3%) not receiving warfarin sodium. This difference was not statistically

Dilemma of Access and Provision of Quality Basic Education in Central Region, Ghana

ERIC Educational Resources Information Center

Amakyi, Michael; Ampah-Mensah, Alfred

2016-01-01

A survey research was conducted to find out if reported improvements in access to education in Ghana are reflected in comparable improvements in delivery of quality education. The study examined theoretical constructs on adequacy and quality assurance in education to ascertain the state of quality provision in education, and whether there is a…

Energy access and sustainable development

NASA Astrophysics Data System (ADS)

Kammen, Daniel M.; Alstone, Peter; Gershenson, Dimitry

2015-03-01

With 1.4 billion people lacking electricity to light their homes and provide other basic services, or to conduct business, and all of humanity (and particularly the poor) are in need of a decarbonized energy system can close the energy access gap and protect the global climate system. With particular focus on addressing the energy needs of the underserved, we present an analytical framework informed by historical trends and contemporary technological, social, and institutional conditions that clarifies the heterogeneous continuum of centralized on-grid electricity, autonomous mini- or community grids, and distributed, individual energy services. We find that the current day is a unique moment of innovation in decentralized energy networks based on super-efficient end-use technology and low-cost photovoltaics, supported by rapidly spreading information technology, particularly mobile phones. Collectively these disruptive technology systems could rapidly increase energy access, contributing to meeting the Millennium Development Goals for quality of life, while simultaneously driving action towards low-carbon, Earth-sustaining, energy systems.

Limited school drinking water access for youth

PubMed Central

Kenney, Erica L.; Gortmaker, Steven L.; Cohen, Juliana F.W.; Rimm, Eric B.; Cradock, Angie L.

2016-01-01

PURPOSE Providing children and youth with safe, adequate drinking water access during school is essential for health. This study utilized objectively measured data to investigate the extent to which schools provide drinking water access that meets state and federal policies. METHODS We visited 59 middle and high schools in Massachusetts during spring 2012. Trained research assistants documented the type, location, and working condition of all water access points throughout each school building using a standard protocol. School food service directors (FSDs) completed surveys reporting water access in cafeterias. We evaluated school compliance with state plumbing codes and federal regulations and compared FSD self-reports of water access with direct observation; data were analyzed in 2014. RESULTS On average, each school had 1.5 (SD: 0.6) water sources per 75 students; 82% (SD: 20) were functioning, and fewer (70%) were both clean and functioning. Less than half of the schools met the federal Healthy Hunger Free Kids Act requirement for free water access during lunch; 18 schools (31%) provided bottled water for purchase but no free water. Slightly over half (59%) met the Massachusetts state plumbing code. FSDs overestimated free drinking water access compared to direct observation (96% FSD-reported versus 48% observed, kappa=0.07, p=0.17). CONCLUSIONS School drinking water access may be limited. In this study, many schools did not meet state or federal policies for minimum student drinking water access. School administrative staff may not accurately report water access. Public health action is needed to increase school drinking water access. IMPLICATIONS AND CONTRIBUTIONS Adolescents’ water consumption is lower than recommended. In a sample of Massachusetts middle and high schools, about half did not meet federal and state minimum drinking water access policies. Direct observation may improve assessments of drinking water access and could be integrated into routine

Limited School Drinking Water Access for Youth.

PubMed

Kenney, Erica L; Gortmaker, Steven L; Cohen, Juliana F W; Rimm, Eric B; Cradock, Angie L

2016-07-01

Providing children and youth with safe, adequate drinking water access during school is essential for health. This study used objectively measured data to investigate the extent to which schools provide drinking water access that meets state and federal policies. We visited 59 middle and high schools in Massachusetts during spring 2012. Trained research assistants documented the type, location, and working condition of all water access points throughout each school building using a standard protocol. School food service directors (FSDs) completed surveys reporting water access in cafeterias. We evaluated school compliance with state plumbing codes and federal regulations and compared FSD self-reports of water access with direct observation; data were analyzed in 2014. On average, each school had 1.5 (standard deviation: .6) water sources per 75 students; 82% (standard deviation: 20) were functioning and fewer (70%) were both clean and functioning. Less than half of the schools met the federal Healthy Hunger-Free Kids Act requirement for free water access during lunch; 18 schools (31%) provided bottled water for purchase but no free water. Slightly over half (59%) met the Massachusetts state plumbing code. FSDs overestimated free drinking water access compared to direct observation (96% FSD reported vs. 48% observed, kappa = .07, p = .17). School drinking water access may be limited. In this study, many schools did not meet state or federal policies for minimum student drinking water access. School administrative staff may not accurately report water access. Public health action is needed to increase school drinking water access. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Transit traverse in Missouri, 1900-1937. Part 7, Central Missouri, 1902-37

USGS Publications Warehouse

Staack, John George

1940-01-01

This bulletin, which for convenience is to be published in eight parts, contains the results of all transit traverse* done In Missouri through 1937 by the Geological Survey, United States Department of the Interior, including those heretofore published. (See page X.) Each of the parts deals with one of eight sections into which the State has been divided for this purpose and which have been designated northeastern, northwestern, southeastern, southwestern, central, east-central, south-central, and west-central Missouri. In each part descriptions of the points for which geodetic positions have been determined are listed according to the quadrangles in which the points occur. Results of transit traverse other than that done by the Geological Survey have not been included.Central Missouri, as the term is used in this bulletin and as the subject of part 7 of the bulletin, is that section of the State lying between latitudes 36°00' and 39°30' and between longitudes 92°00' and 93°30'.

Exploitation rates of two benthic resources across management regimes in central Chile: Evidence of illegal fishing in artisanal fisheries operating in open access areas

PubMed Central

Andreu-Cazenave, Miguel; Subida, Maria Dulce; Fernandez, Miriam

2017-01-01

There is an urgent need to quantify the impacts of artisanal fisheries and define management practices that allow for the recovery and conservation of exploited stocks. The extent of illegal catch is particularly critical as a driver of overexploitation in artisanal fisheries. However, the lack of data at proper spatial scales limits the evaluation of illegal fishing and effectiveness of management practices. We used a catch curve analysis to estimate total instantaneous mortality as a proxy of fishing pressure in the artisanal benthic fishery in central Chile. We compared the patterns of total mortality in fishing grounds under the well-studied territorial use rights for fisheries system (TURF) immersed in a landscape of open access areas (OAA; no access restriction), and from these patterns determined the extent of illegal fishing in open access areas focusing on the two most frequently extracted resources: locos (Concholepas concholepas) and keyhole limpets (Fissurella spp.). The beauty of this seascape is the presence of the no-take (NT) area of Las Cruces as control (no fishing), allowing us to estimate natural mortality. Loco exploitation is banned in OAAs. However, loco mortality in OAAs was 92% higher than in the NT, and 42% higher than in TURFs. Keyhole limpet mortality was similar between TURFs and the NT, but doubled in OAAs. We also found strong differences in mortality among fishing grounds with the same level of protection (i.e. TURFs), and over time. Our results highlight (a) the high level of illegal fishing that may occur in artisanal fisheries under traditional management regimes, and (b) that TURFs can be effective to reduce fishing mortality. However, large variability among TURFs suggests the need for a deeper understanding of the drivers of success of TURFs. PMID:28666013

Exploitation rates of two benthic resources across management regimes in central Chile: Evidence of illegal fishing in artisanal fisheries operating in open access areas.

PubMed

Andreu-Cazenave, Miguel; Subida, Maria Dulce; Fernandez, Miriam

2017-01-01

There is an urgent need to quantify the impacts of artisanal fisheries and define management practices that allow for the recovery and conservation of exploited stocks. The extent of illegal catch is particularly critical as a driver of overexploitation in artisanal fisheries. However, the lack of data at proper spatial scales limits the evaluation of illegal fishing and effectiveness of management practices. We used a catch curve analysis to estimate total instantaneous mortality as a proxy of fishing pressure in the artisanal benthic fishery in central Chile. We compared the patterns of total mortality in fishing grounds under the well-studied territorial use rights for fisheries system (TURF) immersed in a landscape of open access areas (OAA; no access restriction), and from these patterns determined the extent of illegal fishing in open access areas focusing on the two most frequently extracted resources: locos (Concholepas concholepas) and keyhole limpets (Fissurella spp.). The beauty of this seascape is the presence of the no-take (NT) area of Las Cruces as control (no fishing), allowing us to estimate natural mortality. Loco exploitation is banned in OAAs. However, loco mortality in OAAs was 92% higher than in the NT, and 42% higher than in TURFs. Keyhole limpet mortality was similar between TURFs and the NT, but doubled in OAAs. We also found strong differences in mortality among fishing grounds with the same level of protection (i.e. TURFs), and over time. Our results highlight (a) the high level of illegal fishing that may occur in artisanal fisheries under traditional management regimes, and (b) that TURFs can be effective to reduce fishing mortality. However, large variability among TURFs suggests the need for a deeper understanding of the drivers of success of TURFs.

[Dental arch form reverting by four-point method].

PubMed

Pan, Xiao-Gang; Qian, Yu-Fen; Weng, Si-En; Feng, Qi-Ping; Yu, Quan

2008-04-01

To explore a simple method of reverting individual dental arch form template for wire bending. Individual dental arch form was reverted by four-point method. By defining central point of bracket on bilateral lower second premolar and first molar, certain individual dental arch form could be generated. The arch form generating procedure was then be developed to computer software for printing arch form. Four-point method arch form was evaluated by comparing with direct model measurement on linear and angular parameters. The accuracy and reproducibility were assessed by paired t test and concordance correlation coefficient with Medcalc 9.3 software package. The arch form by four-point method was of good accuracy and reproducibility (linear concordance correlation coefficient was 0.9909 and angular concordance correlation coefficient was 0.8419). The dental arch form reverted by four-point method could reproduce the individual dental arch form.

A note on libration point orbits, temporary capture and low-energy transfers

NASA Astrophysics Data System (ADS)

Fantino, E.; Gómez, G.; Masdemont, J. J.; Ren, Y.

2010-11-01

In the circular restricted three-body problem (CR3BP) the weak stability boundary (WSB) is defined as a boundary set in the phase space between stable and unstable motion relative to the second primary. At a given energy level, the boundaries of such region are provided by the stable manifolds of the central objects of the L1 and L2 libration points, i.e., the two planar Lyapunov orbits. Besides, the unstable manifolds of libration point orbits (LPOs) around L1 and L2 have been identified as responsible for the weak or temporary capture around the second primary of the system. These two issues suggest the existence of natural dynamical channels between the Earth's vicinity and the Sun-Earth libration points L1 and L2. Furthermore, it has been shown that the Sun-Earth L2 central unstable manifolds can be linked, through an heteroclinic connection, to the central stable manifolds of the L2 point in the Earth-Moon three-body problem. This concept has been applied to the design of low energy transfers (LETs) from the Earth to the Moon. In this contribution we consider all the above three issues, i.e., weak stability boundaries, temporary capture and low energy transfers, and we discuss the role played by the invariant manifolds of LPOs in each of them. The study is made in the planar approximation.

Access to hepatitis C medicines

PubMed Central

Coppens, Delphi GM; Prasad, Tara L; Rook, Laurien A; Iyer, Jayasree K

2015-01-01

Abstract Hepatitis C is a global epidemic. Worldwide, 185 million people are estimated to be infected, most of whom live in low- and middle-income countries. Recent advances in the development of antiviral drugs have produced therapies that are more effective, safer and better tolerated than existing treatments for the disease. These therapies present an opportunity to curb the epidemic, provided that they are affordable, that generic production of these medicines is scaled up and that awareness and screening programmes are strengthened. Pharmaceutical companies have a central role to play. We examined the marketed products, pipelines and access to medicine strategies of 20 of the world’s largest pharmaceutical companies. Six of these companies are developing medicines for hepatitis C: AbbVie, Bristol-Myers Squibb, Gilead, Johnson & Johnson, Merck & Co. and Roche. These companies employ a range of approaches to supporting hepatitis C treatment, including pricing strategies, voluntary licensing, capacity building and drug donations. We give an overview of the engagement of these companies in addressing access to hepatitis C products. We suggest actions companies can take to play a greater role in curbing this epidemic: (i) prioritizing affordability assessments; (ii) developing access strategies early in the product lifecycle; and (iii) licensing to manufacturers of generic medicines. PMID:26549908

Access to hepatitis C medicines.

PubMed

Edwards, Danny J; Coppens, Delphi Gm; Prasad, Tara L; Rook, Laurien A; Iyer, Jayasree K

2015-11-01

Hepatitis C is a global epidemic. Worldwide, 185 million people are estimated to be infected, most of whom live in low- and middle-income countries. Recent advances in the development of antiviral drugs have produced therapies that are more effective, safer and better tolerated than existing treatments for the disease. These therapies present an opportunity to curb the epidemic, provided that they are affordable, that generic production of these medicines is scaled up and that awareness and screening programmes are strengthened. Pharmaceutical companies have a central role to play. We examined the marketed products, pipelines and access to medicine strategies of 20 of the world's largest pharmaceutical companies. Six of these companies are developing medicines for hepatitis C: AbbVie, Bristol-Myers Squibb, Gilead, Johnson & Johnson, Merck & Co. and Roche. These companies employ a range of approaches to supporting hepatitis C treatment, including pricing strategies, voluntary licensing, capacity building and drug donations. We give an overview of the engagement of these companies in addressing access to hepatitis C products. We suggest actions companies can take to play a greater role in curbing this epidemic: (i) prioritizing affordability assessments; (ii) developing access strategies early in the product lifecycle; and (iii) licensing to manufacturers of generic medicines.

Productivity Measures Associated With a Patient Access Initiative

PubMed Central

Gable, William H.; Pappas, Theodore N.; Jacobs, Danny O.; Cutler, Desmond A.; Kuo, Paul C.

2006-01-01

Objective: To assess financial performance associated with a patient 7-day access initiative. Background Data: Patient access to clinical services is frequently an obstacle at academic medical centers. Conflicting surgeon priorities among academic, clinical, educational, and leadership duties often create difficulties for patient entry into the “system.” Methods: The scope and objectives were identified to be: design of a standard, simple new patient appointment process, design of a standard process in cases where an appointment is not available in 7 days, use subspecialty team search capabilities, minimize/eliminate prescheduling requirements, centralize appointment scheduling, and creation and reporting of 7-day access metrics. Following maturation of the process, the 7-day access metrics from the period July 2004 to December 2004 and January 2005 to June 2005 were compared with corresponding time periods from calendar years 2001, 2002, and 2003. Results: Payor mix was unaltered. The median waiting time for a new patient appointment decreased from 21 days to 10 days. When compared with calendar years 2001, 2002, and 2003, respectively, the 2 periods of the 7-day access initiative in calendar years 2004 and 2005 were associated with significantly increased visits, new patients, operative procedures, hospital charges, and physician charges. Conclusions: Implementation of a 7-day access initiative can significantly increase financial productivity of general surgery groups in academic medical centers. We conclude that simplifying access to services can benefit academic surgical practices. Sustaining this level of productivity will continue to prove challenging. PMID:16632994

A New Experimental Device for Transapical Access of the Aortic and Mitral Valves as well as the Aorta in its Various Segments.

PubMed

Paim, Leonardo; Fonseca, José Honório Palma da; Arruda, Francismar Vidal de; Gutierrez, Paulo Sampaio; Moreira, Luiz Felipe Pinho; Jatene, Fabio Biscegli

2017-01-01

To present the results of a new experimental device developed to facilitate the transapical access in endovascular treatment of structural heart diseases. It aims to reduce the risk of bleeding and complications in this type of access and demonstrate the device as a safe, fast and effective alternative. CorPoint is composed of three parts: introducer, base with coiled spring, and closing capsule. By rotating movements, the spring is introduced into the myocardium and progressively approaches the base to the surface of the heart. Guidewires and catheters are inserted through the hollow central part and, at the end of the procedure, the capsule is screwed over the base, therefore stopping any bleeding. The device was implanted in 15 pigs, weighing 60 kg each, through an anterolateral thoracotomy, while catheters were introduced and guided by fluoroscopy. All animals had minimal bleeding; introducers with diameter up to 22 Fr were used and various catheters and guidewires were easily handled. After finishing the procedure, the closing capsule was attached and no bleeding was observed at the site. This new device has proved effective, fast and secure for the transapical access. This shows great potential for use, especially by ensuring an easier and direct access to the mitral and aortic valves; the shortest distance to be traveled by catheters; access to the ascending and descending aorta; decreased bleeding complications; decreased surgical time; and the possibility of allowing the technique to evolve and become totally percutaneous.

Multi-modal two-step floating catchment area analysis of primary health care accessibility.

PubMed

Langford, Mitchel; Higgs, Gary; Fry, Richard

2016-03-01

Two-step floating catchment area (2SFCA) techniques are popular for measuring potential geographical accessibility to health care services. This paper proposes methodological enhancements to increase the sophistication of the 2SFCA methodology by incorporating both public and private transport modes using dedicated network datasets. The proposed model yields separate accessibility scores for each modal group at each demand point to better reflect the differential accessibility levels experienced by each cohort. An empirical study of primary health care facilities in South Wales, UK, is used to illustrate the approach. Outcomes suggest the bus-riding cohort of each census tract experience much lower accessibility levels than those estimated by an undifferentiated (car-only) model. Car drivers' accessibility may also be misrepresented in an undifferentiated model because they potentially profit from the lower demand placed upon service provision points by bus riders. The ability to specify independent catchment sizes for each cohort in the multi-modal model allows aspects of preparedness to travel to be investigated. Copyright © 2016. Published by Elsevier Ltd.

Open Access: A User Information System. Professional Paper Series, #6.

ERIC Educational Resources Information Center

Gleason, Bernard W.

Focusing on the need for information systems that provide faculty, staff, and students with open access to all necessary information resources, this paper begins by discussing the issues involved in developing such systems. A review of the traditional environment looks at the traditional centralized resources versus the current trend toward…

[Central diabetes insipidus: diagnostic difficulties].

PubMed

Matoussi, N; Aissa, K; Fitouri, Z; Hajji, M; Makni, S; Bellagha, I; Ben Becher, S

2008-06-01

Central diabetes insipidus is rare in children. Characteristic features include polyuria and polydipsia due to arginine vasopressin deficiency. The differential diagnosis of polyuric states may be difficult. Etiologic diagnosis of central diabetes insipidus may be an equally difficult task. To specify the difficulties encountered in the diagnosis of central diabetes insipidus and to point out features of the etiologic work-up and of long-term follow-up of children with idiopathic central diabetes insipidus. A retrospective study of 12 children admitted with a polyuria/polydipsia syndrome to the pediatric - consultation and emergency unit of the children's hospital of Tunis between 1988 and 2005. Children with acquired nephrogenic central diabetes insipidus were excluded. Fourteen-hour fluid restriction test and/or desmopressin test were used without plasma vasopressin measurement. Eight patients were classified as having central diabetes insipidus, which was severe in seven children and partial in one girl. One patient was classified as having primary polydipsia. The diagnosis remains unclear in three patients. The etiological work-up in eight patients with central diabetes insipidus enabled the identification of Langerhan's-cell histiocytosis in two patients and neurosurgical trauma in one. The cause was considered idiopathic in five patients. The median follow-up of the five patients with idiopathic central diabetes insipidus was five years two months plus or minus six years seven months (range five months, 14.5 years). During this follow-up, neither brain magnetic resonance imaging scans findings nor anterior pituitary function have changed. Fluid restriction and desmopressin tests did not enable an accurate distinction between partial diabetes insipidus and primary polydipsia. Regular surveillance is warranted in patients with idiopathic central diabetes insipidus to identify potential etiologies.

Automatic Monitoring of Tunnel Deformation Based on High Density Point Clouds Data

NASA Astrophysics Data System (ADS)

Du, L.; Zhong, R.; Sun, H.; Wu, Q.

2017-09-01

An automated method for tunnel deformation monitoring using high density point clouds data is presented. Firstly, the 3D point clouds data are converted to two-dimensional surface by projection on the XOY plane, the projection point set of central axis on XOY plane named Uxoy is calculated by combining the Alpha Shape algorithm with RANSAC (Random Sampling Consistency) algorithm, and then the projection point set of central axis on YOZ plane named Uyoz is obtained by highest and lowest points which are extracted by intersecting straight lines that through each point of Uxoy and perpendicular to the two -dimensional surface with the tunnel point clouds, Uxoy and Uyoz together form the 3D center axis finally. Secondly, the buffer of each cross section is calculated by K-Nearest neighbor algorithm, and the initial cross-sectional point set is quickly constructed by projection method. Finally, the cross sections are denoised and the section lines are fitted using the method of iterative ellipse fitting. In order to improve the accuracy of the cross section, a fine adjustment method is proposed to rotate the initial sectional plane around the intercept point in the horizontal and vertical direction within the buffer. The proposed method is used in Shanghai subway tunnel, and the deformation of each section in the direction of 0 to 360 degrees is calculated. The result shows that the cross sections becomes flat circles from regular circles due to the great pressure at the top of the tunnel

Introduction to the LaRC central scientific computing complex

NASA Technical Reports Server (NTRS)

Shoosmith, John N.

1993-01-01

The computers and associated equipment that make up the Central Scientific Computing Complex of the Langley Research Center are briefly described. The electronic networks that provide access to the various components of the complex and a number of areas that can be used by Langley and contractors staff for special applications (scientific visualization, image processing, software engineering, and grid generation) are also described. Flight simulation facilities that use the central computers are described. Management of the complex, procedures for its use, and available services and resources are discussed. This document is intended for new users of the complex, for current users who wish to keep appraised of changes, and for visitors who need to understand the role of central scientific computers at Langley.

FNAL central email systems

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

Schmidt, Jack; Lilianstrom, Al; Pasetes, Ray

2004-10-01

The FNAL Email System is the primary point of entry for email destined for an employee or user at Fermilab. This centrally supported system is designed for reliability and availability. It uses multiple layers of protection to help ensure that: (1) SPAM messages are tagged properly; (2) All mail is inspected for viruses; and (3) Valid mail gets delivered. This system employs numerous redundant subsystems to accomplish these tasks.

Access technique and its problems in parenteral nutrition – Guidelines on Parenteral Nutrition, Chapter 9

PubMed Central

Jauch, K. W.; Schregel, W.; Stanga, Z.; Bischoff, S. C.; Braß, P.; Hartl, W.; Muehlebach, S.; Pscheidl, E.; Thul, P.; Volk, O.

2009-01-01

Catheter type, access technique, and the catheter position should be selected considering to the anticipated duration of PN aiming at the lowest complication risks (infectious and non-infectious). Long-term (>7–10 days) parenteral nutrition (PN) requires central venous access whereas for PN <3 weeks percutaneously inserted catheters and for PN >3 weeks subcutaneous tunnelled catheters or port systems are appropriate. CVC (central venous catheter) should be flushed with isotonic NaCl solution before and after PN application and during CVC occlusions. Strict indications are required for central venous access placement and the catheter should be removed as soon as possible if not required any more. Blood samples should not to be taken from the CVC. If catheter infection is suspected, peripheral blood-culture samples and culture samples from each catheter lumen should be taken simultaneously. Removal of the CVC should be carried out immediately if there are pronounced signs of local infection at the insertion site and/or clinical suspicion of catheter-induced sepsis. In case PN is indicated for a short period (max. 7–10 days), a peripheral venous access can be used if no hyperosmolar solutions (>800 mosm/L) or solutions with a high titration acidity or alkalinity are used. A peripheral venous catheter (PVC) can remain in situ for as long as it is clinically required unless there are signs of inflammation at the insertion site. PMID:20049083

Performance of an optical equalizer in a 10 G wavelength converting optical access network.

PubMed

Mendinueta, José Manuel D; Cao, Bowen; Thomsen, Benn C; Mitchell, John E

2011-12-12

A centralized optical processing unit (COPU) that functions both as a wavelength converter (WC) and optical burst equaliser in a 10 Gb/s wavelength-converting optical access network is proposed and experimentally characterized. This COPU is designed to consolidate drifting wavelengths generated with an uncooled laser in the upstream direction into a stable wavelength channel for WDM backhaul transmission and to equalize the optical loud/soft burst power in order to relax the burst-mode receiver dynamic range requirement. The COPU consists of an optical power equaliser composed of two cascaded SOAs followed by a WC. Using an optical packet generator and a DC-coupled PIN-based digital burst-mode receiver, the COPU is characterized in terms of payload-BER for back-to-back and backhaul transmission distances of 22, 40, and 62 km. We show that there is a compromise between the receiver sensitivity and overload points that can be optimized tuning the WC operating point for a particular backhaul fiber transmission distance. Using the optimized settings, sensitivities of -30.94, -30.17, and -27.26 dBm with overloads of -9.3, -5, and >-5 dBm were demonstrated for backhaul transmission distances of 22, 40 and 62 km, respectively. © 2011 Optical Society of America

A Seamless Handoff Scheme with Access Point Load Balance for Real-Time Services Support in 802.11 Wireless LANs

NASA Astrophysics Data System (ADS)

Manodham, Thavisak; Loyola, Luis; Miki, Tetsuya

IEEE 802.11 wirelesses LANs (WLANs) have been rapidly deployed in enterprises, public areas, and households. Voice-over-IP (VoIP) and similar applications are now commonly used in mobile devices over wireless networks. Recent works have improved the quality of service (QoS) offering higher data rates to support various kinds of real-time applications. However, besides the need for higher data rates, seamless handoff and load balancing among APs are key issues that must be addressed in order to continue supporting real-time services across wireless LANs and providing fair services to all users. In this paper, we introduce a novel access point (AP) with two transceivers that improves network efficiency by supporting seamless handoff and traffic load balancing in a wireless network. In our proposed scheme, the novel AP uses the second transceiver to scan and find neighboring STAs in the transmission range and then sends the results to neighboring APs, which compare and analyze whether or not the STA should perform a handoff. The initial results from our simulations show that the novel AP module is more effective than the conventional scheme and a related work in terms of providing a handoff process with low latency and sharing traffic load with neighbor APs.

Data bases for forest inventory in the North-Central Region.

Treesearch

Jerold T. Hahn; Mark H. Hansen

1985-01-01

Describes the data collected by the Forest Inventory and Analysis (FIA) Research Work Unit at the North Central Forest Experiment Station. Explains how interested parties may obtain information from the databases either through direct access or by special requests to the FIA database manager.

Modeling fixation locations using spatial point processes.

PubMed

Barthelmé, Simon; Trukenbrod, Hans; Engbert, Ralf; Wichmann, Felix

2013-10-01

Whenever eye movements are measured, a central part of the analysis has to do with where subjects fixate and why they fixated where they fixated. To a first approximation, a set of fixations can be viewed as a set of points in space; this implies that fixations are spatial data and that the analysis of fixation locations can be beneficially thought of as a spatial statistics problem. We argue that thinking of fixation locations as arising from point processes is a very fruitful framework for eye-movement data, helping turn qualitative questions into quantitative ones. We provide a tutorial introduction to some of the main ideas of the field of spatial statistics, focusing especially on spatial Poisson processes. We show how point processes help relate image properties to fixation locations. In particular we show how point processes naturally express the idea that image features' predictability for fixations may vary from one image to another. We review other methods of analysis used in the literature, show how they relate to point process theory, and argue that thinking in terms of point processes substantially extends the range of analyses that can be performed and clarify their interpretation.

Totally implantable system for peritoneal access.

PubMed

Pfeifle, C E; Howell, S B; Markman, M; Lucas, W E

1984-11-01

A totally implantable system for providing access to the peritoneal cavity was evaluated. Fifty-six Port-A-Cath (Pharmacia Nu Tech, Piscataway, NJ) peritoneal access systems were implanted in 54 cancer patients receiving intraperitoneal chemotherapy. The catheters are accessed by transcutaneous placement of a Huber point needle through a silicone septum at the top of the portal. A total of 32 patient years of experience are reported. The Port-A-Caths have been in place for a median of 22 weeks (range, one to 85). A total of 401 entries have been made for paracentesis, chemotherapy administration, antibiotic administration, peritoneal lavage for cytology, and catheter flushing. There have been six episodes of peritonitis (five Staphylococcus epidermidis, one S aureus) in three patients. There have been no mechanical failures of the Port-A-Caths. Loss of bidirectional flow through the catheter due to fibrin deposition about the catheter has been the major cause of catheter failure. Patient acceptance of the Port-A-Cath has been excellent.

Quantifying Access Disparities in Response Plans

PubMed Central

Indrakanti, Saratchandra; Mikler, Armin R.; O’Neill, Martin; Tiwari, Chetan

2016-01-01

Effective response planning and preparedness are critical to the health and well-being of communities in the face of biological emergencies. Response plans involving mass prophylaxis may seem feasible when considering the choice of dispensing points within a region, overall population density, and estimated traffic demands. However, the plan may fail to serve particular vulnerable subpopulations, resulting in access disparities during emergency response. For a response plan to be effective, sufficient mitigation resources must be made accessible to target populations within short, federally-mandated time frames. A major challenge in response plan design is to establish a balance between the allocation of available resources and the provision of equal access to PODs for all individuals in a given geographic region. Limitations on the availability, granularity, and currency of data to identify vulnerable populations further complicate the planning process. To address these challenges and limitations, data driven methods to quantify vulnerabilities in the context of response plans have been developed and are explored in this article. PMID:26771551

Research on centrality of urban transport network nodes

NASA Astrophysics Data System (ADS)

Wang, Kui; Fu, Xiufen

2017-05-01

Based on the actual data of urban transport in Guangzhou, 19,150 bus stations in Guangzhou (as of 2014) are selected as nodes. Based on the theory of complex network, the network model of Guangzhou urban transport is constructed. By analyzing the degree centrality index, betweenness centrality index and closeness centrality index of nodes in the network, the level of centrality of each node in the network is studied. From a different point of view to determine the hub node of Guangzhou urban transport network, corresponding to the city's key sites and major transfer sites. The reliability of the network is determined by the stability of some key nodes (transport hub station). The research of network node centralization can provide a theoretical basis for the rational allocation of urban transport network sites and public transport system planning.

Central obscuration effects on optical synthetic aperture imaging

NASA Astrophysics Data System (ADS)

Wang, Xue-wen; Luo, Xiao; Zheng, Li-gong; Zhang, Xue-jun

2014-02-01

Due to the central obscuration problem exists in most optical synthetic aperture systems, it is necessary to analyze its effects on their image performance. Based on the incoherent diffraction limited imaging theory, a Golay-3 type synthetic aperture system was used to study the central obscuration effects on the point spread function (PSF) and the modulation transfer function (MTF). It was found that the central obscuration does not affect the width of the central peak of the PSF and the cutoff spatial frequency of the MTF, but attenuate the first sidelobe of the PSF and the midfrequency of the MTF. The imaging simulation of a Golay-3 type synthetic aperture system with central obscuration proved this conclusion. At last, a Wiener Filter restoration algorithm was used to restore the image of this system, the images were obviously better.

Abortion in Australia: access versus protest.

PubMed

Dean, Rebecca Elizabeth; Allanson, Susie

2004-05-01

Currently in Australia anti-choice protesters' right to freedom of speech and freedom to protest is privileged over a woman's right to privacy and to access a health service safely, free from harassment, intimidation and obstruction. This article considers how this situation is played out daily at one Victorian abortion-providing clinic. The Fertility Control Clinic was thrown into the spotlight after the murder of its security guard by an anti-choice crusader in July 2001. Australian common law appears not to offer women protection from anti-choice protesters. By contrast, United States and Canadian "bubble" legislation sits comfortably with key constitutional rights. It would be a useful development if Australian governments passed legislation to ensure the rights, wellbeing and safety of Australian women accessing health services. Such legislation would be another step away from the misogynistic and androcentric values once central to our legislative framework.

Turning Access into a web-enabled secure information system for clinical trials.

PubMed

Dongquan Chen; Chen, Wei-Bang; Soong, Mayhue; Soong, Seng-Jaw; Orthner, Helmuth F

2009-08-01

Organizations that have limited resources need to conduct clinical studies in a cost-effective, but secure way. Clinical data residing in various individual databases need to be easily accessed and secured. Although widely available, digital certification, encryption, and secure web server, have not been implemented as widely, partly due to a lack of understanding of needs and concerns over issues such as cost and difficulty in implementation. The objective of this study was to test the possibility of centralizing various databases and to demonstrate ways of offering an alternative to a large-scale comprehensive and costly commercial product, especially for simple phase I and II trials, with reasonable convenience and security. We report a working procedure to transform and develop a standalone Access database into a secure Web-based secure information system. For data collection and reporting purposes, we centralized several individual databases; developed, and tested a web-based secure server using self-issued digital certificates. The system lacks audit trails. The cost of development and maintenance may hinder its wide application. The clinical trial databases scattered in various departments of an institution could be centralized into a web-enabled secure information system. The limitations such as the lack of a calendar and audit trail can be partially addressed with additional programming. The centralized Web system may provide an alternative to a comprehensive clinical trial management system.

Telemedicine broadening access to care for complex cases.

PubMed

Jue, Joshua S; Spector, Sydney A; Spector, Seth A

2017-12-01

Surgical and nonsurgical specialists are highly centralized, making access to high-quality care difficult for many Americans. We explored the feasibility, benefits, preliminary outcomes, and patient satisfaction with a new type of health visit, in which a surgical oncologist used video telecommunication to manage and treat complex cancer diseases, including patients with severe comorbidities. Patients visited local VA medical centers throughout Florida to engage in video telecommunication visits with a centralized surgical oncologist in Miami, who directed their oncology treatment. The average length of stay and rate of unplanned readmission were calculated within each organ. The total mileage saved was calculated by subtracting the distance between the patient's home address and the local VA from the distance between the patient's home address and the Miami VA. Travel costs were determined by the VA's reimbursement of $0.415/mile for health-related travel and reimbursement of $150.00 for an overnight hotel stay. A Likert scale with both positively and negatively keyed questions was used to assess patient satisfaction. In 24 mo, seven unplanned readmissions occurred among 195 operations. Patients experienced an 80.7% reduction in travel distance and saved a total of 213,007.58 miles by visiting their local VA instead of the Miami VA. Survey results indicate that 86% of patients believed that the telemedicine program made medical care more accessible. The Specialist-Directed Telemedicine Model can save patients substantial time and money by not traveling to centralized areas, while delivering greater continuity of care and patient satisfaction. Copyright © 2017 Elsevier Inc. All rights reserved.

Accuracy assessment of minimum control points for UAV photography and georeferencing

NASA Astrophysics Data System (ADS)

Skarlatos, D.; Procopiou, E.; Stavrou, G.; Gregoriou, M.

2013-08-01

In recent years, Autonomous Unmanned Aerial Vehicles (AUAV) became popular among researchers across disciplines because they combine many advantages. One major application is monitoring and mapping. Their ability to fly beyond eye sight autonomously, collecting data over large areas whenever, wherever, makes them excellent platform for monitoring hazardous areas or disasters. In both cases rapid mapping is needed while human access isn't always a given. Indeed, current automatic processing of aerial photos using photogrammetry and computer vision algorithms allows for rapid orthophomap production and Digital Surface Model (DSM) generation, as tools for monitoring and damage assessment. In such cases, control point measurement using GPS is either impossible, or time consuming or costly. This work investigates accuracies that can be attained using few or none control points over areas of one square kilometer, in two test sites; a typical block and a corridor survey. On board GPS data logged during AUAV's flight are being used for direct georeferencing, while ground check points are being used for evaluation. In addition various control point layouts are being tested using bundle adjustment for accuracy evaluation. Results indicate that it is possible to use on board single frequency GPS for direct georeferencing in cases of disaster management or areas without easy access, or even over featureless areas. Due to large numbers of tie points in the bundle adjustment, horizontal accuracy can be fulfilled with a rather small number of control points, but vertical accuracy may not.

Unbundling in Current Broadband and Next-Generation Ultra-Broadband Access Networks

NASA Astrophysics Data System (ADS)

Gaudino, Roberto; Giuliano, Romeo; Mazzenga, Franco; Valcarenghi, Luca; Vatalaro, Francesco

2014-05-01

This article overviews the methods that are currently under investigation for implementing multi-operator open-access/shared-access techniques in next-generation access ultra-broadband architectures, starting from the traditional "unbundling-of-the-local-loop" techniques implemented in legacy twisted-pair digital subscriber line access networks. A straightforward replication of these copper-based unbundling-of-the-local-loop techniques is usually not feasible on next-generation access networks, including fiber-to-the-home point-to-multipoint passive optical networks. To investigate this issue, the article first gives a concise description of traditional copper-based unbundling-of-the-local-loop solutions, then focalizes on both next-generation access hybrid fiber-copper digital subscriber line fiber-to-the-cabinet scenarios and on fiber to the home by accounting for the mix of regulatory and technological reasons driving the next-generation access migration path, focusing mostly on the European situation.

Advanced Stent Graft Treatment of Venous Stenosis Affecting Hemodialysis Vascular Access: Case Illustrations

PubMed Central

Patel, Darshan; Ray, Charles E.; Lokken, R. Peter; Bui, James T.; Lipnik, Andrew J.; Gaba, Ron C.

2016-01-01

Surgically placed dialysis access is an important component of dialysis replacement therapy. The vast majority of patients undergoing dialysis will have surgically placed accesses at some point in the course of their disease, and for many patients these accesses may represent their definitive renal replacement option. Most, if not all, arteriovenous fistulae and grafts will require interventions at some point in time. Percutaneous angioplasty is the typical first treatment performed for venous stenoses, with stents and stent grafts being reserved for patients in whom angioplasty and surgical options are exhausted. In some salvage situations, stent graft placement may be the only or best option for patients. This article describes, using case illustrations, placement of stent grafts in such patients; a focus will also be made on the techniques utilized in such salvage situations. PMID:27011426

Health information needs of professional nurses required at the point of care.

PubMed

Ricks, Esmeralda; ten Ham, Wilma

2015-06-11

Professional nurses work in dynamic environments and need to keep up to date with relevant information for practice in nursing to render quality patient care. Keeping up to date with current information is often challenging because of heavy workload, diverse information needs and the accessibility of the required information at the point of care. The aim of the study was to explore and describe the information needs of professional nurses at the point of care in order to make recommendations to stakeholders to develop a mobile library accessible by means of smart phones when needed. The researcher utilised a quantitative, descriptive survey design to conduct this study. The target population comprised 757 professional nurses employed at a state hospital. Simple random sampling was used to select a sample of the wards, units and departments for inclusion in the study. A convenience sample of 250 participants was selected. Two hundred and fifty structured self-administered questionnaires were distributed amongst the participants. Descriptive statistics were used to analyse the data. A total of 136 completed questionnaires were returned. The findings highlighted the types and accessible sources of information. Information needs of professional nurses were identified such as: extremely drug-resistant tuberculosis, multi-drug-resistant tuberculosis, HIV, antiretrovirals and all chronic lifestyle diseases. This study has enabled the researcher to identify the information needs required by professional nurses at the point of care to enhance the delivery of patient care. The research results were used to develop a mobile library that could be accessed by professional nurses.

Quality assurance for HIV point-of-care testing and treatment monitoring assays

PubMed Central

Sandstrom, Paul; Denny, Thomas N.; Hurlston, Mackenzie; Ball, Terry B.; Peeling, Rosanna W.; Boeras, Debrah I.

2016-01-01

In 2015, UNAIDS launched the 90-90-90 targets aimed at increasing the number of people infected with HIV to become aware of their status, access antiretroviral therapies and ultimately be virally suppressed. To achieve these goals, countries may need to scale up point-of-care (POC) testing in addition to strengthening central laboratory services. While decentralising testing increases patient access to diagnostics, it presents many challenges with regard to training and assuring the quality of tests and testing. To ensure synergies, the London School of Hygiene & Tropical Medicine held a series of consultations with countries with an interest in quality assurance and their implementing partners, and agreed on an external quality assessment (EQA) programme to ensure reliable results so that the results lead to the best possible care for HIV patients. As a result of the consultations, EQA International was established, bringing together EQA providers and implementers to develop a strategic plan for countries to establish national POC EQA programmes and to estimate the cost of setting up and maintaining the programme. With the dramatic increase in the number of proficiency testing panels required for thousands of POC testing sites across Africa, it is important to facilitate technology transfer from global EQA providers to a network of regional EQA centres in Africa for regional proficiency testing panel production. EQA International will continue to identify robust and cost-effective EQA technologies for quality POC testing, integrating novel technologies to support sustainable country-owned EQA programmes in Africa. PMID:28879133

Point-of-care oral-based diagnostics

PubMed Central

Hart, RW; Mauk, MG; Liu, C; Qiu, X; Thompson, JA; Chen, D; Malamud, D; Abrams, WR; Bau, HH

2014-01-01

Many of the target molecules that reside in blood are also present in oral fluids, albeit at lower concentrations. Oral fluids are, however, relatively easy and safe to collect without the need for specialized equipment and training. Thus, oral fluids provide convenient samples for medical diagnostics. Recent advances in lab-on-a-chip technologies have made minute, fully integrated diagnostic systems practical for an assortment of point-of-care tests. Such systems can perform either immunoassays or molecular diagnostics outside centralized laboratories within time periods ranging from minutes to an hour. The article briefly reviews recent advances in devices for point-of-care testing with a focus on work that has been carried out by the authors as part of a NIH program. PMID:21521419

A preliminary report on the genetic variation in pointed gourd (Trichosanthes dioica Roxb.) as assessed by random amplified polymorphic DNA.

PubMed

Adhikari, S; Biswas, A; Bandyopadhyay, T K; Ghosh, P D

2014-06-01

Pointed gourd (Trichosanthes dioica Roxb.) is an economically important cucurbit and is extensively propagated through vegetative means, viz vine and root cuttings. As the accessions are poorly characterized it is important at the beginning of a breeding programme to discriminate among available genotypes to establish the level of genetic diversity. The genetic diversity of 10 pointed gourd races, referred to as accessions was evaluated. DNA profiling was generated using 10 sequence independent RAPD markers. A total of 58 scorable loci were observed out of which 18 (31.03%) loci were considered polymorphic. Genetic diversity parameters [average and effective number of alleles, Shannon's index, percent polymorphism, Nei's gene diversity, polymorphic information content (PIC)] for RAPD along with UPGMA clustering based on Jaccard's coefficient were estimated. The UPGMA dendogram constructed based on RAPD analysis in 10 pointed gourd accessions were found to be grouped in a single cluster and may represent members of one heterotic group. RAPD analysis showed promise as an effective tool in estimating genetic polymorphism in different accessions of pointed gourd.

Removal of central obscuration and spiders for coronagraphy

NASA Astrophysics Data System (ADS)

Abe, L.; Nishikawa, J.; Murakami, N.; Tamura, M.

2006-06-01

We present a method to remove the central obscuration and spiders, or any kind of geometry inside a telescope pupil. The technique relies on the combination of a first focal plane diffracting mask, and a complex amplitude pupil mask. In this combination, the central obscuration and eventual spider arms patterns in the re-imaged pupil (after the diffracting mask) are filled with coherent light. Adding an appropriate complex amplitude pupil mask allows virtually any kind of pupil shaping (in both amplitude and/or phase). We show that the obtained output pupil can feed a high efficiency coronagraph (any kind) with a very reasonable overall throughput and good performance even when considering pointing errors. In this paper, we specifically assess the performance of this technique when using apodized entrance pupils. This technique is relevant for ground based telescopes foreseeing the advent of higher order (so called ExAO) adaptive optics systems providing very high Strehl ratios. Some feasibility points are also discussed. adaptive optics systems providing very high Strehl ratios. Some feasibility points are also discussed.

Transit traverse in Missouri, 1900-1937. Part 8, West-central Missouri, 1906-37

USGS Publications Warehouse

Staack, John G.

1940-01-01

This bulletin, which for convenience is to be published in eight parts, contains the results of all transit traverse* done In Missouri through 1937 by the Geological Survey, United States Department of the Interior, including those heretofore published. (See page X.) Each of the parts deals with one of eight sections into which the State has been divided for this purpose and which have been designated northeastern, northwestern, southeastern, southwestern, central, east-central, south-central, and west-central Missouri. In each part descriptions of the points for which geodetic positions have been determined are listed according to the quadrangles in which the points occur. Results of transit traverse other than that done by the Geological Survey have not been included.West-central Missouri, as the term is used in this bulletin and as the subject of part 8 of the bulletin, is that section of the State lying between latitudes 38°00' and 39°30' and west of longitude 93°30'.

Low-cost fluorescence microscopy for point-of-care cell imaging

NASA Astrophysics Data System (ADS)

Lochhead, Michael J.; Ives, Jeff; Givens, Monique; Delaney, Marie; Moll, Kevin; Myatt, Christopher J.

2010-02-01

Fluorescence microscopy has long been a standard tool in laboratory medicine. Implementation of fluorescence microscopy for near-patient diagnostics, however, has been limited due to cost and complexity associated with traditional fluorescence microscopy techniques. There is a particular need for robust, low-cost imaging in high disease burden areas in the developing world, where access to central laboratory facilities and trained staff is limited. Here we describe a point-of-care assay that combines a disposable plastic cartridge with an extremely low cost fluorescence imaging instrument. Based on a novel, multi-mode planar waveguide configuration, the system capitalizes on advances in volume-manufactured consumer electronic components to deliver an imaging system with minimal moving parts and low power requirements. A two-color cell imager is presented, with magnification optimized for enumeration of immunostained human T cells. To demonstrate the system, peripheral blood mononuclear cells were stained with fluorescently labeled anti-human-CD4 and anti-human-CD3 antibodies. Registered images were used to generate fractional CD4+ and CD3+ staining and enumeration results that show excellent correlation with flow cytometry. The cell imager is under development as a very low cost CD4+ T cell counter for HIV disease management in limited resource settings.

A scalable and multi-purpose point cloud server (PCS) for easier and faster point cloud data management and processing

NASA Astrophysics Data System (ADS)

Cura, Rémi; Perret, Julien; Paparoditis, Nicolas

2017-05-01

In addition to more traditional geographical data such as images (rasters) and vectors, point cloud data are becoming increasingly available. Such data are appreciated for their precision and true three-Dimensional (3D) nature. However, managing point clouds can be difficult due to scaling problems and specificities of this data type. Several methods exist but are usually fairly specialised and solve only one aspect of the management problem. In this work, we propose a comprehensive and efficient point cloud management system based on a database server that works on groups of points (patches) rather than individual points. This system is specifically designed to cover the basic needs of point cloud users: fast loading, compressed storage, powerful patch and point filtering, easy data access and exporting, and integrated processing. Moreover, the proposed system fully integrates metadata (like sensor position) and can conjointly use point clouds with other geospatial data, such as images, vectors, topology and other point clouds. Point cloud (parallel) processing can be done in-base with fast prototyping capabilities. Lastly, the system is built on open source technologies; therefore it can be easily extended and customised. We test the proposed system with several billion points obtained from Lidar (aerial and terrestrial) and stereo-vision. We demonstrate loading speeds in the ˜50 million pts/h per process range, transparent-for-user and greater than 2 to 4:1 compression ratio, patch filtering in the 0.1 to 1 s range, and output in the 0.1 million pts/s per process range, along with classical processing methods, such as object detection.

Chandra Detects Enigmatic Point X-ray Sources in the Cat's Eye and the Helix Nebulae

NASA Astrophysics Data System (ADS)

Guerrero, M. A.; Gruendl, R. A.; Chu, Y.-H.; Kaler, J. B.; Williams, R. M.

2000-12-01

Central stars of planetary nebulae (PNe) with Teff greater than 100,000 K are expected to emit soft X-rays that peak below 0.1 keV. Chandra ACIS-S observations of the Cat's Eye Nebula (NGC 6543) and the Helix Nebula (NGC 7293) have detected point X-ray sources at their central stars. The point X-ray source at the central star of the Cat's Eye is both unknown previously and unexpected because the stellar temperature is only ~50,000 K. In contrast, the point X-ray source at the central star of the Helix was previously detected by ROSAT and its soft X-ray emission is expected because the stellar temperature is ~100,000 K. However, the Helix X-ray source also shows a harder X-ray component peaking at 0.8 keV that is unexpected and for which Chandra has provided the first high-resolution spectrum for detailed analysis. The spectra of the point X-ray sources in the Cat's Eye and the Helix show line features indicating an origin of thermal plasma emission. The spectrum of the Helix source can be fit by Raymond & Smith's model of plasma emission at ~9*E6 K. The spectrum of the Cat's Eye source has too few counts for a spectral fit, but appears to be consistent with plasma emission at 2-3*E6 K. The X-ray luminosities of both sources are ~5*E29 erg s-1. The observed plasma temperatures are too high for accretion disks around white dwarfs, but they could be ascribed to coronal X-ray emission. While central stars of PNe are not known to have coronae, the observed spectra are consistent with quiescent X-ray emission from dM flare stars. On the other hand, neither the central star of the Helix or the Cat's Eye are known to have a binary companion. It is possible that the X-rays from the Cat's Eye's central star originate from shocks in the stellar wind, but the central star of the Helix does not have a measurable fast stellar wind. This work is supported by the CXC grant number GO0-1004X.

Visiting the Digital Divide: Women Entrepreneurs in Central America

ERIC Educational Resources Information Center

Tapper, Helena

2006-01-01

Micro and small enterprises comprise approximately 60-70% of enterprises in South and Central America. Most of these enterprises, particularly micro enterprises, are managed and owned by women. These women for the most part lack both skills and training in the use of computers and the Internet, and access to the use of information and…

Quality of Widely Available Video Instructional Materials for Point-of-Care Ultrasound-Guided Procedure Training in Internal Medicine.

PubMed

Khandelwal, Aditi; Devine, Luke A; Otremba, Mirek

2017-07-01

Many instructional materials for point-of-care ultrasound (US)-guided procedures exist; however, their quality is unknown. This study assessed widely available educational videos for point-of-care US-guided procedures relevant to internal medicine: central venous catheterization, thoracentesis, and paracentesis. We searched Ovid MEDLINE, YouTube, and Google to identify videos for point-of-care US-guided paracentesis, thoracentesis, and central venous catheterization. Videos were evaluated with a 5-point scale assessing the global educational value and a checklist based on consensus guidelines for competencies in point-of-care US-guided procedures. For point-of-care US-guided central venous catheterization, 12 videos were found, with an average global educational value score ± SD of 4.5 ± 0.7. Indications to abort the procedure were discussed in only 3 videos. Five videos described the indications and contraindications for performing central venous catheterization. For point-of-care US-guided thoracentesis, 8 videos were identified, with an average global educational value score of 4.0 ± 0.9. Only one video discussed indications to abort the procedure, and 3 videos discussed sterile technique. For point-of-care US-guided paracentesis, 7 videos were included, with an average global educational value score of 4.1 ± 0.9. Only 1 video discussed indications to abort the procedure, and 2 described the location of the inferior epigastric artery. The 27 videos reviewed contained good-quality general instruction. However, we noted a lack of safety-related information in most of the available videos. Further development of resources is required to teach internal medicine trainees skills that focus on the safety of point-of-care US guidance. © 2017 by the American Institute of Ultrasound in Medicine.

Artificial Water Point for Livestock Influences Spatial Ecology of a Native Lizard Species

PubMed Central

Leu, Stephan T.; Bull, C. Michael

2016-01-01

Pastoralism is a major agricultural activity in drier environments, and can directly and indirectly impact native species in those areas. We investigated how the supply of an artificial watering point to support grazing livestock affected movement and activity patterns of the Australian sleepy lizard (Tiliqua rugosa) during a drought year. We observed 23 adult lizards; six had access to a dam, whereas 17 lizards did not. Lizards with access to the dam had larger home ranges, were substantially active on more days (days with >100 steps), and moved more steps per day compared to lizards that did not have access to the dam, both during the early and late period of our observation. Furthermore, while the two groups of lizards had similar body condition early in the season, they differed later in the season. Lizards with dam access retained, whereas lizards without access lost body condition. Local heterogeneity in access to an artificial water resource resulted in spatially dependent behavioural variation among sleepy lizard individuals. This suggests that sleepy lizards have flexible responses to changing climatic conditions, depending on the availability of water. Furthermore, while reducing activity appears a suitable short term strategy, if harsh conditions persist, then access to dams could be of substantial benefit and could support sustained lizard activity and movement and allow maintenance of body condition. Hence, artificial watering points, such as the dams constructed by pastoralists, may provide local higher quality refugia for sleepy lizards and other species during drought conditions. PMID:26800274

Coastal single-beam bathymetry data collected in 2015 from Raccoon Point to Point Au Fer Island, Louisiana

USGS Publications Warehouse

Stalk, Chelsea A.; DeWitt, Nancy T.; Kindinger, Jack L.; Flocks, James G.; Reynolds, Billy J.; Kelso, Kyle W.; Fredericks, Joseph J.; Tuten, Thomas M.

2017-03-10

As part of the Barrier Island Comprehensive Monitoring Program (BICM), scientists from the U.S. Geological Survey (USGS) St. Petersburg Coastal and Marine Science Center conducted a nearshore single-beam bathymetry survey along the south-central coast of Louisiana, from Raccoon Point to Point Au Fer Island, in July 2015. The goal of the BICM program is to provide long-term data on Louisiana’s coastline and use this data to plan, design, evaluate, and maintain current and future barrier island restoration projects. The data described in this report will provide baseline bathymetric information for future research investigating island evolution, sediment transport, and recent and long-term geomorphic change, and will support modeling of future changes in response to restoration and storm impacts. The survey area encompasses more than 300 square kilometers of nearshore environment from Raccoon Point to Point Au Fer Island. This data series serves as an archive of processed single-beam bathymetry data, collected from July 22–29, 2015, under USGS Field Activity Number 2015-320-FA. Geographic information system data products include a 200-meter-cell-size interpolated bathymetry grid, trackline maps, and point data files. Additional files include error analysis maps, Field Activity Collection System logs, and formal Federal Geographic Data Committee metadata.

Totally implantable central venous access ports for long-term chemotherapy. A prospective study analyzing complications and costs of 333 devices with a minimum follow-up of 180 days.

PubMed

Biffi, R; de Braud, F; Orsi, F; Pozzi, S; Mauri, S; Goldhirsch, A; Nolè, F; Andreoni, B

1998-07-01

A few data are available from analyses of the complications and costs of central venous access ports for chemotherapy. This prospective study deals with the complications and global costs of central venous ports connected to a Groshong catheter for deliverance of long-term chemotherapy. Patients with a variety of solid neoplastic diseases requiring chemotherapy who were undergoing placement of implantable ports over a 30-month period (1 October 1994 to 31 March 1997) have been prospectively studied. Follow-up continued until the device was removed or the study was closed (30 September 1997); patients with uneventful implant experience and subsequent follow-ups of less than 180 days were not considered for this study. A single port, constructed of titanium and silicone rubber (Dome Port, Bard Inc., Salt Lake City, USA), was used, connected to an 8 F silastic Groshong catheter tubing (Bard Inc., Salt Lake City, USA). Two-hundred ninety-six devices were placed in the operating room under fluoroscopic control even in the patients treated and monitored in a day-hospital setting: 37 of them were in an angiographic suite. A central venous access form was filled in by the operator after the procedure and all ports were followed prospectively for device-related and overall complications. The average purchase cost of the device was obtained from the hospital charges, based on the costs applied during the 30-month period of the study. Insertion and maintenance costs were estimated by obtaining the charges for an average TIAP implant and its subsequent use; the costs of complication management were assessed analytically. The total cost of each device was defined as the purchase cost plus the insertion cost plus the maintenance cost plus the cost of treatment of the complications, if any. The cost of removing the TIAP was also included in the economic analysis when required by the treatment of the complication. Three hundred thirty-three devices, for a total of 79,178 days in

Hemodialysis Reliable Outflow (HeRO) device in end-stage dialysis access: a decision analysis model.

PubMed

Dageforde, Leigh Anne; Bream, Peter R; Moore, Derek E

2012-09-01

The Hemodialysis Reliable Outflow (HeRO) dialysis access device is a permanent tunneled dialysis graft connected to a central venous catheter and is used in patients with end-stage dialysis access (ESDA) issues secondary to central venous stenosis. The safety and effectiveness of the HeRO device has previously been proven, but no study thus far has compared the cost of its use with tunneled dialysis catheters (TDCs) and thigh grafts in patients with ESDA. A decision analytic model was developed to simulate outcomes for patients with ESDA undergoing placement of a HeRO dialysis access device, TDC, or thigh graft. Outcomes of interest were infection, thrombosis, and ischemic events. Baseline values, ranges, and costs were determined from a systematic review of the literature. Total costs were based on 1 year of post-procedure outcomes. Sensitivity analyses were conducted to test model strength. The HeRO dialysis access device is the least costly dialysis access with an average 1-year cost of $6521. The 1-year cost for a TDC was $8477. A thigh graft accounted for $9567 in a 1-year time period. The HeRO dialysis access device is the least costly method of ESDA. The primary determinants of cost in this model are infection in TDCs and leg ischemia necessitating amputation in thigh grafts. Further study is necessary to incorporate patient preference and quality of life into the model. Copyright © 2012 Elsevier Inc. All rights reserved.

Accessing world knowledge: evidence from N400 and reaction time priming.

PubMed

Chwilla, Dorothee J; Kolk, Herman H J

2005-12-01

How fast are we in accessing world knowledge? In two experiments, we tested for priming for word triplets that described a conceptual script (e.g., DIRECTOR-BRIBE-DISMISSAL) but were not associatively related and did not share a category relationship. Event-related brain potentials were used to track the time course at which script information becomes available. In Experiment 1, in which participants made lexical decisions, we found a facilitation for script-related relative to unrelated triplets, as indicated by (i) a decrease in both reaction time and errors, and (ii) an N400-like priming effect. In Experiment 2, we further explored the locus of script priming by increasing the contribution of meaning integration processes. The participants' task was to indicate whether the three words presented a plausible scenario. Again, an N400 script priming effect was obtained. Directing attention to script relations was effective in enhancing the N400 effect. The time course of the N400 effect was similar to that of the standard N400 effect to semantic relations. The present results show that script priming can be obtained in the visual modality, and that script information is immediately accessed and integrated with context. This supports the view that script information forms a central aspect of word meaning. The RT and N400 script priming effects reported in this article are problematic for most current semantic priming models, like spreading activation models, expectancy models, and task-specific semantic matching/integration models. They support a view in which there is no clear cutoff point between semantic knowledge and world knowledge.

Youth and alcoholic beverages: Drinking patterns among high school students in central Thailand.

PubMed

Pichainarong, Natchaporn; Chaveepojnkamjorn, Wisit

2010-11-01

The objective of this study was to determine the drinking patterns of high school students in central Thailand. Eleven thousand three hundred sixty high school students from central Thailand were divided into 2 groups (drinkers and nondrinkers) according to their alcohol consumption. Information was obtained by an anonymous self-reporting questionnaire which consisted of 2 parts: general characteristics, and characteristics of alcohol drinking behavior. Data were analyzed using descriptive and inferential statistics by a computerized statistical package. The socio-demographic factors related to the student's alcohol consumption during the previous 12 months were: age > 15 years old, male sex, grades 9 and 11 education level, living in a private dormitory, staying with a relative or a friend, having a grade point average <2.0 or >3.0, having a job earning money and having family members with alcohol/drug problems (p<0.05). Drinking patterns were classified into 5 categories: life time drinking, drinking during the previous year, drinking during the previous 30 days, binge drinking during the previous 30 days and drinking until intoxication during the previous 30 days. A higher proportion of drinking was reported by boys than girls. The prevalence of drinking increased in proportion to the educational level. The 3 main drinking places were parties (48.5%), at home or in the dormitory (37.5%) and in shops around the school (12.4%). Boys drank alcohol on average 1-2 times per month in 59.8% and 1-2 standard drinks per time in 38.6%. Eighty point one percent of girls drank alcohol 1-2 times per month and 1-2 standard drinks per time in 55.6%. Drinking alcohol among high school students should be controlled by limiting access to alcoholic beverages in order to reduce accidents, injuries, violence and alcohol-related health problems among young people.

Solar thermal power systems point-focusing thermal and electric applications projects. Volume 1: Executive summary

NASA Technical Reports Server (NTRS)

Marriott, A.

1980-01-01

The activities of the Point-Focusing Thermal and Electric Applications (PETEA) project for the fiscal year 1979 are summarized. The main thrust of the PFTEA Project, the small community solar thermal power experiment, was completed. Concept definition studies included a small central receiver approach, a point-focusing distributed receiver system with central power generation, and a point-focusing distributed receiver concept with distributed power generation. The first experiment in the Isolated Application Series was initiated. Planning for the third engineering experiment series, which addresses the industrial market sector, was also initiated. In addition to the experiment-related activities, several contracts to industry were let and studies were conducted to explore the market potential for point-focusing distributed receiver (PFDR) systems. System analysis studies were completed that looked at PFDR technology relative to other small power system technology candidates for the utility market sector.

Accessing Biomedical Literature in the Current Information Landscape

PubMed Central

Khare, Ritu; Leaman, Robert; Lu, Zhiyong

2015-01-01

i. Summary Biomedical and life sciences literature is unique because of its exponentially increasing volume and interdisciplinary nature. Biomedical literature access is essential for several types of users including biomedical researchers, clinicians, database curators, and bibliometricians. In the past few decades, several online search tools and literature archives, generic as well as biomedicine-specific, have been developed. We present this chapter in the light of three consecutive steps of literature access: searching for citations, retrieving full-text, and viewing the article. The first section presents the current state of practice of biomedical literature access, including an analysis of the search tools most frequently used by the users, including PubMed, Google Scholar, Web of Science, Scopus, and Embase, and a study on biomedical literature archives such as PubMed Central. The next section describes current research and the state-of-the-art systems motivated by the challenges a user faces during query formulation and interpretation of search results. The research solutions are classified into five key areas related to text and data mining, text similarity search, semantic search, query support, relevance ranking, and clustering results. Finally, the last section describes some predicted future trends for improving biomedical literature access, such as searching and reading articles on portable devices, and adoption of the open access policy. PMID:24788259

Long-term venous access using a subcutaneous implantable drug delivery system.

PubMed Central

Soo, K. C.; Davidson, T. I.; Selby, P.; Westbury, G.

1985-01-01

To facilitate long-term venous access in patients receiving chemotherapy, a subcutaneous totally implantable system (Port-a-Cath, Phamacia) has been used in 14 patients. The method of implantation and the advantages over conventional central venous catheters are discussed. The expense of the system necessitates careful patient selection. PMID:4037644

Responsibility for Curriculum Evaluation in Centralized Systems.

ERIC Educational Resources Information Center

Deschamp, Phil; McGaw, Barry

1979-01-01

While responsibility for curriculum development in Australia is devolving to the local level, the state systems, in the name of accountability, are retaining responsibility for curriculum evaluation. This article examines the curriculum centralization/decentralization patterns in Australia's states, points out the paradoxes in such systems, and…

Nanoscale cross-point diode array accessing embedded high density PCM

NASA Astrophysics Data System (ADS)

Wang, Heng; Liu, Yan; Liu, Bo; Gao, Dan; Xu, Zhen; Zhan, Yipeng; Song, Zhitang; Feng, Songlin

2017-08-01

The main bottlenecks in the development of current embedded phase change memory (PCM) technology are the current density and data storage density. In this paper, we present a PCM with 4F2 cross-point diode selector and blade-type bottom electrode contact (BEC). A blade TiN BEC with a cross-sectional area of 630 nm2 (10 nm × 63 nm) reduces the reset current down to about 750 μA. The optimized diode array could supply this 750 μA reset current at about 1.7 V and low off-current 1 × 10-4 μA at about -5.05 V. The on-off ratio of this device is 7.5 × 106. The proposed nanoscale PCM device simultaneously exhibits an operation voltage as low as 3 V and a high density drive current with an ultra small cell size of 4F2 (108 nm × 108 nm). Over 106 cycling endurance properties guarantee that it can work effectively on the embedded memory.

ATAC-see reveals the accessible genome by transposase-mediated imaging and sequencing.

PubMed

Chen, Xingqi; Shen, Ying; Draper, Will; Buenrostro, Jason D; Litzenburger, Ulrike; Cho, Seung Woo; Satpathy, Ansuman T; Carter, Ava C; Ghosh, Rajarshi P; East-Seletsky, Alexandra; Doudna, Jennifer A; Greenleaf, William J; Liphardt, Jan T; Chang, Howard Y

2016-12-01

Spatial organization of the genome plays a central role in gene expression, DNA replication, and repair. But current epigenomic approaches largely map DNA regulatory elements outside of the native context of the nucleus. Here we report assay of transposase-accessible chromatin with visualization (ATAC-see), a transposase-mediated imaging technology that employs direct imaging of the accessible genome in situ, cell sorting, and deep sequencing to reveal the identity of the imaged elements. ATAC-see revealed the cell-type-specific spatial organization of the accessible genome and the coordinated process of neutrophil chromatin extrusion, termed NETosis. Integration of ATAC-see with flow cytometry enables automated quantitation and prospective cell isolation as a function of chromatin accessibility, and it reveals a cell-cycle dependence of chromatin accessibility that is especially dynamic in G1 phase. The integration of imaging and epigenomics provides a general and scalable approach for deciphering the spatiotemporal architecture of gene control.

Quantitative methods in electroencephalography to access therapeutic response.

PubMed

Diniz, Roseane Costa; Fontenele, Andrea Martins Melo; Carmo, Luiza Helena Araújo do; Ribeiro, Aurea Celeste da Costa; Sales, Fábio Henrique Silva; Monteiro, Sally Cristina Moutinho; Sousa, Ana Karoline Ferreira de Castro

2016-07-01

Pharmacometrics or Quantitative Pharmacology aims to quantitatively analyze the interaction between drugs and patients whose tripod: pharmacokinetics, pharmacodynamics and disease monitoring to identify variability in drug response. Being the subject of central interest in the training of pharmacists, this work was out with a view to promoting this idea on methods to access the therapeutic response of drugs with central action. This paper discusses quantitative methods (Fast Fourier Transform, Magnitude Square Coherence, Conditional Entropy, Generalised Linear semi-canonical Correlation Analysis, Statistical Parametric Network and Mutual Information Function) used to evaluate the EEG signals obtained after administration regimen of drugs, the main findings and their clinical relevance, pointing it as a contribution to construction of different pharmaceutical practice. Peter Anderer et. al in 2000 showed the effect of 20mg of buspirone in 20 healthy subjects after 1, 2, 4, 6 and 8h after oral ingestion of the drug. The areas of increased power of the theta frequency occurred mainly in the temporo-occipital - parietal region. It has been shown by Sampaio et al., 2007 that the use of bromazepam, which allows the release of GABA (gamma amino butyric acid), an inhibitory neurotransmitter of the central nervous system could theoretically promote dissociation of cortical functional areas, a decrease of functional connectivity, a decrease of cognitive functions by means of smaller coherence (electrophysiological magnitude measured from the EEG by software) values. Ahmad Khodayari-Rostamabad et al. in 2015 talk that such a measure could be a useful clinical tool potentially to assess adverse effects of opioids and hence give rise to treatment guidelines. There was the relation between changes in pain intensity and brain sources (at maximum activity locations) during remifentanil infusion despite its potent analgesic effect. The statement of mathematical and computational

Beyond open access: open discourse, the next great equalizer.

PubMed

Dayton, Andrew I

2006-08-30

The internet is expanding the realm of scientific publishing to include free and open public debate of published papers. Journals are beginning to support web posting of comments on their published articles and independent organizations are providing centralized web sites for posting comments about any published article. The trend promises to give one and all access to read and contribute to cutting edge scientific criticism and debate.

An automated model-based aim point distribution system for solar towers

NASA Astrophysics Data System (ADS)

Schwarzbözl, Peter; Rong, Amadeus; Macke, Ansgar; Säck, Jan-Peter; Ulmer, Steffen

2016-05-01

Distribution of heliostat aim points is a major task during central receiver operation, as the flux distribution produced by the heliostats varies continuously with time. Known methods for aim point distribution are mostly based on simple aim point patterns and focus on control strategies to meet local temperature and flux limits of the receiver. Lowering the peak flux on the receiver to avoid hot spots and maximizing thermal output are obviously competing targets that call for a comprehensive optimization process. This paper presents a model-based method for online aim point optimization that includes the current heliostat field mirror quality derived through an automated deflectometric measurement process.

1. Context view shows approach of access road to summit, ...

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

1. Context view shows approach of access road to summit, communication towers and NW corner of lookout tower at center right. Camera is pointed SE. - Chelan Butte Lookout, Summit of Chelan Butte, Chelan, Chelan County, WA

VIEWCACHE: An incremental pointer-based access method for autonomous interoperable databases

NASA Technical Reports Server (NTRS)

Roussopoulos, N.; Sellis, Timos

1993-01-01

One of the biggest problems facing NASA today is to provide scientists efficient access to a large number of distributed databases. Our pointer-based incremental data base access method, VIEWCACHE, provides such an interface for accessing distributed datasets and directories. VIEWCACHE allows database browsing and search performing inter-database cross-referencing with no actual data movement between database sites. This organization and processing is especially suitable for managing Astrophysics databases which are physically distributed all over the world. Once the search is complete, the set of collected pointers pointing to the desired data are cached. VIEWCACHE includes spatial access methods for accessing image datasets, which provide much easier query formulation by referring directly to the image and very efficient search for objects contained within a two-dimensional window. We will develop and optimize a VIEWCACHE External Gateway Access to database management systems to facilitate database search.

VIEWCACHE: An incremental pointer-based access method for autonomous interoperable databases

NASA Technical Reports Server (NTRS)

Roussopoulos, N.; Sellis, Timos

1992-01-01

One of biggest problems facing NASA today is to provide scientists efficient access to a large number of distributed databases. Our pointer-based incremental database access method, VIEWCACHE, provides such an interface for accessing distributed data sets and directories. VIEWCACHE allows database browsing and search performing inter-database cross-referencing with no actual data movement between database sites. This organization and processing is especially suitable for managing Astrophysics databases which are physically distributed all over the world. Once the search is complete, the set of collected pointers pointing to the desired data are cached. VIEWCACHE includes spatial access methods for accessing image data sets, which provide much easier query formulation by referring directly to the image and very efficient search for objects contained within a two-dimensional window. We will develop and optimize a VIEWCACHE External Gateway Access to database management systems to facilitate distributed database search.

Effect of security threats on primary care access in Logar province, Afghanistan.

PubMed

Morikawa, Masahiro J

2008-01-01

Security threats are a major concern for access to health care in many war-torn communities; however, there is little quantified data on actual access to care in rural communities during war. Kinderberg International e.V. provided primary care in rural Logar province, Afghanistan, for these three years in eight districts until they were integrated into the new health care structure led by the Ministry of Health in early 2005. We examined the number of patients visiting our clinic before and during the security threats related to the parliamentary election and subsequent national assembly in 2004. The number of patients declined in remote clinics while the number increased in central locations. This finding has an important practical implication: the monitoring of access to care should include remote clinics, otherwise it may potentially underestimate compromised access to health care due to security threats.

Open Access Publishing in High-Energy Physics: the SCOAP3 Initiative

NASA Astrophysics Data System (ADS)

Mele, S.

2010-10-01

Scholarly communication in High-Energy Physics (HEP) shows traits very similar to Astronomy and Astrophysics: pervasiveness of Open Access to preprints through community-based services; a culture of openness and sharing among its researchers; a compact number of yearly articles published by a relatively small number of journals which are dear to the community. These aspects have led HEP to spearhead an innovative model for the transition of its scholarly publishing to Open Access. The Sponsoring Consortium for Open Access Publishing in Particle Physics (SCOAP) aims to be a central body to finance peer-review service rather than the purchase of access to information as in the traditional subscription model, with all articles in the discipline eventually available in Open Access. Sustainable funding to SCOAP would come from libraries, library consortia and HEP funding agencies, through a re-direction of funds currently spent for subscriptions to HEP journals. This paper presents the cultural and bibliometric factors at the roots of SCOAP and the current status of this worldwide initiative.

Recovery of central Appalachian forested watershed

Treesearch

Mary Beth Adams; James N. Kochendenfer [sic

2014-01-01

The Fernow Experimental Forest (FEF) was established to conduct research in forest and watershed management in the central Appalachians. The 1868-ha FEF, located south of Parsons, West Virginia, is administered by the Northern Research Station of the USDA Forest Service and provides a valuable point of comparison with the Coweeta Hydrologic Laboratory (CHL), located in...

The effect of access to contraceptive services on injectable use and demand for family planning in Malawi.

PubMed

Skiles, Martha Priedeman; Cunningham, Marc; Inglis, Andrew; Wilkes, Becky; Hatch, Ben; Bock, Ariella; Barden-O'Fallon, Janine

2015-03-01

Previous studies have identified positive relationships between geographic proximity to family planning services and contraceptive use, but have not accounted for the effect of contraceptive supply reliability or the diminishing influence of facility access with increasing distance. Kernel density estimation was used to geographically link Malawi women's use of injectable contraceptives and demand for birth spacing or limiting, as drawn from the 2010 Demographic and Health Survey, with contraceptive logistics data from family planning service delivery points. Linear probability models were run to identify associations between access to injectable services-measured by distance alone and by distance combined with supply reliability-and injectable use and family planning demand among rural and urban populations. Access to services was an important predictor of injectable use. The probability of injectable use among rural women with the most access by both measures was 7‒8 percentage points higher than among rural dwellers with the least access. The probability of wanting to space or limit births among urban women who had access to the most reliable supplies was 18 percentage points higher than among their counterparts with the least access. Product availability in the local service environment plays a critical role in women's demand for and use of contraceptive methods. Use of kernel density estimation in creating facility service environments provides a refined approach to linking women with services and accounts for both distance to facilities and supply reliability. Urban and rural differences should be considered when seeking to improve contraceptive access.

Efficient traffic grooming with dynamic ONU grouping for multiple-OLT-based access network

NASA Astrophysics Data System (ADS)

Zhang, Shizong; Gu, Rentao; Ji, Yuefeng; Wang, Hongxiang

2015-12-01

Fast bandwidth growth urges large-scale high-density access scenarios, where the multiple Passive Optical Networking (PON) system clustered deployment can be adopted as an appropriate solution to fulfill the huge bandwidth demands, especially for a future 5G mobile network. However, the lack of interaction between different optical line terminals (OLTs) results in part of the bandwidth resources waste. To increase the bandwidth efficiency, as well as reduce bandwidth pressure at the edge of a network, we propose a centralized flexible PON architecture based on Time- and Wavelength-Division Multiplexing PON (TWDM PON). It can provide flexible affiliation for optical network units (ONUs) and different OLTs to support access network traffic localization. Specifically, a dynamic ONU grouping algorithm (DGA) is provided to obtain the minimal OLT outbound traffic. Simulation results show that DGA obtains an average 25.23% traffic gain increment under different OLT numbers within a small ONU number situation, and the traffic gain will increase dramatically with the increment of the ONU number. As the DGA can be deployed easily as an application running above the centralized control plane, the proposed architecture can be helpful to improve the network efficiency for future traffic-intensive access scenarios.

Long-Term Impacts of Precolonial Institutions, Geography and Ecological Diversity on Access to Public Infrastructure Services in Nigeria

NASA Astrophysics Data System (ADS)

Archibong, B.

2014-12-01

Do precolonial institutions, geography and ecological diversity affect population access to public infrastructure services over a century later? Can local leaders from historically centralized or 'conqueror' groups still influence access to public goods today? Do precolonial states located in ecologically diverse environments have better access to water, power and sanitation resources today? A growing body of literature examining the sources of the current state of African economic development has cited the enduring impacts of precolonial institutions and geography on contemporary African economic development using large sample cross-sectional analysis. In this paper, I focus on within country effects of local ethnic and political state institutions on access to public infrastructure services in present day Nigeria. Specifically, I combine information on the spatial distribution of ethnic states and ecological diversity in Nigeria circa mid 19th century and political states in Nigeria circa 1785 and 1850 with information, from a novel geocoded survey dataset, on access to public infrastructure at the local government level in present day Nigeria to examine the impact of precolonial state centralization on the current unequal access to public infrastructure services in Nigeria, accounting for the effects of ecological diversity and other geographic covariates. Some preliminary results show evidence for the long-term impacts of institutions, geography and ecological diversity on access to public infrastructure in Nigeria.

Metallic quantum critical points with finite BCS couplings

NASA Astrophysics Data System (ADS)

Raghu, Srinivas

The problem of superconductivity near quantum critical points (QCPs) remains a central topic of modern condensed matter physics. In such systems, there is a competition between the enhanced pairing tendency due to the presence of long-range attractive interactions near criticality, and the suppression of superconductivity due to the destruction of Landau quasiparticles. I will describe some recent work that addresses these competing effects in the context of a solvable model of a metallic quantum critical point. I will show that the two effects - namely the enhanced pairing and the destruction of Landau quasiparticles - can offset one another, resulting in stable ''naked'' quantum critical points without superconductivity. However, the resulting quantum critical metal exhibits strong superconducting fluctuations on all length scales. Reference: S.R., Gonzalo Torroba, and Huajia Wang, arXiv1507.06652, PRB(2015).

Restricting access to publications from funded research: ethical issues and solutions.

PubMed

Manikandan, S; Vani, N Isai

2010-01-01

India is becoming one of the hubs of clinical research. Commensurate with these advances, the government funding for biomedical research in thrust areas is also increasing. The Indian Council of Medical Research (ICMR), Department of Biotechnology (DBT), Department of Science and Technology (DST) are some of the government organizations which provide financial support for various research projects. The results of the funded research projects are published in various international journals. Most of these journals have an access to paid subscribers only. Hence it is unethical to use the research grants from government (people's money) and not allow the scientific community free access to the results of the study. To tackle such issues, these agencies should sign the Berlin declaration and create open access repositories. A public access policy should be formulated and listed in JULIET. The funding bodies in India should also join Pubmed Central (PMC) to form PMC India so that every investigator who has received grants would submit the full text of the paper published from his study and these can be made freely accessible to everyone. Universities and research institutions should also develop institutional open access repositories. The public access policy has definitive advantages and should be implemented.

SN 1986J VLBI. IV. The Nature of the Central Component

NASA Astrophysics Data System (ADS)

Bietenholz, Michael F.; Bartel, Norbert

2017-12-01

We report on Very Large Array measurements between 1 and 45 GHz of the evolving radio spectral energy distribution (SED) of SN 1986J, made in conjunction with very long baseline interferometry (VLBI) imaging. The SED of SN 1986J is unique among supernovae, and shows an inversion point and a high-frequency turnover. Both are due to the central component seen in the VLBI images, and both are progressing downward in frequency with time. The optically thin spectral index of the central component is almost the same as that of the shell. We fit a simple model to the evolving SED consisting of an optically thin shell and a partly absorbed central component. The evolution of the SED is consistent with that of a homologously expanding system. Both components are fading, but the shell is fading more rapidly. We conclude that the central component is physically inside the expanding shell, and not a surface hotspot central only in projection. Our observations are consistent with the central component being due to interaction of the shock with the dense and highly structured circumstellar medium that resulted from a period of common-envelope evolution of the progenitor. However, a young pulsar-wind nebula or emission from an accreting black hole can also not be ruled out at this point.

Percutaneous transfemoral repositioning of malpositioned central venous catheters.

PubMed

Hartnell, G G; Roizental, M

1995-04-01

Central venous catheters inserted by blind surgical placement may not advance into a satisfactory position and may require repositioning. Malpositioning via surgical insertion is common in patients in whom central venous catheters have previously been placed, as these patients are more likely to have central venous thrombosis and distortion of central venous anatomy. This is less of a problem when catheter placement is guided by imaging; however, even when insertion is satisfactory, central venous catheters may become displaced spontaneously after insertion (Fig. 1). Repositioning can be effected by direct manipulation using guidewires or tip-deflecting wires [1, 2], by manipulation via a transfemoral venous approach [3-5], and by injection of contrast material or saline [6]. Limitations of the direct approach include (1) the number and type of maneuvers that can be performed to effect repositioning when anatomy is distorted, (2) difficulty in accessing the catheter, and (3) the risk of introducing infection. Moreover, these patients are often immunosuppressed, and there is a risk of introducing infection by exposing and directly manipulating the venous catheter. Vigorous injection of contrast material or saline may be unsuccessful for the same reasons: It seldom exerts sufficient force to reposition large-caliber central venous catheters and may cause vessel damage or rupture if injection is made into a small or thrombosed vessel. We illustrate several alternative methods for catheter repositioning via a transfemoral venous approach.

Comparison of subcutaneous central venous port via jugular and subclavian access in 347 patients at a single center

PubMed Central

ARIBAŞ, BILGIN KADRI; ARDA, KEMAL; ARIBAŞ, ÖZGE; ÇILEDAĞ, NAZAN; YOLOĞLU, ZEYNEL; AKTAŞ, ELIF; SEBER, TURGUT; KAVAK, ŞEYHMUS; COŞAR, YUSUF; KAYGUSUZ, HIDIR; TEKIN, EKREM

2012-01-01

The purpose of the present study was to examine whether patency times, including complications of subcutaneous venous chest port insertion using ultrasonography (US) guidance, differ between jugular and subclavian venous access. Between December 2008 and July 2010, subcutaneous venous chest ports were placed in 347 patients by an experienced team. All single-lumen port catheters were placed into jugular and subclavian veins under US and fluoroscopy guidance. Patency times and complication rates of ports via these routes were compared and the variables were age, gender, access, site of malignancy and coagulation parameters. The success of the jugular and subclavian groups was compared by univariate Kaplan-Meier survival analysis and the multivariable Cox regression test. A total of 15 patients underwent port removal due to complications. As a rate per 100 catheter days, ports were explanted in 7 (0.0092) due to thrombosis, 4 (0.0053) for catheter malposition, one each (0.0013) of port reservoir flip-over, bleeding, port pocket infection, skin necrosis and incision dehiscence, for a total of 15 patients (0.0197). Patency times were not different in the jugular and subclavian veins. Factors were not significant, with the exception of platelet count. There was no significant difference in patency times, including complications, between jugular vein access and subclavian vein access using US. This should be considered when selecting the access method. PMID:23170125

Thrombotic complications of implanted central venous access devices: prospective evaluation.

PubMed

Labourey, Jean-Luc; Lacroix, Philippe; Genet, Dominique; Gobeaux, François; Martin, Jean; Venat-Bouvet, Laurence; Lavau-Denes, Sandrine; Maubon, Antoine; Tubiana-Mathieu, Nicole

2004-05-01

Implanted venous access devices (IVAD) are routinely used in oncologic patients. Thrombotic complication is a source of morbidity. During one year 246 patients with different solid neoplastic diseases received IVAD for chemotherapy administration. Two hundred forty-nine IVAD were placed percutaneously or by surgical cutdown. IVAD were flushed immediately after implantation with 3-5 mL of heparinized saline (100 U/mL). No monthly flush was required. A prospective evaluation of thrombotic complications was realised. in event of catheter dysfunction and/or clinical symptoms of phlebitis, a catheter opacification and/or a Doppler ultrasonography were performed. Twenty-three catheter dysfunctions were noted, corresponding to 13 catheter occlusions. Twelve patients presented clinical symptoms of phlebitis. Eleven venous thrombosis were diagnosed in this group; 10 by echo-Doppler and one by scanography. A unvaried statistic analysis using Fisher's test was performed to detect risk factors. Two factors were identified: the position of catheter tip above T4 (p < 0.001) and mediastinal or cervical lymph nodes larger than 6 cm (p < 0.001). The first increased the risk of catheter occlusion and the second increased the risk of phlebitis.

Infection and hemodialysis access: an updated review.

PubMed

Gupta, Vineet; Yassin, Mohamed H

2013-06-01

The incidence of end-stage renal disease (ESRD) has almost doubled over past 2 decades. Despite decreasing overall hospital admission rates for ESRD population, the rate of infection-related hospitalizations has steadily increased. Infection remains the second most common cause of mortality in this patient population. Specifically, in the hemodialysis (HD) patients, the vascular access related infections are the most common identifiable source of infection. This concise review provides an update on the bacteremia related to vascular access primarily the catheters (Catheter Related Blood Stream Infection- CRBSI) in HD patients emphasizing on the determinants ranging from the epidemiology to pathogenesis, risk factors, cost implications and prevention. Staphylococcus aureus, coagulase negative Staphylococci, and Enterococci are the most common causative microorganisms implicated in CRBSI. The pathogenesis of CRBSI includes organism entry into the blood stream followed by adherence to catheter, colonization and biofilm formation. Vascular access type, catheter position, and prior bacteremic episodes are strongly associated with blood stream infection. Preventive measures should be multidisciplinary in nature and should include avoidance of central venous catheters, best practices for catheter care, surveillance, antimicrobial catheter lock solutions, and use of antibiotic impregnated catheters.

Global Access to Library of Congress' Digital Resources: National Digital Library and Internet Resources.

ERIC Educational Resources Information Center

Chen, Ching-chih

1996-01-01

Summarizes how the Library of Congress' digital library collections can be accessed globally via the Internet and World Wide Web. Outlines the resources found in each of the various access points: gopher, online catalog, library and legislative Web sites, legal and copyright databases, and FTP (file transfer protocol) sites. (LAM)

System Design and Cataloging Meet the User: User Interfaces to Online Public Access Catalogs.

ERIC Educational Resources Information Center

Yee, Martha M.

1991-01-01

Discusses features of online public access catalogs: (1) demonstration of relationships between records; (2) provision of entry vocabularies; (3) arrangement of multiple entries on the screen; (4) provision of access points; (5) display of single records; and (6) division of catalogs into separate files or indexes. User studies and other research…

A New Regulatory Policy for FTTx-Based Next-Generation Access Networks

NASA Astrophysics Data System (ADS)

Makarovič, Boštjan

2013-07-01

This article critically assesses the latest European Commission policies in relation to next-generation access investment that put focus on regulated prices and relaxing of wholesale access obligations. Pointing at the vital socio-legal and economic arguments, it further challenges the assumptions of the current EU regulatory framework and calls for a more contractual utility-based model of regulation instead of the current system that overly relies on market-driven infrastructure-based competition.

Simple trigonometry on computed tomography helps in planning renal access.

PubMed

Bilen, Cenk Yücel; Koçak, Burak; Kitirci, Gürcan; Danaci, Murat; Sarikaya, Saban

2007-08-01

To retrospectively assess the usefulness of the measurements on preoperative computed tomography (CT) of patients with urinary stone disease for planning the access site using vertical angulation of the C-arm. Of the patients who underwent percutaneous nephrolithotomy from November 2001 to October 2006, 41 patients with superior calix access had undergone preoperative CT. The depth of the target stone (y) and the vertical distance from that point to the first rib free slice (x) were measured on CT. The limit of the ratio of x over y was accepted as 0.58, with ratios below that indicating that infracostal access could be achieved by vertical angulation of the C-arm. We achieved an approach to the superior calix through an infracostal access in 28 patients. The preoperative trigonometric study on CT predicted 24 of them. The stone-free rate was 92.6%, and no chest-related complications developed. Simple trigonometry on CT of the patients with complex stones could help endourologists in planning renal access.

Web Accessibility and Accessibility Instruction

ERIC Educational Resources Information Center

Green, Ravonne A.; Huprich, Julia

2009-01-01

Section 508 of the Americans with Disabilities Act (ADA) mandates that programs and services be accessible to people with disabilities. While schools of library and information science (SLIS*) and university libraries should model accessible Web sites, this may not be the case. This article examines previous studies about the Web accessibility of…

The maxillary molar endodontic access opening: A microscope-based approach

PubMed Central

Mamoun, John Sami

2016-01-01

This article reviews the basic clinical techniques of performing a maxillary molar endodontic access opening, starting from the initial access opening into the pulp chamber, to the point where a size #10 file has been advanced to the apices of all three or four (or more) canals. The article explains how the use of the dental surgical operating microscope or microscope-level loupes magnification of ×6–8 or greater, combined with head-mounted or coaxial illumination, improve the ability of a dentist to identify microscopic root canal orifices, which facilitates the efficient creation of conservative access openings with adequate straight-line access in maxillary molars. Magnified photos illustrate various microscopic anatomical structures or landmarks of the initial access opening. Techniques are explored for implementing an access opening for teeth with vital versus necrotic pulpal tissues. The article also explores the use of piezoelectric or ultrasonic instruments for revealing root canal orifices and for removing pulp stones or calcified pulpal tissue inside the pulp chamber. PMID:27403069

The South Central Superpave Center: Report of Activities

DOT National Transportation Integrated Search

1998-12-01

The planning of the South Central Superpave Center (SCSC) began in mid-1994. The Center hired its first staff in early 1995 and was fully staffed by June 1995, at which point it became fully operational. This report describes SCSC activities that too...

First Person Point of View Augmented Reality for Central Line Insertion Training: A Usability and Feasibility Study

PubMed Central

Rochlen, Lauryn R.; Levine, Robert; Tait, Alan R.

2016-01-01

Introduction The value of simulation in medical education and procedural skills training is well recognized. Despite this, many mannequin-based trainers are limited by the inability of the trainee to view the internal anatomical structures. This study evaluates the usability and feasibility of a 1st person point of view (POV) augmented reality (AR) trainer on needle insertion as a component of central venous catheter (CVC) placement. Methods Forty subjects, including medical students and anesthesiology residents and faculty participated. AR glasses were provided through which the relevant internal anatomical landmarks were projected. Following a practice period, participants were asked to place the needle in the mannequin without the benefit of the AR projected internal anatomy. The ability of the trainees to correctly place the needle was documented. Participants also completed a short survey describing their perceptions of the AR technology. Results Participants reported that the AR technology was realistic (77.5%) and that the ability to view the internal anatomy was helpful (92.5%). Furthermore, 85% and 82.1%, respectively, believed that the AR technology promoted learning and should be incorporated into medical training. The ability to successfully place the needle was similar between experienced and non-experienced participants, however, less experienced participants were more likely to inadvertently puncture the carotid artery. Conclusions Results of this pilot study demonstrated the usability and feasibility of AR technology as a potentially important adjunct to simulated medical skills training. Further development and evaluation of this innovative technology under a variety of simulated medical training settings would be an important next step. PMID:27930431

First-Person Point-of-View-Augmented Reality for Central Line Insertion Training: A Usability and Feasibility Study.

PubMed

Rochlen, Lauryn R; Levine, Robert; Tait, Alan R

2017-02-01

The value of simulation in medical education and procedural skills training is well recognized. Despite this, many mannequin-based trainers are limited by the inability of the trainee to view the internal anatomical structures. This study evaluates the usability and feasibility of a first-person point-of-view-augmented reality (AR) trainer on needle insertion as a component of central venous catheter placement. Forty subjects, including medical students and anesthesiology residents and faculty, participated. Augmented reality glasses were provided through which the relevant internal anatomical landmarks were projected. After a practice period, participants were asked to place the needle in the mannequin without the benefit of the AR-projected internal anatomy. The ability of the trainees to correctly place the needle was documented. Participants also completed a short survey describing their perceptions of the AR technology. Participants reported that the AR technology was realistic (77.5%) and that the ability to view the internal anatomy was helpful (92.5%). Furthermore, 85% and 82.1%, respectively, believed that the AR technology promoted learning and should be incorporated into medical training. The ability to successfully place the needle was similar between experienced and nonexperienced participants; however, less experienced participants were more likely to inadvertently puncture the carotid artery. Results of this pilot study demonstrated the usability and feasibility of AR technology as a potentially important adjunct to simulated medical skills training. Further development and evaluation of this innovative technology under a variety of simulated medical training settings would be an important next step.

INTERIOR FROM MEZZANINE LEVEL OF CENTRAL SECTION, VIEW FACING WEST. ...

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

INTERIOR FROM MEZZANINE LEVEL OF CENTRAL SECTION, VIEW FACING WEST. - Naval Air Station Barbers Point, Aircraft Storehouse, Between Midway & Card Streets at Enterprise Avenue intersection, Ewa, Honolulu County, HI

The central arctic caribou herd

USGS Publications Warehouse

Cameron, Raymond D.; Smith, Walter T.; White, Robert G.; Griffith, Brad; Douglas, David C.; Reynolds, Patricia E.; Rhode, E.B.

2002-01-01

From the mid-1970s through the mid-1980s, use of calving and summer habitats by Central Arctic herd caribou (Rangifer tarandus granti) declined near petroleum development infrastructure on Alaska's arctic coastal plain (Cameron et al. 1979; Cameron and Whitten 1980, Smith and Cameron 1983. Whitten and Cameron 1983a, 1985: Dau and Cameron 1986).With surface development continuing to expand westward from the Prudhoe Bay petroleum development area (Fig. 4.1), concerns arose that the resultant cumulative losses of habitat would eventually reduce productivity of the caribou herd. Specifically, reduced access of adult females to preferred foraging areas might adversely affect growth and fattening (Elison et al. 1986. Clough et al. 1987), in turn depressing calf production (Dauphiné 1976, Thomas 1982, Reimers 1983, White 1983, Eloranta and Nieminen 1986. Lenvik et al. 1988, Thomas and Kiliaan 1991) and survival (Haukioja and Salovaara 1978, Rognmo et al. 1983, Skogland 1984, Eloranta and Nieminen 1986, Adamczewski et al. 1987).Those concerns, though justified in theory, lacked empirical support. With industrial development in arctic Alaska virtually unprecedented, there was little basis for predicting the extent and duration of habitat loss, much less the secondary short- and long-term effects on the well-being of a particular caribou herd.Furthermore, despite a general acceptance that body condition and fecundity of the females are functionally related for reindeer and caribou, it seemed unlikely that any single model would apply to all subspecies of Rangifer, and perhaps not even within a subspecies in different geographic regions. We therefore lacked a complete understanding of the behavioral responses of arctic caribou to industrial development, the manner in which access to habitats might be affected, and how changes in habitat use might translate into measurable effects on fecundity and herd growth rate.Our study addressed the following objectives: 1) estimate

An Evaluation of a Self-Access Centre through EFL Learners' Eyes

ERIC Educational Resources Information Center

Balcikanli, Cem

2017-01-01

Learner autonomy has become a central concern in the recent history of language learning. Self-Access Centres (SACs) play a critical role in fostering learner autonomy specifically in EFL (English as a Foreign Language) settings. As SACs aim at enabling learning to occur independent of teaching, in these centres, language learners are given more…