24 CFR 3280.802 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-04-01

... supply. (15) Distribution panelboard means a single panel or a group of panel units designed for assembly...) Panelboard means a single panel or group of panel units designed for assembly in the form of a single panel... treatment of air so as to control simultaneously its temperature, humidity, cleanliness, and distribution to...

A Formative Evaluation of Me Now, Unit I, Digestion and Circulation, Life Sciences for the Educable Mentally Handicapped Intermediate Grades (11-13 years).

ERIC Educational Resources Information Center

Robinson, James T.; Tolman, Richard R.

In order to evaluate Unit I (Digestion and Circulation) of the Me Now series of Life Sciences for the Educable Mentally Handicapped, 139 students in an experimental group (mean IQ 72.04; mean CA 144.9 months) and 154 control subjects (mean IQ 70.2; mean CA 148.3 months) were pre- and post-tested following instruction in the Me Now series…

Estimating aquatic toxicity as determined through laboratory tests of great lakes sediments containing complex mixtures of environmental contaminants

USGS Publications Warehouse

1996-01-01

We developed and evaluated a total toxic units modeling approach for predicting mean toxicity as measured in laboratory tests for Great Lakes sediments containing complex mixtures of environmental contaminants (e.g., polychlorinated biphenyls, polycyclic aromatic hydrocarbons, pesticides, chlorinated dioxins, and metals). The approach incorporates equilibrium partitioning and organic carbon control of bioavailability for organic contaminants and acid volatile sulfide (AVS) control for metals, and includes toxic equivalency for planar organic chemicals. A toxic unit is defined as the ratio of the estimated pore-water concentration of a contaminant to the chronic toxicity of that contaminant, as estimated by U.S. Environmental Protection Agency Ambient Water Quality Criteria (AWQC). The toxic unit models we developed assume complete additivity of contaminant effects, are completely mechanistic in form, and were evaluated without any a posteriori modification of either the models or the data from which the models were developed and against which they were tested. A linear relationship between total toxic units, which included toxicity attributable to both iron and un-ionized ammonia, accounted for about 88% of observed variability in mean toxicity; a quadratic relationship accounted for almost 94%. Exclusion of either bioavailability components (i.e., equilibrium partitioning control of organic contaminants and AVS control of metals) or iron from the model substantially decreased its ability to predict mean toxicity. A model based solely on un-ionized ammonia accounted for about 47% of the variability in mean toxicity. We found the toxic unit approach to be a viable method for assessing and ranking the relative potential toxicity of contaminated sediments.

24 CFR 3280.802 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-04-01

... panelboard means a single panel or a group of panel units designed for assembly in the form of a single panel... control of light, heat, or power circuits of small individual as well as aggregate capacity; designed to...) Panelboard means a single panel or group of panel units designed for assembly in the form of a single panel...

40 CFR 60.191 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... control system designed to remove gaseous and particulate flourides from exhaust gases which are captured... means a building unit which houses a group of electrolytic cells in which aluminum is produced. Potroom group means an uncontrolled potroom, a potroom which is controlled individually, or a group of potrooms...

40 CFR 60.191 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... control system designed to remove gaseous and particulate flourides from exhaust gases which are captured... means a building unit which houses a group of electrolytic cells in which aluminum is produced. Potroom group means an uncontrolled potroom, a potroom which is controlled individually, or a group of potrooms...

40 CFR 60.191 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... control system designed to remove gaseous and particulate flourides from exhaust gases which are captured... means a building unit which houses a group of electrolytic cells in which aluminum is produced. Potroom group means an uncontrolled potroom, a potroom which is controlled individually, or a group of potrooms...

40 CFR 60.191 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... control system designed to remove gaseous and particulate flourides from exhaust gases which are captured... means a building unit which houses a group of electrolytic cells in which aluminum is produced. Potroom group means an uncontrolled potroom, a potroom which is controlled individually, or a group of potrooms...

40 CFR 60.191 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... control system designed to remove gaseous and particulate flourides from exhaust gases which are captured... means a building unit which houses a group of electrolytic cells in which aluminum is produced. Potroom group means an uncontrolled potroom, a potroom which is controlled individually, or a group of potrooms...

The Role of Parents' Control in Early Adolescents' Psychological Functioning: A Longitudinal Investigation in the United States and China

ERIC Educational Resources Information Center

Wang, Qian; Pomerantz, Eva M.; Chen, Huichang

2007-01-01

This research compared the effects over time of parents' control and autonomy support on children's functioning in the United States and China. American and Chinese (N = 806) seventh graders (mean age = 12.73 years) participated in a 6-month longitudinal study. Children reported on their parents' psychological control, psychological autonomy…

12 CFR 367.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

...) Affiliated business entity means a company that is under the control of the contractor, is in control of the... offense or liability by any court of competent jurisdiction in the United States. (d) Company means any... completion and which rescission or termination involved issues of conflicts of interest or ethical...

26 CFR 1.957-3 - United States person defined.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 26 Internal Revenue 10 2012-04-01 2012-04-01 false United States person defined. 1.957-3 Section 1... (CONTINUED) INCOME TAXES (CONTINUED) Controlled Foreign Corporations § 1.957-3 United States person defined. (a) Basic rule—(1) In general. The term United States person has the same meaning for purposes of...

26 CFR 1.957-3 - United States person defined.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 26 Internal Revenue 10 2013-04-01 2013-04-01 false United States person defined. 1.957-3 Section 1... (CONTINUED) INCOME TAXES (CONTINUED) Controlled Foreign Corporations § 1.957-3 United States person defined. (a) Basic rule—(1) In general. The term United States person has the same meaning for purposes of...

26 CFR 1.957-3 - United States person defined.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 10 2011-04-01 2011-04-01 false United States person defined. 1.957-3 Section 1... (CONTINUED) INCOME TAXES (CONTINUED) Controlled Foreign Corporations § 1.957-3 United States person defined. (a) Basic rule—(1) In general. The term United States person has the same meaning for purposes of...

26 CFR 1.957-3 - United States person defined.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 26 Internal Revenue 10 2014-04-01 2013-04-01 true United States person defined. 1.957-3 Section 1... (CONTINUED) INCOME TAXES (CONTINUED) Controlled Foreign Corporations § 1.957-3 United States person defined. (a) Basic rule—(1) In general. The term United States person has the same meaning for purposes of...

31 CFR 539.307 - Importation into the United States.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false Importation into the United States... CONTROL REGULATIONS General Definitions § 539.307 Importation into the United States. The term importation into the United States means: (a) With respect to goods or technology, the bringing of any goods or...

31 CFR 539.307 - Importation into the United States.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Importation into the United States... CONTROL REGULATIONS General Definitions § 539.307 Importation into the United States. The term importation into the United States means: (a) With respect to goods or technology, the bringing of any goods or...

26 CFR 1.957-3 - United States person defined.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 10 2010-04-01 2010-04-01 false United States person defined. 1.957-3 Section 1... (CONTINUED) INCOME TAXES Controlled Foreign Corporations § 1.957-3 United States person defined. (a) Basic rule—(1) In general. The term United States person has the same meaning for purposes of sections 951...

15 CFR 746.3 - Iraq.

Code of Federal Regulations, 2013 CFR

2013-01-01

... controlled for crime control (CC) or united nations (UN) reasons (including items controlled under ECCN 0A986... reexport and related details (including means of transport); (ii) Description of items (including ECCN) and...

15 CFR 746.3 - Iraq.

Code of Federal Regulations, 2012 CFR

2012-01-01

... controlled for crime control (CC) or united nations (UN) reasons (including items controlled under ECCN 0A986... reexport and related details (including means of transport); (ii) Description of items (including ECCN) and...

15 CFR 746.3 - Iraq.

Code of Federal Regulations, 2011 CFR

2011-01-01

... controlled for crime control (CC) or united nations (UN) reasons (including items controlled under ECCN 0A986... reexport and related details (including means of transport); (ii) Description of items (including ECCN) and...

40 CFR 59.680 - What definitions apply to this subpart?

Code of Federal Regulations, 2011 CFR

2011-07-01

... design that controls or reduces the regulated evaporative emissions from. Emission-data unit means a... PRODUCTS Control of Evaporative Emissions From New and In-Use Portable Fuel Containers Definitions and... amended, 42 U.S.C. 7401-7671q. Adjustable parameter means any device, system, or element of design that...

Effects of barbell deadlift training on submaximal motor unit firing rates for the vastus lateralis and rectus femoris.

PubMed

Stock, Matt S; Thompson, Brennan J

2014-01-01

Previous investigations that have studied motor unit firing rates following strength training have been limited to small muscles, isometric training, or interventions involving exercise machines. We examined the effects of ten weeks of supervised barbell deadlift training on motor unit firing rates for the vastus lateralis and rectus femoris during a 50% maximum voluntary contraction (MVC) assessment. Twenty-four previously untrained men (mean age  = 24 years) were randomly assigned to training (n = 15) or control (n = 9) groups. Before and following the intervention, the subjects performed isometric testing of the right knee extensors while bipolar surface electromyographic signals were detected from the two muscles. The signals were decomposed into their constituent motor unit action potential trains, and motor units that demonstrated accuracy levels less than 92.0% were not considered for analysis. One thousand eight hundred ninety-two and 2,013 motor units were examined for the vastus lateralis and rectus femoris, respectively. Regression analyses were used to determine the linear slope coefficients (pulses per second [pps]/% MVC) and y-intercepts (pps) of the mean firing rate and firing rate at recruitment versus recruitment threshold relationships. Deadlift training significantly improved knee extensor MVC force (Cohen's d = .70), but did not influence force steadiness. Training had no influence on the slopes and y-intercepts for the mean firing rate and firing rate at recruitment versus recruitment threshold relationships. In agreement with previous cross-sectional comparisons and randomized control trials, our findings do not support the notion that strength training affects the submaximal control of motor units.

Digital communication system

NASA Technical Reports Server (NTRS)

Monford, L. G., Jr. (Inventor)

1974-01-01

A digital communication system is reported for parallel operation of 16 or more transceiver units with the use of only four interconnecting wires. A remote synchronization circuit produces unit address control words sequentially in data frames of 16 words. Means are provided in each transceiver unit to decode calling signals and to transmit calling and data signals. The transceivers communicate with each other over one data line. The synchronization unit communicates the address control information to the transceiver units over an address line and further provides the timing information over a clock line. A reference voltage level or ground line completes the interconnecting four wire hookup.

Protective mechanical ventilation in United Kingdom critical care units: A multicentre audit

PubMed Central

Martin, Matthew J; Richardson, Neil; Bourdeaux, Christopher P

2016-01-01

Lung protective ventilation is becoming increasingly used for all critically ill patients being mechanically ventilated on a mandatory ventilator mode. Compliance with the universal application of this ventilation strategy in intensive care units in the United Kingdom is unknown. This 24-h audit of ventilation practice took place in 16 intensive care units in two regions of the United Kingdom. The mean tidal volume for all patients being ventilated on a mandatory ventilator mode was 7.2(±1.4) ml kg−1 predicted body weight and overall compliance with low tidal volume ventilation (≤6.5 ml kg−1 predicted body weight) was 34%. The mean tidal volume for patients ventilated with volume-controlled ventilation was 7.0(±1.2) ml kg−1 predicted body weight and 7.9(±1.8) ml kg−1 predicted body weight for pressure-controlled ventilation (P < 0.0001). Overall compliance with recommended levels of positive end-expiratory pressure was 72%. Significant variation in practice existed both at a regional and individual unit level. PMID:28979556

Protective mechanical ventilation in United Kingdom critical care units: A multicentre audit.

PubMed

Newell, Christopher P; Martin, Matthew J; Richardson, Neil; Bourdeaux, Christopher P

2017-05-01

Lung protective ventilation is becoming increasingly used for all critically ill patients being mechanically ventilated on a mandatory ventilator mode. Compliance with the universal application of this ventilation strategy in intensive care units in the United Kingdom is unknown. This 24-h audit of ventilation practice took place in 16 intensive care units in two regions of the United Kingdom. The mean tidal volume for all patients being ventilated on a mandatory ventilator mode was 7.2(±1.4) ml kg -1 predicted body weight and overall compliance with low tidal volume ventilation (≤6.5 ml kg -1 predicted body weight) was 34%. The mean tidal volume for patients ventilated with volume-controlled ventilation was 7.0(±1.2) ml kg -1 predicted body weight and 7.9(±1.8) ml kg -1 predicted body weight for pressure-controlled ventilation ( P  < 0.0001). Overall compliance with recommended levels of positive end-expiratory pressure was 72%. Significant variation in practice existed both at a regional and individual unit level.

Recruitment of motor units in the medial gastrocnemius muscle during human quiet standing: is recruitment intermittent? What triggers recruitment?

PubMed Central

Loram, Ian D.; Muceli, Silvia; Merletti, Roberto; Farina, Dario

2012-01-01

The recruitment and the rate of discharge of motor units are determinants of muscle force. Within a motoneuron pool, recruitment and rate coding of individual motor units might be controlled independently, depending on the circumstances. In this study, we tested whether, during human quiet standing, the force of the medial gastrocnemius (MG) muscle is predominantly controlled by recruitment or rate coding. If MG control during standing was mainly due to recruitment, then we further asked what the trigger mechanism is. Is it determined internally, or is it related to body kinematics? While seven healthy subjects stood quietly, intramuscular electromyograms were recorded from the MG muscle with three pairs of wire electrodes. The number of active motor units and their mean discharge rate were compared for different sway velocities and positions. Motor unit discharges occurred more frequently when the body swayed faster and forward (Pearson R = 0.63; P < 0.0001). This higher likelihood of observing motor unit potentials was explained chiefly by the recruitment of additional units. During forward body shifts, the median number of units detected increased from 3 to 11 (P < 0.0001), whereas the discharge rate changed from 8 ± 1.1 (mean ± SD) to 10 ± 0.9 pulses/s (P = 0.001). Strikingly, motor units did not discharge continuously throughout standing. They were recruited within individual, forward sways and intermittently, with a modal rate of two recruitments per second. This modal rate is consistent with previous circumstantial evidence relating the control of standing to an intrinsic, higher level planning process. PMID:21994258

Recruitment of motor units in the medial gastrocnemius muscle during human quiet standing: is recruitment intermittent? What triggers recruitment?

PubMed

Vieira, Taian M M; Loram, Ian D; Muceli, Silvia; Merletti, Roberto; Farina, Dario

2012-01-01

The recruitment and the rate of discharge of motor units are determinants of muscle force. Within a motoneuron pool, recruitment and rate coding of individual motor units might be controlled independently, depending on the circumstances. In this study, we tested whether, during human quiet standing, the force of the medial gastrocnemius (MG) muscle is predominantly controlled by recruitment or rate coding. If MG control during standing was mainly due to recruitment, then we further asked what the trigger mechanism is. Is it determined internally, or is it related to body kinematics? While seven healthy subjects stood quietly, intramuscular electromyograms were recorded from the MG muscle with three pairs of wire electrodes. The number of active motor units and their mean discharge rate were compared for different sway velocities and positions. Motor unit discharges occurred more frequently when the body swayed faster and forward (Pearson R = 0.63; P < 0.0001). This higher likelihood of observing motor unit potentials was explained chiefly by the recruitment of additional units. During forward body shifts, the median number of units detected increased from 3 to 11 (P < 0.0001), whereas the discharge rate changed from 8 ± 1.1 (mean ± SD) to 10 ± 0.9 pulses/s (P = 0.001). Strikingly, motor units did not discharge continuously throughout standing. They were recruited within individual, forward sways and intermittently, with a modal rate of two recruitments per second. This modal rate is consistent with previous circumstantial evidence relating the control of standing to an intrinsic, higher level planning process.

Prosthetic urinary sphincter

NASA Technical Reports Server (NTRS)

Helms, C. R.; Smyly, H. M. (Inventor)

1981-01-01

A pump/valve unit for controlling the inflation and deflation of a urethral collar in a prosthetic urinary sphincter device is described. A compressible bulb pump defining a reservoir was integrated with a valve unit for implantation. The valve unit includes a movable valve member operable by depression of a flexible portion of the valve unit housing for controlling fluid flow between the reservoir and collar; and a pressure sensing means which operates the valve member to relieve an excess pressure in the collar should too much pressure be applied by the patient.

Can gynaecology teaching associates provide high quality effective training for medical students in the United Kingdom? Comparative study

PubMed Central

Pickard, Sally; Baraitser, Paula; Rymer, Janice; Piper, Johanna

2003-01-01

Objectives To train laywomen to become professional patients in order to teach medical students speculum and bimanual examination, to assess their effectiveness in this role, and to incorporate this method of teaching into the undergraduate curriculum of a medical school in the United Kingdom. Design Comparative study. Setting Guy's, King's, and St Thomas's School of Medicine, London. Participants 44 medical students trained by gynaecology teaching associates; 48 control students. Main outcome measure Skills in pelvic examination. Results Six laywomen were recruited and all successfully graduated to become gynaecology teaching associates. At assessment 1, in the third week of the reproductive and sexual health block, the mean score achieved by students trained by gynaecology teaching associates was 155, compared with 104 for control group students (difference in mean scores 51 (95% confidence interval 41 to 61), P < 0.001). Similar results were obtained at assessment 2, at the end of the attachment—the mean score for trained students was 148, compared with a mean score of 114 for control group students (difference in mean scores 34 (21 to 46), P < 0.001). Conclusions Laywomen can be trained to teach pelvic examination to medical students in the United Kingdom. Students who receive this training have better skills than students who receive the traditional training alone. PMID:14670887

40 CFR 65.118 - Alternative means of emission limitation: Enclosed-vented process units.

Code of Federal Regulations, 2010 CFR

2010-07-01

... PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CONSOLIDATED FEDERAL AIR RULE Equipment Leaks § 65.118... control device. Process units that are enclosed in such a manner that all emissions from equipment leaks...

[Damage control in trauma patients with hemodynamic instability].

PubMed

Müller, Thorben; Doll, Dietrich; Kliebe, Frank; Ruchholtz, Steffen; Kühne, Christian

2010-10-01

The term "Damage-control" is borrowed from naval terminology. It means the initial control of a damaged ship. Because of the lethal triad in multiple injured patients the classical concept of definitive surgically therapy in the acute phase of the injury has a high rate of complications such as exsanguination, sepsis, heart failure and multiple organ failure. The core idea of the damage control concept was to minimize the additional trauma by surgical operations in these critical patients in the first phase. This means temporary control of a hemorrhage and measures for stopping abdominal contamination. After 24 - 48 hours in the intensive care unit and correction of physiological disturbances further interventions are performed for definitively treatment of the injuries. Summarized, the damage control strategy comprises an abbreviated operation, intensive care unit resuscitation, and a return to the operating room for the definitive operation after hemodynamic stabilisation of the patient. © Georg Thieme Verlag Stuttgart · New York.

Effects of Barbell Deadlift Training on Submaximal Motor Unit Firing Rates for the Vastus Lateralis and Rectus Femoris

PubMed Central

Stock, Matt S.; Thompson, Brennan J.

2014-01-01

Previous investigations that have studied motor unit firing rates following strength training have been limited to small muscles, isometric training, or interventions involving exercise machines. We examined the effects of ten weeks of supervised barbell deadlift training on motor unit firing rates for the vastus lateralis and rectus femoris during a 50% maximum voluntary contraction (MVC) assessment. Twenty-four previously untrained men (mean age  = 24 years) were randomly assigned to training (n = 15) or control (n = 9) groups. Before and following the intervention, the subjects performed isometric testing of the right knee extensors while bipolar surface electromyographic signals were detected from the two muscles. The signals were decomposed into their constituent motor unit action potential trains, and motor units that demonstrated accuracy levels less than 92.0% were not considered for analysis. One thousand eight hundred ninety-two and 2,013 motor units were examined for the vastus lateralis and rectus femoris, respectively. Regression analyses were used to determine the linear slope coefficients (pulses per second [pps]/% MVC) and y-intercepts (pps) of the mean firing rate and firing rate at recruitment versus recruitment threshold relationships. Deadlift training significantly improved knee extensor MVC force (Cohen's d = .70), but did not influence force steadiness. Training had no influence on the slopes and y-intercepts for the mean firing rate and firing rate at recruitment versus recruitment threshold relationships. In agreement with previous cross-sectional comparisons and randomized control trials, our findings do not support the notion that strength training affects the submaximal control of motor units. PMID:25531294

Snaring to control feral pigs sus scrofa in a remote Hawaiian rain forest

USGS Publications Warehouse

Anderson, Stephen J.; Stone, Charles P.

1993-01-01

Feral pig Sus scrofa control in Kipahulu Valley, a remote rain forest in Haleakala National Park, Maui, Hawaiian Islands, has been achieved with snares over a 45-month period. Initial pig densities in fenced management units of 6·2 km2 and 7·8 km2were estimated at 6 animals/km2 and 14·3 animals/km2 for the two units, based on population reconstruction from animals killed and aged. During the 45 months of the study, 1978 snares were set, and 1·6 million snare nights were logged. Snare density reached 96/km2 and 200/km2 for the two management units by the end of the study. A mean effort of 43 worker hours/pig was used to remove 53 pigs from the upper management unit, and a mean of 7 worker hours/pig to remove 175 animals from the more densely populated lower unit. Pig activity monitoring along transects provided a good measure of control effectiveness until densities of about 1 pig/km2 were achieved, after which transects became less useful than scouting for determining pig activity.

Language as a Means of Social Control: The United States Experience.

ERIC Educational Resources Information Center

Leibowitz, Arnold H.

Language is defined here as a means of social control, a viewpoint by which language restrictions can be seen as a method of discriminating against speakers of minority languages. A government designates an official language to restrict access to economic and political power. This view of language is substantiated by an analysis of the United…

10 CFR Appendix B to Subpart F of... - Sampling Plan For Enforcement Testing

Code of Federal Regulations, 2011 CFR

2011-01-01

... performance of the n 1 units in the first sample as follows: ER18MR98.012 Step 5. Compute the upper control limit (UCL1) and lower control limit (LCL1) for the mean of the first sample using the applicable DOE... the mean of the first sample (x 1) with the upper and lower control limits (UCL1 and LCL1) to...

ION SWITCH

DOEpatents

Cook, B.

1959-02-10

An ion switch capable of transferring large magnitudes of power is described. An ion switch constructed in accordance with the invention includes a pair of spaced control electrodes disposed in a highly evacuated region for connection in a conventional circuit to control the passing of power therethrough. A controllable ionic conduction path is provided directiy between the control electrodes by a source unit to close the ion switch. Conventional power supply means are provided to trigger the source unit and control the magnitude, durations and pulse repetition rate of the aforementioned ionic conduction path.

Urine output on an intensive care unit: case-control study.

PubMed

Solomon, Anthony W; Kirwan, Christopher J; Alexander, Neal D E; Nimako, Kofi; Jurukov, Angela; Forth, Rebecca J; Rahman, Tony M

2010-12-14

To compare urine output between junior doctors in an intensive care unit and the patients for whom they are responsible. Case-control study. General intensive care unit in a tertiary referral hospital. 18 junior doctors responsible for clerking patients on weekday day shifts in the unit from 23 March to 23 April 2009 volunteered as "cases." Controls were the patients in the unit clerked by those doctors. Exclusion criteria (for both groups) were pregnancy, baseline estimated glomerular filtration rate <15 ml/min/1.73 m(2), and renal replacement therapy. Oliguria (defined as mean urine output <0.5 ml/kg/hour over six or more hours of measurement) and urine output (in ml/kg/hour) as a continuous variable. Doctors were classed as oliguric and "at risk" of acute kidney injury on 19 (22%) of 87 shifts in which urine output was measured, and oliguric to the point of being "in injury" on one (1%) further shift. Data were available for 208 of 209 controls matched to cases in the data collection period; 13 of these were excluded because the control was receiving renal replacement therapy. Doctors were more likely to be oliguric than their patients (odds ratio 1.99, 95% confidence interval 1.08 to 3.68, P=0.03). For each additional 1 ml/kg/hour mean urine output, the odds ratio for being a case rather than a control was 0.27 (0.12 to 0.58, P=0.001). Mortality among doctors was astonishingly low, at 0% (0% to 18%). Managing our own fluid balance is more difficult than managing it in our patients. We should drink more water. Modifications to the criteria for acute kidney injury could be needed for the assessment of junior doctors in an intensive care unit.

Internal quality control of blood products: An experience from a tertiary care hospital blood bank from Southern Pakistan.

PubMed

Sultan, Sadia; Zaheer, Hasan Abbas; Waheed, Usman; Baig, Mohammad Amjad; Rehan, Asma; Irfan, Syed Mohammed

2018-01-01

Internal quality control (IQC) is the backbone of quality assurance program. In blood banking, the quality control of blood products ensures the timely availability of a blood component of high quality with maximum efficacy and minimal risk to potential recipients. The main objective of this study is to analyze the IQC of blood products as an indicator of our blood bank performance. An observational cross-sectional study was conducted at the blood bank of Liaquat National Hospital and Medical College, from January 2014 to December 2015. A total of 100 units of each blood components were arbitrarily chosen during the study. Packed red cell units were evaluated for hematocrit (HCT); random platelet concentrates were evaluated for pH, yield, and culture; fresh frozen plasma (FFP) and cryoprecipitate (CP) were evaluated for unit volume, factor VIII, and fibrinogen concentrations. A total of 400 units were tested for IQC. The mean HCT of packed red cells was 69.5 ± 7.24, and in 98% units, it met the standard (<80% of HCT). The mean platelet yield was 8.8 ± 3.40 × 10 9 /L and pH was ≥6.2 in 98% bags; cultures were negative in 97% of units tested. Mean factor VIII and fibrinogen levels were found to be 84.24 ± 15.01 and 247.17 ± 49.69 for FFP, respectively. For CP, mean factor VIII and fibrinogen level were found to be 178.75 ± 86.30 and 420.7 ± 75.32, respectively. The IQC of blood products at our blood bank is in overall compliance and met recommended international standards. Implementation of standard operating procedures, accomplishment of standard guidelines, proper documentation with regular audit, and staff competencies can improve the quality performance of the transfusion services.

Travel guidance system for vehicles

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

Takanabe, K.; Yamamoto, M.; Ito, K.

1987-02-24

A travel guidance system is described for vehicles including: a heading sensor for detecting a direction of movement of a vehicle; a distance sensor for detecting a distance traveled by the vehicle; a map data storage medium preliminarily storing map data; a control unit for receiving a heading signal from the heading sensor and a distance signal from the distance sensor to successively compute a present position of the vehicle and for generating video signals corresponding to display data including map data from the map data storage medium and data of the present position; and a display having first andmore » second display portions and responsive to the video signals from the control unit to display on the first display portion a map and a present portion mark, in which: the map data storage medium comprises means for preliminarily storing administrative division name data and landmark data; and the control unit comprises: landmark display means for: (1) determining a landmark closest to the present position, (2) causing a position of the landmark to be displayed on the map and (3) retrieving a landmark massage concerning the landmark from the storage medium to cause the display to display the landmark message on the second display portion; division name display means for retrieving the name of an administrative division to which the present position belongs from the storage medium and causing the display to display a division name message on the second display portion; and selection means for selectively actuating at least one of the landmark display means and the division name display means.« less

Motor control differs for increasing and releasing force

PubMed Central

Park, Seoung Hoon; Kwon, MinHyuk; Solis, Danielle; Lodha, Neha

2016-01-01

Control of the motor output depends on our ability to precisely increase and release force. However, the influence of aging on force increase and release remains unknown. The purpose of this study, therefore, was to determine whether force control differs while increasing and releasing force in young and older adults. Sixteen young adults (22.5 ± 4 yr, 8 females) and 16 older adults (75.7 ± 6.4 yr, 8 females) increased and released force at a constant rate (10% maximum voluntary contraction force/s) during an ankle dorsiflexion isometric task. We recorded the force output and multiple motor unit activity from the tibialis anterior (TA) muscle and quantified the following outcomes: 1) variability of force using the SD of force; 2) mean discharge rate and variability of discharge rate of multiple motor units; and 3) power spectrum of the multiple motor units from 0–4, 4–10, 10–35, and 35–60 Hz. Participants exhibited greater force variability while releasing force, independent of age (P < 0.001). Increased force variability during force release was associated with decreased modulation of multiple motor units from 35 to 60 Hz (R2 = 0.38). Modulation of multiple motor units from 35 to 60 Hz was further correlated to the change in mean discharge rate of multiple motor units (r = 0.66) and modulation from 0 to 4 Hz (r = −0.64). In conclusion, these findings suggest that force control is altered while releasing due to an altered modulation of the motor units. PMID:26961104

Translations on USSR Resources, Number 763

DTIC Science & Technology

1978-01-06

supplying gas pumping units, pipes, and other equipment. 33 Shatlyk . Complex Gas Preparation Unit i 1 * Medvezhe. Gas Prepara- tion Block. Thus...handled satisfactorily. . Shatlyk . Turkmengazprom. Central Control Station Combine with Head Facilities Operating Room. By means of the Impul’s-2 remote

Design and Evaluation of a Fully Implantable Control Unit for Blood Pumps

PubMed Central

Unthan, Kristin; Gräf, Felix; Laumen, Marco; Finocchiaro, Thomas; Sommer, Christoph; Lanmüller, Hermann; Steinseifer, Ulrich

2015-01-01

As the number of donor hearts is limited while more and more patients suffer from end stage biventricular heart failure, Total Artificial Hearts become a promising alternative to conventional treatment. While pneumatic devices sufficiently supply the patients with blood flow, the patient's quality of life is limited by the percutaneous pressure lines and the size of the external control unit. This paper describes the development of the control unit of the ReinHeart, a fully implantable Total Artificial Heart. General requirements for any implantable control unit are defined from a technical and medical point of view: necessity of a Transcutaneous Energy Transmission, autonomous operation, safety, geometry, and efficiency. Based on the requirements, a prototype is designed; it incorporates a LiFePo4 battery pack with charger, a rectifier for transcutaneous energy transmission, the motor's driver electronics, and a microcontroller which monitors and controls all functions. In validation tests, the control unit demonstrated a stable operation on TET and battery supply and a safe switching from one supply to the other. The overall mean efficiency is 14% on TET and 22% on battery supply. The control unit is suitable for chronic animal trials of the ReinHeart. PMID:26583095

40 CFR 63.361 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... oxidation control device or at the exhaust point from the combustion chamber of a thermal oxidation control... scrubber achieves at least 99-percent control of ethylene oxide emissions. Oxidation temperature means the temperature at the outlet point of a catalytic oxidation unit control device or at the exhaust point from the...

Decreased erythrocyte nucleoside transport and hENT1 transporter expression in glucose 6-phosphate dehydrogenase deficiency.

PubMed

Al-Ansari, Mohammad; Craik, James D

2015-01-01

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is associated with erythrocyte sensitivity to oxidative damage and hemolytic crises. In β-thalassemia major, where hemoglobin instability imposes oxidative stress, erythrocytes show reduced hENT1 nucleoside transporter expression and decreased nucleoside uptake. This study investigated hENT1 expression and nucleoside transport in G6PD-deficient erythrocytes to determine if decreased hENT1 activity might be a contributory feature in the variable pathology of this enzymopathy. Uptake of (3)H-uridine was measured at room temperature using an inhibitor-oil stop protocol and 5-s incubations. Erythrocyte membranes were analyzed by SDS-PAGE and nucleoside (hENT1), glucose (GLUT-1), and anion exchange (Band 3) transporter polypeptides quantitated on immunoblots. In G6PD-deficient cells, uridine uptake (mean 8.18, 95 % CI 5.6-10.7 vs controls mean 12.35, 95 % CI 9.2-15.5, pmol uridine/gHb/min; P = 0.031) and expression of hENT1 (mean 50.4 %, 95 % CI 38.1-62.7 %, arbitrary units n = 11 vs controls mean 95.23 %, 95 % CI 88.38-102.1 % arbitrary units, n = 8; P < 0.001) were significantly lower; expression of GLUT-1 (mean 106.9 %, vs control mean 99.75 %; P = 0.308) and Band 3 polypeptides (mean 100.1 %, vs control mean 102.84 %; P = 0.329) were unchanged. Nucleoside transporter activity in human erythrocytes sustains intracellular purine nucleotide levels and assists in control of plasma adenosine levels; decreased hENT1 expression and activity in G6PD-deficiency could affect red metabolism and influence a wide spectrum of responses mediated by adenosine receptors.

Magneto-ionic phase control in a quasi-layered donor/acceptor metal-organic framework by means of a Li-ion battery system

NASA Astrophysics Data System (ADS)

Taniguchi, Kouji; Narushima, Keisuke; Yamagishi, Kayo; Shito, Nanami; Kosaka, Wataru; Miyasaka, Hitoshi

2017-06-01

Electrical magnetism control is realized in a Li-ion battery system through a redox reaction involving ion migrations; “magneto-ionic control”. A quasi-layered metal-organic framework compound with a cross-linked π-conjugated/unconjugated one-dimensional chain motifs composed of electron-donor/acceptor units is developed as the cathode material. A change in magnetic phase from paramagnetic to ferrimagnetic is demonstrated by means of electron-filling control for the acceptor units via insertion of Li+-ions into pores in the material. The transition temperature is as high as that expected for highly π-conjugated layered systems, indicating an extension of π-conjugated exchange paths by rearranging coordination bonds in the first discharge process.

10 CFR 71.4 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... venting, external cooling by an ancillary system, or operational controls during transport. Natural...: The International System of Units (SI) followed or preceded by U.S. standard or customary units. The U... water as a common, contract, or private carrier, or by civil aircraft. Certificate holder means a person...

10 CFR 71.4 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... venting, external cooling by an ancillary system, or operational controls during transport. Natural...: The International System of Units (SI) followed or preceded by U.S. standard or customary units. The U... water as a common, contract, or private carrier, or by civil aircraft. Certificate holder means a person...

10 CFR 71.4 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... venting, external cooling by an ancillary system, or operational controls during transport. Natural...: The International System of Units (SI) followed or preceded by U.S. standard or customary units. The U... water as a common, contract, or private carrier, or by civil aircraft. Certificate holder means a person...

Qualitative application of the theory of planned behavior to understand beverage consumption behaviors among adults.

PubMed

Zoellner, Jamie; Krzeski, Erin; Harden, Samantha; Cook, Emily; Allen, Kacie; Estabrooks, Paul A

2012-11-01

Despite strong scientific data indicating associations among sugar-sweetened beverages (SSB) and numerous adverse health outcomes, little is known about culturally specific beliefs and potential individual-level behavioral strategies to reduce SSB intake. The primary objective of this formative study targeting adults residing in rural southwest Virginia was to apply the Theory of Planned Behavior to investigate culturally specific attitudes, subjective norms, and perceived behavioral control constructs related to the consumption of SSB, water, and artificially sweetened beverages. Using a homogenous sampling strategy, eight focus groups were conducted with 54 adult participants who exceeded recommendations of <1 cup of SSB/day. An experienced moderator and co-moderator utilized a semi-structured script, grounded in the Theory of Planned Behavior, to execute the focus group. All focus groups were audiotaped and transcribed verbatim. Three researchers independently coded meaning units to the major themes and subsequently met to gain consensus in coding. Important beverage-specific themes emerged for attitudes, subjective norms, perceived behavioral control, and intentions. Across all beverages, the most notable themes included taste (n=161 meaning units), availability/convenience (n=95 meaning units), habit/addiction (n=57 meaning units), and cost (n=28 meaning units). Health consequences associated with beverages and water-quality issues also surfaced, as well as normative beliefs, including the influence of doctors and peers. The identified themes and subthemes provide critical insight into understanding culturally relevant context and beliefs associated with beverage consumption behaviors and helps inform the development and evaluation of future intervention efforts targeting SSB consumption in the health disparate region of southwest Virginia. Copyright © 2012 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

7 CFR 301.1 - Purpose and scope.

Code of Federal Regulations, 2011 CFR

2011-01-01

... articles, means of conveyance, plants, plant products, biological control organisms, plant pests, or... biological control organism, plant pest, or noxious weed within the United States. The only exceptions to..., plant products, biological control organisms, plant pests, or noxious weeds that are in addition to the...

7 CFR 301.1 - Purpose and scope.

Code of Federal Regulations, 2010 CFR

2010-01-01

... articles, means of conveyance, plants, plant products, biological control organisms, plant pests, or... biological control organism, plant pest, or noxious weed within the United States. The only exceptions to..., plant products, biological control organisms, plant pests, or noxious weeds that are in addition to the...

System for measuring radioactivity of labelled biopolymers

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

Gross, V.

1980-07-08

A system is described for measuring radioactivity of labelled biopolymers, comprising: a set of containers adapted for receiving aqueous solutions of biological samples containing biopolymers which are subsequently precipitated in said containers on particles of diatomite in the presence of a coprecipitator, then filtered, dissolved, and mixed with a scintillator; radioactivity measuring means including a detection chamber to which is fed the mixture produced in said set of containers; an electric drive for moving said set of containers in a stepwise manner; means for proportional feeding of said coprecipitator and a suspension of diatomite in an acid solution to saidmore » containers which contain the biological sample for forming an acid precipitation of biopolymers; means for the removal of precipitated samples from said containers; precipitated biopolymer filtering means for successively filtering the precipitate, suspending the precipitate, dissolving the biopolymers mixed with said scintillator for feeding of the mixture to said detection chamber; a system of pipelines interconnecting said above-recited means; and said means for measuring radioactivity of labelled biopolymers including, a measuring cell arranged in a detection chamber and communicating with said means for filtering precipitated biopolymers through one pipeline of said system of pipelines; a program unit electrically connected to said electric drive, said means for acid precipatation of biopolymers, said means for the removal of precipitated samples from said containers, said filtering means, and said radioactivity measuring device; said program unit adapted to periodically switch on and off the above-recited means and check the sequence of the radioactivity measuring operations; and a control unit for controlling the initiation of the system and for selecting programs.« less

[Prospects in getting accordance between chemical analytic control means and medical technical requirements to safety system concerning chemical weapons destruction].

PubMed

Rembovskiĭ, V R; Mogilenkova, L A; Savel'eva, E I

2005-01-01

The major unit monitoring chemical weapons destruction objects is a system of chemical analyticcontrol over the technologic process procedures and possibility of environment and workplace pollution withtoxicchemicals and their destruction products. At the same time, physical and chemical control means meet sanitary and hygienic requirements incompletely. To provide efficient control, internationally recognized approaches should be adapted to features of Russian system monitoring pollution of chemical weapons destruction objects with toxic chemicals.

Establishment of local diagnostic reference levels for quality control in intraoral radiography.

PubMed

Izawa, Maki; Harata, Yasuo; Shiba, Noriyoshi; Koizumi, Nobuhide; Ozawa, Tomonori; Takahashi, Nobutoshi; Okumura, Yasuhiko

2017-01-01

To investigate the dosage and imaging conditions for patients undergoing intraoral radiography at Meikai University Hospital and establish assurance and quality control data. Tube voltage, exposure time, and air kinetic energy released per unit mass (air kerma) of three intraoral radiography units were measured. To calculate the patient entrance dose (PED) for each radiograph using Insight film, we extracted data for 1063 patients from their exposure records. The PED was compared with the diagnostic reference level (DRL) from the European Commission and the UK. The tube voltage of the three units was maintained at 60 ± 2 kV. Differences in exposure time were less than 1.7 % for all units. The air kerma rates were well maintained within a 4.2 % error. Based on the patient data, there were no significant differences in the mean exposure times for males and females for all anatomical sites. The mean PED ranged from 1.09 ± 0.31 mGy for the mandibular incisors to 2.42 ± 0.33 mGy for the maxillary molars. The mean PED at the mandibular molars using InSight film was 1.59 ± 0.20 mGy, being less than the recommended value based on the DRL for intraoral radiography in the UK. We concluded that radiographic conditions at the hospital have been properly maintained. This basic quality control data may assist other dental radiation facilities to reduce patient dosage.

22 CFR 308.3 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-04-01

...) The term individual means any citizen of the United States or an alien lawfully admitted to permanent... but not limited to information regarding education, financial transactions, medical history, criminal... finger or voiceprint. (b) System of Records means a group of any records under the control of the agency...

25 CFR 515.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... the United States or an alien lawfully admitted for permanent residence. (b) Maintain means maintain... individual that is maintained by the Commission, including education, financial transactions, medical history... print, or a photograph. (d) System of records means a group of any records under the control of the...

Some Spatial Aspects of Southeastern United States Climatology.

ERIC Educational Resources Information Center

Soule, Peter T.

1998-01-01

Focuses on the climatology of an eight-state region in the southern and southeastern United States. Discusses general controls of climate and spatial patterns of various climatic averages. Examines mapped extremes as a means of fostering increased awareness of the variability that exists for climatic conditions in the region. (CMK)

40 CFR 63.7575 - What definitions apply to this subpart?

Code of Federal Regulations, 2014 CFR

2014-07-01

... having the primary purpose of recovering thermal energy in the form of steam or hot water. Controlled... the energy assessment. Electric utility steam generating unit (EGU) means a fossil fuel-fired... for sale. A fossil fuel-fired unit that cogenerates steam and electricity and supplies more than one...

40 CFR 63.7575 - What definitions apply to this subpart?

Code of Federal Regulations, 2013 CFR

2013-07-01

... having the primary purpose of recovering thermal energy in the form of steam or hot water. Controlled... the energy assessment. Electric utility steam generating unit (EGU) means a fossil fuel-fired... for sale. A fossil fuel-fired unit that cogenerates steam and electricity and supplies more than one...

40 CFR 60.1940 - What definitions must I know?

Code of Federal Regulations, 2014 CFR

2014-07-01

.../combustion unit means a unit that produces gases, liquids, or solids by heating municipal solid waste. The gases, liquids, or solids produced are combusted and the emissions vented to the atmosphere... arithmetic average flue gas temperature measured at the inlet of the particulate matter control device during...

40 CFR 60.1940 - What definitions must I know?

Code of Federal Regulations, 2013 CFR

2013-07-01

.../combustion unit means a unit that produces gases, liquids, or solids by heating municipal solid waste. The gases, liquids, or solids produced are combusted and the emissions vented to the atmosphere... arithmetic average flue gas temperature measured at the inlet of the particulate matter control device during...

40 CFR 60.1940 - What definitions must I know?

Code of Federal Regulations, 2012 CFR

2012-07-01

.../combustion unit means a unit that produces gases, liquids, or solids by heating municipal solid waste. The gases, liquids, or solids produced are combusted and the emissions vented to the atmosphere... arithmetic average flue gas temperature measured at the inlet of the particulate matter control device during...

10 CFR 490.301 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... ENERGY ENERGY CONSERVATION ALTERNATIVE FUEL TRANSPORTATION PROGRAM Alternative Fuel Provider Vehicle..., is controlled by, or is under common ownership or control of a person subject to vehicle acquisition... selling at wholesale or retail electricity. Business Unit means a semi-autonomous major grouping of...

10 CFR 490.301 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... ENERGY ENERGY CONSERVATION ALTERNATIVE FUEL TRANSPORTATION PROGRAM Alternative Fuel Provider Vehicle..., is controlled by, or is under common ownership or control of a person subject to vehicle acquisition... selling at wholesale or retail electricity. Business Unit means a semi-autonomous major grouping of...

10 CFR 490.301 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... ENERGY ENERGY CONSERVATION ALTERNATIVE FUEL TRANSPORTATION PROGRAM Alternative Fuel Provider Vehicle..., is controlled by, or is under common ownership or control of a person subject to vehicle acquisition... selling at wholesale or retail electricity. Business Unit means a semi-autonomous major grouping of...

10 CFR 490.301 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... ENERGY ENERGY CONSERVATION ALTERNATIVE FUEL TRANSPORTATION PROGRAM Alternative Fuel Provider Vehicle..., is controlled by, or is under common ownership or control of a person subject to vehicle acquisition... selling at wholesale or retail electricity. Business Unit means a semi-autonomous major grouping of...

Spool-type control valve assembly with reduced spool stroke for hydraulic belt-and-pulley type continuously variable transmission

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

Itoh, H.; Akashi, T.; Takada, M.

1987-03-31

This patent describes a hydraulic control system for controlling a speed ratio of a hydraulically-operated continuously variable transmission of belt-and-pulley type having a variable-diameter pulley and a hydraulic cylinder for changing an effective diameter of the variable diameter-pulley of the transmission. The hydraulic control system includes a speed-ratio control valve assembly for controlling the supply and discharge of a pressurized fluid to and from the hydraulic cylinder to thereby change the speed ratio of the transmission. The speed-ratio control valve assembly comprises: a shift-direction switching valve unit disposed in fluid supply and discharge conduits communicating with the hydraulic cylinder, formore » controlling a direction in which the speed ratio of the transmission is varied; a shift-speed control valve unit of spool-valve type connected to the shift-direction switching valve unit. The shift-speed control valve unit is selectively placed in a first state in which the fluid supply and discharge flows to and from the hydraulic cylinder through the conduits are permitted, or in a second state in which the fluid supply flow is restricted while the fluid discharge flow is inhibited; an actuator means for placing the shift speed control valve unit alternately in the first and second states to control a rate of variation in the speed ratio of the transmission in the direction established by the shift-direction switching valve unit.« less

40 CFR 97.502 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... products), and landscape or right-of-way tree trimmings. Boiler means an enclosed fossil- or other-fuel... unit means a stationary, fossil-fuel-fired boiler or stationary, fossil-fuel-fired combustion turbine... limitation for the source for such control period. Fossil fuel means— (1) Natural gas, petroleum, coal, or...

40 CFR 97.502 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... products), and landscape or right-of-way tree trimmings. Boiler means an enclosed fossil- or other-fuel... unit means a stationary, fossil-fuel-fired boiler or stationary, fossil-fuel-fired combustion turbine... limitation for the source for such control period. Fossil fuel means— (1) Natural gas, petroleum, coal, or...

40 CFR 97.502 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... products), and landscape or right-of-way tree trimmings. Boiler means an enclosed fossil- or other-fuel... unit means a stationary, fossil-fuel-fired boiler or stationary, fossil-fuel-fired combustion turbine... limitation for the source for such control period. Fossil fuel means— (1) Natural gas, petroleum, coal, or...

An Internet-Mediated Pedometer-Based Program Improves Health-Related Quality-of-Life Domains and Daily Step Counts in COPD

PubMed Central

Moy, Marilyn L.; Collins, Riley J.; Martinez, Carlos H.; Kadri, Reema; Roman, Pia; Holleman, Robert G.; Kim, Hyungjin Myra; Nguyen, Huong Q.; Cohen, Miriam D.; Goodrich, David E.; Giardino, Nicholas D.

2015-01-01

BACKGROUND: Low levels of physical activity (PA) are associated with poor outcomes in people with COPD. Interventions to increase PA could improve outcomes. METHODS: We tested the efficacy of a novel Internet-mediated, pedometer-based exercise intervention. Veterans with COPD (N = 239) were randomized in a 2:1 ratio to the (1) intervention group (Omron HJ-720 ITC pedometer and Internet-mediated program) or (2) wait-list control group (pedometer). The primary outcome was health-related quality of life (HRQL), assessed by the St. George’s Respiratory Questionnaire (SGRQ), at 4 months. We examined the SGRQ total score (SGRQ-TS) and three domain scores: Symptoms, Activities, and Impact. The secondary outcome was daily step counts. Linear regression models assessed the effect of intervention on outcomes. RESULTS: Participants had a mean age of 67 ± 9 years, and 94% were men. There was no significant between-group difference in mean 4-month SGRQ-TS (2.3 units, P = .14). Nevertheless, a significantly greater proportion of intervention participants than control subjects had at least a 4-unit improvement in SGRQ-TS, the minimum clinically important difference (53% vs 39%, respectively, P = .05). For domain scores, the intervention group had a lower (reflecting better HRQL) mean than the control group by 4.6 units for Symptoms (P = .046) and by 3.3 units for Impact (P = .049). There was no significant difference in Activities score between the two groups. Compared with the control subjects, intervention participants walked 779 more steps per day at 4 months (P = .005). CONCLUSIONS: An Internet-mediated, pedometer-based walking program can improve domains of HRQL and daily step counts at 4 months in people with COPD. TRIAL REGISTRY: Clinical Trials.gov; No.: NCT01102777; URL: www.clinicaltrials.gov PMID:25811395

Urine output on an intensive care unit: case-control study

PubMed Central

Kirwan, Christopher J; Alexander, Neal D E; Nimako, Kofi; Jurukov, Angela; Forth, Rebecca J; Rahman, Tony M

2010-01-01

Objective To compare urine output between junior doctors in an intensive care unit and the patients for whom they are responsible. Design Case-control study. Setting General intensive care unit in a tertiary referral hospital. Participants 18 junior doctors responsible for clerking patients on weekday day shifts in the unit from 23 March to 23 April 2009 volunteered as “cases.” Controls were the patients in the unit clerked by those doctors. Exclusion criteria (for both groups) were pregnancy, baseline estimated glomerular filtration rate <15 ml/min/1.73 m2, and renal replacement therapy. Main outcome measures Oliguria (defined as mean urine output <0.5 ml/kg/hour over six or more hours of measurement) and urine output (in ml/kg/hour) as a continuous variable. Results Doctors were classed as oliguric and “at risk” of acute kidney injury on 19 (22%) of 87 shifts in which urine output was measured, and oliguric to the point of being “in injury” on one (1%) further shift. Data were available for 208 of 209 controls matched to cases in the data collection period; 13 of these were excluded because the control was receiving renal replacement therapy. Doctors were more likely to be oliguric than their patients (odds ratio 1.99, 95% confidence interval 1.08 to 3.68, P=0.03). For each additional 1 ml/kg/hour mean urine output, the odds ratio for being a case rather than a control was 0.27 (0.12 to 0.58, P=0.001). Mortality among doctors was astonishingly low, at 0% (0% to 18%). Conclusions Managing our own fluid balance is more difficult than managing it in our patients. We should drink more water. Modifications to the criteria for acute kidney injury could be needed for the assessment of junior doctors in an intensive care unit. PMID:21156738

Effect of lavender aromatherapy on vital signs and perceived quality of sleep in the intermediate care unit: a pilot study.

PubMed

Lytle, Jamie; Mwatha, Catherine; Davis, Karen K

2014-01-01

Sleep deprivation in hospitalized patients is common and can have serious detrimental effects on recovery from illness. Lavender aromatherapy has improved sleep in a variety of clinical settings, but the effect has not been tested in the intermediate care unit. To determine the effect of inhalation of 100% lavender oil on patients' vital signs and perceived quality of sleep in an intermediate care unit. A randomized controlled pilot study was conducted in 50 patients. Control patients received usual care. The treatment group had 3 mL of 100% pure lavender oil in a glass jar in place at the bedside from 10 pm until 6 am. Vital signs were recorded at intervals throughout the night. At 6 am all patients completed the Richard Campbell Sleep Questionnaire to assess quality of sleep. Blood pressure was significantly lower between midnight and 4 am in the treatment group than in the control group (P = .03) According to the overall mean change score in blood pressure between the baseline and 6 am measurements, the treatment group had a decrease in blood pressure and the control group had an increase; however, the difference between the 2 groups was not significant (P = .12). Mean overall sleep score was higher in the intervention group (48.25) than in the control group (40.10), but the difference was not significant. Lavender aromatherapy may be an effective way to improve sleep in an intermediate care unit.

Effect of Tranexamic Acid on Blood Loss and Blood Transfusion Reduction after Total Knee Arthroplasty.

PubMed

Seol, Young-Jun; Seon, Jong-Keun; Lee, Seung-Hun; Jin, Cheng; Prakash, Jatin; Park, Yong-Jin; Song, Eun-Kyoo

2016-09-01

Total knee arthroplasty (TKA) accompanies the risk of bleeding and need for transfusion. There are several methods to reduce postoperative blood loss and blood transfusion. One such method is using tranexamic acid during TKA. The purpose of this study was to confirm whether tranexamic acid reduces postoperative blood loss and blood transfusion after TKA. A total of 100 TKA patients were included in the study. The tranexamic acid group consisted of 50 patients who received an intravenous injection of tranexamic acid. The control included 50 patients who received a placebo injection. The amounts of drainage, postoperative hemoglobin, and transfusion were compared between the groups. The mean amount of drainage was lower in the tranexamic acid group (580.6±355.0 mL) than the control group (886.0±375.5 mL). There was a reduction in the transfusion rate in the tranexamic acid group (48%) compared with the control group (64%). The hemoglobin level was higher in the tranexamic acid group than in the control group at 24 hours postoperatively. The mean units of transfusion were smaller in the tranexamic acid group (0.76 units) than in the control group (1.28 units). Our data suggest that intravenous injection of tranexamic acid decreases the total blood loss and transfusion after TKA.

10 CFR Appendix A1 to Subpart B of... - Uniform Test Method for Measuring the Energy Consumption of Electric Refrigerators and Electric...

Code of Federal Regulations, 2010 CFR

2010-01-01

... freezer compartment volume as defined in HRF-1-1979, in cubic feet. 1.3“Anti-sweat heater” means a device... operating characteristics. 1.7“Standard cycle” means the cycle type in which the anti-sweat heater control... unit under test. Defrost controls are to be operative and the anti-sweat heater switch is to be “on...

46 CFR 61.20-3 - Main and auxiliary machinery and associated equipment, including fluid control systems.

Code of Federal Regulations, 2010 CFR

2010-10-01

... control for the means of stopping machinery driving forced and induced draft fans, fuel oil transfer pumps, fuel oil unit pumps, and fans in the ventilation systems serving machinery and cargo spaces shall be...

Climatology of the interior Columbia River basin.

Treesearch

Sue A. Ferguson

1999-01-01

This work describes climate means and trends in each of three major ecological zones and 13 ecological reporting units in the interior Columbia River basin. Widely differing climates help define each major zone and reporting unit, the pattern of which is controlled by three competing air masses: marine, continental, and arctic. Paleoclimatic evidence and historical...

40 CFR 62.14840 - What definitions must I know?

Code of Federal Regulations, 2010 CFR

2010-07-01

... which typically have enclosed fireboxes and controlled air technology such as mass burn, modular, and... waste is not high-level radioactive waste, spent nuclear fuel, or by-product material as defined by the... unit means a unit that burns the coatings off racks used to hold small items for application of a...

40 CFR 62.14840 - What definitions must I know?

Code of Federal Regulations, 2011 CFR

2011-07-01

... which typically have enclosed fireboxes and controlled air technology such as mass burn, modular, and... waste is not high-level radioactive waste, spent nuclear fuel, or by-product material as defined by the... unit means a unit that burns the coatings off racks used to hold small items for application of a...

40 CFR 63.7575 - What definitions apply to this subpart?

Code of Federal Regulations, 2011 CFR

2011-07-01

... controlled flame combustion and having the primary purpose of recovering thermal energy in the form of steam... on its floor. Electric utility steam generating unit means a fossil fuel-fired combustion unit of more than 25 megawatts that serves a generator that produces electricity for sale. A fossil fuel-fired...

40 CFR 63.7575 - What definitions apply to this subpart?

Code of Federal Regulations, 2012 CFR

2012-07-01

... controlled flame combustion and having the primary purpose of recovering thermal energy in the form of steam... on its floor. Electric utility steam generating unit means a fossil fuel-fired combustion unit of more than 25 megawatts that serves a generator that produces electricity for sale. A fossil fuel-fired...

46 CFR 28.840 - Means for stopping pumps, ventilation, and machinery.

Code of Federal Regulations, 2014 CFR

2014-10-01

... pumps, ventilation, and machinery. All electrically driven fuel oil transfer pumps, fuel oil unit and service pumps, and ventilation fans shall be fitted with remote controls from a readily accessible... 46 Shipping 1 2014-10-01 2014-10-01 false Means for stopping pumps, ventilation, and machinery. 28...

46 CFR 28.840 - Means for stopping pumps, ventilation, and machinery.

Code of Federal Regulations, 2010 CFR

2010-10-01

... pumps, ventilation, and machinery. All electrically driven fuel oil transfer pumps, fuel oil unit and service pumps, and ventilation fans shall be fitted with remote controls from a readily accessible... 46 Shipping 1 2010-10-01 2010-10-01 false Means for stopping pumps, ventilation, and machinery. 28...

46 CFR 28.840 - Means for stopping pumps, ventilation, and machinery.

Code of Federal Regulations, 2013 CFR

2013-10-01

... pumps, ventilation, and machinery. All electrically driven fuel oil transfer pumps, fuel oil unit and service pumps, and ventilation fans shall be fitted with remote controls from a readily accessible... 46 Shipping 1 2013-10-01 2013-10-01 false Means for stopping pumps, ventilation, and machinery. 28...

46 CFR 28.840 - Means for stopping pumps, ventilation, and machinery.

Code of Federal Regulations, 2012 CFR

2012-10-01

... pumps, ventilation, and machinery. All electrically driven fuel oil transfer pumps, fuel oil unit and service pumps, and ventilation fans shall be fitted with remote controls from a readily accessible... 46 Shipping 1 2012-10-01 2012-10-01 false Means for stopping pumps, ventilation, and machinery. 28...

46 CFR 28.840 - Means for stopping pumps, ventilation, and machinery.

Code of Federal Regulations, 2011 CFR

2011-10-01

... pumps, ventilation, and machinery. All electrically driven fuel oil transfer pumps, fuel oil unit and service pumps, and ventilation fans shall be fitted with remote controls from a readily accessible... 46 Shipping 1 2011-10-01 2011-10-01 false Means for stopping pumps, ventilation, and machinery. 28...

46 CFR 10.107 - Definitions in subchapter B.

Code of Federal Regulations, 2012 CFR

2012-10-01

... officer. Ballast control operator or BCO means an officer restricted to service on mobile offshore... attend classes, make contributions of time or money, receive treatment, submit to any manner of probation.... Mobile offshore drilling unit or MODU means a vessel capable of engaging in drilling operations for the...

46 CFR 10.107 - Definitions in subchapter B.

Code of Federal Regulations, 2013 CFR

2013-10-01

... officer. Ballast control operator or BCO means an officer restricted to service on mobile offshore... attend classes, make contributions of time or money, receive treatment, submit to any manner of probation.... Mobile offshore drilling unit or MODU means a vessel capable of engaging in drilling operations for the...

12 CFR 28.11 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... credit. (r) Large United States business means any business entity including a corporation, company... vote 25 percent or more of any class of voting securities of the other entity or controls in any manner...) Establish a Federal branch or agency means to: (1) Open and conduct business through an initial or...

36 CFR 903.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Saturday, Sunday or legal holiday. (d) Individual means a citizen of the United States or an alien lawfully... agency, including, but not limited to, his or her education, financial transactions, medical history, and.... (g) The term system of records means a group of records under the control of an agency from which...

47 CFR 0.551 - Purpose and scope; definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

...: (1) Individual means a citizen of the United States or an alien lawfully admitted for permanent... maintained by the Commission, including but not limited to, such individual's education, financial... finger or voice print or a photograph. (3) System of Records means a group of records under the control...

11 CFR 9410.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Vote Act of 2002, 42 U.S.C. 15323. Individual means a citizen of the United States or an alien lawfully... Commission including, but not limited to, his or her education, financial transactions, medical history, and... a photograph. Systems of records means a group of any records under the control of the Commission...

Estimating contraction level using root mean square amplitude in control subjects and patients with neuromuscular disorders.

PubMed

Boe, Shaun G; Rice, Charles L; Doherty, Timothy J

2008-04-01

To assess the utility of the surface electromyographic signal as a means of estimating the level of muscle force during quantitative electromyography studies by examining the relationship between muscle force and the amplitude of the surface electromyographic activity signal; and to determine the impact of a reduction in the number of motor units on this relationship, through inclusion of a sample of patients with neuromuscular disease. Cross-sectional, cohort study design. Tertiary care, ambulatory, electromyography laboratory. A volunteer, convenience sample of healthy control subjects (n=10), patients with amyotrophic lateral sclerosis (n=9), and patients with Charcot-Marie-Tooth disease type X (n=5). Not applicable. The first dorsal interosseous (FDI) and biceps brachii muscles were examined. Force values (at 10% increments) were calculated from two 4-second maximal voluntary contractions (MVCs). Surface electromyographic activity was recorded during separate 4-second voluntary contractions at 9 force increments (10% -90% of MVC). Additionally, a motor unit number estimate was derived for each subject to quantify the degree of motor unit loss in patients relative to control subjects. The relationships between force and surface electromyographic activity for both muscles (controls and patients) were best fit by a linear function. The variability about the grouped regression lines was quantified by 95% confidence intervals and found to be +/-6.7% (controls) and +/-8.5% (patients) for the FDI and +/-5% (controls) and +/-6.1% (patients) for the biceps brachii. These results suggest that the amplitude of the surface electromyographic activity signal may be used as a means of estimating the level of muscle force during quantitative electromyography studies. Future studies should be directed at examining if the variability associated with these force and surface electromyographic activity relationships is acceptable in replacing previous methods of measuring muscle force.

Increased plasma pancreatic polypeptide in chronic alcohol abuse.

PubMed

Fink, R S; Adrian, T E; Margot, D H; Bloom, S R

1983-04-01

Post-prandial plasma gastrointestinal hormone profiles were measured in nine chronic alcoholics, one and fourteen days after complete alcohol withdrawal. Basal plasma pancreatic polypeptide concentration (PP--mean +/- SE mean) was significantly greater in alcoholics (control, 28 +/- 5 pmol/l; alcoholics, post-withdrawal day 1, 62 +/- 14 pmol/l, P less than 0.05; and post-withdrawal day 14, 89 +/- 17 pmol/1, P less than 0.005). The total integrated (TIR) PP response following a test breakfast was similarly elevated (control, 442 +/- 63 units; alcoholics, day 1, 1310 +/- 231 units, P less than 0.005; day 14,1066 +/- 66, P less than 0.005). Basal and TIR values for gastrin, gastric inhibitory peptide, insulin and glucagon were similar in alcoholics and controls. As PP has been shown to inhibit pancreatic exocrine enzyme secretion, these findings may help explain the abnormal pancreatic function seen frequently in alcoholics.

Association of Vitamin A Supplementation With Disease Course in Children With Retinitis Pigmentosa.

PubMed

Berson, Eliot L; Weigel-DiFranco, Carol; Rosner, Bernard; Gaudio, Alexander R; Sandberg, Michael A

2018-05-01

While oral vitamin A supplementation is considered to potentially slow loss of retinal function in adults with retinitis pigmentosa and normal liver function, little data from children with this disease are available. To compare disease courses in children with retinitis pigmentosa taking or not taking vitamin A supplementation. Retrospective, nonrandomized comparison of vitamin A and control cohorts followed up for a mean of 4 to 5 years by the Electroretinography Service of the Massachusetts Eye and Ear Infirmary. The study included children with different genetic types of typical retinitis pigmentosa: 55 taking vitamin A and 25 not taking vitamin A. The dates for patient evaluations ranged from June 1976 to July 2016, and the data analysis occurred in October 2016. Age-adjusted dose of oral vitamin A palmitate (≤15 000 IU/d). Mean exponential rates of change of full-field cone electroretinogram amplitude to 30-Hz flashes estimated by repeated-measures longitudinal regression without and with adjusting for potential confounders. Of the 55 children in the vitamin A cohort, 38 (69%) were male; the mean [SD] age was 9.1 [1.9] years; and 48 (87%) were white , 6 (11%) were Asian, and 1 (2%) was black. Of the 25 members of the control cohort, 19 (76%) were male; the mean [SD] age was 9.2 [1.7] years; and 25 (100%) were white. The estimated mean rates of change with the unadjusted model were -0.0713 loge unit/y (-6.9% per year) for the vitamin A cohort and -0.1419 loge unit per year (-13.2% per year) for the control cohort (difference, 0.0706 loge unit per year; 95% CI for the difference, 0.0149-0.1263 loge unit per year; P = .01). The adjusted model confirmed a slower mean rate of decline in the vitamin A cohort (difference, 0.0771 loge-unit per year; 95% CI for the difference, 0.0191-0.1350 loge-unit per year; P = .009). With respect to ocular safety, the mean exponential rates of change of visual field area and visual acuity and the incidences of falling to a visual field diameter of 20° or less or a visual acuity of 20/200 or less in at least 1 eye did not differ by cohort. A vitamin A palmitate supplement was associated with a slower loss of cone electroretinogram amplitude in children with retinitis pigmentosa. Although the relatively small-sample, retrospective, nonrandomized design does not allow a test of causation and is subject to possible biases, these findings support consideration of an age-adjusted dose of vitamin A in the management of most children with the common forms of retinitis pigmentosa.

49 CFR 218.93 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... button or radio control when such switch is protected by distant switch indicators, switch point... units are connected so that they may be operated from a single control stand. Locomotive means, for... one or more propelling motors designed for moving other equipment; (2) With one or more propelling...

Charge control microcomputer device for vehicles

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

Morishita, M.; Kouge, S.

1986-10-14

This patent describes a charge control microcomputer device for a vehicle, comprising: speed changing means for transmitting the output torque of an engine. The speed changing means includes a slip clutch means having an output with a variable slippage amount with respect to its input and controlled in accordance with an operating instruction. The speed changing means further includes a speed change gear for changing the rotational speed input thereto at an output thereto, the speed change gear receiving the output of the slip clutch means; a charging generator driven by the output of the speed change gear; a batterymore » charged by an output voltage of the charging generator; a voltage regulator for controlling the output voltage of the charging generator to a predetermined value; an engine controlling microcomputer for receiving data from the engine, to control the engine, the engine data comprising at least an engine speed signal; a charge control microcomputer for processing engine data from the engine controlling microcomputer and charge system data including terminal voltage data from the battery and generated voltage data from the changing generator; and a display unit for displaying detection data, including fault detection data, form the charge control microcomputer.« less

Impact of interactive online units on learning science among students with learning disabilities and English learners

NASA Astrophysics Data System (ADS)

Terrazas-Arellanes, Fatima E.; Gallard M., Alejandro J.; Strycker, Lisa A.; Walden, Emily D.

2018-03-01

The purpose of this study was to document the design, classroom implementation, and effectiveness of interactive online units to enhance science learning over 3 years among students with learning disabilities, English learners, and general education students. Results of a randomised controlled trial with 2,303 middle school students and 71 teachers across 13 schools in two states indicated that online units effectively deepened science knowledge across all three student groups. Comparing all treatment and control students on pretest-to-posttest improvement on standards-based content-specific assessments, there were statistically significant mean differences (17% improvement treatment vs. 6% control; p < .001); no significant interactions were found between treatment condition and learning disability or English learner status, indicating that these two groups performed similarly to their peers; students with learning disabilities had significantly lower assessment scores overall. Teachers and students were moderately satisfied with the units.

10 CFR 61.52 - Land disposal facility operation and disposal site closure.

Code of Federal Regulations, 2013 CFR

2013-01-01

... meters below the top surface of the cover or must be disposed of with intruder barriers that are designed... mapped by means of a land survey. Near-surface disposal units must be marked in such a way that the boundaries of each unit can be easily defined. Three permanent survey marker control points, referenced to...

10 CFR 61.52 - Land disposal facility operation and disposal site closure.

Code of Federal Regulations, 2014 CFR

2014-01-01

... meters below the top surface of the cover or must be disposed of with intruder barriers that are designed... mapped by means of a land survey. Near-surface disposal units must be marked in such a way that the boundaries of each unit can be easily defined. Three permanent survey marker control points, referenced to...

10 CFR 61.52 - Land disposal facility operation and disposal site closure.

Code of Federal Regulations, 2010 CFR

2010-01-01

... meters below the top surface of the cover or must be disposed of with intruder barriers that are designed... mapped by means of a land survey. Near-surface disposal units must be marked in such a way that the boundaries of each unit can be easily defined. Three permanent survey marker control points, referenced to...

10 CFR 61.52 - Land disposal facility operation and disposal site closure.

Code of Federal Regulations, 2011 CFR

2011-01-01

... meters below the top surface of the cover or must be disposed of with intruder barriers that are designed... mapped by means of a land survey. Near-surface disposal units must be marked in such a way that the boundaries of each unit can be easily defined. Three permanent survey marker control points, referenced to...

10 CFR 61.52 - Land disposal facility operation and disposal site closure.

Code of Federal Regulations, 2012 CFR

2012-01-01

... meters below the top surface of the cover or must be disposed of with intruder barriers that are designed... mapped by means of a land survey. Near-surface disposal units must be marked in such a way that the boundaries of each unit can be easily defined. Three permanent survey marker control points, referenced to...

40 CFR 52.1881 - Control strategy: Sulfur oxides (sulfur dioxide).

Code of Federal Regulations, 2013 CFR

2013-07-01

... sulfur oxides. (iii) Fossil fuel means natural gas, refinery fuel gas, coke oven gas, petroleum, coal and any form of solid, liquid, or gaseous fuel derived from such materials. (iv) Fossil fuel-fired steam generating unit means a furnace or boiler used in the process of burning fossil fuel for the purpose of...

40 CFR 52.1881 - Control strategy: Sulfur oxides (sulfur dioxide).

Code of Federal Regulations, 2014 CFR

2014-07-01

... sulfur oxides. (iii) Fossil fuel means natural gas, refinery fuel gas, coke oven gas, petroleum, coal and any form of solid, liquid, or gaseous fuel derived from such materials. (iv) Fossil fuel-fired steam generating unit means a furnace or boiler used in the process of burning fossil fuel for the purpose of...

40 CFR 52.1881 - Control strategy: Sulfur oxides (sulfur dioxide).

Code of Federal Regulations, 2010 CFR

2010-07-01

... sulfur oxides. (iii) Fossil fuel means natural gas, refinery fuel gas, coke oven gas, petroleum, coal and any form of solid, liquid, or gaseous fuel derived from such materials. (iv) Fossil fuel-fired steam generating unit means a furnace or boiler used in the process of burning fossil fuel for the purpose of...

40 CFR 52.1881 - Control strategy: Sulfur oxides (sulfur dioxide).

Code of Federal Regulations, 2012 CFR

2012-07-01

... sulfur oxides. (iii) Fossil fuel means natural gas, refinery fuel gas, coke oven gas, petroleum, coal and any form of solid, liquid, or gaseous fuel derived from such materials. (iv) Fossil fuel-fired steam generating unit means a furnace or boiler used in the process of burning fossil fuel for the purpose of...

40 CFR 52.1881 - Control strategy: Sulfur oxides (sulfur dioxide).

Code of Federal Regulations, 2011 CFR

2011-07-01

... sulfur oxides. (iii) Fossil fuel means natural gas, refinery fuel gas, coke oven gas, petroleum, coal and any form of solid, liquid, or gaseous fuel derived from such materials. (iv) Fossil fuel-fired steam generating unit means a furnace or boiler used in the process of burning fossil fuel for the purpose of...

Biorational control programme for the German cockroach (Blattaria: Blattellidae) in selected urban communities.

PubMed

Shahraki, GholamHossein; Bin Ibrahim, Yusof; Noor, Hafidzi Mohd; Rafinejad, Javad; Shahar, Mohd Khadri

2010-08-01

This study assessed the effectiveness of a biorational control approach using 2% hydramethylnon gel bait on German cockroaches, Blattella germanica (L.) in some residential and hospital buildings in South Western Iran. In total, three buildings consisting of 150 apartment units and 101 hospital units were monitored weekly via sticky trap for German cockroach infestations over a period of eight months. These infested units were randomly subjected to intervention and control treatments. Pamphlets and posters were provided and lectures were given to support the educational programmes as a tactic of the biorational system. Survey on cockroach index for intervention units showed 67-94% recovery to achieve clean level of infestation for intervention units of the residential buildings and 83% for the hospital. Mean percentage reductions for treatment groups throughout the 15-week treatment period were 76.8% for the residential buildings and 88.1% for the hospital, showing significant differences compared to the control groups. Linear regression of infestation rates were recorded weekly after treatment and their negative slope for treatment groups substantiated significant reductions for interventions. The results of this study showed that biorational control method, using gel bait, educational programmes and sanitation, is an effective way to manage German cockroach infestation.

Automatic Control by Microprocessor of a Patient's Weight Loss During an Extrarenal Purification Session by Hemofiltration

PubMed Central

Faucheux, F.; L'Huillier, J.P.; Rouillion, P.; Yvroud, E.; Kessler, M.; Huriet, C.

1982-01-01

The extranephric cleaning by means of hemofiltration and generally operations in extracorporal circulation requires the blood derivation towards a treatment apparatus: filtration by means of hemodialysis, oxygenation. The working principle of the treatment apparatuses does not simply allow to connect the blood flow taken from the patient. A control of the patient is therefore necessary to have a treatment performed in good conditions. The method that we propose consists in weighting the variable containing unit of the apparatus and in subjecting this weight to a value determined by the physician. This value is programmed on the machine before the treatment session. The control is performed by means of an action on the differential flow and allow a precise control of the weight loss of the patient during a treatment in extranephric cleaning by means of hemofiltration.

Comparison through a prospective and randomized study of two replenishment methods at polyvalent hospitalization units with two-bin storage systems

PubMed

Bernal, José Luis; Mera-Flores, Ana María; Baena Lázaro, Pedro Pablo; Sebastián Viana, Tomás

2017-11-27

Two-bin storage systems increase nursing staff satisfaction and decrease inventories, but the implications that logistic staff would determine the needs of replenishment are unknown. This study aimed to evaluate whether entrust to logistics staff this responsibility at the polyvalent hospitalization units with two-bin storage is associated with higher risk of outstanding orders. This was a prospective randomized experiment whit masking. Outstanding orders were considered variable response, those corresponding to assessments of the logistics staff were included in the control group and those corresponding to the nursing staff in the control group. Concordance between observers was analyzed using the Bland-Altman method; the difference between groups, with the U of Mann-Whitney and the cumulative incidence of outstanding orders and their relative risk was calculated. The mean amount requested by the logistic and nursing staff was 29.9 (SD:167.4) and 36 (SD:190) units respectively, the mean difference between observers was 6.11 (SD:128.95) units and no significant differences were found between groups (p = 0.430). The incidence of outstanding orders was 0.64% in the intervention group and 0.15% in the control group; the relative risk, 2.31 (0.83 - 6.48) and the number of cases required for an outstanding order, 516. Outstanding order relative risk is not associated with the category of the staff that identifies the replenishment needs at the polyvalent hospitalization units.

Effect of Tranexamic Acid on Blood Loss and Blood Transfusion Reduction after Total Knee Arthroplasty

PubMed Central

Seol, Young-Jun; Seon, Jong-Keun; Lee, Seung-Hun; Jin, Cheng; Prakash, Jatin; Park, Yong-Jin

2016-01-01

Purpose Total knee arthroplasty (TKA) accompanies the risk of bleeding and need for transfusion. There are several methods to reduce postoperative blood loss and blood transfusion. One such method is using tranexamic acid during TKA. The purpose of this study was to confirm whether tranexamic acid reduces postoperative blood loss and blood transfusion after TKA. Materials and Methods A total of 100 TKA patients were included in the study. The tranexamic acid group consisted of 50 patients who received an intravenous injection of tranexamic acid. The control included 50 patients who received a placebo injection. The amounts of drainage, postoperative hemoglobin, and transfusion were compared between the groups. Results The mean amount of drainage was lower in the tranexamic acid group (580.6±355.0 mL) than the control group (886.0±375.5 mL). There was a reduction in the transfusion rate in the tranexamic acid group (48%) compared with the control group (64%). The hemoglobin level was higher in the tranexamic acid group than in the control group at 24 hours postoperatively. The mean units of transfusion were smaller in the tranexamic acid group (0.76 units) than in the control group (1.28 units). Conclusions Our data suggest that intravenous injection of tranexamic acid decreases the total blood loss and transfusion after TKA. PMID:27595071

33 CFR 141.10 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., unincorporated company, or association, one in which 50% or more of the controlling interest is vested in... laws of the United States or of any State thereof. Citizen of a foreign nation means: (1) In the case..., unincorporated company, or association, one in which more than 50% of the controlling interest is vested in...

Firing rate modulation of human motor units in different muscles during isometric contraction with various forces.

PubMed

Seki, K; Narusawa, M

1996-05-06

To examine the factors affecting the control of human motor units, rate coding strategies of the motor units were investigated in upper limb and intrinsic hand muscles during voluntary isometric contraction of steady force levels up to 80% of maximal voluntary contraction. Numerous spike trains from single motor units were recorded from the m. first dorsal interosseous (FDI) and the m. biceps brachii (BB) of eight human subjects by means of tungsten micro-electrodes, and the mean firing rate (MFR) was calculated for each subject and inter-individual comparisons made. The MFRs of the FDI were larger than that of the BB at the higher force level, and substantial differences were not found between these muscles at the lower force level. The slope of the linear regression line of MFRs vs. exerted forces for the FDI was more than twice that for the BB. Therefore, isometric force control of the FDI depends more on the rate coding strategy. The difference in rate coding between the FDI and BB motor units may be determined by factors other than muscle fiber composition, because both muscles are known to possess a similar composition of fiber types. Possible mechanisms underlying these characteristics of rate coding strategy are considered in this report.

Parents' Involvement in Children's Learning in the United States and China: Implications for Children's Academic and Emotional Adjustment

PubMed Central

Cheung, Cecilia Sin-Sze; Pomerantz, Eva M.

2011-01-01

This research examined parents' involvement in children's learning in the United States and China. Beginning in seventh grade, 825 American and Chinese children (mean age = 12.74 years) reported on their parents' involvement in their learning as well as their parents' psychological control and autonomy support every six months until the end of eighth grade. Information on children's academic and emotional adjustment was obtained. American (vs. Chinese) parents' involvement was associated less with their control and more with their autonomy support. Despite these different associations, parents' heightened involvement predicted children's enhanced engagement and achievement similarly in the United States and China. However, it predicted enhanced perceptions of competence and positive emotional functioning more strongly in the United States than China. PMID:21418057

Nurse- vs nomogram-directed glucose control in a cardiovascular intensive care unit.

PubMed

Chant, Clarence; Mustard, Mary; Thorpe, Kevin E; Friedrich, Jan O

2012-07-01

Paper-based nomograms are reasonably effective for achieving glycemic control but have low adherence and are less adaptive than nurses' judgment. To compare efficacy (glucose control) and safety (hypoglycemia) achieved by use of a paper nomogram versus nurses' judgment. Prospective, randomized, open-label, crossover trial in an intensive care unit in postoperative patients with glucose concentrations greater than 8 mmol/L. Consenting nurses with at least 1 year of experience were randomized to use either their judgment or a validated paper-based nomogram for glucose control. After completion of 2 study shifts, the nurses used the alternative method for the next 2 study shifts. Glucose target level and safety and efficacy boundaries were the same for both methods. The primary end point was area under glucose time curve per hour. Thirty-four nurses contributed 95 shifts of data (44 nomogram-directed, 51 nurse-directed). Adherence to the nomogram was higher in the nomogram group than hypothetical adherence in the nurse-directed group for correct adjustments in insulin infusion (70% vs 37%; P < .001) and glucose checks (58% vs 43%; P = .008). The primary end point did not differ between the 2 groups (mean, 9.0 mmol/L; SD, 3.5 vs mean, 8.3 mmol/L; SD, 2.1; P = .08). Glucose variability, amount of time patients were hypoglycemic or hyperglycemic, and number of glucose checks performed were similar in the 2 groups. In an intensive care unit where nurses generally accepted the need for tight glucose control, nurse-directed control was as effective and as safe as nomogram-based control.

Loss of motor unit size and quadriceps strength over 10 years in post-polio syndrome.

PubMed

Bickerstaffe, A; van Dijk, J P; Beelen, A; Zwarts, M J; Nollet, F

2014-06-01

To investigate whether strength decline in post-polio syndrome (PPS) results from excessive distal axonal degeneration of enlarged motor units. We assessed changes over 10 years in isometric quadriceps strength, mean motor unit action potential (MUAP) size, root mean squared (RMS) amplitude, and level of interference (LOI) in 47 patients with PPS and 12 healthy controls, using high density surface EMG. At baseline, all patients had symptomatic quadriceps dysfunction, evidenced by transmission defects on single-fibre EMG. MU size and strength declined significantly by 20% and 15%, respectively in patients with PPS. Those with the largest initial MU sizes exhibited the greatest losses of mean MU size (27%) and proportional decreases in quadriceps strength (23%). Initial strength, change in LOI and change in RMS amplitude together explained 35% of the variability in strength changes in patients. MU size of controls did not change, although they lost 29% strength. MU size and strength declined concomitantly in a homogeneous cohort of patients with PPS and quadriceps dysfunction. This long term follow-up study provides evidence that size diminution of enlarged MUs combined with a reduced number of active MUs contributes to the gradual strength decline in PPS. Copyright © 2013 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

Teaching the Meaning of the Second Amendment: A Brief Note on Recent Research.

ERIC Educational Resources Information Center

Oder, Broeck N.

1998-01-01

Provides a brief overview of historical and legal scholarship on gun control and the Second Amendment to the United States Constitution. Limits its scope to works by acknowledged legal and historical scholars, avoiding contemporary pro- and anti-gun-control opinion pieces. Includes a bibliography of further resources for teachers. (DSK)

Measurements of forest fire danger

Treesearch

Leo Shames

1938-01-01

Although the annual destruction of life and property attributable to forest fires is enormous, scientific methods of forest fire control in the United States are of comparatively recent origin. In one important phase of control, that of determining how large a network of observers is necessary for the purpose of discovering forest fires in their infancy, accurate means...

The SS x-ray unit as an instrument for "total registration" and "race selection".

PubMed

Schmidt, Mathias; Winzen, Tina; Gross, Dominik

2015-05-01

The aim of this article is to show that, after the onset of World War II at the latest, the central task of the x-ray unit of the Nazi-SS (Schutzstaffel) led by Prof. Hans Holfelder was by no means the early diagnosis of tuberculosis. Its primary purpose, rather, was to serve the various "racial" and inhuman aims of the SS itself. Main historical sources and information about the SS x-ray unit are surveyed and analyzed. Clearly, the significance of the x-ray storm unit was increasingly subordinated to the necessities of the war until its original objectives disappeared from focus completely. The main purpose of operation of the x-ray storm unit thus by no means lay in the early detection of tuberculosis and did not therefore serve tuberculosis control. The actual objective lay, rather, in the implementation of SS aims in terms of Volk politics, genetics, and "racial hygiene".

Diversity of coding profiles of mechanoreceptors in glabrous skin of kittens.

PubMed

Gibson, J M; Beitel, R E; Welker, W

1975-03-21

We examined stimulul-response (S-R) profiles of 35 single mechanoreceptive afferent units having small receptive fields in glabrous forepaw skin of 24 anesthetized domestic kittens. Single unit activity was recorded with tungsten microelectrodes from cervical dorsal root ganglia. The study was designed to be as quantitatively descriptive as possible. We indented each unit's receptive field with a broad battery of simple, carefully controlled stimuli whose major parameters, including amplitude, velocity, acceleration, duration, and interstimulus interval were systematically varied. Stimuli were delivered by a small probe driven by a feedback-controlled axial displacement generator. Single unit discharge data were analyzed by a variety of direct and derived measures including dot patterns, peristimulus histograms, instantaneous and mean instantaneous firing rates, tuning curves, thresholds for amplitude and velocity, adaptation rates, dynamic and static sensitivities, and others. We found that with respect to any of the S-R transactions examined, the properties of our sample of units were continuously and broadly distributed. Any one unit might exhibit either a slow or rapid rate of adaptation, or might superficially appear to preferentially code a single stimulus parameter such as amplitude or velocity. But when the entire range of responsiveness of units to the entire stimulus battery was surveyed by a variety of analytic techniques, we were unable to find any justifiable basis for designation of discrete categories of S-R profiles. Intermediate response types were always found, and in general, all units were both broadly tuned and capable of responding to integrals of several stimulus parameters, our data argue against the usefulness of evaluating a unit's S-R coding capabilities by means of a limited ste of stimulation of response analysis procedures.

Parents' Involvement in Children's Learning in the United States and China: Implications for Children's Academic and Emotional Adjustment

ERIC Educational Resources Information Center

Cheung, Cecilia Sin-Sze; Pomerantz, Eva M.

2011-01-01

This research examined parents' involvement in children's learning in the United States and China. Beginning in seventh grade, 825 American and Chinese children (mean age = 12.74 years) reported on their parents' involvement in their learning as well as their parents' psychological control and autonomy support every 6 months until the end of 8th…

29 CFR 794.106 - Statutory definition of “enterprise.”

Code of Federal Regulations, 2010 CFR

2010-07-01

...: “Enterprise” means the related activities performed (either through unified operation or common control) by... performed in one or more establishments or by one or more corporate or other organizational units including...

Coordinated control system modelling of ultra-supercritical unit based on a new T-S fuzzy structure.

PubMed

Hou, Guolian; Du, Huan; Yang, Yu; Huang, Congzhi; Zhang, Jianhua

2018-03-01

The thermal power plant, especially the ultra-supercritical unit is featured with severe nonlinearity, strong multivariable coupling. In order to deal with these difficulties, it is of great importance to build an accurate and simple model of the coordinated control system (CCS) in the ultra-supercritical unit. In this paper, an improved T-S fuzzy model identification approach is proposed. First of all, the k-means++ algorithm is employed to identify the premise parameters so as to guarantee the number of fuzzy rules. Then, the local linearized models are determined by using the incremental historical data around the cluster centers, which are obtained via the stochastic gradient descent algorithm with momentum and variable learning rate. Finally, with the proposed method, the CCS model of a 1000 MW USC unit in Tai Zhou power plant is developed. The effectiveness of the proposed approach is validated by the given extensive simulation results, and it can be further employed to design the overall advanced controllers for the CCS in an USC unit. Copyright © 2018 ISA. Published by Elsevier Ltd. All rights reserved.

Enabling a flexible exchange of energy of a photovoltaic plant with the grid by means of a controlled storage system

NASA Astrophysics Data System (ADS)

Lazzari, R.; Parma, C.; De Marco, A.; Bittanti, S.

2015-07-01

In this paper, we describe a control strategy for a photovoltaic (PV) power plant equipped with an energy storage system (ESS), based on lithium-ion battery. The plant consists of the following units: the PV generator, the energy storage system, the DC-bus and the inverter. The control, organised in a hierarchical manner, maximises the self-consumption of the local load unit. In particular, the ESS action performs power balance in case of low solar radiation or surplus of PV generation, thus managing the power exchange variability at the plant with the grid. The implemented control strategy is under testing in RSE pilot test facility in Milan, Italy.

Mean cortical curvature reflects cytoarchitecture restructuring in mild traumatic brain injury

PubMed Central

King, Jace B.; Lopez-Larson, Melissa P.; Yurgelun-Todd, Deborah A.

2016-01-01

In the United States alone, the number of persons living with the enduring consequences of traumatic brain injuries is estimated to be between 3.2 and 5 million. This number does not include individuals serving in the United States military or seeking care at Veterans Affairs hospitals. The importance of understanding the neurobiological consequences of mild traumatic brain injury (mTBI) has increased with the return of veterans from conflicts overseas, many of who have suffered this type of brain injury. However, identifying the neuroanatomical regions most affected by mTBI continues to prove challenging. The aim of this study was to assess the use of mean cortical curvature as a potential indicator of progressive tissue loss in a cross-sectional sample of 54 veterans with mTBI compared to 31 controls evaluated with MRI. It was hypothesized that mean cortical curvature would be increased in veterans with mTBI, relative to controls, due in part to cortical restructuring related to tissue volume loss. Mean cortical curvature was assessed in 60 bilateral regions (31 sulcal, 29 gyral). Of the 120 regions investigated, nearly 50% demonstrated significantly increased mean cortical curvature in mTBI relative to controls with 25% remaining significant following multiple comparison correction (all, pFDR < .05). These differences were most prominent in deep gray matter regions of the cortex. Additionally, significant relationships were found between mean cortical curvature and gray and white matter volumes (all, p < .05). These findings suggest potentially unique patterns of atrophy by region and indicate that changes in brain microstructure due to mTBI are sensitive to measures of mean curvature. PMID:26909332

Mean cortical curvature reflects cytoarchitecture restructuring in mild traumatic brain injury.

PubMed

King, Jace B; Lopez-Larson, Melissa P; Yurgelun-Todd, Deborah A

2016-01-01

In the United States alone, the number of persons living with the enduring consequences of traumatic brain injuries is estimated to be between 3.2 and 5 million. This number does not include individuals serving in the United States military or seeking care at Veterans Affairs hospitals. The importance of understanding the neurobiological consequences of mild traumatic brain injury (mTBI) has increased with the return of veterans from conflicts overseas, many of who have suffered this type of brain injury. However, identifying the neuroanatomical regions most affected by mTBI continues to prove challenging. The aim of this study was to assess the use of mean cortical curvature as a potential indicator of progressive tissue loss in a cross-sectional sample of 54 veterans with mTBI compared to 31 controls evaluated with MRI. It was hypothesized that mean cortical curvature would be increased in veterans with mTBI, relative to controls, due in part to cortical restructuring related to tissue volume loss. Mean cortical curvature was assessed in 60 bilateral regions (31 sulcal, 29 gyral). Of the 120 regions investigated, nearly 50% demonstrated significantly increased mean cortical curvature in mTBI relative to controls with 25% remaining significant following multiple comparison correction (all, pFDR < .05). These differences were most prominent in deep gray matter regions of the cortex. Additionally, significant relationships were found between mean cortical curvature and gray and white matter volumes (all, p < .05). These findings suggest potentially unique patterns of atrophy by region and indicate that changes in brain microstructure due to mTBI are sensitive to measures of mean curvature.

A longitudinal ecological study of seasonal influenza deaths in relation to climate conditions in the United States from 1999 through 2011.

PubMed

Geier, David A; Kern, Janet K; Geier, Mark R

2018-01-01

Introduction: Influenza is an acute respiratory disease with significant annual global morbidity/mortality. Influenza transmission occurs in distinct seasonal patterns suggesting an importance of climate conditions on disease pathogenesis. This hypothesis-testing study evaluated microenvironment conditions within different demographic/geographical groups on seasonal influenza deaths in the United States. Materials and methods: The United States Centers for Disease Control and Prevention (CDC) Wonder online computer interface was utilized to integrate and analyze potential correlations in data generated from 1999 through 2011 for climate conditions of mean daily sunlight (KJ/m 2 ), mean daily maximum air temperature ( o C), mean daily minimum air temperature ( o C), and mean daily precipitation (mm) from the North America Land Data Assimilation System (NLDAS) database and on influenza mortality (ICD-10 codes:J09, J10, or J11) from the Underlying Cause of Death database. Results and discussion: Significant inverse correlations between the climate conditions of temperature, sunlight, and precipitation and seasonal influenza death rate were observed. Similar effects were observed among males and females, but when the data were separated by race and urbanization status significant differences were observed. Conclusion: This study highlights key factors that can help shape public health policy to deal with seasonal influenza in the United States and beyond.

Online social networking and US poison control centers: Facebook as a means of information distribution.

PubMed

Vo, Kathy; Smollin, Craig

2015-06-01

Online social networking services such as Facebook provide a novel medium for the dissemination of public health information by poison control centers in the United States. We performed a cross-sectional study of poison control center Facebook pages to describe and assess the use of this medium. Facebook pages associated with poison control centers were identified during a continuous two-week period from December 24, 2012 to January 7, 2013. Data were extracted from each page, including affiliated poison control center; page duration, measured in years since registration; number of subscribers; number of postings by general toxicological category; and measures of user-generated activity including "likes", "shares", and comments per posting. Among the 56 US poison control centers, 39 Facebook pages were identified, of which 29 were currently active. The total number of active pages has increased by 140% from 2009 to 2013 (average of 25% per year). The total number of all subscribers to active pages was 11,211, ranging from 40 to 2,456 (mean 387, SD 523), equal to 0.006% of all Facebook users in the United States. The number of subscribers per page was associated with page duration, number of postings, and type of postings. The types of toxicological postings were public education (45%), self-promotion (28%), childhood safety (12%), drugs of abuse (8%), environmental poisonings (6%), and general overdoses (1%). Slightly over half of all poison control centers in the United States are supplementing their outreach and education efforts through Facebook. In general, the more active the poison control center on Facebook, the more page followers and follower engagement gained.

Achievement of metabolic control among children and adolescents with type 1 diabetes in Spain.

PubMed

Rica, Itxaso; Mingorance, Andrés; Gómez-Gila, Ana Lucía; Clemente, María; González, Isabel; Caimari, María; García-Cuartero, Beatriz; Barrio, Raquel

2017-07-01

To assess metabolic control in a paediatric T1D population in Spain and analyse the rate of severe acute decompensations and chronic complications. Data from patients treated at eight paediatric diabetes units with experienced diabetes teams between June and December 2014 were analysed in an observational prospective study. Variables included: age, sex, diabetes duration, number of follow-up visits/year, anthropometrical data, insulin treatment modalities, mean annual HbA1c and the prevalence of acute and chronic complications. SPSS statistics 21.0 was used. A total of 853 patients (49.7% female) with a mean age of 12.1 ± 3.7 years were included. Anthropometric data were normal. Mean diabetes duration was 8 ± 3.4 years. Mean outpatient follow-up was 4.7 ± 0.04 visits/year. Twenty-five per cent were on continuous subcutaneous insulin infusion (CSII). Mean HbA1c was 7.3 ± 1% (56 ± 8 mmol/mol) and 66.6% had HbA1c < 7.5% (58 mmol/mol). HbA1c value correlated negatively with age at onset and positively with years of diabetes, number of visits/year and current age (F = 7.06; p = 0.01). Patients on CSII (n = 213) were younger, attended the outpatient clinic more frequently, were diagnosed earlier, had better metabolic control and had presented more severe hypoglycaemic episodes the previous year. The rate of severe decompensation (episodes/100 patients/year) was ketoacidosis 1.5 and severe hypoglycaemia 4.5. The prevalence of chronic complications was very low. Our data describe the good compliance of paediatric T1D patients treated at eight paediatric units in Spain following international standards of metabolic control.

33 CFR 157.12a - Definitions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... recordings of data as specified in § 157.12d(h)(2). Oil discharge monitoring and control system or monitoring... RULES FOR THE PROTECTION OF THE MARINE ENVIRONMENT RELATING TO TANK VESSELS CARRYING OIL IN BULK Design... means a unit in a monitoring system composed of the items specified in § 157.12d(a)(4)(viii). Control...

33 CFR 157.12a - Definitions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... recordings of data as specified in § 157.12d(h)(2). Oil discharge monitoring and control system or monitoring... RULES FOR THE PROTECTION OF THE MARINE ENVIRONMENT RELATING TO TANK VESSELS CARRYING OIL IN BULK Design... means a unit in a monitoring system composed of the items specified in § 157.12d(a)(4)(viii). Control...

33 CFR 157.12a - Definitions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... recordings of data as specified in § 157.12d(h)(2). Oil discharge monitoring and control system or monitoring... RULES FOR THE PROTECTION OF THE MARINE ENVIRONMENT RELATING TO TANK VESSELS CARRYING OIL IN BULK Design... means a unit in a monitoring system composed of the items specified in § 157.12d(a)(4)(viii). Control...

33 CFR 157.12a - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... recordings of data as specified in § 157.12d(h)(2). Oil discharge monitoring and control system or monitoring... RULES FOR THE PROTECTION OF THE MARINE ENVIRONMENT RELATING TO TANK VESSELS CARRYING OIL IN BULK Design... means a unit in a monitoring system composed of the items specified in § 157.12d(a)(4)(viii). Control...

33 CFR 157.12a - Definitions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... recordings of data as specified in § 157.12d(h)(2). Oil discharge monitoring and control system or monitoring... RULES FOR THE PROTECTION OF THE MARINE ENVIRONMENT RELATING TO TANK VESSELS CARRYING OIL IN BULK Design... means a unit in a monitoring system composed of the items specified in § 157.12d(a)(4)(viii). Control...

The effect of executive walk rounds on nurse safety climate attitudes: A randomized trial of clinical units

PubMed Central

Thomas, Eric J; Sexton, J Bryan; Neilands, Torsten B; Frankel, Allan; Helmreich, Robert L

2005-01-01

Background Executive walk rounds (EWRs) are a widely used but unstudied activity designed to improve safety culture in hospitals. Therefore, we measured the impact of EWRs on one important part of safety culture – provider attitudes about the safety climate in the institution. Methods Randomized study of EWRs for 23 clinical units in a tertiary care teaching hospital. All providers except physicians participated. EWRs were conducted at each unit by one of six hospital executives once every four weeks for three visits. Providers were asked about their concerns regarding patient safety and what could be done to improve patient safety. Suggestions were tabulated and when possible, changes were made. Provider attitudes about safety climate measured by the Safety Climate Survey before and after EWRs. We report mean scores, percent positive scores (percentage of providers who responded four or higher on a five point scale (agree slightly or agree strongly), and the odds of EWR participants agreeing with individual survey items when compared to non-participants. Results Before EWRs the mean safety climate scores for nurses were similar in the control units and EWR units (78.97 and 76.78, P = 0.458) as were percent positive scores (64.6% positive and 61.1% positive). After EWRs the mean safety climate scores were not significantly different for all providers nor for nurses in the control units and EWR units (77.93 and 78.33, P = 0.854) and (56.5% positive and 62.7% positive). However, when analyzed by exposure to EWRs, nurses in the control group who did not participate in EWRs (n = 198) had lower safety climate scores than nurses in the intervention group who did participate in an EWR session (n = 85) (74.88 versus 81.01, P = 0.02; 52.5% positive versus 72.9% positive). Compared to nurses who did not participate, nurses in the experimental group who reported participating in EWRs also responded more favorably to a majority of items on the survey. Conclusion EWRs have a positive effect on the safety climate attitudes of nurses who participate in the walk rounds sessions. EWRs are a promising tool to improve safety climate and the broader construct of safety culture. PMID:15823204

The Intelligence of Observation: Improving High School Students' Spatial Ability by Means of Intervention Unit

ERIC Educational Resources Information Center

Patkin, Dorit; Dayan, Ester

2013-01-01

This case study of one class versus a control group focused on the impact of an intervention unit, which is not part of the regular curriculum, on the improvement of spatial ability of high school students (forty-six 12th-graders, aged 17-18, both boys and girls) in general as well as from a gender perspective. The study explored three…

The efficacy of interactive, motion capture-based rehabilitation on functional outcomes in an inpatient stroke population: a randomized controlled trial.

PubMed

Cannell, John; Jovic, Emelyn; Rathjen, Amy; Lane, Kylie; Tyson, Anna M; Callisaya, Michele L; Smith, Stuart T; Ahuja, Kiran Dk; Bird, Marie-Louise

2018-02-01

To compare the efficacy of novel interactive, motion capture-rehabilitation software to usual care stroke rehabilitation on physical function. Randomized controlled clinical trial. Two subacute hospital rehabilitation units in Australia. In all, 73 people less than six months after stroke with reduced mobility and clinician determined capacity to improve. Both groups received functional retraining and individualized programs for up to an hour, on weekdays for 8-40 sessions (dose matched). For the intervention group, this individualized program used motivating virtual reality rehabilitation and novel gesture controlled interactive motion capture software. For usual care, the individualized program was delivered in a group class on one unit and by rehabilitation assistant 1:1 on the other. Primary outcome was standing balance (functional reach). Secondary outcomes were lateral reach, step test, sitting balance, arm function, and walking. Participants (mean 22 days post-stroke) attended mean 14 sessions. Both groups improved (mean (95% confidence interval)) on primary outcome functional reach (usual care 3.3 (0.6 to 5.9), intervention 4.1 (-3.0 to 5.0) cm) with no difference between groups ( P = 0.69) on this or any secondary measures. No differences between the rehabilitation units were seen except in lateral reach (less affected side) ( P = 0.04). No adverse events were recorded during therapy. Interactive, motion capture rehabilitation for inpatients post stroke produced functional improvements that were similar to those achieved by usual care stroke rehabilitation, safely delivered by either a physical therapist or a rehabilitation assistant.

A randomized controlled trial oftransfusion-related acute lung injury: is plasma from multiparous blood donors dangerous?

PubMed

Palfi, M; Berg, S; Ernerudh, J; Berlin, G

2001-03-01

Transfusion-related acute lung injury (TRALI) and other posttransfusion reactions may be caused by granulocyte and/or HLA antibodies, which are often present in blood from multiparous donors. The purpose of this study was to compare the effects of plasma from multiparous donors with those of plasma from donors with no history of transfusion or pregnancy (control plasma) in a prospective, randomized, double-blind, crossover study. Intensive care patients, judged to need at least 2 units of plasma, were randomly assigned to receive a unit of control plasma and, 4 hours later, a plasma unit from a multiparous donor (> or = 3 live births) or to receive the plasma units in opposite order. The patients were closely monitored, and body temperature, blood pressure, and heart rate were recorded. Blood samples for analysis of blood gases, TNFalpha, IL-1 receptor antagonist, soluble E selectin, and C3d complement factor were collected at least on four occasions (before and after the transfusion of each unit). Transfusion of plasma from multiparous donors was associated with significantly lower oxygen saturation and higher TNFalpha concentrations than transfusion of control plasma. The mean arterial pressure increased significantly after the transfusion of control plasma, whereas plasma from multiparous donors had no effect on it. Five posttransfusion reactions were observed in 100 patients, in four cases after the transfusion of plasma from multiparous donors. Plasma from multiparous blood donors may impair pulmonary function in intensive care unit patients.

Quality of nursing diagnoses: evaluation of an educational intervention.

PubMed

Florin, Jan; Ehrenberg, Anna; Ehnfors, Margareta

2005-01-01

To investigate the effects on the quality of nursing diagnostic statements in patient records after education in the nursing process and implementation of new forms for recording. Quasi-experimental design. Randomly selected patient records reviewed before and after intervention from one experimental unit (n = 70) and three control units (n = 70). A scale with 14 characteristics pertaining to nursing diagnoses was developed and used together with the instrument (CAT-CH-ING) for record review. Quality of nursing diagnostic statements improved in the experimental unit, whereas no improvement was found in the control units. Serious flaws in the use of the etiology component were found. CONCLUSION. Nurses must be more concerned with the accuracy and quality of the nursing diagnoses and the etiology component needs to be given special attention. Education of RNs in nursing diagnostic statements and peer review using standardized evaluation instruments can be means to further enhance RNs' documentation practice.

Influence of prolonged static stretching on motor unit firing properties.

PubMed

Ye, Xin; Beck, Travis W; Wages, Nathan P

2016-05-01

The purpose of this study was to examine the influence of a stretching intervention on motor control strategy of the biceps brachii muscle. Ten men performed twelve 100-s passive static stretches of the biceps brachii. Before and after the intervention, isometric strength was tested during maximal voluntary contractions (MVCs) of the elbow flexors. Subjects also performed trapezoid isometric contractions at 30% and 70% of MVC. Surface electromyographic signals from the submaximal contractions were decomposed into individual motor unit action potential trains. Linear regression analysis was used to examine the relationship between motor unit mean firing rate and recruitment threshold. The stretching intervention caused significant decreases in y-intercepts of the linear regression lines. In addition, linear slopes at both intensities remained unchanged. Despite reduced motor unit firing rates following the stretches, the motor control scheme remained unchanged. © 2016 Wiley Periodicals, Inc.

Alcohol drinking, mean corpuscular volume of erythrocytes, and alcohol metabolic genotypes in drunk drivers.

PubMed

Pavanello, Sofia; Snenghi, Rossella; Nalesso, Alessandro; Sartore, Daniela; Ferrara, Santo Davide; Montisci, Massimo

2012-02-01

Regular and irregular abuse of alcohol are global health priorities associated with diseases at multiple sites, including cancer. Mechanisms of diseases induced by alcohol are closely related to its metabolism. Among conventional markers of alcohol abuse, the mean corpuscular volume (MCV) of erythrocytes is prognostic of alcohol-related cancer and its predictivity increases when combined with functional polymorphisms of alcohol dehydrogenase (ADH1B [rs1229984] and ADH1C [rs698]) and the mitochondrial aldehyde dehydrogenase (ALDH2 [rs671]). Whether these genetic variants can influence abuse in alcohol drinking and MCV has never been examined in drunk-driving traffic offenders. We examined 149 drunk drivers, diagnosed as alcohol abusers according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth edition Text Revision (DSM-IV-TR) and enrolled in a probation program, and 257 social drinkers (controls), all Caucasian males. Alcohol intake was assessed according to self-reported drink-units/d and MCV unadjusted and adjusted for age, smoking, and body mass index. Multivariable models were used to compute MCV adjusted means. Genotype analyses were performed by PCR on DNA from blood. The adjusted MCV mean was higher in drunk-driving abusers than in controls (92 vs. 91fL; P<.0001) and increased with the number of drink-units/d in both abusers and controls (P-trend=.0316 and .0089) already at intermediate quantities (0-1 vs. 2-4 drink-units/d: P=.054 and .024). Carriers of the common ADH1B*1/*1 (rs1229984) genotype were more likely to be drunk-driving abusers (P=.008), reported higher drink-units/d (P=.0126), and had larger MCV (P=.035). The rs698 ADH1C and rs671 ALDH2 polymorphisms were not associated with MCV. ADH1B*1/*1 polymorphism is significantly associated with being a drunk-driving abuser, higher alcohol drinking, and MCV enlargement. This suggests that drunk drivers with augmented MCV modulated by the alcohol metabolic ADH1B*1/*1 genotype may be at higher risk of driving incapability and of alcohol-related cancer. Copyright © 2012 Elsevier Inc. All rights reserved.

Transfusion of irradiated red blood cell units with a potassium adsorption filter: A randomized controlled trial.

PubMed

Cid, Joan; Villegas, Vanessa; Carbassé, Gloria; Alba, Cristina; Perea, Dolores; Lozano, Miguel

2016-05-01

The irradiation of red blood cells (RBCs) causes damage of the RBC membrane with increased potassium (K) leak during storage compared with nonirradiated RBC units of similar age. A previous in vitro study showed a mean reduction of K of 94 ± 5% with a potassium adsorption filter (PAF). A prospective, single-center, nonblinded, randomized controlled trial (RCT) was designed to evaluate the safety and efficacy of transfusing irradiated RBC units with the PAF. Patients 18 years of age or older who received irradiated RBC units due to chemotherapy-induced anemia were randomly assigned to receive irradiated RBC units with the PAF (PAF group) or with the standard blood infusion set (control group). Primary outcome measures were safety and efficacy of the PAF (absolute change in hemoglobin [Hb] and K, respectively, in patient's blood values after transfusing the irradiated RBC units with or without the PAF). A total of 63 irradiated RBC units were transfused to 17 patients in the control group, and a total of 56 irradiated RBC units were transfused to 13 patients in the PAF group. The absolute change of Hb (9.3 ± 6.3 g/L vs. 8.1 ± 5.8 g/L; p = 0.3) and the absolute change of K (-0.01 ± 0.4 mmol/L vs. -0.01 ± 0.3 mmol/L; p = 0.2) were comparable between the two groups of the trial. The transfusion of 1 irradiated RBC unit with the PAF was as safe and efficacious as the transfusion of 1 irradiated RBC unit with the standard blood infusion set in patients with chemotherapy-induced anemia. © 2016 AABB.

Services for the Detection and Treatment of Retinopathy of Prematurity in Major Indian Cities: The 11-City 9-State Study.

PubMed

Gilbert, Clare; Shukla, Rajan; Kumar, Rakesh; Khera, Ajay; Murthy, G Vs

2016-11-07

Control of visual loss from retinopathy of prematurity requires high quality neonatal care, and timely screening and treatment of sight-threatening disease. We assessed services for retinopathy of prematurity provided by ophthalmic training institutions in major Indian cities. Eleven cities were purposefully selected and eye-care facilities were evaluated using predefined criteria. Field teams visited these facilities to collect data by interview and observation using structured questionnaires. 30 training institutions were visited (18 public; 12 not-for-profit); 24 (24/30, 80%) provided a service for retinopathy of prematurity in 58 neonatal units (30 public, 28 private). 15/24 (63%) screened in one unit; six (25%) in 2-3 units and three (12%) in >3 units. Not-for-profit facilities (n=9) screened in more units than public facilities (n=15)(mean (range) 4.5 [1-12] vs 1.1 [1-2] units). Indirect ophthalmoscopy by ophthalmologists was the commonest screening modality but only half of these visited the units weekly. Laser was the commonest treatment, but only half treated babies in the neonatal unit. Annual treatments ranged from 1-200 (mean 39). Eye-care services for retinopathy of prematurity need to expand, particularly in the government sector.

Differences in liquor prices between control state-operated and license-state retail outlets in the United States.

PubMed

Siegel, Michael; DeJong, William; Albers, Alison B; Naimi, Timothy S; Jernigan, David H

2013-02-01

This study aims to compare the average price of liquor in the United States between retail alcohol outlets in states that have a monopoly ('control' states) with those that do not ('licence' states). A cross-sectional study of brand-specific alcohol prices in the United States. We determined the average prices in February 2012 of 74 brands of liquor among the 13 control states that maintain a monopoly on liquor sales at the retail level and among a sample of 50 license-state liquor stores, using their online-available prices. We calculated average prices for 74 brands of liquor by control versus license state. We used a random-effects regression model to estimate differences between control and license state prices-overall and by alcoholic beverage type. We also compared prices between the 13 control states. The overall mean price for the 74 brands was $27.79 in the license states [95% confidence interval (CI): $25.26-30.32] and $29.82 in the control states (95% CI: $26.98-32.66). Based on the random-effects linear regression model, the average liquor price was approximately $2 lower (6.9% lower) in license states. In the United States monopoly of alcohol retail outlets appears to be associated with slightly higher liquor prices. © 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.

[Duties of institutions and heads of health care centers in the area of infection control, information, assessment, registration and financing of benefits provided to TB patients].

PubMed

Zielonka, Tadeusz M

2011-01-01

The Act on preventing and counteracting infections and infectious diseases in humans effective in Poland provides for the duty of the heads of health care outlets and institutions to counteract spreading of TB in units under their management. They are, by all means, responsible for monitoring infections in their respective units, involving development, implementation and monitoring of practical implementation of procedures aiming at limiting dissemination of TB in hospitals and outpatient clinics. Medical service unit managers are also responsible for providing members of their staffs with means of individual protection against infection with Mycobacterium tuberculosis bacillus. Their duties also include notification of all recognized TB cases in their respective units. TB is an infectious diseases included in the occupational disease list. Assessment of TB as occupational disease is the responsibility of provincial TB prevention clinics. The Act also provides for principles of financing of individual benefits available for the insured TB patients and those not insured.

Short-term Resource Utilization and Cost-Effectiveness of Comprehensive Geriatric Assessment in Acute Hospital Care for Severely Frail Elderly Patients.

PubMed

Ekerstad, Niklas; Karlson, Björn W; Andersson, David; Husberg, Magnus; Carlsson, Per; Heintz, Emelie; Alwin, Jenny

2018-05-18

The objective of this study was to estimate the 3-month within-trial cost-effectiveness of comprehensive geriatric assessment (CGA) in acute medical care for frail elderly patients compared to usual medical care, by estimating health-related quality of life and costs from a societal perspective. Clinical, prospective, controlled, 1-center intervention trial with 2 parallel groups. Structured, systematic interdisciplinary CGA-based care in an acute elderly care unit. If the patient fulfilled the inclusion criteria, and there was a bed available at the CGA unit, the patient was included in the intervention group. If no bed was available at the CGA unit, the patient was included in the control group and admitted to a conventional acute medical care unit. A large county hospital in western Sweden. The trial included 408 frail elderly patients, 75 years or older, in need of acute in-hospital treatment. The patients were allocated to the intervention group (n = 206) or control group (n = 202). Mean age of the patients was 85.7 years, and 56% were female. The primary outcome was the adjusted incremental cost-effectiveness ratio associated with the intervention compared to the control at the 3-month follow-up. We undertook cost-effectiveness analysis, adjusted by regression analyses, including hospital, primary, and municipal care costs and effects. The difference in the mean adjusted quality-adjusted life years gained between groups at 3 months was 0.0252 [95% confidence interval (CI): 0.0082-0.0422]. The incremental cost, that is, the difference between the groups, was -3226 US dollars (95% CI: -6167 to -285). The results indicate that the care in a CGA unit for acutely ill frail elderly patients is likely to be cost-effective compared to conventional care after 3 months. Copyright © 2018 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

The Future Role of the Combined Action Program

DTIC Science & Technology

1991-05-06

control predominates the VC can gain resources by means of covert purchase or hit-and-run raids if not by direct taxation . 36 Similar to the personnel...It may require changing accepted practises that are hundreds of years old. Nevertheless, change is imperative if CAP is to be successful. This is...8217Communist Party of the Philippines: Theory and Practise of United Front.* Masters Thesis, United States Army Command and General Staff College, Ft

SU-D-201-04: Evaluation of Elekta Agility MLC Performance Using Statistical Process Control

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

Meyers, SM; Balderson, MJ; Letourneau, D

2016-06-15

Purpose: to evaluate the performance and stability of the Elekta Agility MLC model using an automated quality control (QC) test in combination with statistical process control tools. Methods: Leaf positions were collected daily for 11 Elekta units over 5–19 months using the automated QC test, which analyzes 23 MV images to determine the location of MLC leaves relative to the radiation isocenter. The leaf positions are measured at 5 nominal positions, and images are acquired at collimator 0° and 180° to capture all MLC leaves in the field-of-view. Leaf positioning accuracy was assessed using individual and moving range control charts.more » Control limits were recomputed following MLC recalibration (occurred 1–2 times for 4 units). Specification levels of ±0.5, ±1 and ±1.5mm were tested. The mean and range of duration between out-of-control and out-of-specification events were determined. Results: Leaf position varied little over time, as confirmed by very tight individual control limits (mean ±0.19mm, range 0.09–0.44). Mean leaf position error was −0.03mm (range −0.89–0.83). Due to sporadic out-of-control events, the mean in-control duration was 3.3 days (range 1–23). Data stayed within ±1mm specification for 205 days on average (range 3–372) and within ±1.5mm for the entire date range. Measurements stayed within ±0.5mm for 1 day on average (range 0–17); however, our MLC leaves were not calibrated to this level of accuracy. Conclusion: The Elekta Agility MLC model was found to perform with high stability, as evidenced by the tight control limits. The in-specification durations support the current recommendation of monthly MLC QC tests with a ±1mm tolerance. Future work is on-going to determine if Agility performance can be optimized further using high-frequency QC test results to drive recalibration frequency. Factors that can affect leaf positioning accuracy, including beam spot motion, leaf gain calibration, drifting leaves, and image artifacts, are under investigation.« less

An Energy-Based Thermodynamic Stabilization Framework for Hybrid Control Design of Large-Scale Aerospace Systems

DTIC Science & Technology

2009-02-27

exchanged by means of line-of-sight sensors that experience periodic communication dropouts due to agent motion. Variation in network topology in...respiratory, and cardiovascular function by man- ual control based on the clinician’s experience and intuition. Open-loop control by clinical personnel can be...to ap- pear. [29] W. M. Haddad and J. M. Bailey, "Closed-Loop Control for Intensive Care Unit Seda- tion," Best Prac. Res. Clinical Anaesthesiology

Nitric oxide synthase inhibition attenuates cutaneous vasodilation during the post-menopausal hot flash

PubMed Central

Hubing, Kimberly A.; Wingo, Jonathan E.; Brothers, R. Matthew; Coso, Juan Del; Low, David A.; Crandall, Craig G.

2010-01-01

Objective The purpose of this study was to test the hypothesis that local inhibition of nitric oxide and prostaglandin synthesis attenuates cutaneous vasodilator responses during post-menopausal hot flashes. Methods Four microdialysis membranes were inserted into forearm skin (dorsal surface) of 8 post-menopausal women (mean ± SD, 51±7 y). Ringers solution (control), 10mM Ketorolac (Keto) to inhibit prostaglandin synthesis, 10mM NG-L-arginine methyl ester (L-NAME) to inhibit nitric oxide synthase, and a combination of 10mM Keto + 10mM L-NAME were each infused at the separate sites. Skin blood flow at each site was indexed using laser-Doppler flowmetry. Cutaneous vascular conductance (CVC) was calculated as laser-Doppler flux/mean arterial blood pressure and was expressed as a percentage of the maximal calculated CVC (CVCmax) obtained following infusion of 50mM sodium nitropruside at all sites at the end of the study. Data from 13 hot flashes were analyzed. Results At the control site, the mean ± SD peak increase in CVC was 15.5±6% CVCmax units. This value was not different relative to the peak increase in CVC at the Keto site (13.0±5 % CVCmax units, P = 0.09). However, the peak increase in CVC during the flash was attenuated at the L-NAME and L-NAME + Keto sites (7.4±4 % CVCmax units and 8.7±7 % CVCmax units, respectively) relative to both the control and the Keto sites (P<0.05 for both comparisons). There were no significant differences in the peak increases in sweat rate between any of the sites (P = 0.24). Conclusions These data demonstrate that cutaneous vasodilation during a hot flash has a nitric oxide component. Increases in CVC despite the inhibition of prostaglandin synthesis suggest prostaglandins do not contribute to cutaneous vasodilation during a hot flash. PMID:20505548

High-dose recombinant endotoxin neutralizing protein improves survival in rabbits, with Escherichia coli sepsis.

PubMed

Saladino, R A; Stack, A M; Thompson, C; Sattler, F; Novitsky, T J; Siber, G R; Fleisher, G R

1996-07-01

To assess the benefit of a recombinant endotoxin neutralizing protein from Limulus polyphemus in treating Gram-negative bacterial sepsis in rabbits. Prospective, blinded, controlled, laboratory trial. Animal research laboratory. New Zealand White rabbits. We established a rabbit model of Escherichia coli peritonitis and bacteremia, with high mortality rate, despite treatment with gentamicin and ceftriaxone. Twenty-five pairs of male New Zealand White rabbits were challenged intraperitoneally with E. coli O18ac K1 in 5% porcine mucin (mean 7 x 10(1) colony-forming units). All animals were treated with intravenous gentamicin (2.5 mg/kg) and ceftriaxone (100 mg/kg), and with either intravenous endotoxin neutralizing protein (50 mg/kg) or saline 1 hr after E. coli challenge. All animals were bacteremic 1 hr after challenge (mean 3.6 x 10(5) colony-forming units/mL). Animals in both groups developed tachycardia, hypotension, and acidosis (NS). Geometric mean serum endotoxin and tumor necrosis factor (TNF) concentrations were significantly ( p < .001) higher 1 hr after challenge compared with baseline prechallenge concentrations in both groups. From 1 to 2 hrs after challenge, endotoxin concentrations increased 2.5-fold in control animals (95% confidence interval = 13.1 to 32.9 endotoxin units/mL, p = .024), whereas endotoxin concentrations increased only 1.2-fold in endotoxin neutralizing protein-treated animals (95% confidence interval = 20.4 to 23.6 endotoxin units/mL, NS). TNF concentrations increased significantly (p < .001) in both groups from 1 to 2 hrs after challenge. Eighteen (72%) of 25 endotoxin neutralizing protein-treated animals vs. 11 (44%) of 25 controls survived 24 hrs (p = .032). Treatment with endotoxin neutralizing protein had the following effects: a) the increase in serum endotoxin was blunted, but not TNF concentrations measured 1 hr after antibiotic treatment; and b) survival in rabbits with E. Coli sepsis was improved.

Bacterial colonization due to increased nurse workload in an intensive care unit.

PubMed

Aycan, Ilker Onguc; Celen, Mustafa Kemal; Yilmaz, Ayhan; Almaz, Mehmet Selim; Dal, Tuba; Celik, Yusuf; Bolat, Esef

2015-01-01

The rates of multiresistant bacteria colonization or infection (MRB+) development in intensive care units are very high. The aim of this study was to determine the possible association between the risk of development of nosocomial infections and increased daily nurse workload due to understaffing in intensive care unit. We included 168 patients. Intensity of workload and applied procedures to patients were scored with the Project de Recherché en Nursing and the Omega scores, respectively. The criteria used for infections were those defined by the Centers for Disease Control. Of the 168 patients, 91 (54.2%) were female and 77 (45.8%) were male patients. The mean age of female and male was 64.9 ± 6.2 years and 63.1 ± 11.9 years, respectively. The mean duration of hospitalization in intensive care unit was 18.4 ± 6.1 days. Multiresistant bacteria were isolated from cultures of 39 (23.2%) patients. The development of MRB+ infection was correlated with length of stay, Omega 1, Omega 2, Omega 3, Total Omega, daily PRN, and Total PRN (p < 0.05). There was no correlation between development of MRB+ infection with gender, age and APACHE-II scores (p > 0.05). The risk of nosocomial infection development in an intensive care unit is directly correlated with increased nurse workload, applied intervention, and length of stay. Understaffing in the intensive care unit is an important health problem that especially affects care-needing patients. Nosocomial infection development has laid a heavy burden on the economy of many countries. To control nosocomial infection development in the intensive care unit, nurse workload, staffing level, and working conditions must be arranged. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

[Bacterial colonization due to increased nurse workload in an intensive care unit].

PubMed

Aycan, Ilker Onguc; Celen, Mustafa Kemal; Yilmaz, Ayhan; Almaz, Mehmet Selim; Dal, Tuba; Celik, Yusuf; Bolat, Esef

2015-01-01

the rates of multiresistant bacteria colonization or infection (MRB+) development in intensive care units are very high. The aim of this study was to determine the possible association between the risk of development of nosocomial infections and increased daily nurse workload due to understaffing in intensive care unit. we included 168 patients. Intensity of workload and applied procedures to patients were scored with the Project de Recherché en Nursing and the Omega scores, respectively. The criteria used for infections were those defined by the Centers for Disease Control. of the 168 patients, 91 (54.2%) were female and 77 (45.8%) were male patients. The mean age of female and male was 64.9±6.2 years and 63.1±11.9 years, respectively. The mean duration of hospitalization in intensive care unit was 18.4±6.1 days. Multiresistant bacteria were isolated from cultures of 39 (23.2%) patients. The development of MRB+ infection was correlated with length of stay, Omega 1, Omega 2, Omega 3, Total Omega, daily PRN, and Total PRN (p<0.05). There was no correlation between development of MRB+ infection with gender, age and Apache-II scores (p>0.05). the risk of nosocomial infection development in an intensive care unit is directly correlated with increased nurse workload, applied intervention, and length of stay. Understaffing in the intensive care unit is an important health problem that especially affects care-needing patients. Nosocomial infection development has laid a heavy burden on the economy of many countries. To control nosocomial infection development in the intensive care unit, nurse workload, staffing level, and working conditions must be arranged. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

The afocal telescope of the ESA ARIEL mission: analysis of the layout

NASA Astrophysics Data System (ADS)

Da Deppo, Vania; Middleton, Kevin; Focardi, Mauro; Morgante, Gianluca; Corso, Alain Jody; Pace, Emanuele; Claudi, Riccardo; Micela, Giuseppina

2017-09-01

ARIEL (Atmospheric Remote-sensing Infrared Exoplanet Large-survey) is one of the three present candidates as an M4 ESA mission to be launched in 2026. During its foreseen 3.5 years operation, it will observe spectroscopically in the infrared a large population of known transiting planets in the neighborhood of the Solar System. The aim is to enable a deep understanding of the physics and chemistry of these exoplanets. ARIEL is based on a 1-m class telescope ahead of a suite of instruments: two spectrometer channels covering the band 1.95 to 7.8 μm and four photometric channels (two wide and two narrow band) in the range 0.5 to 1.9 μm. The ARIEL optical design is conceived as a fore-module common afocal telescope that will feed the spectrometer and photometric channels. The telescope optical design is based on an eccentric pupil two-mirror classic Cassegrain configuration coupled to a tertiary paraboloidal mirror. The temperature of the primary mirror (M1) will be monitored and finely tuned by means of an active thermal control system based on thermistors and heaters. They will be switched on and off to maintain the M1 temperature within ±1 K thanks to a proportional-integral-derivative (PID) controller implemented within the Telescope Control Unit (TCU), a Payload electronics subsystem mainly in charge of the active thermal control of the two detectors owning to the spectrometer. TCU will collect the housekeeping data of the controlled subsystems and will forward them to the spacecraft (S/C) by means of the Instrument Control Unit (ICU), the main Payload's electronic Unit linked to the S/C On Board Computer (OBC).

Initial closed operation of the CELSS Test Facility Engineering Development Unit

NASA Technical Reports Server (NTRS)

Kliss, M.; Blackwell, C.; Zografos, A.; Drews, M.; MacElroy, R.; McKenna, R.; Heyenga, A. G.

2003-01-01

As part of the NASA Advanced Life Support Flight Program, a Controlled Ecological Life Support System (CELSS) Test Facility Engineering Development Unit has been constructed and is undergoing initial operational testing at NASA Ames Research Center. The Engineering Development Unit (EDU) is a tightly closed, stringently controlled, ground-based testbed which provides a broad range of environmental conditions under which a variety of CELSS higher plant crops can be grown. Although the EDU was developed primarily to provide near-term engineering data and a realistic determination of the subsystem and system requirements necessary for the fabrication of a comparable flight unit, the EDU has also provided a means to evaluate plant crop productivity and physiology under controlled conditions. This paper describes the initial closed operational testing of the EDU, with emphasis on the hardware performance capabilities. Measured performance data during a 28-day closed operation period are compared with the specified functional requirements, and an example of inferring crop growth parameters from the test data is presented. Plans for future science and technology testing are also discussed. Published by Elsevier Science Ltd on behalf of COSPAR.

Effect of Epsilon Aminocaproic Acid on Red-Cell Transfusion Requirements in Major Spinal Surgery

PubMed Central

Berenholtz, Sean M.; Pham, Julius Cuong; Garrett-Mayer, Elizabeth; Atchison, Christine W; Kostuik, John P.; Cohen, David B.; Nundy, Shantanu; Dorman, Todd; Ness, Paul M.; Klag, Michael J.; Pronovost, Peter J.; Kebaish, Khaled M.

2009-01-01

Study Design Randomized, placebo-controlled trial Objective To evaluate the efficacy of epsilon aminocaproic acid (EACA) to reduce the number of red-cell (RBC) transfusions in adult patients undergoing major spinal surgery. Summary of Background Data Reconstructive spinal surgery is associated with significant blood loss. The number of studies evaluating the efficacy of EACA in adult patients undergoing spinal surgery remains scarce and limited. Methods EACA (100 mg/kg) or placebo was administered to 182 adult patients after the induction of anesthesia followed by an infusion that was continued for 8 hours postoperatively. Primary end-points included total allogeneic RBC transfusions through postoperative day (POD) 8 and postoperative allogeneic plus autologus RBC transfusions through POD 8. Results Mean total allogeneic RBC transfusions were not statistically different between the groups (5.9 units EACA versus 6.9 units placebo; P=0.17). Mean postoperative RBC transfusions in the EACA group was less (2.0 units versus 2.8 units placebo; P=0.03). There was no significant difference in mean estimated intraoperative EBL (2938 cc EACA vs. 3273 cc placebo; P=0.32). Mean intensive care unit length of stay was decreased (EACA 1.8 days versus 2.8 days placebo; P=0.04). The incidence of thromboembolic complications was similar (2.2% EACA vs 6.6% placebo; P=0.15). Conclusions The difference in total allogeneic RBC transfusions between the groups was not statistically significant. EACA was associated with a 30% (0.8 units) reduction in postoperative RBC transfusions and a one-day reduction in ICU LOS, without an increased incidence of thromboembolic events. EACA may be considered for patients undergoing major spinal surgery. Larger studies are needed to evaluate the relationship between EACA and total RBC requirements. PMID:19730217

Effect of epsilon aminocaproic acid on red-cell transfusion requirements in major spinal surgery.

PubMed

Berenholtz, Sean M; Pham, Julius Cuong; Garrett-Mayer, Elizabeth; Atchison, Christine W; Kostuik, John P; Cohen, David B; Nundy, Shantanu; Dorman, Todd; Ness, Paul M; Klag, Michael J; Pronovost, Peter J; Kebaish, Khaled M

2009-09-01

: Randomized, placebo-controlled trial. : To evaluate the efficacy of epsilon aminocaproic acid (EACA) to reduce the number of red-cell (RBC) transfusions in adult patients undergoing major spinal surgery. : Reconstructive spinal surgery is associated with significant blood loss. The number of studies evaluating the efficacy of EACA in adult patients undergoing spinal surgery remains scarce and limited. : EACA (100 mg/kg) or placebo was administered to 182 adult patients after the induction of anesthesia followed by an infusion that was continued for 8 hours after surgery. Primary end points included total allogeneic RBC transfusions through postoperative day 8 and postoperative allogeneic plus autologus RBC transfusions through postoperative day 8. : Mean total allogeneic RBC transfusions were not statistically different between the groups (5.9 units EACA vs. 6.9 units placebo; P = 0.17). Mean postoperative RBC transfusions in the EACA group was less (2.0 units vs. 2.8 units placebo; P = 0.03). There was no significantdifference in mean estimated intraoperative estimated-blood loss (2938 cc EACA vs. 3273 cc placebo; P = 0.32). Mean intensive care unit length of stay was decreased (EACA: 1.8 days vs. 2.8 days placebo; P = 0.04). The incidence of thromboembolic complications was similar (2.2% EACA vs. 6.6% placebo; P = 0.15). : The difference in total allogeneic RBC transfusions between the groups was not statistically significant. EACA was associated with a 30% (0.8 units) reduction in postoperative RBC transfusions and a 1-day reduction in ICU LOS, without an increased incidence of thromboembolic events. EACA may be considered for patients undergoing major spinal surgery. Larger studies are needed to evaluate the relationship between EACA and total RBC requirements.

Contrast Sensitivity Perimetry and Clinical Measures of Glaucomatous Damage

PubMed Central

Swanson, William H.; Malinovsky, Victor E.; Dul, Mitchell W.; Malik, Rizwan; Torbit, Julie K.; Sutton, Bradley M.; Horner, Douglas G.

2014-01-01

ABSTRACT Purpose To compare conventional structural and functional measures of glaucomatous damage with a new functional measure—contrast sensitivity perimetry (CSP-2). Methods One eye each was tested for 51 patients with glaucoma and 62 age-similar control subjects using CSP-2, size III 24-2 conventional automated perimetry (CAP), 24-2 frequency-doubling perimetry (FDP), and retinal nerve fiber layer (RNFL) thickness. For superior temporal (ST) and inferior temporal (IT) optic disc sectors, defect depth was computed as amount below mean normal, in log units. Bland-Altman analysis was used to assess agreement on defect depth, using limits of agreement and three indices: intercept, slope, and mean difference. A criterion of p < 0.0014 for significance used Bonferroni correction. Results Contrast sensitivity perimetry-2 and FDP were in agreement for both sectors. Normal variability was lower for CSP-2 than for CAP and FDP (F > 1.69, p < 0.02), and Bland-Altman limits of agreement for patient data were consistent with variability of control subjects (mean difference, −0.01 log units; SD, 0.11 log units). Intercepts for IT indicated that CSP-2 and FDP were below mean normal when CAP was at mean normal (t > 4, p < 0.0005). Slopes indicated that, as sector damage became more severe, CAP defects for IT and ST deepened more rapidly than CSP-2 defects (t > 4.3, p < 0.0005) and RNFL defects for ST deepened more slowly than for CSP, FDP, and CAP. Mean differences indicated that FDP defects for ST and IT were on average deeper than RNFL defects, as were CSP-2 defects for ST (t > 4.9, p < 0.0001). Conclusions Contrast sensitivity perimetry-2 and FDP defects were deeper than CAP defects in optic disc sectors with mild damage and revealed greater residual function in sectors with severe damage. The discordance between different measures of glaucomatous damage can be accounted for by variability in people free of disease. PMID:25259758

Contrast sensitivity perimetry and clinical measures of glaucomatous damage.

PubMed

Swanson, William H; Malinovsky, Victor E; Dul, Mitchell W; Malik, Rizwan; Torbit, Julie K; Sutton, Bradley M; Horner, Douglas G

2014-11-01

To compare conventional structural and functional measures of glaucomatous damage with a new functional measure-contrast sensitivity perimetry (CSP-2). One eye each was tested for 51 patients with glaucoma and 62 age-similar control subjects using CSP-2, size III 24-2 conventional automated perimetry (CAP), 24-2 frequency-doubling perimetry (FDP), and retinal nerve fiber layer (RNFL) thickness. For superior temporal (ST) and inferior temporal (IT) optic disc sectors, defect depth was computed as amount below mean normal, in log units. Bland-Altman analysis was used to assess agreement on defect depth, using limits of agreement and three indices: intercept, slope, and mean difference. A criterion of p < 0.0014 for significance used Bonferroni correction. Contrast sensitivity perimetry-2 and FDP were in agreement for both sectors. Normal variability was lower for CSP-2 than for CAP and FDP (F > 1.69, p < 0.02), and Bland-Altman limits of agreement for patient data were consistent with variability of control subjects (mean difference, -0.01 log units; SD, 0.11 log units). Intercepts for IT indicated that CSP-2 and FDP were below mean normal when CAP was at mean normal (t > 4, p < 0.0005). Slopes indicated that, as sector damage became more severe, CAP defects for IT and ST deepened more rapidly than CSP-2 defects (t > 4.3, p < 0.0005) and RNFL defects for ST deepened more slowly than for CSP, FDP, and CAP. Mean differences indicated that FDP defects for ST and IT were on average deeper than RNFL defects, as were CSP-2 defects for ST (t > 4.9, p < 0.0001). Contrast sensitivity perimetry-2 and FDP defects were deeper than CAP defects in optic disc sectors with mild damage and revealed greater residual function in sectors with severe damage. The discordance between different measures of glaucomatous damage can be accounted for by variability in people free of disease.

Single motor unit firing rate after stroke is higher on the less-affected side during stable low-level voluntary contractions

PubMed Central

McNulty, Penelope A.; Lin, Gaven; Doust, Catherine G.

2014-01-01

Muscle weakness is the most common outcome after stroke and a leading cause of adult-acquired motor disability. Single motor unit properties provide insight into the mechanisms of post-stroke motor impairment. Motor units on the more-affected side are reported to have lower peak firing rates, reduced discharge variability and a more compressed dynamic range than healthy subjects. The activity of 169 motor units was discriminated from surface electromyography in 28 stroke patients during sustained voluntary contractions 10% of maximal and compared to 110 units recorded in 16 healthy subjects. Motor units were recorded in three series: ankle dorsiflexion, wrist flexion and elbow flexion. Mean firing rates after stroke were significantly lower on the more-affected than the less-affected side (p < 0.001) with no differences between dominant and non-dominant sides for healthy subjects. When data were combined, firing rates on the less-affected side were significantly higher than those either on the more-affected side or healthy subjects (p < 0.001). Motor unit mean firing rate was higher in the upper-limb than the lower-limb (p < 0.05). The coefficient of variation of motor unit discharge rate was lower for motor units after stroke compared to controls for wrist flexion (p < 0.05) but not ankle dorsiflexion. However the dynamic range of motor units was compressed only for motor units on the more-affected side during wrist flexion. Our results show that the pathological change in motor unit firing rate occurs on the less-affected side after stroke and not the more-affected side as previously reported, and suggest that motor unit behavior recorded in a single muscle after stroke cannot be generalized to muscles acting on other joints even within the same limb. These data emphasize that the less-affected side does not provide a valid control for physiological studies on the more-affected side after stroke and that both sides should be compared to data from age- and sex-matched healthy subjects. PMID:25100969

21 CFR 1404.985 - Person.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Person. 1404.985 Section 1404.985 Food and Drugs OFFICE OF NATIONAL DRUG CONTROL POLICY GOVERNMENTWIDE DEBARMENT AND SUSPENSION (NONPROCUREMENT) Definitions § 1404.985 Person. Person means any individual, corporation, partnership, association, unit of...

The influence of parenteral glutamine supplementation on glucose homeostasis in critically ill polytrauma patients--A randomized-controlled clinical study.

PubMed

Grintescu, Ioana Marina; Luca Vasiliu, Irina; Cucereanu Badica, Ioana; Mirea, Liliana; Pavelescu, Daniela; Balanescu, Andreea; Grintescu, Ioana Cristina

2015-06-01

Rapid onset of resistance to insulin is a prominent component of stress metabolism in multiple trauma patients. Recent studies have clarified the role of amino acids (especially glutamine) in glucose transportation and the benefits of parenteral alanyl-glutamine supplementation (0.3-0.6 g/kg/day) in glucose homeostasis. The aims of this study are to evaluate the incidence of hyperglycemic episodes and the need for exogenous insulin to maintain stable glucose levels in critically ill polytrauma patients supplemented with parenteral glutamine dipeptide (Dipeptiven(®)) versus standard nutritional support. This was an open-label randomized-controlled trial of 82 polytrauma patients aged 20-60 years old, randomly assigned into two equal groups independent of sex, age and Injury Severity Score. We excluded patients with diabetes mellitus, or renal or hepatic failure. One group received parenteral Dipeptiven(®) supplementation of 0.5 g/kg/day and the other received standard isocaloric isoproteinic nutritional support. We found that 63% of patients in the glutamine-supplemented group had no hyperglycemic episodes; only 37% required exogenous insulin (mean daily requirement of 44 units/day). In the control group, 51% of patients required insulin (mean daily requirement 63 unit/day; p = 0.0407). The effect of glutamine supplementation on glucose homeostasis is associated with a lower incidence of hyperglycemia among critically ill polytrauma patients, and leads to a lower mean daily dose of insulin. Controlled-trials.com Identifier: ISRCTN71592366 (http://www.controlled-trials.com/ISRCTN71592366/ISRCTN71592366). Copyright © 2014 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Motor unit number estimation based on high-density surface electromyography decomposition.

PubMed

Peng, Yun; He, Jinbao; Yao, Bo; Li, Sheng; Zhou, Ping; Zhang, Yingchun

2016-09-01

To advance the motor unit number estimation (MUNE) technique using high density surface electromyography (EMG) decomposition. The K-means clustering convolution kernel compensation algorithm was employed to detect the single motor unit potentials (SMUPs) from high-density surface EMG recordings of the biceps brachii muscles in eight healthy subjects. Contraction forces were controlled at 10%, 20% and 30% of the maximal voluntary contraction (MVC). Achieved MUNE results and the representativeness of the SMUP pools were evaluated using a high-density weighted-average method. Mean numbers of motor units were estimated as 288±132, 155±87, 107±99 and 132±61 by using the developed new MUNE at 10%, 20%, 30% and 10-30% MVCs, respectively. Over 20 SMUPs were obtained at each contraction level, and the mean residual variances were lower than 10%. The new MUNE method allows a convenient and non-invasive collection of a large size of SMUP pool with great representativeness. It provides a useful tool for estimating the motor unit number of proximal muscles. The present new MUNE method successfully avoids the use of intramuscular electrodes or multiple electrical stimuli which is required in currently available MUNE techniques; as such the new MUNE method can minimize patient discomfort for MUNE tests. Copyright © 2016 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

Acute effects of dynamic exercises on the relationship between the motor unit firing rate and the recruitment threshold.

PubMed

Ye, Xin; Beck, Travis W; DeFreitas, Jason M; Wages, Nathan P

2015-04-01

The aim of this study was to compare the acute effects of concentric versus eccentric exercise on motor control strategies. Fifteen men performed six sets of 10 repetitions of maximal concentric exercises or eccentric isokinetic exercises with their dominant elbow flexors on separate experimental visits. Before and after the exercise, maximal strength testing and submaximal trapezoid isometric contractions (40% of the maximal force) were performed. Both exercise conditions caused significant strength loss in the elbow flexors, but the loss was greater following the eccentric exercise (t=2.401, P=.031). The surface electromyographic signals obtained from the submaximal trapezoid isometric contractions were decomposed into individual motor unit action potential trains. For each submaximal trapezoid isometric contraction, the relationship between the average motor unit firing rate and the recruitment threshold was examined using linear regression analysis. In contrast to the concentric exercise, which did not cause significant changes in the mean linear slope coefficient and y-intercept of the linear regression line, the eccentric exercise resulted in a lower mean linear slope and an increased mean y-intercept, thereby indicating that increasing the firing rates of low-threshold motor units may be more important than recruiting high-threshold motor units to compensate for eccentric exercise-induced strength loss. Copyright © 2014 Elsevier B.V. All rights reserved.

Non-contact control of the working condition of mechanical units of the steam compressor for desalination plant

NASA Astrophysics Data System (ADS)

Danilin, A. I.; Chernyavsky, A. Zh.; Danilin, S. A.; Neverov, V. V.; Voroh, D. A.; Blagin, E. V.

2018-03-01

New methods and means for monitoring working condition of the rotating elements of steam compressor unit such as blade ring of the impeller and gears of multiplier are considered. Blade control is carried out by the signalling device of pre-emergency deformation of impeller blades. Control of the gears condition is carried out by apparatus system which allows to analyse change of the signal form caused by the gears wear. Influence of the wear types on the typical information parameters of the analysed signals is described. Technical characteristics of the devices and experimental research results are presented. Described control systems allow to detect deviations equal to 1-2% from initial condition. Application of such systems gives the opportunity to improve fault diagnosis and maintenance in 2-3 times.

Effect of pain on the modulation in discharge rate of sternocleidomastoid motor units with force direction.

PubMed

Falla, Deborah; Lindstrøm, Rene; Rechter, Lotte; Farina, Dario

2010-05-01

To compare the behavior of sternocleidomastoid motor units of patients with chronic neck pain and healthy controls. Nine women (age, 40.4+/-3.5 yr) with chronic neck pain and nine age- and gender-matched healthy controls participated. Surface and intramuscular EMG were recorded from the sternocleidomastoid muscle bilaterally as subjects performed isometric contractions of 10-s duration in the horizontal plane at a force of 15 N in eight directions (0-360 degrees ; 45 degrees intervals) and isometric contractions at 15 and 30 N force with continuous change in force direction in the range 0-360 degrees . Motor unit behavior was monitored during the 10-s contractions and the subsequent resting periods. The mean motor unit discharge rate depended on the direction of force in the control subjects (P<0.05) but not in the patients. Moreover, in three of the nine patients, but in none of the controls, single motor unit activity continued for 8.1+/-6.1s upon completion of the contraction. The surface EMG amplitude during the circular contraction at 15N was greater for the patients (43.5+/-54.2 microV) compared to controls (16.9+/-14.9 microV; P<0.05). The modulation in discharge rate of individual motor units with force direction is reduced in the sternocleidomastoid muscle in patients with neck pain, with some patients showing prolonged motor unit activity when they were instructed to rest. These observations suggest that chronic neck pain affects the change in neural drive to muscles with force direction. Copyright 2009 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

Motivational interviewing increases physical activity and self-efficacy in people living in the community after hip fracture: a randomized controlled trial.

PubMed

O'Halloran, Paul D; Shields, Nora; Blackstock, Felicity; Wintle, Elizabeth; Taylor, Nicholas F

2016-11-01

To investigate if motivational interviewing improved physical activity, self-efficacy, quality of life, mobility and mental health in people living in the community after hip fracture. Single-blind randomized controlled trial. Community. A total of 30 adults after hip fracture who had been discharged from rehabilitation to independent living in the community and allocated to a control group ( n = 14) or an intervention group ( n = 16). All participants received usual care. The intervention group also received eight weekly sessions of motivational interviewing as additional input, with the control group having no additional matching input. The primary outcome was physical activity levels as measured by an accelerometer (steps taken per day, time spent walking per day, and time spent sitting or lying each day). Secondary outcomes included self-efficacy (confidence about walking and not falling), health-related quality of life, mobility and mental health. Relative to usual care, the motivational interviewing group took significantly more steps per day (mean = 1237 steps, 95% confidence interval (CI) 12 to 2463), walked for longer per day (mean = 14.4 minutes, 95% CI 0.6 to 28.8), had improved self-efficacy evidenced by being more confident about walking (mean = 1.6 units out of 10, 95% CI 0.3 to 2.9) and not falling (mean = 1.1 units out of 10, 95% CI 0.3 to 1.9) and improved health-related quality of life and mental health. This study provides preliminary evidence that motivational interviewing can result in clinically meaningful improvements in physical activity and psychosocial outcomes for people recovering from hip fracture.

The efficacy of interactive, motion capture-based rehabilitation on functional outcomes in an inpatient stroke population: a randomized controlled trial

PubMed Central

Cannell, John; Jovic, Emelyn; Rathjen, Amy; Lane, Kylie; Tyson, Anna M; Callisaya, Michele L; Smith, Stuart T; Ahuja, Kiran DK; Bird, Marie-Louise

2017-01-01

Objective: To compare the efficacy of novel interactive, motion capture-rehabilitation software to usual care stroke rehabilitation on physical function. Design: Randomized controlled clinical trial. Setting: Two subacute hospital rehabilitation units in Australia. Participants: In all, 73 people less than six months after stroke with reduced mobility and clinician determined capacity to improve. Interventions: Both groups received functional retraining and individualized programs for up to an hour, on weekdays for 8–40 sessions (dose matched). For the intervention group, this individualized program used motivating virtual reality rehabilitation and novel gesture controlled interactive motion capture software. For usual care, the individualized program was delivered in a group class on one unit and by rehabilitation assistant 1:1 on the other. Main measures: Primary outcome was standing balance (functional reach). Secondary outcomes were lateral reach, step test, sitting balance, arm function, and walking. Results: Participants (mean 22 days post-stroke) attended mean 14 sessions. Both groups improved (mean (95% confidence interval)) on primary outcome functional reach (usual care 3.3 (0.6 to 5.9), intervention 4.1 (−3.0 to 5.0) cm) with no difference between groups (P = 0.69) on this or any secondary measures. No differences between the rehabilitation units were seen except in lateral reach (less affected side) (P = 0.04). No adverse events were recorded during therapy. Conclusion: Interactive, motion capture rehabilitation for inpatients post stroke produced functional improvements that were similar to those achieved by usual care stroke rehabilitation, safely delivered by either a physical therapist or a rehabilitation assistant. PMID:28719977

An Evaluation of the Organizational Structure of Air Force Emergency Operations Centers Using Social Network Analysis and Design Structure Matrices

DTIC Science & Technology

2013-03-01

areas that are most frequently needed 4 in a national response” (FEMA, 2008). Finally, during emergencies, individual Unit Control Centers ( UCCs ...stand up, as a means to supporting the response. Typically, the UCCs provide information or resources as required through communication from the...EOC. Currently there is no defined staffing or organizational structure for the UCC , each unit is responsible for adequately staffing the UCCs as

The effect of infection-control barriers on the light intensity of light-cure units and depth of cure of composite.

PubMed

Hodson, Nicholas A; Dunne, Stephen M; Pankhurst, Caroline L

2005-04-01

Dental curing lights are vulnerable to contamination with oral fluids during routine intra-oral use. This controlled study aimed to evaluate whether or not disposable transparent barriers placed over the light-guide tip would affect light output intensity or the subsequent depth of cure of a composite restoration. The impact on light intensity emitted from high-, medium- and low-output light-cure units in the presence of two commercially available disposable infection-control barriers was evaluated against a no-barrier control. Power density measurements from the three intensity light-cure units were recorded with a radiometer, then converted to a digital image using an intra-oral camera and values determined using a commercial computer program. For each curing unit, the measurements were repeated on ten separate occasions with each barrier and the control. Depth of cure was evaluated using a scrape test in a natural tooth model. At each level of light output, the two disposable barriers produced a significant reduction in the mean power density readings compared to the no-barrier control (P<0.005). The cure sleeve inhibited light output to a greater extent than either the cling film or the control (P<0.005). Only composite restorations light-activated by the high level unit demonstrated a small but significant decrease in the depth of cure compared to the control (P<0.05). Placing disposable barriers over the light-guide tip reduced the light intensity from all three curing lights. There was no impact on depth of cure except for the high-output light, where a small decrease in cure depth was noted but this was not considered clinically significant. Disposable barriers can be recommended for use with light-cure lights.

Wearing graduated compression stockings augments cutaneous vasodilation in heat-stressed resting humans.

PubMed

Fujii, Naoto; Nikawa, Toshiya; Tsuji, Bun; Kondo, Narihiko; Kenny, Glen P; Nishiyasu, Takeshi

2017-05-01

We investigated whether graduated compression induced by stockings enhances cutaneous vasodilation in passively heated resting humans. Nine habitually active young men were heated at rest using water-perfusable suits, resulting in a 1.0 °C increase in body core temperature. Heating was repeated twice on separate occasions while wearing either (1) stockings that cause graduated compression (pressures of 26.4 ± 5.3, 17.5 ± 4.4, and 6.1 ± 2.0 mmHg at the ankle, calf, and thigh, respectively), or (2) loose-fitting stockings without causing compression (Control). Forearm vascular conductance during heating was evaluated by forearm blood flow (venous occlusion plethysmography) divided by mean arterial pressure to estimate heat-induced cutaneous vasodilation. Body core (esophageal), skin, and mean body temperatures were measured continuously. Compared to the Control, forearm vascular conductance during heating was higher with graduated compression stockings (e.g., 23.2 ± 5.5 vs. 28.6 ± 5.8 units at 45 min into heating, P = 0.001). In line with this, graduated compression stockings resulted in a greater sensitivity (27.5 ± 8.3 vs. 34.0 ± 9.4 units °C -1 , P = 0.02) and peak level (25.5 ± 5.8 vs. 29.7 ± 5.8 units, P = 0.004) of cutaneous vasodilation as evaluated from the relationship between forearm vascular conductance with mean body temperature. In contrast, the mean body temperature threshold for increases in forearm vascular conductance did not differ between the Control and graduated compression stockings (36.5 ± 0.1 vs. 36.5 ± 0.2 °C, P = 0.85). Our results show that graduated compression associated with the use of stockings augments cutaneous vasodilation by modulating sensitivity and peak level of cutaneous vasodilation in relation to mean body temperature. However, the effect of these changes on whole-body heat loss remains unclear.

Increased oxidative stress in preschool children exposed to passive smoking.

PubMed

Yıldırım, Faruk; Sermetow, Kabil; Aycicek, Ali; Kocyigit, Abdurrahim; Erel, Ozcan

2011-01-01

To study the effect of passive cigarette smoking on plasma oxidative and antioxidative status in passive smoking preschool children and to compare them with controls. Thirty-four passive smoking (five to 50 cigarettes per day) preschool children (study group) and 32 controls who had never been exposed to cigarette smoke were randomly chosen from children aged from 4 to 6 years. Urinary cotinine and plasma indicators of oxidative and antioxidative status, i.e., total oxidant status (TOS), total antioxidant capacity (TAC), and oxidative stress index (OSI), were determined. Mean environmental cigarette consumption was 22±13 cigarettes per day in passive smoking children. Mean urinary cotinine levels were 77.6±41.4 ng/mL and 11.9±2.3 ng/mL in the study and control groups, respectively (p < 0.001). Mean plasma TAC levels were 0.95±0.13 mmol Trolox equivalent/L and 1.01±0.09 mmol Trolox equivalent/L, respectively (p = 0.039). Mean plasma TOS levels were 28.6±7.9 µmol H2O2 equivalent/L and 18.5±6.3 µmol H2O2 equivalent/L, respectively (p < 0.001). Mean OSI levels were 3.08±0.98 arbitrary units and 1.84±0.64 arbitrary units, respectively (p < 0.001). A small amount of cigarette smoke (five to 10 cigarettes per day) causes considerable oxidative stress. There were significant correlations between number of cigarettes consumed and oxidant status and OSI levels. Passive smoke is a potent oxidant in preschool children. Its deleterious effects are not limited just to heavy passive smoking, but also occur with exposure to small amounts of smoke.

Patent Abstract Digest. Volume II.

DTIC Science & Technology

1981-03-01

THE AIR FORCE SYSTEMS COMMAND United States Patent 191 [J 4,190,815 Albanese [45] Feb. 26, 1980 [541 HIGH POWER HYBRID SWITCH 3,659.227 4/1972...R.F. power are controlled and switched [22] Filed: Mar. 9, 1978 by means of a hybrid switching network that employs [511 nt. C. 2...broadband quadrature 3dB hybrid . Switching is accomplished by selectively inserting a [561 Referenees Cited 180 phase shift means into the lower power

31 CFR 560.215 - Prohibitions on foreign entities owned or controlled by U.S. persons.

Code of Federal Regulations, 2014 CFR

2014-07-01

... knowingly means that the person engages in the transaction with actual knowledge or reason to know. (3) For... intelligence activities of the United States Government. Note to § 560.215: A U.S. person is subject to the...

31 CFR 560.215 - Prohibitions on foreign entities owned or controlled by U.S. persons.

Code of Federal Regulations, 2013 CFR

2013-07-01

... knowingly means that the person engages in the transaction with actual knowledge or reason to know. (3) For... intelligence activities of the United States Government. Note to § 560.215: A U.S. person is subject to the...

15 CFR 806.7 - General definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... jurisdiction of a country other than the United States; (f) Business enterprise means any organization... indirectly, owns or controls 10 per centum or more of the voting stock of an incorporated business enterprise, or an equivalent ownership interest in an unincorporated business enterprise, which is located...

40 CFR 61.161 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... conditioned to produce molten glass. The unit includes foundations, superstructure and retaining walls, raw... aerosols. Malfunction means any sudden failure of air pollution control equipment or process equipment or... melted by indirect heating. The openings of the vessels are in the outside wall of the furnace and are...

Prediction of mean circulation velocity in oxidation ditch.

PubMed

Simon, S; Roustan, M; Audic, J M; Chatellier, P

2001-02-01

In wastewater treatment, oxidation ditches are used for the removal of carbon and nitrogen of activated sludge. The control of the single-phase flow is essential to the optimisation of the whole process. Among the two global functioning parameters (mean liquid velocity Uc, power dissipated per unit of volume P/V), the mean circulation velocity can be recommended. Indeed, the values of the power dissipated per unit of volume P/V obtained in different scale plant show that the industrial criterion on P/V leads to an overdesign of channel. Therefore a mean liquid circulation velocity Uc created by horizontal impellers must be maintained inside the ditch. In order to predict the velocity Uc, a model has been proposed based on the Equations of the continuity and motion and using a few simple parameters. Experiments were carried out on pilot plant (1 m3) and full scale ditches (860, 1400 and 2800 m3) in which the characteristics of the mixing system and the dimensions of channels were varied. A good agreement was observed between the model predictions and experimental data for the mean circulation velocity Uc.

Attempting to control mite allergens with mechanical ventilation and dehumidification in British houses.

PubMed

Niven, R; Fletcher, A M; Pickering, A C; Custovic, A; Sivour, J B; Preece, A R; Oldham, L A; Francis, H C

1999-05-01

Allergen avoidance is of considerable interest in the treatment and even prevention of asthma. Attempts to control house dust mites have included environmental manipulation in homes in an attempt to reduce humidity below a level that favors mite survival. This appears to have some benefit in Scandinavia, but a previous attempt with mechanical ventilation heat pump recovery (MVHR) units in the UK failed to achieve the desired results. We report a study using an additional central dehumidification modification of the MVHR (MVHRcd) in an attempt to reduce allergen levels in houses of asthmatic subjects. Ten houses of asthmatic patients allergic to dust mites and 10 architectural control houses were studied. The active houses were fitted with an MVHRcd unit in November/December 1994 and activated in January 1995. The active and control houses were monitored continuously for internal temperature and humidity by using digital sensors in the asthmatic and control bedrooms. Dust samples were collected to determine allergen levels at baseline (January 1994) and 3, 6, 9, and 15 months after switching on the units. The winter seasonal average humidity fell from 50% relative humidity (RH) in control bedrooms to 37% RH in asthmatic bedrooms compared with 72% RH in the ambient air as measured on the intake of the MVHRcd systems. There was no corresponding change in seasonal mean temperature within the houses. Although the temperature and humidity weekly and seasonal means remained below the study target of 45% RH or 7 g/kg absolute humidity at 21 degrees C, there were transient rises in humidity detected by the sensors in the houses with MVHRcd systems. Allergen levels fell both in active and control houses during the study period, but there was no significant advantage gained from the installation of MVHRcd systems. The MVHRcd system failed to confer a benefit in terms of mite allergen reduction despite apparently adequate control of temperature and humidity.

The international normalized ratio does not reflect bleeding risk in esophageal variceal hemorrhage.

PubMed

Hshieh, Tammy T; Kaung, Aung; Hussain, Syed; Curry, Michael P; Sundaram, Vinay

2015-01-01

The international normalized ratio (INR) has not been validated as a predictor of bleeding risk in cirrhotics. The aim of this study was to determine whether elevation in the INR correlated with risk of esophageal variceal hemorrhage and whether correction of the INR prior to endoscopic therapy affects failure to control bleeding. Patient records were retrospectively reviewed from January 1, 2000 to December 31, 2010. Cases were cirrhotics admitted to the hospital due to bleeding esophageal varices. Controls were cirrhotics with a history of non-bleeding esophageal varices admitted with ascites or encephalopathy. All variceal bleeders were treated with octreotide, antibiotics, and band ligation. Failure to control bleeding was defined according to the Baveno V criteria. We analyzed 74 cases and 74 controls. The mean INR at presentation was lower in those with bleeding varices compared to non-bleeders (1.61 vs 1.74, P = 0.03). Those with bleeding varices had higher serum sodium (136.1 vs 133.8, P = 0.02), lower hemoglobin (9.59 vs 11.0, P < 0.001), and lower total bilirubin (2.47 vs 5.50, P < 0.001). Multivariable logistic regression showed total bilirubin to inversely correlate with bleeding (OR = 0.74). Bleeders received a mean of 1.14 units of fresh frozen plasma (FFP) prior to endoscopy (range 0-11 units). Of the 14 patients (20%) with failure to control bleeding, median INR (1.8 vs 1.5, P = 0.02) and median units of FFP transfused (2 vs 0, P = 0.01) were higher than those with hemostasis after the initial endoscopy. The INR reflects liver dysfunction, not bleeding risk. Correction of INR with FFP has little effect on hemostasis.

The International Normalized Ratio does not Reflect Bleeding Risk in Esophageal Variceal Hemorrhage

PubMed Central

Hshieh, Tammy T.; Kaung, Aung; Hussain, Syed; Curry, Michael P.; Sundaram, Vinay

2015-01-01

Background/Aims: The international normalized ratio (INR) has not been validated as a predictor of bleeding risk in cirrhotics. The aim of this study was to determine whether elevation in the INR correlated with risk of esophageal variceal hemorrhage and whether correction of the INR prior to endoscopic therapy affects failure to control bleeding. Patients and Methods: Patient records were retrospectively reviewed from January 1, 2000 to December 31, 2010. Cases were cirrhotics admitted to the hospital due to bleeding esophageal varices. Controls were cirrhotics with a history of non-bleeding esophageal varices admitted with ascites or encephalopathy. All variceal bleeders were treated with octreotide, antibiotics, and band ligation. Failure to control bleeding was defined according to the Baveno V criteria. Results: We analyzed 74 cases and 74 controls. The mean INR at presentation was lower in those with bleeding varices compared to non-bleeders (1.61 vs 1.74, P = 0.03). Those with bleeding varices had higher serum sodium (136.1 vs 133.8, P = 0.02), lower hemoglobin (9.59 vs 11.0, P < 0.001), and lower total bilirubin (2.47 vs 5.50, P < 0.001). Multivariable logistic regression showed total bilirubin to inversely correlate with bleeding (OR = 0.74). Bleeders received a mean of 1.14 units of fresh frozen plasma (FFP) prior to endoscopy (range 0-11 units). Of the 14 patients (20%) with failure to control bleeding, median INR (1.8 vs 1.5, P = 0.02) and median units of FFP transfused (2 vs 0, P = 0.01) were higher than those with hemostasis after the initial endoscopy. Conclusions: The INR reflects liver dysfunction, not bleeding risk. Correction of INR with FFP has little effect on hemostasis. PMID:26228370

Gross Motor Development in Children Aged 3-5 Years, United States 2012.

PubMed

Kit, Brian K; Akinbami, Lara J; Isfahani, Neda Sarafrazi; Ulrich, Dale A

2017-07-01

Objective Gross motor development in early childhood is important in fostering greater interaction with the environment. The purpose of this study is to describe gross motor skills among US children aged 3-5 years using the Test of Gross Motor Development (TGMD-2). Methods We used 2012 NHANES National Youth Fitness Survey (NNYFS) data, which included TGMD-2 scores obtained according to an established protocol. Outcome measures included locomotor and object control raw and age-standardized scores. Means and standard errors were calculated for demographic and weight status with SUDAAN using sample weights to calculate nationally representative estimates, and survey design variables to account for the complex sampling methods. Results The sample included 339 children aged 3-5 years. As expected, locomotor and object control raw scores increased with age. Overall mean standardized scores for locomotor and object control were similar to the mean value previously determined using a normative sample. Girls had a higher mean locomotor, but not mean object control, standardized score than boys (p < 0.05). However, the mean locomotor standardized scores for both boys and girls fell into the range categorized as "average." There were no other differences by age, race/Hispanic origin, weight status, or income in either of the subtest standardized scores (p > 0.05). Conclusions In a nationally representative sample of US children aged 3-5 years, TGMD-2 mean locomotor and object control standardized scores were similar to the established mean. These results suggest that standardized gross motor development among young children generally did not differ by demographic or weight status.

The Effects of High-Altitude Electromagnetic Pulse (HEMP) on Telecommunications Assets

DTIC Science & Technology

1988-06-01

common to a whole class of switches. 5ESS switch software controls the operating system, call processing, and system administration andgmaintenance...LEVEL (ky/rn)3 (a). Mean Fraction of Preset Calls Dropped Due to Induced Transients3 1.0 W -o35kVhM (36 EVENTS) 5-40 kV/M (13 EVENTS) IAUTOMATIC ...eel PERIPHRAL UNIT BUS,IMNA The entire 4ESS system is controlled by the 1A processor. The processor monitors and controls the operation of the

Network interface unit design options performance analysis

NASA Technical Reports Server (NTRS)

Miller, Frank W.

1991-01-01

An analysis is presented of three design options for the Space Station Freedom (SSF) onboard Data Management System (DMS) Network Interface Unit (NIU). The NIU provides the interface from the Fiber Distributed Data Interface (FDDI) local area network (LAN) to the DMS processing elements. The FDDI LAN provides the primary means for command and control and low and medium rate telemetry data transfers on board the SSF. The results of this analysis provide the basis for the implementation of the NIU.

Experiments on Laser Beam Jitter Control with Applications to a Shipboard Free Electron Laser

DTIC Science & Technology

2007-12-01

factor one half converts from peak to rms values. This psd was then converted to units of ( mrms /s2)2/Hz by dividing by the square of the given voltage...the root mean square value in units of mrms for a given frequency range. (3) Vibration Measurement Results. The total displacement from 1-400 Hz...The mass may represent, for example, a component of an FEL. The support, s, is harmonically excited at a peak displacement amplitude of xs. The

32 CFR 1801.2 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) days may be added if responding by international mail; Control means ownership or the authority of... judicial branches of government, United States or foreign, or U.S. Government contractor who, in the sole discretion of NACIC, has a subject matter or physical interest in the documents or information at issue...

32 CFR 1801.2 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-07-01

...) days may be added if responding by international mail; Control means ownership or the authority of... judicial branches of government, United States or foreign, or U.S. Government contractor who, in the sole discretion of NACIC, has a subject matter or physical interest in the documents or information at issue...

32 CFR 1801.2 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-07-01

...) days may be added if responding by international mail; Control means ownership or the authority of... judicial branches of government, United States or foreign, or U.S. Government contractor who, in the sole discretion of NACIC, has a subject matter or physical interest in the documents or information at issue...

32 CFR 1801.2 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) days may be added if responding by international mail; Control means ownership or the authority of... judicial branches of government, United States or foreign, or U.S. Government contractor who, in the sole discretion of NACIC, has a subject matter or physical interest in the documents or information at issue...

48 CFR 752.226-1 - Determination of status as disadvantaged enterprise.

Code of Federal Regulations, 2012 CFR

2012-10-01

... controlled by individuals who are socially and economically disadvantaged. (b) Definitions. (1) Asian Pacific...) Subcontinent Asian Americans, as used in this provision, means United States citizens whose origins are in... Americans, Native Americans, Asian-Pacific Americans, Subcontinent Asian Americans, and women. (End of...

Southwest Research Institute assistance to NASA in biomedical areas of the technology utilization program

NASA Technical Reports Server (NTRS)

1972-01-01

The problem statements presented relate mostly to research on prosthetic equipment and means of attaching biomedical and electronic devices to the human body. A patent application for a reliable switching element in a patient assist control units is also described.

21 CFR 886.5928 - Soft (hydrophilic) contact lens care products.

Code of Federal Regulations, 2011 CFR

2011-04-01

... (hydrophilic) contact lens. This includes all solutions and tablets used together with soft (hydrophilic) contact lenses and heat disinfecting units intended to disinfect a soft (hydrophilic) contact lens by means of heat. (b) Classification. Class II (Special Controls) Guidance Document: “Guidance for Industry...

21 CFR 886.5928 - Soft (hydrophilic) contact lens care products.

Code of Federal Regulations, 2012 CFR

2012-04-01

... (hydrophilic) contact lens. This includes all solutions and tablets used together with soft (hydrophilic) contact lenses and heat disinfecting units intended to disinfect a soft (hydrophilic) contact lens by means of heat. (b) Classification. Class II (Special Controls) Guidance Document: “Guidance for Industry...

21 CFR 886.5928 - Soft (hydrophilic) contact lens care products.

Code of Federal Regulations, 2013 CFR

2013-04-01

... (hydrophilic) contact lens. This includes all solutions and tablets used together with soft (hydrophilic) contact lenses and heat disinfecting units intended to disinfect a soft (hydrophilic) contact lens by means of heat. (b) Classification. Class II (Special Controls) Guidance Document: “Guidance for Industry...

21 CFR 886.5928 - Soft (hydrophilic) contact lens care products.

Code of Federal Regulations, 2014 CFR

2014-04-01

... (hydrophilic) contact lens. This includes all solutions and tablets used together with soft (hydrophilic) contact lenses and heat disinfecting units intended to disinfect a soft (hydrophilic) contact lens by means of heat. (b) Classification. Class II (Special Controls) Guidance Document: “Guidance for Industry...

31 CFR 595.304 - Foreign person.

Code of Federal Regulations, 2010 CFR

2010-07-01

... FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY TERRORISM SANCTIONS REGULATIONS General Definitions § 595.304 Foreign person. The term foreign person means any citizen or national of a foreign state (including any such individual who is also a citizen or national of the United States), or any entity not...

Understanding and Representing Natural Language Meaning.

DTIC Science & Technology

1982-12-01

agent- controller ) (e.g. John hit Mary.) --subject of transitive ( non -agent) (e.g. John received a telegram.) -object-complement (e.g. They elected...UNIT NUMUERS Coordinated Science Laboratory University of Illinois at Urbana-Champaign Urbana, IL 61801 I1. CONTROLLING OFFICE NAME AND ADDRESS 12...REPORT DATE Office of Naval Research DECEMBER 1982 800 N. Quincy Street is. NUMBER OF PAQES Arlington, VA 22217 44 14. MONITORING AGENCY NAME & AODRESS

Effect of Rosa damascene aromatherapy on sleep quality in cardiac patients: a randomized controlled trial.

PubMed

Hajibagheri, Ali; Babaii, Atye; Adib-Hajbaghery, Mohsen

2014-08-01

Sleep disorders are common among patients hospitalized in coronary care unit (CCU). This study aimed to investigate the effect of Rosa damascene aromatherapy on sleep quality of patients hospitalized in CCU. In this randomized controlled trial, 60 patients who met the inclusion criteria were conveniently sampled and randomly allocated to the experimental and control groups. Patients in the control group received routine care. In the experimental group, patients received routine care and Rosa damascene aromatherapy for three subsequent nights. In the both groups the sleep quality was assessed using the Pittsburgh Sleep Quality Index. After the study, the mean scores of five domains of Pittsburg Sleep Quality Index as well as the mean of total score of the index in the experimental group were significantly lower than the control group. Rosa damascene aromatherapy can significantly improve the sleep quality of patients hospitalized in CCUs. Copyright © 2014 Elsevier Ltd. All rights reserved.

15 pixels digital autocorrelation spectrometer system

NASA Astrophysics Data System (ADS)

Lee, Changhoon; Kim, Hyo-Ryung; Kim, Kwang-Dong; Chung, Mun-Hee; Timoc, C.

2006-06-01

In this paper describes the system configuration and the some performance test results of the 15 pixels digital autocorrelation spectrometer to be used at the Taeduk Radio Astronomy Observatory (TRAO) of Korea. This autocorrelation spectrometer instrument enclosed in a 3-slot VXI module and controlled via a USB port by a backend PC. This spectrometer system consists of the 4 band-pass filters unit, the digitizer, the 512 lags correlator, the clock distribution unit, and USB controller. And here we describe the frequency accuracy and the root-mean-square noise characteristic of this spectrometer. After some calibration procedure, this spectrometer can be use as the back-end system at TRAO for the 3x5 focal plane array receivers.

Intraoperative Sensorcaine significantly improves postoperative pain management in outpatient reduction mammaplasty.

PubMed

Culliford, Alfred T; Spector, Jason A; Flores, Roberto L; Louie, Otway; Choi, Mihye; Karp, Nolan S

2007-09-15

Breast reduction is one of the most frequently performed plastic surgical procedures in the United States; more than 160,500 patients underwent the procedure in 2005. Many outpatient reduction mammaplasty patients report the greatest postoperative discomfort in the first 48 hours. The authors' investigated the effect of intraoperative topical application of the long-acting local anesthetic agent bupivacaine (Sensorcaine or Marcaine) on postoperative pain, time to postanesthesia care unit discharge, and postoperative use of narcotic medication. In a prospective, randomized, single-blind trial, intraoperative use of Sensorcaine versus placebo (normal saline) was compared. Postoperative pain was quantified using the visual analogue scale, and time to discharge from the postanesthesia care unit was recorded. Patients documented their outpatient pain medication usage. Of the 37 patients enrolled in the study, 20 were treated with intraoperative topical Sensorcaine and 17 received placebo. Patients treated with Sensorcaine were discharged home significantly faster (2.9 hours versus 3.8 hours, p = 0.002). The control arm consistently had higher pain scores in the postanesthesia care unit (although not statistically significant) than the Sensorcaine group using the visual analogue scale system. Furthermore, patients receiving Sensorcaine required significantly less narcotic medication while recovering at home (mean, 3.5 tablets of Vicodin) than the control group (mean, 6.4 tablets; p = 0.001). There were no complications resulting from Sensorcaine usage. This prospective, randomized, single-blind study demonstrates that a single dose of intraoperative Sensorcaine provides a safe, inexpensive, and efficacious way to significantly shorten the length of postanesthesia care unit stay and significantly decrease postoperative opioid analgesic use in patients undergoing ambulatory reduction mammaplasty.

A structured training programme for caregivers of inpatients after stroke (TRACS): a cluster randomised controlled trial and cost-effectiveness analysis.

PubMed

Forster, Anne; Dickerson, Josie; Young, John; Patel, Anita; Kalra, Lalit; Nixon, Jane; Smithard, David; Knapp, Martin; Holloway, Ivana; Anwar, Shamaila; Farrin, Amanda

2013-12-21

Most patients who have had a stroke are dependent on informal caregivers for activities of daily living. The TRACS trial investigated a training programme for caregivers (the London Stroke Carers Training Course, LSCTC) on physical and psychological outcomes, including cost-effectiveness, for patients and caregivers after a disabling stroke. We undertook a pragmatic, multicentre, cluster randomised controlled trial with a parallel cost-effectiveness analysis. Stroke units were eligible if four of five criteria used to define a stroke unit were met, a substantial number of patients on the unit had a diagnosis of stroke, staff were able to deliver the LSCTC, and most patients were discharged to a permanent place of residence. Stroke units were randomly assigned to either LSCTC or usual care (control group), stratified by geographical region and quality of care, and using blocks of size 2. Patients with a diagnosis of stroke, likely to return home with residual disability and with a caregiver providing support were eligible. The primary outcome for patients was self-reported extended activities of daily living at 6 months, measured with the Nottingham Extended Activities of Daily Living (NEADL) scale. The primary outcome for caregivers was self-reported burden at 6 months, measured with the caregivers burden scale (CBS). We combined patient and caregiver costs with primary outcomes and quality-adjusted life-years (QALYs) to assess cost-effectiveness. This trial is registered with controlled-trials.com, number ISRCTN 49208824. We assessed 49 stroke units for eligibility, of which 36 were randomly assigned to either the intervention group or the control group. Between Feb 27, 2008, and Feb 9, 2010, 928 patient and caregiver dyads were registered, of which 450 were in the intervention group, and 478 in the control group. Patients' self-reported extended activities of daily living did not differ between groups at 6 months (adjusted mean NEADL score 27·4 in the intervention group versus 27·6 in the control group, difference -0·2 points [95% CI -3·0 to 2·5], p value=0·866, ICC=0·027). The caregiver burden scale did not differ between groups either (adjusted mean CBS 45·5 in the intervention group versus 45·0 in the control group, difference 0·5 points [95% CI -1·7 to 2·7], p value=0·660, ICC=0·013). Patient and caregiver costs were similar in both groups (length of the initial stroke admission and associated costs were £13,127 for the intervention group and £12,471 for the control group; adjusted mean difference £1243 [95% CI -1533 to 4019]; p value=0·380). Probabilities of cost-effectiveness based on QALYs were low. In a large scale, robust evaluation, results from this study have shown no differences between the LSCTC and usual care on any of the assessed outcomes. The immediate period after stroke might not be the ideal time to deliver structured caregiver training. Medical Research Council. Copyright © 2013 Elsevier Ltd. All rights reserved.

Assessment of mammographic film processor performance in a hospital and mobile screening unit.

PubMed

Murray, J G; Dowsett, D J; Laird, O; Ennis, J T

1992-12-01

In contrast to the majority of mammographic breast screening programmes, film processing at this centre occurs on site in both hospital and mobile trailer units. Initial (1989) quality control (QC) sensitometric tests revealed a large variation in film processor performance in the mobile unit. The clinical significance of these variations was assessed and acceptance limits for processor performance determined. Abnormal mammograms were used as reference material and copied using high definition 35 mm film over a range of exposure settings. The copies were than matched with QC film density variation from the mobile unit. All films were subsequently ranked for spatial and contrast resolution. Optimal values for processing time of 2 min (equivalent to film transit time 3 min and developer time 46 s) and temperature of 36 degrees C were obtained. The widespread anomaly of reporting film transit time as processing time is highlighted. Use of mammogram copies as a means of measuring the influence of film processor variation is advocated. Careful monitoring of the mobile unit film processor performance has produced stable quality comparable with the hospital based unit. The advantages of on site film processing are outlined. The addition of a sensitometric step wedge to all mammography film stock as a means of assessing image quality is recommended.

[Duties of institutions and heads of health care centers in the area of infection control, information, assessment, registration and financing of benefits provided to TB patients].

PubMed

Zielonka, Tadeusz M

2015-01-01

The Act on preventing and counteracting infections and infectious diseases in humans effective in Poland requires the heads of health care outlets and institutions to counteract spreading of TB in units under their management. They are, by all means, responsible for monitoring infections in their respective units, including development, implementation and monitoring of the implementation of procedures into practice, aiming at limiting the dissemination of TB in hospitals and outpatient clinics. Medical service unit managers are also responsible for providing members of their staff with means of individual protection against infection with Mycobacterium tuberculosis bacillus. Their duties also include reporting all of the recognized TB cases in their respective units. TB is an infectious diseases included in the occupational disease list. Assessment of TB as an occupational disease is the responsibility of provincial TB prevention clinics. The Act also provides principles of financing of individual benefits available for the insured TB patients as well as those not insured.

Placebo-controlled clinical trial of use of 10% hydrogen peroxide whitening strips for medication-induced xerostomia.

PubMed

Papas, Athena S; Kugel, Gerard; Singh, Mabi; Barker, Matthew L; Gerlach, Robert W

2009-01-01

A randomized, double-blind, placebo-controlled clinical trial was conducted to evaluate the effectiveness and safety of peroxide-containing strip-based tooth whitening among subjects with medication-induced hyposalivation. Eligibility for this tooth whitening study was limited to dentate adults taking xerogenic medications with an unstimulated salivary flow < or = 0.2 ml/min. After giving informed consent, 42 subjects were randomized using a 2:1 ratio to 10% hydrogen peroxide whitening strips (Crest Whitestrips Premium) or placebo strips without peroxide. Strips were used for 30 min twice daily for a 14-day period. Usage was unsupervised, and only the maxillary arch was treated. On days 8 and 15, efficacy was assessed from standard digital images of the anterior dentition and quantified using the Cielab color system, while safety was assessed from interviews and clinical examinations. At day 8, the peroxide group experienced significant (p < 0.001) color improvement relative to baseline and placebo. Adjusted means +/- standard errors for yellowness reduction were -1.65 +/- 0.115 units for the peroxide group and -0.32 +/- 0.170 units for the placebo group. For the increase in lightness, adjusted means +/- standard errors on day 8 were 1.53 +/- 0.130 units for the peroxide group and 0.37 +/- 0.191 units for the controls. Continued strip use through day 15 yielded incremental color improvement for the peroxide group. Mild and transient tooth sensitivity represented the most common adverse events. No subject discontinued treatment due to a product-related adverse event. Twice daily use of 10% hydrogen peroxide whitening strips by adults with medication-induced xerostomia was well tolerated, with significant tooth color improvement evident within 7 days. Copyright 2009 S. Karger AG, Basel.

Lansoprazole for children with poorly controlled asthma: a randomized controlled trial.

PubMed

Holbrook, Janet T; Wise, Robert A; Gold, Benjamin D; Blake, Kathryn; Brown, Ellen D; Castro, Mario; Dozor, Allen J; Lima, John J; Mastronarde, John G; Sockrider, Marianna M; Teague, W Gerald

2012-01-25

Asymptomatic gastroesophageal reflux (GER) is prevalent in children with asthma. Untreated GER has been postulated to be a cause of inadequate asthma control in children despite inhaled corticosteroid treatment, but it is not known whether treatment with proton pump inhibitors improves asthma control. To determine whether lansoprazole is effective in reducing asthma symptoms in children without overt GER. The Study of Acid Reflux in Children With Asthma, a randomized, masked, placebo-controlled, parallel clinical trial that compared lansoprazole with placebo in children with poor asthma control who were receiving inhaled corticosteroid treatment. Three hundred six participants enrolled from April 2007 to September 2010 at 19 US academic clinical centers were followed up for 24 weeks. A subgroup had an esophageal pH study before randomization. Participating children were randomly assigned to receive either lansoprazole, 15 mg/d if weighing less than 30 kg or 30 mg/d if weighing 30 kg or more (n = 149), or placebo (n = 157). The primary outcome measure was change in Asthma Control Questionnaire (ACQ) score (range, 0-6; a 0.5-unit change is considered clinically meaningful). Secondary outcome measures included lung function measures, asthma-related quality of life, and episodes of poor asthma control. The mean age was 11 years (SD, 3 years). The mean difference in change (lansoprazole minus placebo) in the ACQ score was 0.2 units (95% CI, 0.0-0.3 units). There were no statistically significant differences in the mean difference in change for the secondary outcomes of forced expiratory volume in the first second (0.0 L; 95% CI, -0.1 to 0.1 L), asthma-related quality of life (-0.1; 95% CI, -0.3 to 0.1), or rate of episodes of poor asthma control (relative risk, 1.2; 95% CI, 0.9-1.5). Among the 115 children with esophageal pH studies, the prevalence of GER was 43%. In the subgroup with a positive pH study, no treatment effect for lansoprazole vs placebo was observed for any asthma outcome. Children treated with lansoprazole reported more respiratory infections (relative risk, 1.3 [95% CI, 1.1-1.6]). In this trial of children with poorly controlled asthma without symptoms of GER who were using inhaled corticosteroids, the addition of lansoprazole, compared with placebo, improved neither symptoms nor lung function but was associated with increased adverse events. clinicaltrials.gov Identifier: NCT00442013.

31 CFR 595.508 - Official activities of certain international organizations; U.S. person employees of certain...

Code of Federal Regulations, 2011 CFR

2011-07-01

... Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL... “United Nations” means its principal organs, including funds, bodies, commissions, agencies, departments... Food Programme, and the World Health Organization. [71 FR 27201, May 10, 2006] ...

31 CFR 595.508 - Official activities of certain international organizations; U.S. person employees of certain...

Code of Federal Regulations, 2012 CFR

2012-07-01

... Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL... “United Nations” means its principal organs, including funds, bodies, commissions, agencies, departments... Food Programme, and the World Health Organization. [71 FR 27201, May 10, 2006] ...

31 CFR 595.508 - Official activities of certain international organizations; U.S. person employees of certain...

Code of Federal Regulations, 2014 CFR

2014-07-01

... Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL... “United Nations” means its principal organs, including funds, bodies, commissions, agencies, departments... Food Programme, and the World Health Organization. [71 FR 27201, May 10, 2006] ...

31 CFR 594.510 - Official activities of certain international organizations; U.S. person employees of certain...

Code of Federal Regulations, 2012 CFR

2012-07-01

... Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL... “United Nations” means its principal organs, including funds, bodies, commissions, agencies, departments... Food Programme, and the World Health Organization. [71 FR 27200, May 10, 2006] ...

31 CFR 595.508 - Official activities of certain international organizations; U.S. person employees of certain...

Code of Federal Regulations, 2013 CFR

2013-07-01

... Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL... “United Nations” means its principal organs, including funds, bodies, commissions, agencies, departments... Food Programme, and the World Health Organization. [71 FR 27201, May 10, 2006] ...

26 CFR 301.7701-7 - Trusts-domestic and foreign.

Code of Federal Regulations, 2010 CFR

2010-04-01

... more United States persons have the authority to control all substantial decisions of the trust... decisions. The term substantial decisions means those decisions that persons are authorized or required to make under the terms of the trust instrument and applicable law and that are not ministerial. Decisions...

21 CFR 1405.665 - State.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 9 2010-04-01 2010-04-01 false State. 1405.665 Section 1405.665 Food and Drugs OFFICE OF NATIONAL DRUG CONTROL POLICY GOVERNMENTWIDE REQUIREMENTS FOR DRUG-FREE WORKPLACE (FINANCIAL ASSISTANCE) Definitions § 1405.665 State. State means any of the States of the United States, the District of...

31 CFR 594.304 - Foreign person.

Code of Federal Regulations, 2010 CFR

2010-07-01

... FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY GLOBAL TERRORISM SANCTIONS REGULATIONS General Definitions § 594.304 Foreign person. The term foreign person means any citizen or national of a foreign state (including any such individual who is also a citizen or national of the United States), or any entity not...

41 CFR 301-10.131 - What does United States mean?

Code of Federal Regulations, 2013 CFR

2013-07-01

... 41 Public Contracts and Property Management 4 2013-07-01 2012-07-01 true What does United States... Carrier Transportation Use of United States Flag Air Carriers § 301-10.131 What does United States mean? For purposes of the use of United States flag air carriers, United States means the 50 states, the...

41 CFR 301-10.131 - What does United States mean?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 4 2010-07-01 2010-07-01 false What does United States... Carrier Transportation Use of United States Flag Air Carriers § 301-10.131 What does United States mean? For purposes of the use of United States flag air carriers, United States means the 50 states, the...

41 CFR 301-10.131 - What does United States mean?

Code of Federal Regulations, 2011 CFR

2011-07-01

... 41 Public Contracts and Property Management 4 2011-07-01 2011-07-01 false What does United States... Carrier Transportation Use of United States Flag Air Carriers § 301-10.131 What does United States mean? For purposes of the use of United States flag air carriers, United States means the 50 states, the...

41 CFR 301-10.131 - What does United States mean?

Code of Federal Regulations, 2014 CFR

2014-07-01

... 41 Public Contracts and Property Management 4 2014-07-01 2014-07-01 false What does United States... Carrier Transportation Use of United States Flag Air Carriers § 301-10.131 What does United States mean? For purposes of the use of United States flag air carriers, United States means the 50 states, the...

Assessment of fetal well-being in cattle by ultrasonography in normal, high-risk, and cloned pregnancies

PubMed Central

Buczinski, Sébastien; Fecteau, Gilles; Lefebvre, Réjean C.; Smith, Lawrence C.

2011-01-01

This study determined ultrasonographic parameters of fetuses and uterine adnexa in late pregnancy in normal, cloned, and high-risk pregnancies in relation to perinatal and neonatal outcome. Ten cows with normal pregnancies (CONTROL, mean pregnancy length 273 d), 10 sick cows with potentially compromised pregnancies (HIGH-RISK, mean pregnancy length 267 d), and 10 heifers with cloned pregnancies (CLONED, mean pregnancy length 274 d) were examined at more than 260 d of gestation. There was no difference in mean fetal heart rates among the groups. The cloned calves were heavier (57 ± 8 kg) than calves from CONTROL group (36 ± 7 kg), and calves from HIGH-RISK group (37 ± 13 kg) (P = 0.003). The diameter of the thoracic aorta was positively correlated (R = 0.62) with fetal birth weight in the CONTROL group (P = 0.01). Fetal activity was not associated with survival. The results suggest that transabdominal ultrasonographic assessment of the fetal well-being may serve as a potential tool for evaluation of the fetoplacental unit. PMID:21532817

Plasma homovanillic acid in adolescents with bulimia nervosa.

PubMed

Castro-Fornieles, Josefina; Deulofeu, Ramón; Martínez-Mallen, Esteve; Baeza, Immaculada; Fernández, Lorena; Lázaro, Luisa; Toro, Josep; Vila, Montserrat; Bernardo, Miquel

2009-12-30

Dopaminergic abnormalities in bulimia nervosa have been reported in some studies, but results are not consistent across studies. In the present study, clinical characteristics, plasma level of homovanillic acid (pHVA) and two scales - the Eating Attitudes Test (EAT) and the Beck Depression Inventory (BDI) - were assessed in 36 adolescent bulimia nervosa patients (mean age16.3 years, S.D. 1.1) who were consecutively seen on an Eating Disorder Unit. Levels of pHVA were also measured in 16 healthy control adolescents from the general population. Patients had significantly higher mean pHVA than controls. Eighteen patients (50%) had a pHVA level equal to or higher than the mean of control subjects plus one standard deviation, and this group of patients had significantly higher mean BDI scores and non-significantly higher mean EAT scores, although they did not differ from the other patients in age, time elapsed since the onset of disorder, body mass index and number of binges or vomits. Moreover, in logistic regression analysis the BDI score proved to be an independent predictor of high pHVA. The level of pHVA is increased in bulimia nervosa patients with high scores on measures of depressive and eating symptomatology.

New insulin glargine 300 units/mL versus glargine 100 units/mL in people with type 2 diabetes using oral agents and basal insulin: glucose control and hypoglycemia in a 6-month randomized controlled trial (EDITION 2).

PubMed

Yki-Järvinen, Hannele; Bergenstal, Richard; Ziemen, Monika; Wardecki, Marek; Muehlen-Bartmer, Isabel; Boelle, Emmanuelle; Riddle, Matthew C

2014-12-01

To compare the efficacy and safety of new insulin glargine 300 units/mL (Gla-300) with glargine 100 units/mL (Gla-100) in people with type 2 diabetes using basal insulin (≥42 units/day) plus oral antihyperglycemic drugs (OADs). EDITION 2 was a multicenter, open-label, two-arm study. Adults receiving basal insulin plus OADs were randomized to Gla-300 or Gla-100 once daily for 6 months. The primary end point was change in HbA1c. The main secondary end point was percentage of participants with one or more nocturnal confirmed (≤3.9 mmol/L [≤70 mg/dL]) or severe hypoglycemic events from week 9 to month 6. Randomized participants (n = 811) had a mean (SD) HbA₁c of 8.24% (0.82) and BMI of 34.8 kg/m(2) (6.4). Glycemic control improved similarly with both basal insulins; least squares mean (SD) reduction from baseline was -0.57% (0.09) for Gla-300 and -0.56% (0.09) for Gla-100 (mean difference -0.01% [95% CI -0.14 to 0.12]), with 10% higher dose of Gla-300. Less nocturnal confirmed (≤3.9 mmol/L [≤70 mg/dL]) or severe hypoglycemia was observed with Gla-300 from week 9 to month 6 (relative risk 0.77 [95% CI 0.61-0.99]; P = 0.038) and during the first 8 weeks. Fewer nocturnal and any time (24 h) hypoglycemic events were reported during the entire 6-month period. Weight gain was lower with Gla-300 than with Gla-100 (P = 0.015). No between-treatment differences in safety parameters were identified. Gla-300 was as effective as Gla-100 and associated with a lower risk of hypoglycemia during the night and at any time of the day. © 2014 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

Interaction Control to Synchronize Non-synchronizable Networks.

PubMed

Schröder, Malte; Chakraborty, Sagar; Witthaut, Dirk; Nagler, Jan; Timme, Marc

2016-11-17

Synchronization constitutes one of the most fundamental collective dynamics across networked systems and often underlies their function. Whether a system may synchronize depends on the internal unit dynamics as well as the topology and strength of their interactions. For chaotic units with certain interaction topologies synchronization might be impossible across all interaction strengths, meaning that these networks are non-synchronizable. Here we propose the concept of interaction control, generalizing transient uncoupling, to induce desired collective dynamics in complex networks and apply it to synchronize even such non-synchronizable systems. After highlighting that non-synchronizability prevails for a wide range of networks of arbitrary size, we explain how a simple binary control may localize interactions in state space and thereby synchronize networks. Intriguingly, localizing interactions by a fixed control scheme enables stable synchronization across all connected networks regardless of topological constraints. Interaction control may thus ease the design of desired collective dynamics even without knowledge of the networks' exact interaction topology and consequently have implications for biological and self-organizing technical systems.

Interaction Control to Synchronize Non-synchronizable Networks

PubMed Central

Schröder, Malte; Chakraborty, Sagar; Witthaut, Dirk; Nagler, Jan; Timme, Marc

2016-01-01

Synchronization constitutes one of the most fundamental collective dynamics across networked systems and often underlies their function. Whether a system may synchronize depends on the internal unit dynamics as well as the topology and strength of their interactions. For chaotic units with certain interaction topologies synchronization might be impossible across all interaction strengths, meaning that these networks are non-synchronizable. Here we propose the concept of interaction control, generalizing transient uncoupling, to induce desired collective dynamics in complex networks and apply it to synchronize even such non-synchronizable systems. After highlighting that non-synchronizability prevails for a wide range of networks of arbitrary size, we explain how a simple binary control may localize interactions in state space and thereby synchronize networks. Intriguingly, localizing interactions by a fixed control scheme enables stable synchronization across all connected networks regardless of topological constraints. Interaction control may thus ease the design of desired collective dynamics even without knowledge of the networks’ exact interaction topology and consequently have implications for biological and self-organizing technical systems. PMID:27853266

Dental unit waterlines disinfection using hypochlorous acid-based disinfectant

PubMed Central

Shajahan, Irfana Fathima; Kandaswamy, D; Srikanth, Padma; Narayana, L Lakshmi; Selvarajan, R

2016-01-01

Objective: The purpose of the study was to investigate the efficacy of a new disinfectant to disinfect the dental unit waterlines. Materials and Methods: New dental unit waterlines were installed in 13 dental chairs, and biofilm was allowed to grow for 10 days. Disinfection treatment procedure was carried out in the 12 units, and one unit was left untreated. The dental unit waterlines were removed and analyzed using the scanning electron microscope (SEM) (TESCAN VEGA3 SBU). Result: On examination, SEM images showed that there was no slime layer or bacterial cells seen in any of the 12 cut sections obtained from the treated dental waterlines which mean that there was no evident of biofilm formation. Untreated dental unit waterlines showed a microbial colonization with continuous filamentous organic matrix. There was significant biofilm formation in the control tube relative to the samples. Conclusion: The tested disinfectant was found to be effective in the removal of biofilm from the dental unit waterlines. PMID:27563184

Comparing ε-Aminocaproic Acid and Tranexamic Acid in Reducing Postoperative Transfusions in Total Knee Arthroplasty.

PubMed

Churchill, Jessica L; Puca, Kathleen E; Meyer, Elizabeth; Carleton, Matthew; Anderson, Michael J

2017-06-01

Multiple studies have shown tranexamic acid (TXA) to reduce blood loss and transfusion rates in patients undergoing total knee arthroplasty (TKA). Accordingly, TXA has become a routine blood conservation agent for TKA. In contrast, ε-aminocaproic acid (EACA), a similar acting antifibrinolytic to TXA, has been less frequently used. This study evaluated whether EACA is as efficacious as TXA in reducing postoperative blood transfusion rates and compared the cost per surgery between agents. A multicenter retrospective chart review of elective unilateral TKA from April 2012 through December 2014 was performed. Five hospitals within a health care system participated. Data collected included age, gender, severity of illness score, use of antifibrinolytic and dose, red blood cell (RBC) transfusions and the number of units, and preadmission and discharge hemoglobin (Hb). Dosing of the antifibrinolytic differed based on the agent used, 5 or 10 g (based on weight) for EACA versus 1 g for TXA. The institutional acquisition cost of each antifibrinolytic was obtained and averaged over the study period. Of 2,922 primary unilateral TKA cases, 820 patients received EACA, 610 patients received TXA, and 1,492 patients received no antifibrinolytic (control group). Compared with the control group both EACA and TXA groups had significantly fewer patients transfused (EACA 2.8% [ p  < 0.0001], TXA 3.2% [ p  < 0.0001] vs. control 10.8%) and lower mean RBC units transfused per patient (EACA 0.05 units/patient [pt] [ p  < 0.0001], TXA 0.05 units/pt [ p  < 0.0001] vs. control 0.19 units/pt]. There was no difference in mean RBC units transfused per patient, percentage of patients transfused, and discharge Hb levels between the EACA and TXA groups ( p  = 0.822, 0.236, and 0.322, respectively). Medication acquisition cost for EACA averaged $2.23 per surgery compared with TXA at $39.58 per surgery. Administration of EACA or TXA significantly decreased postoperative transfusion rates compared with no antifibrinolytic therapy. Utilization of EACA for unilateral TKA proved to be comparable to TXA in all studied aspects at a lower cost. The level of evidence for the study is Level 3. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Evaluation of adenosine triphosphate test for cleaning assessment of gastroscopes and the effect on workload in a busy endoscopy center.

PubMed

Schmitt, Cristiane; Pires Maciel, Amanda Luiz; Boszczowski, Icaro; da Silva, Thaís Pereira; Neves, Eliane Aparecida Job; Rossini, Giulio Fabio; Rizek, Camila; Costa, Silvia Figueiredo; Lourenço, Rogério Ferreira; Alfa, Michelle J

2018-05-18

Using adenosine triphosphate (ATP) tests to assess manual cleaning of gastroscopes and to determine the associated workload in a busy endoscopy unit. Patient-used gastroscopes were sampled before and after cleaning to assess ATP levels, bioburden, and protein. Samples were collected by flushing 20 mL of sterile water through the biopsy port to the distal end. Time spent for reprocessing and performing the ATP test was recorded. Twenty-four samples were collected from 10 gastroscopes. After manual cleaning, 14/24 (58.3%) samples had no microbial growth (mean, 21 colony-forming units/cm 2 ), and in 22/24 (91.7%) samples the protein was undetectable (mean, 0.04 µg/cm 2 ). ATP test was above the cutoff (200 relative light units [RLU]) in 17/24 (70.8%) samples (mean, 498 RLU). After the second cleaning, 11/17 (64.7%) gastroscopes still failed the ATP test (mean, 321.2 RLU). The mean time spent to perform manual cleaning and ATP tests was 16 and 8 minutes, respectively. Hence, each test increased the length of time for cleaning plus testing cleanliness by 50%. Further studies regarding the optimal cutoff for ATP tests are needed. ATP tests for cleaning monitoring are easy to perform and provide immediate feedback to the team. However, the increased workload needs to be considered. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

The effect of uterine fundal pressure on the duration of the second stage of labor: a randomized controlled trial.

PubMed

Api, Olus; Balcin, Muge Emeksiz; Ugurel, Vedat; Api, Murat; Turan, Cem; Unal, Orhan

2009-01-01

To determine the effect of uterine fundal pressure on shortening the second stage of labor and on the fetal outcome. Randomized controlled trial. Teaching and research hospital. One hundred ninety-seven women between 37 and 42 gestational weeks with singleton cephalic presentation admitted to the delivery unit. Random allocation into groups with or without manual fundal pressure during the second stage of labor. The primary outcome measure was the duration of the second stage of labor. Secondary outcome measures were umbilical artery pH, HCO3-, base excess, pO2, pCO2 values and the rate of instrumental delivery, severe maternal morbidity/mortality, neonatal trauma, admission to neonatal intensive care unit, and neonatal death. There were no significant differences in the mean duration of the second stage of labor and secondary outcome measures except for mean pO2 which was lower and mean pCO2 which was higher in the fundal pressure group. Nevertheless, the values still remained within normal ranges and there were no neonates with an Apgar score <7 in either of the groups. Application of fundal pressure on a delivering woman was ineffective in shortening the second stage of labor.

Effects of psychosocial stimulation on growth and development of severely malnourished children in a nutrition unit in Bangladesh.

PubMed

Nahar, B; Hamadani, J D; Ahmed, T; Tofail, F; Rahman, A; Huda, S N; Grantham-McGregor, S M

2009-06-01

Young children with severe malnutrition usually have poor mental development. Psychosocial stimulation may reduce their cognitive deficit, but it is not usually provided. The aim of the study was to incorporate stimulation into the routine treatment of severely malnourished children in a nutrition unit and evaluate the impact on their growth and development. Time-lagged controlled study. Nutritional Rehabilitation Unit (NRU) in ICDDR,B Dhaka Hospital. Severely malnourished children, aged 6-24 months, admitted to the NRU were enrolled. All received standard nutritional care. A control group of 43 children was studied initially, followed by an intervention group of 54 children. The intervened mothers and children participated in daily group meetings and individual play sessions for 2 weeks in hospital and were visited at home for 6 months. Children's growth was measured and development assessed using the Bayley Scales of Infant Development. Twenty-seven children were lost to the study. In the remaining children, both groups had similar developmental scores and anthropometry initially. After 6 months, the intervention group had improved more than the controls did by a mean of 6.9 (P<0.001; 95% CI: 3.9, 10.0) mental and 3.1 (P=0.024; 95% CI: 0.4, 5.7) motor raw scores and a mean of 0.4 (P=0.029; 95% CI: 0.1, 0.8) weight-for-age z scores, controlling for background variables. Psychosocial stimulation integrated into treatment of severely malnourished children in hospital, followed by home visits for 6 months, was effective in improving children's growth and development and should be an integral part of their treatment.

Another face of placebo: The lessebo effect in Parkinson disease

PubMed Central

Mestre, Tiago A.; Shah, Prakesh; Marras, Connie; Tomlinson, George

2014-01-01

Objective: To study the impact of negative expectation related to receiving a placebo (the “lessebo effect”) on efficacy outcome measures of symptomatic treatments in Parkinson disease (PD). Methods: We conducted meta-analyses of double-blind randomized controlled trials (RCTs) of dopamine agonists in PD and compared the pooled mean score change of the motor section of the Unified Parkinson's Disease Rating Scale (mUPDRS) across active treatment arms according to the presence of a placebo arm or the probability of placebo assignment (0%, <50%, and 50%) of the original RCT. A mixed-effects model was used. Heterogeneity was assessed by subgroup analyses and meta-regression modeling. Results: A total of 28 study arms were extracted from active-controlled trials (3,277 patients) and 42 from placebo-controlled trials (4,554 patients). The overall difference between groups in the pooled mean score change in the mUPDRS was 1.6 units (95% confidence interval [CI] 0.2, 3.0; p = 0.023), in favor of the active-controlled group. In subgroup analyses, this difference was of higher magnitude in the early PD group without motor fluctuations (3.3 mUPDRS units, 95% CI 1.1, 5.4; p = 0.003) and for study duration ≤12 weeks (4.1 mUPDRS units, 95% CI 1.0, 7.2; p = 0.009). There was no between-group difference using probability of placebo assignment as criterion. Conclusions: This study shows that the use of a placebo can be associated with a clinically significant reduction in the magnitude of change of the mUPDRS after an active treatment in RCTs for PD. These new findings have potential implications in the development of new treatments and appraisal of current treatment options for PD and possibly for other neurologic disorders. PMID:24658930

Wireless Augmented Reality Prototype (WARP)

NASA Technical Reports Server (NTRS)

Devereaux, A. S.

1999-01-01

Initiated in January, 1997, under NASA's Office of Life and Microgravity Sciences and Applications, the Wireless Augmented Reality Prototype (WARP) is a means to leverage recent advances in communications, displays, imaging sensors, biosensors, voice recognition and microelectronics to develop a hands-free, tetherless system capable of real-time personal display and control of computer system resources. Using WARP, an astronaut may efficiently operate and monitor any computer-controllable activity inside or outside the vehicle or station. The WARP concept is a lightweight, unobtrusive heads-up display with a wireless wearable control unit. Connectivity to the external system is achieved through a high-rate radio link from the WARP personal unit to a base station unit installed into any system PC. The radio link has been specially engineered to operate within the high- interference, high-multipath environment of a space shuttle or space station module. Through this virtual terminal, the astronaut will be able to view and manipulate imagery, text or video, using voice commands to control the terminal operations. WARP's hands-free access to computer-based instruction texts, diagrams and checklists replaces juggling manuals and clipboards, and tetherless computer system access allows free motion throughout a cabin while monitoring and operating equipment.

Spoof surface plasmon polaritons excitation and wavefront control by Pancharatnam–Berry phase manipulating metasurface

NASA Astrophysics Data System (ADS)

Meng, Yueyu; Ma, Hua; Li, Yongfeng; Feng, Mingde; Wang, Jiafu; Li, Zhiqiang; Qu, Shaobo

2018-05-01

Realizing fine control of surface plasmon polaritons (SPPs) and spoof surface plasmon polaritons (SSPPs) is highly desired in many integrated photonic and microwave applications, but the flexibility to control the wavefront of SPPs and SSPPs still need addressing. In this paper, a Pancharatnam–Berry (PB) phase manipulating metasurface (PMM) was designed to achieve SSPPs excitation and wavefront control. Under circular polarization (CP) incidence, simply by designing the rotation angle of the unit cells the reflection phase spatial distribution can be manipulated. By means of different phase profiles on the 2D unit cells array, the SSPPs can be excited with various wavefront shapes, without the need of special excitation structure pattern. Meanwhile, a plasmonic metal is also designed to support SSPPs with both TE and TM polarizations, which can efficiently guide out the energies from the input CP waves. As a proof of concept, a PB PMM composed of N-shape metallic structure was designed. Through designing the rotation of the unit cells, two typical phase profiles were designed to excite SSPPs in arbitrary slant direction or focusing. This scheme could be used to achieve SSPPs excitation with many other wavefront shapes, and would also enable promising applications in other spectra.

Differences in liquor prices between control state-operated and license-state retail outlets in the U.S.

PubMed Central

Siegel, Michael; DeJong, William; Albers, Alison B.; Naimi, Timothy S.; Jernigan, David H.

2012-01-01

Aims This study aims to compare the average price of liquor in the United States between retail alcohol outlets in states that have a monopoly ('control' states) with those that do not ('licence' states). Design A cross-sectional study of brand-specific alcohol prices in the United States. Setting We determined the average prices in February 2012 of 74 brands of liquor among the 13 control states that maintain a monopoly on liquor sales at the retail level and among a sample of 50 license-state liquor stores, using their online-available prices. Measurements We calculated average prices for 74 brands of liquor by control vs. license state. We used a random effects regression model to estimate differences between control and license state prices – overall and by alcoholic beverage type. We also compared prices between the 13 control states. Findings The overall mean price for the 74 brands was $27.79 in the license states (95% confidence interval [CI], $25.26–$30.32) and $29.82 in the control states (95% CI, $26.98–$32.66). Based on the random effects linear regression model, the average liquor price was approximately two dollars lower (6.9% lower) in license states. Conclusions In the United States monopoly of alcohol retail outlets appears to be associated with slightly higher liquor prices. PMID:22934914

Comparison of laser Doppler imaging, fingertip lacticemy test, and nailfold capillaroscopy for assessment of digital microcirculation in systemic sclerosis

PubMed Central

2010-01-01

Introduction Laser Doppler imaging (LDI) is a relatively new method for assessing the functional aspect of superficial skin blood flow in systemic sclerosis (SSc) and Raynaud's phenomenon. The present study investigated the dynamic behavior of digital skin microvascular blood flow before and after cold stimulus (CS) in SSc patients and in healthy controls by means of a comprehensive approach of the functional (LDI), morphological (nailfold capillaroscopy (NFC)), and biochemical (fingertip lacticemy (FTL)) microcirculation components. Methods Forty-four SSc patients and 40 healthy controls were included. After acclimatization, all subjects underwent NFC followed by LDI and FTL measurement. NFC was performed with a stereomicroscope under 10× to 20× magnification in the 10 digits of the hands. Skin blood flow of the dorsum of four fingertips (excluding the thumb) of the left hand was measured using LDI at baseline and for 30 minutes after CS. The mean finger blood flow (FBF) of the four fingertips was expressed as arbitrary perfusion units. FTL was determined on the fourth left finger before (pre-CS-FTL) and 10 minutes after CS. Results LDI showed significantly lower mean baseline FBF in SSc patients as compared with controls (296.9 ± 208.8 vs. 503.6 ± 146.4 perfusion units; P < 0.001) and also at all time points after CS (P < 0.001). There was a significant decrease in mean FBF after CS as compared with baseline in SSc patients and in controls, followed by recovery of the blood flow 27 minutes after CS in healthy controls, but not in SSc patients. FBF tended to be lower in patients with digital scars and previous ulceration/amputation (P = 0.06). There was no correlation between mean baseline FBF and NFC parameters. Interestingly, there was a negative correlation between FTL and FBF measured by LDI in basal conditions and 10 minutes after CS in SSc patients. Conclusions LDI showed lower digital blood flow in SSc patients when compared with healthy controls and correlated well with FTL both at baseline and after CS, allowing objective measurement of blood perfusion in SSc patients. The lack of correlation between functional and morphological microvascular abnormalities, measured by LDI and NFC, suggests they are complementary tools for evaluation of independent microangiopathy aspects in SSc patients. PMID:20696074

Comparison of laser Doppler imaging, fingertip lacticemy test, and nailfold capillaroscopy for assessment of digital microcirculation in systemic sclerosis.

PubMed

Correa, Marcelo Ju; Andrade, Luis Ec; Kayser, Cristiane

2010-01-01

Laser Doppler imaging (LDI) is a relatively new method for assessing the functional aspect of superficial skin blood flow in systemic sclerosis (SSc) and Raynaud's phenomenon. The present study investigated the dynamic behavior of digital skin microvascular blood flow before and after cold stimulus (CS) in SSc patients and in healthy controls by means of a comprehensive approach of the functional (LDI), morphological (nailfold capillaroscopy (NFC)), and biochemical (fingertip lacticemy (FTL)) microcirculation components. Forty-four SSc patients and 40 healthy controls were included. After acclimatization, all subjects underwent NFC followed by LDI and FTL measurement. NFC was performed with a stereomicroscope under 10× to 20× magnification in the 10 digits of the hands. Skin blood flow of the dorsum of four fingertips (excluding the thumb) of the left hand was measured using LDI at baseline and for 30 minutes after CS. The mean finger blood flow (FBF) of the four fingertips was expressed as arbitrary perfusion units. FTL was determined on the fourth left finger before (pre-CS-FTL) and 10 minutes after CS. LDI showed significantly lower mean baseline FBF in SSc patients as compared with controls (296.9 ± 208.8 vs. 503.6 ± 146.4 perfusion units; P < 0.001) and also at all time points after CS (P < 0.001). There was a significant decrease in mean FBF after CS as compared with baseline in SSc patients and in controls, followed by recovery of the blood flow 27 minutes after CS in healthy controls, but not in SSc patients. FBF tended to be lower in patients with digital scars and previous ulceration/amputation (P = 0.06). There was no correlation between mean baseline FBF and NFC parameters. Interestingly, there was a negative correlation between FTL and FBF measured by LDI in basal conditions and 10 minutes after CS in SSc patients. LDI showed lower digital blood flow in SSc patients when compared with healthy controls and correlated well with FTL both at baseline and after CS, allowing objective measurement of blood perfusion in SSc patients. The lack of correlation between functional and morphological microvascular abnormalities, measured by LDI and NFC, suggests they are complementary tools for evaluation of independent microangiopathy aspects in SSc patients.

Effects of inhaled corticosteroids on airway inflammation in chronic obstructive pulmonary disease: a systematic review and meta-analysis

PubMed Central

Jen, Rachel; Rennard, Stephen I; Sin, Don D

2012-01-01

Background: Chronic obstructive pulmonary disease (COPD) is characterized by chronic inflammation in the small airways. The effect of inhaled corticosteroids (ICS) on lung inflammation in COPD remains uncertain. We sought to determine the effects of ICS on inflammatory indices in bronchial biopsies and bronchoalveolar lavage fluid of patients with COPD. Methods: We searched Medline, Embase, Cinahl, and the Cochrane database for randomized, controlled clinical trials that used bronchial biopsies and bronchoalveolar lavage to evaluate the effects of ICS in stable COPD. For each chosen study, we calculated the mean differences in the concentrations of inflammatory cells before and after treatment in both intervention and control groups. These values were then converted into standardized mean differences (SMD) to accommodate the differences in patient selection, clinical treatment, and biochemical procedures that were employed across the original studies. If significant heterogeneity was present (P < 0.1), then a random effects model was used to pool the original data; otherwise, a fixed effects model was used. Results: We identified eight original studies that met the inclusion criteria. Four studies used bronchial biopsies (n =102 participants) and showed that ICS were effective in reducing CD4 and CD8 cell counts (SMD, −0.52 units and −0.66 units, 95% confidence interval). The five studies used bronchoalveolar lavage fluid (n =309), which together showed that ICS reduced neutrophil and lymphocyte counts (SMD, −0.64 units and −0.64 units, 95% confidence interval). ICS on the other hand significantly increased macrophage counts (SMD, 0.68 units, 95% confidence interval) in bronchoalveolar lavage fluid. Conclusion: ICS has important immunomodulatory effects in airways with COPD that may explain its beneficial effect on exacerbations and enhanced risk of pneumonia. PMID:23055709

46 CFR 58.01-25 - Means of stopping machinery.

Code of Federal Regulations, 2014 CFR

2014-10-01

... forced-draft and induced-draft fans, fuel-oil transfer pumps, fuel-oil unit and service pumps, and similar fuel-oil pumps must be fitted with remote controls from a readily accessible position outside the space concerned so that the fans or pumps may be stopped in case of fire in the compartment in which...

46 CFR 58.01-25 - Means of stopping machinery.

Code of Federal Regulations, 2013 CFR

2013-10-01

... forced-draft and induced-draft fans, fuel-oil transfer pumps, fuel-oil unit and service pumps, and similar fuel-oil pumps must be fitted with remote controls from a readily accessible position outside the space concerned so that the fans or pumps may be stopped in case of fire in the compartment in which...

46 CFR 58.01-25 - Means of stopping machinery.

Code of Federal Regulations, 2011 CFR

2011-10-01

... forced-draft and induced-draft fans, fuel-oil transfer pumps, fuel-oil unit and service pumps, and similar fuel-oil pumps must be fitted with remote controls from a readily accessible position outside the space concerned so that the fans or pumps may be stopped in case of fire in the compartment in which...

46 CFR 58.01-25 - Means of stopping machinery.

Code of Federal Regulations, 2012 CFR

2012-10-01

... forced-draft and induced-draft fans, fuel-oil transfer pumps, fuel-oil unit and service pumps, and similar fuel-oil pumps must be fitted with remote controls from a readily accessible position outside the space concerned so that the fans or pumps may be stopped in case of fire in the compartment in which...

40 CFR 63.11237 - What definitions apply to this subpart?

Code of Federal Regulations, 2013 CFR

2013-07-01

... controlled flame combustion in which water is heated to recover thermal energy in the form of steam and/or... this definition. Coal subcategory includes any boiler that burns any solid fossil fuel and no more than... included in this definition. Electric utility steam generating unit (EGU) means a fossil fuel-fired...

40 CFR 63.11237 - What definitions apply to this subpart?

Code of Federal Regulations, 2014 CFR

2014-07-01

... controlled flame combustion in which water is heated to recover thermal energy in the form of steam and/or... this definition. Coal subcategory includes any boiler that burns any solid fossil fuel and no more than... included in this definition. Electric utility steam generating unit (EGU) means a fossil fuel-fired...

METHOD-SPECIFIC PRECISION AND BIAS RELATIONSHIPS DEVELOPED FROM DATA SUBMITTED DURING USEPA DRINKING WATER LABORATORY PERFORMANCE EVALUATION STUDIES

EPA Science Inventory

This paper documents the process used by the United States Environmental Protection Agency (USEPA) to estimate the mean and standard deviation of data reported by in-control drinking water laboratories during Water Supply (WS) studies. This process is then applied to the data re...

METHOD-SPECIFIC PRECISION AND BIAS RELATIONSHIPS DEVELOPED FROM DATA SUBMITTED DURING USEPA WASTEWATER LABORATORY PERFORMANCE EVALUATION STUDIES

EPA Science Inventory

This paper documents the process used by the United States Environmental Protection Agency (USEPA) to estimate the mean and standard deviation of data reported by in-control wastewater laboratories during Water Pollution (WP) studies. This process is then applied to the data rep...

22 CFR 46.1 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Definitions. 46.1 Section 46.1 Foreign Relations DEPARTMENT OF STATE VISAS CONTROL OF ALIENS DEPARTING FROM THE UNITED STATES § 46.1 Definitions. For the purposes of this part: (a) The term alien means any person who is not a citizen or national of...

22 CFR 46.1 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Definitions. 46.1 Section 46.1 Foreign Relations DEPARTMENT OF STATE VISAS CONTROL OF ALIENS DEPARTING FROM THE UNITED STATES § 46.1 Definitions. For the purposes of this part: (a) The term alien means any person who is not a citizen or national of...

22 CFR 46.1 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Definitions. 46.1 Section 46.1 Foreign Relations DEPARTMENT OF STATE VISAS CONTROL OF ALIENS DEPARTING FROM THE UNITED STATES § 46.1 Definitions. For the purposes of this part: (a) The term alien means any person who is not a citizen or national of...

22 CFR 46.1 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Definitions. 46.1 Section 46.1 Foreign Relations DEPARTMENT OF STATE VISAS CONTROL OF ALIENS DEPARTING FROM THE UNITED STATES § 46.1 Definitions. For the purposes of this part: (a) The term alien means any person who is not a citizen or national of...

78 FR 46616 - Virginia Electric and Power Company; North Anna Power Station, Units 1 and 2; Surry Power Station...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-01

... Nuclear Energy Institute (NEI) 99-01, Methodology for Development of Emergency Action Levels.'' The... readily accessible means available in the Control Room. Environmental Impacts of the Proposed Action The... that there are no significant environmental impacts associated with the proposed action. Environmental...

Superconducting Magnetic Energy Storage (SMES) Program

NASA Astrophysics Data System (ADS)

Rogers, J. D.

1985-05-01

The 30 MJ, 10 MW superconducting magnetic energy storage (SMES) system was devised to interact in the Western US Power System as an alternate means to damp unstable oscillations at 0.35 Hz on the Pacific HVAC Interites. The operating limits of the 30 MJ SMES unit were established, and different means of controlling real and reactive power were tested. The unit can follow a sinusoidal power demand signal with an amplitude of up to 8.6 MW with the converter working in a 12 pulse mode. When the converter operates in the constant VAR mode, a time varying real power demand signal of up to 5 MW can be met. It was shown that the Pacific ac Interite has current and reactive power variations of the same frequency as the modulating frequency of the SMES device. The reliability of the SMES subsystems with a narrow band noise input was assessed. Parameters of the ac power system were determined. Converter short circuit tests, load tests under various control conditions, dc breaker tests for coil current interruption, and converter failure mode tests were conducted. The experimental operation of the SMES system is concluded.

Engineering control technologies to reduce occupational silica exposures in masonry cutting and tuckpointing.

PubMed

Meeker, John D; Cooper, Michael R; Lefkowitz, Daniel; Susi, Pam

2009-01-01

A number of tasks in construction generate worker overexposures to respirable crystalline silica dust, which is a significant contributor to occupational mortality and morbidity. This study evaluated the performance of commercially available engineering controls used in dusty construction tasks commonly performed by bricklayers. Local exhaust ventilation (LEV) controls for a portable abrasive cutter and for tuckpointing grinders were examined at a bricklayers' training center, as were two stationary wet saws. Personal breathing zone air samples were collected with and without the use of LEV or water suppression during simulated concrete block cutting, brick cutting, and tuckpointing. Compared with the use of no exposure control during block and brick cutting, the portable LEV unit significantly reduced mean respirable quartz exposures by 96% for block cutting and 91% for brick cutting (p < 0.01). The use of stationary wet saws was also associated with 91% reductions in exposure (p < 0.01). For tuckpointing, the reductions in mean respirable quartz concentrations were between 91% and 93% with the LEV controls (p < 0.05). Reductions of up to 96% in mean respirable quartz concentration were observed between control and no-control scenarios. These reductions with commercially available off-the-shelf tools demonstrate the effectiveness of engineering control interventions to reduce crystalline silica exposures in construction. Strategies to further improve control performance and approaches for increasing control interventions in construction are needed.

Recruitment order of motor units in human vastus lateralis muscle is maintained during fatiguing contractions.

PubMed

Adam, Alexander; De Luca, Carlo J

2003-11-01

Motor-unit firing patterns were studied in the vastus lateralis muscle of five healthy young men [21.4 +/- 0.9 (SD) yr] during a series of isometric knee extensions performed to exhaustion. Each contraction was held at a constant torque level, set to 20% of the maximal voluntary contraction at the beginning of the experiment. Electromyographic signals, recorded via a quadrifilar fine wire electrode, were processed with the precision decomposition technique to identify the firing times of individual motor units. In repeat experiments, whole-muscle mechanical properties were measured during the fatigue protocol using electrical stimulation. The main findings were a monotonic decrease in the recruitment threshold of all motor units and the progressive recruitment of new units, all without a change of the recruitment order. Motor units from the same subject showed a similar time course of threshold decline, but this decline varied among subjects (mean threshold decrease ranged from 23 to 73%). The mean threshold decline was linearly correlated (R2 >or= 0.96) with a decline in the elicited peak tetanic torque. In summary, the maintenance of recruitment order during fatigue strongly supports the notion that the observed common recruitment adaptations were a direct consequence of an increased excitatory drive to the motor unit pool. It is suggested that the increased central drive was necessary to compensate for the loss in force output from motor units whose muscle fibers were actively contracting. We therefore conclude that the control scheme of motor-unit recruitment remains invariant during fatigue at least in relatively large muscles performing submaximal isometric contractions.

Performance of Stochastic Targeted Blood Glucose Control Protocol by virtual trials in the Malaysian intensive care unit.

PubMed

Jamaludin, Ummu K; M Suhaimi, Fatanah; Abdul Razak, Normy Norfiza; Md Ralib, Azrina; Mat Nor, Mohd Basri; Pretty, Christopher G; Humaidi, Luqman

2018-08-01

Blood glucose variability is common in healthcare and it is not related or influenced by diabetes mellitus. To minimise the risk of high blood glucose in critically ill patients, Stochastic Targeted Blood Glucose Control Protocol is used in intensive care unit at hospitals worldwide. Thus, this study focuses on the performance of stochastic modelling protocol in comparison to the current blood glucose management protocols in the Malaysian intensive care unit. Also, this study is to assess the effectiveness of Stochastic Targeted Blood Glucose Control Protocol when it is applied to a cohort of diabetic patients. Retrospective data from 210 patients were obtained from a general hospital in Malaysia from May 2014 until June 2015, where 123 patients were having comorbid diabetes mellitus. The comparison of blood glucose control protocol performance between both protocol simulations was conducted through blood glucose fitted with physiological modelling on top of virtual trial simulations, mean calculation of simulation error and several graphical comparisons using stochastic modelling. Stochastic Targeted Blood Glucose Control Protocol reduces hyperglycaemia by 16% in diabetic and 9% in nondiabetic cohorts. The protocol helps to control blood glucose level in the targeted range of 4.0-10.0 mmol/L for 71.8% in diabetic and 82.7% in nondiabetic cohorts, besides minimising the treatment hour up to 71 h for 123 diabetic patients and 39 h for 87 nondiabetic patients. It is concluded that Stochastic Targeted Blood Glucose Control Protocol is good in reducing hyperglycaemia as compared to the current blood glucose management protocol in the Malaysian intensive care unit. Hence, the current Malaysian intensive care unit protocols need to be modified to enhance their performance, especially in the integration of insulin and nutrition intervention in decreasing the hyperglycaemia incidences. Improvement in Stochastic Targeted Blood Glucose Control Protocol in terms of u en model is also a must to adapt with the diabetic cohort. Copyright © 2018 Elsevier B.V. All rights reserved.

Palliative Care Planner: A Pilot Study to Evaluate Acceptability and Usability of an Electronic Health Records System-integrated, Needs-targeted App Platform.

PubMed

Cox, Christopher E; Jones, Derek M; Reagan, Wen; Key, Mary D; Chow, Vinca; McFarlin, Jessica; Casarett, David; Creutzfeldt, Claire J; Docherty, Sharron L

2018-01-01

The quality and patient-centeredness of intensive care unit (ICU)-based palliative care delivery is highly variable. To develop and pilot an app platform for clinicians and ICU patients and their family members that enhances the delivery of needs-targeted palliative care. In the development phase of the study, we developed an electronic health record (EHR) system-integrated mobile web app system prototype, PCplanner (Palliative Care Planner). PCplanner screens the EHR for ICU patients meeting any of five prompts (triggers) for palliative care consultation, allows families to report their unmet palliative care needs, and alerts clinicians to these needs. The evaluation phase included a prospective before/after study conducted at a large academic medical center. Two control populations were enrolled in the before period to serve as context for the intervention. First, 25 ICU patients who received palliative care consults served as patient-level controls. Second, 49 family members of ICU patients who received mechanical ventilation for at least 48 hours served as family-level controls. Afterward, 14 patients, 18 family members, and 10 clinicians participated in the intervention evaluation period. Family member outcomes measured at baseline and 4 days later included acceptability (Client Satisfaction Questionnaire [CSQ]), usability (Systems Usability Scale [SUS]), and palliative care needs, assessed with the adapted needs of social nature, existential concerns, symptoms, and therapeutic interaction (NEST) scale; the Patient-Centeredness of Care Scale (PCCS); and the Perceived Stress Scale (PSS). Patient outcomes included frequency of goal concordant treatment, hospital length of stay, and discharge disposition. Family members reported high PCplanner acceptability (mean CSQ, 14.1 [SD, 1.4]) and usability (mean SUS, 21.1 [SD, 1.7]). PCplanner family member recipients experienced a 12.7-unit reduction in NEST score compared with a 3.4-unit increase among controls (P = 0.002), as well as improved mean scores on the PCCS (6.6 [SD, 5.8]) and the PSS (-0.8 [SD, 1.9]). The frequency of goal-concordant treatment increased over the course of the intervention (n = 14 [SD, 79%] vs. n = 18 [SD, 100%]). Compared with palliative care controls, intervention patients received palliative care consultation sooner (3.9 [SD, 2.7] vs. 6.9 [SD, 7.1] mean days), had a shorter mean hospital length of stay (20.5 [SD, 9.1] vs. 22.3 [SD, 16.0] patient number), and received hospice care more frequently (5 [36%] vs. 5 [20%]), although these differences were not statistically significant. PCplanner represents an acceptable, usable, and clinically promising systems-based approach to delivering EHR-triggered, needs-targeted ICU-based palliative care within a standard clinical workflow. A clinical trial in a larger population is needed to evaluate its efficacy.

Politico-Military Relations, a Basis for Military Interaction between Argentina and the United States

DTIC Science & Technology

1990-06-15

on which three major points may be located: (1) The first point is where the military acting only as a pressure group with lobbying capability. (2...252) Considering the level of intervention, the pressure group seems to be a natural relation between the military and the government through a civilian...Politicization: induced. (d) Means of control: attempt to infiltrate the military. (e) Level of control: pressure group . (f) Motivation: personal (only a

Randomized controlled trial of toothbrushing to reduce ventilator-associated pneumonia pathogens and dental plaque in a critical care unit.

PubMed

Needleman, Ian G; Hirsch, Nicholas P; Leemans, Michele; Moles, David R; Wilson, Michael; Ready, Derren R; Ismail, Salim; Ciric, Lena; Shaw, Michael J; Smith, Martin; Garner, Anne; Wilson, Sally

2011-03-01

To investigate the effect of a powered toothbrush on colonization of dental plaque by ventilator-associated pneumonia (VAP)-associated organisms and dental plaque removal. Parallel-arm, single-centre, examiner- and analyst-masked randomized controlled trial. Forty-six adults were recruited within 48 h of admission. Test intervention: powered toothbrush, control intervention: sponge toothette, both used four times per day for 2 min. Groups received 20 ml, 0.2% chlorhexidine mouthwash at each time point. The results showed a low prevalence of respiratory pathogens throughout with no statistically significant differences between groups. A highly statistically significantly greater reduction in dental plaque was produced by the powered toothbrush compared with the control treatment; mean plaque index at day 5, powered toothbrush 0.75 [95% confidence interval (CI) 0.53, 1.00], sponge toothette 1.35 (95% CI 0.95, 1.74), p=0.006. Total bacterial viable count was also highly statistically significantly lower in the test group at day 5; Log(10) mean total bacterial counts: powered toothbrush 5.12 (95% CI 4.60, 5.63), sponge toothette 6.61 (95% CI 5.93, 7.28), p=0.002. Powered toothbrushes are highly effective for plaque removal in intubated patients in a critical unit and should be tested for their potential to reduce VAP incidence and health complications. © 2011 John Wiley & Sons A/S.

Efficacy of a videoconferencing intervention compared with standard postnatal care at primary care health centres in Catalonia.

PubMed

Seguranyes, Gloria; Costa, Dolors; Fuentelsaz-Gallego, Carmen; Beneit, Juan Vicente; Carabantes, David; Gómez-Moreno, Carme; Palacio-Tauste, Alicia; Pauli, Angels; Abella, Montserrat

2014-06-01

to evaluate the efficacy of an intervention combining videoconferencing and telephone contact compared to standard post partum care of recent mothers attending health centres in Catalonia were recorded. multicentre, randomised parallel controlled clinical trial. 1598 post partum women with Internet access attending eight 'Attention to Sexual and Reproductive Health' (Catalan acronym ASSIR) units at Primary Health Care centres, in Catalonia (Spain). at each of the eight ASSIR units, 100 women were randomly assigned to the intervention group (IG) and 100 to the control group (CG). Women in the IG could consult midwives by videoconference or telephone and could also receive standard care. Women in the control group received standard care from midwives at their health centres or at home. number and type of visits, reasons for consultation, type of feeding at six weeks and women's satisfaction with the intervention on a scale of 1 to 5. 1401 women were studied (80.9% of the initial sample), 683 in the IG and 718 in the CG. Two hundred and seventy-six women (40.4%) used videoconferencing or telephone in the IG. The mean total visits, virtual and face-to-face, was higher in IG women than in controls (2.74 versus 1.22). IG women made fewer visits to the health centre (mean=1) than CG women (mean=1.17). Both differences were statistically significant, with p<0.001 and p=0.002 respectively. The prevalence of breast feeding was similar in the two groups (IG 64.5%, and CG 65.4%). The mean overall satisfaction of women with midwife care was very high in both groups (IG 4.77, CG 4.76). virtual care via videoconferencing is effective for post partum women. It reduces the number of health centre visits and allows mothers to consult health staff immediately and from their own home. © 2013 Elsevier Ltd. All rights reserved.

Potential benefits of minimum unit pricing for alcohol versus a ban on below cost selling in England 2014: modelling study.

PubMed

Brennan, Alan; Meng, Yang; Holmes, John; Hill-McManus, Daniel; Meier, Petra S

2014-09-30

To evaluate the potential impact of two alcohol control policies under consideration in England: banning below cost selling of alcohol and minimum unit pricing. Modelling study using the Sheffield Alcohol Policy Model version 2.5. England 2014-15. Adults and young people aged 16 or more, including subgroups of moderate, hazardous, and harmful drinkers. Policy to ban below cost selling, which means that the selling price to consumers could not be lower than tax payable on the product, compared with policies of minimum unit pricing at £0.40 (€0.57; $0.75), 45 p, and 50 p per unit (7.9 g/10 mL) of pure alcohol. Changes in mean consumption in terms of units of alcohol, drinkers' expenditure, and reductions in deaths, illnesses, admissions to hospital, and quality adjusted life years. The proportion of the market affected is a key driver of impact, with just 0.7% of all units estimated to be sold below the duty plus value added tax threshold implied by a ban on below cost selling, compared with 23.2% of units for a 45 p minimum unit price. Below cost selling is estimated to reduce harmful drinkers' mean annual consumption by just 0.08%, around 3 units per year, compared with 3.7% or 137 units per year for a 45 p minimum unit price (an approximately 45 times greater effect). The ban on below cost selling has a small effect on population health-saving an estimated 14 deaths and 500 admissions to hospital per annum. In contrast, a 45 p minimum unit price is estimated to save 624 deaths and 23,700 hospital admissions. Most of the harm reductions (for example, 89% of estimated deaths saved per annum) are estimated to occur in the 5.3% of people who are harmful drinkers. The ban on below cost selling, implemented in the England in May 2014, is estimated to have small effects on consumption and health harm. The previously announced policy of a minimum unit price, if set at expected levels between 40 p and 50 p per unit, is estimated to have an approximately 40-50 times greater effect. © Brennan et al 2014.

Potential benefits of minimum unit pricing for alcohol versus a ban on below cost selling in England 2014: modelling study

PubMed Central

Meng, Yang; Holmes, John; Hill-McManus, Daniel; Meier, Petra S

2014-01-01

Objective To evaluate the potential impact of two alcohol control policies under consideration in England: banning below cost selling of alcohol and minimum unit pricing. Design Modelling study using the Sheffield Alcohol Policy Model version 2.5. Setting England 2014-15. Population Adults and young people aged 16 or more, including subgroups of moderate, hazardous, and harmful drinkers. Interventions Policy to ban below cost selling, which means that the selling price to consumers could not be lower than tax payable on the product, compared with policies of minimum unit pricing at £0.40 (€0.57; $0.75), 45p, and 50p per unit (7.9 g/10 mL) of pure alcohol. Main outcome measures Changes in mean consumption in terms of units of alcohol, drinkers’ expenditure, and reductions in deaths, illnesses, admissions to hospital, and quality adjusted life years. Results The proportion of the market affected is a key driver of impact, with just 0.7% of all units estimated to be sold below the duty plus value added tax threshold implied by a ban on below cost selling, compared with 23.2% of units for a 45p minimum unit price. Below cost selling is estimated to reduce harmful drinkers’ mean annual consumption by just 0.08%, around 3 units per year, compared with 3.7% or 137 units per year for a 45p minimum unit price (an approximately 45 times greater effect). The ban on below cost selling has a small effect on population health—saving an estimated 14 deaths and 500 admissions to hospital per annum. In contrast, a 45p minimum unit price is estimated to save 624 deaths and 23 700 hospital admissions. Most of the harm reductions (for example, 89% of estimated deaths saved per annum) are estimated to occur in the 5.3% of people who are harmful drinkers. Conclusions The ban on below cost selling, implemented in the England in May 2014, is estimated to have small effects on consumption and health harm. The previously announced policy of a minimum unit price, if set at expected levels between 40p and 50p per unit, is estimated to have an approximately 40-50 times greater effect. PMID:25270743

Polysomnographic findings in a cohort of chronic insomnia patients with benzodiazepine abuse.

PubMed

Mazza, Marianna; Losurdo, Anna; Testani, Elisa; Marano, Giuseppe; Di Nicola, Marco; Dittoni, Serena; Gnoni, Valentina; Di Blasi, Chiara; Giannantoni, Nadia Mariagrazia; Lapenta, Leonardo; Brunetti, Valerio; Bria, Pietro; Janiri, Luigi; Mazza, Salvatore; Della Marca, Giacomo

2014-01-15

To evaluate sleep modifications induced by chronic benzodiazepine (BDZ) abuse. Cohort study, comparison of sleep measures between BDZs abusers and controls. Drug Addiction Unit (Institute of Psychiatry) and Unit of Sleep Disorders (Institute of Neurology) of the Catholic University in Rome. Six outpatients affected by chronic BDZ abuse were enrolled, (4 men, 2 women, mean age 53.3 ± 14.8, range: 34-70 years); 55 healthy controls were also enrolled (23 men, 32 women, mean age 54.2 ± 13.0, range: 27-76 years). All patients underwent clinical evaluation, psychometric measures, ambulatory polysomnography, scoring of sleep macrostructure and microstructure (power spectral fast-frequency EEG arousal, cyclic alternating pattern [CAP]), and heart rate variability. BDZ abusers had relevant modification of sleep macrostructure and a marked reduction of fast-frequency EEG arousal in NREM (patients: 6.6 ± 3.7 events/h, controls 13.7 ± 4.9 events/h, U-test: 294, p = 0.002) and REM (patients: 8.4 ± 2.4 events/h, controls 13.3 ± 5.1 events/h, U-test: 264, p = 0.016), and of CAP rate (patients: 15.0 ± 8.6%, controls: 51.2% ± 12.1%, U-test: 325, p < 0.001). BDZ abusers have reduction of arousals associated with increased number of nocturnal awakenings and severe impairment of sleep architecture. The effect of chronic BDZ abuse on sleep may be described as a severe impairment of arousal dynamics; the result is the inability to modulate levels of vigilance.

Prevalence, Awareness, Treatment, and Control of Hypertension Among Arab Americans

PubMed Central

Tailakh, Ayman; Mentes, Janet C.; Morisky, Donald E.; Pike, Nancy A.; Phillips, Linda R.; Evangelista, Lorraine S.

2015-01-01

Background Hypertension (HTN) is a major risk factor for heart disease, which is the leading cause of death in the United States. Hypertension detection and blood pressure (BP) control are critically important for reducing the risk of myocardial infarction and strokes. Although there are more than 3.5 million Arab Americans in the United States, there are no national or regional data on HTN prevalence among Arab Americans. Objective This study aims to estimate the prevalence of HTN in a community sample of Arab Americans; assess levels of awareness, treatment, and control in hypertensive patients; and describe and compare lifestyle behaviors (eg, physical activity, nutrition, and weight control). Methods In this cross-sectional, descriptive study, 126 participants completed a self-administered questionnaire to measure physical activity, nutrition, and medical history. Height and weight were measured. Three BP measurements were obtained at 60-second intervals after resting for 5 minutes. Hypertension was defined as a mean systolic BP of 140 mm Hg or higher, or a diastolic BP 90 mm Hg or higher, and/or taking antihypertensive medications. Results Overall, 36.5% of participants had HTN and 39.7% had pre-HTN. Among hypertensive participants, only 67.4% were aware of their high BP, and 52.2% were taking antihypertensive medication. Among those taking medication, 46% had controlled BP. The prevalence of HTN was higher in men than in women (45.9% and 23.2%, respectively; P = .029) and increased with age (P = .01). Hypertensive participants also had higher body mass index (mean, 31.55 kg/m2) compared with normotensive participants (mean, 28.37 kg/m2; P = .01). Conclusion Our results indicate that HTN and pre-HTN are highly prevalent in Arab Americans. Hypertension awareness and control rates were inadequate and low compared with national data. These results emphasize the urgent need to develop public health strategies to improve the prevention, detection, and treatment of HTN among Arab Americans. PMID:22722474

Development of an intelligent controller for power generators

NASA Astrophysics Data System (ADS)

Maxted, Clive; Waller, Winston

2005-01-01

This paper is a description of the development of an embedded controller for high power industrial diesel generators. The aim of the project was to replace the existing discrete logic design by an intelligent versatile and user configurable control system. A prototype embedded PC controlled system was developed, capable of fully replacing the existing system, with a colour TFT display and keypad. Features include fully automatic generator control as before with status and alarm display and monitoring of engine parameters, along with data logging, remote communications and a means of analysing data. The unit was tested on the bench and on diesel generators for the core controlling functionality to prove compliance with the specifications. The results of the testing proved the unit's suitability as a replacement for the existing system in its intended environment. The significance of this study is that a low cost replacement solution has been found for an industrial application by transferring modern technological knowledge to a small business. The company are now able to build on the design and take it into production, reducing servicing and production costs.

Cost-effectiveness of social marketing of insecticide-treated nets for malaria control in the United Republic of Tanzania.

PubMed Central

Hanson, Kara; Kikumbih, Nassor; Armstrong Schellenberg, Joanna; Mponda, Haji; Nathan, Rose; Lake, Sally; Mills, Anne; Tanner, Marcel; Lengeler, Christian

2003-01-01

OBJECTIVE: To assess the costs and consequences of a social marketing approach to malaria control in children by means of insecticide-treated nets in two rural districts of the United Republic of Tanzania, compared with no net use. METHODS: Project cost data were collected prospectively from accounting records. Community effectiveness was estimated on the basis of a nested case-control study and a cross-sectional cluster sample survey. FINDINGS: The social marketing approach to the distribution of insecticide-treated nets was estimated to cost 1560 US dollars per death averted and 57 US dollars per disability-adjusted life year averted. These figures fell to 1018 US dollars and 37 US dollars, respectively, when the costs and consequences of untreated nets were taken into account. CONCLUSION: The social marketing of insecticide-treated nets is an attractive intervention for preventing childhood deaths from malaria. PMID:12764493

Agrichemicals in surface water and birth defects in the United States

PubMed Central

Winchester, Paul D; Huskins, Jordan; Ying, Jun

2009-01-01

Objectives: To investigate if live births conceived in months when surface water agrichemicals are highest are at greater risk for birth defects. Methods: Monthly concentrations during 1996–2002 of nitrates, atrazine and other pesticides were calculated using United States Geological Survey's National Water Quality Assessment data. Monthly United States birth defect rates were calculated for live births from 1996 to 2002 using United States Centers for Disease Control and Prevention natality data sets. Birth defect rates by month of last menstrual period (LMP) were then compared to pesticide/nitrate means using logistical regression models. Results: Mean concentrations of agrichemicals were highest in April–July. Total birth defects, and eleven of 22 birth defect subcategories, were more likely to occur in live births with LMPs between April and July. A significant association was found between the season of elevated agrichemicals and birth defects. Conclusion: Elevated concentrations of agrichemicals in surface water in April–July coincided with higher risk of birth defects in live births with LMPs April–July. While a causal link between agrichemicals and birth defects cannot be proven from this study an association might provide clues to common factors shared by both variables. PMID:19183116

Overlap between treatment and control distributions as an effect size measure in experiments.

PubMed

Hedges, Larry V; Olkin, Ingram

2016-03-01

The proportion π of treatment group observations that exceed the control group mean has been proposed as an effect size measure for experiments that randomly assign independent units into 2 groups. We give the exact distribution of a simple estimator of π based on the standardized mean difference and use it to study the small sample bias of this estimator. We also give the minimum variance unbiased estimator of π under 2 models, one in which the variance of the mean difference is known and one in which the variance is unknown. We show how to use the relation between the standardized mean difference and the overlap measure to compute confidence intervals for π and show that these results can be used to obtain unbiased estimators, large sample variances, and confidence intervals for 3 related effect size measures based on the overlap. Finally, we show how the effect size π can be used in a meta-analysis. (c) 2016 APA, all rights reserved).

Hypertension in patients admitted to clinical units at university hospital: post-discharge evaluation rated by telephone

PubMed Central

de Campos, Cássia Lima; Pierin, Angela Maria Geraldo; de Pinho, Natalia Alencar

2017-01-01

ABSTRACT Objective To characterize hypertensive patients after admission to hospital considering the current status, compliance to treatment, habits and lifestyle, and knowledge and beliefs about the disease. Methods This was an exploratory study with 265 hypertensive patients admitted to a medical inpatients unit of a university hospital. Data were collected in an interview over the telephone. The level of significance was set as p<0.05. Results It was found that 32% of hypertensive patients had died. One hundred patients were interviewed, mean age of 64.15 (13.2) years, 51% were women, 56% non-white, 51% with primary education, 52% were retired, 13% were smokers, 38% used alcohol, 80% did not perform physical exercise, and the mean body mass index was 35.9 (15.5) kg/m2. The comorbidities were heart problem (52%), diabetes (49%) and stroke (25%). As to antihypertensive treatment, 75% were on use, 17.3% stopped taking them and 21.3% missed visits. The treatment sites were the primary care unit (49%) and hospital (36%). As for knowledge and beliefs, 25% believed hypertension is curable, 77% that treatment should last for the rest of their lives, and hypertension brings complications (84%). A total of 46.7% were controlled. The lack of control was associated (p<0.05) with non-white ethnicity and absence of heart problems. Conclusion There were significant deaths occurred after hospitalization and poor control of blood pressure, probably due to inadequate habits and lifestyles and non-compliance to antihypertensive treatment. PMID:28444088

Getting the hang of it: preferential gist over verbatim story recall and the roles of attentional capacity and the episodic buffer in Alzheimer disease.

PubMed

Foldi, Nancy S

2011-01-01

Story recall in Alzheimer disease (AD) is typically used as a measure of episodic memory, but the degree to which recall is dependent on available attentional resources is not fully understood. The current study investigated how measures of attention were associated to verbatim recall (exact reproduction) or gist recall (relevant semantic meaning). Sixteen participants with AD and 16 age-matched healthy older adults recalled a story on immediate free recall and recognition. Controls recalled more units overall than AD. A group X response interaction revealed more gist than verbatim recall in AD, but those with mild disease generated approximately the same number gist responses as controls. For each group, qualitatively different attentional resources were associated with recall units. In controls, verbatim units correlated positively with primacy serial position items of the California Verbal Learning Test II (CVLTII), suggesting that episodic buffer resources may be associated with story recall. In AD, gist units were positively correlated with digits forward, but inversely related to the CVLTII primacy region items, suggesting reliance on low-level capacity resources. Possible explanations of the impaired performance in AD may be a bias in favor of gist processing, poor verbatim encoding, and/or processing failure at the level of the episodic buffer.

Medical costs associated with non-Hodgkin's lymphoma in the United States during the first two years of treatment.

PubMed

Kutikova, Lucie; Bowman, Lee; Chang, Stella; Long, Stacey R; Arning, Michael; Crown, William H

2006-08-01

To determine the direct costs of medical care associated with aggressive and indolent non-Hodgkin's lymphoma (NHL) in the United States; to show how costs for aggressive NHL change over time by examining costs related to initial, secondary and palliative treatment phases; and to evaluate the economic consequences of treatment failure in aggressive NHL. A retrospective cohort analysis of 1999 - 2000 direct costs in newly diagnosed NHL patients and controls (subjects without any cancer) was conducted using the MarketScan medical and drug claims database of large employers across the United States. Treatment failure analysis was conducted for aggressive NHL patients, and was defined by the need for secondary treatment or palliative care after initial therapy. Cost of treatment failure was calculated as difference in regression-adjusted costs between patients with initial therapy only and patients experiencing initial treatment failure. Patients with aggressive (n = 356) and indolent (n = 698) NHL had significantly greater health service utilization and associated costs (all P < 05) than controls (n = 1068 for aggressive, n = 2094 for indolent). Mean monthly costs were 5871 dollars for aggressive NHL vs. 355 dollars for controls (P < 0001) and 3833 dollars for indolent NHL vs. 289 dollars for controls (P < 0001). The primary cost drivers were hospitalization (aggressive NHL = 44% of total costs, indolent NHL = 50%) and outpatient office visits (aggressive NHL = 39%, indolent NHL = 34%). For aggressive NHL, mean monthly initial treatment phase costs (10,970 dollars) and palliative care costs (9836 dollars) were higher than costs incurred during secondary phase (3302 dollars). The mean cost of treatment failure in aggressive NHL was 14,174 dollars per month, and 85,934 dollars over the study period. The treatment of NHL was associated with substantial health care costs. Patients with aggressive lymphomas tended to accrue higher costs, compared with those with indolent lymphomas. These costs varied over time, with the highest costs occurring during the initial treatment and palliative care phases. Treatment failure was the most expensive treatment pattern. New strategies to prevent or delay treatment failure in aggressive NHL could help reduce the economic burden of NHL.

36 CFR 1202.4 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... other than the subject individual. (f) Individual means a citizen of the United States or an alien...) NARA Privacy Act Appeal Official means the Deputy Archivist of the United States for appeals of denials... manager is the Inspector General; then the term means the Archivist of the United States. (i) Record means...

7 CFR 1160.104 - United States.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 9 2012-01-01 2012-01-01 false United States. 1160.104 Section 1160.104 Agriculture... Definitions § 1160.104 United States. United States means the 48 contiguous states in the continental United States and the District of Columbia, except that United States means the 50 states of the United States...

7 CFR 1160.104 - United States.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 9 2011-01-01 2011-01-01 false United States. 1160.104 Section 1160.104 Agriculture... Definitions § 1160.104 United States. United States means the 48 contiguous states in the continental United States and the District of Columbia, except that United States means the 50 states of the United States...

7 CFR 1160.104 - United States.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 9 2014-01-01 2013-01-01 true United States. 1160.104 Section 1160.104 Agriculture... Definitions § 1160.104 United States. United States means the 48 contiguous states in the continental United States and the District of Columbia, except that United States means the 50 states of the United States...

7 CFR 1160.104 - United States.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 9 2013-01-01 2013-01-01 false United States. 1160.104 Section 1160.104 Agriculture... Definitions § 1160.104 United States. United States means the 48 contiguous states in the continental United States and the District of Columbia, except that United States means the 50 states of the United States...

7 CFR 1160.104 - United States.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 9 2010-01-01 2009-01-01 true United States. 1160.104 Section 1160.104 Agriculture... Definitions § 1160.104 United States. United States means the 48 contiguous states in the continental United States and the District of Columbia, except that United States means the 50 states of the United States...

Effects of an alternating work shift on air traffic controllers and the relationship with excessive daytime sleepiness and stress.

PubMed

Freitas, Ângela M; Portuguez, Mirna Wetters; Russomano, Thaís; Freitas, Marcos de; Silvello, Silvio Luis da Silva; Costa, Jaderson Costa da

2017-10-01

To evaluate symptoms of stress and excessive daytime sleepiness (EDS) in air traffic control (ATC) officers in Brazil. Fifty-two ATC officers participated, based at three air traffic control units, identified as A, B and C. Stress symptoms were assessed using the Lipp Inventory of Stress Symptoms for Adults, and EDS by the Epworth Sleepiness Scale. The sample mean age was 37 years, 76.9% of whom were male. Excessive daytime sleepiness was identified in 25% of the ATC officers, with 84.6% of these based at air traffic control unit A, which has greater air traffic flow, operating a 24-hour alternating work shift schedule. A total of 16% of the ATC officers had stress symptoms, and of these, 62% showed a predominance of physical symptoms. The high percentage of ATC officers with EDS identified in group A may be related to chronodisruption due to night work and alternating shifts.

Evaluation of the effect of an intervention on the nutritional status of hospitalized patients.

PubMed

Miguel Montoya, Isabel; Ortí Lucas, Rafael; Ferrer Ferrándiz, Esperanza; Martín Baena, David; Montejano Lozoya, Raimunda

2017-04-07

To compare the nutritional status of a population of hospitalized patients, divided into 2 different groups, both at admission and hospital discharge, and to assess the influence of nutritional alteration during the hospital stay. Quasi-experimental study comprising 2 groups of patients (N=581); an intervention group (n=303), in which nurses received specific training on managing care methodology, and a control group (n=278), in which nurses continued their usual dynamics. Each group was made up of 2 care units with patients from both surgical and medical specialties. patients admitted to the selected units with a minimum stay of 5 days. The sample selection was performed prospectively and consecutively after implementing the training. Of the 581 patients studied, 49.4% were women and 50.6% were men. Mean patient age was 68.29 (SD 16.23) years. In the intervention group, the odds ratio (OR) associated with good nutritional status was multiplied by 1.7 (OR=1.67) compared to the control group in the first evaluation and by 1.4 times (OR=1.43) at hospital discharge. The average stay in days was higher in the control group (13.71, SD 10.19) than in the intervention group (10.89, SD 7.49) (P<.001). The systematic methodology-based intervention in the chosen units was positive. Patients admitted to the intervention units had a lower nutritional alteration and a shorter hospital stay than those admitted to the control units. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Good to Great: Quality-Improvement Initiative Increases and Sustains Pediatric Health Care Worker Hand Hygiene Compliance.

PubMed

McLean, Heather S; Carriker, Charlene; Bordley, William Clay

2017-04-01

The Joint Commission, the Centers for Disease Control and Prevention, and the World Health Organization challenge hospitals to achieve and sustain compliance with effective hand hygiene (HH) practice; however, many inpatient units fail to achieve a high level of reliability. The aim of the project was to increase and sustain health care worker (HCW) compliance with HH protocols from 87% (level of reliability [LOR] 1) to ≥95% (LOR 2) within 9 months on 2 pediatric inpatient units in an academic children's hospital. This study was a time-series, quality-improvement project. Interventions were tested through multiple plan-do-study-act cycles on 2 pediatric inpatient units. HH compliance audits of HCWs on these units were performed randomly each week by the hospital infection prevention program. Control charts of percentages of HCW HH compliance were constructed with 3-σ (data within 3 SDs from a mean) control limits. These control limits were adjusted after achieving significant improvements in performance over time. Charts were annotated with interventions including (1) increasing awareness, (2) providing timely feedback, (3) empowering patients and families to participate in mitigation, (4) providing focused education, and (5) developing interdisciplinary HH champions. HH compliance rates improved from an average of 87% (LOR 1) to ≥95% (LOR 2) within 9 months, and this improvement has been sustained for >2 years on both pediatric inpatient units. Significant and sustained gains in HH compliance rates of ≥95% (LOR 2) can be achieved by applying high-reliability human-factor interventions. Copyright © 2017 by the American Academy of Pediatrics.

40 CFR 52.145 - Visibility protection.

Code of Federal Regulations, 2013 CFR

2013-07-01

... paragraph is applicable to the fossil fuel-fired, steam-generating equipment designated as Units 1, 2, and 3... applicable. Unit-Week of Maintenance means a period of 7 days during which a fossil fuel-fired steam... means million British thermal unit(s). Operating hour means any hour that fossil fuel is fired in the...

Portable tester for determining gas content within a core sample

DOEpatents

Garcia, Jr., Fred; Schatzel, Steven J.

1998-01-01

A portable tester is provided for reading and displaying the pressure of a gas released from a rock core sample stored within a sealed container and for taking a sample of the released pressurized gas for chemical analysis thereof for subsequent use in a modified direct method test which determines the volume of gas and specific type of gas contained within the core sample. The portable tester includes a pair of low and high range electrical pressure transducers for detecting a gas pressure; a pair of low and high range display units for displaying the pressure of the detected gas- a selector valve connected to the low and high range pressure transducers, a selector knob for selecting gas flow to one of the flow paths; control valve having an inlet connection to the sealed container, and outlets connected to: a sample gas canister, a second outlet port connected to the selector valve means for reading the pressure of the gas from the sealed container to either the low range or high range pressure transducers, and a connection for venting gas contained within the sealed container to the atmosphere. A battery is electrically connected to and supplies the power for operating the unit. The pressure transducers, display units, selector and control valve means and the battery is mounted to and housed within a protective casing for portable transport and use.

Portable tester for determining gas content within a core sample

DOEpatents

Garcia, F. Jr.; Schatzel, S.J.

1998-04-21

A portable tester is provided for reading and displaying the pressure of a gas released from a rock core sample stored within a sealed container and for taking a sample of the released pressurized gas for chemical analysis thereof for subsequent use in a modified direct method test which determines the volume of gas and specific type of gas contained within the core sample. The portable tester includes a pair of low and high range electrical pressure transducers for detecting a gas pressure; a pair of low and high range display units for displaying the pressure of the detected gas; a selector valve connected to the low and high range pressure transducers and a selector knob for selecting gas flow to one of the flow paths; control valve having an inlet connection to the sealed container; and outlets connected to: a sample gas canister, a second outlet port connected to the selector valve means for reading the pressure of the gas from the sealed container to either the low range or high range pressure transducers, and a connection for venting gas contained within the sealed container to the atmosphere. A battery is electrically connected to and supplies the power for operating the unit. The pressure transducers, display units, selector and control valve means and the battery is mounted to and housed within a protective casing for portable transport and use. 5 figs.

A model-based gain scheduling approach for controlling the common-rail system for GDI engines

NASA Astrophysics Data System (ADS)

di Gaeta, Alessandro; Montanaro, Umberto; Fiengo, Giovanni; Palladino, Angelo; Giglio, Veniero

2012-04-01

The progressive reduction in vehicle emission requirements have forced the automotive industry to invest in research for developing alternative and more efficient control strategies. All control features and resources are permanently active in an electronic control unit (ECU), ensuring the best performance with respect to emissions, fuel economy, driveability and diagnostics, independently from engine working point. In this article, a considerable step forward has been achieved by the common-rail technology which has made possible to vary the injection pressure over the entire engine speed range. As a consequence, the injection of a fixed amount of fuel is more precise and multiple injections in a combustion cycle can be made. In this article, a novel gain scheduling pressure controller for gasoline direct injection (GDI) engine is designed to stabilise the mean fuel pressure into the rail and to track demanded pressure trajectories. By exploiting a simple control-oriented model describing the mean pressure dynamics in the rail, the control structure turns to be simple enough to be effectively implemented in commercial ECUs. Experimental results in a wide range of operating points confirm the effectiveness of the proposed control method to tame efficiently the mean value pressure dynamics of the plant showing a good accuracy and robustness with respect to unavoidable parameters uncertainties, unmodelled dynamics, and hidden coupling terms.

High Phobic Anxiety Is Related to Lower Leukocyte Telomere Length in Women

PubMed Central

Okereke, Olivia I.; Prescott, Jennifer; Wong, Jason Y. Y.; Han, Jiali; Rexrode, Kathryn M.; De Vivo, Immaculata

2012-01-01

Background Chronic psychological distress has been linked to shorter telomeres, an indication of accelerated aging. Yet, little is known about relations of anxiety to telomeres. We examined whether a typically chronic form of anxiety – phobic anxiety – is related to telomere length. Methodology/Principal Findings Relative telomere lengths (RTLs) in peripheral blood leukocytes were measured by quantitative real-time polymerase chain reaction among 5,243 women (aged 42–69 years) who: were participants in the Nurses' Health Study; were controls in prior case-control studies of telomeres and disease, or randomly selected healthy participants in a cognitive function sub-study; had completed the Crown-Crisp phobic index proximal to blood collection. Adjusted least-squares mean RTLs (z-scores) were calculated across phobic categories. Higher phobic anxiety was generally associated with lower RTLs (age-adjusted p-trend = 0.09); this association was similar after adjustment for confounders – paternal age-at-birth, smoking, body mass index (BMI) and physical activity (p-trend = 0.15). Notably, a threshold was identified. Among women with Crown-Crisp<6 points, the multivariable-adjusted least-squares mean RTL z-score = 0.02 standard units; however, among the most phobic women (Crown-Crisp≥6), the multivariable-adjusted least-squares mean RTL z-score = −0.09 standard units (mean difference = −0.10 standard units; p = 0.02). The magnitude of this difference was comparable to that for women 6 years apart in age. Finally, effect modification by BMI, smoking and paternal age was observed: associations were stronger among highly phobic women with BMI≥25 kg/m2, without smoking history, or born to fathers aged ≥40 years. Conclusions/Significance In this large, cross-sectional study high phobic anxiety was associated with shorter telomeres. These results point toward prospective investigations relating anxiety to telomere length change. PMID:22808180

The political economy of medical care. An explanation of the composition, nature, and functions of the present health sector of the United States.

PubMed

Navarro, V

1975-01-01

This presentation provides an alternative explanation of the present composition, nature, and functions of the health sector in the United States to those frequently given in sociological, economic, and medical care literature. These expalantions usually maintain that the Amcerican health sector is a result of the value system of the assumedly middle class American society. In this presentation it is postulated that the present economic structure of the United States determines and maintains a social class structure, both outside and within the health sector, and that the different degrees of ownership, control, and influence that these classes have on the means of production, reproduction, and legitimization in the United States explain the composition, nature, and functions of the health sector. It is further postulated that the value system is not the cuase, but a sysmptom, of these class controls and influences. The paper is divided into three sections. The first part profices a description of the class structure, which includes the corporate class, upper middle class, lower middle class, and working class, and it describes the mechanisms whereby this structure is maintained and replicated, both outside and within the health sector. The second section analyzes: (1)the production characteristics and social make-up of the thre main sectors of the U. S. economy-the monpolistic, state, and competitive sectors-and it focuses especially on the monopolistic sector, which is assumed to be the dominant sector in the U. S. economy, with its needs determining to a large degree the functions of the social sectors, including those of the health sector; (2) the increasing dominance of the monopolistic sector in the health sector, by means of the financial institutions, which conflicts primarily with the providers'relative control of the financing of health services; and (3) the main conflict in the control of the reproductive (academic) an distributive (delivery) institutions which, it is postulated, is not, as is generally belived, between the providers and the so-called consumers, but rather between the corporate and upper middle classes (including the providers), who control those institutions, and the majority of the U. S. population, the lower middle and working classes, who do not control them...

Extravehicular Activity/Air Traffic Control (EVA/ATC) test report. [communication links to the astronaut

NASA Technical Reports Server (NTRS)

Tomaro, D. J.

1982-01-01

During extravehicular activity (EVA), communications between the EVA astronaut and the space shuttle orbiter are maintained by means of transceiver installed in the environmental support system backpack. Onboard the orbiter, a transceiver line replaceable unit and its associated equipment performs the task of providing a communications link to the astronaut in the extravehicular activity/air traffic control (EVA/ATC) mode. Results of the acceptance tests that performed on the system designed and fabricated for EVA/ATC testing are discussed.

34 CFR 263.20 - What definitions apply to the Demonstration Grants for Indian Children program?

Code of Federal Regulations, 2013 CFR

2013-07-01

... the Indian Education Act of 1988 as it was in effect October 19, 1994. Indian institution of higher education means an accredited college or university within the United States cited in section 532 of the... under the Tribally Controlled College or University Assistance Act of 1978, and the Navajo Community...

34 CFR 263.20 - What definitions apply to the Demonstration Grants for Indian Children program?

Code of Federal Regulations, 2014 CFR

2014-07-01

... the Indian Education Act of 1988 as it was in effect October 19, 1994. Indian institution of higher education means an accredited college or university within the United States cited in section 532 of the... under the Tribally Controlled College or University Assistance Act of 1978, and the Navajo Community...

34 CFR 263.20 - What definitions apply to the Demonstration Grants for Indian Children program?

Code of Federal Regulations, 2010 CFR

2010-07-01

... the Indian Education Act of 1988 as it was in effect October 19, 1994. Indian institution of higher education means an accredited college or university within the United States cited in section 532 of the... under the Tribally Controlled College or University Assistance Act of 1978, and the Navajo Community...

34 CFR 263.20 - What definitions apply to the Demonstration Grants for Indian Children program?

Code of Federal Regulations, 2011 CFR

2011-07-01

... the Indian Education Act of 1988 as it was in effect October 19, 1994. Indian institution of higher education means an accredited college or university within the United States cited in section 532 of the... under the Tribally Controlled College or University Assistance Act of 1978, and the Navajo Community...

34 CFR 263.20 - What definitions apply to the Demonstration Grants for Indian Children program?

Code of Federal Regulations, 2012 CFR

2012-07-01

... the Indian Education Act of 1988 as it was in effect October 19, 1994. Indian institution of higher education means an accredited college or university within the United States cited in section 532 of the... under the Tribally Controlled College or University Assistance Act of 1978, and the Navajo Community...

Changing Community Policies: Your Role in Eliminating Corporal Punishment in Schools.

ERIC Educational Resources Information Center

Richardson, Rita C.; Evans, Elizabeth T.

This paper examines the use of corporal punishment in public schools. It presents a brief history of corporal-punishment practices and explains why corporal punishment remains a legal means of control in the schools of 23 states in the United States. Opponents of corporal punishment argue that it should be abolished from schools because it models…

46 CFR 161.002-10 - Automatic fire detecting system control unit.

Code of Federal Regulations, 2012 CFR

2012-10-01

... that part of the supply circuit on the load side of the battery transfer switch and fuses. On a system supplied by a branch circuit the “normal source” shall be construed to mean the load side of any... fire alarm shall be electrically supervised. (d) Power failure alarms—(1) Loss of potential. The loss...

Stratum corneum hydration and skin surface pH in patients with atopic dermatitis.

PubMed

Knor, Tanja; Meholjić-Fetahović, Ajša; Mehmedagić, Aida

2011-01-01

Atopic dermatitis (AD) is a chronically relapsing skin disease with genetic predisposition, which occurs most frequently in preschool children. It is considered that dryness and pruritus, which are always present in AD, are in correlation with degradation of the skin barrier function. Measurement of hydration and pH value of the stratum corneum is one of the noninvasive methods for evaluation of skin barrier function. The aim of the study was to assess skin barrier function by measuring stratum corneum hydration and skin surface pH of the skin with lesions, perilesional skin and uninvolved skin in AD patients, and skin in a healthy control group. Forty-two patients were included in the study: 21 young and adult AD patients and 21 age-matched healthy controls. Capacitance, which is correlated with hydration of stratum corneum and skin surface pH were measured on the forearm in the above areas by SM810/CM820/pH900 combined units (Courage AND Khazaka, Germany). The mean value of water capacitance measured in AD patients was 44.1 ± 11.6 AU (arbitrary units) on the lesions, 60.2 ± 12.4 AU on perilesional skin and 67.2 ± 8.8 AU on uninvolved skin. In healthy controls, the mean value was 74.1 ± 9.2 AU. The mean pH value measured in AD patients was 6.13 ± 0.52 on the lesions, 5.80 ± 0.41 on perilesional skin, and 5.54 ± 0.49 on uninvolved skin. In control group, the mean pH of the skin surface was 5.24 ± 0.40. The values of both parameters measured on lesional skin were significantly different (capacitance decreased and pH increased) from the values recorded on perilesional skin and uninvolved skin. The same held for the relation between perilesional and uninvolved skin. According to study results, the uninvolved skin of AD patients had significantly worse values of the measured parameters as compared with control group. The results of this study suggested the skin barrier function to be degraded in AD patients, which is specifically expressed in lesional skin.

Effectiveness of a diabetes mellitus pictorial diary handbook program for middle-aged and elderly type 2 diabetes mellitus patients: a quasi-experimental study at Taladnoi Primary Care Unit, Saraburi, Thailand.

PubMed

Eknithiset, Rapat; Somrongthong, Ratana

2017-01-01

The research question is "How does a diabetes mellitus (DM) pictorial diary handbook (PDHB) affect the knowledge, practice, and HbA1c among patients with DM type 2?" The aim of this study was to evaluate the effect of a PDHB program among middle-aged and elderly patients with DM type 2 in primary care units in Thailand. A quasi-experimental study design was applied. DM type 2 patients were recruited in the PDHB program by a simple random sampling method. The 3-month program consisted of a weekly health education structured for ~20 minutes, a 15-minute group activity training, a 10-minute individual record of participants' knowledge and practice regarding diet control, exercise, oral hypoglycemic drug taking, diet, self-care, alcohol consumption, smoking, weight management, and HbA1c, and a 15- to 30-minute home visit as well as the PDHB for recording self-care behavior daily. The control group received only the usual diabetes care. The primary expected outcomes were changes in HbA1c from the baseline data to 3 months after the program compared between the intervention and control groups. The secondary expected outcomes were compared within the intervention group. The third expected outcomes were changes in the mean score of knowledge and practice from baseline to 3 months after the program within and between the intervention and control groups. Compared with the baseline data, there was no significant difference in HbA1c, knowledge, and practice mean score between the intervention and control groups. However, there was a significant difference in HbA1c, knowledge, and practice mean score in the intervention group after they received a 3-month PDHB program and within the intervention group ( p -value =0.00). The PDHB program was effective in lowering HbA1c while also improving the mean score of knowledge and practice among elderly patients with DM type 2. However, larger and longer trial studies will be needed to evaluate the sustainability of this program.

Performance comparison of improvised prehospital blood warming techniques and a commercial blood warmer.

PubMed

Milligan, James; Lee, Anna; Gill, Martin; Weatherall, Andrew; Tetlow, Chloe; Garner, Alan A

2016-08-01

Prehospital transfusion of packed red blood cells (PRBC) may be life saving for hypovolaemic trauma patients. PRBCs should preferably be warmed prior to administration but practical prehospital devices have only recently become available. The effectiveness of purpose designed prehospital warmers compared with previously used improvised methods of warming has not previously been described. Expired units of PRBCs were randomly assigned to a warming method in a bench study. Warming methods were exposure to body heat of an investigator, leaving the blood in direct sunlight on a dark material, wrapping the giving set around gel heat pads or a commercial fluid warmer (Belmont Buddy Lite). Methods were compared with control units that were run through the fluid circuit with no active warming strategy. The mean temperature was similar for all methods on removal from the fridge (4.5°C). The mean temperatures (degrees centigrade) for all methods were higher than the control group at the end of the circuit (all P≤0.001). For each method the mean (95% CI) temperature at the end of the circuit was; body heat 17.2 (16.4-18.0), exposure to sunlight 20.2 (19.4-21.0), gel heat pads 18.8 (18.0-19.6), Buddy Lite 35.2 (34.5-36.0) and control group 14.7 (13.9-15.5). All of the warming methods significantly warmed the blood but only the Buddy Lite reliably warmed the blood to a near normal physiological level. Improvised warming methods therefore cannot be recommended. Copyright © 2016 Elsevier Ltd. All rights reserved.

A randomized controlled trial testing the efficacy of an HIV/AIDS symptom management manual.

PubMed

Wantland, Dean J; Holzemer, William L; Moezzi, Shahnaz; Willard, Suzanne S; Arudo, John; Kirksey, Kenn M; Portillo, Carmen J; Corless, Inge B; Rosa, María E; Robinson, Linda L; Nicholas, Patrice K; Hamilton, Mary Jane; Sefcik, Elizabeth F; Human, Sarie; Rivero, Marta M; Maryland, Mary; Huang, Emily

2008-09-01

This study investigates whether using an HIV/AIDS symptom management manual with self-care strategies for 21 common symptoms, compared to a basic nutrition manual, had an effect on reducing symptom frequency and intensity. A 775-person, repeated measures, randomized controlled trial was conducted over three months in 12 sites from the United States, Puerto Rico, and Africa to assess the relationship between symptom intensity with predictors for differences in initial symptom status and change over time. A mixed model growth analysis showed a significantly greater decline in symptom frequency and intensity for the group using the symptom management manual (intervention) compared to those using the nutrition manual (control) (t=2.36, P=0.018). The models identified three significant predictors for increased initial symptom intensities and in intensity change over time: (1) protease inhibitor-based therapy (increased mean intensity by 28%); (2) having comorbid illness (nearly twice the mean intensity); and (3) being Hispanic receiving care in the United States (increased the mean intensity by 2.5 times). In addition, the symptom manual showed a significantly higher helpfulness rating and was used more often compared to the nutrition manual. The reduction in symptom intensity scores provides evidence of the need for palliation of symptoms in individuals with HIV/AIDS, as well as symptoms and treatment side effects associated with other illnesses. The information from this study may help health care providers become more aware of self-management strategies that are useful to persons with HIV/AIDS and help them to assist patients in making informed choices.

Automatic control of the Skylab Astronaut Maneuvering Research Vehicle.

NASA Technical Reports Server (NTRS)

Murtagh, T. B.; Goodwin, M. A.; Greenlee, J. E.; Whitsett , C. E.

1973-01-01

The two automatic control modes of the Astronaut Maneuvering Research Vehicle (AMRV) are analyzed: the control moment gyro (CMG) and the rate gyro (RG). The AMRV is an autonomous maneuvering unit which translates and rotates the pilot by means of hand-controller input commands. The CMG normal operation, desaturation, and cage/lock dynamics are described in terms of a realistic AMRV mass property configuration. No propellant is used for normal operation in the CMG mode, and the maximum rotation rate is 5 deg/sec about each AMRV axis. The RG attitude maneuvering and limit cycle submode dynamic are described in terms of the same AMRV mass property configuration.

Axonal loss in patients with inflammatory demyelinating polyneuropathy as determined by motor unit number estimation and MUNIX.

PubMed

Paramanathan, Sansuthan; Tankisi, Hatice; Andersen, Henning; Fuglsang-Frederiksen, Anders

2016-01-01

This study quantifies functioning axons and reinnervation by applying two methods multiple point stimulation (MPS) MUNE, and motor unit number index (MUNIX), in patients with acute- and chronic inflammatory demyelinating polyneuropathy (AIDP, CIDP). Nineteen patients with inflammatory demyelinating polyneuropathy (eleven AIDP and eight CIDP) were prospectively included. MPS MUNE and MUNIX examinations on the thenar muscle group by stimulating the median nerve were applied on all patients. Motor unit size was calculated as single motor unit potential (sMUP) and motor unit size index (MUSIX). The results were compared with twenty healthy subjects. In AIDP patients mean MPS MUNE (106) and MUNIX (80) were lower than control MPS MUNE (329) and MUNIX (215) (p<0.001). In CIDP patients both MPS MUNE (88) and MUNIX (67) were lower than controls (p<0.001). In CIDP patients sMUP (63) and MUSIX (90) were higher than control sMUP (35) and MUSIX (58) (p<0.05 and p<0.01). When AIDP and CIDP groups were combined the sensitivity for MPS MUNE and MUNIX were 89.5% and 68.4%, respectively. Decreased MPS MUNE and MUNIX suggest presence of axonal loss or loss of functioning axons in AIDP and CIDP. Increased motor unit size in CIDP patients indicates compensatory reinnervation. Moreover, both MPS MUNE and MUNIX can discriminate between disease versus non-disease. Estimation of the number and the average size of motor units may have clinical value for the assessment of axonal loss or loss of functioning axons in patients with AIDP and CIDP. Copyright © 2015 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

A cluster randomised controlled trial of a staff-training intervention in residential units for people with long-term mental illness in Portugal: the PromQual trial.

PubMed

Cardoso, Graça; Papoila, Ana; Tomé, Gina; Killaspy, Helen; King, Michael; Caldas-de-Almeida, José Miguel

2017-11-01

This study aimed to assess the efficacy of a staff-training intervention to improve service users' engagement in activities and quality of care, by means of a cluster randomised controlled trial. All residential units with at least 12-h a day staff support (n = 23) were invited to participate. Quality of care was assessed with the Quality Indicator for Rehabilitative Care (QuIRC) filled online by the unit's manager. Half the units (n = 12) were randomly assigned to continue providing treatment as usual, and half (n = 11) received a staff-training intervention that focused on skills for engaging service users in activities, with trainers working alongside staff to embed this learning in the service. The primary outcome was service users' level of activity (measured with the Time Use Diary), reassessed at 4 and 8 months. Secondary outcomes were the quality of care provided (QuIRC), and service users' quality of life (Manchester Short Assessment of Quality of Life) reassessed at 8 months. Generalized linear mixed effect models were used to assess the difference in outcomes between units in the two trial arms. The trial was registered with Current Controlled Trials (Ref NCT02366117). Knowledge acquired by the staff during the initial workshops increased significantly (p ≤ 0.01). However, the intervention and comparison units did not differ significantly in primary and secondary outcomes at either follow-up. The intervention increased the level of knowledge of staff without leading to an improvement in service users' engagement in activities, quality of life, or quality of care in the units.

22 CFR 1101.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Relations INTERNATIONAL BOUNDARY AND WATER COMMISSION, UNITED STATES AND MEXICO, UNITED STATES SECTION... and Mexico. (d) Commissioner means head of the United States Section, International Boundary and Water Commission, United States and Mexico. (e) Individual means a citizen of the United States or an alien...

22 CFR 1101.2 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-04-01

... Relations INTERNATIONAL BOUNDARY AND WATER COMMISSION, UNITED STATES AND MEXICO, UNITED STATES SECTION... and Mexico. (d) Commissioner means head of the United States Section, International Boundary and Water Commission, United States and Mexico. (e) Individual means a citizen of the United States or an alien...

22 CFR 1101.2 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Relations INTERNATIONAL BOUNDARY AND WATER COMMISSION, UNITED STATES AND MEXICO, UNITED STATES SECTION... and Mexico. (d) Commissioner means head of the United States Section, International Boundary and Water Commission, United States and Mexico. (e) Individual means a citizen of the United States or an alien...

22 CFR 1101.2 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-04-01

... Relations INTERNATIONAL BOUNDARY AND WATER COMMISSION, UNITED STATES AND MEXICO, UNITED STATES SECTION... and Mexico. (d) Commissioner means head of the United States Section, International Boundary and Water Commission, United States and Mexico. (e) Individual means a citizen of the United States or an alien...

Geomorphic Controls on Floodplain Soil Organic Carbon in the Yukon Flats, Interior Alaska, From Reach to River Basin Scales

NASA Astrophysics Data System (ADS)

Lininger, K. B.; Wohl, E.; Rose, J. R.

2018-03-01

Floodplains accumulate and store organic carbon (OC) and release OC to rivers, but studies of floodplain soil OC come from small rivers or small spatial extents on larger rivers in temperate latitudes. Warming climate is causing substantial change in geomorphic process and OC fluxes in high latitude rivers. We investigate geomorphic controls on floodplain soil OC concentrations in active-layer mineral sediment in the Yukon Flats, interior Alaska. We characterize OC along the Yukon River and four tributaries in relation to geomorphic controls at the river basin, segment, and reach scales. Average OC concentration within floodplain soil is 2.8% (median = 2.2%). Statistical analyses indicate that OC varies among river basins, among planform types along a river depending on the geomorphic unit, and among geomorphic units. OC decreases with sample depth, suggesting that most OC accumulates via autochthonous inputs from floodplain vegetation. Floodplain and river characteristics, such as grain size, soil moisture, planform, migration rate, and riverine DOC concentrations, likely influence differences among rivers. Grain size, soil moisture, and age of surface likely influence differences among geomorphic units. Mean OC concentrations vary more among geomorphic units (wetlands = 5.1% versus bars = 2.0%) than among study rivers (Dall River = 3.8% versus Teedrinjik River = 2.3%), suggesting that reach-scale geomorphic processes more strongly control the spatial distribution of OC than basin-scale processes. Investigating differences at the basin and reach scale is necessary to accurately assess the amount and distribution of floodplain soil OC, as well as the geomorphic controls on OC.

Social capital and adverse treatment outcomes of tuberculosis: a case-control study.

PubMed

Deshmukh, P R; Mundra, A; Dawale, A

2017-08-01

'Social capital' refers to social norms, relationships, networks and values that affect the functioning and development of society. Social capital influences health positively, but its role in the treatment outcomes of tuberculosis (TB) is not known. To study the role of social capital in determining adverse TB treatment outcomes. Of 516 patients registered under the Revised National Tuberculosis Control Programme in 2014 in Wardha Tuberculosis Unit, Wardha, India, we included 88 patients with adverse treatment outcomes as cases and 187 controls from among those without adverse outcomes. Multiple logistic regression was used to compare standardised Z-scores. A greater proportion of controls than cases belonged to higher quartiles of social capital and its domains than cases, and the mean standardised Z-score was also consistently higher among controls than cases. Respectively 47% and 15% of cases and controls were in the poorest quartile of social capital, whereas respectively 10% and 33% of cases and controls were in the richest quartile. Each unit increase in Z-score of overall social capital reduced the odds of adverse treatment outcomes by 63.1%. Appropriate interventions for building social capital for TB patients and linking them with the programme would improve programme performance.

Embedding an enriched environment in an acute stroke unit increases activity in people with stroke: a controlled before-after pilot study.

PubMed

Rosbergen, Ingrid Cm; Grimley, Rohan S; Hayward, Kathryn S; Walker, Katrina C; Rowley, Donna; Campbell, Alana M; McGufficke, Suzanne; Robertson, Samantha T; Trinder, Janelle; Janssen, Heidi; Brauer, Sandra G

2017-11-01

To determine whether an enriched environment embedded in an acute stroke unit could increase activity levels in acute stroke patients and reduce adverse events. Controlled before-after pilot study. An acute stroke unit in a regional Australian hospital. Acute stroke patients admitted during (a) initial usual care control period, (b) an enriched environment period and (c) a sustainability period. Usual care participants received usual one-on-one allied health intervention and nursing care. The enriched environment participants were provided stimulating resources, communal areas for eating and socializing and daily group activities. Change management strategies were used to implement an enriched environment within existing staffing levels. Behavioural mapping was used to estimate patient activity levels across groups. Participants were observed every 10 minutes between 7.30 am and 7.30 pm within the first 10 days after stroke. Adverse and serious adverse events were recorded using a clinical registry. The enriched environment group ( n = 30, mean age 76.7 ± 12.1) spent a significantly higher proportion of their day engaged in 'any' activity (71% vs. 58%, P = 0.005) compared to the usual care group ( n = 30, mean age 76.0 ± 12.8). They were more active in physical (33% vs. 22%, P < 0.001), social (40% vs. 29%, P = 0.007) and cognitive domains (59% vs. 45%, P = 0.002) and changes were sustained six months post implementation. The enriched group experienced significantly fewer adverse events (0.4 ± 0.7 vs.1.3 ± 1.6, P = 0.001), with no differences found in serious adverse events (0.5 ± 1.6 vs.1.0 ± 2.0, P = 0.309). Embedding an enriched environment in an acute stroke unit increased activity in stroke patients.

The meaning of technology in an intensive care unit--an interview study.

PubMed

Wikström, Ann-Charlott; Cederborg, Ann-Christin; Johanson, Marita

2007-08-01

Previous research has suggested technology may dehumanise patient care and also that technology may restrict nurses' freedom of action. This raises questions about the relationship between technology, care and medicine in units where the patient's need for treatment is often an emergency. The aim of the study was to explore how staff members in an intensive care unit (ICU) make sense of technology in their everyday practice. Twelve staff members from one ICU were interviewed about their understanding of technology in their everyday practice. Three main findings emerged from the analysis: Technology seems to be considered decisive as it directs and controls medical treatment and results in the patients' well being; technology is seen as facilitating everyday practice because it makes treatment more secure and decreases workload; however technology can complicate the staff members' everyday practice as it is not completely trustworthy, is not easy to handle and can cause ethical dilemmas. Contrary to previous findings this study shows that technology seems to be embedded in care and medical treatment. Furthermore, the meaning of technology appears to be dependent on the different staff members' accounting practices.

Improving actuation efficiency through variable recruitment hydraulic McKibben muscles: modeling, orderly recruitment control, and experiments.

PubMed

Meller, Michael; Chipka, Jordan; Volkov, Alexander; Bryant, Matthew; Garcia, Ephrahim

2016-11-03

Hydraulic control systems have become increasingly popular as the means of actuation for human-scale legged robots and assistive devices. One of the biggest limitations to these systems is their run time untethered from a power source. One way to increase endurance is by improving actuation efficiency. We investigate reducing servovalve throttling losses by using a selective recruitment artificial muscle bundle comprised of three motor units. Each motor unit is made up of a pair of hydraulic McKibben muscles connected to one servovalve. The pressure and recruitment state of the artificial muscle bundle can be adjusted to match the load in an efficient manner, much like the firing rate and total number of recruited motor units is adjusted in skeletal muscle. A volume-based effective initial braid angle is used in the model of each recruitment level. This semi-empirical model is utilized to predict the efficiency gains of the proposed variable recruitment actuation scheme versus a throttling-only approach. A real-time orderly recruitment controller with pressure-based thresholds is developed. This controller is used to experimentally validate the model-predicted efficiency gains of recruitment on a robot arm. The results show that utilizing variable recruitment allows for much higher efficiencies over a broader operating envelope.

Hand held phase-shifting diffraction moire interferometer

DOEpatents

Deason, Vance A.; Ward, Michael B.

1994-01-01

An interferometer in which a coherent beam of light is generated within a remote case and transmitted to a hand held unit tethered to said remote case, said hand held unit having optical elements for directing a pair of mutually coherent collimated laser beams at a diffraction grating. Data from the secondary or diffracted beams are then transmitted to a separate video and data acquisition system for recording and analysis for load induced deformation or for identification purposes. Means are also provided for shifting the phase of one incident beam relative to the other incident beam and being controlled from within said remote case.

22 CFR 1104.2 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-04-01

... Relations INTERNATIONAL BOUNDARY AND WATER COMMISSION, UNITED STATES AND MEXICO, UNITED STATES SECTION... Commission, United States and Mexico, and his delegate. (d) Public lands means lands to which the United... Boundary and Water Commission, United States and Mexico. (e) Indian tribe as defined in the Act means any...

New insulin glargine 300 units/mL versus glargine 100 units/mL in people with type 2 diabetes using basal and mealtime insulin: glucose control and hypoglycemia in a 6-month randomized controlled trial (EDITION 1).

PubMed

Riddle, Matthew C; Bolli, Geremia B; Ziemen, Monika; Muehlen-Bartmer, Isabel; Bizet, Florence; Home, Philip D

2014-10-01

To compare the efficacy and safety of new insulin glargine 300 units/mL (Gla-300) with glargine 100 units/mL (Gla-100) in people with type 2 diabetes on basal insulin (≥42 units/day) plus mealtime insulin. EDITION 1 (NCT01499082) was a 6-month, multinational, open-label, parallel-group study. Adults with glycated hemoglobin A1c (HbA1c) 7.0-10.0% (53-86 mmol/mol) were randomized to Gla-300 or Gla-100 once daily with dose titration seeking fasting plasma glucose 4.4-5.6 mmol/L. Primary end point was HbA1c change from baseline; main secondary end point was percentage of participants with one or more confirmed (≤3.9 mmol/L) or severe nocturnal hypoglycemia from week 9 to month 6. Participants (n = 807) had mean age 60 years, diabetes duration 16 years, BMI 36.6 kg/m(2), and HbA1c 8.15% (65.6 mmol/mol). HbA1c reduction was equivalent between regimens; least squares mean difference -0.00% (95% CI -0.11 to 0.11) (-0.00 mmol/mol [-1.2 to 1.2]). Fewer participants reported one or more confirmed (≤3.9 mmol/L) or severe nocturnal hypoglycemic events between week 9 and month 6 with Gla-300 (36 vs. 46% with Gla-100; relative risk 0.79 [95% CI 0.67-0.93]; P < 0.005); nocturnal hypoglycemia incidence and event rates were also lower with Gla-300 in the first 8 weeks of treatment. No between-treatment differences in tolerability or safety were identified. Gla-300 controls HbA1c as well as Gla-100 for people with type 2 diabetes treated with basal and mealtime insulin but with consistently less risk of nocturnal hypoglycemia. © 2014 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

[Effects of blood glucose control on glucose variability and clinical outcomes in patients with severe acute pancreatitis in intensive care unit].

PubMed

Wu, Jing; Sun, Qiuhong; Yang, Hua

2015-05-19

To explore the effects of blood glucose control on glucose variability and clinical outcomes in patients with severe acute pancreatitis in intensive care unit (ICU). A total of 72 ICU patients with severe acute pancreatitis were recruited and divided randomly into observation and control groups (n = 36 each). Both groups were treated conventionally. And the observation group achieved stable blood glucose at 6.1-8.3 mmol/L with intensive glucose control. The length of ICU and hospital stays, ICU mortality rate, transit operative rate, concurrent infection rate, admission blood glucose, glycosylated hemoglobin, mean insulin dose, mean blood glucose, blood glucose value standard deviation (GLUSD), glycemic liability index (GLUGLI) and mean amplitude of glycemic excursion (GLUMAGE) of two groups were compared. At the same time, the relationship between blood glucose variability, ICU mortality rate and its predictive value were analyzed by correlation analysis and receiver operating characteristic curve (ROC). The lengths of ICU and hospital stays of observation group were all significantly less than those of the control group [(11.7 ± 9.9) vs (15.9 ± 8.02) days, (21.8 ± 10.8) vs (28.2 ± 12.7) days, P < 0.05]. In observation group, the rates of pulmonary infection (27.78%) and hematogenous infection (5.56%) were all significantly lower than those of control group (72.22%, 38.89%, P < 0.05). The values of mean blood glucose value and GLUSD of observation group were significantly lower than those of control group [(7.4 ± 1.1) vs (9.6 ± 1.2), (1.8 ± 1.0) vs (2.5 ± 1.3) mmol/L]. The differences were statistically significant (P < 0.05). While the dose of insulin [(70.2 ± 47.6) vs (34.4 ± 38.6) U/d] was significantly higher than that of control group (P < 0.05). Bivariate correlation analysis showed that ICU mortality rate was positively correlated with GLUGLI (r = 0.368, P < 0.05). ROC curve analysis showed that, AUC of GLUGLI was 0.748 and 95% CI 0.551-0.965 (P < 0.05). Intensive glucose control in patients with severe acute pancreatitis helps reduce the blood sugar fluctuations, lower the risks of infectious complications and promote the patient rehabilitation. And GLUGLI is positively correlated with ICU mortality rate. It has good predictive values.

Effect of a multifactorial fall-and-fracture risk assessment and management program on gait and balance performances and disability in hospitalized older adults: a controlled study.

PubMed

Trombetti, A; Hars, M; Herrmann, F; Rizzoli, R; Ferrari, S

2013-03-01

This controlled intervention study in hospitalized oldest old adults showed that a multifactorial fall-and-fracture risk assessment and management program, applied in a dedicated geriatric hospital unit, was effective in improving fall-related physical and functional performances and the level of independence in activities of daily living in high-risk patients. Hospitalization affords a major opportunity for interdisciplinary cooperation to manage fall-and-fracture risk factors in older adults. This study aimed at assessing the effects on physical performances and the level of independence in activities of daily living (ADL) of a multifactorial fall-and-fracture risk assessment and management program applied in a geriatric hospital setting. A controlled intervention study was conducted among 122 geriatric inpatients (mean ± SD age, 84 ± 7 years) admitted with a fall-related diagnosis. Among them, 92 were admitted to a dedicated unit and enrolled into a multifactorial intervention program, including intensive targeted exercise. Thirty patients who received standard usual care in a general geriatric unit formed the control group. Primary outcomes included gait and balance performances and the level of independence in ADL measured 12 ± 6 days apart. Secondary outcomes included length of stay, incidence of in-hospital falls, hospital readmission, and mortality rates. Compared to the usual care group, the intervention group had significant improvements in Timed Up and Go (adjusted mean difference [AMD] = -3.7s; 95 % CI = -6.8 to -0.7; P = 0.017), Tinetti (AMD = -1.4; 95 % CI = -2.1 to -0.8; P < 0.001), and Functional Independence Measure (AMD = 6.5; 95 %CI = 0.7-12.3; P = 0.027) test performances, as well as in several gait parameters (P < 0.05). Furthermore, this program favorably impacted adverse outcomes including hospital readmission (hazard ratio = 0.3; 95 % CI = 0.1-0.9; P = 0.02). A multifactorial fall-and-fracture risk-based intervention program, applied in a dedicated geriatric hospital unit, was effective and more beneficial than usual care in improving physical parameters related to the risk of fall and disability among high-risk oldest old patients.

Respiration-related discharge of hyoglossus muscle motor units in the rat.

PubMed

Powell, Gregory L; Rice, Amber; Bennett-Cross, Seres J; Fregosi, Ralph F

2014-01-01

Although respiratory muscle motor units have been studied during natural breathing, simultaneous measures of muscle force have never been obtained. Tongue retractor muscles, such as the hyoglossus (HG), play an important role in swallowing, licking, chewing, breathing, and, in humans, speech. The HG is phasically recruited during the inspiratory phase of the respiratory cycle. Moreover, in urethane anesthetized rats the drive to the HG waxes and wanes spontaneously, providing a unique opportunity to study motor unit firing patterns as the muscle is driven naturally by the central pattern generator for breathing. We recorded tongue retraction force, the whole HG muscle EMG and the activity of 38 HG motor units in spontaneously breathing anesthetized rats under low-force and high-force conditions. Activity in all cases was confined to the inspiratory phase of the respiratory cycle. Changes in the EMG were correlated significantly with corresponding changes in force, with the change in EMG able to predict 53-68% of the force variation. Mean and peak motor unit firing rates were greater under high-force conditions, although the magnitude of discharge rate modulation varied widely across the population. Changes in mean and peak firing rates were significantly correlated with the corresponding changes in force, but the correlations were weak (r(2) = 0.27 and 0.25, respectively). These data indicate that, during spontaneous breathing, recruitment of HG motor units plays a critical role in the control of muscle force, with firing rate modulation playing an important but lesser role.

A comparison between probability and information measures of uncertainty in a simulated soil map and the economic value of imperfect soil information.

NASA Astrophysics Data System (ADS)

Lark, R. Murray

2014-05-01

Conventionally the uncertainty of a conventional soil map has been expressed in terms of the mean purity of its map units: the probability that the soil profile class examined at a site would be found to correspond to the eponymous class of the simple map unit that is delineated there (Burrough et al, 1971). This measure of uncertainty has an intuitive meaning and is used for quality control in soil survey contracts (Western, 1978). However, it may be of limited value to the manager or policy maker who wants to decide whether the map provides a basis for decision making, and whether the cost of producing a better map would be justified. In this study I extend a published analysis of the economic implications of uncertainty in a soil map (Giasson et al., 2000). A decision analysis was developed to assess the economic value of imperfect soil map information for agricultural land use planning. Random error matrices for the soil map units were then generated, subject to constraints which ensure consistency with fixed frequencies of the different soil classes. For each error matrix the mean map unit purity was computed, and the value of the implied imperfect soil information was computed by the decision analysis. An alternative measure of the uncertainty in a soil map was considered. This is the mean soil map information which is the difference between the information content of a soil observation, at a random location in the region, and the information content of a soil observation given that the map unit is known. I examined the relationship between the value of imperfect soil information and the purity and information measures of map uncertainty. In both cases there was considerable variation in the economic value of possible maps with fixed values of the uncertainty measure. However, the correlation was somewhat stronger with the information measure, and there was a clear upper bound on the value of an imperfect soil map when the mean information takes some particular value. This suggests that the information measure may be a useful one for general communication of the value of soil and similar thematic data. Burrough, P.A., Beckett, P.H.T., Jarvis, M.G., 1971. The relation between cost and utility in soil survey. J. Soil Sci. 22, 359-394. Giasson, E., van Es, C, van Wambeke, A., Bryant, R.B. 2000. Assessing the economic value of soil information using decision analysis techniques. Soil Science 165, 971-978 Western, S., 1978. Soil survey contracts and quality control. Oxford Univ. Press, Oxford.

Small area variation in diabetes prevalence in Puerto Rico.

PubMed

Tierney, Edward F; Burrows, Nilka R; Barker, Lawrence E; Beckles, Gloria L; Boyle, James P; Cadwell, Betsy L; Kirtland, Karen A; Thompson, Theodore J

2013-06-01

To estimate the 2009 prevalence of diagnosed diabetes in Puerto Rico among adults ≥ 20 years of age in order to gain a better understanding of its geographic distribution so that policymakers can more efficiently target prevention and control programs. A Bayesian multilevel model was fitted to the combined 2008-2010 Behavioral Risk Factor Surveillance System and 2009 United States Census data to estimate diabetes prevalence for each of the 78 municipios (counties) in Puerto Rico. The mean unadjusted estimate for all counties was 14.3% (range by county, 9.9%-18.0%). The average width of the confidence intervals was 6.2%. Adjusted and unadjusted estimates differed little. These 78 county estimates are higher on average and showed less variability (i.e., had a smaller range) than the previously published estimates of the 2008 diabetes prevalence for all United States counties (mean, 9.9%; range, 3.0%-18.2%).

Altered erythrocyte Na-K pump in anorectic patients

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

Pasquali, R.; Strocchi, E.; Malini, P.

1985-07-01

The status of the erythrocyte sodium pump was evaluated in a group of patients suffering from anorexia nervosa and a group of healthy female control subjects. Anorectic patients showed significantly higher mean values of digoxin-binding sites/cell (ie, the number of Na-K-ATPase units) with respect to control subjects while no differences were found in the specific /sup 86/Rb uptake (which reflects the Na-K-ATPase activity) between the two groups. A significant correlation was found between relative weight and the number of Na-K-ATPase pump units (r = -0.66; P less than 0.0001). Anorectic patients showed lower serum T3 concentrations (71.3 +/- 53 ng/dL)more » with respect to control subjects (100.8 +/- 4.7 ng/dL; P less than 0.0005) and a significant negative correlation between T3 levels and the number of pump units (r = -0.52; P less than 0.003) was found. This study therefore shows that the erythrocyte Na-K pump may be altered in several anorectic patients. The authors suggest that this feature could be interrelated with the degree of underweight and/or malnutrition.« less

Planar solid oxide fuel cell with staged indirect-internal air and fuel preheating and reformation

DOEpatents

Geisbrecht, Rodney A; Williams, Mark C

2003-10-21

A solid oxide fuel cell arrangement and method of use that provides internal preheating of both fuel and air in order to maintain the optimum operating temperature for the production of energy. The internal preheat passes are created by the addition of two plates, one on either side of the bipolar plate, such that these plates create additional passes through the fuel cell. This internal preheat fuel cell configuration and method reduce the requirements for external heat exchanger units and air compressors. Air or fuel may be added to the fuel cell as required to maintain the optimum operating temperature through a cathode control valve or an anode control valve, respectively. A control loop comprises a temperature sensing means within the preheat air and fuel passes, a means to compare the measured temperature to a set point temperature and a determination based on the comparison as to whether the control valves should allow additional air or fuel into the preheat or bypass manifolds of the fuel cell.

Heparin for prolonging peripheral intravenous catheter use in neonates: a randomized controlled trial.

PubMed

Upadhyay, A; Verma, K K; Lal, P; Chawla, D; Sreenivas, V

2015-04-01

To determine the efficacy of heparinized saline administered as intermittent flush on functional duration of the peripheral intravenous catheter (PIVC) in neonates. Randomized, double-blind and placebo-controlled trial. Neonatal intensive care unit of a teaching hospital. Term and preterm neonates born at >32 weeks of gestation who required PIVC only for intermittent administration of antibiotics. Eligible neonates were randomized to receive 1 ml of either heparinized saline (10 U ml(-1)) (n=60) or normal saline (n=60) every 12 h before and after intravenous antibiotics. Functional duration of first peripheral intravenous catheter. A total of 120 neonates were randomized to two groups of 60 neonates each. The mean (s.d.) of age of babies in case and control group was 5.7 (2.5) days and 4.6 (3.1) days, respectively. The average weight of babies in both the groups was 2.1 kg. Mean functional duration of first catheter was more in heparinized saline group, mean (s.d.) of 71.68 h  (27.3) as compared with 57.7 h (23.6) in normal saline group (P<0.005). The mean (95% confidence interval) difference in functional duration in the two groups was 13.9 h (4.7-23.15). Mean duration of patency for any catheter was also significantly more in heparinized saline group than control group. Heparinized saline flush increases the functional duration of peripheral intravenous catheter.

Cerebral Oximetry Monitoring to Maintain Normal Cerebral Oxygen Saturation during High-risk Cardiac Surgery: A Randomized Controlled Feasibility Trial.

PubMed

Deschamps, Alain; Hall, Richard; Grocott, Hilary; Mazer, C David; Choi, Peter T; Turgeon, Alexis F; de Medicis, Etienne; Bussières, Jean S; Hudson, Christopher; Syed, Summer; Seal, Doug; Herd, Stuart; Lambert, Jean; Denault, André; Deschamps, Alain; Mutch, Alan; Turgeon, Alexis; Denault, Andre; Todd, Andrea; Jerath, Angela; Fayad, Ashraf; Finnegan, Barry; Kent, Blaine; Kennedy, Brent; Cuthbertson, Brian H; Kavanagh, Brian; Warriner, Brian; MacAdams, Charles; Lehmann, Christian; Fudorow, Christine; Hudson, Christopher; McCartney, Colin; McIsaac, Dan; Dubois, Daniel; Campbell, David; Mazer, David; Neilpovitz, David; Rosen, David; Cheng, Davy; Drapeau, Dennis; Dillane, Derek; Tran, Diem; Mckeen, Dolores; Wijeysundera, Duminda; Jacobsohn, Eric; Couture, Etienne; de Medicis, Etienne; Alam, Fahad; Abdallah, Faraj; Ralley, Fiona E; Chung, Frances; Lellouche, Francois; Dobson, Gary; Germain, Genevieve; Djaiani, George; Gilron, Ian; Hare, Gregory; Bryson, Gregory; Clarke, Hance; McDonald, Heather; Roman-Smith, Helen; Grocott, Hilary; Yang, Homer; Douketis, James; Paul, James; Beaubien, Jean; Bussières, Jean; Pridham, Jeremy; Armstrong, J N; Parlow, Joel; Murkin, John; Gamble, Jonathan; Duttchen, Kaylene; Karkouti, Keyvan; Turner, Kim; Baghirzada, Leyla; Szabo, Linda; Lalu, Manoj; Wasowicz, Marcin; Bautista, Michael; Jacka, Michael; Murphy, Michael; Schmidt, Michael; Verret, Michaël; Perrault, Michel-Antoine; Beaudet, Nicolas; Buckley, Norman; Choi, Peter; MacDougall, Peter; Jones, Philip; Drolet, Pierre; Beaulieu, Pierre; Taneja, Ravi; Martin, Rene; Hall, Richard; George, Ronald; Chun, Rosa; McMullen, Sarah; Beattie, Scott; Sampson, Sonia; Choi, Stephen; Kowalski, Stephen; McCluskey, Stuart; Syed, Summer; Boet, Sylvain; Ramsay, Tim; Saha, Tarit; Mutter, Thomas; Chowdhury, Tumul; Uppal, Vishal; Mckay, William

2016-04-01

Cerebral oxygen desaturation during cardiac surgery has been associated with adverse perioperative outcomes. Before a large multicenter randomized controlled trial (RCT) on the impact of preventing desaturations on perioperative outcomes, the authors undertook a randomized prospective, parallel-arm, multicenter feasibility RCT to determine whether an intervention algorithm could prevent desaturations. Eight Canadian sites randomized 201 patients between April 2012 and October 2013. The primary outcome was the success rate of reversing cerebral desaturations below 10% relative to baseline in the intervention group. Anesthesiologists were blinded to the cerebral saturation values in the control group. Intensive care unit personnel were blinded to cerebral saturation values for both groups. Secondary outcomes included the area under the curve of cerebral desaturation load, enrolment rates, and a 30-day follow-up for adverse events. Cerebral desaturations occurred in 71 (70%) of the 102 intervention group patients and 56 (57%) of the 99 control group patients (P = 0.04). Reversal was successful in 69 (97%) of the intervention group patients. The mean cerebral desaturation load (SD) in the operating room was smaller for intervention group patients compared with control group patients (104 [217] %.min vs. 398 [869] %.min, mean difference, -294; 95% CI, -562 to -26; P = 0.03). This was also true in the intensive care unit (P = 0.02). There were no differences in adverse events between the groups. Study sites were successful in reversal of desaturation, patient recruitment, randomization, and follow-up in cardiac surgery, supporting the feasibility of conducting a large multicenter RCT.

Decreased mean platelet volume is associated with the developing stage of fetoplacental unit in spontaneous abortion.

PubMed

Kaplanoglu, Mustafa; Yuce, Tuncay; Bulbul, Mehmet

2015-01-01

The aim was to evaluate the place of mean platelet volume (MPV) in predicting spontaneous miscarriage and to identify any differences in its values following miscarriage after biochemical and clinical pregnancy. We retrospectively evaluated the data of 305 spontaneous miscarriages and 168 control subjects. The miscarriage subjects were evaluated in two groups: miscarriage after biochemical pregnancy (n=79) (BA group) and miscarriage after clinical pregnancy (n=226) (CA group). Demographic and laboratory data of all subjects were statistically compared. No statistically significant difference was found between the miscarriage and control subjects in terms of demographic data and Hb, Htc, WBC, and Plt values. The mean platelet volume (MPV) value in the miscarriage group (8.99±1.47 fl) was statistically significantly lower than in the control group (9.66±1.64 fl) (P<0.001). A statistically significant difference was present between the BA, CA and control group, with the lowest MPV value in the BA group (8.64±1.34 fl, 9.11±1.49 fl, and 9.66±1.64 fl, respectively) (P<0.001). MPV was significantly lower in patients with miscarriage than the control group, and this was correlated with the gestational stage when the miscarriage occurred.

Anthropometric characteristics and evaluation of nutritional status amongst female brick field workers of the unorganized sectors of West Bengal, India.

PubMed

Sett, M; Sahu, S

2016-06-01

The purpose of the study is to evaluate the body composition and hand grip strength as indirect measures of nutritional status of 162 female workers and the status of the serum oxidative stress enzymes of 35 female workers engaged in the manual brick making units of the unorganized sectors of West Bengal, India. Results show that the waist-hip ratio values (mean 0.79 vs. 0.83; p=0.0034) are significantly greater amongst the brick carriers than the moulders. The body density (mean 1067.0 vs. 1056.0kg/m(3); p<0.0001) is lower and the body fat % (mean 10.63% vs. 13.09%; p<0.0001) of the brick carriers is significantly higher. The hand grip strength (HGS) (horizontal) of the brick workers in right (mean 379.52 vs. 267.72N; p<0.0001) and left (mean 268.78 vs. 162.79N; p<0.0001) hands are significantly greater than the control group. The serum malondialdehyde level is significantly higher (mean 99.97 vs. 160.21nmol/mg of protein; p<0.0001) but the superoxide dismutase level (mean 6.71 vs. 3.34unit/mg of protein; p<0.0001), glutathione level (GSH) (mean 3.93 vs. 2.11μg/mg of protein; p<0.0001) and glutathione-s-transferase (GST) activity (mean 5.4 vs. 2.73nmole/min/mg of protein; p<0.0001) are significantly lower than that of the control group. The indirect nutritional assessments have shown that the women are poorly nourished. The hand grip strength is quite high in both groups of workers but consecutively decreases with the passage of time. Reduced levels of GSH and GST indicate that there is a higher level of reactive oxygen species inducing oxidative stress in the body. The probable causes of this state might be the intake of less nutritious food, polluted environment, excess ambient temperature and improper workstation. Copyright © 2016 Elsevier GmbH. All rights reserved.

37 CFR 202.20 - Deposit of copies and phonorecords for copyright registration.

Code of Federal Regulations, 2013 CFR

2013-07-01

...; HTML; WAV; and MPEG family of formats, including MP3. This list of file formats is non-exhaustive and... distributed and used in such a manner that ownership and control of copies remain with the test sponsor or...” shall mean one of the following: (1) The first and last 25 pages or equivalent units of the source code...

Learner-Centered Instruction (LCI): Volume IV, The Simulated Maintenance Task Environment (SMTE): A Job Specific Simulator.

ERIC Educational Resources Information Center

Rifkin, Kenneth I.; And Others

The purpose of the simulated maintenance task environment is to provide a means for training and job performance testing of the flight line weapon control systems mechanic/technician for the F-111A aircraft. It provides practice in flight line equipment checkout, troubleshooting, and removal and replacement of line replaceable units in the…

Prenatal micronutrient supplementation and intellectual and motor function in early school-aged children in Nepal.

PubMed

Christian, Parul; Murray-Kolb, Laura E; Khatry, Subarna K; Katz, Joanne; Schaefer, Barbara A; Cole, Pamela M; Leclerq, Steven C; Tielsch, James M

2010-12-22

Iron and zinc are important for the development of both intellectual and motor skills. Few studies have examined whether iron and zinc supplementation during gestation, a critical period of central nervous system development, affects children's later functioning. To examine intellectual and motor functioning of children whose mothers received micronutrient supplementation during pregnancy. Cohort follow-up of 676 children aged 7 to 9 years in June 2007-April 2009 who had been born to women in 4 of 5 groups of a community-based, double-blind, randomized controlled trial of prenatal micronutrient supplementation between 1999 and 2001 in rural Nepal. Study children were also in the placebo group of a subsequent preschool iron and zinc supplementation trial. Women whose children were followed up had been randomly assigned to receive daily iron/folic acid, iron/folic acid/zinc, or multiple micronutrients containing these plus 11 other micronutrients, all with vitamin A, vs a control group of vitamin A alone from early pregnancy through 3 months postpartum. These children did not receive additional micronutrient supplementation other than biannual vitamin A supplementation. Children's intellectual functioning, assessed using the Universal Nonverbal Intelligence Test (UNIT); tests of executive function, including go/no-go, the Stroop test, and backward digit span; and motor function, assessed using the Movement Assessment Battery for Children (MABC) and finger-tapping test. The difference across outcomes was significant (Bonferroni-adjusted P < .001) for iron/folic acid vs control but not for other supplement groups. The mean UNIT T score in the iron/folic acid group was 51.7 (SD, 8.5) and in the control group was 48.2 (SD, 10.2), with an adjusted mean difference of 2.38 (95% confidence interval [CI], 0.06-4.70; P = .04). Differences were not significant between the control group and either the iron/folic acid/zinc (0.73; 95% CI, -0.95 to 2.42) or multiple micronutrient (1.00; 95% CI, -0.55 to 2.56) groups. In tests of executive function, scores were better in the iron/folic acid group relative to the control group for the Stroop test (adjusted mean difference in proportion who failed, -0.14; 95% CI, -0.23 to -0.04) and backward digit span (adjusted mean difference, 0.36; 95% CI, 0.01-0.71) but not for the go/no-go test. The MABC score was lower (better) in the iron/folic acid group compared with the control group but not after adjustment for confounders (mean difference, -1.47; 95% CI, -3.06 to 0.12; P = .07). Finger-tapping test scores were higher (mean difference, 2.05; 95% CI, 0.87-3.24; P = .001) in the iron/folic acid group. Aspects of intellectual functioning including working memory, inhibitory control, and fine motor functioning among offspring were positively associated with prenatal iron/folic acid supplementation in an area where iron deficiency is prevalent. clinicaltrials.gov Identifier: NCT00115271.

Does single use of an autologous transfusion system in TKA reduce the need for allogenic blood?: a prospective randomized trial.

PubMed

Cip, Johannes; Widemschek, Mark; Benesch, Thomas; Waibel, Roman; Martin, Arno

2013-04-01

Mechanical autotransfusion systems for washed shed blood (WSB) were introduced to reduce the need for postoperative allogenic blood transfusions (ABTs). Although some authors have postulated decreased requirements for ABT by using autologous retransfusion devices, other trials, mostly evaluating retransfusion devices for unwashed shed blood (USB), verified a small or no benefit in reducing the need for postoperative ABT. Because of these contradictory findings it is still unclear whether autologous retransfusion systems for WSB can reduce transfusion requirements. We therefore asked whether one such autologous transfusion system for WSB can reduce the requirements for postoperative ABT. In a prospective, randomized, controlled study, we enrolled 151 patients undergoing TKA. In Group A (n=76 patients), the autotransfusion system was used for a total of 6 hours (intraoperatively and postoperatively) and the WSB was retransfused after processing. In Control Group B (n=75 patients), a regular drain without suction was used. We used signs of anemia and/or a hemoglobin value less than 8 g/dL as indications for transfusion. If necessary, we administered one or two units of allogenic blood. Twenty-three patients (33%) in Group A, who received an average of 283 mL (range, 160-406 mL) of salvaged blood, needed a mean of 2.1 units of allogenic blood, compared with 23 patients (33%) in Control Group B who needed a mean of 2.1 units of allogenic blood. We found the use of an autotransfusion system did not reduce the rate of postoperative ABTs. Level II, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

Basal-Bolus Insulin Therapy with Gla-300 During Hospitalization Reduces Nocturnal Hypoglycemia in Patients with Type 2 Diabetes Mellitus: A Randomized Controlled Study.

PubMed

Okajima, Fumitaka; Nakamura, Yuko; Yamaguchi, Yuji; Shuto, Yuki; Kato, Katsuhito; Sugihara, Hitoshi; Emoto, Naoya

2018-04-04

Although reduction in the incidence of nocturnal hypoglycemia, as estimated by symptom or self-monitored plasma glucose, was shown to be more pronounced with 300 units/mL insulin glargine (Gla-300) than with 100 units/mL insulin glargine (Gla-100) in type 2 diabetes patients, the exact frequency of nocturnal hypoglycemia estimated with continuous glucose monitoring (CGM) has not been reported. Forty patients with type 2 diabetes who were admitted for glycemic control with basal-bolus insulin therapy (BBT) were randomized into the Gla-100 and Gla-300 groups. Insulin doses were adjusted to maintain blood glucose levels within 100-120 mg/dL at each meal. Plasma glucose and C-peptide profiles were estimated serially after admission and before discharge. Daily CGM was also performed before discharge. In the Gla-100 and Gla-300 groups, the mean duration of hospitalization was 15 ± 2 and 15 ± 1 days, respectively, and the mean basal insulin dose before discharge was 13 ± 7 and 15 ± 10 units, respectively. The dose of meal-time insulin was not different between the two groups. Compared with the Gla-300 group, the Gla-100 group had significantly lower nocturnal profiles of plasma glucose and C-peptide, but significantly higher frequency of CGM-estimated nocturnal hypoglycemia (10.7% ± 18.4% versus 1.2% ± 3.6%, P = 0.033). In type 2 diabetic patients, reduction in the incidence of CGM-estimated nocturnal hypoglycemia by BBT under tightly controlled diet therapy was higher with Gla-300 than with Gla-100. UMIN clinical trials registry (UMIN000023360).

Comparison of ε-Aminocaproic Acid and Tranexamic Acid in Reducing Postoperative Transfusions in Total Hip Arthroplasty.

PubMed

Churchill, Jessica L; Puca, Kathleen E; Meyer, Elizabeth S; Carleton, Matthew C; Truchan, Susan L; Anderson, Michael J

2016-12-01

Use of antifibrinolytic agents in total hip arthroplasty (THA) is well supported; however, most studies used tranexamic acid (TXA), whereas few used ε-aminocaproic acid (EACA), a similar antifibrinolytic. This study compares the efficacy and cost per surgery of intraoperative infusion of EACA and TXA in reducing postoperative blood transfusion rates in THA. Retrospective chart review of 1799 primary unilateral THA cases from April 2012 through December 2014 at 5 hospitals within our health care network. In our cohort, 711 received EACA, 445 received TXA, and 643 (control group) received no antifibrinolytic. Both antifibrinolytic groups had significantly fewer patients receiving red blood cell (RBC) transfusions when compared with control group (EACA 6.8% [P < .0001], TXA 9.7% [P < .0001] vs control group 24.7%). Average number of RBC units per patient were similar for EACA and TXA (0.11 units/patient and 0.15 units/patient, respectively), and both were significantly lower than the control group (0.48 units/patient, P < .0001). No significant difference was noted in mean RBC units per patient and percentage of patients transfused between EACA and TXA groups (P = .144, P = .074). Logistic regression showed no difference between EACA and TXA when adjusting for age, gender, higher severity of illness levels, admission hemoglobin, performing surgeon, and hospital. Medication acquisition cost for EACA averaged $2.70 per surgery compared with TXA at $39.58 per surgery. Intraoperative antifibrinolytic use significantly decreases need for postoperative blood transfusions. At our institution, EACA is comparable to TXA in THA for reducing transfusion rates while at a lower cost per surgery. Copyright © 2016 Elsevier Inc. All rights reserved.

Fungal endophyte communities reflect environmental structuring across a Hawaiian landscape

PubMed Central

Zimmerman, Naupaka B.; Vitousek, Peter M.

2012-01-01

We surveyed endophytic fungal communities in leaves of a single tree species (Metrosideros polymorpha) across wide environmental gradients (500–5,500 mm of rain/y; 10–22 °C mean annual temperature) spanning short geographic distances on Mauna Loa Volcano, Hawai’i. Using barcoded amplicon pyrosequencing at 13 sites (10 trees/site; 10 leaves/tree), we found very high levels of diversity within sites (a mean of 551 ± 134 taxonomic units per site). However, among-site diversity contributed even more than did within-site diversity to the overall richness of more than 4,200 taxonomic units observed in M. polymorpha, and this among-site variation in endophyte community composition correlated strongly with temperature and rainfall. These results are consistent with suggestions that foliar endophytic fungi are hyperdiverse. They further suggest that microbial diversity may be even greater than has been assumed and that broad-scale environmental controls such as temperature and rainfall can structure eukaryotic microbial diversity. Appropriately constrained study systems across strong environmental gradients present a useful means to understand the environmental factors that structure the diversity of microbial communities. PMID:22837398

Lead poisoning among internally displaced Roma, Ashkali and Egyptian children in the United Nations-Administered Province of Kosovo.

PubMed

Brown, Mary Jean; McWeeney, Gerry; Kim, Rokho; Tahirukaj, Ardita; Bulat, Petar; Syla, Skender; Savic, Zoran; Amitai, Yona; Dignam, Timothy; Kaluski, Dorit Nitzan

2010-06-01

This study assessed the association between lead poisoning prevention activities and blood lead levels (BLLs) among children living in lead-contaminated camps for internally displaced persons in the United Nations-Administered Province of Kosovo. We conducted a population-based study to examine the relationship among geometric mean BLLs in children (i) born before any lead poisoning prevention activities were instituted, (ii) born when specific interim interventions were instituted and (iii) born after relocation and medical therapy were available. The study population consisted of 145 of the 186 children born in the camps between December 1999 and July 2007. Lower mean BLLs were found in children born following implementation of the interventions as compared with the children born before the interventions. However, this decrease in mean BLLs was attenuated in children born into families suspected of informal lead smelting. Despite lower BLLs following interventions, children living in these camps have BLLs that remain unacceptably high. Further efforts are urgently needed to control or eliminate lead exposure in this population. Continued blood lead monitoring of the population is also warranted.

Hospital costs of central line-associated bloodstream infections and cost-effectiveness of closed vs. open infusion containers. The case of Intensive Care Units in Italy

PubMed Central

2010-01-01

Objectives The aim was to evaluate direct health care costs of central line-associated bloodstream infections (CLABSI) and to calculate the cost-effectiveness ratio of closed fully collapsible plastic intravenous infusion containers vs. open (glass) infusion containers. Methods A two-year, prospective case-control study was undertaken in four intensive care units in an Italian teaching hospital. Patients with CLABSI (cases) and patients without CLABSI (controls) were matched for admission departments, gender, age, and average severity of illness score. Costs were estimated according to micro-costing approach. In the cost effectiveness analysis, the cost component was assessed as the difference between production costs while effectiveness was measured by CLABSI rate (number of CLABSI per 1000 central line days) associated with the two infusion containers. Results A total of 43 cases of CLABSI were compared with 97 matched controls. The mean age of cases and controls was 62.1 and 66.6 years, respectively (p = 0.143); 56% of the cases and 57% of the controls were females (p = 0.922). The mean length of stay of cases and controls was 17.41 and 8.55 days, respectively (p < 0.001). Overall, the mean total costs of patients with and without CLABSI were € 18,241 and € 9,087, respectively (p < 0.001). On average, the extra cost for drugs was € 843 (p < 0.001), for supplies € 133 (p = 0.116), for lab tests € 171 (p < 0.001), and for specialist visits € 15 (p = 0.019). The mean extra cost for hospital stay (overhead) was € 7,180 (p < 0.001). The closed infusion container was a dominant strategy. It resulted in lower CLABSI rates (3.5 vs. 8.2 CLABSIs per 1000 central line days for closed vs. open infusion container) without any significant difference in total production costs. The higher acquisition cost of the closed infusion container was offset by savings incurred in other phases of production, especially waste management. Conclusions CLABSI results in considerable and significant increase in utilization of hospital resources. Use of innovative technologies such as closed infusion containers can significantly reduce the incidence of healthcare acquired infection without posing additional burden on hospital budgets. PMID:20459753

Hospital costs of central line-associated bloodstream infections and cost-effectiveness of closed vs. open infusion containers. The case of Intensive Care Units in Italy.

PubMed

Tarricone, Rosanna; Torbica, Aleksandra; Franzetti, Fabio; Rosenthal, Victor D

2010-05-10

The aim was to evaluate direct health care costs of central line-associated bloodstream infections (CLABSI) and to calculate the cost-effectiveness ratio of closed fully collapsible plastic intravenous infusion containers vs. open (glass) infusion containers. A two-year, prospective case-control study was undertaken in four intensive care units in an Italian teaching hospital. Patients with CLABSI (cases) and patients without CLABSI (controls) were matched for admission departments, gender, age, and average severity of illness score. Costs were estimated according to micro-costing approach. In the cost effectiveness analysis, the cost component was assessed as the difference between production costs while effectiveness was measured by CLABSI rate (number of CLABSI per 1000 central line days) associated with the two infusion containers. A total of 43 cases of CLABSI were compared with 97 matched controls. The mean age of cases and controls was 62.1 and 66.6 years, respectively (p = 0.143); 56% of the cases and 57% of the controls were females (p = 0.922). The mean length of stay of cases and controls was 17.41 and 8.55 days, respectively (p < 0.001). Overall, the mean total costs of patients with and without CLABSI were euro 18,241 and euro 9,087, respectively (p < 0.001). On average, the extra cost for drugs was euro 843 (p < 0.001), for supplies euro 133 (p = 0.116), for lab tests euro 171 (p < 0.001), and for specialist visits euro 15 (p = 0.019). The mean extra cost for hospital stay (overhead) was euro 7,180 (p < 0.001). The closed infusion container was a dominant strategy. It resulted in lower CLABSI rates (3.5 vs. 8.2 CLABSIs per 1000 central line days for closed vs. open infusion container) without any significant difference in total production costs. The higher acquisition cost of the closed infusion container was offset by savings incurred in other phases of production, especially waste management. CLABSI results in considerable and significant increase in utilization of hospital resources. Use of innovative technologies such as closed infusion containers can significantly reduce the incidence of healthcare acquired infection without posing additional burden on hospital budgets.

Testing and evaluation of the LES-6 pulsed plasma thruster by means of a torsion pendulum system

NASA Technical Reports Server (NTRS)

Hamidian, J. P.; Dahlgren, J. B.

1973-01-01

Performance characteristics of the LES-6 pulsed plasma thruster over a range of input conditions were investigated by means of a torsion pendulum system. Parameters of particular interest included the impulse bit and time average thrust (and their repeatability), specific impulse, mass ablated per discharge, specific thrust, energy per unit area, efficiency, and variation of performance with ignition command rate. Intermittency of the thruster as affected by input energy and igniter resistance were also investigated. Comparative experimental data correlation with the data presented. The results of these tests indicate that the LES-6 thruster, with some identifiable design improvements, represents an attractive reaction control thruster for attitude contol applications on long-life spacecraft requiring small metered impulse bits for precise pointing control of science instruments.

22 CFR 40.1 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... not precede the principal alien to the United States. (b) Act means the Immigration and Nationality... of adjustment of status in the United States of the principal alien; or (iii) The date on which the... officer” within the meaning of INA 101(a)(9). (e) Department means the Department of State of the United...

22 CFR 40.1 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-04-01

... not precede the principal alien to the United States. (b) Act means the Immigration and Nationality... of adjustment of status in the United States of the principal alien; or (iii) The date on which the... officer” within the meaning of INA 101(a)(9). (e) Department means the Department of State of the United...

22 CFR 40.1 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-04-01

... not precede the principal alien to the United States. (b) Act means the Immigration and Nationality... of adjustment of status in the United States of the principal alien; or (iii) The date on which the... officer” within the meaning of INA 101(a)(9). (e) Department means the Department of State of the United...

22 CFR 40.1 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-04-01

... not precede the principal alien to the United States. (b) Act means the Immigration and Nationality... of adjustment of status in the United States of the principal alien; or (iii) The date on which the... officer” within the meaning of INA 101(a)(9). (e) Department means the Department of State of the United...

40 CFR 63.1016 - Alternative means of emission limitation: Enclosed-vented process units.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 10 2010-07-01 2010-07-01 false Alternative means of emission limitation: Enclosed-vented process units. 63.1016 Section 63.1016 Protection of Environment ENVIRONMENTAL... § 63.1016 Alternative means of emission limitation: Enclosed-vented process units. (a) Use of closed...

40 CFR 63.1016 - Alternative means of emission limitation: Enclosed-vented process units.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 10 2011-07-01 2011-07-01 false Alternative means of emission limitation: Enclosed-vented process units. 63.1016 Section 63.1016 Protection of Environment ENVIRONMENTAL... § 63.1016 Alternative means of emission limitation: Enclosed-vented process units. (a) Use of closed...

24 CFR 990.115 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-04-01

... Definitions. The following definitions apply to the Operating Fund program: 1937 Act means the United States... this part. Other operating costs (add-ons) means PHA expenses that are recognized as formula expenses...) expressed as a PUM cost. Project units means all dwelling units in all of a PHA's projects under an ACC...

24 CFR 990.115 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-04-01

... Definitions. The following definitions apply to the Operating Fund program: 1937 Act means the United States... this part. Other operating costs (add-ons) means PHA expenses that are recognized as formula expenses...) expressed as a PUM cost. Project units means all dwelling units in all of a PHA's projects under an ACC...

24 CFR 990.115 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Definitions. The following definitions apply to the Operating Fund program: 1937 Act means the United States... this part. Other operating costs (add-ons) means PHA expenses that are recognized as formula expenses...) expressed as a PUM cost. Project units means all dwelling units in all of a PHA's projects under an ACC...

24 CFR 990.115 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Definitions. The following definitions apply to the Operating Fund program: 1937 Act means the United States... this part. Other operating costs (add-ons) means PHA expenses that are recognized as formula expenses...) expressed as a PUM cost. Project units means all dwelling units in all of a PHA's projects under an ACC...

24 CFR 990.115 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-04-01

... Definitions. The following definitions apply to the Operating Fund program: 1937 Act means the United States... this part. Other operating costs (add-ons) means PHA expenses that are recognized as formula expenses...) expressed as a PUM cost. Project units means all dwelling units in all of a PHA's projects under an ACC...

A randomized controlled clinical trial of 3-unit posterior zirconia-ceramic fixed dental prostheses (FDP) with layered or pressed veneering ceramics: 3-year results.

PubMed

Naenni, Nadja; Bindl, Andreas; Sax, Caroline; Hämmerle, Christoph; Sailer, Irena

2015-11-01

The aim of the present pilot study was to test whether or not posterior zirconia-ceramic fixed dental prostheses (FDPs) with pressed veneering ceramic exhibit less chipping than FDPs with layered veneering ceramics. Forty patients (13 female, 27 male; mean age 54 years (range 26.1-80.7 years) in need of one maxillary or mandibular three-unit FDP in the second premolar or molar region were recruited and treated at two separate centers at the University of Zurich according to the same study protocol. The frameworks were made out of zirconia using a CAD/CAM system (Cerec Sirona, Bensheim, Germany). The patients were randomly assigned to either the test group (zirconia frameworks veneered with pressed ceramic; IPS e.max ZirPress, Ivoclar Vivadent AG, Schaan, Liechtenstein; n=20) or the control group (layered veneering ceramic; IPS e.max Ceram, Ivoclar Vivadent AG, Schaan, Liechtenstein; n=20). All FDPs were adhesively cemented and evaluated at baseline (i.e., cementation), at 6 months and at 1 and 3 years of clinical service. The survival of the reconstruction was recorded. The technical outcome was assessed using modified United States Public Health Services (USPHS) criteria. The biologic parameters analyzed at abutment teeth and analogous non-restored teeth included probing pocket depth (PPD), plaque control record (PCR), bleeding on probing (BOP), and tooth vitality (CO2). Data was descriptively analyzed and survival was calculated using Kaplan-Meier statistics. 36 patients (25 female, 11 male; mean age 52.3 years) with 18 test and 18 control FDPs were examined after a mean follow-up of 36 months (95% CI: 32.6-39.1 months). Comparison of groups was done by Crosstabulation showing even distribution of the respective restored teeth amidst the groups. Survival rate was 100% for both test and control FDPs. Chipping of the veneering ceramic tended to occur more frequently in test (n=8; 40%) than in control (n=4; 20%) FDPs, albeit not significantly (p=0.3). No further differences of the technical outcomes of test and control FDPs occurred.In both test and control group healthy conditions and no difference of the biologic parameters at the abutment and un-restored teeth was found. Zirconia FDPs with pressed and layered veneering ceramics exhibited similar outcomes at 3 years. A trend to more chipping of the pressed veneering ceramic, however, was observed. Posterior restorations with zirconia frameworks are a viable treatment method. When restoring posterior teeth with all-ceramic restorations, care providers should be aware of the higher rate of chipping compared to the published data on conventional metal-ceramic restorations. Copyright © 2015. Published by Elsevier Ltd.

Heterogeneity of Mosquito (Diptera: Culicidae) Control Community Size, Research Productivity, and Arboviral Diseases Across the United States.

PubMed

Hamer, Gabriel L

2016-05-01

Multiple factors lead to extensive variation in mosquito and mosquito-borne virus control programs throughout the United States. This variation is related to differences in budgets, number of personnel, operational activities targeting nuisance or vector species, integration of Geographical Information Systems, and the degree of research and development to improve management interventions through collaboration with academic institutions. To highlight this heterogeneity, the current study evaluates associations among the size of a mosquito control community, the research productivity, and the mosquito-borne virus human disease burden among states within the continental United States. I used the attendance at state mosquito and vector control meetings as a proxy for the size of the mosquito control community in each state. To judge research productivity, I used all peer-reviewed publications on mosquitoes and mosquito-borne viruses using data originating in each state over a 5- and 20-yr period. Total neuroinvasive human disease cases caused by mosquito-borne viruses were aggregated for each state. These data were compared directly and after adjusting for differences in human population size for each state. Results revealed that mean meeting attendance was positively correlated with the number of publications in each state, but not after correcting for the size of the population in each state. Additionally, human disease cases were positively correlated with the number of publications in each state. Finally, mean meeting attendance and human disease cases were only marginally positively associated, and no correlation existed after correcting for human population size. These analyses indicated that the mosquito control community size, research productivity, and mosquito-borne viral human disease burden varied greatly among states. The mechanisms resulting in this variation were discussed and the consequences of this variation are important given the constantly changing environment due to invasive mosquito species and arboviruses, urbanization, immigration, global travel, and climate change. © The Authors 2016. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Effect of iodine on mercury concentrations in dental-unit wastewater.

PubMed

Stone, Mark E; Kuehne, John C; Cohen, Mark E; Talbott, Jonathan L; Scott, John W

2006-02-01

This study was undertaken to determine whether iodine used to control bacteria in dental unit waterlines could increase mercury concentrations in dental wastewater. The study was conducted in four parts. Part 1. Solutions containing iodine in concentrations ranging from zero (control) to 20 mg/L were mixed with ground and sieved dental amalgam and then allowed to equilibrate by settling. Cold vapor atomic absorption spectrometry was used to determine mercury levels in the settled supernatants at 24 h and at 7 days. Part 2. Deionized water was pumped through an iodine-releasing water-treatment cartridge, collected, and mixed with ground and sieved dental amalgam. Mercury levels in settled supernatants were measured at 24 h and at 7 days. Part 3. Iodine in water from two commercial iodine-releasing cartridges was measured using Inductively Couple Plasma Mass Spectrometry. Part 4. Baseline mercury levels in settled supernatants from wastewater collected from two dental chairs were compared to samples taken from chairs equipped with iodine-releasing cartridges. Part 1. A linear correlation between iodine and mercury concentration (r2=0.9167 and 0.9459, respectively, both P<0.001) was seen at both 24 h and 7 days. Part 2. Mean mercury levels in 24h samples were 3.0 times higher than the controls (0.2864 mg/L compared with 0.0939mg/L for the 24 h controls). Mean mercury levels in the 7-day samples were 5.9 times higher than the 7-day controls (0.2048 mg/L compared with 0.0348 mg/L for the 7-day controls). Part 3. The effluent from two iodine-releasing cartridges showed iodine concentrations averaging 3.2 mg/L (n=10, SD=0.8, range=2.5-4.6). Part 4. Data from the clinical study showed a statistically significant 2.5-fold increase in mercury levels with iodine-containing samples compared to baseline (0.0853 mg/L, n=18, SD=0.0441 and 0.0345 mg/L, n=18, SD=0.0145, respectively; P<0.001). Data suggest that iodine can increase concentrations of dissolved mercury in dental unit wastewater.

Investigation of multidimensional control systems in the state space and wavelet medium

NASA Astrophysics Data System (ADS)

Fedosenkov, D. B.; Simikova, A. A.; Fedosenkov, B. A.

2018-05-01

The notions are introduced of “one-dimensional-point” and “multidimensional-point” automatic control systems. To demonstrate the joint use of approaches based on the concepts of state space and wavelet transforms, a method for optimal control in a state space medium represented in the form of time-frequency representations (maps), is considered. The computer-aided control system is formed on the basis of the similarity transformation method, which makes it possible to exclude the use of reduced state variable observers. 1D-material flow signals formed by primary transducers are converted by means of wavelet transformations into multidimensional concentrated-at-a point variables in the form of time-frequency distributions of Cohen’s class. The algorithm for synthesizing a stationary controller for feeding processes is given here. The conclusion is made that the formation of an optimal control law with time-frequency distributions available contributes to the improvement of transient processes quality in feeding subsystems and the mixing unit. Confirming the efficiency of the method presented is illustrated by an example of the current registration of material flows in the multi-feeding unit. The first section in your paper.

Effects of robot-assisted upper limb rehabilitation on daily function and real-world arm activity in patients with chronic stroke: a randomized controlled trial.

PubMed

Liao, Wan-Wen; Wu, Ching-Yi; Hsieh, Yu-Wei; Lin, Keh-Chung; Chang, Wan-Ying

2012-02-01

To compare the outcome of robot-assisted therapy with dose-matched active control therapy by using accelerometers to study functional recovery in chronic stroke patients. Prospective, randomized, controlled trial. Stroke units in three medical centres. Twenty patients post stroke for a mean of 22 months. Robot-assisted therapy (n = 10) or dose-matched active control therapy (n = 10). All patients received either of these two therapies for 90-105 minutes each day, 5 days per week, for four weeks. Outcome measures included arm activity ratio (the ratio of mean activity between the impaired and unimpaired arm) and scores on the Fugl-Meyer Assessment Scale, Functional Independence Measure, Motor Activity Log and ABILHAND questionnaire. The robot-assisted therapy group significantly increased motor function, hemiplegic arm activity and bilateral arm coordination (Fugl-Meyer Assessment Scale: 51.20 ± 8.82, P = 0.002; mean arm activity ratio: 0.76 ± 0.10, P = 0.026; ABILHAND questionnaire: 1.24 ± 0.28, P = 0.043) compared with the dose-matched active control group (Fugl-Meyer Assessment Scale: 40.90 ± 13.14; mean arm movement ratio: 0.69 ± 0.11; ABILHAND questionnaire: 0.95 ± 0.43). Symmetrical and bilateral robotic practice, combined with functional task training, can significantly improve motor function, arm activity, and self-perceived bilateral arm ability in patients late after stroke.

Shift in responsibilities in diabetes care: the Nurse-Driven Diabetes In-Hospital Treatment protocol (N-DIABIT).

PubMed

Manders, I G; Stoecklein, K; Lubach, C H C; Bijl-Oeldrich, J; Nanayakkara, P W B; Rauwerda, J A; Kramer, M H H; Eekhoff, E M W

2016-06-01

To investigate the feasibility, safety and efficacy of the Nurse-Driven Diabetes In-Hospital Treatment protocol (N-DIABIT), which consists of nurse-driven correctional therapy, in addition to physician-guided basal therapy, and is carried out by trained ward nurses. Data on 210 patients with diabetes consecutively admitted in the 5-month period after the introduction of N-DIABIT (intervention group) were compared with the retrospectively collected data on 200 consecutive patients with diabetes admitted in the 5-month period before N-DIABIT was introduced (control group). Additional per-protocol analyses were performed in patients in whom mean patient-based protocol adherence was ≥ 70% (intervention subgroup, n = 173 vs. control subgroup, n = 196). There was no difference between the intervention and the control group in mean blood glucose levels (8.9 ± 0.1 and 9.1 ± 0.2 mmol/l, respectively; P = 0.38), consecutive hyperglycaemic (blood glucose ≥ 10.0 mmol/l) episodes; P = 0.15), admission duration (P = 0.79), mean number of blood glucose measurements (P = 0.21) and incidence of severe hypoglycaemia (P = 0.29). Per-protocol analyses showed significant reductions in mean blood glucose levels and consecutive hypoglycaemia and hyperglycaemia in the intervention compared with the control group. Implementation of N-DIABIT by trained ward nurses in non-intensive care unit diabetes care is feasible, safe and non-inferior to physician-driven care alone. High protocol adherence was associated with improved glycaemic control. © 2015 Diabetes UK.

[Sterility in drained serums; before their use in emergency wards and in non-hospital emergency use].

PubMed

Carrasco, Juan Antonio Péculo; Escorza, Juana Gómez; Sánchez, María Del Mar Casal; Bouza, Mónica Rodríguez; Sanchez, José Luis Avecilla; Ruiz, Hugo José Rodríguez

2008-01-01

The authors detail the characteristics for the sterility of drained serums placed in a mobile emergency service unit and they determine how much time they can maintain optimum conditions for the use of these serums by means of a controlled, random, triple blind clinical test in which the units studied were serums prepared by an infusion system and a three-way valve. Data were gathered during a 12 month study period. The authors designed six operating groups based on their exposure time and where they were kept. These samples totaled 672 units. The authors carried out 12 microbiological cultural analyses for each unit; these analyses were tested for bacteria and fungi, both aerobic and anaerobic. The authors contrasted their hypothesis with a multivariable logistic regression model used as the variable for sterility A value of p < 0.05 was considered to be significant. Results were obtained on 669 serums, 98.82% of samples. Colonization was found in 1.7% of the 8028 cultures analyzed; in only 2 cases was there a register greater than 10 UFC/ml. This colonization corresponded to 103 serums which were then classified as non-sterile. For sterility the logistic regression model did not show any significant association with the various operating groups, which were controlled by means of two possible variable methods. The authors did not find evidence that recently drained serums were different, from the point of view of sterility, than the serums exposed during 24, 48 or 72 hours but, as well as for the groups, the incidences of these serums tripled the risk of colonization. The authors concluded they could use serums prepared previously and these serums sterility were guaranteed to the same degree as recently drained serums.

The price of a drink: the potential of alcohol minimum unit pricing as a public health measure in the UK.

PubMed

Rice, Peter; Drummond, Colin

2012-09-01

The UK has seen a dramatic increase in alcohol consumption and alcohol-related harm over the past 30 years. Alcohol taxation has long been considered a key method of controlling alcohol-related harm but a combination of factors has recently led to consideration of methods which affect the price of the cheapest alcohol as a means of improved targeting of alcohol control measures to curb the consumption of the heaviest drinkers. Although much of the evidence in favour of setting a minimum price of a unit of alcohol is based on complex econometric models rather than empirical data, all jurisdictions within the UK now intend to make selling alcohol below a set price illegal, which will provide a naturalistic experiment allowing assessment of the impact of minimum pricing.

Microprocessor-controlled hemodynamics: a step towards improved efficiency and safety.

PubMed

Keogh, B E; Jacobs, J; Royston, D; Taylor, K M

1989-02-01

Manual titration of sodium nitroprusside (SNP) is widely used for treatment of hypertension following cardiac surgery. This study compared conventional manual control with control by a research prototype of an automatic infusion module based on a proportional plus integral plus derivative (PID) negative feedback loop. Two groups of coronary artery bypass patients requiring SNP for postoperative hypertension were studied prospectively. In the first group, hypertension was controlled by manual adjustment of the SNP infusion rate, and in the second, the infusion rate was controlled automatically. The actual and desired mean arterial pressures (MAP) over consecutive ten-second epochs were recorded during the period of infusion. The MAP was maintained within 10% of the desired MAP 45.8% of the time in the manual group, compared with 90.0% in the automatic group, and the mean percent error in the automatic group was significantly less than in the manual group (P less than 0.01). It is concluded that adoption of such systems will result in improved patient safety and may facilitate more effective distribution of nursing staff within intensive care units.

Prostitution, AIDS, and preventive health behavior.

PubMed

Campbell, C A

1991-01-01

Although considerable attention has been placed on the role of prostitutes in the AIDS epidemic, little attention has been directed to features of prostitutes' work lives which are relevant to the control of AIDS. This article reviews several aspects of prostitution in the United States which have implications for control of the epidemic. The article first reviews the epidemiology of human immunodeficiency virus (HIV) infection among prostitutes. The legalized system of prostitution in Nevada serves as a basis for comparison to illegal prostitution. This article examines the effectiveness of mandatory testing of prostitutes for monitoring and controlling the epidemic. And finally, a peer education approach as a means to control HIV infection among prostitutes is explored.

Vibration characterization and control of miniature Stirling-cycle cryocoolers for space application

NASA Technical Reports Server (NTRS)

Ross, R. G., Jr.; Johnson, D. L.; Kotsubo, V.

1991-01-01

This paper provides a summary overview of the vibration characteristics of split Stirling cryocoolers of the Oxford type and describes means being developed to achieve vibration levels consistent with the exacting requirements of sensitive infrared spectrometer instruments currently under development for NASA applications. A key emphasis of the paper is on exploring both active and passive means of reducing the residual upper harmonics of the drive frequency that remain with nulled back-to-back compressor and displacer units. Vibration supression results, measured with JPL's unique six-DOF force dynamometer, are presented for an 80 K Stirling cooler.

An experimental model to measure the ability of headphones with active noise control to reduce patient's exposure to noise in an intensive care unit.

PubMed

Gallacher, Stuart; Enki, Doyo; Stevens, Sian; Bennett, Mark J

2017-10-17

Defining the association between excessive noise in intensive care units, sleep disturbance and morbidity, including delirium, is confounded by the difficulty of implementing successful strategies to reduce patient's exposure to noise. Active noise control devices may prove to be useful adjuncts but there is currently little to quantify their ability to reduce noise in this complex environment. Sound meters were embedded in the auditory meatus of three polystyrene model heads with no headphones (control), with headphones alone and with headphones using active noise control and placed in patient bays in a cardiac ICU. Ten days of recording sound levels at a frequency of 1 Hz were performed, and the noise levels in each group were compared using repeated measures MANOVA and subsequent pairwise testing. Multivariate testing demonstrated that there is a significant difference in the mean noise exposure levels between the three groups (p < 0.001). Subsequent pairwise testing between the three groups shows that the reduction in noise is greatest with headphones and active noise control. The mean reduction in noise exposure between the control and this group over 24 h is 6.8 (0.66) dB. The use of active noise control was also associated with a reduction in the exposure to high-intensity sound events over the course of the day. The use of active noise cancellation, as delivered by noise-cancelling headphones, is associated with a significant reduction in noise exposure in our model of noise exposure in a cardiac ICU. This is the first study to look at the potential effectiveness of active noise control in adult patients in an intensive care environment and shows that active noise control is a candidate technology to reduce noise exposure levels the patients experience during stays on intensive care.

40 CFR 63.1402 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... properties may vary with time. For a unit operation operated in a batch mode (i.e., batch unit operation... means a unit operation operated in a batch mode. Block means the time period that comprises a single batch cycle. Combustion device burner means a device designed to mix and ignite fuel and air to provide...

40 CFR 63.1402 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... properties may vary with time. For a unit operation operated in a batch mode (i.e., batch unit operation... means a unit operation operated in a batch mode. Block means the time period that comprises a single batch cycle. Combustion device burner means a device designed to mix and ignite fuel and air to provide...

40 CFR 63.1402 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... properties may vary with time. For a unit operation operated in a batch mode (i.e., batch unit operation... means a unit operation operated in a batch mode. Block means the time period that comprises a single batch cycle. Combustion device burner means a device designed to mix and ignite fuel and air to provide...

40 CFR 63.1402 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... properties may vary with time. For a unit operation operated in a batch mode (i.e., batch unit operation... means a unit operation operated in a batch mode. Block means the time period that comprises a single batch cycle. Combustion device burner means a device designed to mix and ignite fuel and air to provide...

40 CFR 63.1402 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... properties may vary with time. For a unit operation operated in a batch mode (i.e., batch unit operation... means a unit operation operated in a batch mode. Block means the time period that comprises a single batch cycle. Combustion device burner means a device designed to mix and ignite fuel and air to provide...

Multifaceted intervention to decrease the rate of severe postpartum haemorrhage: the PITHAGORE6 cluster-randomised controlled trial

PubMed Central

Deneux-Tharaux, Catherine; Dupont, Corinne; Colin, C.; Rabilloud, Muriel; Touzet, S.; Lansac, Jacques; Harvey, Thierry; Tessier, Véronique; Chauleur, C.; Pennehouat, G.; Morin, X.; Bouvier-Colle, Marie-Hélène; Rudigoz, René

2010-01-01

Objective Decreasing the prevalence of severe postpartum haemorrhages (PPH) is a major obstetrical challenge. These are often considered to be associated with substandard initial care. Strategies to increase the appropriateness of early management of PPH must be assessed. We tested the hypothesis that a multifaceted intervention aimed at increasing the translation into practice of a protocol for early management of PPH, would reduce the incidence of severe PPH. Design Cluster-randomised trial Population 106 maternity units in 6 French regions Methods Maternity units were randomly assigned to receive the intervention, or to have the protocol passively disseminated. The intervention combined outreach visits to discuss the protocol in each local context, reminders, and peer reviews of severe cases, and was implemented in each maternity hospital by a team pairing an obstetrician and a midwife. Main outcome measures The primary outcome was the incidence of severe PPH, defined as a composite of one or more of: transfusion, embolisation, surgical procedure, transfer to intensive care, peripartum haemoglobin delta of 4 g/dl or more, death. The main secondary outcomes were PPH management practices. Results The mean rate of severe PPH was 1.64% (SD0.80) in the intervention units and 1.65% (SD0.96) in control units; difference not significant. Some elements of PPH management were applied more frequently in intervention units –help from senior staff (p=0.005)-, or tended to – second line pharmacological treatment (p=0.06), timely blood test (p=0.09). Conclusion This educational intervention did not affect the rate of severe PPH as compared to control units, although it improved some practices. Trial registration: ClinicalTrials.gov NCT 00344929 PMID:20573150

Shortened telomeres in individuals with abuse in alcohol consumption

PubMed Central

Pavanello, Sofia; Hoxha, Mirjam; Dioni, Laura; Bertazzi, Pier Alberto; Snenghi, Rossella; Nalesso, Alessandro; Ferrara, Santo Davide; Montisci, Massimo; Baccarelli, Andrea

2011-01-01

Alcohol abuse leads to earlier onset of aging-related diseases, including cancer at multiple sites. Shorter telomere length (TL) in peripheral blood leucocytes (PBLs), a marker of biological aging, has been associated with alcohol-related cancer risks. Whether alcohol abusers exhibit accelerated biological aging, as reflected in PBL-TL, has never been examined. To investigated the effect of alcohol abuse on PBL-TL and its interaction with alcohol metabolic genotypes, we examined 200 drunk-driving traffic offenders diagnosed as alcohol abusers as per the Diagnostic and Statistical Manual of Mental Disorders [DSM-IV-TR] and enrolled in a probation program, and 257 social drinkers (controls). We assessed alcohol intake using self-reported drink-units/day and conventional alcohol abuse biomarkers (serum γ-glutamyltrasferase [GGT] and mean corpuscular volume of erythrocytes [MCV]). We used multivariable models to compute TL geometric means (GM) adjusted for age, smoking, BMI, diet, job at elevated risk of accident, genotoxic exposures. TL was nearly halved in alcohol abusers compared to controls (GMs 0.42 vs. 0.87 relative T/S ratio; P<0.0001) and decreased in relation with increasing drink-units/day (P-trend=0.003). Individuals drinking >4 drink-units/day had substantially shorter TL than those drinking 4 drink-units/day (GMs 0.48 vs. 0.61 T/S, P=0.002). Carriers of the common ADH1B*1/*1 (rs1229984) genotype were more likely to be abusers (P=0.008), reported higher drink-units/day (P=0.0003), and exhibited shorter TL (P<0.0001). The rs698 ADH1C and rs671 ALDH2 polymorphisms were not associated with TL. The decrease in PBL-TL modulated by the alcohol metabolic genotype ADH1B*1/*1 may represent a novel mechanism potentially related to alcohol carcinogenesis in alcohol abusers. PMID:21351086

Shortened telomeres in individuals with abuse in alcohol consumption.

PubMed

Pavanello, Sofia; Hoxha, Mirjam; Dioni, Laura; Bertazzi, Pier Alberto; Snenghi, Rossella; Nalesso, Alessandro; Ferrara, Santo Davide; Montisci, Massimo; Baccarelli, Andrea

2011-08-15

Alcohol abuse leads to earlier onset of aging-related diseases, including cancer at multiple sites. Shorter telomere length (TL) in peripheral blood leucocytes (PBLs), a marker of biological aging, has been associated with alcohol-related cancer risks. Whether alcohol abusers exhibit accelerated biological aging, as reflected in PBL-TL, has never been examined. To investigated the effect of alcohol abuse on PBL-TL and its interaction with alcohol metabolic genotypes, we examined 200 drunk-driving traffic offenders diagnosed as alcohol abusers as per the Diagnostic and Statistical Manual of Mental Disorders [DSM-IV-TR] and enrolled in a probation program, and 257 social drinkers (controls). We assessed alcohol intake using self-reported drink-units/day and conventional alcohol abuse biomarkers (serum γ-glutamyltrasferase [GGT] and mean corpuscular volume of erythrocytes [MCV]). We used multivariable models to compute TL geometric means (GM) adjusted for age, smoking, BMI, diet, job at elevated risk of accident, genotoxic exposures. TL was nearly halved in alcohol abusers compared with controls (GMs 0.42 vs. 0.87 relative T/S ratio; p<0.0001) and decreased in relation with increasing drink-units/day (p-trend=0.003). Individuals drinking >4 drink-units/day had substantially shorter TL than those drinking ≤4 drink-units/day (GMs 0.48 vs. 0.61 T/S, p=0.002). Carriers of the common ADH1B*1/*1 (rs1229984) genotype were more likely to be abusers (p=0.008), reported higher drink-units/day (p=0.0003), and exhibited shorter TL (p<0.0001). The rs698 ADH1C and rs671 ALDH2 polymorphisms were not associated with TL. The decrease in PBL-TL modulated by the alcohol metabolic genotype ADH1B*1/*1 may represent a novel mechanism potentially related to alcohol carcinogenesis in alcohol abusers. Copyright © 2011 UICC.

Weight Control Intervention for Truck Drivers: The SHIFT Randomized Controlled Trial, United States

PubMed Central

Wipfli, Brad; Thompson, Sharon V.; Elliot, Diane L.; Anger, W. Kent; Bodner, Todd; Hammer, Leslie B.; Perrin, Nancy A.

2016-01-01

Objectives. To evaluate the effectiveness of the Safety and Health Involvement For Truckers (SHIFT) intervention with a randomized controlled design. Methods. The multicomponent intervention was a weight-loss competition supported with body weight and behavioral self-monitoring, computer-based training, and motivational interviewing. We evaluated intervention effectiveness with a cluster-randomized design involving 22 terminals from 5 companies in the United States in 2012 to 2014. Companies were required to provide interstate transportation services and operate at least 2 larger terminals. We randomly assigned terminals to intervention or usual practice control conditions. We assessed participating drivers (n = 452) at baseline and 6 months. Results. In an intent-to-treat analysis, the postintervention difference between groups in mean body mass index change was 1.00 kilograms per meters squared (P < .001; intervention = −0.73; control = +0.27). Behavioral changes included statistically significant improvements in fruit and vegetable consumption and physical activity. Conclusions. Results establish the effectiveness of a multicomponent and remotely administered intervention for producing significant weight loss among commercial truck drivers. PMID:27463067

Weight Control Intervention for Truck Drivers: The SHIFT Randomized Controlled Trial, United States.

PubMed

Olson, Ryan; Wipfli, Brad; Thompson, Sharon V; Elliot, Diane L; Anger, W Kent; Bodner, Todd; Hammer, Leslie B; Perrin, Nancy A

2016-09-01

To evaluate the effectiveness of the Safety and Health Involvement For Truckers (SHIFT) intervention with a randomized controlled design. The multicomponent intervention was a weight-loss competition supported with body weight and behavioral self-monitoring, computer-based training, and motivational interviewing. We evaluated intervention effectiveness with a cluster-randomized design involving 22 terminals from 5 companies in the United States in 2012 to 2014. Companies were required to provide interstate transportation services and operate at least 2 larger terminals. We randomly assigned terminals to intervention or usual practice control conditions. We assessed participating drivers (n = 452) at baseline and 6 months. In an intent-to-treat analysis, the postintervention difference between groups in mean body mass index change was 1.00 kilograms per meters squared (P < .001; intervention = -0.73; control = +0.27). Behavioral changes included statistically significant improvements in fruit and vegetable consumption and physical activity. Results establish the effectiveness of a multicomponent and remotely administered intervention for producing significant weight loss among commercial truck drivers.

Televised state-sponsored antitobacco advertising and youth smoking beliefs and behavior in the United States, 1999-2000.

PubMed

Emery, Sherry; Wakefield, Melanie A; Terry-McElrath, Yvonne; Saffer, Henry; Szczypka, Glen; O'Malley, Patrick M; Johnston, Lloyd D; Chaloupka, Frank J; Flay, Brian

2005-07-01

Recent state budget crises have dramatically reduced funding for state-sponsored antitobacco media campaigns. If campaigns are associated with reduced smoking, such cuts could result in long-term increases in state health care costs. Commercial ratings data on mean audience exposure to antitobacco advertising that appeared on network and cable television across the largest 75 media markets in the United States for 1999 through 2000 were combined with nationally representative survey data from school-based samples of youth in the contiguous 48 states. Multivariate regression models were used to analyze associations between mean exposure to state antitobacco advertising and youth smoking-related beliefs and behaviors, controlling for individual and environmental factors usually associated with youth smoking and other televised tobacco-related advertising. Mean exposure to at least 1 state-sponsored antitobacco advertisement in the past 4 months was associated with lower perceived rates of friends' smoking (odds ratio [OR], 0.72; 95% confidence interval [CI], 0.58-0.88), greater perceived harm of smoking (OR, 1.25; 95% CI, 1.11-1.42), stronger intentions not to smoke in the future (OR, 1.43; 95% CI, 1.17-1.74), and lower odds of being a smoker (OR, 0.74; 95% CI, 0.63-0.88). To our knowledge, this study is the first to explore the potential impact of state-sponsored antitobacco media campaigns while controlling for other tobacco-related advertising and other tobacco control policies. State-sponsored antitobacco advertising is associated with desired outcomes of greater antitobacco sentiment and reduced smoking among youth. Recent cuts in these campaigns may have future negative health and budgetary consequences.

[Stress level assessment of the nursing staff in the Intensive Care Unit of a university hospital].

PubMed

Carrillo-García, C; Ríos-Rísquez, M I; Martínez-Hurtado, R; Noguera-Villaescusa, P

2016-01-01

The objective was to determine the work stress level among nursing staff in the Intensive Care Unit of a university hospital and to analyse its relationship with the various sociodemographic and working variables of the studied sample. A study was designed using a quantitative, descriptive and cross-sectional approach. The target population of the study was the nursing staff selected by non-random sampling. The instrument used was the Job Content Questionnaire. Data analysis was performed using SPSS 20. The mean, ranges and standard deviation for each of the variables were calculated. A bivariate analysis was also performed on the social and occupational variables of the sample. The participation rate was 80.90% (N=89). The mean of the Social support dimension was 3.13±0.397, for the Psychological demands at work dimension it was 3.10±0.384, with a mean of 2.96±0.436 being obtained for the Control over the work dimension. In the analysis of sociodemographic and work variables of the sample, only the professional category was significant, with nurses recording higher values in perception of job demands and control over their work compared to nursing assistants. In conclusion, there is a moderate perception of work stress in the analysed group of professionals. Among the sources of stress in the workplace was the low control in decision-making by practitioners, as well as the need to continually learn new things. On the other hand, the support received from colleagues is valued positively by the sample. Copyright © 2016 Elsevier España, S.L.U. y SEEIUC. All rights reserved.

Effect of education based on the “4A Model” on the Iranian nurses’ moral distress in CCU wards

PubMed Central

Molazem, Zahra; Tavakol, Nahid; Sharif, Farkhondeh; Keshavarzi, Sareh; Ghadakpour, Soraya

2013-01-01

Complexity of health care has caused ethical dilemmas and moral distress to be quite unavoidable for nurses. Moral distress is a major, highly prevalent problem in the nursing profession. The study aims to investigate the effect of education based on the “4A model” on the rate of moral distress among the nurses working in Cardiac Care Units (CCU). The participants consisted of 60 nurses working in Cardiac Care Units (CCU), 30 in the control and 30 in the intervention group. Those in the intervention group took part in the educational workshop about “moral distress” and “4A model”. The moral distress questionnaire was completed by both study groups 1 and 2 months after the intervention. After the intervention, the results of repeated measures analysis of variance revealed a significant difference in the moral distress mean scores between the intervention and the control groups (P<0.001) and within the two groups (P<0.001). Moreover, a significant difference was found between the two study groups regarding the mean score of moral distress 1 and 2 months after the intervention. The findings of the current study revealed a decreasing trend in the moral distress mean score in the intervention group, while there was an increasing trend in the control group after the intervention. It can be concluded that the “4A model” can be used for reducing moral distress and educational interventions can reduce the rate of moral distress among nurses. Authors of this study recommend that more studies with larger sample sizes be conducted in different hospital wards as well. PMID:23967371

Why are Chinese Mothers More Controlling than American Mothers? “My Child is My Report Card”

PubMed Central

Ng, Florrie Fei-Yin; Pomerantz, Eva M.; Deng, Ciping

2013-01-01

Chinese parents exert more control over children than do American parents. The current research examined whether this is due in part to Chinese parents' feelings of worth being more contingent on children's performance. Twice over a year, 215 mothers and children (mean age = 12.86 years) in China and the United States (European and African Americans) reported on psychologically controlling parenting. Mothers also indicated the extent to which their worth is contingent on children's performance. Psychologically controlling parenting was higher among Chinese than American mothers, particularly European (vs. African) American mothers. Chinese (vs. American) mothers' feelings of worth were more contingent on children's performance, with this contributing to their heightened psychological control relative to American mothers. PMID:23581633

Adolescents’ use of purpose built shade in secondary schools: cluster randomised controlled trial

PubMed Central

White, Vanessa; Wakefield, Melanie A; Jamsen, Kris M; White, Victoria; Livingston, Patricia M; English, Dallas R; Simpson, Julie A

2009-01-01

Objective To examine whether students use or avoid newly shaded areas created by shade sails installed at schools. Design Cluster randomised controlled trial with secondary schools as the unit of randomisation. Setting 51 secondary schools with limited available shade, in Australia, assessed over two spring and summer terms. Participants Students outside at lunch times. Intervention Purpose built shade sails were installed in winter 2005 at full sun study sites to increase available shade for students in the school grounds. Main outcome measure Mean number of students using the primary study sites during weekly observations at lunch time. Results Over the study period the mean change in students using the primary study site from pre-test to post-test was 2.63 (95% confidence interval 0.87 to 4.39) students in intervention schools and −0.03 (−1.16 to 1.09) students in control schools. The difference in mean change between groups was 2.67 (0.65 to 4.68) students (P=0.011). Conclusions Students used rather than avoided newly shaded areas provided by purpose built shade sails at secondary schools in this trial, suggesting a practical means of reducing adolescents’ exposure to ultraviolet radiation. Trial registration Exempt. PMID:19223344

The intelligence of observation: improving high school students' spatial ability by means of intervention unit

NASA Astrophysics Data System (ADS)

Patkin, Dorit; Dayan, Ester

2013-03-01

This case study of one class versus a control group focused on the impact of an intervention unit, which is not part of the regular curriculum, on the improvement of spatial ability of high school students (forty-six 12th-graders, aged 17-18, both boys and girls) in general as well as from a gender perspective. The study explored three sub-abilities: mental rotation (MR), spatial visualization (VS) and spatial orientation (SO). Findings indicated that the spatial orientation of the experimental group students had considerably improved. The findings also illustrated a significant gender-based advantage in favour of the boys in some of the spatial abilities even before the implementation of the intervention unit. The hypothesis relating to the reduction of the gender differences was not corroborated.

Validation of a proposal for evaluating hospital infection control programs.

PubMed

Silva, Cristiane Pavanello Rodrigues; Lacerda, Rúbia Aparecida

2011-02-01

To validate the construct and discriminant properties of a hospital infection prevention and control program. The program consisted of four indicators: technical-operational structure; operational prevention and control guidelines; epidemiological surveillance system; and prevention and control activities. These indicators, with previously validated content, were applied to 50 healthcare institutions in the city of São Paulo, Southeastern Brazil, in 2009. Descriptive statistics were used to characterize the hospitals and indicator scores, and Cronbach's α coefficient was used to evaluate the internal consistency. The discriminant validity was analyzed by comparing indicator scores between groups of hospitals: with versus without quality certification. The construct validity analysis was based on exploratory factor analysis with a tetrachoric correlation matrix. The indicators for the technical-operational structure and epidemiological surveillance presented almost 100% conformity in the whole sample. The indicators for the operational prevention and control guidelines and the prevention and control activities presented internal consistency ranging from 0.67 to 0.80. The discriminant validity of these indicators indicated higher and statistically significant mean conformity scores among the group of institutions with healthcare certification or accreditation processes. In the construct validation, two dimensions were identified for the operational prevention and control guidelines: recommendations for preventing hospital infection and recommendations for standardizing prophylaxis procedures, with good correlation between the analysis units that formed the guidelines. The same was found for the prevention and control activities: interfaces with treatment units and support units were identified. Validation of the measurement properties of the hospital infection prevention and control program indicators made it possible to develop a tool for evaluating these programs in an ethical and scientific manner in order to obtain a quality diagnosis in this field.

Motor Unit Number Estimate and Isometric Hand Grip Strength in Military Veterans with or Without Muscular Complaints: Reference Values for Longitudinal Follow-up.

PubMed

Li, Mian; Yao, Wenguo; Sundahl, Cynthia

2018-03-26

It remains unclear if Gulf War (GW) veterans have a higher risk of developing motor neuron disorder. We intended to establish baseline neurophysiological values, including thenar motor unit number estimate (MUNE) and isometric hand grip (IHG) strength, to compare future follow-ups of deployed GW veterans with or without muscular complaints. We evaluated 19 GW veterans with self-reported weakness, cramps, or excessive muscle fatigue (Ill-19) and compared them with 18 controls without such muscular complaints (C-18). We performed MUNE on hand thenar muscles using adapted multipoint stimulation method for Ill-19 and 15 controls (C-15). We measured IHG strength (maximum force, endurance, and fatigue level) on Ill-19 and C-18 with a hand dynamometer. We performed nerve conduction studies on all study participants to determine which subjects had mild carpal tunnel syndrome (CTS). We compared the MUNE and IHG strength measures between Ill group and controls and between those with CTS and those without CTS. We obtained thenar MUNE of Ill-19 (95% CI of mean: 143-215; mean age: 46 yr) and compared it with that of C-15 (95% CI of mean: 161-230; mean age: 45 yr), and 95% of CI of mean among IHG strength variables (maximum force: 324-381 Newton; endurance: 32-42 s; fatigue level: 24%-33%) compared with C-18 (maximum force: 349-408 Newton; endurance: 35-46 s; fatigue level: 21%-27%). There was no significant difference in either MUNE or IHG strength between Ill-19 group and controls. The MUNE and IHG maximum forces were significantly lower in those with CTS compared with those without CTS. As a surrogate of mild CTS, the median versus ulnar distal sensory latency on nerve conduction study was only weakly associated with MUNE, maximum force, and fatigue level, respectively. To our knowledge, no published study on MUNE reference values of military veteran population has been available. The quantifiable values of both thenar MUNE and IHG strength of military veterans serve as baselines for our longitudinal follow-up of motor neuron function of deployed troops. These reference values are also useful for other laboratories to study veterans' motor system with or without mild CTS.

Hand held phase-shifting diffraction Moire interferometer

DOEpatents

Deason, V.A.; Ward, M.B.

1994-09-20

An interferometer is described in which a coherent beam of light is generated within a remote case and transmitted to a hand held unit tethered to said remote case, said hand held unit having optical elements for directing a pair of mutually coherent collimated laser beams at a diffraction grating. Data from the secondary or diffracted beams are then transmitted to a separate video and data acquisition system for recording and analysis for load induced deformation or for identification purposes. Means are also provided for shifting the phase of one incident beam relative to the other incident beam and being controlled from within said remote case. 4 figs.

Lumbar extensor muscle force control is associated with disability in people with chronic low back pain.

PubMed

Pranata, Adrian; Perraton, Luke; El-Ansary, Doa; Clark, Ross; Fortin, Karine; Dettmann, Tim; Brandham, Robert; Bryant, Adam

2017-07-01

The ability to control lumbar extensor force output is necessary for daily activities. However, it is unknown whether this ability is impaired in chronic low back pain patients. Similarly, it is unknown whether lumbar extensor force control is related to the disability levels of chronic low back pain patients. Thirty-three chronic low back pain and 20 healthy people performed lumbar extension force-matching task where they increased and decreased their force output to match a variable target force within 20%-50% maximal voluntary isometric contraction. Force control was quantified as the root-mean-square-error between participants' force output and target force across the entire, during the increasing and decreasing portions of the force curve. Within- and between-group differences in force-matching error and the relationship between back pain group's force-matching results and their Oswestry Disability Index scores were assessed using ANCOVA and linear regression respectively. Back pain group demonstrated more overall force-matching error (mean difference=1.60 [0.78, 2.43], P<0.01) and more force-matching error while increasing force output (mean difference=2.19 [1.01, 3.37], P<0.01) than control group. The back pain group demonstrated more force-matching error while increasing than decreasing force output (mean difference=1.74, P<0.001, 95%CI [0.87, 2.61]). A unit increase in force-matching error while decreasing force output is associated with a 47% increase in Oswestry score in back pain group (R 2 =0.19, P=0.006). Lumbar extensor muscle force control is compromised in chronic low back pain patients. Force-matching error predicts disability, confirming the validity of our force control protocol for chronic low back pain patients. Copyright © 2017 Elsevier Ltd. All rights reserved.

Australian tiger snake (Notechis scutatus) and mexican coral snake (Micruris species) antivenoms prevent death from United States coral snake (Micrurus fulvius fulvius) venom in a mouse model.

PubMed

Wisniewski, Michael S; Hill, Robert E; Havey, Joshua M; Bogdan, Gregory M; Dart, Richard C

2003-01-01

Wyeth-Ayerst has discontinued production of Antivenin (Micrurus fulvius). Currently, there is no other approved coral snake antivenom available in the United States. This study was a randomized, placebo-controlled and blinded determination of the ability of a Mexican Micrurus (coral snake) antivenom and an Australian Notechis (tiger snake) antivenom to prevent lethality from a United States Micrurus fulvius fulvius venom in a mouse model. Venom dosing was based on an LD50 determined for this experiment. Our comparison groups included: (1) M. f. fulvius venom + Micrurus antivenom, (2) M. f. fulvius venom + Notechis antivenom, (3) M. f. fulvius venom + protein control, (4) 0.9% normal saline + protein control, (5) saline + Notechis antivenom, (6) saline + Micrurus antivenom. Venom dose was 5 times the determined LD50. The antivenom amounts were capable of neutralizing 10 times the venom injected (50 times the LD50). The LD50 of M. f. fulvius venom was determined to be 0.85 mg/kg. All mice in both antivenom test groups were protected from lethality for the entire 24-hour observation period. Six of the 7 mice in the venom test group died, with a survival time of 349 +/- 382 minutes (mean +/- s.d.) after the venom injection. All three groups of control mice survived the entire 24-hour observation period. Mexican Micrurus antivenom and Australian Notechis antivenom provide protection from lethality in mice envenomated with a United States M. f. filvius venom.

The effect of need-based spiritual/religious intervention on spiritual well-being and anxiety of elderly people.

PubMed

Elham, Hedayati; Hazrati, Maryam; Momennasab, Marzieh; Sareh, Keshavarzi

2015-01-01

Anxiety and spiritual distress are the most common problems among the patients admitted in intensive care units. The elderly are more vulnerable to this problem due to impairment of their adaptation mechanisms. Hence, helping to reduce anxiety is one of the most effective nursing interventions. Therefore, this study aimed at investigating the effect of need-based spiritual/religious interventions on spiritual well-being (SWB) and anxiety of the elderly admitted to coronary care unit (CCU). This quasi-experimental study with pre- and posttest control group design was conducted on 66 patients admitted to CCU of Imam Reza hospital in Lar, southern Iran, in 2014. After obtaining informed consents, the data were collected using the Spielberger State-Trait Anxiety Inventory, the SWB Scale, and a demographic questionnaire. The questionnaires were completed through interviewing the patients before and after the intervention. The participants of the intervention group underwent 60- to 90-minute sessions of spiritual and religious need-based interventions for 3 consecutive days. The results showed a significant increase in the mean scores of SWB in the intervention group after the intervention (P = .001). Also, a significant decrease was found in mean scores of trait and state anxiety in the intervention group in comparing to control group (P < .001). Moreover, a significant correlation was observed between the mean scores of SWB and state and trait anxiety. Spiritual/religious interventions could enhance SWB and reduce anxiety in the elderly admitted to CCU.

EFFECTS OF AROMATHERAPY MASSAGE ON THE SLEEP QUALITY AND PHYSIOLOGICAL PARAMETERS OF PATIENTS IN A SURGICAL INTENSIVE CARE UNIT.

PubMed

Özlü, Zeynep Karaman; Bilican, Pınar

2017-01-01

Surgical pain is experienced by inpatients with clinical, disease-related concerns, unknown encounters after surgery, quality of sleep, restrictions in position after surgery is known to be serious. The study was conducted to determine the effect of aromatherapy massage on quality of sleep and physiological parameters in surgical intensive care patients. This is an experimental study. The sample of this study consisted of 60 patients who were divided into two groups as experimental group and control group including 30 patients in each one. The participants were postoperative patients, absent complications, who were unconscious and extubated. A data collection form on personal characteristics of the patients, a registration form on their physical parameters and the Richards-Campbell Sleep Scale (RCSQ) were used to collect the data of the study. The Richards-Campbell Sleep Scale indicated that while the experimental group had a mean score of 53.80 ± 13.20, the control group had a mean score of 29.08 ± 9.71 and there was a statistically significant difference between mean scores of the groups. In a comparison of physiologic parameters, only diastolic blood pressure measuring between parameters in favor of an assembly as a statistically significant difference was detected. Results of the study showed that aromatherapy massage enhanced the sleep quality of patients in a surgical intensive care unit and resulted in some positive changes in their physiological parameters.

EFFECTS OF AROMATHERAPY MASSAGE ON THE SLEEP QUALITY AND PHYSIOLOGICAL PARAMETERS OF PATIENTS IN A SURGICAL INTENSIVE CARE UNIT

PubMed Central

Özlü, Zeynep Karaman; Bilican, Pınar

2017-01-01

Background: Surgical pain is experienced by inpatients with clinical, disease-related concerns, unknown encounters after surgery, quality of sleep, restrictions in position after surgery is known to be serious. The study was conducted to determine the effect of aromatherapy massage on quality of sleep and physiological parameters in surgical intensive care patients. Materials and Methods: This is an experimental study. The sample of this study consisted of 60 patients who were divided into two groups as experimental group and control group including 30 patients in each one. The participants were postoperative patients, absent complications, who were unconscious and extubated. A data collection form on personal characteristics of the patients, a registration form on their physical parameters and the Richards-Campbell Sleep Scale (RCSQ) were used to collect the data of the study. Results: The Richards-Campbell Sleep Scale indicated that while the experimental group had a mean score of 53.80 ± 13.20, the control group had a mean score of 29.08 ± 9.71 and there was a statistically significant difference between mean scores of the groups. In a comparison of physiologic parameters, only diastolic blood pressure measuring between parameters in favor of an assembly as a statistically significant difference was detected. Conclusions: Results of the study showed that aromatherapy massage enhanced the sleep quality of patients in a surgical intensive care unit and resulted in some positive changes in their physiological parameters. PMID:28480419

Anti-Nociceptive Effects of Elcatonin Injection for Postmenopausal Women with Back Pain: A Randomized Controlled Trial

PubMed Central

Ikegami, Shota; Kamimura, Mikio; Uchiyama, Shigeharu; Nakagawa, Hiroyuki; Hashidate, Hiroyuki; Takahara, Kenji; Takahashi, Jun; Kato, Hiroyuki

2010-01-01

Background: Eel calcitonin (elcatonin) injection is widely used for elderly patients suffering from somatic pain in Japan. However, there have been few reports on the analgesic effects of elcatonin injection. The purpose of this study was to examine the analgesic effects of elcatonin injection in postmenopausal women with lower back pain. Methods: This study was designed as a double-blind, randomized, placebo-controlled study. Thirty-six women aged ≥50 years with acute lower back pain participated in this study. They were randomly divided into two treatment groups according to whether they received a placebo or a weekly trigger point injection of elcatonin (20 units). They were observed for 5 weeks and the extent of pain at motion and at rest according to the visual analog scale (VAS) was evaluated. The mean VAS scores for the elcatonin group were then compared with those of the placebo group. Results: There were no statistically significant differences in the mean VAS scores for pain at rest between the two groups during the 5-week treatment course. However, the mean VAS scores for motion pain in the elcatonin group were significantly lower than those in the placebo group at the third, fifth and sixth weeks. Conclusions: Elcatonin injection (20 units) significantly relieved motion pain in the lower back in postmenopausal women after three weeks of treatment. This analgesic effect continued for the subsequent 3 weeks. PMID:20448810

Relationship between fatigue, perfectionism, and functional dysphonia.

PubMed

O'Hara, James; Miller, Tracey; Carding, Paul; Wilson, Janet; Deary, Vincent

2011-06-01

Increased levels of fatigue and perfectionism were noted during evaluation of cognitive behavioral therapy for the treatment of functional dysphonia. The investigators thus aimed to explore levels of general fatigue and perfectionism in patients with functional dysphonia and controls. Case-control study. Teaching hospital, United Kingdom. Patients recruited through speech therapy were asked to recruit a friend as a control, of the same sex and within 5 years of their age. An 11-point fatigue questionnaire, previously validated on a normal population, was analyzed using both Likert (0123) and bimodal (0011) systems, with a score greater than 4 on the bimodal system implying substantial fatigue. A 35-point perfectionism questionnaire was also completed and analyzed for "healthy" and "unhealthy" perfectionist traits. There were 75 cases and 62 controls. The mean fatigue score in patients with functional dysphonia was 17.0 and 14.4 for the controls (Likert, P = .009). Under the bimodal scoring system, the mean fatigue scores in functional dysphonia (5.10) and controls (3.01) were also significantly different (P = .003). The mean perfectionism scores were 98.9 for patients with functional dysphonia and 91.2 for controls (P = 0.043). To the investigators' knowledge, this is the first substantial report that fatigue and perfectionism scores are significantly elevated in functional dysphonia. Functional dysphonia is shown to be analogous to other medically unexplained physical symptoms that are also marked by generic somatopsychic distress and for which multiple factors are implicated in their onset and maintenance. This has implications for both research and treatment.

Comparison of Insulin Glargine 300 Units/mL and 100 Units/mL in Adults With Type 1 Diabetes: Continuous Glucose Monitoring Profiles and Variability Using Morning or Evening Injections.

PubMed

Bergenstal, Richard M; Bailey, Timothy S; Rodbard, David; Ziemen, Monika; Guo, Hailing; Muehlen-Bartmer, Isabel; Ahmann, Andrew J

2017-04-01

The objective of this study was to compare glucose control in participants with type 1 diabetes receiving insulin glargine 300 units/mL (Gla-300) or glargine 100 units/mL (Gla-100) in the morning or evening, in combination with mealtime insulin. In this 16-week, exploratory, open-label, parallel-group, two-period crossover study (clinicaltrials.gov identifier NCT01658579), 59 adults with type 1 diabetes were randomized (1:1:1:1) to once-daily Gla-300 or Gla-100 given in the morning or evening (with crossover in the injection schedule). The primary efficacy end point was the mean percentage of time in the target glucose range (80-140 mg/dL), as measured using continuous glucose monitoring (CGM), during the last 2 weeks of each 8-week period. Additional end points included other CGM glycemic control parameters, hypoglycemia (per self-monitored plasma glucose [SMPG]), and adverse events. The percentage of time within the target glucose range was comparable between the Gla-300 and Gla-100 groups. There was significantly less increase in CGM-based glucose during the last 4 h of the 24-h injection interval for Gla-300 compared with Gla-100 (least squares mean difference -14.7 mg/dL [95% CI -26.9 to -2.5]; P = 0.0192). Mean 24-h glucose curves for the Gla-300 group were smoother (lower glycemic excursions), irrespective of morning or evening injection. Four metrics of intrasubject interstitial glucose variability showed no difference between Gla-300 and Gla-100. Nocturnal confirmed (<54 mg/dL by SMPG) or severe hypoglycemia rate was lower for Gla-300 participants than for Gla-100 participants (4.0 vs. 9.0 events per participant-year; rate ratio 0.45 [95% CI 0.24-0.82]). Less increase in CGM-based glucose levels in the last 4 h of the 24-h injection interval, smoother average 24-h glucose profiles irrespective of injection time, and reduced nocturnal hypoglycemia were observed with Gla-300 versus Gla-100. © 2017 by the American Diabetes Association.

The relationship between three-dimensional knee MRI bone shape and total knee replacement—a case control study: data from the Osteoarthritis Initiative

PubMed Central

Barr, Andrew J.; Dube, Bright; Hensor, Elizabeth M. A.; Kingsbury, Sarah R.; Peat, George; Bowes, Mike A.; Sharples, Linda D.

2016-01-01

Objective. There is growing understanding of the importance of bone in OA. Our aim was to determine the relationship between 3D MRI bone shape and total knee replacement (TKR). Methods. A nested case-control study within the Osteoarthritis Initiative cohort identified case knees with confirmed TKR for OA and controls that were matched using propensity scores. Active appearance modelling quantification of the bone shape of all knee bones identified vectors between knees having or not having OA. Vectors were scaled such that −1 and +1 represented the mean non-OA and mean OA shapes. Results. Compared to controls (n = 310), TKR cases (n = 310) had a more positive mean baseline 3D bone shape vector, indicating more advanced structural OA, for the femur [mean 0.98 vs −0.11; difference (95% CI) 1.10 (0.88, 1.31)], tibia [mean 0.86 vs −0.07; difference (95% CI) 0.94 (0.72, 1.16)] and patella [mean 0.95 vs 0.03; difference (95% CI) 0.92 (0.65, 1.20)]. Odds ratios (95% CI) for TKR per normalized unit of 3D bone shape vector for the femur, tibia and patella were: 1.85 (1.59, 2.16), 1.64 (1.42, 1.89) and 1.36 (1.22, 1.50), respectively, all P < 0.001. After including Kellgren–Lawrence grade in a multivariable analysis, only the femur 3D shape vector remained significantly associated with TKR [odds ratio 1.24 (1.02, 1.51)]. Conclusion. 3D bone shape was associated with the endpoint of this study, TKR, with femoral shape being most associated. This study contributes to the validation of quantitative MRI bone biomarkers for OA structure-modification trials. PMID:27185958

Patient-Reported Factors Associated With Poor Phosphorus Control in a Maintenance Hemodialysis Population.

PubMed

Joson, Cherriday G; Henry, Shayna L; Kim, Sue; Cheung, Mandy Y; Parab, Prajakta; Abcar, Antoine C; Jacobsen, Steven J; Morisky, Donald E; Sim, John J

2016-05-01

The purpose of this study was to determine the influence of patient-reported medication adherence and phosphorus-related knowledge on phosphorus control and pharmacy-reported adherence to phosphorus binding medication among patients on maintenance hemodialysis. Retrospective, cross-sectional cohort study. Seventy-nine hemodialysis patients (mean age 64.2 years, SD = 14 years; 46.8% female) in a stand-alone hemodialysis unit within an integrated learning healthcare system. Ten percent (10%) of subjects were Caucasian, 42% Latino, 19% African American, and 29% Asian. Forty-eight percent had diabetes; 72% had BMI ≥ 30. Inclusion criteria included the provision of survey data and having medication refill data available in the pharmacy system. 77.2% had mean phosphorus levels ≤ 5.5 mg/dL; 22.8% had mean phosphorus levels > 5.5 mg/dL. Subjects were administered the 8-item Morisky Medication Adherence Scale (MMAS-8) and also reported on their phosphorus-related knowledge. Phosphorus levels within an adequate range. The mean serum phosphorus level was 4.96 mg/dL (SD = 1.21). In the well-controlled group, mean phosphorus was 4.44 mg/dL (SD = 0.76). In the poorly controlled group, mean phosphorus was 6.69 mg/dL (SD = 0.74). A total of 61% of patients reported at least some unintentional medication nonadherence, and 48% reported intentional medication nonadherence. Phosphorus-specific knowledge was low, with just under half of patients reporting that they could not name two high-phosphorus foods or identify a phosphorus-related health risk. Phosphorus binder-related nonadherence was substantially higher in the uncontrolled than the controlled group. Adjusting for age, individuals with poorer self-reported binder adherence were less likely to have controlled phosphorus levels (odds ratio = 0.71, P = .06). Phosphorus-related non-adherence, but not low phosphorus-specific knowledge, was associated with poorer phosphorus control. Such findings provide important information for the development of evidence-based strategies for improving phosphorus control among patients on dialysis. Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

8 CFR 215.1 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... is not a citizen or national of the United States. (b) The term Commissioner means the Commissioner... Alaska and Hawaii. (g) The term geographical part of the United States means: (1) The continental United... for any foreign place, or (2) from one geographical part of the United States for a separate...

8 CFR 215.1 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... is not a citizen or national of the United States. (b) The term Commissioner means the Commissioner... Alaska and Hawaii. (g) The term geographical part of the United States means: (1) The continental United... for any foreign place, or (2) from one geographical part of the United States for a separate...

8 CFR 215.1 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... is not a citizen or national of the United States. (b) The term Commissioner means the Commissioner... Alaska and Hawaii. (g) The term geographical part of the United States means: (1) The continental United... for any foreign place, or (2) from one geographical part of the United States for a separate...

Effectiveness of an infection control programmed unit of instruction in nursing education.

PubMed

Goldrick, B A

1987-02-01

To determine whether programmed instruction is an acceptable, cost-effective alternative to classroom lectures for teaching the basic principles of infection control to nursing students, a 46-frame programmed unit of instruction (PUI), with a pretest and posttest, was developed, piloted, and tested for reliability and validity. The instruments were developed on the basis of current knowledge of the epidemiology of infectious diseases and the 1983 revised Centers for Disease Control guideline for category-specific isolation precautions. A study was undertaken to test the hypothesis: Student nurses who take a PUI in the basic principles of infection control will score higher on posttests than those who do not take the PUI. A sample of 40 subjects was selected from the senior class in a baccalaureate nursing program at a public university. The subjects were randomly assigned to four groups of 10. A Solomon four-group design was used for data analysis, and a two-way analysis of variance was performed on the posttest means. Results indicated that the treatment (PUI) effect was significant (p less than 0.001). Therefore, it was concluded that the PUI in the basic principles of infection control is an effective instrument for nursing education.

Abnormal pulmonary function and respiratory muscle strength findings in Chinese patients with Parkinson's disease and multiple system atrophy--comparison with normal elderly.

PubMed

Wang, Yao; Shao, Wei-bo; Gao, Li; Lu, Jie; Gu, Hao; Sun, Li-hua; Tan, Yan; Zhang, Ying-dong

2014-01-01

There have been limited comparative data regarding the investigations on pulmonary and respiratory muscle function in the patients with different parkinsonism disorders such as Parkinson's disease (PD) and multiple system atrophy (MSA) versus normal elderly. The present study is aiming to characterize the performance of pulmonary function and respiratory muscle strength in PD and MSA, and to investigate the association with severity of motor symptoms and disease duration. Pulmonary function and respiratory muscle strength tests were performed in 30 patients with PD, 27 with MSA as well as in 20 age-, sex-, height-, weight-matched normal elderly controls. All the patients underwent United Parkinson's disease rating scale (UPDRS) or united multiple system atrophy rating scale (UMSARS) separately as diagnosed. Vital capacity, forced expiratory volume in 1 second and forced vital capacity decreased, residual volume and ratio of residual volume to total lung capacity increased in both PD and MSA groups compared to controls (p<0.05). Diffusing capacity was decreased in the MSA group, compared with PD and normal elderly control groups (p<0.05). Respiratory muscle strength was lower in both PD and MSA groups than in controls (p<0.05). The values representing spirometry function and respiratory muscle strength were found to have a negative linear correlation with mean score of UPDRS-III in PD and mean score of UMSARS-I in MSA. Respiratory muscle strength showed a negative linear correlation with the mean score of UMSARS-II and disease duration in MSA patients. These findings suggest that respiratory dysfunction is involved in PD and MSA. Respiratory muscle strength is remarkably reduced, and some of the parameters correlate with disease duration and illness severity. The compromised respiratory function in neurodegenerative disorders should be the focus of further researches.

Mercury and halogens in coal: Chapter 2

USGS Publications Warehouse

Kolker, Allan; Quick, Jeffrey C.; Granite, Evan J.; Pennline, Henry W.; Senior, Constance L.

2014-01-01

Apart from mercury itself, coal rank and halogen content are among the most important factors inherent in coal that determine the proportion of mercury captured by conventional controls during coal combustion. This chapter reviews how mercury in coal occurs, gives available concentration data for mercury in U.S. and international commercial coals, and provides an overview of the natural variation in halogens that influence mercury capture. Three databases, the U.S. Geological Survey coal quality (USGS COALQUAL) database for in-ground coals, and the 1999 and 2010 U.S. Environmental Protection Agency (EPA) Information Collection Request (ICR) databases for coals delivered to power stations, provide extensive results for mercury and other parameters that are compared in this chapter. In addition to the United States, detailed characterization of mercury is available on a nationwide basis for China, whose mean values in recent compilations are very similar to the United States in-ground mean of 0.17 ppm mercury. Available data for the next five largest producers (India, Australia, South Africa, the Russian Federation, and Indonesia) are more limited and with the possible exceptions of Australia and the Russian Federation, do not allow nationwide means for mercury in coal to be calculated. Chlorine in coal varies as a function of rank and correspondingly, depth of burial. As discussed elsewhere in this volume, on a proportional basis, bromine is more effective than chlorine in promoting mercury oxidation in flue gas and capture by conventional controls. The ratio of bromine to chlorine in coal is indicative of the proportion of halogens present in formation waters within a coal basin. This ratio is relatively constant except in coals that have interacted with deep-basin brines that have reached halite saturation, enriching residual fluids in bromine. Results presented here help optimize mercury capture by conventional controls and provide a starting point for implementation of mercury-specific controls discussed elsewhere in this volume.

Clinical outcomes of pulsed radiofrequency neuromodulation for the treatment of occipital neuralgia.

PubMed

Choi, Hyuk Jai; Oh, In Ho; Choi, Seok Keun; Lim, Young Jin

2012-05-01

Occipital neuralgia is characterized by paroxysmal jabbing pain in the dermatomes of the greater or lesser occipital nerves caused by irritation of these nerves. Although several therapies have been reported, they have only temporary therapeutic effects. We report the results of pulsed radiofrequency treatment of the occipital nerve, which was used to treat occipital neuralgia. Patients were diagnosed with occipital neuralgia according to the International Classification of Headache Disorders classification criteria. We performed pulsed radiofrequency neuromodulation when patients presented with clinical findings suggestive occipital neuralgia with positive diagnostic block of the occipital nerves with local anesthetics. Patients were analyzed according to age, duration of symptoms, surgical results, complications and recurrence. Pain was measured every month after the procedure using the visual analog and total pain indexes. From 2010, ten patients were included in the study. The mean age was 52 years (34-70 years). The mean follow-up period was 7.5 months (6-10 months). Mean Visual Analog Scale and mean total pain index scores declined by 6.1 units and 192.1 units, respectively, during the follow-up period. No complications were reported. Pulsed radiofrequency neuromodulation of the occipital nerve is an effective treatment for occipital neuralgia. Further controlled prospective studies are necessary to evaluate the exact effects and long-term outcomes of this treatment method.

A second chance: meanings of body weight, diet, and physical activity to women who have experienced cancer.

PubMed

Maley, Mary; Warren, Barbour S; Devine, Carol M

2013-01-01

To understand the meanings of diet, physical activity, and body weight in the context of women's cancer experiences. Grounded theory using 15 qualitative interviews and 3 focus groups. Grassroots community cancer organizations in the northeastern United States. Thirty-six white women cancer survivors; 86% had experienced breast cancer. Participants' views of the meanings of body weight, diet, and physical activity in the context of the cancer. Procedures adapted from the constant comparative method of qualitative analysis using iterative open coding. Themes emerged along 3 intersecting dimensions: vulnerability and control, stress and living well, and uncertainty and confidence. Diet and body weight were seen as sources of increased vulnerability and distress. Uncertainty about diet heightened distress and lack of control. Physical activity was seen as a way to regain control and reduce distress. Emergent themes of vulnerability-control, stress-living well, and uncertainty-confidence may aid in understanding and promoting health behaviors in the growing population of cancer survivors. Messages that resonated with participants included taking ownership over one's body, physical activity as stress reduction, healthy eating for overall health and quality of life, and a second chance to get it right. Copyright © 2013 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Health effects of neighborhood demolition and housing improvement: a prospective controlled study of 2 natural experiments in urban renewal.

PubMed

Egan, Matt; Katikireddi, Srinivasa Vittal; Kearns, Ade; Tannahill, Carol; Kalacs, Martins; Bond, Lyndal

2013-06-01

We took advantage of a 2-intervention natural experiment to investigate the impacts of neighborhood demolition and housing improvement on adult residents' mental and physical health. We identified a longitudinal cohort (n = 1041, including intervention and control participants) by matching participants in 2 randomly sampled cross-sectional surveys conducted in 2006 and 2008 in 14 disadvantaged neighborhoods of Glasgow, United Kingdom. We measured residents' self-reported health with Medical Outcomes Study Short Form Health Survey version 2 mean scores. After adjustment for potential confounders and baseline health, mean mental and physical health scores for residents living in partly demolished neighborhoods were similar to the control group (mental health, b = 2.49; 95% confidence interval [CI] = -1.25, 6.23; P = .185; physical health, b = -0.24; 95% CI = -2.96, 2.48; P = .859). Mean mental health scores for residents experiencing housing improvement were higher than in the control group (b = 2.41; 95% CI = 0.03, 4.80; P = .047); physical health scores were similar between groups (b = -0.66; 95% CI = -2.57, 1.25; P = .486). Our findings suggest that housing improvement may lead to small, short-term mental health benefits. Physical deterioration and demolition of neighborhoods do not appear to adversely affect residents' health.

Pneumococcal Colonization Rates in Patients Admitted to a United Kingdom Hospital with Lower Respiratory Tract Infection: a Prospective Case-Control Study

PubMed Central

Johnstone, Catherine M. K.; Gritzfeld, Jenna F.; Banyard, Antonia; Hancock, Carole A.; Wright, Angela D.; Macfarlane, Laura; Ferreira, Daniela M.

2016-01-01

Current diagnostic tests are ineffective for identifying the etiological pathogen in hospitalized adults with lower respiratory tract infections (LRTIs). The association of pneumococcal colonization with disease has been suggested as a means to increase the diagnostic precision. We compared the pneumococcal colonization rates and the densities of nasal pneumococcal colonization by (i) classical culture and (ii) quantitative real-time PCR (qPCR) targeting lytA in patients with LRTIs admitted to a hospital in the United Kingdom and control patients. A total of 826 patients were screened for inclusion in this prospective case-control study. Of these, 38 patients were recruited, 19 with confirmed LRTIs and 19 controls with other diagnoses. Nasal wash (NW) samples were collected at the time of recruitment. Pneumococcal colonization was detected in 1 patient with LRTI and 3 controls (P = 0.6) by classical culture. By qPCR, pneumococcal colonization was detected in 10 LRTI patients and 8 controls (P = 0.5). Antibiotic usage prior to sampling was significantly higher in the LRTI group than in the control group (19 versus 3; P < 0.001). With a clinically relevant cutoff of >8,000 copies/ml on qPCR, pneumococcal colonization was found in 3 LRTI patients and 4 controls (P > 0.05). We conclude that neither the prevalence nor the density of nasal pneumococcal colonization (by culture and qPCR) can be used as a method of microbiological diagnosis in hospitalized adults with LRTI in the United Kingdom. A community-based study recruiting patients prior to antibiotic therapy may be a useful future step. PMID:26791364

Thresholds for Abdominal Aortic Aneurysm Repair in England and the United States

PubMed Central

Karthikesalingam, Alan; Vidal-Diez, Alberto; Holt, Peter J.; Loftus, Ian M.; Schermerhorn, Marc L.; Soden, Peter A.; Landon, Bruce E.; Thompson, Matthew M.

2016-01-01

BACKGROUND Thresholds for repair of abdominal aortic aneurysms vary considerably among countries. METHODS We examined differences between England and the United States in the frequency of aneurysm repair, the mean aneurysm diameter at the time of the procedure, and rates of aneurysm rupture and aneurysm-related death. Data on the frequency of repair of intact (nonruptured) abdominal aortic aneurysms, in-hospital mortality among patients who had undergone aneurysm repair, and rates of aneurysm rupture during the period from 2005 through 2012 were extracted from the Hospital Episode Statistics database in England and the U.S. Nationwide Inpatient Sample. Data on the aneurysm diameter at the time of repair were extracted from the U.K. National Vascular Registry (2014 data) and from the U.S. National Surgical Quality Improvement Program (2013 data). Aneurysm-related mortality during the period from 2005 through 2012 was determined from data obtained from the Centers for Disease Control and Prevention and the U.K. Office of National Statistics. Data were adjusted with the use of direct standardization or conditional logistic regression for differences between England and the United States with respect to population age and sex. RESULTS During the period from 2005 through 2012, a total of 29,300 patients in England and 278,921 patients in the United States underwent repair of intact abdominal aortic aneurysms. Aneurysm repair was less common in England than in the United States (odds ratio, 0.49; 95% confidence interval [CI], 0.48 to 0.49; P<0.001), and aneurysm-related death was more common in England than in the United States (odds ratio, 3.60; 95% CI, 3.55 to 3.64; P<0.001). Hospitalization due to an aneurysm rupture occurred more frequently in England than in the United States (odds ratio, 2.23; 95% CI, 2.19 to 2.27; P<0.001), and the mean aneurysm diameter at the time of repair was larger in England (63.7 mm vs. 58.3 mm, P<0.001). CONCLUSIONS We found a lower rate of repair of abdominal aortic aneurysms and a larger mean aneurysm diameter at the time of repair in England than in the United States and lower rates of aneurysm rupture and aneurysm-related death in the United States than in England. (Funded by the Circulation Foundation and others.) PMID:27959727

PubMed Central

GUZZO, A.S.; MEGGIOLARO, A.; MANNOCCI, A.; TECCA, M.; SALOMONE, I.

2015-01-01

Summary Introduction. "Umberto I" Teaching Hospital adopted 'Conley scale' as internal procedure for fall risk assessment, with the aim of strengthening surveillance and improving prevention and management of impatient falls. Materials and methods. Case-control study was performed. Fall events from 1st March 2012 to 30th September 2013 were considered. Cases have been matched for gender, department and period of hospitalization with two or three controls when it is possible. A table including intrinsic and extrinsic 'fall risk' factors, not foreseen by Conley Scale, and setted up after a literature overview was built. Univariate analysis and conditional logistic regression model have been performed. Results. 50 cases and 102 controls were included. Adverse event 'fall' were associated with filled Conley scale at the admission to care unit (OR = 4.92, 95%CI = 2.34-10.37). Univariate analysis identified intrinsic factors increasing risk of falls: dizziness (OR = 3.22; 95%CI = 1.34-7.75), psychomotor agitation (OR = 2.61; 95%CI = 1.06-6.43); and use of means of restraint (OR = 5.05 95%CI = 1.77-14.43). Conditional logistic regression model revealed a significant association with the following variables: use of instruments of restraint (HR = 5.54, 95%CI = 1.2- 23.80), dizziness (OR = 3.97, 95%CI = 1.22-12.89). Discussion. Conley Scale must be filled at the access of patient to care unit. There were no significant differences between cases and controls with regard to risk factors provided by Conley, except for the use of means of restraint. Empowerment strategies for Conley compilation are needed. PMID:26789993

A randomized controlled trial of the effect of a photographic display with and without music on pre-operative anxiety.

PubMed

Gómez-Urquiza, Jose L; Hueso-Montoro, César; Urquiza-Olmo, Josefa; Ibarrondo-Crespo, Rocío; González-Jiménez, Emilio; Schmidt-Riovalle, Jacqueline

2016-07-01

To determine the effectiveness of photographic display at reducing pre-operative anxiety in an ear, nose and throat surgery unit; alone and in combination with music. The waiting time prior to the surgery is often unpleasant and a time of anxiety for patients. Anxiety can affect physical recovery and psychological well-being; lengthening convalescence and hospital stay after the surgery. Improving pre-operative anxiety is a challenge with potential impacts on improving patients' satisfaction and well-being and decreasing the cost of care. A clinical trial was conducted with two intervention groups and one control group. The sample consisted of 180 subjects from the otolaryngology major ambulatory surgery unit in a tertiary hospital in the province of Granada, with 60 subjects per group. The outcome variables measured were state anxiety, heart and respiratory rate and blood pressure. The data were collected from May-December 2013. After the intervention, in the comparison between control group and photographic display group, all variables had lower means in the intervention group, although a significant P value was only obtained for respiratory rate using one-way anova test. When comparing control group and photographic display combined with music group, using one-way anova test, all mean values were lower in the intervention group and a significant P value were observed for all variables except diastolic blood pressure. Photographic display in combination with music is more effective at reducing pre-operative anxiety than the standard intervention and photographic display alone. © 2016 John Wiley & Sons Ltd.

Whole body massage for reducing anxiety and stabilizing vital signs of patients in cardiac care unit

PubMed Central

Adib-Hajbaghery, Mohsen; Abasi, Ali; Rajabi-Beheshtabad, Rahman

2014-01-01

Background: Patients admitted in coronary care units face various stressors. Ambiguity of future life conditions and unawareness of caring methods intensifies the patients’ anxiety and stress. This study was conducted to assess the effects of whole body massage on anxiety and vital signs of patients with acute coronary disorders. Methods: A randomized controlled trial was conducted on 120 patients. Patients were randomly allocated into two groups. The intervention group received a session of whole body massage and the control group received routine care. The levels of State, Trait and overall anxiety and vital signs were assessed in both groups before and after intervention. Independent sample t-test, paired t-test, Chi-square and Fischer exact tests were used for data analysis. Results: The baseline overall mean score of anxiety was 79.43±29.34 in the intervention group and was decreased to 50.38±20.35 after massage therapy (p=0.001). However, no significant changes were occurred in the overall mean anxiety in the control group during the study. The baseline diastolic blood pressure was 77.05±8.12 mmHg and was decreased to 72.18±9.19 mmHg after the intervention (p=0.004). Also, significant decreases were occurred in heart rate and respiration rate of intervention group after massage therapy (p=0.001). However, no significant changes were occurred in vital signs of the control group during the study. Conclusion: The results suggest that whole body massage was effective in reducing anxiety and stabilizing vital signs of patients with acute coronary disorders. PMID:25405113

The effect of intermittent energy and carbohydrate restriction v. daily energy restriction on weight loss and metabolic disease risk markers in overweight women.

PubMed

Harvie, Michelle; Wright, Claire; Pegington, Mary; McMullan, Debbie; Mitchell, Ellen; Martin, Bronwen; Cutler, Roy G; Evans, Gareth; Whiteside, Sigrid; Maudsley, Stuart; Camandola, Simonetta; Wang, Rui; Carlson, Olga D; Egan, Josephine M; Mattson, Mark P; Howell, Anthony

2013-10-01

Intermittent energy restriction may result in greater improvements in insulin sensitivity and weight control than daily energy restriction (DER). We tested two intermittent energy and carbohydrate restriction (IECR) regimens, including one which allowed ad libitum protein and fat (IECR+PF). Overweight women (n 115) aged 20 and 69 years with a family history of breast cancer were randomised to an overall 25 % energy restriction, either as an IECR (2500-2717 kJ/d, < 40 g carbohydrate/d for 2 d/week) or a 25 % DER (approximately 6000 kJ/d for 7 d/week) or an IECR+PF for a 3-month weight-loss period and 1 month of weight maintenance (IECR or IECR+PF for 1 d/week). Insulin resistance reduced with the IECR diets (mean - 0·34 (95% CI - 0·66, - 0·02) units) and the IECR+PF diet (mean - 0·38 (95% CI - 0·75, - 0·01) units). Reductions with the IECR diets were significantly greater compared with the DER diet (mean 0·2 (95% CI - 0·19, 0·66) μU/unit, P= 0·02). Both IECR groups had greater reductions in body fat compared with the DER group (IECR: mean - 3·7 (95% CI - 2·5, - 4·9) kg, P= 0·007; IECR+PF: mean - 3·7 (95% CI - 2·8, - 4·7) kg, P= 0·019; DER: mean - 2·0 (95% CI - 1·0, 3·0) kg). During the weight maintenance phase, 1 d of IECR or IECR+PF per week maintained the reductions in insulin resistance and weight. In the short term, IECR is superior to DER with respect to improved insulin sensitivity and body fat reduction. Longer-term studies into the safety and effectiveness of IECR diets are warranted.

Ischemia-modified albumin levels in cerebrovascular accidents.

PubMed

Gunduz, Abdulkadir; Turedi, Suleyman; Mentese, Ahmet; Altunayoglu, Vildan; Turan, Ibrahim; Karahan, Suleyman Caner; Topbas, Murat; Aydin, Murat; Eraydin, Ismet; Akcan, Buket

2008-10-01

Previous studies have demonstrated that ischemia-modified albumin (IMA) is a useful marker for the diagnosis of ischemic events. It was also recently demonstrated that IMA levels increase in the acute phase of cerebrovascular diseases. Yet the data regarding IMA levels in various types of cerebrovascular events are insufficient. The aim of this study was to evaluate IMA levels in various types of cerebrovascular events such as ischemic stroke, subarachnoid hemorrhage (SAH), and intracranial hemorrhage. This case-controlled study consisted of 106 consecutive patients, 43 with brain infarction (BI), 11 with brain hemorrhage (ICH), 52 with SAH, and a 43-member control group. We investigated whether there was a statistical correlation between these 3 groups and the control group. The relations among the 3 groups were also examined. Comparisons among groups were done with analysis of variance. Mean serum IMA levels were 0.280 +/- 0.045 absorbance units (ABSU) for BI patients, 0.259 +/- 0.053 ABSU for ICH patients, 0.243 +/- 0.061 ABSU for SAH patients, and 0.172 +/- 0.045 ABSU for the control group.There was a statistically significant difference between the mean IMA levels of BI, ICH, and SAH patients and the mean control patient IMA levels (P b .0001). Ischemia-modified albumin levels are high in cerebrovascular diseases. Ischemia-modified albumin measurement can also be used to distinguish SAH from BI during the acute phase of cerebrovascular event in the emergency department.

Motor Unit Interpulse Intervals During High Force Contractions.

PubMed

Stock, Matt S; Thompson, Brennan J

2016-01-01

We examined the means, medians, and variability for motor-unit interpulse intervals (IPIs) during voluntary, high force contractions. Eight men (mean age = 22 years) attempted to perform isometric contractions at 90% of their maximal voluntary contraction force while bipolar surface electromyographic (EMG) signals were detected from the vastus lateralis and vastus medialis muscles. Surface EMG signal decomposition was used to determine the recruitment thresholds and IPIs of motor units that demonstrated accuracy levels ≥ 96.0%. Motor units with high recruitment thresholds demonstrated longer mean IPIs, but the coefficients of variation were similar across all recruitment thresholds. Polynomial regression analyses indicated that for both muscles, the relationship between the means and standard deviations of the IPIs was linear. The majority of IPI histograms were positively skewed. Although low-threshold motor units were associated with shorter IPIs, the variability among motor units with differing recruitment thresholds was comparable.

Gun-Control Legislation and the Impact on Suicide.

PubMed

Leenaars, Antoon A

2007-01-01

Gun control is the prototypical example of controlling the environment for the means of suicide, an effective public health approach to suicide prevention. Canada's Criminal Law Amendment Act of 1977 (Bill C-51) provides an excellent opportunity to illustrate the effects of legislative gun-control laws and the impact on suicide. The research in Canada supports the significant effect of C-51 in reducing suicides and firearm suicides, even if one controls for socioeconomic factors, although not equally for all ages. The young, a high-risk group, show the most significant decrease, without significant substitution of other methods (displacement). Studies on gun-control laws from New Zealand, the United States, and Australia support the Canadian findings. It is concluded that, although not equally applicable in all countries, gun control may well have significant applications in reducing suicide worldwide.

[Differences in attachment and personality in children from child guidance centers, child psychiatry units, and control families].

PubMed

Zimmermann, Peter; Scheuerer-Englisch, Hermann

2013-01-01

Insecure attachment and deficits in self-regulation as personality traits are risk factors for the development of psychopathological symptoms from infancy on. This study examines differences in attachment and personality in late childhood, comparing children from non-clinical families, from a child guidance center, and child psychiatry units with in-patient care. Children's attachment representations, their attachment behavior strategy, reported distressing parental behavior, their emotional openness, and attachment coherency were assessed with the Late Childhood Attachment Interview (LCAI). Ego-resiliency, ego-undercontrol, field-independence, aggressiveness, and anxiety were assessed by means of the California Child Q-Sort. The results show clear attachment differences, with the child guidance group showing more attachment insecurity in the LCAI compared to the control group, and the psychiatric in-patient group even more attachment insecurity, more distressing parenting from both mother and father, and more attachment disorganization than the other two groups. Whereas children from the child guidance center and the child psychiatry unit did not differ in personality, both groups were significantly different from the control group in all personality dimensions. The results suggest that personality differences may be a risk factor for behaviour problems, however problem severity and the choice of the treatment institution seem to be influenced by attachment security.

Effects of group songwriting on motivation and readiness for treatment on patients in detoxification: a randomized wait-list effectiveness study.

PubMed

Silverman, Michael J

2012-01-01

Songwriting is a commonly utilized music therapy technique for clients in substance abuse rehabilitation. For these patients, motivation and readiness for treatment remain two key treatment areas. Moreover, there is a lack of randomized and controlled music therapy studies systematically investigating how group songwrit-ing can affect patients on a detoxification unit. The purposes of this study were to measure the effects of a single group songwriting session on motivation and readiness for treatment and determine emerging themes from patient-composed songs with patients on a detoxification unit. Participants (N = 99) were randomized to experimental (posttest only) or wait-list control (pretest only) conditions to provide treatment to all participants in an inclusive single-session design. There were significant between-group differences in motivation and readiness for treatment, with experimental participants having higher means than control participants. Code categorizations from patients' composed song lyrics concerned "action," "emotions and feelings," "change," "reflection," "admission," and "responsibility." From the results of this study, it seems that a single group songwriting session can be an effective intervention concerning motivation and readiness for treatment in patients on a detoxification unit. Implications for clinical practice, suggestions for future research, and limitations are provided.

25 CFR 161.1 - What definitions do I need to know?

Code of Federal Regulations, 2013 CFR

2013-04-01

... number of animal units authorized in each grazing permit. Animal Unit (AU) means one adult cow and her 6...: Housing permits, farm leases, governmental facilities, rights-of-way, schools, parks, business leases, etc. Stocking rate means the maximum number of sheep units, or animal units authorized to graze on a particular...

8 CFR 1215.1 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-01-01

...) The term alien means any person who is not a citizen or national of the United States. (b) The term... Hawaii. (g) The term geographical part of the United States means: (1) The continental United States, (2... place, or (2) from one geographical part of the United States for a separate geographical part of the...

8 CFR 1215.1 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

...) The term alien means any person who is not a citizen or national of the United States. (b) The term... Hawaii. (g) The term geographical part of the United States means: (1) The continental United States, (2... place, or (2) from one geographical part of the United States for a separate geographical part of the...

Maternal blood lead level during pregnancy in South Central Los Angeles.

PubMed

Rothenberg, S J; Manalo, M; Jiang, J; Khan, F; Cuellar, R; Reyes, S; Sanchez, M; Reynoso, B; Aguilar, A; Diaz, M; Acosta, S; Jauregui, M; Johnson, C

1999-01-01

Twenty-five years of public health efforts produced a striking reduction in lead exposure; the blood lead average in the United States has decreased to less than 20% of levels measured in the 1970s. However, poor minority groups that live in large urban centers are still at high risk for elevated lead levels. In this study, our data showed that pregnant immigrants (n = 1,428) who live in South Central Los Angeles--one of the most economically depressed regions of California--have significantly higher (p < .0001) blood lead levels (geometric mean = 2.3 microg/dl [0.11 micromol/l]) than 504 pregnant nonimmigrants (geometric mean = 1.9 microg/dl [0.09 micromol/l]). The most important factors associated with lower blood lead levels in both groups were younger age; more-recent date of blood sampling (i.e., decreasing secular trend); and blood sampling in mid-autumn, instead of mid-spring (i.e., seasonal trend). Blood lead levels of immigrants were strongly dependent on time elapsed since immigration to the United States; each natural log increase in years of residence was associated with an approximately 19% decrease in blood lead levels. Although blood lead means for both groups were almost the same as the estimated national average, 25 of the 30 cases of elevated blood lead (i.e., > or = 10 microg/dl [0.48 micromol/l) occurred in the immigrant group. The odds ratio (95% confidence intervals within parentheses) for having elevated blood lead levels (a) was 9.3 (1.9, 45.8) if the immigrant engaged in pica; (b) was 3.8 (1.4, 10.5) if the immigrant had low dietary calcium intake during pregnancy; and (c) was .65 (.43, .98) for every natural log unit increase of years of residence in the United States. The control of pica and dietary calcium intake may offer a means of reducing lead exposure in immigrants.

Moderators of Effects of Internet-Delivered Exercise and Pain Coping Skills Training for People With Knee Osteoarthritis: Exploratory Analysis of the IMPACT Randomized Controlled Trial.

PubMed

Lawford, Belinda J; Hinman, Rana S; Kasza, Jessica; Nelligan, Rachel; Keefe, Francis; Rini, Christine; Bennell, Kim L

2018-05-09

Internet-delivered exercise, education, and pain coping skills training is effective for people with knee osteoarthritis, yet it is not clear whether this treatment is better suited to particular subgroups of patients. The aim was to explore demographic and clinical moderators of the effect of an internet-delivered intervention on changes in pain and physical function in people with knee osteoarthritis. Exploratory analysis of data from 148 people with knee osteoarthritis who participated in a randomized controlled trial comparing internet-delivered exercise, education, and pain coping skills training to internet-delivered education alone. Primary outcomes were changes in knee pain while walking (11-point Numerical Rating Scale) and physical function (Western Ontario and McMaster Universities Osteoarthritis Index function subscale) at 3 and 9 months. Separate regression models were fit with moderator variables (age, gender, expectations of outcomes, self-efficacy [pain], education, employment status, pain catastrophizing, body mass index) and study group as covariates, including an interaction between the two. Participants in the intervention group who were currently employed had significantly greater reductions in pain at 3 months than similar participants in the control group (between-group difference: mean 2.38, 95% CI 1.52-3.23 Numerical Rating Scale units; interaction P=.02). Additionally, within the intervention group, pain at 3 months reduced by mean 0.53 (95% CI 0.28-0.78) Numerical Rating Scale units per unit increase in baseline self-efficacy for managing pain compared to mean 0.11 Numerical Rating Scale units (95% CI -0.13 to 0.35; interaction P=.02) for the control group. People who were employed and had higher self-efficacy at baseline were more likely to experience greater improvements in pain at 3 months after an internet-delivered exercise, education, and pain coping skills training program. There was no evidence of a difference in the effect across gender, educational level, expectation of treatment outcome, or across age, body mass index, or tendency to catastrophize pain. Findings support the effectiveness of internet-delivered care for a wide range of people with knee osteoarthritis, but future confirmatory research is needed. Australian New Zealand Clinical Trials Registry ACTRN12614000243617; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=365812&isReview=true (Archived by WebCite at http://www.webcitation.org/6z466oTPs). ©Belinda J Lawford, Rana S Hinman, Jessica Kasza, Rachel Nelligan, Francis Keefe, Christine Rini, Kim L Bennell. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 09.05.2018.

Language processing and executive functions in early treated adults with phenylketonuria (PKU).

PubMed

De Felice, Sara; Romani, Cristina; Geberhiwot, Tarekegn; MacDonald, Anita; Palermo, Liana

We provide an in-depth analysis of language functions in early-treated adults with phenylketonuria (AwPKUs, N = 15-33), as compared to age- and education-matched controls (N = 24-32; N varying across tasks), through: a. narrative production (the Cinderella story), b. language pragmatics comprehension (humour, metaphors, inferred meaning), c. prosody discrimination d. lexical inhibitory control and planning (Blocked Cyclic Naming; Hayling Sentence Completion Test, Burgess & Shallice, 1997). AwPKUs exhibited intact basic language processing (lexical retrieval, phonology/articulation, sentence construction). Instead, deficits emerged in planning and reasoning abilities. Compared to controls, AwPKUs were: less informative in narrative production (lower rate of Correct Information Units); slower in metaphorical understanding and inferred meaning; less accurate in focused lexical-search (Hayling test). These results suggest that i) executive deficits in PKU cannot be explained by an accumulation of lower-order deficits and/or general speed impairments, ii) executive functions engage dedicated neurophysiological resources, rather than simply being an emergent property of lower-level systems.

The effect of 3 torque delivery systems on gold screw preload at the gold cylinder-abutment screw joint.

PubMed

Tan, Keson B; Nicholls, Jack I

2002-01-01

This study measured the gold screw preload at the gold cylinder-abutment screw joint interface obtained by 3 torque delivery systems. Using a precalibrated, strain-gauged standard abutment as the load cell, 3 torque delivery systems tested were shown to have significant differences in gold screw preload when a gold cylinder was attached. Mean preloads measured were 291.2 N for hand torque drivers set at 10 Ncm, 340.3 N for electronic torque controllers at low setting/10 Ncm, 384.4 N for electronic torque controllers at high setting/10 Ncm; and 140.8 N for hand-tightening with a prosthetic slot screwdriver. Significant differences in screw preload were also found between operators using a hand torque driver. Hand-tightening delivered insufficient preload and cannot be recommended for final gold screw tightening. Different electronic torque controller units set at 10 Ncm induced mean gold screw preloads that ranged from 264.1 N to as high as 501.2 N. Electronic torque controllers should be regularly recalibrated to ensure optimal output.

19 CFR 10.3002 - General definitions.

Code of Federal Regulations, 2013 CFR

2013-04-01

.... “Party” means the United States or Colombia; (q) Person. “Person” means a natural person or an enterprise..., the United States may exercise rights with respect to the seabed and subsoil and their natural resources; (v) WTO. “WTO” means the World Trade Organization; and (w) WTO Agreement. “WTO Agreement” means...

19 CFR 10.3002 - General definitions.

Code of Federal Regulations, 2014 CFR

2014-04-01

.... “Party” means the United States or Colombia; (q) Person. “Person” means a natural person or an enterprise..., the United States may exercise rights with respect to the seabed and subsoil and their natural resources; (v) WTO. “WTO” means the World Trade Organization; and (w) WTO Agreement. “WTO Agreement” means...

United States Airline Transport Pilot International Flight Language Experiences, Report 2: Word Meaning and Pronunciation

DTIC Science & Technology

2010-04-01

different countries are understood; (4) Poor radios and transmission quality contribute to the unintelligibility of some controller transmissions; (5...going into a foreign country; (7) Differences associated with U.S. and ICAO phraseology need to be resolved and procedural ambiguities eliminated...affect you most related to differences in the word(s) used to describe a clearance, instruction, advisory, or request? Please list some examples

The effect of a physical activity intervention on preschoolers' fundamental motor skills - A cluster RCT.

PubMed

Wasenius, Niko S; Grattan, Kimberly P; Harvey, Alysha L J; Naylor, Patti-Jean; Goldfield, Gary S; Adamo, Kristi B

2018-07-01

To assess the effect of a physical activity intervention delivered in the childcare centres (CC), with or without a parent-driven home physical activity component, on children's fundamental motor skills (FMS). Six-month 3-arm cluster randomized controlled trial. Preschoolers were recruited from 18 licensed CC. CC were randomly assigned to a typical curriculum comparison group (COM), childcare intervention alone (CC), or childcare intervention with parental component (CC+HOME). FMS was measured with the Test of Gross Motor Development-2. Linear mixed models were performed at the level of the individual while accounting for clustering. Raw locomotor skills score increased significantly in the CC group (mean difference=2.5 units, 95% Confidence Intervals, CI, 1.0-4.1, p<0.001) and the CC+HOME group (mean difference=2.4 units, 95% CI, 0.8-4.0, p<0.001) compared to the COM group. No significant (p>0.05) between group differences were observed in the raw object control skills, sum of raw scores, or gross motor quotient. No significant sex differences were found in any of the measured outcomes. A physical activity intervention delivered in childcare with or without parents' involvement was effective in increasing locomotor skills in preschoolers. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Automated drug dispensing system reduces medication errors in an intensive care setting.

PubMed

Chapuis, Claire; Roustit, Matthieu; Bal, Gaëlle; Schwebel, Carole; Pansu, Pascal; David-Tchouda, Sandra; Foroni, Luc; Calop, Jean; Timsit, Jean-François; Allenet, Benoît; Bosson, Jean-Luc; Bedouch, Pierrick

2010-12-01

We aimed to assess the impact of an automated dispensing system on the incidence of medication errors related to picking, preparation, and administration of drugs in a medical intensive care unit. We also evaluated the clinical significance of such errors and user satisfaction. Preintervention and postintervention study involving a control and an intervention medical intensive care unit. Two medical intensive care units in the same department of a 2,000-bed university hospital. Adult medical intensive care patients. After a 2-month observation period, we implemented an automated dispensing system in one of the units (study unit) chosen randomly, with the other unit being the control. The overall error rate was expressed as a percentage of total opportunities for error. The severity of errors was classified according to National Coordinating Council for Medication Error Reporting and Prevention categories by an expert committee. User satisfaction was assessed through self-administered questionnaires completed by nurses. A total of 1,476 medications for 115 patients were observed. After automated dispensing system implementation, we observed a reduced percentage of total opportunities for error in the study compared to the control unit (13.5% and 18.6%, respectively; p<.05); however, no significant difference was observed before automated dispensing system implementation (20.4% and 19.3%, respectively; not significant). Before-and-after comparisons in the study unit also showed a significantly reduced percentage of total opportunities for error (20.4% and 13.5%; p<.01). An analysis of detailed opportunities for error showed a significant impact of the automated dispensing system in reducing preparation errors (p<.05). Most errors caused no harm (National Coordinating Council for Medication Error Reporting and Prevention category C). The automated dispensing system did not reduce errors causing harm. Finally, the mean for working conditions improved from 1.0±0.8 to 2.5±0.8 on the four-point Likert scale. The implementation of an automated dispensing system reduced overall medication errors related to picking, preparation, and administration of drugs in the intensive care unit. Furthermore, most nurses favored the new drug dispensation organization.

Effectiveness of a baking soda toothpaste delivering calcium and phosphate in reducing dentinal hypersensitivity.

PubMed

Ghassemi, A; Hooper, W; Winston, A E; Sowinski, J; Bowman, J; Sharma, N

2009-01-01

The purpose of this controlled clinical trial was to determine the effectiveness and safety of a single-phase dentifrice that delivers calcium, phosphate, and fluoride to the tooth surface (Arm & Hammer Enamel Care for Sensitive Teeth toothpaste, United Kingdom) in reducing dentinal hypersensitivity. Two-hundred and eight qualifying subjects were randomly assigned to either the Enamel Care dentifrice group or a control dentifrice group, and brushed twice daily with their assigned dentifrice for eight weeks. Pain/discomfort in response to a thermal stimulus was assessed at baseline, week 4, and week 8 using a Visual Analogue Scale (VAS; primary outcome variable) and the Schiff Thermal Sensitivity Scale (STSS; secondary outcome variable). After eight weeks, volunteers from the Enamel Care group were switched to the control dentifrice and participated in a second eight-week study to determine the degree of persistence of pain reduction. Both groups had statistically significant VAS score reductions from baseline at weeks 4 and 8, with mean VAS scores in the Enamel Care group decreasing by 45.6% at week 4 and 61.1% at week 8 (p < 0.0001). Enamel Care was statistically significantly more effective than the control at weeks 4 and 8, with respective mean VAS reductions of 63% (p < 0.0001) and 33% (p = 0.0004) greater than the control. Consistent with the VAS score results, the Enamel Care group had respective statistically significant STSS score reductions of 77% and 58% greater than the control group (p < 0.0001). The reductions in dentinal hypersensitivity seen in the Enamel Care group at week 8 persisted for an additional eight weeks, during which the subjects discontinued use of Enamel Care and brushed with the control dentifrice. Enamel Care for Sensitive Teeth toothpaste (United Kingdom) is an effective dentifrice for the management of dentinal hypersensitivity, and its efficacy persists for a least eight weeks following discontinued product use.

Improvement in neonatal intensive care unit care: a cluster randomised controlled trial of active dissemination of information.

PubMed

Acolet, Dominique; Allen, Elizabeth; Houston, Rosie; Wilkinson, Andrew R; Costeloe, Kate; Elbourne, Diana

2011-11-01

Research findings are not rapidly or fully implemented into policies and practice in care. To assess whether an 'active' strategy was more likely to lead to changes in policy and practice in preterm baby care than traditional information dissemination. Cluster randomised trial. 180 neonatal units (87 active, 93 control) in England; clinicians from active arm units; babies born <27 weeks gestation. CONTROL ARM: Dissemination of research report; slides; information about newborn care position statement. ACTIVE ARM: As above plus offer to become 'regional 'champion' (attend two workshops, support clinicians to implement research evidence regionally), or attend one workshop, promote implementation of research evidence locally. timing of surfactant administration; admission temperature; staffing of resuscitation team present at birth. 48/87 Lead clinicians in the active arm attended one or both workshops. There was no evidence of difference in post-intervention policies between trial arms. Practice outcomes based on babies in the active (169) and control arms (186), in 45 and 49 neonatal units respectively, showed active arm babies were more likely to have been given surfactant on labour ward (RR=1.30; 95% CI 0.99 to 1.70); p=0.06); to have a higher temperature on admission to neonatal intensive care unit (mean difference=0.29(o)C; 95% CI 0.22 to 0.55; p=0.03); and to have had the baby's trunk delivered into a plastic bag (RR=1.27; 95% CI 1.01 to 1.60; p=0.04) than the control group. The effect on having an 'ideal' resuscitation team at birth was in the same direction of benefit for the active arm (RR=1.18; 95% CI 0.97 to 1.43; p=0.09). The costs of the intervention were modest. This is the first trial to evaluate methods for transferring information from neonatal research into local policies and practice in England. An active approach to research dissemination is both feasible and cost-effective. Current controlled trials ISRCTN89683698.

Sources of signal-dependent noise during isometric force production.

PubMed

Jones, Kelvin E; Hamilton, Antonia F; Wolpert, Daniel M

2002-09-01

It has been proposed that the invariant kinematics observed during goal-directed movements result from reducing the consequences of signal-dependent noise (SDN) on motor output. The purpose of this study was to investigate the presence of SDN during isometric force production and determine how central and peripheral components contribute to this feature of motor control. Peripheral and central components were distinguished experimentally by comparing voluntary contractions to those elicited by electrical stimulation of the extensor pollicis longus muscle. To determine other factors of motor-unit physiology that may contribute to SDN, a model was constructed and its output compared with the empirical data. SDN was evident in voluntary isometric contractions as a linear scaling of force variability (SD) with respect to the mean force level. However, during electrically stimulated contractions to the same force levels, the variability remained constant over the same range of mean forces. When the subjects were asked to combine voluntary with stimulation-induced contractions, the linear scaling relationship between the SD and mean force returned. The modeling results highlight that much of the basic physiological organization of the motor-unit pool, such as range of twitch amplitudes and range of recruitment thresholds, biases force output to exhibit linearly scaled SDN. This is in contrast to the square root scaling of variability with mean force present in any individual motor-unit of the pool. Orderly recruitment by twitch amplitude was a necessary condition for producing linearly scaled SDN. Surprisingly, the scaling of SDN was independent of the variability of motoneuron firing and therefore by inference, independent of presynaptic noise in the motor command. We conclude that the linear scaling of SDN during voluntary isometric contractions is a natural by-product of the organization of the motor-unit pool that does not depend on signal-dependent noise in the motor command. Synaptic noise in the motor command and common drive, which give rise to the variability and synchronization of motoneuron spiking, determine the magnitude of the force variability at a given level of mean force output.

Enhancing the Communication of Suddenly Speechless Critical Care Patients.

PubMed

Rodriguez, Carmen S; Rowe, Meredeth; Thomas, Loris; Shuster, Jonathan; Koeppel, Brent; Cairns, Paula

2016-05-01

Sudden speechlessness is common in critically ill patients who are intubated or have had surgery for head and neck cancer. Sudden inability to speak poses challenges for hospitalized patients because strategies to facilitate communication are often limited and unreliable. To determine the impact of a technology-based communication intervention on patients' perception of communication difficulty, satisfaction with communication methods, and frustration with communication. A quasi-experimental, 4-cohort (control and intervention) repeated-measures design was used. Data were collected daily for up to 10 days. Patients in adult critical care units were followed up as they were transferred to other units within the institutions selected for the study. The impact of a technology-based communication system (intervention) was compared with usual care (control). Patients' communication outcomes pertinent to communication with nursing staff that were evaluated included perception of communication ease, satisfaction with methods used for communication, and frustration with communication. Compared with participants in the control group, participants in the intervention group reported lower mean frustration levels (-2.68; SE, 0.17; 95% CI, -3.02 to -2.34; P < .001) and higher mean satisfaction levels (0.59; SE, 0.16; 95% CI, 0.27 to 0.91; P < .001) with use of the communication intervention. Participants in the intervention group reported a consistent increase in perception of communication ease during the hospital stay. The results facilitated evaluation of a bedside technology-based communication intervention tailored to the needs of suddenly speechless critically ill patients. ©2016 American Association of Critical-Care Nurses.

Infectious Disease in a Warming World: How Weather Influenced West Nile Virus in the United States (2001–2005)

PubMed Central

Soverow, Jonathan E.; Wellenius, Gregory A.; Fisman, David N.; Mittleman, Murray A.

2009-01-01

Background The effects of weather on West Nile virus (WNV) mosquito populations in the United States have been widely reported, but few studies assess their overall impact on transmission to humans. Objectives We investigated meteorologic conditions associated with reported human WNV cases in the United States. Methods We conducted a case–crossover study to assess 16,298 human WNV cases reported to the Centers for Disease Control and Prevention from 2001 to 2005. The primary outcome measures were the incidence rate ratio of disease occurrence associated with mean weekly maximum temperature, cumulative weekly temperature, mean weekly dew point temperature, cumulative weekly precipitation, and the presence of ≥ 1 day of heavy rainfall (≥ 50 mm) during the month prior to symptom onset. Results Increasing weekly maximum temperature and weekly cumulative temperature were similarly and significantly associated with a 35–83% higher incidence of reported WNV infection over the next month. An increase in mean weekly dew point temperature was significantly associated with a 9–38% higher incidence over the subsequent 3 weeks. The presence of at least 1 day of heavy rainfall within a week was associated with a 29–66% higher incidence during the same week and over the subsequent 2 weeks. A 20-mm increase in cumulative weekly precipitation was significantly associated with a 4–8% increase in incidence of reported WNV infection over the subsequent 2 weeks. Conclusions Warmer temperatures, elevated humidity, and heavy precipitation increased the rate of human WNV infection in the United States independent of season and each others’ effects. PMID:19654911

Three-unit posterior zirconia-ceramic fixed dental prostheses (FDPs) veneered with layered and milled (CAD-on) veneering ceramics: 1-year follow-up of a randomized controlled clinical trial.

PubMed

Grohmann, Philipp; Bindl, Andreas; Hämmerle, Christoph; Mehl, Albert; Sailer, Irena

2015-01-01

The aim of this multicenter randomized controlled clinical trial was to test posterior zirconia-ceramic fixed dental prostheses (FDPs) veneered with a computer-aided design/computer- assisted manufacture (CAD/CAM) lithium disilicate veneering ceramic (CAD-on) and manually layered zirconia veneering ceramic with respect to survival of the FDPs, and technical and biologic outcomes. Sixty patients in need of one posterior three-unit FDP were included. The zirconia frameworks were produced with a CAD/CAM system (Cerec inLab 3D/Cerec inEOS inLab). Thirty FDPs were veneered with a CAD/CAM lithium disilicate veneering ceramic (Cad-on) (test) and 30 were veneered with a layered zirconia veneering ceramic (control). For the clinical evaluation at baseline, 6, and 12 months, the United States Public Health Service (USPHS) criteria were used. The biologic outcome was judged by comparing the plaque control record (PCR), bleeding on probing (BOP), and probing pocket depth (PPD). Data were statistically analyzed. Fifty-six patients were examined at a mean follow-up of 13.9 months. At the 1-year follow-up the survival rate was 100% in the test and in the control group. No significant differences of the technical outcomes occurred. Major chipping occurred in the control group (n = 3) and predominantly minor chipping in the test group (minor n = 2, major n = 1). No biologic problems or differences were found. Both types of zirconia-ceramic FDPs exhibited very good clinical outcomes without differences between groups. Chipping occurred in both types of FDPs at small amounts, yet the extension of the chippings differed. The test FDPs predominantly exhibited minor chipping, the control FDPs major chipping.

Evaluation of the severity of malocclusions in children affected by osteogenesis imperfecta with the peer assessment rating and discrepancy indexes.

PubMed

Rizkallah, Jean; Schwartz, Stephane; Rauch, Frank; Glorieux, Francis; Vu, Duy-Dat; Muller, Katia; Retrouvey, Jean-Marc

2013-03-01

Osteogenesis imperfecta is a heritable disorder affecting bone and tooth development. Malocclusion is frequent in those affected by osteogenesis imperfecta, but this has not been studied in detail. The purpose of this study was to describe and quantify the severity of malocclusions in patients with osteogenesis imperfecta. Articulated dental casts were obtained from 49 patients diagnosed with osteogenesis imperfecta (ages 5-19 years; 28 female) and 49 age- and sex-matched control subjects who did not have osteogenesis imperfecta. Both groups were seeking orthodontic treatment. Malocclusions were scored by using the peer assessment rating (PAR) and the discrepancy index (DI). The average United Kingdom weighted PAR scores were 31.1 (SD, 14.5) for the osteogenesis imperfecta group and 22.7 (SD, 10.7) for the control group (P <0.05). The mean United States weighted PAR scores were 32.2 (SD, 15.0) for patients with osteogenesis imperfecta and 21.6 (SD, 9.6) for the controls (P <0.05). The average modified DI scores were 29.8 (SD, 20.2) for the osteogenesis imperfecta group and 12.4 (SD, 6.8) for the control group (P <0.05). Group differences were greatest for lateral open bite (osteogenesis imperfecta group, 7.1; control group, 0.3) for the DI parameters and anterior crossbite (osteogenesis imperfecta group, 13.0; control group, 3.8 [United Kingdom]) for the PAR. Both the PAR and the DI showed that malocclusions were significantly more severe in patients with osteogenesis imperfecta than in the control group. There was a higher incidence of Class III malocclusion associated with anterior and lateral open bites in patients affected by osteogenesis imperfecta. Copyright © 2013 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Garment Counting in a Textile Warehouse by Means of a Laser Imaging System

PubMed Central

Martínez-Sala, Alejandro Santos; Sánchez-Aartnoutse, Juan Carlos; Egea-López, Esteban

2013-01-01

Textile logistic warehouses are highly automated mechanized places where control points are needed to count and validate the number of garments in each batch. This paper proposes and describes a low cost and small size automated system designed to count the number of garments by processing an image of the corresponding hanger hooks generated using an array of phototransistors sensors and a linear laser beam. The generated image is processed using computer vision techniques to infer the number of garment units. The system has been tested on two logistic warehouses with a mean error in the estimated number of hangers of 0.13%. PMID:23628760

Garment counting in a textile warehouse by means of a laser imaging system.

PubMed

Martínez-Sala, Alejandro Santos; Sánchez-Aartnoutse, Juan Carlos; Egea-López, Esteban

2013-04-29

Textile logistic warehouses are highly automated mechanized places where control points are needed to count and validate the number of garments in each batch. This paper proposes and describes a low cost and small size automated system designed to count the number of garments by processing an image of the corresponding hanger hooks generated using an array of phototransistors sensors and a linear laser beam. The generated image is processed using computer vision techniques to infer the number of garment units. The system has been tested on two logistic warehouses with a mean error in the estimated number of hangers of 0.13%.

Small area variation in diabetes prevalence in Puerto Rico

PubMed Central

Tierney, Edward F.; Burrows, Nilka R.; Barker, Lawrence E.; Beckles, Gloria L.; Boyle, James P.; Cadwell, Betsy L.; Kirtland, Karen A.; Thompson, Theodore J.

2015-01-01

Objective To estimate the 2009 prevalence of diagnosed diabetes in Puerto Rico among adults ≥ 20 years of age in order to gain a better understanding of its geographic distribution so that policymakers can more efficiently target prevention and control programs. Methods A Bayesian multilevel model was fitted to the combined 2008–2010 Behavioral Risk Factor Surveillance System and 2009 United States Census data to estimate diabetes prevalence for each of the 78 municipios (counties) in Puerto Rico. Results The mean unadjusted estimate for all counties was 14.3% (range by county, 9.9%–18.0%). The average width of the confidence intervals was 6.2%. Adjusted and unadjusted estimates differed little. Conclusions These 78 county estimates are higher on average and showed less variability (i.e., had a smaller range) than the previously published estimates of the 2008 diabetes prevalence for all United States counties (mean, 9.9%; range, 3.0%–18.2%). PMID:23939364

On effective temperature in network models of collective behavior

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

Porfiri, Maurizio, E-mail: mporfiri@nyu.edu; Ariel, Gil, E-mail: arielg@math.biu.ac.il

Collective behavior of self-propelled units is studied analytically within the Vectorial Network Model (VNM), a mean-field approximation of the well-known Vicsek model. We propose a dynamical systems framework to study the stochastic dynamics of the VNM in the presence of general additive noise. We establish that a single parameter, which is a linear function of the circular mean of the noise, controls the macroscopic phase of the system—ordered or disordered. By establishing a fluctuation–dissipation relation, we posit that this parameter can be regarded as an effective temperature of collective behavior. The exact critical temperature is obtained analytically for systems withmore » small connectivity, equivalent to low-density ensembles of self-propelled units. Numerical simulations are conducted to demonstrate the applicability of this new notion of effective temperature to the Vicsek model. The identification of an effective temperature of collective behavior is an important step toward understanding order–disorder phase transitions, informing consistent coarse-graining techniques and explaining the physics underlying the emergence of collective phenomena.« less

Willingness to pay for small solar powered bed net fans: results of a Becker-DeGroot-Marschak auction in Ghana.

PubMed

Yukich, Joshua O; Briët, Olivier J T; Ahorlu, Collins K; Nardini, Peter; Keating, Joseph

2017-08-07

Long-lasting insecticidal nets (LLINs) are one of the main interventions recommended by the World Health Organization for malaria vector control. LLINs are ineffective if they are not being used. Subsequent to the completion of a cluster randomized cross over trial conducted in rural Greater Accra where participants were provided with the 'Bɔkɔɔ System'-a set of solar powered net fan and light consoles with a solar panel and battery-or alternative household water filters, all trial participants were invited to participate in a Becker-DeGroot-Marschak auction to determine the mean willingness to pay (WTP) for the fan and light consoles and to estimate the demand curve for the units. Results demonstraed a mean WTP of approximately 55 Cedis (~13 USD). Demand results suggested that at a price which would support full manufacturing cost recovery, a majority of households in the area would be willing to purchase at least one such unit.

Fitness variables and the lipid profile in United States astronauts

NASA Technical Reports Server (NTRS)

Berry, M. A.; Squires, W. G.; Jackson, A. S.

1980-01-01

The study examines the relationship between several measures of fitness and the lipid profile in United States astronauts. Data were collected on 89 astronauts, previously selected (PSA) and newly selected (NSA), during their annual physical examinations. Several similarities were seen in the two groups. The PSA (mean age of 46.1) had a lower maximum oxygen capacity (41.7 ml kg/min vs. 47.5 ml kg/min); when adjusted for age, it was no different from the NSA (mean age 33.5). The PSA had similar body composition with 15.7% - lower than expected for age. The lipid profiles of the two groups were basically the same with the differences being a function of age. Compared to a normative population, the astronauts had similar cholesterols, lower triglycerides, and higher HDLs. The astronaut profiles were generally more favorable than the age-matched controls, which is felt to be a result of the self-supervised conditioning program and annual preventive medicine consultation and education.

Vaginitis.

PubMed

Friedrich, E G

1985-06-01

Vaginitis is one of the most common complaints of women in the United States today. About 90% of patients with this problem suffer from infection of the vagina caused by Candida, Gardnerella, or Trichomonas. The diagnosis and effective treatment of these common infections depend on accurate identification of the entity, effective specific therapy, and restoration of the normal ecosystem of the vagina. At the same time women should be made aware that not all discharge means infection and that any attempts at self-treatment may only worsen their condition. Proper hygiene habits, dietary control, and management of stress are all helpful factors in the control of recurrent vaginal infections.

7 CFR 1260.510 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... means live, domesticated bovine animals regardless of age. Department means the United States Department... United States. Livestock and Seed Division means the Livestock and Seed Division of the Department's...

Estimates of Flow Duration, Mean Flow, and Peak-Discharge Frequency Values for Kansas Stream Locations

USGS Publications Warehouse

Perry, Charles A.; Wolock, David M.; Artman, Joshua C.

2004-01-01

Streamflow statistics of flow duration and peak-discharge frequency were estimated for 4,771 individual locations on streams listed on the 1999 Kansas Surface Water Register. These statistics included the flow-duration values of 90, 75, 50, 25, and 10 percent, as well as the mean flow value. Peak-discharge frequency values were estimated for the 2-, 5-, 10-, 25-, 50-, and 100-year floods. Least-squares multiple regression techniques were used, along with Tobit analyses, to develop equations for estimating flow-duration values of 90, 75, 50, 25, and 10 percent and the mean flow for uncontrolled flow stream locations. The contributing-drainage areas of 149 U.S. Geological Survey streamflow-gaging stations in Kansas and parts of surrounding States that had flow uncontrolled by Federal reservoirs and used in the regression analyses ranged from 2.06 to 12,004 square miles. Logarithmic transformations of climatic and basin data were performed to yield the best linear relation for developing equations to compute flow durations and mean flow. In the regression analyses, the significant climatic and basin characteristics, in order of importance, were contributing-drainage area, mean annual precipitation, mean basin permeability, and mean basin slope. The analyses yielded a model standard error of prediction range of 0.43 logarithmic units for the 90-percent duration analysis to 0.15 logarithmic units for the 10-percent duration analysis. The model standard error of prediction was 0.14 logarithmic units for the mean flow. Regression equations used to estimate peak-discharge frequency values were obtained from a previous report, and estimates for the 2-, 5-, 10-, 25-, 50-, and 100-year floods were determined for this report. The regression equations and an interpolation procedure were used to compute flow durations, mean flow, and estimates of peak-discharge frequency for locations along uncontrolled flow streams on the 1999 Kansas Surface Water Register. Flow durations, mean flow, and peak-discharge frequency values determined at available gaging stations were used to interpolate the regression-estimated flows for the stream locations where available. Streamflow statistics for locations that had uncontrolled flow were interpolated using data from gaging stations weighted according to the drainage area and the bias between the regression-estimated and gaged flow information. On controlled reaches of Kansas streams, the streamflow statistics were interpolated between gaging stations using only gaged data weighted by drainage area.

Spacecraft flight control with the new phase space control law and optimal linear jet select

NASA Technical Reports Server (NTRS)

Bergmann, E. V.; Croopnick, S. R.; Turkovich, J. J.; Work, C. C.

1977-01-01

An autopilot designed for rotation and translation control of a rigid spacecraft is described. The autopilot uses reaction control jets as control effectors and incorporates a six-dimensional phase space control law as well as a linear programming algorithm for jet selection. The interaction of the control law and jet selection was investigated and a recommended configuration proposed. By means of a simulation procedure the new autopilot was compared with an existing system and was found to be superior in terms of core memory, central processing unit time, firings, and propellant consumption. But it is thought that the cycle time required to perform the jet selection computations might render the new autopilot unsuitable for existing flight computer applications, without modifications. The new autopilot is capable of maintaining attitude control in the presence of a large number of jet failures.

Independence of motor unit recruitment and rate modulation during precision force control.

PubMed

Kamen, G; Du, D C

1999-01-01

The vertebrate motor system chiefly employs motor unit recruitment and rate coding to modulate muscle force output. In this paper, we studied how the recruitment of new motor units altered the firing rate of already-active motor units during precision force production in the first dorsal interosseous muscle. Six healthy adults performed linearly increasing isometric voluntary contractions while motor unit activity and force output were recorded. After motor unit discharges were identified, motor unit firing rates were calculated before and after the instances of new motor unit recruitment. Three procedures were applied to compute motor unit firing rate, including the mean of a fixed number of inter-spike intervals and the constant width weighted Hanning window filter method, as well as a modified boxcar technique. In contrast to previous reports, the analysis of the firing rates of over 200 motor units revealed that reduction of the active firing rates was not a common mechanism used to accommodate the twitch force produced by the recruitment of a new motor unit. Similarly, during de-recruitment there was no tendency for motor unit firing rates to increase immediately following the cessation of activity in other motor units. Considerable consistency in recruitment behavior was observed during repeated contractions. However, firing rates during repeated contractions demonstrated considerably more fluctuation. It is concluded that the neuromuscular system does not use short-term preferential motor unit disfacilitation to effect precise regulation of muscular force output.

Position versus force control: using the 2-DOF robotic ankle trainer to assess ankle's motor control.

PubMed

Farjadian, Amir B; Nabian, Mohsen; Hartman, Amber; Corsino, Johnathan; Mavroidis, Constantinos; Holden, Maureen K

2014-01-01

An estimated of 2,000,000 acute ankle sprains occur annually in the United States. Furthermore, ankle disabilities are caused by neurological impairments such as traumatic brain injury, cerebral palsy and stroke. The virtually interfaced robotic ankle and balance trainer (vi-RABT) was introduced as a cost-effective platform-based rehabilitation robot to improve overall ankle/balance strength, mobility and control. The system is equipped with 2 degrees of freedom (2-DOF) controlled actuation along with complete means of angle and torque measurement mechanisms. Vi-RABT was used to assess ankle strength, flexibility and motor control in healthy human subjects, while playing interactive virtual reality games on the screen. The results suggest that in the task with 2-DOF, subjects have better control over ankle's position vs. force.

48 CFR 470.101 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... commodity or product produced in the United States cannot be readily distinguished from a commodity or product not produced in the United States. Department means the Department of Agriculture. Food and... organization means an organization which will receive commodities from the United States Agency for...

Cardiovascular medication use in patients with undiagnosed obstructive sleep apnoea

PubMed Central

Otake, K; Delaive, K; Walld, R; Manfreda, J; Kryger, M

2002-01-01

Background: A study was undertaken in patients with undiagnosed sleep apnoea/hypopnoea syndrome (OSAS) to document the use of prescribed medications, especially those used in cardiovascular diseases, in the year before the OSAS diagnosis was confirmed. Methods: A total of 549 patients with OSAS (401 men of mean age 47.2 years, mean body mass index (BMI) 35.5 kg/m2, mean apnoea/hypopnoea index (AHI) 47.2 and148 women of mean age 50.2 years, BMI 39.6 kg/m2, AHI 32.6) were each matched to one general population control by age, sex, geographical location, and family physician. Medication use was evaluated for patients and controls using a database containing information about all prescriptions completed in the province of Manitoba, Canada. Results: In the year before OSAS was diagnosed, prescribed medication costs were $155.91 (Can) (95 % CI $91.34 to $220.49) greater for cases than for controls. Cases were dispensed 3.3 (95% CI 1.5 to 5.2) more prescriptions, were on 1.2 (95% CI 0.8 to 1.6) more medications, and were supplied with 157.4 (95% CI 95.9 to 218.8) more daily doses of medication. The odds ratio of OSAS cases being on a prescribed medication was 1.88 relative to controls (95% CI 1.38 to 2.54, p<0.0001). In the same year 36.6% of cases and 19.7% of controls were using medications for cardiovascular disease (OR 2.82, 95% CI 2.05 to 3.89, p<0.0001), consuming 79.4 (95% CI 48.9 to 109.8) more daily doses of medication, having been dispensed 1.7 (95% CI 1.0 to 2.4) more prescriptions, and at a $75.26 (95% CI $44.03 to $106.50) greater cost. The odds ratio of patients with OSAS being on medications indicated for the treatment of systemic hypertension was 2.71 (95% CI 1.96 to 3.77) relative to controls; however, such medications might also be prescribed for other indications such as angina pectoris and congestive heart failure, and for the secondary prevention of myocardial infarction. The use of medications indicated for the treatment of systemic hypertension was predicted significantly by age (odds ratio (OR) 1.10 per year), BMI (OR 1.05 per unit), and AHI (OR 1.01 per unit). Conclusions: In the year before OSAS was diagnosed, patients with OSAS were heavy users of medications, particularly those used to treat cardiovascular diseases. PMID:11978918

Clinical and financial analysis of an acute palliative care unit in an oncological department.

PubMed

Mercadante, S; Intravaia, G; Villari, P; Ferrera, P; David, F; Casuccio, A; Mangione, S

2008-09-01

The aim of this article is to describe the clinical activity and medical intervention of an acute model of palliative care unit (APC), as well as the reimbursement procedures and economic viability. A sample of 504 patients admitted at an APC in 1 year was surveyed. Indications for admission, pain and symptom intensity, analgesic treatments, procedures, instrumental examinations and modalities of discharge were recorded. For each patient, tariff for reimbursement was calculated according to the existent disease related grouping (DRG) system. The mean age was 62 years, and 246 patients were males. The mean hospital stay was 5.4 days. Pain control was the most frequent indication for admission. All patients had laboratory tests and several instrumental examinations. Almost all patients were prescribed one or more opioids at significant doses, and different routes of administration, as well as medication as needed. 59 patients received blood cell transfusions and 34 interventional procedures. Only 40 patients died in the unit, 11 of them being sedated at the end of life. Treatment efficacy was considered optimal and mild in 264 and 226 patients respectively. A mean of 3019 euros for admission was reimbursed by the Health Care System. APCs are of paramount importance within an oncological department, as they provide effective and intensive treatments during the entire course of disease, providing a simultaneous and integrated approach. Our findings also suggest both a cost and quality incentive for oncological departments to develop APC.

A tailored educational intervention improves doctor's performance in managing depression: a randomized controlled trial.

PubMed

Shirazi, Mandana; Lonka, Kirsti; Parikh, Sagar V; Ristner, Gunilla; Alaeddini, Farshid; Sadeghi, Majid; Wahlstrom, Rolf

2013-02-01

To assess the effects of a tailored and activating educational intervention, based on a three-stage modified Prochaska model of readiness-to-change, on the performance of general physicians in primary care (GPs) regarding management of depressive disorders. Parallel group, randomized control trial. Primary hypothesis was that performance would improve by 20 percentage units in the intervention arm. The setting was primary care in southern Tehran. The participants were 192 GPs stratified on stage of readiness-to-change, sex, age and work experience. The intervention was a 2-day interactive workshop for a small group of GPs' at a higher stage of readiness-to-change ('intention') and a 2-day interactive large group meeting for those with lower propensity to change ('attitude') at the pre-assessment. GPs in the control arm participated in a standard educational programme on the same topic. The main outcome measures were validated tools to assess GPs' performance by unannounced standardized patients, regarding diagnosis and treatment of depressive disorders. The assessments were made 2 months before and 2 months after the intervention. GPs in the intervention arm significantly improved their overall mean scores for performance regarding both diagnosis, with an intervention effect of 14 percentage units (P = 0.007), and treatment and referral, with an intervention effect of 20 percentage units (P < 0.0001). The largest improvement after the intervention appeared in the small group: 30 percentage units for diagnosis (P = 0.027) and 29 percentage units for treatment and referral (P < 0.0001). Activating learning methods, tailored according to the participants' readiness to change, improved clinical performance of GPs in continuing medical education and can be recommended for continuing professional development. © 2011 Blackwell Publishing Ltd.

Automatic Control of the Concrete Mixture Homogeneity in Cycling Mixers

NASA Astrophysics Data System (ADS)

Anatoly Fedorovich, Tikhonov; Drozdov, Anatoly

2018-03-01

The article describes the factors affecting the concrete mixture quality related to the moisture content of aggregates, since the effectiveness of the concrete mixture production is largely determined by the availability of quality management tools at all stages of the technological process. It is established that the unaccounted moisture of aggregates adversely affects the concrete mixture homogeneity and, accordingly, the strength of building structures. A new control method and the automatic control system of the concrete mixture homogeneity in the technological process of mixing components have been proposed, since the tasks of providing a concrete mixture are performed by the automatic control system of processing kneading-and-mixing machinery with operational automatic control of homogeneity. Theoretical underpinnings of the control of the mixture homogeneity are presented, which are related to a change in the frequency of vibrodynamic vibrations of the mixer body. The structure of the technical means of the automatic control system for regulating the supply of water is determined depending on the change in the concrete mixture homogeneity during the continuous mixing of components. The following technical means for establishing automatic control have been chosen: vibro-acoustic sensors, remote terminal units, electropneumatic control actuators, etc. To identify the quality indicator of automatic control, the system offers a structure flowchart with transfer functions that determine the ACS operation in transient dynamic mode.

Particle Capture Devices and Methods of Use Thereof

NASA Technical Reports Server (NTRS)

Voldman, Joel (Inventor); Skelley, Alison M. (Inventor); Kirak, Oktay (Inventor); Jaenisch, Rudolf (Inventor)

2015-01-01

The present invention provides a device and methods of use thereof in microscale particle capturing and particle pairing. This invention provides particle patterning device, which mechanically traps individual particles within first chambers of capture units, transfer the particles to second chambers of opposing capture units, and traps a second type of particle in the same second chamber. The device and methods allow for high yield assaying of trapped cells, high yield fusion of trapped, paired cells, for controlled binding of particles to cells and for specific chemical reactions between particle interfaces and particle contents. The device and method provide means of identification of the particle population and a facile route to particle collection.

Logic design for dynamic and interactive recovery.

NASA Technical Reports Server (NTRS)

Carter, W. C.; Jessep, D. C.; Wadia, A. B.; Schneider, P. R.; Bouricius, W. G.

1971-01-01

Recovery in a fault-tolerant computer means the continuation of system operation with data integrity after an error occurs. This paper delineates two parallel concepts embodied in the hardware and software functions required for recovery; detection, diagnosis, and reconfiguration for hardware, data integrity, checkpointing, and restart for the software. The hardware relies on the recovery variable set, checking circuits, and diagnostics, and the software relies on the recovery information set, audit, and reconstruct routines, to characterize the system state and assist in recovery when required. Of particular utility is a handware unit, the recovery control unit, which serves as an interface between error detection and software recovery programs in the supervisor and provides dynamic interactive recovery.

Focal-surface detector for heavy ions

DOEpatents

Erskine, John R.; Braid, Thomas H.; Stoltzfus, Joseph C.

1979-01-01

A detector of the properties of individual charged particles in a beam includes a gridded ionization chamber, a cathode, a plurality of resistive-wire proportional counters, a plurality of anode sections, and means for controlling the composition and pressure of gas in the chamber. Signals generated in response to the passage of charged particles can be processed to identify the energy of the particles, their loss of energy per unit distance in an absorber, and their angle of incidence. In conjunction with a magnetic spectrograph, the signals can be used to identify particles and their state of charge. The detector is especially useful for analyzing beams of heavy ions, defined as ions of atomic mass greater than 10 atomic mass units.

Dynamic thermoregulation of the sample in flow cytometry.

PubMed

Graves, Steven W; Habbersett, Robert C; Nolan, John P

2002-05-01

Fine control of temperature is an important capability for any analytical platform. A circulating water bath has been the traditional means of maintaining constant temperature in the sample chamber of a flow cytometer, but this approach does not permit rapid changes in sample temperature. This unit explains the use of Peltier modules for regulation of sample temperature. The heat pumping generated by the passage of current through properly matched semiconductors, known as the Peltier effect, makes it possible for these thermoelectric modules to both heat and cool. The authors describe the construction of a Peltier module based thermoregulation unit in step-by-step detail and present a demonstration of flow cytometry measurements as a function of temperature.

Active Power Control of Wind Turbines for Ancillary Services: A Comparison of Pitch and Torque Control Methodologies

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

Aho, Jacob; Fleming, Paul; Pao, Lucy Y.

As wind energy generation becomes more prevalent in some regions, there is increased demand for wind power plants to provide ancillary services, which are essential for grid reliability. This paper compares two different wind turbine control methodologies to provide active power control (APC) ancillary services, which include derating or curtailing power generation, providing automatic generation control (AGC), and providing primary frequency control (PFC). The torque APC controller provides all power control through the power electronics whereas the pitch APC controller uses the blade pitch actuators as the primary means of power control. These controllers are simulated under various wind conditionsmore » with different derating set points and AGC participation levels. The metrics used to compare their performance are the damage equivalent loads (DELs) induced on the structural components and AGC performance metrics, which are used to determine the payments for AGC services by system operators in the United States. The simulation results show that derating the turbine reduces structural loads for both control methods, with the APC pitch control providing larger reductions in DELs, lower AGC performance scores, and higher root-mean-square pitch rates. Providing AGC increases the structural loads when compared to only derating the turbine, but even the AGC DELs are generally lower than those of the baseline control system. The torque APC control methodology also allows for more sustained PFC responses under certain derating conditions.« less

A reassessment of mercury in silastic strain gauge plethysmography for microvascular permeability assessment in man.

PubMed Central

Gamble, J; Gartside, I B; Christ, F

1993-01-01

1. We have used non-invasive mercury in a silastic strain gauge system to assess the effect of pressure step size, on the time course of the rapid volume response (RVR) to occlusion pressure. We also obtained values for hydraulic conductance (Kf), isovolumetric venous pressure (Pvi) and venous pressure (Pv) in thirty-five studies on the legs of twenty-three supine control subjects. 2. The initial rapid volume response to small (9.53 +/- 0.45 mmHg, mean +/- S.E.M.) stepped increases in venous pressure, the rapid volume response, could be described by a single exponential of time constant 15.54 +/- 1.14 s. 3. Increasing the size of the pressure step, to 49.8 +/- 1.1 mmHg, gave a larger value for the RVR time constant (mean 77.3 +/- 11.6 s). 4. We propose that the pressure-dependent difference in the duration of the rapid volume response, in these two situations, might be due to a vascular smooth muscle-based mechanism, e.g. the veni-arteriolar reflex. 5. The mean (+/- S.E.M.) values for Kf, Pvi and Pv were 4.27 +/- 0.18 (units, ml min-1 (100 g)-1 mmHg-1 x 10(-3), 21.50 +/- 0.81 (units, mmHg) and 9.11 +/- 0.94 (units, mmHg), respectively. 6. During simultaneous assessment of these parameters in arms and legs, it was found that they did not differ significantly from one another. 7. We propose that the mercury strain gauge system offers a useful, non-invasive means of studying the mechanisms governing fluid filtration in human limbs. Images Fig. 1 PMID:8229810

Effect of Kangaroo Mother Care on physical growth, breastfeeding and its acceptability.

PubMed

Gathwala, Geeta; Singh, Bir; Singh, Jagjit

2010-10-01

The aim of this study was to determine whether the implementation of Kangaroo Mother Care (KMC) to low birth weight infants would improve physical growth, breastfeeding and its acceptability. A randomized controlled trial was performed over 16 months in which 110 neonates were randomized into a KMC group and a control group using a random number table. The KMC group was subjected to KMC for at least 6 h per day. The babies also received KMC after moving from the neonatal intensive care unit and at home. The control group received standard care (incubator or open care system). Weight, length and occipitofrontal circumference (OFC) were measured weekly for three months. The acceptability of KMC by mothers and nursing staff was assessed on day 7 after the start of KMC using a questionnaire incorporating the Likert scale. Breastfeeding rates were calculated based on history at end of three months. The mean gestational age was 35.48 ± 1.20 weeks in the KMC group and 35.04 ± 1.09 weeks in the control group (P > 0.05). KMC was initiated at a mean age of 1.72 ± 0.45 days and the duration of KMC was 9.74 ± 1.48 h/day. The mean birth weight was 1.69 ± 0.11 kg in the KMC group compared to 1.69 ± 0.12 kg in the control group (P > 0.05). The mean weight gain in gm/day in the KMC group was 21.92 ± 1.44 compared to 18.61 ± 1.28 in the control group (P < 0.05). The mean length gain in cm/week was 1.03 ± 0.5 in the KMC group compared to 0.74 ± 0.05 in the control group (P < 0.05). The mean OFC gain in cm/week was 0.59 ± 0.04 in the KMC group compared to 0.47 ± 0.03 in the control group (P < 0.05). The exclusive breast-feeding rate at end of three months was 88% in the KMC group compared to 72% in the control group (P < 0.05). KMC improved physical growth, breastfeeding rates and was well accepted by both mothers and nursing staff.

Association of Resident Coverage with Cost, Length of Stay, and Profitability at a Community Hospital

PubMed Central

Shine, Daniel; Beg, Sumbul; Jaeger, Joseph; Pencak, Dorothy; Panush, Richard

2001-01-01

OBJECTIVE The effect of care by medical residents on hospital length of stay (LOS), indirect costs, and reimbursement was last examined across a range of illnesses in 1981; the issue has never been examined at a community hospital. We studied resource utilization and reimbursement at a community hospital in relation to the involvement of medical residents. DESIGN This nonrandomized observational study compared patients discharged from a general medicine teaching unit with those discharged from nonteaching general medical/surgical units. SETTING A 620-bed community teaching hospital with a general medicine teaching unit (resident care) and several general medicine nonteaching units (no resident care). PATIENTS All medical discharges between July 1998 and February 1999, excluding those from designated subspecialty and critical care units. MEASUREMENTS AND MAIN RESULTS Endpoints included mean LOS in excess of expected LOS, mean cost in excess of expected mean payments, and mean profitability (payments minus total costs). Observed values were obtained from the hospital's database and expected values from a proprietary risk–cost adjustment program. No significant difference in LOS between 917 teaching-unit patients and 697 nonteaching patients was demonstrated. Costs averaged $3,178 (95% confidencence interval (CI) ± $489) less than expected among teaching-unit patients and $4,153 (95% CI ± $422) less than expected among nonteaching-unit patients. Payments were significantly higher per patient on the teaching unit than on the nonteaching units, and as a result mean, profitability was higher: $848 (95% CI ± $307) per hospitalization for teaching-unit patients and $451 (95% CI ± $327) for patients on the nonteaching units. Teaching-unit patients of attendings who rarely admitted to the teaching unit (nonteaching attendings) generated an average profit of $1,299 (95% CI ± $613), while nonteaching patients of nonteaching attendings generated an average profit of $208 (95% CI ± $437). CONCLUSIONS Resident care at our community teaching hospital was associated with significantly higher costs but also with higher payments and greater profitability. PMID:11251744

Iron supplementation and 2-unit red blood cell apheresis: a randomized, double-blind, placebo-controlled study.

PubMed

Radtke, Hartmut; Mayer, Beate; Röcker, Lothar; Salama, Abdulgabar; Kiesewetter, Holger

2004-10-01

The benefits of 2-unit red blood cell (RBC) apheresis are evident, but iron depletion may be a limiting factor in using this technology. Regular iron supplementation may allow a better utilization of this technique. In this study, 260 regular blood donors donated 2-unit RBCs on each of a total of seven visits at intervals of 8 to 10 weeks. The volunteers were randomly assigned to receive 100 mg of iron(II) or placebo daily. Group A received iron capsules after the first three donations, and Group B after the second three donations, respectively. Hemoglobin, serum ferritin, and serum iron were measured before each donation. Mean serum ferritin concentration decreased after each donation in the placebo phase of both treatment groups, but it remained largely constant during the iron phase in Group A, and even increased during the iron phase in Group B. Regular iron supplementation prevents iron depletion in the majority of donors after 2-unit RBC apheresis within an 8- to 10-week period.

The effects of adding fat to diets of lactating dairy cows on total-tract neutral detergent fiber digestibility: A meta-analysis.

PubMed

Weld, K A; Armentano, L E

2017-03-01

The objective of this meta-analysis was to determine the effects of supplemental fat on fiber digestibility in lactating dairy cattle. Published papers that evaluated the effects of adding fat to the diets of lactating dairy cattle on total-tract neutral detergent fiber digestibility (ttNDFd) and dry matter intake (DMI) were compiled. The final data set included 108 fat-supplemented treatment means, not including low-fat controls, from 38 publications. The fat-supplemented treatment means exhibited a wide range of ttNDFd (49.4% ± 9.3, mean ± standard deviation) and DMI (21.3 kg/d ± 3.5). Observations were summarized as the difference between the treatment means for fat-supplemented diets minus their respective low-fat control means. Additionally, those differences were divided by the difference in diet fatty acid (FA) concentration between the treatment and control diets. Treatment means were categorized by the type of fat supplement. Supplementing 3% FA in the diet as medium-chain fats (containing predominately 12- and 14-carbon saturated FA) or unsaturated vegetable oil decreased ttNDFd by 8.0 and 1.2 percentage units, respectively. Adding 3% calcium salts of long-chain FA or saturated fats increased ttNDFd by 3.2 and 1.3 percentage units, respectively. No other fat supplement type affected ttNDFd. Except for saturated fats and animal-vegetable fats, supplementing dietary fat decreased DMI. When the values for changes in ttNDFd are regressed on changes in DMI there was a positive relationship, though the coefficient of determination is only 0.20. When changes in ttNDFd were regressed on changes in DMI, within individual fat supplement types, there was no relationship within calcium salt supplements. There was a positive relationship between changes in ttNDFd and changes in DMI for saturated fats. Neither relationship suggested that the increased ttNDFd with calcium salts or saturated FA was due to decreased DMI for these fat sources. A subset of the means included measured ruminal neutral detergent fiber digestion. Analysis of this smaller data set did not suggest that ruminal neutral detergent fiber digestibility is depressed by fat supplementation more than ttNDFd. Adding fats, other than those with medium-chain FA, consistently increased digestible energy density of the diet. However, due to reduced DMI, this increased energy density may not result in increased digestible nutrient intake. Copyright © 2017 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Reverse transport of children from a tertiary pediatric hospital.

PubMed

McPherson, Mona L; Jefferson, Larry S; Smith, E O'Brian; Sitler, Garry C; Graf, Jeanine M

2007-01-01

The purpose of this study was to determine the epidemiology and resources used and to study the potential savings of pediatric reverse transport patients. A case control study was performed with patients undergoing a reverse or outbound transport from a large, pediatric hospital. Twenty-five children undergoing reverse transport were compared with matched controls. Lengths of stay and costs were compared between the reverse transport and matched control patients. Fifty-two percent of the reverse transport patients returned home, whereas 32% went home for end-of-life care and 16% went to other facilities. The average reverse transport was more than 400 miles and cost $6,064. The reverse transport of these patients did not save pediatric intensive care unit (PICU) days but did result in a shorter hospital stay compared with the matched controls (10 vs. 19 days, P = .03). Decreased utilization of bed days came from less use of intermediate care unit resources. Pediatric patients undergo reverse transports for a variety of reasons, often for end-of-life care. The ability to reverse transport pediatric patients may not save PICU bed days but may offer pediatric tertiary care hospitals a means to provide more intermediate care bed availability.

Computer-assisted propofol administration.

PubMed

O'Connor, J P A; O'Moráin, C A; Vargo, J J

2010-01-01

The use of propofol for sedation in endoscopy may allow for better quality of sedation, quicker recovery and facilitate greater throughput in endoscopy units. The cost-effectiveness and utility of propofol sedation for endoscopic procedures is contingent on the personnel and resources required to carry out the procedure. Computer-based platforms are based on the patients response to stimulation and physiologic parameters. They offer an appealing means of delivering safe and effective doses of propofol. One such means is the bispectral index where continuous EEG recordings are used to assess the degree of sedation. Another is the closed-loop target-controlled system where a set of physical parameters, such as muscle relaxation and auditory-evoked potential, determine a level of medication appropriate to achieve sedation. Patient-controlled platforms may also be used. These electronic adjuncts may help endoscopists who wish to adopt propofol sedation to change current practices with greater confidence. Copyright 2010 S. Karger AG, Basel.

Dynamic phasing of multichannel cw laser radiation by means of a stochastic gradient algorithm

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

Volkov, V A; Volkov, M V; Garanin, S G

2013-09-30

The phasing of a multichannel laser beam by means of an iterative stochastic parallel gradient (SPG) algorithm has been numerically and experimentally investigated. The operation of the SPG algorithm is simulated, the acceptable range of amplitudes of probe phase shifts is found, and the algorithm parameters at which the desired Strehl number can be obtained with a minimum number of iterations are determined. An experimental bench with phase modulators based on lithium niobate, which are controlled by a multichannel electronic unit with a real-time microcontroller, has been designed. Phasing of 16 cw laser beams at a system response bandwidth ofmore » 3.7 kHz and phase thermal distortions in a frequency band of about 10 Hz is experimentally demonstrated. The experimental data are in complete agreement with the calculation results. (control of laser radiation parameters)« less

Air conditioning system and component therefore distributing air flow from opposite directions

NASA Technical Reports Server (NTRS)

Obler, H. D.; Bauer, H. B. (Inventor)

1974-01-01

The air conditioning system comprises a plurality of separate air conditioning units coupled to a common supply duct such that air may be introduced into the supply duct in two opposite flow directions. A plurality of outlets such as registers or auxiliary or branch ducts communicate with the supply duct and valve means are disposed in the supply duct at at least some of the outlets for automatically channelling a controllable amount of air from the supply duct to the associated outlet regardless of the direction of air flow within the supply duct. The valve means comprises an automatic air volume control apparatus for distribution within the air supply duct into which air may be introduced from two opposite directions. The apparatus incorporates a freely swinging movable vane in the supply duct to automatically channel into the associated outlet only the deflected air flow which has the higher relative pressure.

Distributed and recoverable digital control system

NASA Technical Reports Server (NTRS)

Stange, Kent (Inventor); Hess, Richard (Inventor); Kelley, Gerald B (Inventor); Rogers, Randy (Inventor)

2010-01-01

A real-time multi-tasking digital control system with rapid recovery capability is disclosed. The control system includes a plurality of computing units comprising a plurality of redundant processing units, with each of the processing units configured to generate one or more redundant control commands. One or more internal monitors are employed for detecting data errors in the control commands. One or more recovery triggers are provided for initiating rapid recovery of a processing unit if data errors are detected. The control system also includes a plurality of actuator control units each in operative communication with the computing units. The actuator control units are configured to initiate a rapid recovery if data errors are detected in one or more of the processing units. A plurality of smart actuators communicates with the actuator control units, and a plurality of redundant sensors communicates with the computing units.

Simultaneous Risk Factor Control Using Telehealth to slOw Progression of Diabetic Kidney Disease (STOP-DKD) study: Protocol and baseline characteristics of a randomized controlled trial.

PubMed

Diamantidis, Clarissa J; Bosworth, Hayden B; Oakes, Megan M; Davenport, Clemontina A; Pendergast, Jane F; Patel, Sejal; Moaddeb, Jivan; Barnhart, Huiman X; Merrill, Peter D; Baloch, Khaula; Crowley, Matthew J; Patel, Uptal D

2018-06-01

Diabetic kidney disease (DKD) is the leading cause of end-stage kidney disease (ESKD) in the United States. Multiple risk factors contribute to DKD development, yet few interventions target more than a single DKD risk factor at a time. This manuscript describes the study protocol, recruitment, and baseline participant characteristics for the Simultaneous Risk Factor Control Using Telehealth to slOw Progression of Diabetic Kidney Disease (STOP-DKD) study. The STOP-DKD study is a randomized controlled trial designed to evaluate the effectiveness of a multifactorial behavioral and medication management intervention to mitigate kidney function decline at 3 years compared to usual care. The intervention consists of up to 36 monthly educational modules delivered via telephone by a study pharmacist, home blood pressure monitoring, and medication management recommendations delivered electronically to primary care physicians. Patients seen at seven primary care clinics in North Carolina, with diabetes and [1] uncontrolled hypertension and [2] evidence of kidney dysfunction (albuminuria or reduced estimated glomerular filtration rate [eGFR]) were eligible to participate. Study recruitment completed in December 2014. Of the 281 participants randomized, mean age at baseline was 61.9; 52% were male, 56% were Black, and most were high school graduates (89%). Baseline co-morbidity was high- mean blood pressure was 134/76 mmHg, mean body mass index was 35.7 kg/m 2 , mean eGFR was 80.7 ml/min/1.73 m 2 , and mean glycated hemoglobin was 8.0%. Experiences of recruiting and implementing a comprehensive DKD program to individuals at high risk seen in the primary care setting are provided. NCT01829256. Copyright © 2018 Elsevier Inc. All rights reserved.

Parkinson's disease compromises the appraisal of action meanings evoked by naturalistic texts.

PubMed

García, Adolfo M; Bocanegra, Yamile; Herrera, Elena; Moreno, Leonardo; Carmona, Jairo; Baena, Ana; Lopera, Francisco; Pineda, David; Melloni, Margherita; Legaz, Agustina; Muñoz, Edinson; Sedeño, Lucas; Baez, Sandra; Ibáñez, Agustín

2018-03-01

The linguistic profile of Parkinson's disease (PD) is characterized by difficulties in processing units which denote bodily movements. However, the available evidence has low ecological validity, as it stems from atomistic tasks which are never encountered in real life. Here, we assessed whether such deficits also occur for meanings evoked by context-rich narratives, considering patients with and without mild cognitive impairment (PD-MCI and PD-nMCI, respectively) and matched controls for each group. Participants read two naturalistic stories (an action text and a neutral text) and responded to questions tapping the appraisal of verb-related and circumstantial information. In PD-MCI, impairments in the appraisal of action meanings emerged alongside difficulties in other categories, but they were unique in their independence from general cognitive dysfunction. However, in PD-nMCI, deficits were observed only for action meanings, irrespective of the patients' domain-general skills (executive functions and general cognitive state). Also, using multiple group discriminant function analyses, we found that appraisal of action meanings was the only discourse-level variable that robustly contributed to classifying PD-MCI patients from controls (with an accuracy of 88% for all participants and for each sample separately). Moreover, this variable actually superseded a sensitive executive battery in discriminating between PD-nMCI and controls (with a combined accuracy of 83% for all participants, correctly classifying 79.2% of patients and 87.5% of controls). In sum, action appraisal deficits seem to constitute both a hallmark of naturalistic discourse processing in PD and a sensitive subject-level marker for patients with and without MCI. Such findings highlight the relevance of ecological measures of embodied cognitive functions in the assessment of this population. Copyright © 2017 Elsevier Ltd. All rights reserved.

Randomized Clinical Trial of Sevelamer Carbonate on Serum Klotho and Fibroblast Growth Factor 23 in CKD.

PubMed

Liabeuf, Sophie; Ryckelynck, Jean-Philippe; El Esper, Najeh; Ureña, Pablo; Combe, Christian; Dussol, Bertrand; Fouque, Denis; Vanhille, Philippe; Frimat, Luc; Thervet, Eric; Mentaverri, Romuald; Prié, Dominique; Choukroun, Gabriel

2017-12-07

Epidemiologic studies suggest that higher serum phosphaturic hormone fibroblast growth factor 23 levels are associated with increase morbidity and mortality. The aim of the FGF23 Reduction Efficacy of a New Phosphate Binder in CKD Trial was to evaluate the effect of sevelamer carbonate on serum C-terminal fibroblast growth factor 23 levels in normophosphatemic patients with CKD stage 3b/4. Patients with CKD, eGFR between 45 and 15 ml/min per 1.73 m 2 , fasting serum phosphate concentration >3.1 mg/dl, and serum C-terminal fibroblast growth factor 23 >80 relative units/ml were included in our double-blind, placebo-controlled, randomized multicenter study. All patients received 100,000 IU cholecalciferol at time of randomization. Participants received either placebo or sevelamer carbonate 4.8 g daily during a 12-week period. Biologic parameters, including serum C-terminal fibroblast growth factor 23, intact fibroblast growth factor 23, and α -klotho, were evaluated at baseline and 12 weeks after inclusion. Of 96 screened patients, 78 (mean±SD age: 63±13 years old; 70% men; mean eGFR: 27±9 ml/min per 1.73 m 2 ) met the inclusion criteria. At baseline, mean eGFR was 27±9 ml/min per 1.73 m 2 , mean serum phosphate level was 3.8±0.5 mg/dl, and median (interquartile range) serum C-terminal fibroblast growth factor 23 level was 157 (120-241) relative units/ml. After 12 weeks of treatment, urinary phosphate-to-creatinine ratio fell significantly in the sevelamer group. The sevelamer and placebo groups did not differ significantly in terms of median change in serum C-terminal fibroblast growth factor 23 levels: the median (interquartile range) change was 38 (-13-114) relative units/ml in the placebo group and 37 (-1-101) relative units/ml in the sevelamer group ( P =0.77). There was no significant difference in serum intact fibroblast growth factor 23, α -klotho, or phosphate levels changes between the two groups. Serum total and LDL cholesterol levels fell significantly in the sevelamer group. In our double-blind, placebo-controlled, randomized study performed in normophosphatemic patients with CKD, a 12-week course of sevelamer carbonate significantly reduced phosphaturia without changing serum phosphorus but did not significantly modify serum C-terminal fibroblast growth factor 23 and intact fibroblast growth factor 23 or α -klotho levels. Copyright © 2017 by the American Society of Nephrology.

Testing a dissonance body image intervention among young girls.

PubMed

Halliwell, Emma; Diedrichs, Phillippa C

2014-02-01

Body image and eating disorder interventions based on cognitive dissonance have been shown to be effective among girls and women aged 14 and above. This article reports a preliminary examination of whether a dissonance intervention is also effective when delivered in a school setting to 12- and 13-year-old girls in the United Kingdom. Girls (N = 106, mean age = 12.07 years, SD = .27) were allocated to the intervention condition or a waitlist control. In contrast to the control group, girls in the intervention condition reported significant reductions in body dissatisfaction and internalization of a thin body ideal post-intervention. There was no significant change in self-reported dietary restraint for either condition. In addition, compared with the control group, girls in the intervention condition showed increased resilience to negative media effects 1-month post-intervention. Results suggests that dissonance based programs can reduce body dissatisfaction, internalization and negative media effects among a younger group of girls than previously examined and in a United Kingdom school setting. PsycINFO Database Record (c) 2014 APA, all rights reserved.

The concept of "buffering" in systems and control theory: from metaphor to math.

PubMed

Schmitt, Bernhard M

2004-10-04

The paradigm of "buffering" is used increasingly for the description of diverse "systemic" phenomena encountered in evolutionary genetics, ecology, integrative physiology, and other areas. However, in this new context, the paradigm has not yet matured into a truly quantitative concept inasmuch as it lacks a corresponding quantitative measure of "systems-level buffering strength". Here, I develop such measures on the basis of a formal and general approach to the quantitation of buffering action. "Systems-level buffering" is shown to be synonymous with "disturbance rejection" in feedback-control systems, and can be quantitated by means of dimensionless proportions between partial flows in two-partitioned systems. The units allow either the time-independent, "static" buffering properties or the time-dependent, "dynamic" ones to be measured. Analogous to this "resistance to change", one can define and measure the "conductance to change"; this quantity corresponds to "set-point tracking" in feedback-control systems. Together, these units provide a systematic framework for the quantitation of buffering action in systems biology, and reveal the common principle behind systems-level buffering, classical acid-base buffering, and multiple other manifestations of buffering.

Marketing alcohol to young people: implications for industry regulation and research policy.

PubMed

Jackson, M C; Hastings, G; Wheeler, C; Eadie, D; Mackintosh, A M

2000-12-01

This paper focuses on the marketing of alcohol to young people in the United Kingdom, but the lessons that emerge have international significance. Alcohol is a global enterprise and recent consolidation means that it is controlled by a decreasing number of expanding multi-nationals. Alcohol companies are able to allocate significant resources to researching consumer preferences, developing new products and promoting them on an international level. Recent years have seen a growth in the value that youth culture attaches to brand labels and symbols and a move away from the healthy-living ethos. The alcohol industry's response to these trends has been to design alcoholic beverages that appeal to young people, using well-informed and precisely targeted marketing strategies. This has led to growing concerns about the implications for public health and a demand for tighter controls to regulate alcohol marketing practices. In the United Kingdom, controls on alcohol are piecemeal and reactive and the current system of voluntary regulation appears ineffective. This paper argues for more research to establish current industry practice and inform the development of a comprehensive regulatory structure and system of monitoring.

Principal-agent problems in health care systems: an international perspective.

PubMed

Smith, P C; Stepan, A; Valdmanis, V; Verheyen, P

1997-07-01

A central feature of all health care systems is the flow of finances from the population, via a variety of agencies, to the providers of health care. Each transfer of funds within the system involves a principal-agent problem, in the sense that a principal is entrusting funds to an agent with the intention that some desired aspect of health care delivery can be secured. This paper examines within the context of a principal-agent model three key elements of the health care system: the raising of finance, the transfer of funds to hospitals, and spending by hospitals. At each of these stages there is a danger that the objectives of society for the health care system are lost. In order to illustrate the issues involved, five mature systems of health care are examined: Austria, Germany, the United Kingdom, the Netherlands and the United States of America. The paper concludes that three aspects of the flow of funds are crucial to securing adequate control: the means of controlling patient entry to hospitals; the mechanism for remunerating hospitals for additional patients; and the control of physicians by hospital management.

Validation of the ASTER Global Digital Elevation Model Version 2 over the conterminous United States

USGS Publications Warehouse

Gesch, Dean B.; Oimoen, Michael J.; Zhang, Zheng; Meyer, David J.; Danielson, Jeffrey J.

2012-01-01

The ASTER Global Digital Elevation Model Version 2 (GDEM v2) was evaluated over the conterminous United States in a manner similar to the validation conducted for the original GDEM Version 1 (v1) in 2009. The absolute vertical accuracy of GDEM v2 was calculated by comparison with more than 18,000 independent reference geodetic ground control points from the National Geodetic Survey. The root mean square error (RMSE) measured for GDEM v2 is 8.68 meters. This compares with the RMSE of 9.34 meters for GDEM v1. Another important descriptor of vertical accuracy is the mean error, or bias, which indicates if a DEM has an overall vertical offset from true ground level. The GDEM v2 mean error of -0.20 meters is a significant improvement over the GDEM v1 mean error of -3.69 meters. The absolute vertical accuracy assessment results, both mean error and RMSE, were segmented by land cover to examine the effects of cover types on measured errors. The GDEM v2 mean errors by land cover class verify that the presence of aboveground features (tree canopies and built structures) cause a positive elevation bias, as would be expected for an imaging system like ASTER. In open ground classes (little or no vegetation with significant aboveground height), GDEM v2 exhibits a negative bias on the order of 1 meter. GDEM v2 was also evaluated by differencing with the Shuttle Radar Topography Mission (SRTM) dataset. In many forested areas, GDEM v2 has elevations that are higher in the canopy than SRTM.

Predictive Value of Oxidized Low-Density Lipoprotein/β2-Glycoprotein-I Complexes (oxLDL/β2GPI) in Nonautoimmune Atherothrombosis.

PubMed

Ames, Paul R J; Di Girolamo, Giuseppe; D'Andrea, Giovanna; Lopez, Luis R; Gaeta, Giovanni; Iannaccone, Luigi; Maraglione, Maurizio

2018-01-01

Lipid oxidation is a definite feature of atherosclerosis, and oxidized low-density lipoprotein (oxLDL) is not only highly immunogenic but toxic to several cell types. Beta-2-glycoprotein-I (β 2 GPI) dampens oxLDL toxicity by forming binary oxLDL/β 2 GPI complexes. We evaluated whether circulating oxLDL/β 2 GPI complexes are associated to atherosclerosis-related events (ARE) and to venous thromboembolism (VTE). In a cross-sectional case-control study, cases were (a) 57 consecutive patients (male/female [M/F] 33/24, mean age 57 [10] years) attending a thrombosis unit for ARE (myocardial infarction [MI] n = 20, peripheral vascular disease n = 7, and ischemic strokes n = 30); (b) 52 consecutive patients (M/F 22/30, mean age 55 [17] years) attending the same unit for unprovoked (VTE); (c) normal controls comprised 90 participants (M/F 35/55, mean age 41 [15] years); and (d) oxLDL/β 2 GPI complexes were measured by immunoassay and resulting levels divided into quartiles. The odds ratio (OR) of ARE was greater in the fourth and second quartiles than in the first quartile (8.5 and 6.0, respectively); the OR of developing MI was greatest in the fourth quartile (17.8). By multivariable analysis with age, sex, smoking, lipid status, statin, and ARE phenotypes as independent variables and oxLDL/β 2 GPI as the dependent variable, only MI predicted oxLDL/β 2 GPI ( P < .0001). OxLDL/β 2 GPI may be regarded as a marker of ARE, in particular of MI.

A standardized model for predicting flap failure using indocyanine green dye

NASA Astrophysics Data System (ADS)

Zimmermann, Terence M.; Moore, Lindsay S.; Warram, Jason M.; Greene, Benjamin J.; Nakhmani, Arie; Korb, Melissa L.; Rosenthal, Eben L.

2016-03-01

Techniques that provide a non-invasive method for evaluation of intraoperative skin flap perfusion are currently available but underutilized. We hypothesize that intraoperative vascular imaging can be used to reliably assess skin flap perfusion and elucidate areas of future necrosis by means of a standardized critical perfusion threshold. Five animal groups (negative controls, n=4; positive controls, n=5; chemotherapy group, n=5; radiation group, n=5; chemoradiation group, n=5) underwent pre-flap treatments two weeks prior to undergoing random pattern dorsal fasciocutaneous flaps with a length to width ratio of 2:1 (3 x 1.5 cm). Flap perfusion was assessed via laser-assisted indocyanine green dye angiography and compared to standard clinical assessment for predictive accuracy of flap necrosis. For estimating flap-failure, clinical prediction achieved a sensitivity of 79.3% and a specificity of 90.5%. When average flap perfusion was more than three standard deviations below the average flap perfusion for the negative control group at the time of the flap procedure (144.3+/-17.05 absolute perfusion units), laser-assisted indocyanine green dye angiography achieved a sensitivity of 81.1% and a specificity of 97.3%. When absolute perfusion units were seven standard deviations below the average flap perfusion for the negative control group, specificity of necrosis prediction was 100%. Quantitative absolute perfusion units can improve specificity for intraoperative prediction of viable tissue. Using this strategy, a positive predictive threshold of flap failure can be standardized for clinical use.

The use of fibrin tissue adhesive to reduce blood loss and the need for blood transfusion after total knee arthroplasty. A prospective, randomized, multicenter study.

PubMed

Levy, O; Martinowitz, U; Oran, A; Tauber, C; Horoszowski, H

1999-11-01

Total knee arthroplasty is associated with major postoperative blood loss of approximately 800 to 1200 milliliters, and blood transfusion is frequently required. With the increased concern about the risks of blood transfusion, various methods of blood conservation in orthopaedic surgery have been studied. The most appropriate solution, however, is to reduce the loss of blood during and after an operation. The present prospective, controlled, randomized study was designed to evaluate the hemostatic efficacy of the use of fibrin tissue adhesive in patients managed with total knee arthroplasty. Fifty-eight patients who were scheduled to have a total knee arthroplasty were randomly divided into two groups: a control group, in which the standard means of hemostasis were applied, and a treatment group, in which the standard means to control local bleeding were applied and a fibrin tissue adhesive was sprayed on the internal aspects of the operative field before skin closure. All operations were performed in a bloodless field with use of a pneumatic tourniquet. All patients received low-molecular-weight heparin as thromboprophylaxis twelve hours before the operation and every twelve hours postoperatively. Blood loss during the operation was evaluated by measuring the volume in the suction apparatus and by estimating the amount of lost blood in the swabs at the end of the operation. The apparent postoperative lost blood was determined by measuring the volume in the suction-drain bottles. All blood transfusions were recorded. The mean apparent postoperative blood loss (and standard deviation) in the fibrin-tissue-adhesive group was 360+/-287.7 milliliters compared with 878+/-403.0 milliliters in the control group, with a mean difference of 518 milliliters (p<0.001). The decrease in the level of hemoglobin was 25+/-10 grams per liter in the treatment group compared with 37+/-12 grams per liter in the control group (p<0.001). Sixteen patients (55 percent) in the control group required a blood transfusion and eight (28 percent) required two units of blood, whereas only five (17 percent) of the patients in the fibrin-tissue-adhesive group required a blood transfusion and only one (3 percent) required two units (p = 0.004). The number of adverse events was comparable between the two groups. None of the adverse events were considered to be related to the use of fibrin tissue adhesive. One death, which was due to massive pulmonary embolism, was reported in the control group. No seroconversion was reported at three and six months after the operation. The use of fibrin tissue adhesive in total knee arthroplasty seems to be an effective and safe means with which to reduce blood loss and blood-transfusion requirements. Furthermore, the importance of these findings was enhanced by a significant reduction in blood loss, in the postoperative decrease in the level of hemoglobin, and in blood-transfusion requirements despite preoperative thromboprophylaxis with low-molecular-weight heparin.

40 CFR 60.4102 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... products), and landscape or right-of-way tree trimmings. Boiler means an enclosed fossil-or other fuel.... Total energy input means, with regard to a cogeneration unit, total energy of all forms supplied to the cogeneration unit, excluding energy produced by the cogeneration unit itself. Each form of energy supplied...

40 CFR 60.4102 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... products), and landscape or right-of-way tree trimmings. Boiler means an enclosed fossil-or other fuel.... Total energy input means, with regard to a cogeneration unit, total energy of all forms supplied to the cogeneration unit, excluding energy produced by the cogeneration unit itself. Each form of energy supplied...

Training Field Grade Officers to Exploit the Maneuver Control System

DTIC Science & Technology

2002-03-20

the decision-making process can explore system capabilities, refine procedures, and build unit confidence. The relationship between the commander’s...Thinking” Consequences of possibilities ISTP “Thinking” Data that give order and meaning INTP “Thinking” Unique and ingenious options ESFJ “Feeling...Tangible views of key people ENFJ “Feeling” Ways to harmonize ISFP “Feeling” People’s values INFP “Feeling” What’s right ESTP “Sensates” Practical action

Real-time simulation clock

NASA Technical Reports Server (NTRS)

Bennington, Donald R. (Inventor); Crawford, Daniel J. (Inventor)

1990-01-01

The invention is a clock for synchronizing operations within a high-speed, distributed data processing network. The clock is actually a distributed system comprising a central clock and multiple site clock interface units (SCIUs) which are connected by means of a fiber optic star network and which operate under control of separate clock software. The presently preferred embodiment is a part of the flight simulation system now in current use at the NASA Langley Research Center.

Toxic Hazards Research Unit - 1988

DTIC Science & Technology

1989-07-01

and control groups, and all group means for these parameters were within the normal range for the age and species of test animals used (Wolford et al...13 APPENDIX 1 DRAIZEa SCALE FOR SCALING OCULAR LESIONS Parameter Score 1. Cornea A Opacity degree of density (area most taken for reading) No opacity...Therap 32 377 390 14 APPENDIX 2 DRAIZEa SCALE FOR EVALUATING AND SCORING SKIN REACTIONS Parameter Score 1. Erythema No erythema 0 Very slight erythema

Influence Strategy: Principles and Levels of Analysis

DTIC Science & Technology

2011-12-01

expended its own. The United States formally entered the war on in December 1941 following the Japanese surprise attack at Pearl Harbor. Less formally...placed in key positions and the Reich Cinema Law (RLG) introduced as a means to exercise further control. For instance, the RLG required all film...Western Europe by Germany. However for this purpose it will not be counted until the formal declaration of war in 1941. Following the Japanese

28 CFR 541.50 - Release from a control unit.

Code of Federal Regulations, 2010 CFR

2010-07-01

... general population of the institution which has a control unit. [49 FR 32991, Aug. 17, 1984, as amended at... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Release from a control unit. 541.50... INMATE DISCIPLINE AND SPECIAL HOUSING UNITS Control Unit Programs § 541.50 Release from a control unit...

28 CFR 541.50 - Release from a control unit.

Code of Federal Regulations, 2013 CFR

2013-07-01

... general population of the institution which has a control unit. [49 FR 32991, Aug. 17, 1984, as amended at... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Release from a control unit. 541.50... INMATE DISCIPLINE AND SPECIAL HOUSING UNITS Control Unit Programs § 541.50 Release from a control unit...

28 CFR 541.50 - Release from a control unit.

Code of Federal Regulations, 2012 CFR

2012-07-01

... general population of the institution which has a control unit. [49 FR 32991, Aug. 17, 1984, as amended at... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Release from a control unit. 541.50... INMATE DISCIPLINE AND SPECIAL HOUSING UNITS Control Unit Programs § 541.50 Release from a control unit...

28 CFR 541.50 - Release from a control unit.

Code of Federal Regulations, 2011 CFR

2011-07-01

... general population of the institution which has a control unit. [49 FR 32991, Aug. 17, 1984, as amended at... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Release from a control unit. 541.50... INMATE DISCIPLINE AND SPECIAL HOUSING UNITS Control Unit Programs § 541.50 Release from a control unit...

28 CFR 541.50 - Release from a control unit.

Code of Federal Regulations, 2014 CFR

2014-07-01

... general population of the institution which has a control unit. [49 FR 32991, Aug. 17, 1984, as amended at... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Release from a control unit. 541.50... INMATE DISCIPLINE AND SPECIAL HOUSING UNITS Control Unit Programs § 541.50 Release from a control unit...

Patients Receiving Prebiotics and Probiotics Before Liver Transplantation Develop Fewer Infections Than Controls: A Systematic Review and Meta-Analysis.

PubMed

Sawas, Tarek; Al Halabi, Shadi; Hernaez, Ruben; Carey, William D; Cho, Won Kyoo

2015-09-01

Among patients who have received liver transplants, infections increase morbidity and mortality and prolong hospital stays. Administration of antibiotics and surgical trauma create intestinal barrier dysfunction and microbial imbalances that allow enteric bacteria to translocate to the blood. Probiotics are believed to prevent bacterial translocation by stabilizing the intestinal barrier and stimulating proliferation of the intestinal epithelium, mucus secretion, and motility. We performed a meta-analysis to determine the effects of probiotics on infections in patients receiving liver transplants. We searched PubMed and EMBASE for controlled trials that evaluated the effects of prebiotics and probiotics on infections in patients who underwent liver transplantation. Heterogeneity was analyzed by the Cochran Q statistic. Pooled Mantel-Haenszel relative risks were calculated with a fixed-effects model. We identified 4 controlled studies, comprising 246 participants (123 received probiotics, 123 served as controls), for inclusion in the meta-analysis. In these studies, the intervention groups received enteric nutrition and fiber (prebiotics) with probiotics, and the control groups received only enteric nutrition and fiber without probiotics. The infection rate was 7% in groups that received probiotics vs 35% in control groups (relative risk [RR], 0.21; 95% confidence interval [CI], 0.11-0.41; P = .001). The number needed to treat to prevent 1 infection was 3.6. In subgroup analyses, only 2% of subjects in the probiotic groups developed urinary tract infections, compared with 16% of controls (RR, 0.14; 95% CI, 0.04-0.47; P < .001); only 2% of subjects in the probiotic groups developed intra-abdominal infections, compared with 11% of controls (RR, 0.27; 95% CI, 0.09-0.78; P = .02). Subjects receiving probiotics also had shorter stays in the hospital than controls (mean difference, 1.41 d; P < .001), as well as in the intensive care unit (mean difference, 1.41 d; P < .001), and duration of antibiotic use (mean difference, 3.89 d; P < .001). There was no difference in mortality between groups (RR, 0.97; 95% CI, 0.21-4.47). There was no significant heterogeneity among studies. Based on the meta-analysis, giving patients a combination of probiotics and prebiotics before, or on the day of, liver transplantation reduces the rate of infection after surgery. These agents also reduced the amount of time spent in the hospital or intensive care unit and the duration of antibiotic use. Copyright © 2015 AGA Institute. Published by Elsevier Inc. All rights reserved.

A placebo-controlled, double-blind, dose-escalation study to assess the safety, tolerability and pharmacokinetics/pharmacodynamics of single and multiple intravenous infusions of AZD9773 in patients with severe sepsis and septic shock

PubMed Central

2012-01-01

Introduction Tumor necrosis factor-alpha (TNF-α), an early mediator in the systemic inflammatory response to infection, is a potential therapeutic target in sepsis. The primary objective of this study was to determine the safety and tolerability of AZD9773, an ovine, polyclonal, anti-human TNF-α Fab preparation, in patients with severe sepsis. Secondary outcomes related to pharmacokinetic (PK) and pharmacodynamic (PD) parameters. Methods In this double-blind, placebo-controlled, multicenter Phase IIa study, patients were sequentially enrolled into five escalating-dose cohorts (single doses of 50 or 250 units/kg; multiple doses of 250 units/kg loading and 50 units/kg maintenance, 500 units/kg loading and 100 units/kg maintenance, or 750 units/kg loading and 250 units/kg maintenance). In each cohort, patients were randomized 2:1 to receive AZD9773 or placebo. Results Seventy patients received AZD9773 (n = 47) or placebo (n = 23). Baseline characteristics were similar across cohorts. Mean baseline APACHE score was 25.9. PK data demonstrated an approximately proportional increase in concentration with increasing dose and a terminal half-life of 20 hours. For the multiple-dose cohorts, serum TNF-α concentrations decreased to near-undetectable levels within two hours of commencing AZD9773 infusion. This suppression was maintained in most patients for the duration of treatment. AZD9773 was well tolerated. Most adverse events were of mild-to-moderate intensity and considered by the reporting investigator as unrelated to study treatment. Conclusions The safety, PK and PD data support the continued evaluation of AZD9773 in larger Phase IIb/III studies. PMID:22340283

An afocal telescope configuration for the ESA Ariel mission

NASA Astrophysics Data System (ADS)

Da Deppo, V.; Middleton, K.; Focardi, M.; Morgante, G.; Pace, E.; Claudi, R.; Micela, G.

2017-09-01

ARIEL (Atmospheric Remote-sensing Infrared Exoplanet Large-survey) is one of the three candidates for the next ESA medium-class science mission (M4) expected to be launched in 2026. This mission will be devoted to observing spectroscopically in the infrared (IR) a large population of known transiting planets in the neighborhood of the Solar System, opening a new discovery space in the field of extrasolar planets and enabling the understanding of the physics and chemistry of these far away worlds. ARIEL is based on a 1-m class telescope ahead of two spectrometer channels covering the band 1.95 to 7.8 microns. In addition there are four photometric channels: two wide band, also used as fine guidance sensors, and two narrow band. During its 3.5 years of operations from L2 orbit, ARIEL will continuously observe exoplanets transiting their host star. The ARIEL optical design is conceived as a fore-module common afocal telescope that will feed the spectrometer and photometric channels. The telescope optical design is composed of an off-axis portion of a two-mirror classic Cassegrain coupled to a tertiary off-axis paraboloidal mirror. The telescope and optical bench operating temperatures, as well as those of some subsystems, will be monitored and fine tuned/stabilised mainly by means of a thermal control subsystem (TCU-Telescope Control Unit) working in closed-loop feedback and hosted by the main Payload electronics unit, the Instrument Control Unit (ICU). Another important function of the TCU will be to monitor the telescope and optical bench thermistors when the Payload decontamination heaters will be switched on (when operating the instrument in Decontamination Mode) during the Commissioning Phase and cyclically, if required. Then the thermistors data will be sent by the ICU to the On Board Computer by means of a proper formatted telemetry. The latter (OBC) will be in charge of switching on and off the decontamination heaters on the basis of the thermistors readout values.