Pedobacter panacis sp. nov., isolated from Panax ginseng soil.

PubMed

Singh, Priyanka; Singh, Hina; Kim, Yeon-Ju; Yang, Deok-Chun

2017-02-01

A novel strain, DCY108 T was isolated from soil of a Panax ginseng field, Yeoncheon province (38°04'N 126°57'E), Republic of Korea. Strain DCY108 T is Gram-negative, non-motile, non-flagellate, rod-shaped, and aerobic. The bacterium grows optimally at 25-30 °C, pH 6.5-7.0 and 1 % NaCl. Phylogenetically, strain DCY108 T is closely related to Pedobacter jejuensis JCM 18824 T , Pedobacter aquatilis JCM 13454 T , Pedobacter kyungheensis LMG 26577 T and the type strain of the genus Pedobacter heparinus DSM 2366 T . The DNA-DNA relatedness values between strain DCY108 T and its close phylogenetic neighbors were below 30.0 %. The DNA G+C content of strain DCY108 T was determined to be 45.1 mol%. The predominant quinone was menaquinone 7 (MK-7). The major polar lipids were identified as phosphatidylethanolamine and three unidentified aminolipids AL1, AL13 and AL17. Iso-C 15:00 , iso-C 17:0 3OH and summed feature 3 (C 16:1 ω7c/C 16:1 ω6c) were identified as the major fatty acids present in strain DCY108 T . The results of physiological and biochemical tests allowed strain DCY108 T to be differentiated phenotypically from other recognized species belonging to the genus Pedobacter. Therefore, it is suggested that the newly isolated organism represents a novel species, for which the name Pedobacter panacis sp. nov is proposed with the type strain designated as DCY108 T (=CCTCCAB 2015196 T  = KCTC 42748 T ).

Measuring the Impact of Delayed Cerebral Ischemia on Neuropsychological Outcome After Aneurysmal Subarachnoid Hemorrhage-Protocol of a Swiss Nationwide Observational Study (MoCA-DCI Study).

PubMed

Stienen, Martin N; Fung, Christian; Bijlenga, Philippe; Zumofen, Daniel W; Maduri, Rodolfo; Robert, Thomas; Seule, Martin A; Marbacher, Serge; Geisseler, Olivia; Brugger, Peter; Gutbrod, Klemens; Chicherio, Christian; Monsch, Andreas U; Beaud, Valérie; Rossi, Stefania; Früh, Severin; Schmid, Nicole; Smoll, Nicolas R; Keller, Emanuela; Regli, Luca

2018-05-11

The exact relationship between delayed cerebral ischemia (DCI) following aneurysmal subarachnoid hemorrhage (aSAH) and neuropsychological impairment remains unknown, as previous studies lacked a baseline examination after aneurysm occlusion but before the DCI-period. Neuropsychological evaluation of acutely ill patients is often applied in a busy intensive care unit (ICU), where distraction represents a bias to the obtained results. To evaluate the relationship between DCI and neuropsychological outcome after aSAH by comparing the Montreal Cognitive Assessment (MoCA) results in aSAH patients with and without DCI at 3 mo with a baseline examination before the DCI-period (part 1). To determine the reliability of the MoCA, when applied in an ICU setting (part 2). Prospective, multicenter, and observational study performed at all Swiss neurovascular centers. For part 1, n = 240 consecutive aSAH patients and for part 2, n = 50 patients with acute brain injury are recruited. Part 1: Effect size of the relationship between DCI and neuropsychological outcome (MoCA). Part 2: Reliability measures for the MoCA. The institutional review boards approved this study on July 4, 2017 under case number BASEC 2017-00103. After completion, the results will be offered to an international scientific journal for peer-reviewed publication. This study determines the exact impact of DCI on the neuropsychological outcome after aSAH, unbiased by confounding factors such as early brain injury or patient-specific characteristics. The study provides unique insights in the neuropsychological state of patients in the early period after aSAH.

Validation of the Dyadic Coping Inventory with Chinese couples: Factorial structure, measurement invariance, and construct validity.

PubMed

Xu, Feng; Hilpert, Peter; Randall, Ashley K; Li, Qiuping; Bodenmann, Guy

2016-08-01

The Dyadic Coping Inventory (DCI, Bodenmann, 2008) assesses how couples support each other when facing individual (e.g., workload) and common (e.g., parenting) stressors. Specifically, the DCI measures partners' perceptions of their own (Self) and their partners' behaviors (Partner) when facing individual stressors, and partners' common coping behaviors when facing common stressors (Common). To date, the DCI has been validated in 6 different languages from individualistic Western cultures; however, because culture can affect interpersonal interactions, it is unknown whether the DCI is a reliable measure of coping behaviors for couples living in collectivistic Eastern cultures. Based on data from 474 Chinese couples (N = 948 individuals), the current study examined the Chinese version of the DCI's factorial structure, measurement invariance (MI), and construct validity of test scores. Using 3 cultural groups (China, Switzerland, and the United States [U.S.]), confirmatory factor analysis revealed a 5-factor structure regarding Self and Partner and a 2-factor structure regarding Common dyadic coping (DC). Results from analyses of MI indicated that the DCI subscales met the criteria for configural, metric, and full/partial scalar invariance across cultures (Chinese-Swiss and Chinese-U.S.) and genders (Chinese men and women). Results further revealed good construct validity of the DCI test scores. In all, the Chinese version of the DCI can be used for measuring Chinese couples' coping behaviors, and is available for cross-cultural studies examining DC behaviors between Western and Eastern cultures. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Decompression illness in goats following simulated submarine escape: 1993-2006.

PubMed

Seddon, F M; Thacker, J C; Fisher, A S; Jurd, K M; White, M G; Loveman, G A M

2014-01-01

The United Kingdom Ministry of Defence commissioned work to define the relationship between the internal pressure of a distressed submarine (DISSUB), the depth from which escape is made and the risk of decompression illness (DCI). The program of work used an animal model (goat) to define these risks and this paper reports the incidence and type of DCI observed. A total of 748 pressure exposures comprising saturation only, escape only or saturation followed by escape were conducted in the submarine escape simulator between 1993 and 2006. The DCI following saturation exposures was predominantly limb pain, whereas following escape exposures the DCI predominantly involved the central nervous system and was fast in onset. There was no strong relationship between the risk of DCI and the range of escape depths investigated. The risk of DCI incurred from escape following saturation was greater than that obtained by combining the risks for the independent saturation only, and escape only, exposures. The output from this program of work has led to improved advice on the safety of submarine escape.

Paenibacillus yonginensis sp. nov., a potential plant growth promoting bacterium isolated from humus soil of Yongin forest.

PubMed

Sukweenadhi, Johan; Kim, Yeon-Ju; Lee, Kwang Je; Koh, Sung-Cheol; Hoang, Van-An; Nguyen, Ngoc-Lan; Yang, Deok-Chun

2014-11-01

Strain DCY84(T), a Gram-stain positive, rod-shaped, aerobic, spore-forming bacterium, motile by means of peritrichous flagella, was isolated from humus soil from Yongin forest in Gyeonggi province, South Korea. Strain DCY84(T) shared the highest sequence similarity with Paenibacillus barengoltzii KACC 15270(T) (96.86 %), followed by Paenibacillus timonensis KACC 11491(T) (96.49 %) and Paenibacillus phoenicis NBRC 106274(T) (95.77 %). Strain DCY84(T) was found to able to grow best in TSA at temperature 30 °C, at pH 8 and at 0.5 % NaCl. MK-7 menaquinone was identified as the isoprenoid quinone. The major polar lipids were identified as phosphatidylethanolamine, an unidentified aminophospholipid, two unidentified aminolipids and an unidentified polar lipid. The peptidoglycan was found to contain the amino acids meso-diaminopimelic acid, alanine and D-glutamic acid. The major fatty acids of strain DCY84(T) were identified as branched chain anteiso-C15:0, saturated C16:0 and branched chain anteiso-C17:0. The cell wall sugars of strain DCY84(T) were found to comprise of ribose, galactose and xylose. The major polyamine was identified as spermidine. The DNA G+C content was determined to be 62.6 mol%. After 6 days of incubation, strain DCY84(T) produced 52.96 ± 1.85 and 72.83 ± 2.86 µg/ml L-indole-3-acetic acid, using media without L-tryptophan and supplemented with L-tryptophan, respectively. Strain DCY84(T) was also found to be able to solubilize phosphate and produce siderophores. On the basis of the phenotypic characteristics, genotypic analysis and chemotaxonomic characteristics, strain DCY84(T) is considered to represent a novel species of the genus Paenibacillus, for which the name Paenibacillus yonginensis sp. nov. is proposed. The type strain is DCY84(T) (=KCTC 33428(T) = JCM 19885(T)).

Retrospective review of previous minor leak before major subarachnoid hemorrhage diagnosed by MRI as a predictor of occurrence of symptomatic delayed cerebral ischemia.

PubMed

Oda, Shinri; Shimoda, Masami; Hirayama, Akihiro; Imai, Masaaki; Komatsu, Fuminari; Shigematsu, Hideaki; Nishiyama, Jun; Hotta, Kazuko; Matsumae, Mitsunori

2018-02-01

OBJECTIVE This study attempted to determine whether a previous minor leak correlated with the occurrence of symptomatic delayed cerebral ischemia (sDCI). METHODS The authors retrospectively evaluated sDCI-related clinical features and findings from MRI, including T1-weighted imaging (T1WI)-FLAIR mismatch at the time of admission, in 151 patients admitted with subarachnoid hemorrhage (SAH) within 48 hours of ictus. RESULTS The overall incidence of sDCI was 23% (35 of 151 patients). In all subjects, multivariate analysis revealed that World Federation of Neurosurgical Societies Grades II-V, age 70 years or older, presence of rebleeding after admission, a previous minor leak before the major SAH attack as diagnosed by T1WI-FLAIR mismatch, acute infarction on diffusion-weighted imaging, and CT SAH score were significantly associated with occurrence of sDCI. In patients with no previous minor leak before major SAH as diagnosed by T1WI-FLAIR mismatch, the incidence of sDCI was only 7% (7 of 97 patients). CONCLUSIONS A previous minor leak before major SAH as diagnosed by T1WI-FLAIR mismatch represents an important sDCI-related factor. When the analysis was restricted to patients with true acute SAH without a previous minor leak diagnosed by T1WI-FLAIR mismatch, the incidence of sDCI was extremely low.

Management of delayed cerebral ischemia after subarachnoid hemorrhage.

PubMed

Francoeur, Charles L; Mayer, Stephan A

2016-10-14

For patients who survive the initial bleeding event of a ruptured brain aneurysm, delayed cerebral ischemia (DCI) is one of the most important causes of mortality and poor neurological outcome. New insights in the last decade have led to an important paradigm shift in the understanding of DCI pathogenesis. Large-vessel cerebral vasospasm has been challenged as the sole causal mechanism; new hypotheses now focus on the early brain injury, microcirculatory dysfunction, impaired autoregulation, and spreading depolarization. Prevention of DCI primarily relies on nimodipine administration and optimization of blood volume and cardiac performance. Neurological monitoring is essential for early DCI detection and intervention. Serial clinical examination combined with intermittent transcranial Doppler ultrasonography and CT angiography (with or without perfusion) is the most commonly used monitoring paradigm, and usually suffices in good grade patients. By contrast, poor grade patients (WFNS grades 4 and 5) require more advanced monitoring because stupor and coma reduce sensitivity to the effects of ischemia. Greater reliance on CT perfusion imaging, continuous electroencephalography, and invasive brain multimodality monitoring are potential strategies to improve situational awareness as it relates to detecting DCI. Pharmacologically-induced hypertension combined with volume is the established first-line therapy for DCI; a good clinical response with reversal of the presenting deficit occurs in 70 % of patients. Medically refractory DCI, defined as failure to respond adequately to these measures, should trigger step-wise escalation of rescue therapy. Level 1 rescue therapy consists of cardiac output optimization, hemoglobin optimization, and endovascular intervention, including angioplasty and intra-arterial vasodilator infusion. In highly refractory cases, level 2 rescue therapies are also considered, none of which have been validated. This review provides an overview of current state-of-the-art care for DCI management.

Peer victimization and subjective health among students reporting disability or chronic illness in 11 Western countries.

PubMed

Sentenac, Mariane; Gavin, Aoife; Gabhainn, Saoirse Nic; Molcho, Michal; Due, Pernille; Ravens-Sieberer, Ulrike; Matos, Margarida Gaspar de; Malkowska-Szkutnik, Agnieszka; Gobina, Inese; Vollebergh, Wilma; Arnaud, Catherine; Godeau, Emmanuelle

2013-06-01

To compare the strength of the association between peer victimization at school and subjective health according to the disability or chronic illness (D/CI) status of students across countries. This study used data from 55 030 students aged 11, 13 and 15 years from 11 countries participating in the 2005-06 Health Behaviour in School-aged Children survey. Self-completed questionnaires were administered in classrooms. Multivariate models of logistic regression (controlled for confounding factors and countries) were used to investigate differences in the association between peer victimization and poor subjective health according to the D/CI status. Overall, 13.5% of the students reported having been bullied at least two or three times a month. The percentage of victims was significantly higher among those reporting D/CI than among others in all countries studied. Victims of bullying were more likely to report poor self-rated health, low life satisfaction and multiple health complaints. However, there were no differences in the associations between peer victimization and subjective health indicators according to the D/CI status. In all countries studied, students reporting D/CI were more likely to report being victims of bullying. Victims of bullying reported more negative subjective health outcomes regardless of their D/CI status. Although inclusive education is currently a major topic of educational policies in most countries, additional efforts should be made to improve the quality of the integration of students with D/CI.

Comparison of the size of persistent foramen ovale and atrial septal defects in divers with shunt-related decompression illness and in the general population.

PubMed

Wilmshurst, Peter T; Morrison, W Lindsay; Walsh, Kevin P

2015-06-01

Decompression illness (DCI) is associated with a right-to-left shunt, such as persistent foramen ovale (PFO), atrial septal defect (ASD) and pulmonary arteriovenous malformations. About one-quarter of the population have a PFO, but considerably less than one-quarter of divers suffer DCI. Our aim was to determine whether shunt-related DCI occurs mainly or entirely in divers with the largest diameter atrial defects. Case control comparison of diameters of atrial defects (PFO and ASD) in 200 consecutive divers who had transcatheter closure of an atrial defect following shunt-related DCI and in an historic group of 263 individuals in whom PFO diameter was measured at post-mortem examination. In the divers who had experienced DCI, the median atrial defect diameter was 10 mm and the mean (standard deviation) was 9.9 (3.6) mm. Among those in the general population who had a PFO, the median diameter was 5 mm and mean was 4.9 (2.6) mm. The difference between the two groups was highly significant (P < 0.0001). Of divers with shunt-related DCI, 101 (50.5%) had an atrial defect 10 mm diameter or larger, but only 1.3% of the general population studied had a PFO that was 10 mm diameter of larger. The risk of a diver suffering DCI is related to the size of the atrial defect rather than just the presence of a defect.

Definition of delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage as an outcome event in clinical trials and observational studies: proposal of a multidisciplinary research group.

PubMed

Vergouwen, Mervyn D I; Vermeulen, Marinus; van Gijn, Jan; Rinkel, Gabriel J E; Wijdicks, Eelco F; Muizelaar, J Paul; Mendelow, A David; Juvela, Seppo; Yonas, Howard; Terbrugge, Karel G; Macdonald, R Loch; Diringer, Michael N; Broderick, Joseph P; Dreier, Jens P; Roos, Yvo B W E M

2010-10-01

In clinical trials and observational studies there is considerable inconsistency in the use of definitions to describe delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage. A major cause for this inconsistency is the combining of radiographic evidence of vasospasm with clinical features of cerebral ischemia, although multiple factors may contribute to DCI. The second issue is the variability and overlap of terms used to describe each phenomenon. This makes comparisons among studies difficult. An international ad hoc panel of experts involved in subarachnoid hemorrhage research developed and proposed a definition of DCI to be used as an outcome measure in clinical trials and observational studies. We used a consensus-building approach. It is proposed that in observational studies and clinical trials aiming to investigate strategies to prevent DCI, the 2 main outcome measures should be: (1) cerebral infarction identified on CT or MRI or proven at autopsy, after exclusion of procedure-related infarctions; and (2) functional outcome. Secondary outcome measure should be clinical deterioration caused by DCI, after exclusion of other potential causes of clinical deterioration. Vasospasm on angiography or transcranial Doppler can also be used as an outcome measure to investigate proof of concept but should be interpreted in conjunction with DCI or functional outcome. The proposed measures reflect the most relevant morphological and clinical features of DCI without regard to pathogenesis to be used as an outcome measure in clinical trials and observational studies.

The Discovery Channel Telescope: Construction and Design Progress, June 2006

NASA Astrophysics Data System (ADS)

Bida, Thomas A.; Smith, B. W.; Millis, R. L.; Dunham, E. W.; Wiecha, O. M.; Marshall, H.

2006-06-01

The Discovery Channel Telescope (DCT) is a 4.2m telescope under construction in northern Arizona. The DCT is located at a new site near Happy Jack at 2361m elevation, which was selected following a lengthy site testing campaign that demonstrated median ground-level seeing of 0.84-arcsec FWHM. The DCT science mission includes targeted studies of astrophysical and solar system objects utilizing RC and Nasmyth-mounted imaging and spectroscopic instrumentation, and wide-field surveys of KBO’s, Centaurs, NEA’s, and other time-variable objects with a 2-degree FOV prime focus camera.The DCT facility enclosure and control building will be completed this year, including the supports for the telescope mount and dome, the major infrastructure for facility machinery, the instrument laboratory, control and computer rooms, and the auxiliary building for the mirror coating facility. Meanwhile, the 4.3m ULE meniscus primary mirror blank was completed at Corning, Inc., in October 2005, and the 2-3 year mirror figuring effort is due to begin June 2006. The primary mirror and its design support, and the preliminary integrated telescope mount model, were finite-element analyzed to optimize the design of the mirror and top-end support configurations. The prime focus camera design has been refined to achieve atmospheric dispersion-compensated 0.25-arcsec images at 1-degree field radius, from B to I-band, at reduced cost through simplification of glasses to standard types and utilization of spheres on all but two lens surfaces.The Discovery Channel Telescope is a project of the Lowell Observatory with major financial support from Discovery Communications, Inc. (DCI). DCI plans ongoing television programming featuring the construction of the telescope and the research ultimately conducted with the DCT. Lowell Observatory is actively seeking additional partners in the project; interested parties should contact R. L. Millis, Director.

The Discovery Channel Telescope: Construction and Design Progress, January 2007

NASA Astrophysics Data System (ADS)

Bida, Thomas A.; Millis, R. L.; Smith, B. W.; Dunham, E. W.; Marshall, H.

2006-12-01

The Discovery Channel Telescope (DCT) is a 4.2m telescope under construction in northern Arizona. The DCT is located at a new site near Happy Jack at 2361m elevation, which was selected following a lengthy site testing campaign that demonstrated DIMM-characterized median ground-level seeing of 0.84-arcsec FWHM. The DCT science mission includes targeted studies of astrophysical and solar system objects utilizing RC and Nasmyth-mounted imaging and spectroscopic instrumentation, and wide-field surveys of KBO’s, NEA’s, and astrophysical objects with a 2-degree FOV prime focus camera. The DCT facility enclosure and control buildings will be completed soon, including the telescope mount and dome supports, major machinery infrastructure, the instrument laboratory, control and computer rooms, and the auxiliary building for the mirror coating plant. Meanwhile, the effort for final figuring and polishing of the 4.3m ULE meniscus primary mirror blank began in August 2006 at the University of Arizona College of Optical Sciences. The primary mirror and its design support, and the integrated telescope mount model, were finite-element analyzed to optimize the design of the mirror and top-end support configurations. The primary mirror axial and tangential actuators will be fabricated in early 2007 and utilized in the final figure and polish cycle. The prime focus camera design has been refined to achieve atmospheric dispersion-compensated 0.25-arcsec images at 1-degree field radius, from B to I-band, at reduced cost through simplification of glasses to standard types and utilization of spheres on all but two lens surfaces. The Discovery Channel Telescope is a project of the Lowell Observatory with major financial support from Discovery Communications, Inc. (DCI). DCI plans ongoing television programming featuring the construction of the telescope and the research ultimately conducted with the DCT. Lowell Observatory and Discovery Communications are actively seeking additional partners in the project; interested parties should contact R. L. Millis, Director.

Correlation between 99Tcm-HMPAO-SPECT brain image and a history of decompression illness or extent of diving experience in commercial divers.

PubMed Central

Shields, T G; Duff, P M; Evans, S A; Gemmell, H G; Sharp, P F; Smith, F W; Staff, R T; Wilcock, S E

1997-01-01

OBJECTIVES: To explore the use of 99technetiumm-hexamethyl propylene amine oxime single photon computed tomography (HMPAO-SPECT) of the brain as a means of detecting nervous tissue damage in divers and to determine if there is any correlation between brain image and a diver's history of diving or decompression illness (DCI). METHODS: 28 commercial divers with a history of DCI, 26 divers with no history of DCI, and 19 non-diving controls were examined with brain HMPAO-SPECT. Results were classified by observer assessment as normal (I) or as a pattern variants (II-V). The brain images of a subgroup of these divers (n = 44) and the controls (n = 17) were further analysed with a first order texture analysis technique based on a grey level histogram. RESULTS: 15 of 54 commercial divers (28%) were visually assessed as having HMPAO-SPECT images outside normal limits compared with 15.8% in appropriately identified non-diver control subjects. 18% of divers with a history of DCI were classified as having a pattern different from the normal image compared with 38% with no history of DCI. No association was established between the presence of a pattern variant from the normal image and history of DCI, diving, or other previous possible neurological insult. On texture analysis of the brain images, divers had a significantly lower mean grey level (MGL) than non-divers. Divers with a history of DCI (n = 22) had a significantly lower MGL when compared with divers with no history of DCI (n = 22). Divers with > 14 years professional diving or > 100 decompression days a year had a significantly lower MGL value. CONCLUSIONS: Observer assessment of HMPAO-SPECT brain images can lead to disparity in results. Texture analysis of the brain images supplies both an objective and consistent method of measurement. A significant correlation was found between a low measure of MGL and a history of DCI. There was also an indication that diving itself had an effect on texture measurement, implying that it had caused subclinical nervous tissue damage. PMID:9166130

Asymmetric and Symmetric Dimethylarginines are Markers of Delayed Cerebral Ischemia and Neurological Outcome in Patients with Subarachnoid Hemorrhage.

PubMed

Appel, Daniel; Seeberger, Miriam; Schwedhelm, Edzard; Czorlich, Patrick; Goetz, Alwin E; Böger, Rainer H; Hannemann, Juliane

2018-03-20

Delayed cerebral ischemia (DCI) is the major cause of lethality and neuronal damage in patients who survived the primary subarachnoid hemorrhage (SAH). Asymmetric and symmetric dimethylarginines (ADMA and SDMA) inhibit nitric oxide production from L-arginine via distinct mechanisms. Elevated ADMA levels are associated with vasospasm after SAH. We aimed to study the time course of ADMA and SDMA in plasma and ventricular cerebrospinal fluid (CSF) and their associations with DCI and outcome. We measured ADMA and SDMA in 34 SAH patients with an external ventricular drain at admission and on days 3, 6, 8, 12, and 15 and followed them up for clinical status and neurological outcome until 30 days post-discharge. DCI was defined as the appearance of new infarctions on cerebral computed tomography or magnetic resonance imaging. ADMA and SDMA plasma concentrations did not differ significantly at baseline between patients who suffered DCI (N = 14; 41%) and not; however, plasma ADMA reached a peak on days 8 and 15 after hemorrhage in patients with DCI (0.81-0.91 µmol/l). Baseline plasma L-arginine/ADMA ratio was significantly lower in patients with DCI (57.1 [34.3; 70.8] vs. 68.7 [55.7; 96.2]; p < 0.05). ADMA and SDMA concentrations in CSF were significantly higher in patients with DCI than without. In multivariable-adjusted linear regression models, CSF ADMA was negatively associated with the incidence of DCI (OR 0.03 [0.02-0.70]; p = 0.04), whereas CSF SDMA on the day of hemorrhage predicted poor neurological outcome until 30 days after discharge (OR 22.4 [1.21-416.02]; p = 0.04). Our study shows that ADMA and the L-arginine/ADMA ratio are associated with the incidence of DCI after SAH. By contrast, SDMA was associated with initial neuronal damage and poor neurological outcome after SAH. These data support the hypothesis that ADMA and L-arginine affect the pathophysiology of cerebral ischemia after SAH, while SDMA is a biomarker of neurological outcome after SAH.

The Influence of Water Conservancy Projects on River Network Connectivity, A Case of Luanhe River Basin

NASA Astrophysics Data System (ADS)

Li, Z.; Li, C.

2017-12-01

Connectivity is one of the most important characteristics of a river, which is derived from the natural water cycle and determine the renewability of river water. The water conservancy project can change the connectivity of natural river networks, and directly threaten the health and stability of the river ecosystem. Based on the method of Dendritic Connectivity Index (DCI), the impacts from sluices and dams on the connectivity of river network are deeply discussed herein. DCI quantitatively evaluate the connectivity of river networks based on the number of water conservancy facilities, the connectivity of fish and geographical location. The results show that the number of water conservancy facilities and their location in the river basin have a great influence on the connectivity of the river network. With the increase of the number of sluices and dams, DCI is decreasing gradually, but its decreasing range is becoming smaller and smaller. The dam located in the middle of the river network cuts the upper and lower parts of the whole river network, and destroys the connectivity of the river network more seriously. Therefore, this method can be widely applied to the comparison of different alternatives during planning of river basins and then provide a reference for the site selection and design of the water conservancy project and facility concerned.

Decompression illness secondary to occupational diving: recommended management based current legistation and practice in Malaysia.

PubMed

Rozali, A; Khairuddin, H; Sherina, M S; Zin, B Mohd; Sulaiman, A

2008-06-01

Occupational divers are exposed to hazards which contribute to the risk of developing decompression illnesses (DCI). DCI consists of Type I decompression sickness (DCS), Type II DCS and arterial gas embolism (AGE), developed from formation of bubbles in the tissues or circulation as a result of inadequate elimination of inert gas (nitrogen) after a dive. In Malaysia, DCI is one of the significant contributions to mortality and permanent residual morbidity in diving accidents. This is a case of a diver who suffered from Type II DCS with neurological complications due to an occupational diving activity. This article mentions the clinical management of the case and makes several recommendations based on current legislations and practise implemented in Malaysia in order to educate medical and health practitioners on the current management of DCI from the occupational perspective. By following these recommendations, hopefully diving accidents mainly DCI and its sequalae among occupational divers can be minimized and prevented, while divers who become injured receive the proper compensation for their disabilities.

In vitro analysis of platelet function in acute aneurysmal subarachnoid haemorrhage.

PubMed

von der Brelie, Christian; Subai, Alexander; Limperger, Verena; Rohde, Veit; Dempfle, Astrid; Boström, Azize

2018-04-01

Platelet function might play an essential role in the pathogenesis of delayed cerebral ischemia (DCI) after aneurysmal subarachnoid haemorrhage (SAH). Thus, impaired platelet function and disturbed primary haemostasis induced by intake of acetylsalicylic acid (ASA) might influence the rate of DCI. Primary haemostasis and platelet function can be measured with in vitro diagnosis (platelet function analyser test, PFA 100). The aim of this study is to evaluate the rate of DCI, haemorrhagic complications and the neurological outcome. Two groups were compared (patients with regular platelet function versus patients with impaired platelet function). This is a retrospective observational study. An initial cohort of 787 patients with SAH has been treated from January 2005 to September 2012. Seventy-nine patients (10%) with aneurysmal SAH, a history of ASA medication and PFA testing within the first 24 h after aneurysm rupture have been included. The overall rate of DCI in the present study was 43%. In vitro platelet function testing showed pathological primary haemostasis in 69.6%. The DCI rate was higher in patients with regular tested primary haemostasis (p = 0.02, OR = 3.16, 95%CI = [1.19; 8.83]). However, outcome assessment by mGOS did not show a significant difference between the groups. Patients with impaired primary haemostasis did not display a higher rate of haemorrhagic complications. Impairment of primary haemostasis resulting from an impairment of platelet function at an early stage after SAH might lead to a lower rate of DCI. In vitro testing of platelet function might be useful to predict the occurrence of DCI in the course.

Flavobacterium panacis sp. nov., isolated from rhizosphere of Panax ginseng.

PubMed

Kim, Dong Hyun; Singh, Priyanka; Farh, Mohamed El-Agamy; Kim, Yeon-Ju; Nguyen, Ngoc-Lan; Lee, Hyun A; Yang, Deok-Chun

2016-09-01

A novel bacterial strain, designated DCY106(T), was isolated from soil collected from the rhizosphere of ginseng (Panax ginseng), in Gochang, Republic of Korea. Strain DCY106(T) is Gram-negative, yellow-pigmented, non-flagellate, motile, non-spore-forming, rod-shaped, and strictly aerobic. The strain grows optimally at 25-30 °C and pH 6.5-7.5. Phylogenetically, strain DCY106(T) is closely related to Flavobacterium arsenitoxidans KCTC 22507(T) (98.41 %), followed by Flavobacterium cutihirudini LMG 26922(T) (97.67 %), Flavobacterium nitrogenifigens LMG 28694(T) (97.59 %), Flexibacter auranticus LMG 3987(T) (97.38 %), Flavobacterium defluvi KCTC 12612(T) (97.21 %) and Flavobacterium chilense LMG 26360(T) (97.05 %). The 16S rRNA gene sequence similarities to all other Flavobacterium species were below 97 %. The DNA G+C content of strain DCY106(T) is 34.2 mol% and the DNA-DNA relatedness between strain DCY106(T) and F. cutihirudini LMG 26922(T), F. auranticus LMG 3987(T), F. defluvi KCTC 12612(T) and F. chilense LMG 26360(T) were below 40.0 %. The menaquinone of the type MK-6 was found to be the predominant respiratory quinone. The major polar lipids were identified as phosphatidylethanolamine, phosphatidylserine, two unidentified aminolipids (APL1, APL6) and one unidentified lipid L2. C15:0, iso-C15:0 and summed feature 3 (iso-C15:0 2OH/C16:1 ω7c) were identified as the major fatty acids present in DCY106(T). The results of physiological and biochemical tests allowed strain DCY106(T) to be differentiated phenotypically from other recognized species belonging to the genus Flavobacterium. Therefore, it is suggested that the newly isolated organism represents a novel species, for which the name Flavobacterium panacis sp. nov. is proposed with the type strain designated as DCY106(T) (= JCM 31468(T)= KCTC 42747(T)).

Paenibacillus kyungheensis sp. nov., isolated from flowers of magnolia.

PubMed

Siddiqi, Muhammad Zubair; Siddiqi, Muhammad Hanif; Im, Wan Taek; Kim, Yeon-Ju; Yang, Deok-Chun

2015-11-01

A Gram-staining-positive, catalase-positive, oxidase-negative, facultatively anaerobic, rod-shaped bacterium designated strain DCY88T, was isolated from flowers of magnolia. Phylogenetic analysis based on 16S rRNA gene sequence comparison revealed that the strain formed a distinct lineage within the genus Paenibacillus that was closely related to Paenibacillus hordei RH-N24T (97.8 %). The other most closely related species were Paenibacillus illinoisensis NRRL NRS-1356T (94.3 %), Paenibacillus hunanensis DSM 22170T (94.2 %), Paenibacillus peoriae DSM 8320T (93.9 %), Paenibacillus kribbensis Am49T (93.8 %) and the type species of the genus, Paenibacillus polymyxa ATCC 842T (93.3 %). Cells of the strain were endospore-forming and motile by peritrichous flagella. Strain DCY88T formed pink-pigmented colonies on trypticase soy agar and R2A agar medium. Growth of strain DCY88T occurs at temperatures 5-37 °C, at pH 4-9 and 0.5-5.5 % NaCl (w/v). The menaquinone was MK-7.The cell wall peptidoglycan of strain DCY88T contained meso-diaminopimelic acid. The major fatty acids were anteiso-C15 : 0 (61.0 %) and C16 : 0 (11.0 %). The major polar lipids were diphosphatidylglycerol, phosphatidylglycerol, phosphatidylethanolamine and an unidentified polar lipid. The strain DCY88T contained spermidine as the major polyamine. The DNA G+C content was 51.6 mol%. The DNA-DNA hybridization relatedness between strain DCY88T and P. hordei RH-N24T was 48 ± 2 %. The phenotypic, phylogenetic and chemotaxonomic results indicate that the strain DCY88T represents a novel species of the genus Paenibacillus, for which the name Paenibacillus kyungheensis sp. nov. is proposed. The type strain is DCY88T ( = JCM 19886T = KCTC 33429T).

Decreased clinical pregnancy and live birth rates after short interval from delivery to subsequent assisted reproductive treatment cycle.

PubMed

Quinn, Molly M; Rosen, Mitchell P; Allen, Isabel Elaine; Huddleston, Heather G; Cedars, Marcelle I; Fujimoto, Victor Y

2018-06-15

Does the interval from delivery to initiation of a subsequent ART treatment cycle impact clinical pregnancy or live birth rates? An interval from delivery to treatment start of <6 months or ≥24 months is associated with decreased likelihood of clinical pregnancy and live birth. Short interpregnancy intervals are associated with poor obstetric outcomes in the naturally conceiving population prompting birth spacing recommendations of 18-24 months from international organizations. Deferring a subsequent pregnancy attempt means a woman will age in the interval with an attendant decline in her fertility. Retrospective analysis of the Society for Assisted Reproductive Technology Clinical Outcome Reporting System (SARTCORS) cohort containing 61 686 ART cycles from 2004 to 2013. The delivery-to-cycle interval (DCI) was calculated for patients from SARTCORS with a history of live birth from ART who returned to the same clinic for a first subsequent treatment cycle. Generalized linear models were fit to determine the risk of clinical pregnancy and live birth by DCI with subsequent adjustment for factors associated with outcomes of interest. Predicted probabilities of clinical pregnancy and live birth were generated from each model. A DCI of <6 months was associated with a 5.6% reduction in probability of clinical pregnancy (40.1 ± 1.9 versus 45.7 ± 0.6%, P = 0.009) and 6.8% reduction in live birth (31.6 ± 1.7 versus 38.4 ± 0.6%, P = 0.001) per cycle start compared to a DCI of 12 to <18 months. A DCI of ≥24 months was associated with a 5.1% reduction in probability of clinical pregnancy (40.6 ± 0.5 versus 45.7 ± 0.6%, P < 0.001) and 5.7% reduction in live birth (32.7 ± 0.5 versus 38.4 ± 0.6%, P < 0.001) compared to 12 to <18 months. The SART database is reliant upon self-report of many variables of interest including live birth. It remains unclear whether poorer outcomes are a result of residual confounding from factors inherent to the population with a very short or long DCI or the interval itself. Birth spacing recommendations for naturally conceiving populations may not be generally applicable to patients with a history of infertility. Patients planning ART treatment should wait a minimum of 6 months, but not more than 24 months, from a live birth for optimization of clinical pregnancy and live birth rates. National Center for Advancing Translational Sciences, National Institutes of Health, UCSF-CTSI Grant number UL1TR001872. The authors have no competing interests.

Time Courses of Inflammatory Markers after Aneurysmal Subarachnoid Hemorrhage and Their Possible Relevance for Future Studies.

PubMed

Höllig, Anke; Stoffel-Wagner, Birgit; Clusmann, Hans; Veldeman, Michael; Schubert, Gerrit A; Coburn, Mark

2017-01-01

Aneurysmal subarachnoid hemorrhage triggers an intense inflammatory response, which is suspected to increase the risk for secondary complications such as delayed cerebral ischemia (DCI). However, to date, the monitoring of the inflammatory response to detect secondary complications such as DCI has not become part of the clinical routine diagnostic. Here, we aim to illustrate the time courses of inflammatory parameters after aneurysmal subarachnoid hemorrhage (aSAH) and discuss the problems of inflammatory parameters as biomarkers but also their possible relevance for deeper understanding of the pathophysiology after aSAH and sophisticated planning of future studies. In this prospective cohort study, 109 patients with aSAH were initially included, n  = 28 patients had to be excluded. Serum and-if possible-cerebral spinal fluid samples ( n  = 48) were retrieved at days 1, 4, 7, 10, and 14 after aSAH. Samples were analyzed for leukocyte count and C-reactive protein (CRP) (serum samples only) as well as matrix metallopeptidase 9 (MMP9), intercellular adhesion molecule 1 (ICAM1), and leukemia inhibitory factor (LIF) [both serum and cerebrospinal fluid (CSF) samples]. Time courses of the inflammatory parameters were displayed and related to the occurrence of DCI. We illustrate the time courses of leukocyte count, CRP, MMP9, ICAM1, and LIF in patients' serum samples from the first until the 14th day after aSAH. Time courses of MMP9, ICAM1, and LIF in CSF samples are demonstrated. Furthermore, no significant difference was shown relating the time courses to the occurrence of DCI. We estimate that the wide range of the measured values hampers their interpretation and usage as a biomarker. However, understanding the inflammatory response after aSAH and generating a multicenter database may facilitate further studies: realistic sample size calculations on the basis of a multicenter database will increase the quality and clinical relevance of the acquired results.

Polycystic Ovary Syndrome: Insights into the Therapeutic Approach with Inositols

PubMed Central

Sortino, Maria A.; Salomone, Salvatore; Carruba, Michele O.; Drago, Filippo

2017-01-01

Polycystic ovary syndrome (PCOS) is characterized by hormonal abnormalities that cause menstrual irregularity and reduce ovulation rate and fertility, associated to insulin resistance. Myo-inositol (cis-1,2,3,5-trans-4,6-cyclohexanehexol, MI) and D-chiro-inositol (cis-1,2,4-trans-3,5,6-cyclohexanehexol, DCI) represent promising treatments for PCOS, having shown some therapeutic benefits without substantial side effects. Because the use of inositols for treating PCOS is widespread, a deep understanding of this treatment option is needed, both in terms of potential mechanisms and efficacy. This review summarizes the current knowledge on the biological effects of MI and DCI and the results obtained from relevant intervention studies with inositols in PCOS. Based on the published results, both MI and DCI represent potential valid therapeutic approaches for the treatment of insulin resistance and its associated metabolic and reproductive disorders, such as those occurring in women affected by PCOS. Furthermore, the combination MI/DCI seems also effective and might be even superior to either inositol species alone. However, based on available data, a particular MI:DCI ratio to be administered to PCOS patients cannot be established. Further studies are then necessary to understand the real contents of MI or DCI uptaken by the ovary following oral administration in order to identify optimal doses and/or combination ratios. PMID:28642705

Final Technical Report for Automated Manufacturing of Innovative CPV/PV Modules

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

Okawa, David

Cogenra’s Dense Cell Interconnect system was designed to use traditional front-contact cells and string them together into high efficiency and high reliability “supercells”. This novel stringer allows one to take advantage of the ~100 GW/year of existing cell production capacity and create a solar product for the customer that will produce more power and last longer than traditional PV products. The goal for this program was for Cogenra Solar to design and develop a first-of-kind automated solar manufacturing line that produces strings of overlapping cells or “supercells” based on Cogenra’s Dense Cell Interconnect (DCI) technology for their Low Concentration Photovoltaicmore » (LCPV) systems. This will enable the commercialization of DCI technology to improve the efficiency, reliability and economics for their Low Concentration Photovoltaic systems. In this program, Cogenra Solar very successfully designed, developed, built, installed, and started up the ground-breaking manufacturing tools required to assemble supercells. Cogenra then successfully demonstrated operation of the integrated line at high yield and throughput far exceeding expectations. The development of a supercell production line represents a critical step toward a high volume and low cost Low Concentration Photovoltaic Module with Dense Cell Interconnect technology and has enabled the evaluation of the technology for reliability and yield. Unfortunately, performance and cost headwinds on Low Concentration Photovoltaics systems including lack of diffuse capture (10-15% hit) and more expensive tracker requirements resulted in a move away from LCPV technology. Fortunately, the versatility of Dense Cell Interconnect technology allows for application to flat plate module technology as well and Cogenra has worked with the DOE to utilize the learning from this grant to commercialize DCI technology for the solar market through the on-going grant: Catalyzing PV Manufacturing in the US With Cogenra Solar’s Next-Generation Dense Cell Interconnect PV Module Manufacturing Technology. This program is now very successfully building off of this work and commercializing the technology to enable increased solar adoption.« less

Studies in Intelligence. Volume 58, Number 1, March 2014

DTIC Science & Technology

2014-03-01

contact for defense intelli- gence, more effective implementa- tion of DCI policy guidance, consolidated oversight of DoD pro - grams and improved...disparate parts of the budget. As USD(I) Clapper went even fur- ther in exercising MIP authorities and developing an intelligence pro - gram between...the MIP and the broader National Intelligence Pro - gram (NIP), making defense intelli- gence program planning more effective and efficient. Over time

Genetic modification of Bacillus subtilis for production of D-chiro-inositol, an investigational drug candidate for treatment of type 2 diabetes and polycystic ovary syndrome.

PubMed

Yoshida, Ken-ichi; Yamaguchi, Masanori; Morinaga, Tetsuro; Ikeuchi, Maya; Kinehara, Masaki; Ashida, Hitoshi

2006-02-01

D-chiro-inositol (DCI) is a drug candidate for the treatment of type 2 diabetes and polycystic ovary syndrome, since it improves the efficiency with which the body uses insulin and also promotes ovulation. Here, we report genetic modification of Bacillus subtilis for production of DCI from myo-inositol (MI). The B. subtilis iolABCDEFGHIJ operon encodes enzymes for the multiple steps of the MI catabolic pathway. In the first and second steps, MI is converted to 2-keto-MI (2KMI) by IolG and then to 3D-(3,5/4)-trihydroxycyclohexane-1,2-dione by IolE. In this study, we identified iolI encoding inosose isomerase, which converts 2KMI to 1-keto-D-chiro-inositol (1KDCI), and found that IolG reduces 1KDCI to DCI. Inactivation of iolE in a mutant constitutively expressing the iol operon blocked the MI catabolic pathway to accumulate 2KMI, which was converted to DCI via the activity of IolI and IolG. The mutant was able to convert at least 6% of input MI in the culture medium to DCI.

Discovery of Novel Inhibitors of Indoleamine 2,3-Dioxygenase 1 Through Structure-Based Virtual Screening

PubMed Central

Zhang, Guoqing; Xing, Jing; Wang, Yulan; Wang, Lihao; Ye, Yan; Lu, Dong; Zhao, Jihui; Luo, Xiaomin; Zheng, Mingyue; Yan, Shiying

2018-01-01

Indoleamine 2,3-dioxygenase 1 (IDO1) is an intracellular monomeric heme-containing enzyme that catalyzes the first and the rate limiting step in catabolism of tryptophan via the kynurenine (KYN) pathway, which plays a significant role in the proliferation and differentiation of T cells. IDO1 has been proven to be an attractive target for anticancer therapy and chronic viral infections. In the present study, a class of IDO1 inhibitors with novel scaffolds were identified by virtual screening and biochemical validation, in which the compound DC-I028 shows moderate IDO1 inhibitory activity with an IC50 of 21.61 μM on enzymatic level and 89.11 μM on HeLa cell. In the following hit expansion stage, DC-I02806, an analog of DC-I028, showed better inhibitory activity with IC50 about 18 μM on both enzymatic level and cellular level. The structure–activity relationship (SAR) of DC-I028 and its analogs was then discussed based on the molecular docking result. The novel IDO1 inhibitors of DC-I028 and its analogs may provide useful clues for IDO1 inhibitor development. PMID:29651242

Paracoccus panacisoli sp. nov., isolated from a forest soil cultivated with Vietnamese ginseng.

PubMed

Nguyen, Ngoc-Lan; Kim, Yeon-Ju; Hoang, Van-An; Tran, Bao-Tram; Pham, Huong-Son; Yang, Deok-Chun

2015-05-01

A novel bacterial strain, designated DCY94(T), was isolated from forest soil cultivated with ginseng in Vietnam. The strain was Gram-reaction-negative, facultatively anaerobic, non-motile, rod-shaped and catalase- and oxidase-positive. 16S rRNA gene sequence analysis demonstrated that strain DCY94(T) was closely related to Paracoccus sphaerophysae Zy-3(T) (97.5% 16S rRNA gene sequence similarity) and Paracoccus caeni MJ17(T) (96.9%). The fatty acid profile of strain DCY94(T) contained a predominant amount of summed feature 8 (C18 : 1ω7c and/or C18 : 1ω6c; 88.4%) and moderate to small quantities of C8 : 0 3-OH (1.0%), C10 : 0 3-OH (2.8%) and C18 : 0 (5.2%). Phosphatidylethanolamine, phosphatidylglycerol, phosphatidylcholine and one unidentified glycolipid were major polar lipids; one unidentified aminolipid, one unidentified aminophospholipid, one unidentified phospholipid and four unidentified polar lipids were minor components. The polyamine pattern comprised the major compounds putrescine and spermidine and minor amounts of sym-homospermidine and spermine. The ubiquinone of the strain was Q-10 and the G+C content of its genomic DNA was 68.3 mol%. All these results support the placement of strain DCY94(T) within the genus Paracoccus . Levels of DNA-DNA relatedness between strain DCY94(T) and P. sphaerophysae HAMBI 3106(T) and P. caeni KCTC 22480(T) were 52 and 50%, respectively. The results of phylogenetic analysis, phenotypic tests, chemotaxonomic characterization and DNA-DNA relatedness studies distinguished strain DCY94(T) from the closest recognized species of the genus Paracoccus , suggesting that this strain represents a novel species, for which the name Paracoccus panacisoli sp. nov. is proposed. The type strain is DCY94(T) ( = KCTC 42086(T) =JCM 30337(T)). © 2015 IUMS.

Performance of a Dynamically Controlled Inverter in a Photovoltaic System Interconnected with a Secondary Network Distribution System

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

Coddington, M. H.; Kroposki, B. D.; Basso, T.

In 2008, a 300 kW{sub peak} photovoltaic (PV) system was installed on the rooftop of the Colorado Convention Center (CCC). The installation was unique for the electric utility, Xcel Energy, as it had not previously permitted a PV system to be interconnected on a building served by the local secondary network distribution system (network). The PV system was installed with several provisions; one to prevent reverse power flow, another called a dynamically controlled inverter (DCI), that curtails the output of the PV inverters to maintain an amount of load supplied by Xcel Energy at the CCC. The DCI system utilizesmore » current transformers (CTs) to sense power flow to insure that a minimum threshold is maintained from Xcel Energy through the network transformers. The inverters are set to track the load on each of the three phases and curtail power from the PV system when the generated PV system current reaches 95% of the current on any phase. This is achieved by the DCI, which gathers inputs from current transformers measuring the current from the PV array, Xcel, and the spot network load. Preventing reverse power flow is a critical technical requirement for the spot network which serve this part of the CCC. The PV system was designed with the expectation that the DCI system would not curtail the PV system, as the expected minimum load consumption was historically higher than the designed PV system size. However, the DCI system has operated many days during the course of a year, and the performance has been excellent. The DCI system at the CCC was installed as a secondary measure to insure that a minimum level of power flows to the CCC from the Xcel Energy network. While this DCI system was intended for localized control, the system could also reduce output percent if an external smart grid control signal was employed. This paper specifically focuses on the performance of the innovative design at this installation; however, the DCI system could also be used for new s- art grid-enabled distribution systems where renewables power contributions at certain conditions or times may need to be curtailed.« less

Pre-donation cognitions of potential living organ donors: the development of the Donation Cognition Instrument in potential kidney donors.

PubMed

Wirken, Lieke; van Middendorp, Henriët; Hooghof, Christina W; Sanders, Jan-Stephan F; Dam, Ruth E; van der Pant, Karlijn A M I; Berendsen, Elsbeth C M; Wellink, Hiske; Dackus, Henricus J A; Hoitsma, Andries J; Hilbrands, Luuk B; Evers, Andrea W M

2017-03-01

Cognitions surrounding living organ donation, including the motivation to donate, expectations of donation and worries about donation, are relevant themes during living donor evaluation. However, there is no reliable psychometric instrument assessing all these different cognitions. This study developed and validated a questionnaire to assess pre-donation motivations, expectations and worries regarding donation, entitled the Donation Cognition Instrument (DCI). Psychometric properties of the DCI were examined using exploratory factor analysis for scale structure and associations with validated questionnaires for construct validity assessment. From seven Dutch transplantation centres, 719 potential living kidney donors were included. The DCI distinguishes cognitions about donor benefits, recipient benefits, idealistic incentives, gratitude and worries about donation (Cronbach's alpha 0.76-0.81). Scores on pre-donation cognitions differed with regard to gender, age, marital status, religion and donation type. With regard to construct validity, the DCI was moderately correlated with expectations regarding donor's personal well-being and slightly to moderately to health-related quality of life. The DCI is found to be a reliable instrument assessing cognitions surrounding living organ donation, which might add to pre-donation quality of life measures in facilitating psychosocial donor evaluation by healthcare professionals. © The Author 2017. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

MicroRNA Changes in Cerebrospinal Fluid After Subarachnoid Hemorrhage.

PubMed

Bache, Søren; Rasmussen, Rune; Rossing, Maria; Laigaard, Finn Pedersen; Nielsen, Finn Cilius; Møller, Kirsten

2017-09-01

Delayed cerebral ischemia (DCI) accounts for a major part of the morbidity and mortality after aneurysmal subarachnoid hemorrhage (SAH). MicroRNAs (miRNAs) are pathophysiologically involved in acute cerebral ischemia. This study compared miRNA profiles in cerebrospinal fluid from neurologically healthy patients, as well as SAH patients with and without subsequent development of DCI. In a prospective case-control study of SAH patients treated with external ventricular drainage and neurologically healthy patients, miRNA profiles in cerebrospinal fluid were screened and validated using 2 different high-throughput real-time quantification polymerase chain reaction techniques. The occurrence of DCI was documented in patient charts and subsequently reviewed independently by 2 physicians. MiRNA profiles from 27 SAH patients and 10 neurologically healthy patients passed quality control. In the validation, 66 miRNAs showed a relative increase in cerebrospinal fluid from SAH patients compared with neurologically healthy patients ( P <0.001); 2 (miR-21 and miR-221) showed a relative increase in SAH patients with DCI compared with those without ( P <0.05) in both the screening and validation. SAH is associated with marked changes in the cerebrospinal fluid miRNA profile. These changes could be associated to the development of DCI. URL: http://www.clinicaltrials.gov. Unique identifier: NCT01791257. © 2017 The Authors.

Assessment of the Impact of a New Guanidine Suppressor In NGS on F/H Laboratory Analyses For DWPF and Saltstone MCU Transfers

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

Bannochie, C. J.

2013-04-29

Implementation of the Next Generation Solvent (NGS) in the Modular Caustic-Side Solvent Extraction Unit (MCU) will now proceed with a new suppressor compound, 1,2,3-tris(3,7-dimethyloctyl)guanidine (TiDG), replacing the originally planned suppressor for NGS, 1,3-dicyclohexyl-2-(11-methyldodecyl) guanidine (DCiTG). The Savannah River National Laboratory (SRNL) was tasked with evaluating the potential impact to F/H Laboratory analyses supporting the Defense Waste Processing Facility (DWPF) Waste Acceptance Criteria (WAC) used to qualify transfers of MCU Strip Effluent (SE) into the facility and the Saltstone WAC used to qualify transfers of Tank 50 containing Decontaminated Salt Solution (DSS) from MCU into Saltstone. This assigned scope is coveredmore » by a Task Technical and Quality Assurance Plan (TTQAP). Previous impact evaluations were conducted when the DCiTG suppressor was planned for NGS and concluded that there was no impact to either the determination of MCU SE pH nor the analysis of Isopar® L carryover in the MCU SE and DSS streams. SRNL reported on this series of cross-check studies between the SRNL and F/H Laboratories. The change in suppressor from DCiTG to TiDG in the NGS should not impact the measurement of Isopar® L or pH in SE or DSS necessary to satisfy DWPF and Saltstone WAC (Tank 50) criteria, respectively. A statistical study of the low bias observed in Isopar® L measurements in both SRNL and F/H Laboratories may be necessary now that the final NGS composition is fixed in order to quantify the low bias so that a proper correction can be applied to measurements critical to the DWPF and Saltstone WACs. Depending upon the final DWPF WAC requirement put in place for SE pH, it could become necessary to implement an alternative ICP-AES measurement of boron. The current blended solvent system testing in SRNL should address any impacts to Isopar® L carryover into either the DSS or the SE. It is recommended that SRNL monitor the current blended solvent work underway with simulants in SRNL as well as any DWPF CPC testing done with the new SE stream to ascertain whether any need develops that could result in modification of any currently planned F/H Laboratory testing protocols.« less

Ineffective esophageal motility phenotypes following fundoplication in gastroesophageal reflux disease.

PubMed

Mello, M D; Shriver, A R; Li, Y; Patel, A; Gyawali, C P

2016-02-01

Ineffective esophageal motility (IEM) is associated with reflux disease, but its natural history is unclear. We evaluated patients undergoing repeat esophageal high resolution manometry (HRM) for symptomatic presentations after antireflux surgery (ARS) to understand the progression of IEM. Patients with repeat HRM after ARS were included. Ineffective esophageal motility was diagnosed if ≥5 sequences had distal contractile integral (DCI) <450 mmHg cm s. Augmentation of DCI following multiple rapid swallows (MRS) was assessed. The esophagogastric junction (EGJ) was interrogated using the EGJ contractile integral (EGJ-CI). Esophageal motor function was compared between patients with and without IEM. Sixty-eight patients (53.9 ± 1.8 years, 66.2% female) had pre- and post-ARS HRM studies 2.1 ± 0.19 years apart. Esophagogastric junction-CI augmented by a mean of 26.3% following ARS. Four IEM phenotypes were identified: 14.7% had persistent IEM, 8.8% resolved IEM after ARS, 19.1% developed new IEM, and 57.4% had no IEM at any point. Patients with IEM had a lower DCI pre- and post-ARS, lower pre-ARS EGJ CI, and lower pre-ARS-integrated relaxation pressure (p ≤ 0.02 for all comparisons); presenting symptoms and other EGJ metrics were similar (p ≥ 0.08 for all comparisons). The IEM phenotypes could be predicted by MRS DCI response patterns (p = 0.008 across groups); patients with persistent IEM had the least DCI augmentation (p = 0.007 compared to no IEM), while those who resolved IEM had DCI augmentation comparable to no IEM (p = 0.08). Distinct phenotypes of IEM exist among symptomatic reflux patients following ARS. Provocative testing with MRS may help identify these phenotypes pre-ARS. © 2015 John Wiley & Sons Ltd.

Pulse shape discrimination and classification methods for continuous depth of interaction encoding PET detectors.

PubMed

Roncali, Emilie; Phipps, Jennifer E; Marcu, Laura; Cherry, Simon R

2012-10-21

In previous work we demonstrated the potential of positron emission tomography (PET) detectors with depth-of-interaction (DOI) encoding capability based on phosphor-coated crystals. A DOI resolution of 8 mm full-width at half-maximum was obtained for 20 mm long scintillator crystals using a delayed charge integration linear regression method (DCI-LR). Phosphor-coated crystals modify the pulse shape to allow continuous DOI information determination, but the relationship between pulse shape and DOI is complex. We are therefore interested in developing a sensitive and robust method to estimate the DOI. Here, linear discriminant analysis (LDA) was implemented to classify the events based on information extracted from the pulse shape. Pulses were acquired with 2×2×20 mm(3) phosphor-coated crystals at five irradiation depths and characterized by their DCI values or Laguerre coefficients. These coefficients were obtained by expanding the pulses on a Laguerre basis set and constituted a unique signature for each pulse. The DOI of individual events was predicted using LDA based on Laguerre coefficients (Laguerre-LDA) or DCI values (DCI-LDA) as discriminant features. Predicted DOIs were compared to true irradiation depths. Laguerre-LDA showed higher sensitivity and accuracy than DCI-LDA and DCI-LR and was also more robust to predict the DOI of pulses with higher statistical noise due to low light levels (interaction depths further from the photodetector face). This indicates that Laguerre-LDA may be more suitable to DOI estimation in smaller crystals where lower collected light levels are expected. This novel approach is promising for calculating DOI using pulse shape discrimination in single-ended readout depth-encoding PET detectors.

Pulse Shape Discrimination and Classification Methods for Continuous Depth of Interaction Encoding PET Detectors

PubMed Central

Roncali, Emilie; Phipps, Jennifer E.; Marcu, Laura; Cherry, Simon R.

2012-01-01

In previous work we demonstrated the potential of positron emission tomography (PET) detectors with depth-of-interaction (DOI) encoding capability based on phosphor-coated crystals. A DOI resolution of 8 mm full-width at half-maximum was obtained for 20 mm long scintillator crystals using a delayed charge integration linear regression method (DCI-LR). Phosphor-coated crystals modify the pulse shape to allow continuous DOI information determination, but the relationship between pulse shape and DOI is complex. We are therefore interested in developing a sensitive and robust method to estimate the DOI. Here, linear discriminant analysis (LDA) was implemented to classify the events based on information extracted from the pulse shape. Pulses were acquired with 2 × 2 × 20 mm3 phosphor-coated crystals at five irradiation depths and characterized by their DCI values or Laguerre coefficients. These coefficients were obtained by expanding the pulses on a Laguerre basis set and constituted a unique signature for each pulse. The DOI of individual events was predicted using LDA based on Laguerre coefficients (Laguerre-LDA) or DCI values (DCI-LDA) as discriminant features. Predicted DOIs were compared to true irradiation depths. Laguerre-LDA showed higher sensitivity and accuracy than DCI-LDA and DCI-LR and was also more robust to predict the DOI of pulses with higher statistical noise due to low light levels (interaction depths further from the photodetector face). This indicates that Laguerre-LDA may be more suitable to DOI estimation in smaller crystals where lower collected light levels are expected. This novel approach is promising for calculating DOI using pulse shape discrimination in single-ended readout depth-encoding PET detectors. PMID:23010690

Protection against the synaptic targeting and toxicity of Alzheimer's-associated Aβ oligomers by insulin mimetic chiro-inositols

PubMed Central

Pitt, Jason; Thorner, Michael; Brautigan, David; Larner, Joseph; Klein, William L.

2013-01-01

Alzheimer's disease (AD) is a progressive dementia that correlates highly with synapse loss. This loss appears due to the synaptic accumulation of toxic Aβ oligomers (ADDLs), which damages synapse structure and function. Although it has been reported that oligomer binding and toxicity can be prevented by stimulation of neuronal insulin signaling with PPARγ agonists, these agonists have problematic side effects. We therefore investigated the therapeutic potential of chiro-inositols, insulin-sensitizing compounds safe for human consumption. Chiro-inositols have been studied extensively for treatment of diseases associated with peripheral insulin resistance, but their insulin mimetic function in memory-relevant central nervous system (CNS) cells is unknown. Here we demonstrate that mature cultures of hippocampal neurons respond to d-chiro-inositol (DCI), pinitol (3-O-methyl DCI), and the inositol glycan INS-2 (pinitol β-1-4 galactosamine) with increased phosphorylation in key upstream components in the insulin-signaling pathway (insulin receptor, insulin receptor substrate-1, and Akt). Consistent with insulin stimulation, DCI treatment promotes rapid withdrawal of dendritic insulin receptors. With respect to neuroprotection, DCI greatly enhances the ability of insulin to prevent ADDL-induced synapse damage (EC50 of 90 nM). The mechanism comprises inhibition of oligomer binding at synapses and requires insulin/IGF signaling. DCI showed no effects on Aβ oligomerization. We propose that inositol glycans and DCI, a compound already established as safe for human consumption, have potential as AD therapeutics by protecting CNS synapses against Aβ oligomers through their insulin mimetic activity.—Pitt, J., Thorner, M., Brautigan, D., Larner, J., Klein, W. L. Protection against the synaptic targeting and toxicity of Alzheimer's-associated Aβ oligomers by insulin mimetic chiro-inositols. PMID:23073831

MicroRNA Changes in Cerebrospinal Fluid After Subarachnoid Hemorrhage

PubMed Central

Rasmussen, Rune; Rossing, Maria; Laigaard, Finn Pedersen; Nielsen, Finn Cilius; Møller, Kirsten

2017-01-01

Background and Purpose— Delayed cerebral ischemia (DCI) accounts for a major part of the morbidity and mortality after aneurysmal subarachnoid hemorrhage (SAH). MicroRNAs (miRNAs) are pathophysiologically involved in acute cerebral ischemia. This study compared miRNA profiles in cerebrospinal fluid from neurologically healthy patients, as well as SAH patients with and without subsequent development of DCI. Methods— In a prospective case–control study of SAH patients treated with external ventricular drainage and neurologically healthy patients, miRNA profiles in cerebrospinal fluid were screened and validated using 2 different high-throughput real-time quantification polymerase chain reaction techniques. The occurrence of DCI was documented in patient charts and subsequently reviewed independently by 2 physicians. Results— MiRNA profiles from 27 SAH patients and 10 neurologically healthy patients passed quality control. In the validation, 66 miRNAs showed a relative increase in cerebrospinal fluid from SAH patients compared with neurologically healthy patients (P<0.001); 2 (miR-21 and miR-221) showed a relative increase in SAH patients with DCI compared with those without (P<0.05) in both the screening and validation. Conclusions— SAH is associated with marked changes in the cerebrospinal fluid miRNA profile. These changes could be associated to the development of DCI. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT01791257. PMID:28768799

Decompression illness in divers treated in Auckland, New Zealand, 1996-2012.

PubMed

Haas, Rachel M; Hannam, Jacqueline A; Sames, Christopher; Schmidt, Robert; Tyson, Andrew; Francombe, Marion; Richardson, Drew; Mitchell, Simon J

2014-03-01

The treatment of divers for decompression illness (DCI) in Auckland, New Zealand, has not been described since 1996, and subsequent trends in patient numbers and demographics are unmeasured. This was a retrospective audit of DCI cases requiring recompression in Auckland between 01 January 1996 and 31 December 2012. Data describing patient demographics, dive characteristics, presentation of DCI and outcomes were extracted from case notes and facility databases. Trends in annual case numbers were evaluated using Spearman's correlation coefficients (ρ) and compared with trends in entry-level diver certifications. Trends in patient demographics and delay between diving and recompression were evaluated using regression analyses. There were 520 DCI cases. Annual caseload decreased over the study period (ρ = 0.813, P < 0.0001) as did entry level diving certifications in New Zealand (ρ = 0.962, P < 0.0001). Mean diver age was 33.6 (95% confidence limits (CI) 32.7 to 34.5) years and age increased (P < 0.0001) over the study period. Median (range) delay to recompression was 2.06 (95% CI 0.02 to 23.6) days, and delay declined over the study period (P = 0.005). Numbers of DCI cases recompressed in Auckland have declined significantly over the last 17 years. The most plausible explanation is declining diving activity but improvements in diving safety cannot be excluded. The delay between diving and recompression has reduced.

AGOR 28: SIO Shipyard Representative Bi-Weekly Progress Report

DTIC Science & Technology

2015-07-30

sides of the lower engine room still have sections of bare acoustic tile that require thermal insulation and Quad-Zero • Main Deck Noise Levels, Sally...for Sally Ride. ii. Working on NS5 Hierarchy 4. Operator Concerns: • Acoustic Tiles & MLV – No additional tiles have been removed this...reporting period. DCI has no plans to remove any more per USCG. No indication as to what sound treatment will be placed in the engine room bilge or on

Utilizing mobile networks for the detection of clinically relevant interactions between chemotherapy regimens and complementary and alternative medicines.

PubMed

Yap, Kevin Yi-Lwern; See, Cheng Shang; Kuo, En Yi; Chui, Wai Keung; Chan, Alexandre

2012-02-01

Patients with cancer who use complementary and alternative medicines (CAMs) in conjunction with chemotherapy treatment are at risk of manifesting anticancer drug-CAM interactions (DCIs), which may lead to negative therapeutic outcomes. This article describes a novel iPhone application developed for the Mobile Internet, called OncoRx-MI, which identifies DCIs of single-agent and multiple-agent chemotherapy regimen (CReg) prescriptions. Drug-, CAM-, and DCI-related information was compiled from various hardcopy and softcopy sources, and published literature from PubMed. Overall management plans for the CRegs were then developed. The iPhone Web documents were constructed using Adobe software and programming scripts, and mounted onto a third-party server. DCI searches are based on CReg acronyms, and OncoRx-MI is designed to fit the iPhone screen configuration for improved usability. A small usability study was also carried out and the user feedback presented. OncoRx-MI is able to detect over 2700 interactions between 256 CRegs and 166 CAMs, making up a total of over 4400 DCI pairs. The CAMs are classified into seven categories based on their uses in supportive care, and non-cancer-related CAMs are also included. The majority of the DCIs are pharmacokinetic in nature (79%), involving the induction and inhibition of the cytochrome P450 isozymes and p-glycoprotein. Pharmacodynamic DCIs include hepatotoxicity (39%), altered corticosteroid efficacies (30%), and increased risks of hypoglycemia (4%), hypertensive crisis (2%), bleeding, and serotonin syndrome (1% each). OncoRx-MI is the first mobile application of its kind that allows searching of DCIs for CRegs through 3G networks, and is intended to improve pharmaceutical care of patients with cancer by assisting health care practitioners in managing CReg interactions in their clinical practices.

Incorporating High-Frequency Physiologic Data Using Computational Dictionary Learning Improves Prediction of Delayed Cerebral Ischemia Compared to Existing Methods.

PubMed

Megjhani, Murad; Terilli, Kalijah; Frey, Hans-Peter; Velazquez, Angela G; Doyle, Kevin William; Connolly, Edward Sander; Roh, David Jinou; Agarwal, Sachin; Claassen, Jan; Elhadad, Noemie; Park, Soojin

2018-01-01

Accurate prediction of delayed cerebral ischemia (DCI) after subarachnoid hemorrhage (SAH) can be critical for planning interventions to prevent poor neurological outcome. This paper presents a model using convolution dictionary learning to extract features from physiological data available from bedside monitors. We develop and validate a prediction model for DCI after SAH, demonstrating improved precision over standard methods alone. 488 consecutive SAH admissions from 2006 to 2014 to a tertiary care hospital were included. Models were trained on 80%, while 20% were set aside for validation testing. Modified Fisher Scale was considered the standard grading scale in clinical use; baseline features also analyzed included age, sex, Hunt-Hess, and Glasgow Coma Scales. An unsupervised approach using convolution dictionary learning was used to extract features from physiological time series (systolic blood pressure and diastolic blood pressure, heart rate, respiratory rate, and oxygen saturation). Classifiers (partial least squares and linear and kernel support vector machines) were trained on feature subsets of the derivation dataset. Models were applied to the validation dataset. The performances of the best classifiers on the validation dataset are reported by feature subset. Standard grading scale (mFS): AUC 0.54. Combined demographics and grading scales (baseline features): AUC 0.63. Kernel derived physiologic features: AUC 0.66. Combined baseline and physiologic features with redundant feature reduction: AUC 0.71 on derivation dataset and 0.78 on validation dataset. Current DCI prediction tools rely on admission imaging and are advantageously simple to employ. However, using an agnostic and computationally inexpensive learning approach for high-frequency physiologic time series data, we demonstrated that we could incorporate individual physiologic data to achieve higher classification accuracy.

Dynamic cervical stabilization: a multicenter study.

PubMed

Matgé, Guy; Buddenberg, Peter; Eif, Marcus; Schenke, Holger; Herdmann, Joerg

2015-12-01

The dynamic cervical implant (DCI) is a novel motion-preserving concept for the treatment of degenerative cervical disorders. The aim of this prospective clinical study was to validate the concept and analyse clinical and radiological performance of the implant. One hundred seventy-five consecutive patients with degenerative cervical disorders, median age, 47 years, were treated with discectomy and DCI, and followed for 2 years. Clinical outcome was evaluated with the Neck Disability Index (NDI), the SF-12, and visual analogue scale (VAS) assessment of arm and neck pain. Range of motion (ROM) and cervical alignment were analysed using radiographic imaging. All clinical outcome measures--VAS neck and arm pain, NDI, and SF-12 mental and physical component summaries--improved significantly after surgery (each p < 0.001) and remained stable over the whole observation period. The ROM (flexion/extension) at the level treated with DCI was slightly reduced, but no significant changes could be verified at the adjacent levels. Six surgery or device-related adverse events were documented during the study. Good clinical and excellent radiological outcomes demonstrate that DCI is a safe and efficient treatment option in patients with degenerative cervical disorders.

The evolution of invasive cerebral vasospasm treatment in patients with spontaneous subarachnoid hemorrhage and delayed cerebral ischemia-continuous selective intracarotid nimodipine therapy in awake patients without sedation.

PubMed

Paľa, Andrej; Schneider, Max; Brand, Christine; Pedro, Maria Teresa; Özpeynirci, Yigit; Schmitz, Bernd; Wirtz, Christian Rainer; Kapapa, Thomas; König, Ralph; Braun, Michael

2018-05-26

Cerebral vasospasm (CV) and delayed cerebral ischemia (DCI) are major factors that limit good outcome in patients with spontaneous subarachnoid hemorrhage (SAH). Continuous therapy with intra-arterial calcium channel blockers has been introduced as a new step in the invasive treatment cascade of CV and DCI. Sedation is routinely necessary for this procedure. We report about the feasibility to apply this therapy in awake compliant patients without intubation and sedation. Out of 67 patients with invasive endovascular treatment of cerebral vasospasm due to spontaneous SAH, 5 patients underwent continuous superselective intracarotid nimodipine therapy without intubation and sedation. Complications, neurological improvement, and outcome at discharge were summarized. Very good outcome was achieved in all 5 patients. The Barthel scale was 100 and the modified Rankin scale 0-1 in all cases at discharge. We found no severe complications and excellent neurological monitoring was possible in all cases due to patients' alert status. Symptoms of DCI resolved within 24 h in all 5 cases. We could demonstrate the feasibility and safety of selective intracarotid arterial nimodipine treatment in awake, compliant patients with spontaneous SAH and symptomatic CV and DCI. Using this method, an excellent monitoring of neurological function as well as early detection of other complications is possible. It might be an important step in the risk reduction of invasive CV therapy to improve the outcome with CV and DCI after SAH in selected patients.

Lactobacillus vespulae sp. nov., isolated from gut of a queen wasp (Vespula vulgaris).

PubMed

Hoang, Van-An; Kim, Yeon-Ju; Nguyen, Ngoc-Lan; Kim, Si-Kwan; Yang, Deok-Chun

2015-10-01

A Gram-stain-positive, oxidase- and catalase-negative, rod-shaped, facultatively anaerobic bacterial strain, DCY75T, was isolated from a queen wasp (Vespula vulgaris). Growth occurred at 4–37 °C (optimum, 30 °C), at pH 3.5–8.0 (optimum, pH 5.0–6.0) and with ≤ 7.0 % (w/v) NaCl. Strain DCY75T produced gas during growth on glucose. Phylogenetic analysis based on 16S rRNA gene sequences indicated that strain DCY75T belonged to the genus Lactobacillus and was closely related to Lactobacillus sanfranciscensis ATCC 27651T and Lactobacillus lindneri DSM 20690T at sequence similarities of 96.7 and 96.4 %, respectively. A comparison of two housekeeping genes, pheS and rpoA, revealed that strain DCT75T was well separated from other species of the genus Lactobacillus. Strain DCY75T produced d- and l-lactic acid isomers in a ratio of 22.5 : 77.5 (v/v). The major fatty acids were summed feature 8 (comprising C18 :  1ω7c and/or C18 : 1ω6c), C16 : 0, C18 : 1ω9c and C18 : 0.The peptidoglycan structure was of the A4α (l-Lys–d-Asp) type. Cell-wall sugars were glucose, galactose and ribose. The DNA G+C content was 35.5 ± 1.3 mol%. Based on phenotypic and genotypic properties, strain DCY75T represents a novel species of the genus Lactobacillus, for which the name Lactobacillus vespulae sp. nov. is proposed. The type strain is DCY75T ( = KCTC 21023T = JCM 19742T).

Socio-ecological perspective of older age life expectancy: income, gender inequality, and financial crisis in Europe.

PubMed

Kim, Jong In; Kim, Gukbin

2017-08-18

Population is aging rapidly in Europe. Older age life expectancy (OLE) can be influenced by country-level depth of credit information (DCI) as an indicator of financial crisis, gross national income (GNI) per capita, and gender inequality index (GII). These factors are key indicators of socio-ecological inequality. They can be used to develop strategies to reduce country-level health disparity. The objective of this study was to confirm the relationship between socio-ecological factors and OLE in Europe. Data were obtained from World Bank, WHO, and UN database for 34 Europe countries. Associations between socio-ecological factors and OLE were assessed with Pearson correlation coefficients and three regression models. These models assumed that appropriate changes in country-level strategies of healthy aging would produce changes in GNI per capital as personal perspective, GII in social environment perspective, and DCI in public policy perspective to implement socio-ecological changes. Hierarchal linear regression was used for final analysis. Although OLE (women and men) had significant negative correlation with GII (gender inequality index, r = - 0.798, p = 0.001), it had positive correlations with GNI (gross national income per capita, r = 0.834, p = 0.001) and DCI (depth of credit information index, r = 0.704, p = 0.001) levels caused by financial crisis. Higher levels GNI and DCI but lower GII were found to be predictors of OLE (women and men) (R 2  = 0.804, p < 0.001). Factors affecting older age life expectancy in Europe were identified from socio-ecological perspective. Socio-ecological indicators (GII, GNI, and DCI) in Europe appear to have a latent effect on OLE levels. Thus, country-level strategies of successful aging in Europe should target socio-ecological factors such as GII, GNI, and DCI value.

PDCI Wide-Area Damping Control: PSLF Simulations of the 2016 Open and Closed Loop Test Plan

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

Wilches Bernal, Felipe; Pierre, Brian Joseph; Elliott, Ryan Thomas

To demonstrate and validate the performance of the wide-are a damping control system, the project plans to conduct closed-loop tests on the PDCI in summer/fall 2016. A test plan details the open and closed loop tests to be conducted on the P DCI using the wide-area damping control system. To ensure the appropriate level of preparedness, simulations were performed in order to predict and evaluate any possible unsafe operations before hardware experiments are attempted. This report contains the result s from these simulations using the power system dynamics software PSLF (Power System Load Flow, trademark of GE). The simulations usemore » the WECC (Western Electricity Coordinating Council) 2016 light summer and heavy summer base cases.« less

Global model comparison of heterogeneous ice nucleation parameterizations in mixed phase clouds

NASA Astrophysics Data System (ADS)

Yun, Yuxing; Penner, Joyce E.

2012-04-01

A new aerosol-dependent mixed phase cloud parameterization for deposition/condensation/immersion (DCI) ice nucleation and one for contact freezing are compared to the original formulations in a coupled general circulation model and aerosol transport model. The present-day cloud liquid and ice water fields and cloud radiative forcing are analyzed and compared to observations. The new DCI freezing parameterization changes the spatial distribution of the cloud water field. Significant changes are found in the cloud ice water fraction and in the middle cloud fractions. The new DCI freezing parameterization predicts less ice water path (IWP) than the original formulation, especially in the Southern Hemisphere. The smaller IWP leads to a less efficient Bergeron-Findeisen process resulting in a larger liquid water path, shortwave cloud forcing, and longwave cloud forcing. It is found that contact freezing parameterizations have a greater impact on the cloud water field and radiative forcing than the two DCI freezing parameterizations that we compared. The net solar flux at top of atmosphere and net longwave flux at the top of the atmosphere change by up to 8.73 and 3.52 W m-2, respectively, due to the use of different DCI and contact freezing parameterizations in mixed phase clouds. The total climate forcing from anthropogenic black carbon/organic matter in mixed phase clouds is estimated to be 0.16-0.93 W m-2using the aerosol-dependent parameterizations. A sensitivity test with contact ice nuclei concentration in the original parameterization fit to that recommended by Young (1974) gives results that are closer to the new contact freezing parameterization.

Phenotypes and clinical context of hypercontractility in high resolution esophageal pressure topography (EPT)

PubMed Central

Roman, Sabine; Pandolfino, John E; Chen, Joan; Boris, Lubomyr; Luger, Daniel; Kahrilas, Peter J

2013-01-01

Backgrounds & Aims This study aimed to refine the criteria for esophageal hypercontractility in high resolution esophageal pressure topography (EPT) and examine the clinical context in which it occurs. Subjects & Methods 72 control subjects were used to define the threshold for hypercontractility as a distal contractile integral (DCI) greater than observed in normals. 2,000 consecutive EPT studies were reviewed to find patients exceeding this threshold. Concomitant EPT and clinical variables were explored. Results The greatest DCI value observed in any swallow among the control subjects was 7,732 mmHg-s-cm; the threshold for hypercontractility was established as a swallow with DCI >8,000 mmHg-s-cm. 44 patients were identified with a median maximal DCI of 11,077 mmHg-s-cm, all with normal contractile propagation and normal distal contractile latency, thereby excluding achalasia and distal esophageal spasm. Hypercontractility was associated with multipeaked contractions in 82% of instances leading to the name Jackhammer Esophagus . Dysphagia was the dominant symptom although subsets of patients had hypercontractility in the context of EGJ outflow obstruction, reflux disease, or as an apparent primary motility disorder. Conclusion We describe an extreme phenotype of hypercontractility characterized in EPT by the occurrence of at least a single contraction with DCI > 8,000 mmHg-s-cm, a value not encountered in control subjects. This phenomenon, branded Jackhammer Esophagus was usually accompanied by dysphagia and occurred both in association with other esophageal pathology (EGJ outflow obstruction, reflux disease) or as an isolated motility disturbance. Further studies are required to define the pathophysiology and treatment of this disorder. PMID:21931377

Different CT perfusion algorithms in the detection of delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage.

PubMed

Cremers, Charlotte H P; Dankbaar, Jan Willem; Vergouwen, Mervyn D I; Vos, Pieter C; Bennink, Edwin; Rinkel, Gabriel J E; Velthuis, Birgitta K; van der Schaaf, Irene C

2015-05-01

Tracer delay-sensitive perfusion algorithms in CT perfusion (CTP) result in an overestimation of the extent of ischemia in thromboembolic stroke. In diagnosing delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (aSAH), delayed arrival of contrast due to vasospasm may also overestimate the extent of ischemia. We investigated the diagnostic accuracy of tracer delay-sensitive and tracer delay-insensitive algorithms for detecting DCI. From a prospectively collected series of aSAH patients admitted between 2007-2011, we included patients with any clinical deterioration other than rebleeding within 21 days after SAH who underwent NCCT/CTP/CTA imaging. Causes of clinical deterioration were categorized into DCI and no DCI. CTP maps were calculated with tracer delay-sensitive and tracer delay-insensitive algorithms and were visually assessed for the presence of perfusion deficits by two independent observers with different levels of experience. The diagnostic value of both algorithms was calculated for both observers. Seventy-one patients were included. For the experienced observer, the positive predictive values (PPVs) were 0.67 for the delay-sensitive and 0.66 for the delay-insensitive algorithm, and the negative predictive values (NPVs) were 0.73 and 0.74. For the less experienced observer, PPVs were 0.60 for both algorithms, and NPVs were 0.66 for the delay-sensitive and 0.63 for the delay-insensitive algorithm. Test characteristics are comparable for tracer delay-sensitive and tracer delay-insensitive algorithms for the visual assessment of CTP in diagnosing DCI. This indicates that both algorithms can be used for this purpose.

Population is the main driver of war group size and conflict casualties.

PubMed

Oka, Rahul C; Kissel, Marc; Golitko, Mark; Sheridan, Susan Guise; Kim, Nam C; Fuentes, Agustín

2017-12-26

The proportions of individuals involved in intergroup coalitional conflict, measured by war group size (W), conflict casualties (C), and overall group conflict deaths (G), have declined with respect to growing populations, implying that states are less violent than small-scale societies. We argue that these trends are better explained by scaling laws shared by both past and contemporary societies regardless of social organization, where group population (P) directly determines W and indirectly determines C and G. W is shown to be a power law function of P with scaling exponent X [demographic conflict investment (DCI)]. C is shown to be a power law function of W with scaling exponent Y [conflict lethality (CL)]. G is shown to be a power law function of P with scaling exponent Z [group conflict mortality (GCM)]. Results show that, while W/P and G/P decrease as expected with increasing P, C/W increases with growing W. Small-scale societies show higher but more variance in DCI and CL than contemporary states. We find no significant differences in DCI or CL between small-scale societies and contemporary states undergoing drafts or conflict, after accounting for variance and scale. We calculate relative measures of DCI and CL applicable to all societies that can be tracked over time for one or multiple actors. In light of the recent global emergence of populist, nationalist, and sectarian violence, our comparison-focused approach to DCI and CL will enable better models and analysis of the landscapes of violence in the 21st century. Copyright © 2017 the Author(s). Published by PNAS.

Effectiveness of diagnostic strategies in suspected delayed cerebral ischemia: a decision analysis.

PubMed

Rawal, Sapna; Barnett, Carolina; John-Baptiste, Ava; Thein, Hla-Hla; Krings, Timo; Rinkel, Gabriel J E

2015-01-01

Delayed cerebral ischemia (DCI) is a serious complication after aneurysmal subarachnoid hemorrhage. If DCI is suspected clinically, imaging methods designed to detect angiographic vasospasm or regional hypoperfusion are often used before instituting therapy. Uncertainty in the strength of the relationship between imaged vasospasm or perfusion deficits and DCI-related outcomes raises the question of whether imaging to select patients for therapy improves outcomes in clinical DCI. Decision analysis was performed using Markov models. Strategies were either to treat all patients immediately or to first undergo diagnostic testing by digital subtraction angiography or computed tomography angiography to assess for angiographic vasospasm, or computed tomography perfusion to assess for perfusion deficits. According to current practice guidelines, treatment consisted of induced hypertension. Outcomes were survival in terms of life-years and quality-adjusted life-years. When treatment was assumed to be ineffective in nonvasospasm patients, Treat All and digital subtraction angiography were equivalent strategies; when a moderate treatment effect was assumed in nonvasospasm patients, Treat All became the superior strategy. Treating all patients was also superior to selecting patients for treatment via computed tomography perfusion. One-way sensitivity analyses demonstrated that the models were robust; 2- and 3-way sensitivity analyses with variation of disease and treatment parameters reinforced dominance of the Treat All strategy. Imaging studies to test for the presence of angiographic vasospasm or perfusion deficits in patients with clinical DCI do not seem helpful in selecting which patients should undergo treatment and may not improve outcomes. Future directions include validating these results in prospective cohort studies. © 2014 American Heart Association, Inc.

Population is the main driver of war group size and conflict casualties

PubMed Central

Oka, Rahul C.; Kissel, Marc; Golitko, Mark; Sheridan, Susan Guise; Kim, Nam C.; Fuentes, Agustín

2017-01-01

The proportions of individuals involved in intergroup coalitional conflict, measured by war group size (W), conflict casualties (C), and overall group conflict deaths (G), have declined with respect to growing populations, implying that states are less violent than small-scale societies. We argue that these trends are better explained by scaling laws shared by both past and contemporary societies regardless of social organization, where group population (P) directly determines W and indirectly determines C and G. W is shown to be a power law function of P with scaling exponent X [demographic conflict investment (DCI)]. C is shown to be a power law function of W with scaling exponent Y [conflict lethality (CL)]. G is shown to be a power law function of P with scaling exponent Z [group conflict mortality (GCM)]. Results show that, while W/P and G/P decrease as expected with increasing P, C/W increases with growing W. Small-scale societies show higher but more variance in DCI and CL than contemporary states. We find no significant differences in DCI or CL between small-scale societies and contemporary states undergoing drafts or conflict, after accounting for variance and scale. We calculate relative measures of DCI and CL applicable to all societies that can be tracked over time for one or multiple actors. In light of the recent global emergence of populist, nationalist, and sectarian violence, our comparison-focused approach to DCI and CL will enable better models and analysis of the landscapes of violence in the 21st century. PMID:29229847

Bedside Xenon-CT Shows Lower CBF in SAH Patients with Impaired CBF Pressure Autoregulation as Defined by Pressure Reactivity Index (PRx).

PubMed

Johnson, Ulf; Engquist, Henrik; Howells, Tim; Nilsson, Pelle; Ronne-Engström, Elisabeth; Lewén, Anders; Rostami, Elham; Enblad, Per

2016-08-01

Subarachnoid hemorrhage (SAH) is a disease with a high rate of unfavorable outcome, often related to delayed cerebral ischemia (DCI), i.e., ischemic injury that develops days-weeks after onset, with a multifactorial etiology. Disturbances in cerebral pressure autoregulation, the ability to maintain a steady cerebral blood flow (CBF), despite fluctuations in systemic blood pressure, have been suggested to play a role in the development of DCI. Pressure reactivity index (PRx) is a well-established measure of cerebral pressure autoregulation that has been used to study traumatic brain injury, but not extensively in SAH. To study the relation between PRx and CBF in SAH patients, and to examine if PRx can be used to predict DCI. Retrospective analysis of prospectively collected data. PRx was calculated as the correlation coefficient between mean arterial blood pressure (MABP) and intracranial pressure (ICP) in a 5 min moving window. CBF was measured using bedside Xenon-CT (Xe-CT). DCI was diagnosed clinically. 47 poor-grade mechanically ventilated patients were studied. Patients with disturbed pressure autoregulation (high PRx values) had lower CBF, as measured by bedside Xe-CT; both in the early (day 0-3) and late (day 4-14) acute phase of the disease. PRx did not differ significantly between patients who developed DCI or not. In mechanically ventilated and sedated SAH patients, high PRx (more disturbed CBF pressure autoregulation) is associated with low CBF, both day 0-3 and day 4-14 after onset. The role of PRx as a monitoring tool in SAH patients needs further studying.

Novel management strategies for medically-refractory vasospasm following aneurysmal subarachnoid hemorrhage.

PubMed

Al-Mufti, Fawaz; Amuluru, Krishna; Damodara, Nitesh; El-Ghanem, Mohammad; Nuoman, Rolla; Kamal, Naveed; Al-Marsoummi, Sarmad; Morris, Nicholas A; Dangayach, Neha S; Mayer, Stephan A

2018-07-15

Delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (SAH) is an important cause of further morbidity and mortality after an already devastating condition. Though traditionally attributed to vasospasm of large capacitance arteries and the resulting down-stream disruption of cerebral blood flow, the pathogenesis of DCI has proven to be more complex with early brain injury, blood-brain barrier disruption, microthrombosis, cortical spreading depolarizations, and the failure of cerebral autoregulation as newly elucidated factors. Vasospasm is a known consequence of SAH. The standard of care includes close monitoring for neurological deterioration, most often with serial clinical examinations, transcranial Doppler ultrasonography, and vascular imaging (crucial for early detection of DCI and allows for prompt intervention). Nimodipine continues to remain an important pharmacological strategy to improve functional outcomes in patients with SAH at risk for developing vasospasm. The paradigm for first line therapy in patients with vasospasm of induced hypertension, hypervolemia, and hemodilution has recently been challenged. Current American Heart Association guidelines recommend targeting euvolemia and judicious use of the pharmacologically induced hypertension component. Symptomatic vasospasm patients who do not improve with this first line therapy require rescue intervention with mechanical or chemical angioplasty and optimization of cardiac output and hemoglobin levels. This can be escalated in a step-wise fashion to include adjunct treatments such as intrathecal administration of vasodilators and sympatholytic or thrombolytic therapies. This review provides a general overview of the treatment modalities for DCI with a focus on novel management strategies that show promising results for treating vasospasm to prevent DCI. Copyright © 2018. Published by Elsevier B.V.

Neurocardiac protection with milrinone for restoring acute cerebral hypoperfusion and delayed ischemic injury after experimental subarachnoid hemorrhage.

PubMed

Mutoh, Tomoko; Mutoh, Tatsushi; Sasaki, Kazumasu; Nakamura, Kazuhiro; Tatewaki, Yasuko; Ishikawa, Tatsuya; Taki, Yasuyuki

2017-02-15

Acute cerebral hypoperfusion following subarachnoid hemorrhage (SAH) is highly related to the pathogenesis of delayed cerebral ischemia (DCI), but the therapeutic option is poorly available. This study aimed to clarify the effect of milrinone (MIL) on cerebral blood flow (CBF) and related outcomes after experimental SAH. Twenty-seven male C57BL/6 mice were assigned to either sham surgery (SAH-sham; n=6), SAH induced by endovascular perforation (control; n=10), or SAH followed by cardiac support with intravenous MIL (n=11) performed 1.5-h after SAH induction. CBF, neurobehavioral function, occurrence of DCI were assessed by MR-continuous arterial spin labeling, daily neurological score testing, and diffusion- and T2-weighted MR images on days 1 and 3, respectively. Initial global CBF depression was notable in mice of control and MIL groups as compared to the SAH-sham group (P<0.05). MIL raised CBF in a dose-dependent manner (P<0.001), resulted in lower incidence of DCI (P=0.008) and better recovery from neurobehavioral decline than control (P<0.001). The CBF values on day 1 predicted DCI with a cut-off of 42.5ml/100g/min (82% specificity and 83% sensitivity), which was greater in mice treated with MIL than those of control (51.7 versus 37.6ml/100g/min; P<0.001). MIL improves post-SAH acute hypoperfusion that can lead to the prevention of DCI and functional worsening, acting as a neurocardiac protective agent against EBI. Copyright © 2017 Elsevier B.V. All rights reserved.

Modulatory role of D-chiro-inositol (DCI) on LH and insulin secretion in obese PCOS patients.

PubMed

Genazzani, Alessandro D; Santagni, Susanna; Rattighieri, Erika; Chierchia, Elisa; Despini, Giulia; Marini, Giulia; Prati, Alessia; Simoncini, Tommaso

2014-06-01

Polycystic ovary syndrome (PCOS) is a common endocrine condition that affects fertility through oligo-ovulation, hyperandrogenism and polycystic morphology of the ovaries. Since it has been demonstrated a high incidence of insulin resistance in PCOS patients, our study aimed to evaluate the efficacy of the integrative treatment with D-chiro-inositol (DCI) (500 mg die, per os, for 12 weeks) on hormonal parameters and insulin sensitivity in a group of overweight/obese PCOS patients (body mass index; BMI > 26). After the treatment, interval several endocrine parameters improved (luteinizing hormone [LH], LH/follicle stimulating hormone [FSH], androstenedione and insulin), insulin response to oral glucose tolerance test reported the significant improvement of insulin sensitivity as well as the gonadotropin-releasing hormone (GnRH)-induced (10 µg, in bolus) LH response. BMI decreased, though no lifestyle modification was requested. When data were analyzed according to the presence or absence of first-grade diabetic relatives, PCOS patients with diabetic relatives showed greater improvement after DCI administration. In conclusion DCI administration is effective in restoring better insulin sensitivity and an improved hormonal pattern in obese hyperinsulinemic PCOS patients, in particular, in hyperinsulinemic PCOS patients who have diabetic relatives.

Expanding Primary Care at William Beaumont Army Medical Center to Support an Increased Beneficiary Population Resulting from the 2005 Base Realignment and Closure Commission Report

DTIC Science & Technology

2006-07-01

the Army Health Facility Planning Agency (HFPA). F HFPA Bl s B CCSIMakhldr PA& E ecision MECOM anpowe Support GPRMS SuthWest egion - IM CTRI WEIST (DcI 4...providers or resources. Finally, is there potential for consolidation of staff support areas such as lounges , locker rooms or conference areas (DoD Medical...Organization and Equipment for the ist AD (see appendix I). Utilizing this identified structure, the Army Force Management Support Agency web portal

Vasospasm on transcranial Doppler is predictive of delayed cerebral ischemia in aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis.

PubMed

Kumar, Gyanendra; Shahripour, Reza Bavarsad; Harrigan, Mark R

2016-05-01

OBJECT The impact of transcranial Doppler (TCD) ultrasonography evidence of vasospasm on patient-centered clinical outcomes following aneurysmal subarachnoid hemorrhage (aSAH) is unknown. Vasospasm is known to lead to delayed cerebral ischemia (DCI) and poor outcomes. This systematic review and meta-analysis evaluates the predictive value of vasospasm on DCI, as diagnosed on TCD. METHODS MEDLINE, Scopus, the Cochrane trial register, and clinicaltrials.gov were searched through September 2014 using key words and the terms "subarachnoid hemorrhage," "aneurysm," "aneurysmal," "cerebral vasospasm," "vasospasm," "transcranial Doppler," and "TCD." Sensitivities, specificities, and positive and negative predictive values were pooled by a DerSimonian and Laird random-effects model. RESULTS Seventeen studies (n = 2870 patients) met inclusion criteria. The amount of variance attributable to heterogeneity was significant (I(2) > 50%) for all syntheses. No studies reported the impact of TCD evidence of vasospasm on functional outcome or mortality. TCD evidence of vasospasm was found to be highly predictive of DCI. Pooled estimates for TCD diagnosis of vasospasm (for DCI) were sensitivity 90% (95% confidence interval [CI] 77%-96%), specificity 71% (95% CI 51%-84%), positive predictive value 57% (95% CI 38%-71%), and negative predictive value 92% (95% CI 83%-96%). CONCLUSIONS TCD evidence of vasospasm is predictive of DCI with high accuracy. Although high sensitivity and negative predictive value make TCD an ideal monitoring device, it is not a mandated standard of care in aSAH due to the paucity of evidence on clinically relevant outcomes, despite recommendation by national guidelines. High-quality randomized trials evaluating the impact of TCD monitoring on patient-centered and physician-relevant outcomes are needed.

A Propensity Score Analysis of the Impact of Dexamethasone Use on Delayed Cerebral Ischemia and Poor Functional Outcomes After Subarachnoid Hemorrhage.

PubMed

Mohney, Nathaniel; Williamson, Craig A; Rothman, Edward; Ball, Ron; Sheehan, Kyle M; Pandey, Aditya S; Fletcher, Jeffrey J; Jacobs, Teresa L; Thompson, B Gregory; Rajajee, Venkatakrishna

2018-01-01

An inflammatory response occurs after aneurysmal subarachnoid hemorrhage (aSAH) and predicts poor outcomes. Glucocorticoids suppress inflammation and promote fluid retention. Dexamethasone is often administered after aSAH for postoperative cerebral edema and refractory headache. Our objective was to examine the impact of dexamethasone use on functional outcomes and delayed cerebral ischemia (DCI) after aSAH. Patients with aSAH admitted between 2010 and 2015 were included; the data source was a single-center subarachnoid hemorrhage registry. The intervention of interest was a dexamethasone taper used <7 days from ictus. The primary outcome was poor discharge functional outcome, with a modified Rankin Scale score >3. Other outcomes included DCI and infection. A propensity score for use of dexamethasone was calculated using a logistic regression model that included potential predictors of dexamethasone use and outcome. The impact of dexamethasone on outcomes of interest was calculated and the propensity score was controlled for. A total of 440 patients with subarachnoid hemorrhage were admitted during the study period and 309 met eligibility criteria. Dexamethasone was administered in 101 patients (33%). A total of 127 patients (41%) had a discharge modified Rankin Scale score >3, 105 (34%) developed DCI, and 94 (30%) developed an infection. After propensity score analysis, dexamethasone use was associated with a significant reduction in poor functional outcomes (odds ratio [OR], 0.35; 95% confidence interval [CI], 0.19-0.66) but showed no significant association with DCI (OR, 0.93; 95% CI, 0.53-1.64) or infection (OR, 0.60; 95% CI, 0.34-1.06). Dexamethasone use after aSAH was associated with a reduction in poor functional outcomes at discharge but not DCI, controlling for predictors of dexamethasone use. Copyright © 2017 Elsevier Inc. All rights reserved.

Incidence of delayed seizures, delayed cerebral ischemia and poor outcome with the use of levetiracetam versus phenytoin after aneurysmal subarachnoid hemorrhage.

PubMed

Karamchandani, Rahul Ramesh; Fletcher, Jeffrey James; Pandey, Aditya Swarup; Rajajee, Venkatakrishna

2014-09-01

Current guidelines recommend against the use of phenytoin following aneurysmal subarachnoid hemorrhage (aSAH) but consider other anticonvulsants, such as levetiracetam, acceptable. Our objective was to evaluate the risk of poor functional outcomes, delayed cerebral ischemia (DCI) and delayed seizures in aSAH patients treated with levetiracetam versus phenytoin. Medical records of patients with aSAH admitted between 2005-2012 receiving anticonvulsant prophylaxis with phenytoin or levetiracetam for >72 hours were reviewed. The primary outcome measure was poor functional outcome, defined as modified Rankin Scale (mRS) score >3 at first recorded follow-up. Secondary outcomes measures included DCI and the incidence of delayed seizures. The association between the use of levetiracetam and phenytoin and the outcomes of interest was studied using logistic regression. Medical records of 564 aSAH patients were reviewed and 259 included in the analysis after application of inclusion/exclusion criteria. Phenytoin was used exclusively in 43 (17%), levetiracetam exclusively in 132 (51%) while 84 (32%) patients were switched from phenytoin to levetiracetam. Six (2%) patients had delayed seizures, 94 (36%) developed DCI and 63 (24%) had mRS score >3 at follow-up. On multivariate analysis, only modified Fisher grade and seizure before anticonvulsant administration were associated with DCI while age, Hunt-Hess grade and presence of intraparenchymal hematoma were associated with mRS score >3. Choice of anticonvulsant was not associated with any of the outcomes of interest. There was no difference in the rate of delayed seizures, DCI or poor functional outcome in patients receiving phenytoin versus levetiracetam after aSAH. The high rate of crossover from phenytoin suggests that levetiracetam may be better tolerated. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

The Association Between Spontaneous Hyperventilation, Delayed Cerebral Ischemia, and Poor Neurological Outcome in Patients with Subarachnoid Hemorrhage.

PubMed

Williamson, Craig A; Sheehan, Kyle M; Tipirneni, Renuka; Roark, Christopher D; Pandey, Aditya S; Thompson, B Gregory; Rajajee, Venkatakrishna

2015-12-01

The frequency and associations of spontaneous hyperventilation in subarachnoid hemorrhage (SAH) are unknown. Because hyperventilation decreases cerebral blood flow, it may exacerbate delayed cerebral ischemia (DCI) and worsen neurological outcome. This is a retrospective analysis of data from a prospectively collected cohort of SAH patients at an academic medical center. Spontaneous hyperventilation was defined by PaCO2 <35 mmHg and pH >7.45 and subdivided into moderate and severe groups. Clinical and demographic characteristics of patients with and without spontaneous hyperventilation were compared using χ (2) or t tests. Bivariate and multivariable logistic regression analyses were conducted to examine the association of moderate and severe hyperventilation with DCI and discharge neurological outcome. Of 207 patients, 113 (55 %) had spontaneous hyperventilation. Spontaneously hyperventilating patients had greater illness severity as measured by the Hunt-Hess, World Federation of Neurosurgical Societies (WFNS), and SAH sum scores. They were also more likely to develop the following complications: pneumonia, neurogenic myocardial injury, systemic inflammatory response syndrome (SIRS), radiographic vasospasm, DCI, and poor neurological outcome. In a multivariable logistic regression model including age, gender, WFNS, SAH sum score, pneumonia, neurogenic myocardial injury, etiology, and SIRS, only moderate [odds ratio (OR) 2.49, 95 % confidence interval (CI) 1.10-5.62] and severe (OR 3.12, 95 % CI 1.30-7.49) spontaneous hyperventilation were associated with DCI. Severe spontaneous hyperventilation (OR 4.52, 95 % CI 1.37-14.89) was also significantly associated with poor discharge outcome in multivariable logistic regression analysis. Spontaneous hyperventilation is common in SAH and is associated with DCI and poor neurological outcome.

Early Magnesium Treatment After Aneurysmal Subarachnoid Hemorrhage: Individual Patient Data Meta-Analysis.

PubMed

Dorhout Mees, Sanne M; Algra, Ale; Wong, George K C; Poon, Wai S; Bradford, Celia M; Saver, Jeffrey L; Starkman, Sidney; Rinkel, Gabriel J E; van den Bergh, Walter M; van Kooten, F; Dirven, C M; van Gijn, J; Vermeulen, M; Rinkel, G J E; Boet, R; Chan, M T V; Gin, T; Ng, S C P; Zee, B C Y; Al-Shahi Salman, R; Boiten, J; Kuijsten, H; Lavados, P M; van Oostenbrugge, R J; Vandertop, W P; Finfer, S; O'Connor, A; Yarad, E; Firth, R; McCallister, R; Harrington, T; Steinfort, B; Faulder, K; Assaad, N; Morgan, M; Starkman, S; Eckstein, M; Stratton, S J; Pratt, F D; Hamilton, S; Conwit, R; Liebeskind, D S; Sung, G; Kramer, I; Moreau, G; Goldweber, R; Sanossian, N

2015-11-01

Delayed cerebral ischemia (DCI) is an important cause of poor outcome after aneurysmal subarachnoid hemorrhage (SAH). Trials of magnesium treatment starting <4 days after symptom onset found no effect on poor outcome or DCI in SAH. Earlier installment of treatment might be more effective, but individual trials had not enough power for such a subanalysis. We performed an individual patient data meta-analysis to study whether magnesium is effective when given within different time frames within 24 hours after the SAH. Patients were divided into categories according to the delay between symptom onset and start of the study medication: <6, 6 to 12, 12 to 24, and >24 hours. We calculated adjusted risk ratios with corresponding 95% confidence intervals for magnesium versus placebo treatment for poor outcome and DCI. We included 5 trials totaling 1981 patients; 83 patients started treatment<6 hours. For poor outcome, the adjusted risk ratios of magnesium treatment for start <6 hours were 1.44 (95% confidence interval, 0.83-2.51); for 6 to 12 hours 1.03 (0.65-1.63), for 12 to 24 hours 0.84 (0.65-1.09), and for >24 hours 1.06 (0.87-1.31), and for DCI, <6 hours 1.76 (0.68-4.58), for 6 to 12 hours 2.09 (0.99-4.39), for 12 to 24 hours 0.80 (0.56-1.16), and for >24 hours 1.08 (0.88-1.32). This meta-analysis suggests no beneficial effect of magnesium treatment on poor outcome or DCI when started early after SAH onset. Although the number of patients was small and a beneficial effect cannot be definitively excluded, we found no justification for a new trial with early magnesium treatment after SAH. © 2015 American Heart Association, Inc.

Evaluating the risk of decompression sickness for a yo-yo dive using a rat model.

PubMed

Ofir, Dror; Yanir, Yoav; Abramovich, Amir; Bar, Ronen; Arieli, Yehuda

2016-01-01

The frequent ascents made during yo-yo diving may contribute to gas bubble clearance but paradoxically may also increase the risk of central nervous system decompression illness (DCI). We evaluated the risk of DCI due to yo-yo dives with very short surface intervals, using a controlled animal model. Dives were conducted on air to a depth of 90 meters (10 atmospheres absolute) for 32 minutes of bottom time, at a descent/ascent rate of 10 meters/ minute. Sprague-Dawley rats weighing ~ 300 grams were divided randomly into three groups. Group A performed a square dive protocol without any surface intervals, Group B conducted a protocol that included two surface intervals during the dive, and Group C performed a protocol with three surface intervals. Ascent/descent rate for surface intervals, each lasting one minute, was also 10 meters/minute. Manifestations of DCI were observed in 13 of 16 animals in Group A (81.3%), six of 12 in Group B (58.3%), and two of 12 in Group C (16.7%). Mortality rates were similar in all groups. Surface intervals during dives breathing air significantly reduced DCI risk in the rat. Further studies are required using a larger animal model to reinforce the results of the present investigation.

Importance of Early Postoperative Body Temperature Management for Treatment of Subarachnoid Hemorrhage.

PubMed

Suehiro, Eiichi; Sadahiro, Hirokazu; Goto, Hisaharu; Oku, Takayuki; Oka, Fumiaki; Fujiyama, Yuichi; Shirao, Satoshi; Yoneda, Hiroshi; Koizumi, Hiroyasu; Ishihara, Hideyuki; Suzuki, Michiyasu

2016-06-01

The importance of acute-phase brain temperature management is widely accepted for prevention of exacerbation of brain damage by a high body temperature. In this study, we investigated the influence of body temperature in the early postoperative period on the outcomes of 62 patients with subarachnoid hemorrhage who were admitted to our department. Body temperature was measured from day 4 to day 14 after onset. The patients were divided into those treated with surgical clipping (clip group) and coil embolization (coil group), those graded I-III (mild) and IV-V (severe) based on the Hunt & Hess classification on admission, those with and without development of delayed cerebral ischemia (DCI), and those with favorable and poor outcomes. Body temperatures throughout the hospital stay were compared in each group. There was no significant difference in body temperature between the clip and coil groups or between the mild and severe groups, but body temperature was significantly higher in patients with DCI compared to those without DCI, and in patients with a poor outcome compared to those with a favorable outcome. Fever in the early postoperative period of subarachnoid hemorrhage is associated with development of DCI and a poor outcome. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.

A Teaching Model for Scaffolding 4th Grade Students' Scientific Explanation Writing

NASA Astrophysics Data System (ADS)

Yang, Hsiu-Ting; Wang, Kuo-Hua

2014-08-01

Improving students scientific explanations is one major goal of science education. Both writing activities and concept mapping are reported as effective strategies for enhancing student learning of science. The purpose of this study was to examine the effect of a teaching model, named the DCI model, which integrates a Descriptive explanation writing activity, Concept mapping, and an Interpretive explanation writing activity, is introduced in a 4th grade science class to see if it would improve students' scientific explanations and understanding. A quasi-experimental design, including a non-randomized comparison group and a pre- and post-test design, was adopted for this study. An experimental group of 25 students were taught using the DCI teaching model, while a comparison group received a traditional lecture teaching. A rubric and content analysis was used to assess students' scientific explanations. The independent sample t test was used to measure difference in conceptual understanding between the two groups, before and after instruction. Then, the paired t test analysis was used to understand the promotion of the DCI teaching model. The results showed that students in the experimental group performed better than students in the comparison group, both in scientific concept understanding and explanation. Suggestions for using concept mapping and writing activities (the DCI teaching model) in science classes are provided in this study.

Inhibition by antioxidants of nitric oxide synthase expression in murine macrophages: role of nuclear factor kappa B and interferon regulatory factor 1.

PubMed Central

Hecker, M.; Preiss, C.; Klemm, P.; Busse, R.

1996-01-01

1. In view of the potential deleterious effects of high amounts of nitric oxide (NO) produced by the inducible isoform of NO synthase (iNOS) in inflammation, the prevention of the expression of this enzyme represents an important therapeutic goal. In cytokine-stimulated cells, activation of nuclear factor kappa B (NF-kappa B) is crucial for the increase in iNOS gene expression. Since NF-kappa B activation appears to involve a redox-sensitive step, we have investigated whether three structurally unrelated antioxidants, 5,7-dihydroxyflavone (chrysin), 3,4-dichloroisocoumarin (DCI) and N-acetyl 5-hydroxytryptamine (N-acetylserotonin, NAS), affect iNOS expression in cultured RAW 264.7 monocyte/macrophages stimulated with bacterial lipopolysaccharide (LPS, 140 ng ml-1) and interferon-gamma (IFN gamma, 5 u ml-1). 2. During a 6 h incubation period neither LPS nor IFN gamma alone exerted a significant effect but when combined, caused a prominent increase in nitrite formation, iNOS mRNA and protein abundance. Co-incubation with chrysin (50 microM), DCI (50 microM) or NAS (1 mM) markedly attenuated this increase in iNOS gene expression. 3. DCI, but not chrysin or NAS, prevented the activation of NF-kappa B in cells exposed to LPS plus IFN gamma for 30 min. In contrast, all three antioxidants significantly blunted the DNA-binding activity of interferon regulatory factor 1 (IRF-1), which mediates the synergistic effect of IFN gamma on iNOS gene expression in cells treated for 2 h with LPS plus IFN gamma. 4. DCI thus appears to inhibit iNOS gene expression at the transcriptional level by preventing the activation of both NF-kappa B and IRF-1. The inhibitory effect of DCI on NF-kappa B activation, however, does not seem to be related to its antioxidative properties, since DCI, unlike chrysin or NAS, is a potent serine protease inhibitor which stabilizes the inactive NF-kappa B complex by protecting the inhibitory I kappa B-alpha subunit from proteolytic degradation. 5. The virtually identical inhibitory effect of chrysin, DCI and NAS on the activation of IRF-1 points to a redox-sensitive step in the activation of this transcription factor, which in contrast to NF-kappa B requires de novo protein synthesis. 6. Since iNOS gene expression in human cells and tissues usually requires the combination of several cytokines, antioxidants such as chrysin and NAS which do not interfere with the activation of NF-kappa B may be of therapeutic value for selectively inhibiting the enhanced expression of this enzyme in inflammation. Images Figure 4 Figure 6 Figure 7 PMID:8864559

Evaluation of Military Fuels Using a Ford 6.7L Powerstroke Diesel Engine

DTIC Science & Technology

2011-08-01

natural steady state values during idle testing steps. Engine oil cooler plumbing was factory integrated to the engine water jacket, thus not...Innospec Fuel Specialties DCI-4A. Per QPL-25017, the minimum effective treat rate of DCI-4A required an additive concentration level of 9ppm in the...dynamometer was used to control engine speed and dissipate load. Engine load was manipulated through the actuation of the engine throttle pedal assembly

[Emergency transcranial doppler ultrasound: predictive value for the development of symptomatic vasospasm in spontaneous subarachnoid hemorrhage in patients in good neurological condition].

PubMed

Muñoz-Sanchez, M A; Murillo-Cabezas, F; Egea-Guerrero, J J; Gascón-Castillo, M L; Cancela, P; Amaya-Villar, R; Rincón-Ferrari, M D; Flores-Cordero, J M; Cayuela, A; García-Alfaro, C

2012-12-01

To examine the predictive value of an early transcranial Doppler ultrasound (TCD) study performed in the emergency department in patients with spontaneous subarachoniod hemorrhage (SAH) in good neurological condition, in order to know which patients are at high risk of developing delayed cerebral ischemia (DCI). A descriptive observational study was carried out involving a period of 3 years. Critical Care and Emergency Department. The study consecutively included patients with SAH of grade I-III on the Hunt and Hess scale. DCI (decrease of 2 points in GCS or focal deficit), Mean Velocity (MV) of middle cerebral arteries (MCA), Lindegaard Index (IL). Sonographic vasospasm pattern (SVP) was considered if MCA-MV>120cm/sc and IL>3. The mean age of the 122 patients was 54.1±13.7 years; 57.3% were women. SVP was detected in 24 patients (19.7%), although high velocities patterns (HVP) were present in 38 patients (31.1%). DCI developed in 21 patients (MV183+/-49cm/sc), all with previous SVP. In this group MV increased 22+/-5cm/sc/day during the first 3 days. The group without HVP (84 patients/MV of 67+/-16.6cm/sc), compared with DCI group, showed differences in highest MV (p<0.001), and also ΔMV/day (8.30+/-4,5cm/sc Vs 22+/-5cm/sc) during the first 3 days (p=0.009). In our series, ROC analysis selected the best cut-off value for ΔMV/day as 21cm/sc (p<0.001). During the first 3 days, an increase of 21cm/s/24h in MCA-MV was associated with the development of symptomatic vasospasm. TCD is a useful tool for the early detection of patients at risk of DCI after SAH. Copyright © 2011 Elsevier España, S.L. and SEMICYUC. All rights reserved.

Treatment of juvenile recurrent parotitis of childhood: an analysis of effectiveness.

PubMed

Roby, Brianne Barnett; Mattingly, Jameson; Jensen, Emily L; Gao, Dexiang; Chan, Kenny H

2015-02-01

Juvenile recurrent parotitis (JRP) is characterized by recurrent painful swelling of the parotid gland that occurs in the pediatric population. Sialendoscopy with and without ductal corticosteroid infusion (DCI) has been found to be effective in the treatment of JRP and autoimmune parotitis. To determine the utility of instrumentation vs pharmacotherapy alone for juvenile recurrent parotitis. A retrospective medical record review of pediatric patients undergoing DCI without sialendoscopy at a tertiary pediatric hospital was conducted. The medical records were reviewed to determine the frequency of parotitis events before and after treatment. A multiquestion telephone survey of patients and their parents who underwent the procedure was then conducted to determine patient satisfaction. Ductal corticosteroid infusion with hydrocortisone through catheter inserted in the parotid duct. Frequency of symptoms before and after treatment and parental satisfaction with the treatment. Twelve patients with a mean age of 6.7 years were identified. The mean duration and frequency of symptoms before the procedure were 22 months and every 2 months, respectively. Five patients had a recurrence, on average 4 months after the procedure. Four patients underwent repeated surgical procedures. All had a longer duration between episodes compared with before DCI. Eight parents participated in the survey on satisfaction with the procedure, and 75% reported improvement in their child's life postprocedure. Current literature shows sialendoscopy with corticosteroid application is successful in treating JRP, but it is unclear whether corticosteroid application alone would treat JRP equally. This study shows that DCI alone has similar results as sialendoscopy with corticosteroid application, indicating that it is the corticosteroid application and not the sialendoscopy causing improvement in symptoms. Because JRP must be differentiated from sialolithiasis, we recommend ultrasonography of the involved parotid(s) prior to using DCI alone to ensure no stone is present. Sialendoscopy should be reserved to rule out other parotid ductal pathologic conditions.

Chicago Classification normative metrics in a healthy Indian cohort for a 16-channel water-perfused high-resolution esophageal manometry system.

PubMed

Srinivas, M; Jain, M; Bawane, P; Jayanthi, V

2018-06-01

High-resolution esophageal manometry (HREM) interpretation by the Chicago Classification (CC) derives its normal values from western volunteers using solid-state catheters. There is no normative data for the 16-channel water-perfused HREM system commonly used in India. To determine normal values for a 16-channel water-perfused HREM catheter in supine posture using healthy volunteers and substitute these normal values (if different from CC values) in the CC v3.0 algorithm. After ethics approval and informed consent, 53 volunteers (31 men) with no gastrointestinal (GI) symptoms or medications affecting GI motility underwent HREM by standard protocol. Age, gender, body mass index (BMI), and manometry parameters analyzed using Trace 1.3.3 software were collected. The median, range, and 5, 10, 75, and 95 percentiles (where applicable) were obtained for all HREM metrics. Normal value percentiles were defined as 95th (integrated relaxation pressure [IRP]), 10th-100th (distal contractile integral [DCI]), and minimum (distal latency [DL]). The mean age was 30 years and the BMI was 24.2 kg m -2 . Compared to CC, our normal metrics were lower for IRP (13 mm Hg) and DCI (350-4500 mm Hg s cm). DCI >4500 and <70 (<5th percentile) were defined as hypercontractile and failed contraction, respectively. Abnormal DL (<4.5 s) and peristaltic break size (>5 cm) were similar to CC metrics. Applying these metrics, CC diagnoses changed in 15% (8/53) with downgrading of ineffective motility to fragmented peristalsis or normal, due to lower DCI cutoff used. This is the first report of normative data for the 16-channel water-perfused system in supine posture. It revealed lower IRP and DCI, necessitating modification of CC cutoffs for this system. © 2018 John Wiley & Sons Ltd.

High Resolution Manometry Correlates of Ineffective Esophageal Motility

PubMed Central

Xiao, Yinglian; Kahrilas, Peter J.; Kwasny, Mary J.; Roman, Sabine; Lin, Zhiyue; Nicodème, Frédéric; Lu, Chang; Pandolfino, John E.

2013-01-01

Background There are currently no criteria for ineffective esophageal motility (IEM) and ineffective swallow (IES) in High Resolution Manometry (HRM) and Esophageal Pressure Topography (EPT). Our aims were to utilize HRM metrics to define IEM within the Chicago Classification and to determine the distal contractile integral (DCI) threshold for IES. Methods The EPT of 150 patients with either dysphagia or reflux symptoms were reviewed for the breaks >2 cm in the proximal, middle and distal esophagus in the 20 mmHg isobaric contour (IBC). Peristaltic function in EPT was defined by the Chicago Classification, the corresponding conventional line tracing (CLT) were reviewed separately for IEM and IES. Generalized linear mixed models were used to find thresholds for DCI corresponding to traditionally determined IES and failed swallows. An external validation sample was used to confirm these thresholds. Results In terms of swallow subtypes, IES in CLT were a mixture of normal, weak and failed peristalsis in EPT. A DCI of 450mmHg-s-cm was determined to be optimal in predicting IES. In the validation sample, the threshold of 450 mmHg-s-cm showed strong agreement with CLT determination of IES (positive percent agreement 83%, negative percent agreement 90%) Thirty-three among 42 IEM patients in CLT had large peristaltic breaks, small peristaltic breaks or ‘frequent failed peristalsis’ in EPT; 87.2% (34/39) of patients classified as normal in CLT had proximal IBC-breaks in EPT. the patient level diagnostic agreement between CLT and EPT was good (78.6% positive percent agreement, 63.9% negative percent agreement), with negative agreement increasing to 92.0% if proximal breaks were excluded. Conclusions The manometric correlate of IEM in EPT is a mixture of failed swallows and IBC break in the middle/ distal troughs. A DCI value<450 mmHg-s-cm can be utilized to predict IES previously defined in CLT. IEM can be defined by >5 swallows with weak /failed peristalsis or with a DCI <450 mmHg-s-cm. PMID:22929758

Burst of Energy

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

Not Available

1992-01-01

The Discovery Center of Idaho (DCI) was the recipient of a grant from US DOE's Museum Science Education Program to build six permanent energy related exhibits to provide the public with hands-on experience with energy issues. Because of its volunteer support system, DC was able to build eleven exhibits. These exhibits are described and photographs are included. The signs used for the exhibits are reproduced as well as the materials used to advertise them to the public. Examples of DCI's newsletter are included that mention the new exhibits.

Burst of energy

NASA Astrophysics Data System (ADS)

The Discovery Center of Idaho (DCI) was the recipient of a grant from US DOE's Museum Science Education Program to build six permanent energy related exhibits to provide the public with hands-on experience with energy issues. Because of its volunteer support system, DC was able to build eleven exhibits. These exhibits are described and photographs are included. The signs used for the exhibits are reproduced as well as the materials used to advertise them to the public. Examples of DCI's newsletter are included that mention the new exhibits.

Patent Foramen Ovale as a Risk Factor for Altitude Decompression Illness

DTIC Science & Technology

2001-06-01

TTE ). In 48 volunteers at DCIEM screened for the PRP studies with a TTE , 14 (29%) were found to have an echo-probable PFO. In 29 altitude-exposed...subjects who had a TTE , there were 5 echo-probable PFOs. None of these 5 subjects experienced DCI. Two of these subjects had a high bubble load with grade...16% incidence (by TTE ) of PFO amongst 24 cases of Type II altitude DCI using trans- esophogeal echocardiography (TEE), suggesting that there was no

Burst of Energy. Final report

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

Not Available

1992-12-01

The Discovery Center of Idaho (DCI) was the recipient of a grant from US DOE`s Museum Science Education Program to build six permanent energy related exhibits to provide the public with hands-on experience with energy issues. Because of its volunteer support system, DC was able to build eleven exhibits. These exhibits are described and photographs are included. The signs used for the exhibits are reproduced as well as the materials used to advertise them to the public. Examples of DCI`s newsletter are included that mention the new exhibits.

Safety of Performing a Delayed Anastomosis During Damage Control Laparotomy in Patients with Destructive Colon Injuries

PubMed Central

Ordoñez, Carlos A; Pino, Luis F; Badiel, Marisol; Sánchez, Alvaro I; Loaiza, Jhon; Ballestas, Leonardo; Puyana, Juan Carlos

2011-01-01

Background Recent studies report the safety and feasibility of performing delayed anastomosis (DA) in patients undergoing damage control laparotomy (DCL) for destructive colon injuries (DCI). Despite accumulating experience in both civilian and military trauma, questions regarding how to best identify high risk patients and minimize the number of anastomosis-associated complications remain. Our current practice is to perform a definitive closure of the colon during DCL, unless there is persistent acidosis, bowel wall edema, or evidence of intra-abdominal abscess. In this study, we evaluated the safety of this approach by comparing outcomes of patients with DCI who underwent definitive closure of the colon during DCL versus patients managed with colostomy with or without DCL. Methods We performed a retrospective chart review of patients with penetrating DCI during 2003–2009. Severity of injury, surgical management, and clinical outcome were assessed. Results Sixty patients with severe gunshot wounds (GSW) and 3 patients with stab wounds were included in the analysis. DCL was required in 30 patients, all with GSW. Three patients died within the first 48 hours, 3 underwent colostomy, and 24 were managed with DA. Thirty-three patients were managed with standard laparotomy: 26 patients with primary anastomosis, and 7 with colostomy. Overall mortality rate was 9.5%. Three late deaths occurred in the DCL group, and only one death was associated with an anastomotic leak. Conclusions Performing a DA in DCI during DCL is a reliable and feasible approach as long as severe acidosis, bowel wall edema, and/or persistent intra-abdominal infections are not present. PMID:22182861

Jackhammer esophagus: Observations on a European cohort.

PubMed

Herregods, T V K; Smout, A J P M; Ooi, J L S; Sifrim, D; Bredenoord, A J

2017-04-01

With the advent of high-resolution manometry (HRM), a new diagnosis, jackhammer esophagus, was introduced. Little is known about this rare condition, and the relationship between symptoms and hypercontractility is not always straightforward. The aim of our study was to describe a large cohort of patients with jackhammer esophagus and to investigate whether manometric findings are associated with the presence of symptoms. All patients from 06, 2014 until 12, 2015 seen at two tertiary centers with at least one hypercontractile swallow (distal contractile integral [DCI] >8000 mm Hg/s/cm) on HRM were analyzed. Patients with ≥20% premature swallows, or patients with another diagnosis explaining their symptoms were excluded. Of the 34 patients identified with jackhammer esophagus, most suffered from dysphagia (67.6%) and/or chest pain (47.1%). The symptom chest pain was not associated with any of the manometric findings, whereas dysphagia was associated with the DCI of the hypercontractile swallows and with intrabolus pressure. In addition, all patients who had an isolated DCI of the lower esophageal sphincter (LES) zone >2000 mm Hg/s/cm had dysphagia. The differences in HRM and clinical characteristics between subgroups based on the contraction type (single- or multi-peaked) or based on meeting criteria of the Chicago Classification v3.0 and v2.0 were limited. The symptom dysphagia is accompanied with strong contractions of the LES, signs of a possible outflow obstruction, and a very high DCI. The presence of a multipeaked contraction seems to be of limited relevance, and caution is warranted in labeling patients with one hypercontractile swallow as normal. © 2016 John Wiley & Sons Ltd.

Low concentration of sodium bicarbonate improves the bioactive compound levels and antioxidant and α-glucosidase inhibitory activities of tartary buckwheat sprouts.

PubMed

Qin, Peiyou; Wei, Aichun; Zhao, Degang; Yao, Yang; Yang, Xiushi; Dun, Baoqing; Ren, Guixing

2017-06-01

This study aimed to investigate the effects of different concentrations of sodium bicarbonate (NaHCO 3 ) on the accumulation of flavonoids, total phenolics and d-chiro-inositol (DCI), as well as the antioxidant and α-glucosidase inhibitory activities, in tartary buckwheat sprouts. Treatment with low concentrations of NaHCO 3 (0.05, 0.1, and 0.2%) resulted in an increase in flavonoids, total phenolic compounds and DCI concentrations, and improved DPPH radical-scavenging and α-glucosidase inhibition activities compared with the control (0%). The highest levels of total flavonoids (26.69mg/g DW), individual flavonoids (rutin, isoquercitrin, quercetin, and kaempferol), total phenolic compounds (29.31mg/g DW), DCI (12.56mg/g DW), as well as antioxidant and α-glucosidase inhibition activities, were observed in tartary buckwheat sprouts treated with 0.05% NaHCO 3 for 96h. These results indicated that appropriate treatment with NaHCO 3 could improve the healthy benefits of tartary buckwheat sprouts. Copyright © 2016 Elsevier Ltd. All rights reserved.

Thermomechanical Fatigue of Ductile Cast Iron and Its Life Prediction

NASA Astrophysics Data System (ADS)

Wu, Xijia; Quan, Guangchun; MacNeil, Ryan; Zhang, Zhong; Liu, Xiaoyang; Sloss, Clayton

2015-06-01

Thermomechanical fatigue (TMF) behaviors of ductile cast iron (DCI) were investigated under out-of-phase (OP), in-phase (IP), and constrained strain-control conditions with temperature hold in various temperature ranges: 573 K to 1073 K, 723 K to 1073 K, and 433 K to 873 K (300 °C to 800 °C, 450 °C to 800 °C, and 160 °C to 600 °C). The integrated creep-fatigue theory (ICFT) model was incorporated into the finite element method to simulate the hysteresis behavior and predict the TMF life of DCI under those test conditions. With the consideration of four deformation/damage mechanisms: (i) plasticity-induced fatigue, (ii) intergranular embrittlement, (iii) creep, and (iv) oxidation, as revealed from the previous study on low cycle fatigue of the material, the model delineates the contributions of these physical mechanisms in the asymmetrical hysteresis behavior and the damage accumulation process leading to final TMF failure. This study shows that the ICFT model can simulate the stress-strain response and life of DCI under complex TMF loading profiles (OP and IP, and constrained with temperature hold).

Fragmentation alters stream fish community structure in dendritic ecological networks.

PubMed

Perkin, Joshuah S; Gido, Keith B

2012-12-01

Effects of fragmentation on the ecology of organisms occupying dendritic ecological networks (DENs) have recently been described through both conceptual and mathematical models, but few hypotheses have been tested in complex, real-world ecosystems. Stream fishes provide a model system for assessing effects of fragmentation on the structure of communities occurring within DENs, including how fragmentation alters metacommunity dynamics and biodiversity. A recently developed habitat-availability measure, the "dendritic connectivity index" (DCI), allows for assigning quantitative measures of connectivity in DENs regardless of network extent or complexity, and might be used to predict fish community response to fragmentation. We characterized stream fish community structure in 12 DENs in the Great Plains, USA, during periods of dynamic (summer) and muted (fall) discharge regimes to test the DCI as a predictive model of fish community response to fragmentation imposed by road crossings. Results indicated that fish communities in stream segments isolated by road crossings had reduced species richness (alpha diversity) relative to communities that maintained connectivity with the surrounding DEN during summer and fall. Furthermore, isolated communities had greater dissimilarity (beta diversity) to downstream sites notisolated by road crossings during summer and fall. Finally, dissimilarity among communities within DENs decreased as a function of increased habitat connectivity (measured using the DCI) for summer and fall, suggesting that communities within highly connected DENs tend to be more homogeneous. Our results indicate that the DCI is sensitive to community effects of fragmentation in riverscapes and might be used by managers to predict ecological responses to changes in habitat connectivity. Moreover, our findings illustrate that relating structural connectivity of riverscapes to functional connectivity among communities might aid in maintaining metacommunity dynamics and biodiversity in complex dendritic ecosystems.

Effects of phosphate addition on biofilm bacterial communities and water quality in annular reactors equipped with stainless steel and ductile cast iron pipes.

PubMed

Jang, Hyun-Jung; Choi, Young-June; Ro, Hee-Myong; Ka, Jong-Ok

2012-02-01

The impact of orthophosphate addition on biofilm formation and water quality was studied in corrosion-resistant stainless steel (STS) pipe and corrosion-susceptible ductile cast iron (DCI) pipe using cultivation and culture-independent approaches. Sample coupons of DCI pipe and STS pipe were installed in annular reactors, which were operated for 9 months under hydraulic conditions similar to a domestic plumbing system. Addition of 5 mg/L of phosphate to the plumbing systems, under low residual chlorine conditions, promoted a more significant growth of biofilm and led to a greater rate reduction of disinfection by-products in DCI pipe than in STS pipe. While the level of THMs (trihalomethanes) increased under conditions of low biofilm concentration, the levels of HAAs (halo acetic acids) and CH (chloral hydrate) decreased in all cases in proportion to the amount of biofilm. It was also observed that chloroform, the main species of THM, was not readily decomposed biologically and decomposition was not proportional to the biofilm concentration; however, it was easily biodegraded after the addition of phosphate. Analysis of the 16S rDNA sequences of 102 biofilm isolates revealed that Proteobacteria (50%) was the most frequently detected phylum, followed by Firmicutes (10%) and Actinobacteria (2%), with 37% of the bacteria unclassified. Bradyrhizobium was the dominant genus on corroded DCI pipe, while Sphingomonas was predominant on non-corroded STS pipe. Methylobacterium and Afipia were detected only in the reactor without added phosphate. PCR-DGGE analysis showed that the diversity of species in biofilm tended to increase when phosphate was added regardless of the pipe material, indicating that phosphate addition upset the biological stability in the plumbing systems.

Multiple Rapid Swallow Responses During Esophageal High-Resolution Manometry Reflect Esophageal Body Peristaltic Reserve

PubMed Central

Shaker, Anisa; Stoikes, Nathaniel; Drapekin, Jesse; Kushnir, Vladimir; Brunt, L. Michael; Gyawali, C. Prakash

2014-01-01

OBJECTIVES Dysphagia may develop following antireflux surgery as a consequence of poor esophageal peristaltic reserve. We hypothesized that suboptimal contraction response following multiple rapid swallows (MRS) could be associated with chronic transit symptoms following antireflux surgery. METHODS Wet swallow and MRS responses on esophageal high-resolution manometry (HRM) were characterized collectively in the esophageal body (distal contractile integral (DCI)), and individually in each smooth muscle contraction segment (S2 and S3 amplitudes) in 63 patients undergoing antireflux surgery and in 18 healthy controls. Dysphagia was assessed using symptom questionnaires. The MRS/wet swallow ratios were calculated for S2 and S3 peak amplitudes and DCI. MRS responses were compared in patients with and without late postoperative dysphagia following antireflux surgery. RESULTS Augmentation of smooth muscle contraction (MRS/wet swallow ratios > 1.0) as measured collectively by DCI was seen in only 11.1% with late postoperative dysphagia, compared with 63.6% in those with no dysphagia and 78.1% in controls (P≤0.02 for each comparison). Similar results were seen with S3 but not S2 peak amplitude ratios. Receiver operating characteristics identified a DCI MRS/wet swallow ratio threshold of 0.85 in segregating patients with late postoperative dysphagia from those with no postoperative dysphagia with a sensitivity of 0.67 and specificity of 0.64. CONCLUSIONS Lack of augmentation of smooth muscle contraction following MRS is associated with late postoperative dysphagia following antireflux surgery, suggesting that MRS responses could assess esophageal smooth muscle peristaltic reserve. Further research is warranted to determine if antireflux surgery needs to be tailored to the MRS response. PMID:24019081

Results from the International Consensus Conference on Myo-inositol and d-chiro-inositol in Obstetrics and Gynecology: the link between metabolic syndrome and PCOS.

PubMed

Facchinetti, Fabio; Bizzarri, Mariano; Benvenga, Salvatore; D'Anna, Rosario; Lanzone, Antonio; Soulage, Christophe; Di Renzo, Gian Carlo; Hod, Moshe; Cavalli, Pietro; Chiu, Tony T; Kamenov, Zdravko A; Bevilacqua, Arturo; Carlomagno, Gianfranco; Gerli, Sandro; Oliva, Mario Montanino; Devroey, Paul

2015-12-01

In recent years, interest has been focused to the study of the two major inositol stereoisomers: myo-inositol (MI) and d-chiro-inositol (DCI), because of their involvement, as second messengers of insulin, in several insulin-dependent processes, such as metabolic syndrome and polycystic ovary syndrome. Although these molecules have different functions, very often their roles have been confused, while the meaning of several observations still needs to be interpreted under a more rigorous physiological framework. With the aim of clarifying this issue, the 2013 International Consensus Conference on MI and DCI in Obstetrics and Gynecology identified opinion leaders in all fields related to this area of research. They examined seminal experimental papers and randomized clinical trials reporting the role and the use of inositol(s) in clinical practice. The main topics were the relation between inositol(s) and metabolic syndrome, polycystic ovary syndrome (with a focus on both metabolic and reproductive aspects), congenital anomalies, gestational diabetes. Clinical trials demonstrated that inositol(s) supplementation could fruitfully affect different pathophysiological aspects of disorders pertaining Obstetrics and Gynecology. The treatment of PCOS women as well as the prevention of GDM seem those clinical conditions which take more advantages from MI supplementation, when used at a dose of 2g twice/day. The clinical experience with MI is largely superior to the one with DCI. However, the existence of tissue-specific ratios, namely in the ovary, has prompted researchers to recently develop a treatment based on both molecules in the proportion of 40 (MI) to 1 (DCI). Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Domestication of Lambda Phage Genes into a Putative Third Type of Replicative Helicase Matchmaker

PubMed Central

Brézellec, Pierre; Petit, Marie-Agnès; Pasek, Sophie; Vallet-Gely, Isabelle; Possoz, Christophe

2017-01-01

Abstract At the onset of the initiation of chromosome replication, bacterial replicative helicases are recruited and loaded on the DnaA-oriC nucleoprotein platform, assisted by proteins like DnaC/DnaI or DciA. Two orders of bacteria appear, however, to lack either of these factors, raising the question of the essentiality of these factors in bacteria. Through a phylogenomic approach, we identified a pair of genes that could have substituted for dciA. The two domesticated genes are specific of the dnaC/dnaI- and dciA-lacking organisms and apparently domesticated from lambdoid phage genes. They derive from λO and λP and were renamed dopC and dopE, respectively. DopE is expected to bring the replicative helicase to the bacterial origin of replication, while DopC might assist DopE in this function. The confirmation of the implication of DopCE in the handling of the replicative helicase at the onset of replication in these organisms would generalize to all bacteria and therefore to all living organisms the need for specific factors dedicated to this function. PMID:28854626

Venous gas emboli and exhaled nitric oxide with simulated and actual extravehicular activity.

PubMed

Karlsson, Lars L; Blogg, S Lesley; Lindholm, Peter; Gennser, Mikael; Hemmingsson, Tryggve; Linnarsson, Dag

2009-10-01

The decompression experienced due to the change in pressure from a space vehicle (1013hPa) to that in a suit for extravehicular activity (EVA) (386hPa) was simulated using a hypobaric chamber. Previous ground-based research has indicated around a 50% occurrence of both venous gas emboli (VGE) and symptoms of decompression illness (DCI) after similar decompressions. In contrast, no DCI symptoms have been reported from past or current space activities. Twenty subjects were studied using Doppler ultrasound to detect any VGE during decompression to 386hPa, where they remained for up to 6h. Subjects were supine to simulate weightlessness. A large number of VGE were found in one subject at rest, who had a recent arm fracture; a small number of VGE were found in another subject during provocation with calf contractions. No changes in exhaled nitric oxide were found that can be related to either simulated EVA or actual EVA (studied in a parallel study on four cosmonauts). We conclude that weightlessness appears to be protective against DCI and that exhaled NO is not likely to be useful to monitor VGE.

Microstructure and Sliding Wear Behaviour of In-Situ TiC-Reinforced Composite Surface Layers Fabricated on Ductile Cast Iron by Laser Alloying.

PubMed

Janicki, Damian

2018-01-05

TiC-reinforced composite surface layers (TRLs) on a ductile cast iron EN-GJS-700-2 grade (DCI) substrate were synthesized using a diode laser surface alloying with a direct injection of titanium powder into the molten pool. The experimental results were compared with thermodynamic calculations. The TRLs having a uniform distribution of the TiC particles and their fraction up to 15.4 vol % were achieved. With increasing titanium concentration in the molten pool, fractions of TiC and retained austenite increase and the shape of TiC particles changes from cubic to dendritic form. At the same time, the cementite fraction decreases, lowering the overall hardness of the TRL. A good agreement between experimental and calculated results was achieved. Comparative dry sliding wear tests between the as-received DCI, the TRLs and also laser surface melted layers (SMLs) have been performed following the ASTM G 99 standard test method under contact pressures of 2.12 and 4.25 MPa. For both the as-received DCI and the SMLs, the wear rates increased with increasing contact pressure. The TRLs exhibited a significantly higher wear resistance than the others, which was found to be load independent.

d-chiro-Inositol and alpha lipoic acid treatment of metabolic and menses disorders in women with PCOS.

PubMed

Cianci, Antonio; Panella, Marco; Fichera, Michele; Falduzzi, Cristina; Bartolo, Manuela; Caruso, Salvatore

2015-06-01

To evaluate the effects of the combination of d-chiro-inositol (DCI) and alpha lipoic acid on menses and metabolic disorders in women with polycystic ovary syndrome (PCOS). Forty-six women (26 study group subjects and 20 controls) of reproductive age with PCOS according to Rotterdam criteria were enrolled in this prospective study. Fasting serum samples were collected from each woman. Homeostasis model of insulin resistance, insulin levels, lipid profile, frequency of menstrual cycles, number of ovarian peripheral cysts and BMI of both groups were investigated at baseline and after 180 days. Clinical and metabolic aspects of women on DCI and lipoic acid treatment underwent improvement (p < 0.5) with respect to the control group. Regarding lipid profile, no statistically difference was observed in total cholesterol and triglycerides levels in both groups at follow-up with respect the baseline values (p = NS). DCI and alpha lipoic acid treatment has been thought because it plays an essential role in mitochondrial specific pathways that generate energy from glucose and its potent effect as antioxidant. The association might have a strong impact on metabolic profile even with a short-term treatment. Further investigations are needed to evaluate other effects on reproductive physiology of women with PCOS.

Microstructure and Sliding Wear Behaviour of In-Situ TiC-Reinforced Composite Surface Layers Fabricated on Ductile Cast Iron by Laser Alloying

PubMed Central

Janicki, Damian

2018-01-01

TiC-reinforced composite surface layers (TRLs) on a ductile cast iron EN-GJS-700-2 grade (DCI) substrate were synthesized using a diode laser surface alloying with a direct injection of titanium powder into the molten pool. The experimental results were compared with thermodynamic calculations. The TRLs having a uniform distribution of the TiC particles and their fraction up to 15.4 vol % were achieved. With increasing titanium concentration in the molten pool, fractions of TiC and retained austenite increase and the shape of TiC particles changes from cubic to dendritic form. At the same time, the cementite fraction decreases, lowering the overall hardness of the TRL. A good agreement between experimental and calculated results was achieved. Comparative dry sliding wear tests between the as-received DCI, the TRLs and also laser surface melted layers (SMLs) have been performed following the ASTM G 99 standard test method under contact pressures of 2.12 and 4.25 MPa. For both the as-received DCI and the SMLs, the wear rates increased with increasing contact pressure. The TRLs exhibited a significantly higher wear resistance than the others, which was found to be load independent. PMID:29304001

Quantitative trait loci controlling leaf appearance and curd initiation of cauliflower in relation to temperature.

PubMed

Hasan, Yaser; Briggs, William; Matschegewski, Claudia; Ordon, Frank; Stützel, Hartmut; Zetzsche, Holger; Groen, Simon; Uptmoor, Ralf

2016-07-01

QTL regions on chromosomes C06 and C09 are involved in temperature dependent time to curd induction in cauliflower. Temperature is the main environmental factor influencing curding time of cauliflower (Brassica oleracea var. botrytis). Temperatures above 20-22 °C inhibit development towards curding even in many summer cultivars. To identify quantitative trait loci (QTL) controlling curding time and its related traits in a wide range of different temperature regimes from 12 to 27 °C, a doubled haploid (DH) mapping population segregating for curding time was developed and days to curd initiation (DCI), leaf appearance rate (LAR), and final leaf number (FLN) were measured. The population was genotyped with 176 single nucleotide polymorphism (SNP) markers. Composite interval mapping (CIM) revealed repeatedly detected QTL for DCI on C06 and C09. The estimated additive effect increased at high temperatures. Significant QTL × environment interactions (Q × E) for FLN and DCI on C06 and C09 suggest that these hotspot regions have major influences on temperature mediated curd induction. 25 % of the DH lines did not induce curds at temperatures higher than 22 °C. Applying a binary model revealed a QTL with LOD >15 on C06. Nearly all lines carrying the allele of the reliable early maturing parental line (PL) on that locus induced curds at high temperatures while only half of the DH lines carrying the allele of the unreliable PL reached the generative phase during the experiment. Large variation in LAR was observed. QTL for LAR were detected repeatedly in several environments on C01, C04 and C06. Negative correlations between LAR and DCI and QTL co-localizations on C04 and C06 suggest that LAR has also effects on development towards curd induction.

Haptoglobin phenotype predicts cerebral vasospasm and clinical deterioration after aneurysmal subarachnoid hemorrhage.

PubMed

Ohnishi, Hiroyuki; Iihara, Koji; Kaku, Yasuyuki; Yamauchi, Keita; Fukuda, Kenji; Nishimura, Kunihiro; Nakai, Michikazu; Satow, Tetsu; Nakajima, Norio; Ikegawa, Masaya

2013-05-01

Vasospasm (VS) and delayed cerebral ischemia (DCI) after subarachnoid hemorrhage (SAH) are thought to greatly affect prognosis. Haptoglobin (Hp) is a hemoglobin-binding protein expressed by a genetic polymorphism (1-1, 2-1, and 2-2). Our objects were to investigate whether the Hp phenotype could predict the incidence of cerebral infarction, favorable outcome, clinical deterioration by DCI, and angiographical VS after aneurysmal SAH. Ninety-five consecutive patients who underwent clipping or coil embolization were studied. Favorable functional outcome was defined as a modified Rankin Scale score of 0-2 at 3 months. Angiographical VS was diagnosed based on cerebral angiography findings performed between days 7 and 10 after SAH. The Hp 2-2 group had a significantly greater risk of angiographical VS than that of Hp 2-1 and 1-1 groups combined on univariate (odds ratio [OR]: 3.60, confidence interval [CI]: 1.49-8.67, P = .003) and multivariate logistic regression analyses after being adjusted for age, sex, Fisher groups, and other risk factors (OR: 3.75, CI: 1.54-9.16, P = .004). The Hp 2-2 group also showed the tendency of a greater risk of clinical deterioration by DCI with marginal significance on univariate and age- and sex-adjusted analyses (univariate OR: 2.46, CI: .90-6.74, P = .080; age- and sex-adjusted OR: 2.46, CI: .89-6.82, P = .080) but not after being adjusted for other multiple risk factors. The Hp 2-2 group was not associated with the favorable 3-month outcome and cerebral infarction (univariate: P = .867, P = .209; multivariate: P = .905, P = .292). The Hp phenotype seems to be associated with a higher rate of angiographical VS and clinical deterioration by DCI but does not affect the incidence of cerebral infarction and favorable outcome. Copyright © 2013 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Results of an International Survey on the Investigation and Endovascular Management of Cerebral Vasospasm and Delayed Cerebral Ischemia.

PubMed

Hollingworth, Milo; Chen, Peng Roc; Goddard, Antony J P; Coulthard, Alan; Söderman, Michael; Bulsara, Ketan R

2015-06-01

Delayed cerebral ischemia (DCI) is a major cause of morbidity and mortality in aneurysmal subarachnoid hemorrhage. Endovascular management of this condition offers a new hope in preventing adverse outcome; however, a uniform standard of practice is lacking owing to a paucity of clinical trials. We conducted an international survey on the use of investigative and endovascular techniques in the treatment of DCI to assess the variability of current practice. Neurovascular neurosurgeons and neuroradiologists were contacted through professional societies from America, United Kingdom, Europe, and Australasia. Members were invited to complete a 13-item questionnaire regarding screening techniques, first-line and second-line therapies in endovascular intervention, and the role of angioplasty. Answers were compared using χ(2) testing for nonparametric data. Data from 344 respondents from 32 countries were analyzed: 167 non-United States and 177 U.S. More than half of all clinicians had 10+ years of experience in units with a mixture of higher and lower case volumes. Daily transcranial Doppler ultrasonography was the most commonly used screening technique by both U.S. (70%) and non-U.S. (53%) practitioners. Verapamil was the most common first-line therapy in the United States, whereas nimodipine was most popular in non-U.S. countries. Angioplasty was performed by 83% of non-U.S. and 91% of U.S. clinicians in the treatment of vasospasm; however, more U.S. clinicians reported using angioplasty for distal vasospasm. Treatment practices for DCI vary considerably, with the greatest variability in the choice of agent for intra-arterial therapy. Our data demonstrate the wide variation of approaches in use at present. However, without further clinical trials and development of a uniform standard of best practice, variability in treatment and outcome for DCI is likely to continue. Copyright © 2015 Elsevier Inc. All rights reserved.

Esophagogastric junction and esophageal body contraction metrics on high-resolution manometry predict esophageal acid burden.

PubMed

Rengarajan, A; Bolkhir, A; Gor, P; Wang, D; Munigala, S; Gyawali, C P

2018-05-01

Distal contractile integral (DCI) and esophagogastric junction contractile integral (EGJ-CI) are high-resolution manometry (HRM) software metrics assessing esophageal motor function in gastroesophageal reflux disease (GERD). Patients undergoing HRM and ambulatory pH monitoring off antisecretory therapy prospectively completed symptom questionnaires assessing symptom burden and a global symptom score (GSS) at baseline and after GERD therapy. DCI<450 mm Hg/cm/s in ≥5 swallows diagnosed ineffective esophageal motility (IEM); proportions of failed (DCI<100 mm Hg/cm/s) and weak (DCI 100-450 mm Hg/cm/s) sequences were separately assessed. EGJ-CI assessed vigor of the EGJ barrier. Univariate and multivariate analyses addressed performance of esophageal body and EGJ metrics in predicting abnormal esophageal reflux burden, and symptom outcome from antireflux therapy. Of 188 patients (55.2 ± 0.9 year, 64% F), 42.6% had low EGJ-CI, and 25.0% had IEM. While low EGJ-CI was associated with abnormal reflux burden (P = 0.003), IEM alone was not (P = 0.2). Increasing proportions of failed swallows predicted abnormal AET better than the current IEM definition. Combined low EGJ-CI and IEM segregated abnormal total and supine acid burden compared to patients with normal EGJ-CI and no IEM (P ≤ 0.007 for each comparison). Medical therapy and surgical antireflux therapy were similarly effective in improving symptom burden; surgery resulted in better outcomes with low EGJ-CI (P ≤ 0.04), especially with intact esophageal body motor function (P = 0.02). While abnormal EGJ and esophageal body metrics are collectively associated with elevated esophageal reflux burden, increasing proportions of failed swallows are better predictors of reflux burden and outcome compared to the current IEM definition. © 2017 John Wiley & Sons Ltd.

In-water recompression.

PubMed

Doolette, David J; Mitchell, Simon J

2018-06-30

Divers suspected of suffering decompression illness (DCI) in locations remote from a recompression chamber are sometimes treated with in-water recompression (IWR). There are no data that establish the benefits of IWR compared to conventional first aid with surface oxygen and transport to the nearest chamber. However, the theoretical benefit of IWR is that it can be initiated with a very short delay to recompression after onset of manifestations of DCI. Retrospective analyses of the effect on outcome of increasing delay generally do not capture this very short delay achievable with IWR. However, in military training and experimental diving, delay to recompression is typically less than two hours and more than 90% of cases have complete resolution of manifestations during the first treatment, often within minutes of recompression. A major risk of IWR is that of an oxygen convulsion resulting in drowning. As a result, typical IWR oxygen-breathing protocols use shallower maximum depths (9 metres' sea water (msw), 191 kPa) and are shorter (1-3 hours) than standard recompression protocols for the initial treatment of DCI (e.g., US Navy Treatment Tables 5 and 6). There has been no experimentation with initial treatment of DCI at pressures less than 285 kPa since the original development of these treatment tables, when no differences in outcomes were seen between maximum pressures of 203 kPa (10 msw) and 285 kPa (18 msw) or deeper. These data and case series suggest that recompression treatment comprising pressures and durations similar to IWR protocols can be effective. The risk of IWR is not justified for treatment of mild symptoms likely to resolve spontaneously or for divers so functionally compromised that they would not be safe in the water. However, IWR conducted by properly trained and equipped divers may be justified for manifestations that are life or limb threatening where timely recompression is unavailable. Copyright: This article is the copyright of the authors who grant Diving and Hyperbaric Medicine a non-exclusive licence to publish the article in electronic and other forms.

Stabilization with the Dynamic Cervical Implant: a novel treatment approach following cervical discectomy and decompression.

PubMed

Matgé, Guy; Berthold, Christophe; Gunness, Vimal Raj Nitish; Hana, Ardian; Hertel, Frank

2015-03-01

Although cervical total disc replacement (TDR) has shown equivalence or superiority to anterior cervical discectomy and fusion (ACDF), potential problems include nonphysiological motion (hypermobility), accelerated degeneration of the facet joints, particulate wear, and compromise of the mechanical integrity of the endplate during device fixation. Dynamic cervical stabilization is a novel motion-preserving concept that facilitates controlled, limited flexion and extension, but prevents axial rotation and lateral bending, thereby reducing motion across the facet joints. Shock absorption of the Dynamic Cervical Implant (DCI) device is intended to protect adjacent levels from accelerated degeneration. The authors conducted a prospective evaluation of 53 consecutive patients who underwent DCI stabilization for the treatment of 1-level (n = 42), 2-level (n = 9), and 3-level (n = 2) cervical disc disease with radiculopathy or myelopathy. Forty-seven patients (89%) completed all clinical and radiographic outcomes at a minimum of 24 months. Clinical outcomes consisted of Neck Disability Index (NDI) and visual analog scale (VAS) scores, neurological function at baseline and at latest follow-up, as well as patient satisfaction. Flexion-extension radiography was evaluated for device motion, implant migration, subsidence, and heterotopic ossification. Cervical sagittal alignment (Cobb angle), functional spinal unit (FSU) angle, and range of motion (ROM) at index and adjacent levels were evaluated with WEB 1000 software. The NDI score, VAS neck and arm pain scores, and neurological deficits were significantly reduced at each postoperative time point compared with baseline (p < 0.0001). At 24 months postoperatively, 91% of patients were very satisfied and 9% somewhat satisfied, while 89% would definitely and 11% would probably elect to have the same surgery again. In 47 patients with 58 operated levels, the radiographic assessment showed good motion (5°-12°) of the device in 57%, reduced motion (2°-5°) in 34.5%, and little motion (0-2°) in 8.5%. The Cobb and FSU angles improved, showing a clear tendency for lordosis with the DCI. Motion greater than 2° of the treated segment could be preserved in 91.5%, while 8.5% had a near segmental fusion. Mean ROM at index levels demonstrated satisfying motion preservation with DCI. Mean ROM at upper and lower adjacent levels showed maintenance of adjacent-level kinematics. Heterotopic ossification, including 20% minor and 15% major, had no direct impact on clinical results. There were 2 endplate subsidences detected with an increased segmental lordosis. One asymptomatic anterior device migration required reoperation. Three patients underwent a secondary surgery in another segment during follow-up, twice for a new disc herniation and once for an adjacent degeneration. There was no posterior migration and no device breakage. Preliminary results indicate that the DCI implanted using a proper surgical technique is safe and facilitates excellent clinical outcomes, maintains index-and adjacent-level ROM in the majority of cases, improves sagittal alignment, and may be suitable for patients with facet arthrosis who would otherwise not be candidates for cervical TDR. Shock absorption together with maintained motion in the DCI may protect adjacent levels from early degeneration in longer follow-up.

Evolution of deceased organ donation activity vs. efficiency over a 15 year period: an international comparison.

PubMed

Weiss, Julius; Elmer, Andreas; Mahíllo, Beatriz; Domínguez-Gil, Beatriz; Avsec, Danica; Costa, Alessandro Nanni; Haase-Kromwijk, Bernadette J J M; Laouabdia, Karim; Immer, Franz F

2018-04-19

The donation rate (DR) per million population is not ideal for an efficiency comparison of national deceased organ donation programs. The DR does not account for variabilities in the potential for deceased donation which mainly depends on fatalities from causes leading to brain death. In this study, the donation activity was put into relation to the mortality from selected causes. Based on that metric, this study assesses the efficiency of different donation programs. This is a retrospective analysis of 2001-2015 deceased organ donation and mortality registry data. Included are 27 Council of Europe countries, as well as the USA. A donor conversion index (DCI) was calculated for assessing donation program efficiency over time and in international comparisons. According to the DCI and of the countries included in the study, Spain, France, and the USA had the most efficient donation programs in 2015. Even though mortality from the selected causes decreased in most countries during the study period, differences in international comparisons persist. This indicates that the potential for deceased organ donation and its conversion into actual donation is far from being similar internationally. Compared with the DR, the DCI takes into account the potential for deceased organ donation, and therefore is a more accurate metric of performance. National donation programs could optimize performance by identifying the areas where most potential is lost, and by implementing measures to tackle these issues.

Milrinone via lumbar subarachnoid catheter for vasospasm after aneurysmal subarachnoid hemorrhage.

PubMed

Sadamasa, Nobutake; Yoshida, Kazumichi; Narumi, Osamu; Chin, Masaki; Yamagata, Sen

2014-12-01

Delayed ischemic neurological deficit (DIND) due to symptomatic vasospasm is a major cause of morbidity and mortality after aneurysmal subarachnoid hemorrhage (aSAH). The aim of this study was to elucidate the safety and feasibility of intrathecal milrinone infusion via lumber subarachnoid catheter for prevention of DIND after aSAH. We diagnosed 425 consecutive patients with aSAH who received clipping or coil embolization within 48 h after arrival. Patients with the evidence of vasospasm on CT angiography (CTA) received the milrinone therapy via lumbar subarachnoid catheter. DIND, delayed cerebral infarction (DCI), and modified Rankin scale at 3 months after SAH were used for the assessment of outcome. Of 425 patients, 170 patients (40.0 %) with CTA-proven vasospasm received the milrinone therapy. DIND was observed in 68 patients (16.0 %), DCI in 30 patients (7.1 %), and the overall mortality was 7.2 %. In patients with WFNS grade IV and V aSAH, 26 out of 145 patients (17.9 %) were presented with DIND, 12 (8.3 %) with DCI, and the mortality was 16.0 %. No major complication related to the milrinone injection was observed. Intrathecal milrinone injection via lumbar catheter was safe and feasible, and further randomized prospective studies are needed to confirm the effectiveness of this regimen in the patients with SAH.

Directional connectivity in hydrology and ecology.

PubMed

Larsen, Laurel G; Choi, Jungyill; Nungesser, Martha K; Harvey, Judson W

2012-12-01

Quantifying hydrologic and ecological connectivity has contributed to understanding transport and dispersal processes and assessing ecosystem degradation or restoration potential. However, there has been little synthesis across disciplines. The growing field of ecohydrology and recent recognition that loss of hydrologic connectivity is leading to a global decline in biodiversity underscore the need for a unified connectivity concept. One outstanding need is a way to quantify directional connectivity that is consistent, robust to variations in sampling, and transferable across scales or environmental settings. Understanding connectivity in a particular direction (e.g., streamwise, along or across gradient, between sources and sinks, along cardinal directions) provides critical information for predicting contaminant transport, planning conservation corridor design, and understanding how landscapes or hydroscapes respond to directional forces like wind or water flow. Here we synthesize progress on quantifying connectivity and develop a new strategy for evaluating directional connectivity that benefits from use of graph theory in ecology and percolation theory in hydrology. The directional connectivity index (DCI) is a graph-theory based, multiscale metric that is generalizable to a range of different structural and functional connectivity applications. It exhibits minimal sensitivity to image rotation or resolution within a given range and responds intuitively to progressive, unidirectional change. Further, it is linearly related to the integral connectivity scale length--a metric common in hydrology that correlates well with actual fluxes--but is less computationally challenging and more readily comparable across different landscapes. Connectivity-orientation curves (i.e., directional connectivity computed over a range of headings) provide a quantitative, information-dense representation of environmental structure that can be used for comparison or detection of subtle differences in the physical-biological feedbacks driving pattern formation. Case-study application of the DCI to the Everglades in south Florida revealed that loss of directional hydrologic connectivity occurs more rapidly and is a more sensitive indicator of declining ecosystem function than other metrics (e.g., habitat area) used previously. Here and elsewhere, directional connectivity can provide insight into landscape drivers and processes, act as an early-warning indicator of environmental degradation, and serve as a planning tool or performance measure for conservation and restoration efforts.

Directional connectivity in hydrology and ecology

USGS Publications Warehouse

Larsen, Laurel G.; Choi, Jungyill; Nungesser, Martha K.; Harvey, Judson W.

2012-01-01

Quantifying hydrologic and ecological connectivity has contributed to understanding transport and dispersal processes and assessing ecosystem degradation or restoration potential. However, there has been little synthesis across disciplines. The growing field of ecohydrology and recent recognition that loss of hydrologic connectivity is leading to a global decline in biodiversity underscore the need for a unified connectivity concept. One outstanding need is a way to quantify directional connectivity that is consistent, robust to variations in sampling, and transferable across scales or environmental settings. Understanding connectivity in a particular direction (e.g., streamwise, along or across gradient, between sources and sinks, along cardinal directions) provides critical information for predicting contaminant transport, planning conservation corridor design, and understanding how landscapes or hydroscapes respond to directional forces like wind or water flow. Here we synthesize progress on quantifying connectivity and develop a new strategy for evaluating directional connectivity that benefits from use of graph theory in ecology and percolation theory in hydrology. The directional connectivity index (DCI) is a graph-theory based, multiscale metric that is generalizable to a range of different structural and functional connectivity applications. It exhibits minimal sensitivity to image rotation or resolution within a given range and responds intuitively to progressive, unidirectional change. Further, it is linearly related to the integral connectivity scale length—a metric common in hydrology that correlates well with actual fluxes—but is less computationally challenging and more readily comparable across different landscapes. Connectivity-orientation curves (i.e., directional connectivity computed over a range of headings) provide a quantitative, information-dense representation of environmental structure that can be used for comparison or detection of subtle differences in the physical-biological feedbacks driving pattern formation. Case-study application of the DCI to the Everglades in south Florida revealed that loss of directional hydrologic connectivity occurs more rapidly and is a more sensitive indicator of declining ecosystem function than other metrics (e.g., habitat area) used previously. Here and elsewhere, directional connectivity can provide insight into landscape drivers and processes, act as an early-warning indicator of environmental degradation, and serve as a planning tool or performance measure for conservation and restoration efforts.

[Dyadic coping and well-being -- the Hungarian version of the Dyadic Coping Inventory].

PubMed

Martos, Tamás; Sallay, Viola; Nistor, Michaela; Józsa, Péter

2012-01-01

In studying coping processes, there is often a focus on individual coping while dyadic processes in couples are seldom addressed. Therefore we present here data with the Hungarian version of the Dyadic Coping Inventory (DCI) that was developed to assess dyadic forms of coping (e.g., stress communication, support, delegated and negative coping). 473 adult participants, living in committed relationships (176 male and 296 female, aged 34,0 +/- 11,9 years) were involved in a questionnaire study. Along with the Hungarian version of the Dyadic Coping Inventory we assessed satisfaction with life (SWLS) and marital satisfaction (Marital Stress Scale). Subscales of the Dyadic Coping Inventory were found reliable and the expected factor structure for both the dyadic coping of oneself and the partner were replicable. Moreover, specific forms of dyadic coping accounted for significant amount of explained variance in life satisfaction (31,8 and 27,7% for male and female respondents) and marital satisfaction (1,8 and 48,5%). Results imply possible gender differences, since marital satisfaction of women was negatively predicted both by negative coping of oneself and the partner (betas=-0,174 and -0,152), and positively by the support of the partner and the evaluation of the common dyadic coping (betas= 0,255 and 0,187), whereas there was only one significant link in male respondents, supportive coping of oneself (beta= 0,320). Results show that 1. the Hungarian version of the DCI is a reliable and valid measure, and 2. there may be specific gender differences in dyadic coping that has to be considered when planning further research, training programs and therapeutic interventions for couples.

Development of an efficient fractionation method for the preparative separation of sesquiterpenoids from Tussilago farfara by counter-current chromatography.

PubMed

Song, Kwangho; Lee, Kyoung Jin; Kim, Yeong Shik

2017-03-17

A novel application of counter-current chromatography (CCC) to enrich plant extracts using direct and continuous injection (CCC-DCI) was developed to fractionate sesquiterpenoids from the buds of Tussilago farfara L. In this study, an n-hexane-acetonitrile-water (HAcW) solvent system was separately pumped into the CCC column, and an extraction solution (45% acetonitrile) was directly and continuously injected into the CCC column. Since the extraction solution was used as a mobile phase in this method, solvent consumption could be greatly reduced. To enrich the extraction solution (315.9g/5.4L), only 4.2L water, 4.6L acetonitrile, and 1.2L n-hexane were used, including the extraction step. Finally, 6.8g of a sesquiterpenoid-enriched (STE) fraction was obtained from the crude extract (315.9g) of Tussilago farfara (1kg) in a single CCC run with a separation time of 8.5h. The sample injection capacity of CCC-DCI was greater than 300g; this amount of sample could not be handled in conventional CCC or other fractionation methods with the same column volume. Moreover, three major sesquiterpenoids (1: tussilagone, 2: 14-acetoxy-7β-(3'-ethyl cis-crotonoyloxy)-1α-(2'-methylburyryloxy)-notonipetranone, and 3: 7β-(3'-ethyl cis-crotonoyloxy)-1α-(2'-methylburyryloxy)-3, 14-dehydro-Z-notonipetranone) were purified from the STE fraction by CCC, and their chemical structures were elucidated by 1 H NMR and 13 C NMR. A quantification study was conducted, and the contents of compounds 1-3 in the CCC-DCI fraction were higher than those of conventional multi-step fractionations performed in series: solvent partitioning and open column chromatography. Furthermore, the average CCC-DCI recoveries were 96.1% (1), 96.9% (2), and 94.6% (3), whereas the open column chromatography recoveries were 77.7% (1), 66.5% (2), and 58.4% (3). The developed method demonstrates that CCC is a useful technique for enriching target components from natural products. Copyright © 2017 Elsevier B.V. All rights reserved.

Diving Medicine: Frequently Asked Questions

MedlinePlus

... after diving In-Water Recompression Inter-Island Flights Massage & Diving Return to Diving After DCI Subcutaneous Emphysema ... Donating Blood Flu-like Symptoms Following a Dive Foot Pain After Diving Fin Foot Frontal Headaches Hand & ...

Situation Awareness of Onboard System Autonomy

NASA Technical Reports Server (NTRS)

Schreckenghost, Debra; Thronesbery, Carroll; Hudson, Mary Beth

2005-01-01

We have developed intelligent agent software for onboard system autonomy. Our approach is to provide control agents that automate crew and vehicle systems, and operations assistants that aid humans in working with these autonomous systems. We use the 3 Tier control architecture to develop the control agent software that automates system reconfiguration and routine fault management. We use the Distributed Collaboration and Interaction (DCI) System to develop the operations assistants that provide human services, including situation summarization, event notification, activity management, and support for manual commanding of autonomous system. In this paper we describe how the operations assistants aid situation awareness of the autonomous control agents. We also describe our evaluation of the DCI System to support control engineers during a ground test at Johnson Space Center (JSC) of the Post Processing System (PPS) for regenerative water recovery.

Intrathecal application of the nimodipine slow-release microparticle system eg-1962 for prevention of delayed cerebral ischemia and improvement of outcome after aneurysmal subarachnoid hemorrhage.

PubMed

Etminan, Nima; Macdonald, R Loch; Davis, Cara; Burton, Kevin; Steiger, Hans-Jakob; Hänggi, Daniel

2015-01-01

The effective reduction of delayed cerebral ischemia (DCI), a main contributor for poor outcome following aneurysmal subarachnoid hemorrhage (SAH), remains challenging. Previous clinical trials on systemic pharmaceutical treatment of SAH mostly failed to improve outcome, probably because of insensitive pharmaceutical targets and outcome measures, small sample size, insufficient subarachnoid drug concentrations and also detrimental, systemic effects of the experimental treatment per se. Interestingly, in studies that are more recent, intrathecal administration of nicardipine pellets following surgical aneurysm repair was suggested to have a beneficial effect on DCI and neurological outcome. However, this positive effect remained restricted to patients who were treated surgically for a ruptured aneurysm. Because of the favorable results of the preclinical data on DCI and neurological outcome in the absence of neurotoxicity or systemic side effects, we are initiating clinical trials. The PROMISE (Prolonged Release nimOdipine MIcro particles after Subarachnoid hemorrhage) trial is designed as an unblinded, nonrandomized, single-center, single-dose, dose-escalation safety and tolerability phase 1 study in patients surgically treated for aSAH and will investigate the effect of intracisternal EG-1962 administration. The NEWTON (Nimodipine microparticles to Enhance recovery While reducing TOxicity after subarachNoid hemorrhage) trial is a phase 1/2a multicenter, controlled, randomized, open-label, dose-escalation, safety, tolerability, and pharmacokinetic study comparing EG-1962 and nimodipine in patients with aneurysmal SAH.

Decompression to altitude: assumptions, experimental evidence, and future directions.

PubMed

Foster, Philip P; Butler, Bruce D

2009-02-01

Although differences exist, hypobaric and hyperbaric exposures share common physiological, biochemical, and clinical features, and their comparison may provide further insight into the mechanisms of decompression stress. Although altitude decompression illness (DCI) has been experienced by high-altitude Air Force pilots and is common in ground-based experiments simulating decompression profiles of extravehicular activities (EVAs) or astronauts' space walks, no case has been reported during actual EVAs in the non-weight-bearing microgravity environment of orbital space missions. We are uncertain whether gravity influences decompression outcomes via nitrogen tissue washout or via alterations related to skeletal muscle activity. However, robust experimental evidence demonstrated the role of skeletal muscle exercise, activities, and/or movement in bubble formation and DCI occurrence. Dualism of effects of exercise, positive or negative, on bubble formation and DCI is a striking feature in hypobaric exposure. Therefore, the discussion and the structure of this review are centered on those highlighted unresolved topics about the relationship between muscle activity, decompression, and microgravity. This article also provides, in the context of altitude decompression, an overview of the role of denitrogenation, metabolic gases, gas micronuclei, stabilization of bubbles, biochemical pathways activated by bubbles, nitric oxide, oxygen, anthropometric or physiological variables, Doppler-detectable bubbles, and potential arterialization of bubbles. These findings and uncertainties will produce further physiological challenges to solve in order to line up for the programmed human return to the Moon, the preparation for human exploration of Mars, and the EVAs implementation in a non-zero gravity environment.

Insecticide resistance of adults and nymphs of Asian citrus psyllid populations from Apatzingán Valley, Mexico.

PubMed

Pardo, Saúl; Martínez, Ana M; Figueroa, José I; Chavarrieta, Juan M; Viñuela, Elisa; Rebollar-Alviter, Ángel; Miranda, Mario A; Valle, Javier; Pineda, Samuel

2018-01-01

Control of the Asian citrus psyllid Diaphorina citri Kuwayama, the most important pest of citrus worldwide, is based on the use of insecticides, though unsatisfactory results have recently been reported. In this study, insecticide resistance of D. citri to three insecticides (bifenthrin, malathion, and chlorpyrifos) was examined. Three populations (designated Dci-CParácuaro, Dci-El Junco, and Dci-Antúnez) of both adults and fourth-instar D. citri individuals were collected in 2014 at two different times and on one occasion, respectively, from three locations (Crucero de Parácuaro, El Junco, and Antúnez). These locations represent the major commercial Mexican lemon production areas in the Apatzingán Valley in the state of Michoacán, Mexico. The three populations of D. citri adults and fourth-instar nymphs at the different collection times showed low levels of resistance (≤7-fold) to bifenthrin, but were very resistant to malathion (≤345- and ≤432-fold for adults and fourth instars, respectively) and chlorpyrifos (≤2435- and ≤1424-fold for adults and fourth instars, respectively). Resistance levels to the tested insecticides were highly variable but homogeneous among seasons and localities. Resistance management programmes that include crop sanitation, use of biological and cultural control practices, and rotation of insecticide classes should be established, particularly in areas where D. citri has developed resistance to malathion and chlorpyrifos. © 2017 Society of Chemical Industry. © 2017 Society of Chemical Industry.

Persistent (patent) foramen ovale (PFO): implications for safe diving.

PubMed

Germonpré, Peter

2015-06-01

Diving medicine is a peculiar specialty. There are physicians and scientists from a wide variety of disciplines with an interest in diving and who all practice 'diving medicine': the study of the complex whole-body physiological changes and interactions upon immersion and emersion. To understand these, the science of physics and molecular gas and fluid movements comes into play. The ultimate goal of practicing diving medicine is to preserve the diver's health, both during and after the dive. Good medicine starts with prevention. For most divers, underwater excursions are not a professional necessity but a hobby; avoidance of risk is generally a much better option than risk mitigation or cure. However, prevention of diving illnesses seems to be even more difficult than treating those illnesses. The papers contained in this issue of DHM are a nice mix of various aspects of PFO that divers are interested in, all of them written by specialist doctors who are avid divers themselves. However, diving medicine should also take advantage of research from the "non-diving" medicine community, and PFO is a prime example. Cardiology and neurology have studied PFO for as long, or even longer than divers have been the subjects of PFO research, and with much greater numbers and resources. Unexplained stroke has been associated with PFO, as has severe migraine with aura. As the association seems to be strong, investigating the effect of PFO closure was a logical step. Devices have been developed and perfected, allowing now for a relatively low-risk procedure to 'solve the PFO problem'. However, as with many things in science, the results have not been as spectacular as hoped for: patients still get recurrences of stroke, still have migraine attacks. The risk-benefit ratio of PFO closure for these non-diving diseases is still debated. For diving, we now face a similar problem. Let there be no doubt that PFO is a pathway through which venous gas emboli (VGE) can arterialize, given sufficiently favourable circumstances (such as: a large quantity of VGE, size of the PFO, straining or provocation manoeuvres inducing increased right atrial pressure, delayed tissue desaturation so that seeding arterial gas emboli (AGE) grow instead of shrink, and there may be other, as yet unknown factors). There is no doubt that closing a PFO, either surgically or using a catheter-delivered device, can reduce the number of VGE becoming AGE. There is also no doubt that the procedure itself carries some health risks which are, at 1% or higher risk of serious complications, an order of magnitude greater than the risk for decompression illness (DCI) in recreational diving. Scientists seek the 'truth', but the truth about how much of a risk PFO represents for divers is not likely to be discovered nor universally accepted. First of all, the exact prevalence of PFO in divers is not known. As it has been pointed out in the recent literature, a contrast echocardiography (be it transthoracic or transoesophageal) or Doppler examination is only reliable if performed according to a strict protocol, taking into account the very many pitfalls yielding false negative results. The optimal procedure for injection of contrast medium was described several years ago, but has not received enough attention. Indeed, it is our and others' experience that many divers presenting with PFO-related DCI symptoms initially are declared "PFO-negative" by eminent, experienced cardiologists! Failing a prospective study, the risks of diving with a right-to left vascular shunt can only be expressed as an 'odds ratio', which is a less accurate measure than is 'relative risk'. The DAN Europe Carotid Doppler Study, started in 2001, is nearing completion and will provide more insight into the actual risks of DCI for recreational divers. The degree of DCI risk reduction from closing a PFO is thus not only dependent on successful closure but also (mostly?) on how the diver manages his/her dive and decompression in order to reduce the incidence of VGE. It has been convincingly shown that conservative dive profiles reduce DCI incidence even in divers with large PFOs, just as PFO closure does not protect completely from DCI if the dive profiles are aggressive. Prospective studies should not only focus on the reduction of DCI incidence after closure, but should take into account the costs and side effects of the procedure, as has been done in the cardiology and neurology studies. Imagine lung transplants becoming a routine operation, costly but with a high success rate; imagine also a longterm smoker suffering from a mild form of obstructive lung disease and exercise-limiting dyspnoea. Which of two options would you recommend: having a lung transplant and continue smoking as before, or quit smoking and observe a progressive improvement of pulmonary and cardiac pathology? As opposed to patients with thrombotic disease and migraine, divers can choose to reduce DCI risk. In fact, all it takes is acceptance that some types of diving carry too high a health risk - whether it is because of a PFO or another 'natural' factor. It would be unethical to promote PFO closure in divers solely on the basis of its efficacy of shunt reduction. Unfortunately, at least one device manufacturer has already done so in the past, citing various publications to specifically target recreational divers. Some technical diving organizations even have recommended preventive PFO closure in order to undertaking high-risk dive training. As scientists, we must not allow ourselves to be drawn into intuitive diver fears and beliefs. Nor should we let ourselves be blinded by the ease and seemingly low risk of the procedure. With proper and objective information provided by their diving medicine specialist, divers could make an informed decision, rather than focus on the simplistic idea that they need 'to get it fixed' in order to continue diving. A significant relationship between PFO and cerebral damage, in the absence of high-risk diving or DCI, has yet to be confirmed. Studying PFO-related DCI provides us with unique opportunities to learn more about the effect of gas bubbles in various tissues, including the central vascular bed and neurological tissue. It may also serve to educate divers that safe diving is something that needs to be learned, not something that can be implanted.

A Collaborative, Ongoing University Strategic Planning Framework: Process, Landmines, and Lessons

ERIC Educational Resources Information Center

Hill, Susan E. Kogler; Thomas, Edward G.; Keller, Lawrence F.

2009-01-01

This article examines the strategic planning process at Cleveland State University, a large metropolitan state university in Ohio. A faculty-administrative team used a communicative planning approach to develop a collaborative, ongoing, bottom-up, transparent strategic planning process. This team then spearheaded the process through plan…

Dyadic coping in Latino couples: validity of the Spanish version of the Dyadic Coping Inventory.

PubMed

Falconier, Mariana Karin; Nussbeck, Fridtjof; Bodenmann, Guy

2013-01-01

This study seeks to validate the Spanish version of the Dyadic Coping Inventory (DCI) in a Latino population with data from 113 heterosexual couples. Results for both partners confirm the factorial structure for the Spanish version (Subscales: Stress Communication, Emotion- and Problem-Focused Supportive, Delegated, and Negative Dyadic Coping, Emotion- and Problem-Focused Common Dyadic Coping, and Evaluation of Dyadic Coping; Aggregated Scales: Dyadic Coping by Oneself and by Partner) and support the discriminant validity of its subscales and the concurrent, and criterion validity of the subscales and aggregated scales. These results do not only indicate that the Spanish version of the DCI can be used reliably as a measure of coping in Spanish-speaking Latino couples, but they also suggest that this group relies on dyadic coping frequently and that this type of coping is associated with positive relationship functioning and individual coping. Limitations and implications are discussed.

Continuing professional development of dentists through distant learning: an Indira Gandhi National Open University-Dental Council of India experiment a report.

PubMed

Kuba, Ruchika; Kohli, Anil

2014-01-01

To keep themselves updated with all the advancements in the field of dentistry, dentists should involve themselves in some kind of professional development. Distance learning is the most appropriate way to serve the growing demand due to technological advancements. Indira Gandhi National Open University in collaboration with Dental Council of India (DCI) developed and launched two continuing professional development programs in Endodontics (postgraduate certificate in endodontics) and postgraduate certificate in oral implantology and has trained over 400 and 280 BDS dentists respectively till date. The program package consists of self-instructional material, assignments, videos and practical training. The training is conducted in premiere dental colleges and institutions recognized by DCI. The certificate is awarded after a term end examination, both in theory and practical. The pass percentages of the theory courses ranged from around 63% to 98%, and 90% of the candidates cleared the practical exam.

Cardiac Imaging System

NASA Technical Reports Server (NTRS)

1990-01-01

Although not available to all patients with narrowed arteries, balloon angioplasty has expanded dramatically since its introduction with an estimated further growth to 562,000 procedures in the U.S. alone by 1992. Growth has fueled demand for higher quality imaging systems that allow the cardiologist to be more accurate and increase the chances of a successful procedure. A major advance is the Digital Cardiac Imaging (DCI) System designed by Philips Medical Systems International, Best, The Netherlands and marketed in the U.S. by Philips Medical Systems North America Company. The key benefit is significantly improved real-time imaging and the ability to employ image enhancement techniques to bring out added details. Using a cordless control unit, the cardiologist can manipulate images to make immediate assessment, compare live x-ray and roadmap images by placing them side-by-side on monitor screens, or compare pre-procedure and post procedure conditions. The Philips DCI improves the cardiologist's precision by expanding the information available to him.

Failure Mechanisms and Damage Model of Ductile Cast Iron Under Low-Cycle Fatigue Conditions

NASA Astrophysics Data System (ADS)

Wu, Xijia; Quan, Guangchun; MacNeil, Ryan; Zhang, Zhong; Sloss, Clayton

2014-10-01

Strain-controlled low-cycle fatigue (LCF) tests were conducted on ductile cast iron (DCI) at strain rates of 0.02, 0.002, and 0.0002/s in the temperature range from room temperature to 1073 K (800 °C). A constitutive-damage model was developed within the integrated creep-fatigue theory (ICFT) framework on the premise of strain decomposition into rate-independent plasticity and time-dependent creep. Four major damage mechanisms: (i) plasticity-induced fatigue, (ii) intergranular embrittlement (IE), (iii) creep, and (iv) oxidation were considered in a nonlinear creep-fatigue interaction model which represents the overall damage accumulation process consisting of oxidation-assisted fatigue crack nucleation and propagation in coalescence with internally distributed damage ( e.g., IE and creep), leading to final fracture. The model was found to agree with the experimental observations of the complex DCI-LCF phenomena, for which the linear damage summation rule would fail.

Safety of performing a delayed anastomosis during damage control laparotomy in patients with destructive colon injuries.

PubMed

Ordoñez, Carlos A; Pino, Luis F; Badiel, Marisol; Sánchez, Alvaro I; Loaiza, Jhon; Ballestas, Leonardo; Puyana, Juan Carlos

2011-12-01

Recent studies report the safety and feasibility of performing delayed anastomosis (DA) in patients undergoing damage control laparotomy (DCL) for destructive colon injuries (DCIs). Despite accumulating experience in both civilian and military trauma, questions regarding how to best identify high-risk patients and minimize the number of anastomosis-associated complications remain. Our current practice is to perform a definitive closure of the colon during DCL, unless there is persistent acidosis, bowel wall edema, or evidence of intra-abdominal abscess. In this study, we evaluated the safety of this approach by comparing outcomes of patients with DCI who underwent definitive closure of the colon during DCL versus patients managed with colostomy with or without DCL. We performed a retrospective chart review of patients with penetrating DCI during 2003 to 2009. Severity of injury, surgical management, and clinical outcome were assessed. Sixty patients with severe gunshot wounds and three patients with stab wounds were included in the analysis. DCL was required in 30 patients, all with gunshot wounds. Three patients died within the first 48 hours, three underwent colostomy, and 24 were managed with DA. Thirty-three patients were managed with standard laparotomy: 26 patients with primary anastomosis and 7 with colostomy. Overall mortality rate was 9.5%. Three late deaths occurred in the DCL group, and only one death was associated with an anastomotic leak. Performing a DA in DCI during DCL is a reliable and feasible approach as long as severe acidosis, bowel wall edema, and/or persistent intra-abdominal infections are not present.

Sedation of Patients with Acute Aneurysmal Subarachnoid Hemorrhage with Ketamine Is Safe and Might Influence the Occurrence of Cerebral Infarctions Associated with Delayed Cerebral Ischemia.

PubMed

Von der Brelie, Christian; Seifert, Michael; Rot, Sergej; Tittel, Anja; Sanft, Carsten; Meier, Ullrich; Lemcke, Johannes

2017-01-01

Ketamine has neuroprotective characteristics as well as beneficial cardiocirculatory properties and may thus reduce vasopressor consumption. In contrast, sedation with ketamine (like any other sedative drug) has side effects. This study assesses the influence of ketamine on intracranial pressure (ICP), on the consumption of vasopressors in induced hypertension therapy, and on the occurrence of delayed cerebral ischemia (DCI)-associated cerebral infarctions, with particular focus on the complications of sedation in patients with aneurysmal subarachnoid hemorrhage (SAH). This is a retrospective, observational study. Sixty-five patients with SAH who underwent a period of sedation were included. The clinical course variables (Richmond Agitation and Sedation scale score, ICP values, consumption of vasopressors, complications of sedation, outcome, and other clinical parameters) were analyzed. Cranial computed tomography results were analyzed. Forty-one patients underwent sedation including ketamine (63.1%). Ketamine decreased the ICP in 92.7% of the cases. Vasopressors was reduced in 53.6%. DCI-associated cerebral infarctions occurred significantly less often in the patient cohort being treated with sedation including ketamine (7.3% vs. 25% in the nonketamine group; P = 0.04). The rate of major complications was not higher in the ketamine group. Outcome was not different regarding the groups if they were sedated with or without ketamine. Ketamine decreases the ICP and is not associated with a higher rate of complications. The rate of DCI-associated cerebral infarctions was lower in the ketamine group. Ketamine administration led to a reduction of vasopressors used for induced hypertension. Copyright © 2016 Elsevier Inc. All rights reserved.

Plant utilization against digestive system disorder in Southern Assam, India.

PubMed

Choudhury, Prakash Roy; Choudhury, Manabendra Dutta; Ningthoujam, Sanjoy Singh; Mitra, Abhijit; Nath, Deepa; Talukdar, Anupam Das

2015-12-04

Being one of the most common types of life threatening diseases in Southern Assam, India, the digestive system disorders (DSD) have gained much attention in recent decades. Traditional beliefs and inadequate income of mass population result in the use of alternative phytotherapies to treat the diseases. The present paper documents the medicinal knowledge and utilization of plants for treatment of digestive system disorders in Southern Assam, India by Disease Consensus Index (DCI). It also determines the most suitable plant species used to treat digestive system disorders in the study area. The study was based on ethnomedicinal field survey covering a period of 1 year from 2014-2015. The ethnomedicinal information was collected by using semi-structured questionnaires from different traditional Bengali people having knowledge on medicinal plants. Collected data were analyzed by calculating DCI. During the survey, 29 informants were interviewed and a total of 49 plants under 46 genera belonging to 33 families were listed. Data analysis revealed that Litsea glutinosa, Momordica charantia, Andrographis paniculata, Lawsonia inermis, Cleome viscosa, Psidium guajava, Ageratum conyzoides, Cuscuta reflexa, Cynodon dactylon and Carica papaya are the most prominent plants among the people of Southern Assam for treating DSD. This explorative survey emphasizes the need to preserve and document the traditional healing practices for managing DSD inviting for more imminent scientific research on the plants to determine their efficacy as well as safety. With the help of statistical analysis (DCI), we propose 10 priority plants for DSD in present work. Systematic pharmacological study with these plants may contribute significant result. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

'Sea legs': sharpened Romberg test after three days on a live-aboard dive boat.

PubMed

Gibbs, Clinton R; Commons, Katherine H; Brown, Lawrence H; Blake, Denise F

2010-12-01

The sharpened Romberg test (SRT) is commonly used by diving and hyperbaric physicians as an indicator of neurological decompression illness (DCI). People who spend a prolonged time on a boat at sea experience impairment in their balance on returning to shore, a condition known as mal de debarquement ('sea legs'). This conditioning of the vestibular system to the rocking motion of a boat at sea may impact on the utility of the SRT in assessing a diver with potential DCI after a live-aboard dive trip. To assess the impact 'sea legs' has on the SRT after three days on a live-aboard dive trip. Thirty-nine staff and passengers of a three-day, live-aboard dive trip performed a SRT before and after their journey, with assessment of potential variables, including middle ear barotrauma, alcohol consumption, sea-sickness and occult DCI. There was no statistically significant impact on SRT performance, with 100% completion pre-trip and 35 out of 36 divers (97.2%) post-trip. There were trends towards more attempts being required and time needed for successful SRT post-trip, but these were not statistically significant. There was a small, but noteworthy incidence of middle-ear barotrauma, with seven people affected pre-trip, and 13 post-trip. There was a higher incidence in student divers. Middle-ear barotrauma did not appear to have a direct impact on SRT performance. There was no significant impact on SRT performance resulting from 'sea legs' after three days at sea. Recreational divers, especially dive students, have a substantial incidence of mild middle ear barotrauma.

Comparison of induced hypertension, fluid bolus, and blood transfusion to augment cerebral oxygen delivery after subarachnoid hemorrhage.

PubMed

Dhar, Rajat; Scalfani, Michael T; Zazulia, Allyson R; Videen, Tom O; Derdeyn, Colin P; Diringer, Michael N

2012-03-01

Critical reductions in oxygen delivery (DO(2)) underlie the development of delayed cerebral ischemia (DCI) after subarachnoid hemorrhage (SAH). If DO(2) is not promptly restored, then irreversible injury (that is, cerebral infarction) may result. Hemodynamic therapies for DCI (that is, induced hypertension [IH] and hypervolemia) aim to improve DO(2) by raising cerebral blood flow (CBF). Red blood cell (RBC) transfusion may be an alternate strategy that augments DO(2) by improving arterial O(2) content. The authors compared the relative ability of these 3 interventions to improve cerebral DO(2), specifically their ability to restore DO(2) to regions where it is impaired. The authors compared 3 prospective physiological studies in which PET imaging was used to measure global and regional CBF and DO(2) before and after the following treatments: 1) fluid bolus of 15 ml/kg normal saline (9 patients); 2) raising mean arterial pressure 25% (12 patients); and 3) transfusing 1 U of RBCs (17 patients) in 38 individuals with aneurysmal SAH at risk for DCI. Response between groups in regions with low DO(2) (< 4.5 ml/100 g/min) was compared using repeated-measures ANOVA. Groups were similar except that the fluid bolus cohort had more patients with symptoms of DCI and lower baseline CBF. Global CBF or DO(2) did not rise significantly after any of the interventions, except after transfusion in patients with hemoglobin levels < 9 g/dl. All 3 treatments improved CBF and DO(2) to regions with impaired baseline DO(2), with a greater improvement after transfusion (23%) than hypertension (14%) or volume loading (10%); p < 0.001. Transfusion also resulted in a nonsignificantly greater (47%) reduction in the number of brain regions with low DO(2) when compared with fluid bolus (7%) and hypertension (12%) (p = 0.33). The IH, fluid bolus, and blood transfusion interventions all improve DO(2) to vulnerable brain regions at risk for ischemia after SAH. Transfusion appeared to provide a physiological benefit at least comparable to IH, especially among patients with anemia, but transfusion is associated with risks. The clinical significance of these findings remains to be established in controlled clinical trials.

Breed of cow and herd productivity affect milk nutrient recovery in curd, and cheese yield, efficiency and daily production.

PubMed

Stocco, G; Cipolat-Gotet, C; Gasparotto, V; Cecchinato, A; Bittante, G

2018-02-01

Little is known about cheese-making efficiency at the individual cow level, so our objective was to study the effects of herd productivity, individual herd within productivity class and breed of cow within herd by producing, then analyzing, 508 model cheeses from the milk of 508 cows of six different breeds reared in 41 multi-breed herds classified into two productivity classes (high v. low). For each cow we obtained six milk composition traits; four milk nutrient (fat, protein, solids and energy) recovery traits (REC) in curd; three actual % cheese yield traits (%CY); two theoretical %CYs (fresh cheese and cheese solids) calculated from milk composition; two overall cheese-making efficiencies (% ratio of actual to theoretical %CYs); daily milk yield (dMY); and three actual daily cheese yield traits (dCY). The aforementioned phenotypes were analyzed using a mixed model which included the fixed effects of herd productivity, parity, days in milk (DIM) and breed; the random effects were the water bath, vat, herd and residual. Cows reared in high-productivity herds yielded more milk with higher nutrient contents and more cheese per day, had greater theoretical %CY, and lower cheese-making efficiency than low-productivity herds, but there were no differences between them in terms of REC traits. Individual herd within productivity class was an intermediate source of total variation in REC, %CY and efficiency traits (10.0% to 17.2%), and a major source of variation in milk yield and dCY traits (43.1% to 46.3%). Parity of cows was an important source of variation for productivity traits, whereas DIM affected almost all traits. Breed within herd greatly affected all traits. Holsteins produced more milk, but Brown Swiss cows produced milk with higher actual and theoretical %CYs and cheese-making efficiency, so that the two large-framed breeds had the same dCY. Compared with the two large-framed breeds, the small Jersey cows produced much less milk, but with greater actual and theoretical %CYs, similar efficiencies and a slightly lower dCY. Compared with the average of the specialized dairy breeds, the three dual-purpose breeds (Simmental and the local Rendena and Alpine Grey) had, on average, similar dMY, lower actual and theoretical %CY, similar fat and protein REC, and slightly greater cheese-making efficiency.

Persistence and diversity of directional landscape connectivity improves biomass pulsing in expanding and contracting wetlands

USGS Publications Warehouse

Yurek, Simeon; DeAngelis, Donald L.; Trexler, Joel C.; Klassen, Stephen; Larsen, Laurel G.

2016-01-01

In flood-pulsed ecosystems, hydrology and landscape structure mediate transfers of energy up the food chain by expanding and contracting in area, enabling spatial expansion and growth of fish populations during rising water levels, and subsequent concentration during the drying phase. Connectivity of flooded areas is dynamic as waters rise and fall, and is largely determined by landscape geomorphology and anisotropy. We developed a methodology for simulating fish dispersal and concentration on spatially-explicit, dynamic floodplain wetlands with pulsed food web dynamics, to evaluate how changes in connectivity through time contribute to the concentration of fish biomass that is essential for higher trophic levels. The model also tracks a connectivity index (DCI) over different compass directions to see if fish biomass dynamics can be related in a simple way to topographic pattern. We demonstrate the model for a seasonally flood-pulsed, oligotrophic system, the Everglades, where flow regimes have been greatly altered. Three dispersing populations of functional fish groups were simulated with empirically-based dispersal rules on two landscapes, and two twelve-year time series of managed water levels for those areas were applied. The topographies of the simulations represented intact and degraded ridge-and-slough landscapes (RSL). Simulation results showed large pulses of biomass concentration forming during the onset of the drying phase, when water levels were falling and fish began to converge into the sloughs. As water levels fell below the ridges, DCI declined over different directions, closing down dispersal lanes, and fish density spiked. Persistence of intermediate levels of connectivity on the intact RSL enabled persistent concentration events throughout the drying phase. The intact landscape also buffered effects of wet season population growth. Water level reversals on both landscapes negatively affected fish densities by depleting fish populations without allowing enough time for them to regenerate. Testable, spatiotemporal predictions of the timing, location, duration, and magnitude of fish concentration pulses were produced by the model, and can be applied to restoration planning.

Quality of preimplantation embryos recovered in vivo from dairy cows in relation to their body condition.

PubMed

Makarevich, A V; Stádník, L; Kubovičová, E; Hegedüšová, Z; Holásek, R; Louda, F; Beran, J; Nejdlová, M

2016-06-01

This study examined the impact of cow body condition on the quality of bovine preimplantation embryos. The embryos (n = 107) were flushed from dairy cows and classified according to a five-point scale body condition score (BCS2 n = 17; BCS3 n = 31; BCS4 n = 11) on the 7th day after insemination and then analyzed for development, dead cell index (DCI), cell number and actin cytoskeleton quality. The highest embryo recovery rate (P < 0.05) was recorded in the BCS3 group and the lowest in the BCS4 group. More transferable (morula, blastocyst) embryos were obtained from the BCS4 cows (79%), compared with the BCS2 (64%) or BCS3 (63%) animals. However, cell numbers were higher in the BCS2 and BCS3 groups (P < 0.05) compared with the BCS4 embryos. Conversely, the DCI was lowest in the BCS2 (3.88%; P < 0.05) and highest in the BCS4 (6.56%) embryos. The proportion of embryos with the best actin quality (grade I) was higher in the BCS2 and BCS3 cows compared with the BCS4 group. Almost 25% of all embryos showed fragmented morphology and a higher DCI (5.65%) than normal morulas (1.76%). More fragmented embryos were revealed in the BCS2 (28.6%) and BCS4 (31.25%) groups, and less (19.15%) in the BCS3 group. The cell numbers in such embryos were lower in the BCS4 (22.57) than in the BCS2 (46.25) or BCS3 (42.4) groups. In conclusion, the body condition of dairy cows affects the quality of preimplantation embryos. A BCS over 3.0 resulted in a higher incidence of poor (fragmented) embryos.

High-resolution Manometry and Globus: Comparison of Globus, Gastroesophageal Reflux Disease and Normal Controls Using High-resolution Manometry.

PubMed

Choi, Won Seok; Kim, Tae Wan; Kim, Ja Hyun; Lee, Sang Hyuk; Hur, Woon Je; Choe, Young Gil; Lee, Sang Hyuk; Park, Jung Ho; Sohn, Chong Il

2013-10-01

Globus is a foreign body sense in the throat without dysphagia, odynophagia, esophageal motility disorders, or gastroesophageal reflux. The etiology is unclear. Previous studies suggested that increased upper esophageal sphincter pressure, gastroesophageal reflux and hypertonicity of esophageal body were possible etiologies. This study was to quantify the upper esophageal sphincter (UES) pressure, contractile front velocity (CFV), proximal contractile integral (PCI), distal contractile integral (DCI) and transition zone (TZ) in patient with globus gastroesophageal reflux disease (GERD) without globus, and normal controls to suggest the correlation of specific high-resolution manometry (HRM) findings and globus. Fifty-seven globus patients, 24 GERD patients and 7 normal controls were studied with HRM since 2009. We reviewed the reports, and selected 5 swallowing plots suitable for analysis in each report, analyzed each individual plot with ManoView. The 5 parameters from each plot in 57 globus patients were compared with that of 24 GERD patients and 7 normal controls. There was no significant difference in the UES pressure, CFV, PCI and DCI. TZ (using 30 mmHg isobaric contour) in globus showed significant difference compared with normal controls and GERD patients. The median values of TZ were 4.26 cm (interquartile range [IQR], 2.30-5.85) in globus patients, 5.91 cm (IQR, 3.97-7.62) in GERD patients and 2.26 cm (IQR, 1.22-2.92) in normal controls (P = 0.001). HRM analysis suggested that UES pressure, CFV, PCI and DCI were not associated with globus. Instead increased length of TZ may be correlated with globus. Further study comparing HRM results in globus patients within larger population needs to confirm their correlation.

Multiple Rapid Swallow Maneuver Enhances the Clinical Utility of High-Resolution Manometry in Patients Showing Ineffective Esophageal Motility

PubMed Central

Min, Yang Won; Shin, Inseub; Son, Hee Jung; Rhee, Poong-Lyul

2015-01-01

Abstract The clinical significance of ineffective esophageal motility (IEM) together with multiple rapid swallow (MRS) has not been yet evaluated in the Chicago Classification v3.0. This study evaluated the adjunctive role of MRS in IEM and determined the criteria of abnormal MRS to maximize the utility of IEM. We analyzed 186 patients showing IEM or normal esophageal motility (NEM), who underwent esophageal high-resolution impedance–manometry for esophageal symptoms. Two different criteria for abnormal MRS were applied to IEM subjects, resulting in 2 corresponding subgroups: IEM-A when distal contractile integral (DCI) ratio between an average wet swallows and MRS contraction was <1 and IEM-B when MRS contraction DCI was <450 mm Hg-s-cm. One IEM subject inadequately performed MRS. Among the remaining 52 IEM subjects, 18 (34.6%) were classified into IEM-A and 23 (44.2%) into IEM-B. IEM subjects showed less complete bolus transit (median 0.0%, interquartile range 0.0–20.0% vs 60.0%, 30.0–80.0; P < 0.001) resulting in higher impaired bolus transit than NEM subjects (98.1% vs 66.9%, P = 0.001). IEM-B subjects showed additionally higher pathologic bolus exposure than NEM subjects (55.6% vs 29.3%, P = 0.001), whereas IEM-A subjects could not. Although IEM-B subjects had the highest prevalence of gastroesophageal reflux disease among the subjects groups, it did not reach statistical significance. In conclusion, IEM patients with abnormal MRS contraction have an increased risk of prolonged bolus clearance, poor bolus transit, and pathologic bolus exposure. IEM patients need to be assessed concerning whether MRS contraction DCI is <450 mm Hg-s-cm to segregate clinically relevant patients. PMID:26448010

High-resolution Manometry and Globus: Comparison of Globus, Gastroesophageal Reflux Disease and Normal Controls Using High-resolution Manometry

PubMed Central

Choi, Won Seok; Kim, Tae Wan; Kim, Ja Hyun; Lee, Sang Hyuk; Hur, Woon Je; Choe, Young Gil; Lee, Sang Hyuk; Park, Jung Ho

2013-01-01

Background/Aims Globus is a foreign body sense in the throat without dysphagia, odynophagia, esophageal motility disorders, or gastroesophageal reflux. The etiology is unclear. Previous studies suggested that increased upper esophageal sphincter pressure, gastroesophageal reflux and hypertonicity of esophageal body were possible etiologies. This study was to quantify the upper esophageal sphincter (UES) pressure, contractile front velocity (CFV), proximal contractile integral (PCI), distal contractile integral (DCI) and transition zone (TZ) in patient with globus gastroesophageal reflux disease (GERD) without globus, and normal controls to suggest the correlation of specific high-resolution manometry (HRM) findings and globus. Methods Fifty-seven globus patients, 24 GERD patients and 7 normal controls were studied with HRM since 2009. We reviewed the reports, and selected 5 swallowing plots suitable for analysis in each report, analyzed each individual plot with ManoView. The 5 parameters from each plot in 57 globus patients were compared with that of 24 GERD patients and 7 normal controls. Results There was no significant difference in the UES pressure, CFV, PCI and DCI. TZ (using 30 mmHg isobaric contour) in globus showed significant difference compared with normal controls and GERD patients. The median values of TZ were 4.26 cm (interquartile range [IQR], 2.30-5.85) in globus patients, 5.91 cm (IQR, 3.97-7.62) in GERD patients and 2.26 cm (IQR, 1.22-2.92) in normal controls (P = 0.001). Conclusions HRM analysis suggested that UES pressure, CFV, PCI and DCI were not associated with globus. Instead increased length of TZ may be correlated with globus. Further study comparing HRM results in globus patients within larger population needs to confirm their correlation. PMID:24199007

Effect and Feasibility of Therapeutic Hypothermia in Patients with Hemorrhagic Stroke: A Systematic Review and Meta-Analysis.

PubMed

Yao, Zhong; You, Chao; He, Min

2018-03-01

Therapeutic hypothermia (TH) has shown good results in experimental models of hemorrhagic stroke. The clinical application of TH, however, remains controversial, since reports regarding its therapeutic effect are inconsistent. We conducted a systematic review based on Preferred Reporting Items for Systematic Reviews and Meta-analyses comparing TH with a control group in terms of mortality, poor outcome, delayed cerebral ischemia (DCI), and specific complications. The subgroup analyses were stratified by study type, country, mean age, hemorrhage type, cooling method, treatment duration, rewarming velocity, and follow-up time. Nine studies were included, most of which were of moderate quality. The overall effect demonstrated insignificant differences in mortality (risk ratio [RR] 0.78; 95% confidence interval [CI] 0.58-1.06; P = 0.11) and poor outcome rate (RR 0.89; 95% CI 0.70-1.12; P = 0.32) between TH and the control group. However, sensitivity analyses, after we omitted 1 study, achieved a statistically significant difference in poor outcome favoring TH. Moreover, in the subgroup analyses, the results derived from randomized studies revealed that TH significantly reduced poor outcomes (RR 0.40; 95% CI 0.22-0.74; P = 0.003). In addition, TH significantly reduced DCI compared with control (RR 0.61; 95% CI 0.40-0.93; P = 0.02). The incidence of specific complications (rebleeding, pneumonia, sepsis, arrhythmia, and hydrocephalus) between the 2 groups were comparable and did not reach significant difference. The overall effect showed TH did not significantly reduce mortality and poor outcomes but led to a decreased incidence of DCI. Compared with control, TH resulted in comparable incidences of specific complications. Copyright © 2018 Elsevier Inc. All rights reserved.

Acute cardiac support with intravenous milrinone promotes recovery from early brain injury in a murine model of severe subarachnoid haemorrhage.

PubMed

Mutoh, Tomoko; Mutoh, Tatsushi; Nakamura, Kazuhiro; Yamamoto, Yukiko; Tsuru, Yoshiharu; Tsubone, Hirokazu; Ishikawa, Tatsuya; Taki, Yasuyuki

2017-04-01

Early brain injury/ischaemia (EBI) is a serious complication early after subarachnoid haemorrhage (SAH) that contributes to development of delayed cerebral ischaemia (DCI). This study aimed to determine the role of inotropic cardiac support using milrinone (MIL) on restoring acute cerebral hypoperfusion attributable to EBI and improving outcomes after experimental SAH. Forty-three male C57BL/6 mice were assigned to either sham surgery (SAH-sham), SAH induced by endovascular perforation plus postconditioning with 2% isoflurane (Control), or SAH plus isoflurane combined with MIL with and without hypoxia-inducible factor inhibitor (HIF-I) pretreatment. Cardiac output (CO) during intravenous MIL infusion (0.25-0.75 μg/kg/min) between 1.5 and 2.5 hours after SAH induction was monitored with Doppler echocardiography. Magnetic resonance imaging (MRI)-continuous arterial spin labelling was used for quantitative cerebral blood flow (CBF) measurements. Neurobehavioral function was assessed daily by neurological score and open field test. DCI was analyzed 3 days later by determining infarction on MRI. Mild reduction of cardiac output (CO) and global cerebral blood flow (CBF) depression were notable early after SAH. MIL increased CO in a dose-dependent manner (P<.001), which was accompanied by improved hypoperfusion, incidence of DCI and functional recovery than Control (P<.05). The neuroprotective effects afforded by MIL or Control were attenuated by hypoxia-inducible factor (HIF) inhibition (P<.05). These results suggest that MIL improves acute hypoperfusion by its inotropic effect, leading to neurobehavioral improvement in mice after severe SAH, in which HIF may be acting as a critical mediator. © 2017 John Wiley & Sons Australia, Ltd.

HIMALAIA (Hypertension Induction in the Management of AneurysmaL subArachnoid haemorrhage with secondary IschaemiA): a randomized single-blind controlled trial of induced hypertension vs. no induced hypertension in the treatment of delayed cerebral ischemia after subarachnoid hemorrhage.

PubMed

Gathier, C S; van den Bergh, W M; Slooter, A J C

2014-04-01

Delayed cerebral ischemia (DCI) is a major complication after aneurysmal subarachnoid hemorrhage (SAH). One option to treat delayed cerebral ischemia is to use induced hypertension, but its efficacy on the eventual outcome has not been proven in a randomized clinical trial. This article describes the design of the HIMALAIA trial (Hypertension Induction in the Management of AneurysmaL subArachnoid haemorrhage with secondary IschaemiA), designed to assess the effectiveness of induced hypertension on neurological outcome in patients with DCI after SAH. To investigate whether induced hypertension improves the functional outcome in patients with delayed cerebral ischemia after SAH. The HIMALAIA trial is a multicenter, singe-blinded, randomized controlled trial in patients with DCI after a recent SAH. Eligible patients will be randomized to either induced hypertension (n = 120) or to no induced hypertension (n = 120). In selected centers, the efficacy of induced hypertension in augmenting cerebral blood flow will be measured by means of cerebral perfusion computerized tomography scanning. Follow-up assessments will be performed at 3 and 12 months after randomization by trial nurses who are blinded to the treatment allocation and management. We will include patients during five years. The primary outcome is the proportion of subarachnoid hemorrhage patients with delayed cerebral ischemia with poor outcome three-months after randomization, defined as a modified Rankin scale of more than 3. Secondary outcome measures are related to treatment failure, functional outcome, adverse events, and cerebral hemodynamics. The HIMALAIA trial is registered at clinicaltrials.gov under identifier NCT01613235. © 2013 The Authors. International Journal of Stroke © 2013 World Stroke Organization.

Systems and technologies for high-speed inter-office/datacenter interface

NASA Astrophysics Data System (ADS)

Sone, Y.; Nishizawa, H.; Yamamoto, S.; Fukutoku, M.; Yoshimatsu, T.

2017-01-01

Emerging requirements for inter-office/inter-datacenter short reach links for data center interconnects (DCI) and metro transport networks have led to various inter-office and inter-datacenter optical interface technologies. These technologies are bringing significant changes to systems and network architectures. In this paper, we present a system and ZR optical interface technologies for DCI and metro transport networks, then introduce the latest challenges facing the system framework. There are two trends in reach extension; one is to use Ethernet and the other is to use digital coherent technologies. The first approach achieves reach extension while using as many existing Ethernet components as possible. It offers low costs as reuses the cost-effective components created for the large Ethernet market. The second approach adopts low-cost and low power coherent DSPs that implement the minimal set long haul transmission functions. This paper introduces an architecture that integrates both trends. The architecture satisfies both datacom and telecom needs with a common control and management interface and automated configuration.

Precision medicine of aneurysmal subarachnoid hemorrhage, vasospasm and delayed cerebral ischemia.

PubMed

Burrell, Christian; Avalon, Nicole E; Siegel, Jason; Pizzi, Michael; Dutta, Tumpa; Charlesworth, M Cristine; Freeman, William D

2016-11-01

Precision medicine provides individualized treatment of diseases through leveraging patient-to-patient variation. Aneurysmal subarachnoid hemorrhage carries tremendous morbidity and mortality with cerebral vasospasm and delayed cerebral ischemia proving devastating and unpredictable. Lack of treatment measures for these conditions could be improved through precision medicine. Areas covered: Discussed are the pathophysiology of CV and DCI, treatment guidelines, and evidence for precision medicine used for prediction and prevention of poor outcomes following aSAH. A PubMed search was performed using keywords cerebral vasospasm or delayed cerebral ischemia and either biomarkers, precision medicine, metabolomics, proteomics, or genomics. Over 200 peer-reviewed articles were evaluated. The studies presented cover biomarkers identified as predictive markers or therapeutic targets following aSAH. Expert commentary: The biomarkers reviewed here correlate with CV, DCI, and neurologic outcomes after aSAH. Though practical use in clinical management of aSAH is not well established, using these biomarkers as predictive tools or therapeutic targets demonstrates the potential of precision medicine.

3-Chlorotyrosine and 3,5-Dichlorotyrosine as biomarkers of respiratory tract exposure to chlorine gas

EPA Science Inventory

Modification of tyrosine by reactive chlorine can produce both 3-chlorotyrosine (CY) and 3,5-dichlorotyrosine (dCY). Both of these amino acids have proven to be promising biomarkers for assessing the extent of myeloperoxidase-catalyzed chlorine stress in a number of adverse physi...

Combining Information on Multiple Detection Techniques to Estimate the Effect of Patent Foramen Ovale on Susceptibility to Decompression Illness

NASA Technical Reports Server (NTRS)

Feiveson, Alan H.; Foster, Philip P.

2001-01-01

The assembly and the maintenance of the International Space Station is expected to require hundreds of extravehicular excursions (EVA's) in the next 10 years. During an EVA, in order to allow movement and bending of limbs, spacesuit pressures are reduced to about 4.3 psi. as compared with about 14.7 psi. for normal atmospheric pressure at sea level. However, the exposure of astronauts to reduced pressures in spacesuits, is conducive to fonnation and growth of gas bubbles within venous blood or tissues, which could cause decompression illness (DCI), a pathology best known to occur among deep-sea divers when they return to the surface. To reduce the risk of DCI, astronauts adjust to the reduced pressure in stages for a prolonged time known as a "pre-breathe" period prior to their extravehicular activity. Despite the use of pre-breathe protocols, an increased risk of DCI can arise for about 25% of humans who have a small hole, known as a patent foramen ovale (PFO), between two chambers of the heart. The atrial septum's fossa oval is, an embryological remnant of a flap between the septae primum and secundum allows fetal right atrial blood to pass into the left atrium, and usually closes after birth (Hagen, et al,. 1984). If fusion does not occur, a valve-like opening, the foramen ovale persists between the two atria. It has been suggested that astronauts with PFO's might be at greater risk of stroke or other serious neurological DCI because bubbles from a venous site may traverse a PFO, travel to the aorta and then enter the cerebral circulatory system causing a stroke (Figure 1). Astronauts are not now screened for PFO's, however consideration is being given to doing so. Here, we study three main methods abbreviated here as "ITE", "TCD" and "TEE", for detecting PFO's in living subjects. All involve the introduction of bubbles into a vein, immediately after which a sensory probe attempts to detect the bubbles in systemic circulation. Presence of the injected bubbles in the systemic circulation is indicative of a PFO. More detailed descriptions are given after the explanation of PFO's under Figure I. Even if a true PFO affects the risk of DCI, there remains a question of how effective screening would be if the detection method has errors of omission and/or commission. Of the three methods studied here, TEE is the "gold standard", matching autopsy results with near-perfect sensitivity and specificity (Schneider, et al. , 1996). However TEE is also the most difficult method to implement, requiring an internal esophagal probe, and is therefore not widely used. Currently, the easiest to use and most common PFO detection method is TTE, which uses an external chest probe. This method has a specificity of near 100%, but suffers from a low sensitivity rate (about 30%). More recently, TCD has been developed, which uses ultrasound probes to detect the presence of bubbles in cerebral arteries. Studies indicate that TCD is quite effective, having a sensitivity of about 91% and a specificity of about 93% (Droste, et al., 1999) when applied correctly, however implementation is difficult and requires considerable training.

7 CFR 25.403. - Ongoing 2-year work plan requirement.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 25.403. Agriculture Office of the Secretary of Agriculture RURAL EMPOWERMENT ZONES AND ENTERPRISE COMMUNITIES Post-Designation Requirements § 25.403. Ongoing 2-year work plan requirement. (a) Each Empowerment... conditional upon the designation of the community as an Empowerment Zone; and (iv) Documentation of...

7 CFR 25.403. - Ongoing 2-year work plan requirement.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 25.403. Agriculture Office of the Secretary of Agriculture RURAL EMPOWERMENT ZONES AND ENTERPRISE COMMUNITIES Post-Designation Requirements § 25.403. Ongoing 2-year work plan requirement. (a) Each Empowerment... conditional upon the designation of the community as an Empowerment Zone; and (iv) Documentation of...

7 CFR 25.403. - Ongoing 2-year work plan requirement.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 25.403. Agriculture Office of the Secretary of Agriculture RURAL EMPOWERMENT ZONES AND ENTERPRISE COMMUNITIES Post-Designation Requirements § 25.403. Ongoing 2-year work plan requirement. (a) Each Empowerment... conditional upon the designation of the community as an Empowerment Zone; and (iv) Documentation of...

7 CFR 25.403. - Ongoing 2-year work plan requirement.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 25.403. Agriculture Office of the Secretary of Agriculture RURAL EMPOWERMENT ZONES AND ENTERPRISE COMMUNITIES Post-Designation Requirements § 25.403. Ongoing 2-year work plan requirement. (a) Each Empowerment... conditional upon the designation of the community as an Empowerment Zone; and (iv) Documentation of...

AGOR 28: SIO Shipyard Representative Bi-Weekly Progress Report

DTIC Science & Technology

2015-08-25

DCI was not able to obtain the FDA Certificate of Sanitation for Armstrong because the sewage discharge is ahead of the water maker suction. The...unclassified c. THIS PAGE unclassified Standard Form 298 (Rev. 8-98) Prescribed by ANSI Std Z39-18 is to move the sewage discharge aft of the

AIMES Final Technical Report

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

Katz, Daniel S; Jha, Shantenu; Weissman, Jon

2017-01-31

This is the final technical report for the AIMES project. Many important advances in science and engineering are due to large-scale distributed computing. Notwithstanding this reliance, we are still learning how to design and deploy large-scale production Distributed Computing Infrastructures (DCI). This is evidenced by missing design principles for DCI, and an absence of generally acceptable and usable distributed computing abstractions. The AIMES project was conceived against this backdrop, following on the heels of a comprehensive survey of scientific distributed applications. AIMES laid the foundations to address the tripartite challenge of dynamic resource management, integrating information, and portable and interoperablemore » distributed applications. Four abstractions were defined and implemented: skeleton, resource bundle, pilot, and execution strategy. The four abstractions were implemented into software modules and then aggregated into the AIMES middleware. This middleware successfully integrates information across the application layer (skeletons) and resource layer (Bundles), derives a suitable execution strategy for the given skeleton and enacts its execution by means of pilots on one or more resources, depending on the application requirements, and resource availabilities and capabilities.« less

AIMES Final Technical Report

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

Weissman, Jon; Katz, Dan; Jha, Shantenu

2017-01-31

This is the final technical report for the AIMES project. Many important advances in science and engineering are due to large scale distributed computing. Notwithstanding this reliance, we are still learning how to design and deploy large-scale production Distributed Computing Infrastructures (DCI). This is evidenced by missing design principles for DCI, and an absence of generally acceptable and usable distributed computing abstractions. The AIMES project was conceived against this backdrop, following on the heels of a comprehensive survey of scientific distributed applications. AIMES laid the foundations to address the tripartite challenge of dynamic resource management, integrating information, and portable andmore » interoperable distributed applications. Four abstractions were defined and implemented: skeleton, resource bundle, pilot, and execution strategy. The four abstractions were implemented into software modules and then aggregated into the AIMES middleware. This middleware successfully integrates information across the application layer (skeletons) and resource layer (Bundles), derives a suitable execution strategy for the given skeleton and enacts its execution by means of pilots on one or more resources, depending on the application requirements, and resource availabilities and capabilities.« less

Inositol as putative integrative treatment for PCOS.

PubMed

Genazzani, Alessandro D

2016-12-01

Studies over the last decade have demonstrated that some polycystic ovary syndrome (PCOS) patients have abnormal insulin sensitivity (insulin resistance), independently from being overweight or obese. This induces the risk of developing type 2 diabetes in such PCOS patients. The use of insulin sensitizers (i.e. metformin), reduces such metabolic, and most hormonal, impairments. As metformin often induces side effects, new integrative strategies have been proposed to treat insulin resistance, such as the use of inositols. Such compounds are mainly represented in humans by two inositol stereoisomers: myo-inositol (MYO) and d-chiro-inositol (DCI). MYO is the precursor of inositol triphosphate, a second messenger that regulates thyroid-stimulating hormone (TSH) and FSH as well as insulin. DCI derives from the conversion of myo-inositol via an insulin-dependent pathway. Several preliminary studies have indicated possible benefits of inositol therapy in PCOS patients, but to date no meta-analysis has been performed. This review aims to give clinical insights for the clinical use of inositol in PCOS. Copyright © 2016 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

Changes in esophageal motility after endoscopic submucosal dissection for superficial esophageal cancer: a high-resolution manometry study.

PubMed

Takahashi, K; Sato, Y; Takeuchi, M; Sato, H; Nakajima, N; Ikarashi, S; Hayashi, K; Mizuno, K-I; Honda, Y; Hashimoto, S; Yokoyama, J; Terai, S

2017-11-01

The effect of endoscopic submucosal dissection (ESD) on esophageal motility remains unknown. Therefore, the aim of this study is to elucidate changes in esophageal motility after ESD along with the cause of dysphagia using high-resolution manometry (HRM). This is a before-and-after trial of the effect of ESD on the esophageal motility. Twenty patients who underwent ESD for superficial esophageal carcinoma were enrolled in this study. Patients filled out a questionnaire about dysphagia and underwent HRM before and after ESD. Results before and after ESD were compared. Data were obtained from 19 patients. The number of patients who complained of dysphagia before and after ESD was 1/19 (5.3%) and 6/19 (31.6%), respectively (P = 0.131). Scores from the five-point Likert scale before and after ESD were 0.1 ± 0.5 and 1.0 ± 1.6, respectively (P = 0.043). The distal contractile integral (DCI) before and after ESD and the number of failed, weak, or fragmented contractions were not significantly different. However, in five patients with circumferential ESD, DCI was remarkably decreased and the frequency of fail, weak, or fragmented contractions increased. Univariate regression analysis showed a relatively strong inverse correlation of ΔDCI with the circumferential mucosal defect ratio {P < 0.01, standardized regression coefficient (r) = -0.65}, the number of stricture preventions (P < 0.01, r = -0.601), and the number of stricture resolutions (P < 0.01, r = -0.77). This HRM study showed that impairment of esophageal motility could be caused by ESD. The impairment of esophageal motility was conspicuous, especially in patients with circumferential ESD and subsequent procedures such as endoscopic triamcinolone injection and endoscopic balloon dilatation. Impaired esophageal motility after ESD might explain dysphagia. © The Authors 2017. Published by Oxford University Press on behalf of International Society for Diseases of the Esophagus. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Nanobubbles Form at Active Hydrophobic Spots on the Luminal Aspect of Blood Vessels: Consequences for Decompression Illness in Diving and Possible Implications for Autoimmune Disease-An Overview.

PubMed

Arieli, Ran

2017-01-01

Decompression illness (DCI) occurs following a reduction in ambient pressure. Decompression bubbles can expand and develop only from pre-existing gas micronuclei. The different hypotheses hitherto proposed regarding the nucleation and stabilization of gas micronuclei have never been validated. It is known that nanobubbles form spontaneously when a smooth hydrophobic surface is submerged in water containing dissolved gas. These nanobubbles may be the long sought-after gas micronuclei underlying decompression bubbles and DCI. We exposed hydrophobic and hydrophilic silicon wafers under water to hyperbaric pressure. After decompression, bubbles appeared on the hydrophobic but not the hydrophilic wafers. In a further series of experiments, we placed large ovine blood vessels in a cooled high pressure chamber at 1,000 kPa for about 20 h. Bubbles evolved at definite spots in all the types of blood vessels. These bubble-producing spots stained positive for lipids, and were henceforth termed "active hydrophobic spots" (AHS). The lung surfactant dipalmitoylphosphatidylcholine (DPPC), was found both in the plasma of the sheep and at the AHS. Bubbles detached from the blood vessel in pulsatile flow after reaching a mean diameter of ~1.0 mm. Bubble expansion was bi-phasic-a slow initiation phase which peaked 45 min after decompression, followed by fast diffusion-controlled growth. Many features of decompression from diving correlate with this finding of AHS on the blood vessels. (1) Variability between bubblers and non-bubblers. (2) An age-related effect and adaptation. (3) The increased risk of DCI on a second dive. (4) Symptoms of neurologic decompression sickness. (5) Preconditioning before a dive. (6) A bi-phasic mechanism of bubble expansion. (7) Increased bubble formation with depth. (8) Endothelial injury. (9) The presence of endothelial microparticles. Finally, constant contact between nanobubbles and plasma may result in distortion of proteins and their transformation into autoantigens.

Nanobubbles Form at Active Hydrophobic Spots on the Luminal Aspect of Blood Vessels: Consequences for Decompression Illness in Diving and Possible Implications for Autoimmune Disease—An Overview

PubMed Central

Arieli, Ran

2017-01-01

Decompression illness (DCI) occurs following a reduction in ambient pressure. Decompression bubbles can expand and develop only from pre-existing gas micronuclei. The different hypotheses hitherto proposed regarding the nucleation and stabilization of gas micronuclei have never been validated. It is known that nanobubbles form spontaneously when a smooth hydrophobic surface is submerged in water containing dissolved gas. These nanobubbles may be the long sought-after gas micronuclei underlying decompression bubbles and DCI. We exposed hydrophobic and hydrophilic silicon wafers under water to hyperbaric pressure. After decompression, bubbles appeared on the hydrophobic but not the hydrophilic wafers. In a further series of experiments, we placed large ovine blood vessels in a cooled high pressure chamber at 1,000 kPa for about 20 h. Bubbles evolved at definite spots in all the types of blood vessels. These bubble-producing spots stained positive for lipids, and were henceforth termed “active hydrophobic spots” (AHS). The lung surfactant dipalmitoylphosphatidylcholine (DPPC), was found both in the plasma of the sheep and at the AHS. Bubbles detached from the blood vessel in pulsatile flow after reaching a mean diameter of ~1.0 mm. Bubble expansion was bi-phasic—a slow initiation phase which peaked 45 min after decompression, followed by fast diffusion-controlled growth. Many features of decompression from diving correlate with this finding of AHS on the blood vessels. (1) Variability between bubblers and non-bubblers. (2) An age-related effect and adaptation. (3) The increased risk of DCI on a second dive. (4) Symptoms of neurologic decompression sickness. (5) Preconditioning before a dive. (6) A bi-phasic mechanism of bubble expansion. (7) Increased bubble formation with depth. (8) Endothelial injury. (9) The presence of endothelial microparticles. Finally, constant contact between nanobubbles and plasma may result in distortion of proteins and their transformation into autoantigens. PMID:28861003

C-arm flat detector computed tomography parenchymal blood volume imaging: the nature of parenchymal blood volume parameter and the feasibility of parenchymal blood volume imaging in aneurysmal subarachnoid haemorrhage patients.

PubMed

Kamran, Mudassar; Byrne, James V

2015-09-01

C-arm flat detector computed tomography (FDCT) parenchymal blood volume (PBV) measurements allow assessment of cerebral haemodynamics in the neurointerventional suite. This paper explores the feasibility of C-arm computed tomography (CT) PBV imaging and the relationship between the C-arm CT PBV and the MR-PWI-derived cerebral blood volume (CBV) and cerebral blood flow (CBF) parameters in aneurysmal subarachnoid haemorrhage (SAH) patients developing delayed cerebral ischemia (DCI). Twenty-six patients with DCI following aneurysmal SAH underwent a research C-arm CT PBV scan using a biplane angiography system and contemporaneous MR-PWI scan as part of a prospective study. Quantitative whole-brain atlas-based volume-of-interest analysis in conjunction with Pearson correlation and Bland-Altman tests was performed to explore the agreement between C-arm CT PBV and MR-derived CBV and CBF measurements. All patients received medical management, while eight patients (31%) underwent selective intra-arterial chemical angioplasty. Colour-coded C-arm CT PBV maps were 91% sensitive and 100% specific in detecting the perfusion abnormalities. C-arm CT rPBV demonstrated good agreement and strong correlation with both MR-rCBV and MR-rCBF measurements; the agreement and correlation were stronger for MR-rCBF relative to MR-rCBV and improved for C-arm CT PBV versus the geometric mean of MR-rCBV and MR-rCBF. Analysis of weighted means showed that the C-arm CT PBV has a preferential blood flow weighting (≈ 60% blood flow and ≈ 40% blood volume weighting). C-arm CT PBV imaging is feasible in DCI following aneurysmal SAH. PBV is a composite perfusion parameter incorporating both blood flow and blood volume weightings. That PBV has preferential (≈ 60%) blood flow weighting is an important finding, which is of clinical significance when interpreting the C-arm CT PBV maps, particularly in the setting of acute brain ischemia.

Examining the Alignment of Subject Learning Outcomes and Course Curricula through Curriculum Mapping

ERIC Educational Resources Information Center

Lam, Bick-Har; Tsui, Kwok-Tung

2013-01-01

Content analysis has been used to conduct curriculum mapping to map the course objectives, course content, and the assessment tasks of 14 compulsory courses, onto the five Subject Learning Objective (SLO) factors of the Department of Curriculum and Instruction (DC&I) in a teacher education institution in Hong Kong. The results show that the…

A Teaching Model for Scaffolding 4th Grade Students' Scientific Explanation Writing

ERIC Educational Resources Information Center

Yang, Hsiu-Ting; Wang, Kuo-Hua

2014-01-01

Improving students scientific explanations is one major goal of science education. Both writing activities and concept mapping are reported as effective strategies for enhancing student learning of science. The purpose of this study was to examine the effect of a teaching model, named the DCI model, which integrates a Descriptive explanation…

75 FR 38417 - Carbaryl; Order Denying Washington Toxics Coalition Petition to Revoke Tolerances and Notice of...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-02

... uses on lawns and gardens, and indoors in kennels and on pet sleeping quarters. It was also registered...; cancellation of the following uses and application methods: all pet uses (dusts and liquids) except collars... carbaryl in pet collars, and environmental fate data. The product-specific DCI required acute toxicity and...

Speed Versus Accuracy: A Zero Sum Game

DTIC Science & Technology

2009-05-11

sacrificed to mitigate the risk to credibility. In Ongoing Crisis Communication : Planning, Managing, and Responding, Timothy W. Coombs presents speed in...Carlson and Abelson, 24. 10 Timothy W. Coombs , Crisis Management and Communication , http://www.instituteforpr.org/essential_knowledge/detail...crisi_management_and_communication s (accessed 30 April 2009). 11 Timothy W. Coombs , Ongoing Crisis Communication : Planning, Managing, and Responding, 2nd

Iowa in motion : transit system plan : implementing Iowa's state transportation plan

DOT National Transportation Integrated Search

1999-09-14

The Iowa Transit System Plan was developed as a result of the on-going long-range transportation planning process known as Iowa In Motion This planning document, the 1999 Iowa Transit System Plan, is the result of this continuing planning process and...

Enhancing the European Union’s Development Strategy in Afghanistan

DTIC Science & Technology

2010-06-01

REE Rare Earth Element SCA Swedish Committee for Afghanistan SIDA Swedish International Development Cooperation Agency SIGAR Special Inspector...member states such as Ireland’s Development Cooperation Ireland (DCI), Sweden’s Swedish International Development Cooperation Agency ( SIDA ), and the...Command and General Staff College, June 2008.) 71. 142 Swedish International Development Cooperation Agency, “Afghanistan Sida Country Report 2005

Traditional plants used for the treatment of diabetes mellitus in Sursagar constituency, Jodhpur, Rajasthan - An ethnomedicinal survey.

PubMed

Goyal, Manoj

2015-11-04

In Jodhpur, large number of people suffering with non-insulin dependent diabetes mellitus (type 2 diabetes). They are using medicinal plants along with modern medicine for the management of diabetes. The aim of this work is to document the anti-diabetic plants and determine the most relevant anti-diabetic plant species using the Disease Consensus Index. Ethnomedicinal survey was conducted for selection of anti-diabetic plant. Structured questionnaire was developed for calculation of Disease Consensus Index and administered to fifty Type 2 diabetic patients for recording their response. Twenty-one species of anti-diabetic plants were recorded, Momordica charantia (score: 0.71), Azadirachta indica (score: 0.64), Trigonella foenum-graecum (score: 0.63), Capparis decidua (score: 0.60), Withania coagulans (score: 0.54), Gymnema sylvestre (score: 0.52) and Syzygium cumini (score: 0.51) were the most significant anti-diabetic plants of the area of study, having DCI more than 0.5. Use of anti-diabetic plants is prevalent diabetic patients of the area. C. decidua, W. coagulans and G. sylvestre are recommend the further phytochemical and pharmacological investigation due to high DCI score and relatively unexplored status. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

DCASR (Defense Contract Administration Services Region) New York, Total Quality Management Plan

DTIC Science & Technology

1989-07-01

service quality measures on-going Commanders Directors 2. Investigate significant changes on-going Commanders in trends in terms of quality Directors 3...customer satisfaction on-going Commanders indicators and significance of the trends in Directors terms of improvements in product and service quality , and

Cryotank Skin/Stringer Bondline Analysis

NASA Technical Reports Server (NTRS)

Nguyen, Bao

1999-01-01

The need for light weight structure for advanced launch systems have presented great challenges and led to the usage of composites materials in a variety of structural assemblies where joining of two or more components is imperative. Although joints can be mechanically bolted, adhesive bonding has always been a very desirable method for joining the composite components, particularly for the cryotank systems, to achieve maximum structural efficiency. This paper presents the analytical approach resulted from the conceptual development of the DC-Y composite cryotank, conducted under the NASA/Boeing NRA 8-12 Partnership, to support the continued progress of SSTO (Single-Stage-To-Orbit) concepts. One of the critical areas of design was identified as the bonded interface between the skin (tank wall) and stringer. The approach to analyze this critical area will be illustrated through the steps which were used to evaluate the structural integrity of the bondline. Detailed finite element models were developed and numerous coupon test data were also gathered as part of the approach. Future plan is to incorporate this approach as a building block in analyzing bondline for the cryotank systems of RLVs (Reusable Launch Vehicles).

Tech notes: Ongoing or planned hydro research, results of recent studies, and reviews of new books, publications, and software

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

NONE

Ongoing or planned hydro research, results of recent studies, and reviews of new books, publications, and software are covered. This month`s Tech Notes include: (1) a study linking development and reservoir silting in El Salvador, (2) publication of a guide for small hydro operatos, and (3) publication of a text outlining the development of hydroelectric power in Russia.

Statewide ITS development and deployment plan

DOT National Transportation Integrated Search

2002-10-01

This plan was developed to create a means to implement the ongoing, short-term and long-term activities identified in the Statewide ITS Action Plan. As part of the process for organizing the approximately seventy-five Action Plan activities, these we...

Field validation of Tasmania's aquaculture industry bounce-diving schedules using Doppler analysis of decompression stress.

PubMed

Smart, David R; Van den Broek, Cory; Nishi, Ron; Cooper, P David; Eastman, David

2014-09-01

Tasmania's aquaculture industry produces over 40,000 tonnes of fish annually, valued at over AUD500M. Aquaculture divers perform repetitive, short-duration bounce dives in fish pens to depths up to 21 metres' sea water (msw). Past high levels of decompression illness (DCI) may have resulted from these 'yo-yo' dives. This study aimed to assess working divers, using Doppler ultrasonic bubble detection, to determine if yo-yo diving was a risk factor for DCI, determine dive profiles with acceptable risk and investigate productivity improvement. Field data were collected from working divers during bounce diving at marine farms near Hobart, Australia. Ascent rates were less than 18 m·min⁻¹, with routine safety stops (3 min at 3 msw) during the final ascent. The Kisman-Masurel method was used to grade bubbling post dive as a means of assessing decompression stress. In accordance with Defence Research and Development Canada Toronto practice, dives were rejected as excessive risk if more than 50% of scores were over Grade 2. From 2002 to 2008, Doppler data were collected from 150 bounce-dive series (55 divers, 1,110 bounces). Three series of bounce profiles, characterized by in-water times, were validated: 13-15 msw, 10 bounces inside 75 min; 16-18 msw, six bounces inside 50 min; and 19-21 msw, four bounces inside 35 min. All had median bubble grades of 0. Further evaluation validated two successive series of bounces. Bubble grades were consistent with low-stress dive profiles. Bubble grades did not correlate with the number of bounces, but did correlate with ascent rate and in-water time. These data suggest bounce diving was not a major factor causing DCI in Tasmanian aquaculture divers. Analysis of field data has improved industry productivity by increasing the permissible number of bounces, compared to earlier empirically-derived tables, without compromising safety. The recommended Tasmanian Bounce Diving Tables provide guidance for bounce diving to a depth of 21 msw, and two successive bounce dive series in a day's diving.

Traditional management of diabetes in Pakistan: Ethnobotanical investigation from Traditional Health Practitioners.

PubMed

Yaseen, Ghulam; Ahmad, Mushtaq; Zafar, Muhammad; Sultana, Shazia; Kayani, Sadaf; Cetto, Adolfo Andrade; Shaheen, Shabnum

2015-11-04

The uses of anti-diabetic plants are well anchored in the traditional health care system of Pakistan. To the best of our knowledge, this is the first ethno-botanical study about the uses of plants for the treatment of diabetes. The aim of the study is to record indigenous knowledge on anti-diabetic plants from Traditional Health Practitioners (THPs) and diabetic patients. In addition, it is aimed to ascertain and validate the traditional uses of anti-diabetic plants by citing pharmacological activities and phytochemical constitutes from previously published literature. The ethno-medicinal data was documented during 14 field surveys, each comprising of 10 days, from 3 regions of Pakistan (Islamabad, Khyber Pukhtoonkhwa and Deserts of Sindh). In total, 113 THPs and 44 diabetic patients were interviewed using open-ended and semi-structured questionnaires. Quantitative indices, including Relative Frequency of Citation percentage (RFC %) and Disease Consensus Index (DCI) were calculated. The documented data is authenticated by comparing with 28 published articles on ethno-botanical aspects and many pharmacological studies. In total, 120 plant species belonging to 50 families were reported. The ethno-botanical results indicated that Moraceae (11 species); herb (56 reports) is dominant life form; the leaves (56 reports) are the most used plant part and decoction (24%) is the preferred mode of preparation. The quantitative analysis shows that RFC% ranges from 14 to 42 and DCI varies from 0.15 to 0.74. By comparing to previous studies, 64 species are reported new in traditional treatment of DM; 40 species are new to pharmacological evidence and 3 species are new to phytochemical studies. This study recoded the significant indigenous knowledge about anti-diabetic plants among the THPs and diabetic patients in Pakistan. This type of ethno-botanical knowledge on traditional use of anti-diabetic plants is an important step in designing detailed pharmacological and clinical trials for Diabetes Miletus treatment. It is recommended that further pharmacological and phytochemical analysis should be conducted on those species which lack previous references in literature and have highest Frequency of Citation (FC), Disease Consensus Index (DCI) and Relative Frequency of Citation percentage (RFC%). Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Cerebral Taurine Levels are Associated with Brain Edema and Delayed Cerebral Infarction in Patients with Aneurysmal Subarachnoid Hemorrhage.

PubMed

Kofler, Mario; Schiefecker, Alois; Ferger, Boris; Beer, Ronny; Sohm, Florian; Broessner, Gregor; Hackl, Werner; Rhomberg, Paul; Lackner, Peter; Pfausler, Bettina; Thomé, Claudius; Schmutzhard, Erich; Helbok, Raimund

2015-12-01

Cerebral edema and delayed cerebral infarction (DCI) are common complications after aneurysmal subarachnoid hemorrhage (aSAH) and associated with poor functional outcome. Experimental data suggest that the amino acid taurine is released into the brain extracellular space secondary to cytotoxic edema and brain tissue hypoxia, and therefore may serve as a biomarker for secondary brain injury after aSAH. On the other hand, neuroprotective mechanisms of taurine treatment have been described in the experimental setting. We analyzed cerebral taurine levels using high-performance liquid chromatography in the brain extracellular fluid of 25 consecutive aSAH patients with multimodal neuromonitoring including cerebral microdialysis (CMD). Patient characteristics and clinical course were prospectively recorded. Associations with CMD-taurine levels were analyzed using generalized estimating equations with an autoregressive process to handle repeated observations within subjects. CMD-taurine levels were highest in the first days after aSAH (11.2 ± 3.2 µM/l) and significantly decreased over time (p < 0.001). Patients with brain edema on admission or during hospitalization (N = 20; 80 %) and patients developing DCI (N = 5; 20 %) had higher brain extracellular taurine levels compared to those without (Wald = 7.3, df = 1, p < 0.01; Wald = 10.1, df = 1, p = 0.001, respectively) even after adjusting for disease severity and CMD-probe location. There was no correlation between parenteral taurine supplementation and brain extracellular taurine (p = 0.6). Moreover, a significant correlation with brain extracellular glutamate (r = 0.82, p < 0.001), lactate (r = 0.56, p < 0.02), pyruvate (r = 0.39, p < 0.01), potassium (r = 0.37, p = 0.01), and lactate-to-pyruvate ratio (r = 0.24, p = 0.02) was found. Significantly higher CMD-taurine levels were found in patients with brain edema or DCI after aneurysmal subarachnoid hemorrhage. Its value as a potential biomarker deserves further investigation.

Career Planning: Developing the Nation's Primary Resource.

ERIC Educational Resources Information Center

Jarvis, Phillip S.

1995-01-01

Argues for intensive and ongoing career planning assistance for all age groups to ensure the development of people resources to meet Canada's economic needs. Points out the economic consequences of inadequate planning. (LKS)

Columbia River Basin Fish and Wildlife Program Work Plan for Fiscal Year 1989.

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

United States. Bonneville Power Administration. Division of Fish and Wildlife.

1988-11-01

The FY 1989 Columbia River Basin Fish and Wildlife Program Work Plan (Work Plan) presents Bonneville Power Administration's plans for implementing the Columbia River Basin Fish and Wildlife Program (Program) in FY 1989. The Work Plan focuses on individual Action Items found in the 1987 Program for which Bonneville Power Administration (BPA) has determined that it has authority and responsibility to implement. Each of the entries in the Work Plan includes objectives, background, and progress to date in achieving those objectives, and a summary of plans for implementation in FY 1989. Most Action Items are implemented through one or moremore » BPA-funded projects. Each Action Item entry is followed by a list of completed, ongoing, and planned projects, along with objectives, results, schedules, and milestones for each project. The FY 1989 Work Plan emphasizes continuation of 113 projects, most of which involve protection, mitigation, or enhancement of anadromous fishery resources. BPA also plans to start 20 new projects in FY 1989. The number of ongoing FY 1988 projects to be continued in FY 1989 and the number of new projects planned to start in FY 1989 are based on current (September 7, 1988) procurement expectations. Several projects presently in BPA's procurement process are expected to be contracted by September 30, 1988, the last day of FY 1988. Although these projects have not yet started, they have been listed in the Work Plan as ongoing FY 1988 projects, based on projected start dates in late September 1988. Throughout the Work Plan, those projects with projected start dates in September 1988 have been noted.« less

Tech notes: Ongoing or planned hydro research, results of recent studies, and reviews of new books, publications, and software

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

NONE

Ongoing or planned hydro research, results of recent studies, and reviews of new books, publications, and software. Items covered this month include: (1) a recommendation that dam designers give more consideration to earthquake resistance, (2) the development of a new wave rotor design, (3) the development of a small hydro database in China, and (4) an ICOLD bulletin on the optimization of constuction costs.

20 CFR 663.245 - What is the individual employment plan?

Code of Federal Regulations, 2010 CFR

2010-04-01

... ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Intensive Services § 663.245 What is the individual employment plan? The individual employment plan is an ongoing strategy...

Director of National Intelligence: Another Bureaucratic Layer or an Effective Office?

DTIC Science & Technology

2006-12-15

created the Director of Central Intelligence (DCI). After the dissolution of COI, its various intelligence functions were divided between the State...demands of these two full time jobs on the time and attention of any person, no matter how skilled in management, are overwhelming . . . Even if one...The literature review is divided by the intelligence subjects of analysis, policy, and reform.. 1Michael Lee Lanning, Senseless Secrets: The

AGOR 28

DTIC Science & Technology

2015-04-23

to work on initial outfitting lists for Sally Ride. ii. Working on NS5 Hierarchy 4. Operator Concerns: • Tuff-Mass MLV and Acoustic Tiles...The yard is continuing to install the Quad-zero MLV in various locations throughout Sally Ride. DCI is holding off on installing any new insulation ...in location with no sound dampening tiles. This includes the Main Engine Space overhead and aft bulkhead as well as the MCS. The Quad-Zeros is not

AGOR 28

DTIC Science & Technology

2014-11-06

Foc’sle Deck. Associated wiring, hvac and plumbing also going in. Minimal joiner work on other decks and pilot house. 6. Call-outs...TEST PROCEDURES ( MCCS Design Verification Test Procedure)(R/ASR) 173/0 AGOR27 A002 STD Report - DESIGN REVIEW AGENDAS AND MINUTES ( DR #17 DCI... HVAC Book 1 of 3)(DARC REV) 340/1 AGOR27 A055 TM Report - COMMERCIAL TECHNICAL MANUALS AND SUPPLEMENTAL DATA ( 512 Wilhelmsen HVAC Book 2 of 3

Possible Role of Inflammation and Galectin-3 in Brain Injury after Subarachnoid Hemorrhage

PubMed Central

2018-01-01

Aneurysmal subarachnoid hemorrhage (SAH) is known as one of the most devastating diseases in the central nervous system. In the past few decades, research on SAH has focused on cerebral vasospasm to prevent post-SAH delayed cerebral ischemia (DCI) and to improve outcomes. However, increasing evidence has suggested that early brain injury (EBI) is an important mechanism contributing to DCI, cerebral vasospasm as well as poor outcomes. Though the mechanism of EBI is very complex, inflammation is thought to play a pivotal role in EBI. Galectin-3 is a unique chimera type in the galectin family characterized by its β-galactoside-binding lectin, which mediates various pathologies, such as fibrosis, cell adhesion, and inflammation. Recently, two clinical studies revealed galectin-3 to be a possible prognostic biomarker in SAH patients. In addition, our recent report suggested that higher acute-stage plasma galectin-3 levels correlated with subsequent development of delayed cerebral infarction that was not associated with vasospasm in SAH patients. We review the possible role and molecular mechanisms of inflammation as well as galectin-3 in brain injuries, especially focusing on EBI after SAH, and discuss galectin-3 as a potential new therapeutic or research target in post-SAH brain injuries. PMID:29414883

Intracranial Biodegradable Silica-Based Nimodipine Drug Release Implant for Treating Vasospasm in Subarachnoid Hemorrhage in an Experimental Healthy Pig and Dog Model

PubMed Central

Koskimäki, Janne; Tarkia, Miikka; Ahtola-Sätilä, Tuula; Saloranta, Lasse; Laakso, Aki; Frantzén, Janek

2015-01-01

Nimodipine is a widely used medication for treating delayed cerebral ischemia (DCI) after subarachnoid hemorrhage. When administrated orally or intravenously, systemic hypotension is an undesirable side effect. Intracranial subarachnoid delivery of nimodipine during aneurysm clipping may be more efficient way of preventing vasospasm and DCI due to higher concentration of nimodipine in cerebrospinal fluid (CSF). The risk of systemic hypotension may also be decreased with intracranial delivery. We used animal models to evaluate the feasibility of surgically implanting a silica-based nimodipine releasing implant into the subarachnoid space through a frontotemporal craniotomy. Concentrations of released nimodipine were measured from plasma samples and CSF samples. Implant degradation was followed using CT imaging. After completing the recovery period, full histological examination was performed on the brain and meninges. The in vitro characteristics of the implant were determined. Our results show that the biodegradable silica-based implant can be used for an intracranial drug delivery system and no major histopathological foreign body reactions were observed. CT imaging is a feasible method for determining the degradation of silica implants in vivo. The sustained release profiles of nimodipine in CSF were achieved. Compared to a traditional treatment, higher nimodipine CSF/plasma ratios can be obtained with the implant. PMID:25685803

Columbia River Basin Fish and Wildlife Program Annual Implementation Work Plan for Fiscal Year 1993.

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

United States. Bonneville Power Administration; Northwest Power Planning Council; Columbia Basin Fish and Wildlife Authority

1992-09-01

The Columbia River Basin Fish and Wildlife Program (Program) was developed by the Northwest Power Planning Council (Council) in accordance with Public Law 96-501, the Pacific Northwest Electric Power Planning and Conservation Act (Act). The purpose of the Program is to guide the Bonneville Power Administration (BPA) and other Federal agencies in carrying out their responsibilities to protect, mitigate, and enhance fish and wildlife of the Columbia River Basin. The Annual Implementation World Plan (AIWP) presents BPA`s plans for implementing the Program during fiscal year (FY) 1993. The FY 1993 AIWP emphasizes continuation of 143 ongoing or projecting ongoing Programmore » projects, tasks, or task orders, most of which involve protection, mitigation, or enhancement of anadromous fishery resources. The FY 1993 AIWP also contains three new Program projects or tasks that are planned to start in FY 1993.« less

Asthma Quiz

MedlinePlus

... Asthma is a chronic disease that requires ongoing management. Personalized plans for treatment may include medications, an asthma action plan, and environmental control measures to avoid your child's asthma triggers. ...

Integration of Palliative Care Principles into the Ongoing Care of Children with Cancer: Individualized Care Planning and Coordination

PubMed Central

Baker, Justin N; Hinds, Pamela S; Spunt, Sheri L; Barfield, Raymond C; Allen, Caitlin; Powell, Brent C; Anderson, Lisa H; Kane, Javier R

2008-01-01

Synopsis The Individualized Care Planning and Coordination Model is designed to integrate palliative care principles and practices into the ongoing care of children with cancer. Application of the model helps clinicians to generate a comprehensive individualized care plan that is implemented through Individualized Care Coordination processes as detailed here. Clinicians’ strong desire to provide compassionate, competent and sensitive care to the seriously ill child and the child’s family can be effectively translated into clinical practice through these processes. “To cure sometimes, to relieve often, to comfort always -- this is our work.” Author Unknown PMID:18242323

Downscaling seasonal to centennial simulations on distributed computing infrastructures using WRF model. The WRF4G project

NASA Astrophysics Data System (ADS)

Cofino, A. S.; Fernández Quiruelas, V.; Blanco Real, J. C.; García Díez, M.; Fernández, J.

2013-12-01

Nowadays Grid Computing is powerful computational tool which is ready to be used for scientific community in different areas (such as biomedicine, astrophysics, climate, etc.). However, the use of this distributed computing infrastructures (DCI) is not yet common practice in climate research, and only a few teams and applications in this area take advantage of this infrastructure. Thus, the WRF4G project objective is to popularize the use of this technology in the atmospheric sciences area. In order to achieve this objective, one of the most used applications has been taken (WRF; a limited- area model, successor of the MM5 model), that has a user community formed by more than 8000 researchers worldwide. This community develop its research activity on different areas and could benefit from the advantages of Grid resources (case study simulations, regional hind-cast/forecast, sensitivity studies, etc.). The WRF model is used by many groups, in the climate research community, to carry on downscaling simulations. Therefore this community will also benefit. However, Grid infrastructures have some drawbacks for the execution of applications that make an intensive use of CPU and memory for a long period of time. This makes necessary to develop a specific framework (middleware). This middleware encapsulates the application and provides appropriate services for the monitoring and management of the simulations and the data. Thus,another objective of theWRF4G project consists on the development of a generic adaptation of WRF to DCIs. It should simplify the access to the DCIs for the researchers, and also to free them from the technical and computational aspects of the use of theses DCI. Finally, in order to demonstrate the ability of WRF4G solving actual scientific challenges with interest and relevance on the climate science (implying a high computational cost) we will shown results from different kind of downscaling experiments, like ERA-Interim re-analysis, CMIP5 models, or seasonal. WRF4G is been used to run WRF simulations which are contributing to the CORDEX initiative and others projects like SPECS and EUPORIAS. This work is been partially funded by the European Regional Development Fund (ERDF) and the Spanish National R&D Plan 2008-2011 (CGL2011-28864)

Fluor Hanford (FH) River Corridor Transition Plan

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

MCBRIDE, D.J.

2002-08-28

This Transition Plan defines the scope and schedule for actions that are critical for a smooth transition of the River Corridor scope of work and to ensure the achievement of transition as planned, with minimal or no impact to ongoing baseline activities.

AGOR 28: SIO Shipyard Representative Bi-Weekly Progress Report

DTIC Science & Technology

2015-08-10

government and SIO were started. Marine Outfitting has started working on a schedule. • Acoustic Tiles & MLV – Yard continues to apply Delta DT...direct the sound away from the main deck working area. NCE will be here to recheck the level during the underway portion of the PSTP next week on...ABS Correspondence - Self-Extinguishing Insulation )(R/ASR) 116/2 AGOR27 A024 STD Report - REGULATORY BODY CORRESPONDENCE ( DCI/USCG - ACCU, QFA

Clinical Investigation Program. Annual Progress Report. Volume 1

DTIC Science & Technology

1994-01-20

Suport Labs Resch Chemist 13 0644 GS Salata, KF Allergy Microbiologist 12 0403 CS Billups, L Flow Cytom Microbiologist 12 0403 GS Dobek, AS Inf Disease 5...continued to increase laboratory research support to principal investigators throughout the medical center. The DCI Flow Cytometry Laboratory provided...Kalman PhD. Mitogen-Inducible T Suppressor Cell 12 Assay by Flow Cytometry (12/89) * Reference is to page number(s) in Volume II. 30 PROTOCOL NUMBER

AGOR 28: SIO Shipyard Representative Bi-Weekly Progress Report

DTIC Science & Technology

2015-01-29

Crane FAT at Sherwood, OR iii. Design Review at Anacortes 2. The following Shipyard Question Submittals were reviewed and commented on: No...two 100-kw chill water heaters for HVAC winter operation. New for this reporting period – DCI is installing the hardware (cables and shut trips) to...the two 100-kw HVAC heaters and the galley equipment breakers. • Main Crane Towing & Coring Crutch – The crutch assembly being provided by Allied

A New U.S. Carbon Cycle Science Plan

NASA Astrophysics Data System (ADS)

Michalak, A. M.; Jackson, R.; Marland, G.; Sabine, C.

2009-05-01

The report "A U.S. carbon cycle science plan" (J. L. Sarmiento and S. C. Wofsy, U.S. Global Change Res. Program, Washington, D. C., 1999) outlined research priorities and promoted coordinated carbon cycle research across federal agencies in the United States for nearly a decade. Building on this framework and subsequent reports (http://www.carboncyclescience.gov/docs.php), a working group comprised of 27 scientists was formed in 2008 under the United States Carbon Cycle Science Program to review the 1999 Science Plan, and to develop an updated strategy for carbon cycle research for the period from 2010 to 2020. This comprehensive review is being conducted with wide input from the research and stakeholder communities. The recommendations of the Carbon Cycle Science Working Group (CCSWG) will go to U.S. agency managers who have collective responsibility for setting national carbon cycle science priorities and for sponsoring much of the carbon cycle research in the United States. This presentation will provide an update on the ongoing planning process, will outline the steps that the CCSWG is undertaking in building consensus towards an updated U.S. Carbon Cycle Science Plan, and will seek input on the best ways in which to coordinate efforts with ongoing and upcoming research in Canada and Mexico, as well as with ongoing work globally.

Using Baltimore HIV behavioral surveillance data for local HIV prevention planning.

PubMed

German, Danielle; Linton, Sabriya; Cassidy-Stewart, Hope; Flynn, Colin

2014-04-01

In response to the National HIV/AIDS Strategy (NHAS) and as part of CDC's Enhanced Comprehensive HIV Prevention Plan (ECHPP) project, Maryland developed a comprehensive local HIV prevention plan for the Baltimore-Towson Metropolitan Statistical Area and identified a series of priority HIV prevention and service goals. The current project sought to: (1) determine how well National HIV Behavioral Surveillance (NHBS) indicators were aligned with NHAS/ECHPP-informed local HIV prevention goals (2) facilitate on-going NHBS data utilization to inform on-going local HIV prevention and service planning, and (3) build a foundation for future NHBS data utilization in local HIV decision-making. Project activities identified key HIV-related indicators in NHBS that are directly or indirectly related to local HIV priorities as informed by NHAS/ECHPP, which can be used for HIV prevention planning in the Baltimore area. Areas for enhancing NHBS and local data collection to further inform HIV prevention priorities are highlighted.

Comparison of Thermal Performance Characteristics of Ammonia and Propylene Loop Heat Pipes

NASA Technical Reports Server (NTRS)

Kaya, Tarik; Baker, Charles; Ku, Jentung

2000-01-01

In this paper, experimental work performed on a breadboard Loop Heat Pipe (LHP) is presented. The test article was built by DCI for the Geoscience Laser Altimeter System (GLAS) instrument on the ICESat spacecraft. The thermal system requirements of GLAS have shown that ammonia cannot be used as the working fluid in this LHP because GLAS radiators could cool to well below the freezing point of ammonia. As a result, propylene was proposed as an alternative LHP working fluid since it has a lower freezing point than ammonia. Both working fluids were tested in the same LHP following a similar test plan in ambient conditions. The thermal performance characteristics of ammonia and propylene LHP's were then compared. In general, the propylene LHP required slightly less startup superheat 5nd less control heater power than the ammonia LHP, The thermal conductance values for the propylene LHP were also lower than the ammonia LHP. Later, the propylene LHP was tested in a thermal vacuum chamber. These tests demonstrated that propylene could meet the GLAS thermal design requirements. Design guidelines were proposed for the next flight-like Development Model (DM) LHP for thermal control of the GLAS instrument.

7 CFR 25.404 - Validation of designation.

Code of Federal Regulations, 2010 CFR

2010-01-01

... maintain a process for ensuring ongoing broad-based participation by community residents consistent with the approved application and planning process outlined in the strategic plan. (1) Continuous... benchmarks, the process it will use for reviewing goals and benchmarks and revising its strategic plan. (2...

Annual Progress Report FY-92. Volume 1

DTIC Science & Technology

1993-01-21

Billups, L Flow Cytom Resh Psychologist 12 0180 CS Hamm, C DCI 7 DESCRIPTION GRADE MOS BRANCH NAME ACTIVITY Kyle Metabolic Unit Nursing Service Supv...3349 Salata, Kalman PhD. Mitogen-Inducible T Suppressor Cell 13 Assay by Flow Cytometry (12/89) 3350 Salata, Kalman PhD. Flow Cytometric Analysis of...17 Immunotherapy (3/90) 3354 Salata, Kalman PhD. Two Way Mixed Lymphocyte Culture: 18 Analysis by Two Color Flow Cytometry (4/90) 3355 Salata, Kalman

China and Proliferation of Weapons of Mass Destruction and Missiles: Policy Issues

DTIC Science & Technology

2006-12-11

Ghauri (Hatf-5) medium-range ballistic missile (MRBM), which is based on the North Korean No Dong missile. U.S. intelligence was said to suspect that...confirming these stories, the DCI reported in August 2000 that, besides North Korean help, PRC entities provided “increased assistance” to Pakistan’s...ranges, respectively, of about 800 mi. and 1,250 mi.). Over 100 PRC and North Korean experts worked there, reported the Washington Times (November 23

Morphology and Distribution of the Acanthoecidae (Choanoflagellata) from the Weddell Sea during the Austral Summer, 1977,

DTIC Science & Technology

1980-07-01

jun our onivof he ( inhou, iavall ddrsse tonalof(e( i’(e. vol 17,1p 14121lliin~ ict lii’Ac itlci ’ dci’, ,ll ~ddmcssed iiiihhird, 1) 1 (1976) the U...Ili(] postir t.t piI4 wit, ’itim 25-35 gym . Number of longitudinal (ostae 12, pill Habitat. the sea In tile. 1( 11111 i. lit-.1t each composed of 9 or

The Dominance Concept Inventory: A Tool for Assessing Undergraduate Student Alternative Conceptions about Dominance in Mendelian and Population Genetics

PubMed Central

Perez, Kathryn E.; Price, Rebecca M.

2014-01-01

Despite the impact of genetics on daily life, biology undergraduates understand some key genetics concepts poorly. One concept requiring attention is dominance, which many students understand as a fixed property of an allele or trait and regularly conflate with frequency in a population or selective advantage. We present the Dominance Concept Inventory (DCI), an instrument to gather data on selected alternative conceptions about dominance. During development of the 16-item test, we used expert surveys (n = 12), student interviews (n = 42), and field tests (n = 1763) from introductory and advanced biology undergraduates at public and private, majority- and minority-serving, 2- and 4-yr institutions in the United States. In the final field test across all subject populations (n = 709), item difficulty ranged from 0.08 to 0.84 (0.51 ± 0.049 SEM), while item discrimination ranged from 0.11 to 0.82 (0.50 ± 0.048 SEM). Internal reliability (Cronbach's alpha) was 0.77, while test–retest reliability values were 0.74 (product moment correlation) and 0.77 (intraclass correlation). The prevalence of alternative conceptions in the field tests shows that introductory and advanced students retain confusion about dominance after instruction. All measures support the DCI as a useful instrument for measuring undergraduate biology student understanding and alternative conceptions about dominance. PMID:26086665

A combined time-of-flight and depth-of-interaction detector for total-body positron emission tomography.

PubMed

Berg, Eric; Roncali, Emilie; Kapusta, Maciej; Du, Junwei; Cherry, Simon R

2016-02-01

In support of a project to build a total-body PET scanner with an axial field-of-view of 2 m, the authors are developing simple, cost-effective block detectors with combined time-of-flight (TOF) and depth-of-interaction (DOI) capabilities. This work focuses on investigating the potential of phosphor-coated crystals with conventional PMT-based block detector readout to provide DOI information while preserving timing resolution. The authors explored a variety of phosphor-coating configurations with single crystals and crystal arrays. Several pulse shape discrimination techniques were investigated, including decay time, delayed charge integration (DCI), and average signal shapes. Pulse shape discrimination based on DCI provided the lowest DOI positioning error: 2 mm DOI positioning error was obtained with single phosphor-coated crystals while 3-3.5 mm DOI error was measured with the block detector module. Minimal timing resolution degradation was observed with single phosphor-coated crystals compared to uncoated crystals, and a timing resolution of 442 ps was obtained with phosphor-coated crystals in the block detector compared to 404 ps without phosphor coating. Flood maps showed a slight degradation in crystal resolvability with phosphor-coated crystals; however, all crystals could be resolved. Energy resolution was degraded by 3%-7% with phosphor-coated crystals compared to uncoated crystals. These results demonstrate the feasibility of obtaining TOF-DOI capabilities with simple block detector readout using phosphor-coated crystals.

Microenvironmental Regulation of Chemokine (C-X-C-motif) Receptor 4 in Ovarian Carcinoma

PubMed Central

Barbolina, Maria V.; Kim, Mijung; Liu, Yueying; Shepard, Jaclyn; Belmadani, Abdelhak; Miller, Richard J.; Shea, Lonnie D.; Stack, M. Sharon

2010-01-01

The majority of women diagnosed with epithelial ovarian carcinoma (EOC) succumb due to complications of metastatic disease, suggesting that anti-metastatic therapies may improve patient survival. EOC metastasis involves intra-peritoneal shedding of cells from the primary tumor, followed by adhesion and localized penetration of the submesothelial matrix to anchor metastatic implants. Accumulation of malignant ascites is also common. Thus, a unique microenvironmental niche is established, which includes malignant cells and a plethora of soluble factors secreted by – or in response to – tumor cells. As cells penetrating the sub-mesothelial surface encounter an interstitial collagen-rich ECM, we have used 3-dimensional type I collagen (3DCI) gels to model early events resulting from intra-peritoneal anchoring. In this study we demonstrate a novel pathway of CXCR4 upregulation through β1-integrin- and NFκB- dependent signaling pathways in response to 3DCI. We also demonstrate the involvement of CXCR4-SDF1 axis in collagen invasion and proliferation, relevant to the metastatic EOC. Our data show that CXCR4 expression in human EOCs, as well as SDF1 presence in the ascites, is correlated with disease progression and metastasis. These data emphasize the importance of CXCR4 – SDF1 axis in EOC metastasis and suggest that this mechanism should be accounted for when targeting EOC metastasis. PMID:20460402

7 CFR 25.403. - Ongoing 2-year work plan requirement.

Code of Federal Regulations, 2010 CFR

2010-01-01

... the start of the applicable 2-year period. (c) The 2-year work plan must include the following... Federal, State and local governments, non-profit organizations, foundations, private businesses, and any...

Superfund Program Review

EPA Pesticide Factsheets

This document presents outcomes of implementing a number of the actions described in the November 2013 Superfund Remedial Program Review (SPR) Action Plan . It also describes ongoing Action Plan efforts and projects future outcomes anticipated in FY 2015

Long-Range Strategic Planning: The Rochester Experience.

ERIC Educational Resources Information Center

Schultz, John M.; Anthony, Deborah L.

The administration of Rochester Community Schools (Michigan) initiated a process for long-range strategic planning in 1984, described in this synopsis. Strategic planning is an ongoing, evolutionary process of defining the business one is in or should be in; establishing organizational goals and objectives; and developing and implementing…

Leadership Succession Planning in Catholic Education: An Ongoing Plan for Leadership Development, Identification, and Selection

ERIC Educational Resources Information Center

Fitzgerald, Mary; Sabatino, Anthony

2014-01-01

The fundamental elements of successful leadership succession in any organization are recognizing the inevitability of leadership change and the necessity of a plan for leadership succession. This book provides a rationale and planning guideline for board chairs, superintendents, and superiors of religious communities to use when the need arises to…

How rolling forecasting facilitates dynamic, agile planning.

PubMed

Miller, Debra; Allen, Michael; Schnittger, Stephanie; Hackman, Theresa

2013-11-01

Rolling forecasting may be used to replace or supplement the annual budget process. The rolling forecast typically builds on the organization's strategic financial plan, focusing on the first three years of plan projections and comparing the strategic financial plan assumptions with the organization's expected trajectory. Leaders can then identify and respond to gaps between the rolling forecast and the strategic financial plan on an ongoing basis.

76 FR 57744 - Agency Information Collection Activities: Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-16

... of forms necessary to conduct ongoing business with State partners in the implementation of Medicaid... reporting templates. The development of streamlined submission forms is critical for States to implement... requests for State plan amendments, waivers, and demonstration, as well as ongoing reporting.; Form Number...

Stormtime Magnetosphere-Ionosphere-Thermosphere Interactions and Dynamics

DTIC Science & Technology

2013-03-13

1 2. BACKGROUND ... BACKGROUND The studies described in this report were performed in support of ongoing and planned space weather programs in the areas of Space Situational...Ionosphere The purpose of this effort was to initiate on-going analysis of COSMIC -GPS measurements of total electron content (TEC) in the dayside

Annual Plan for the EPA - FY 2011

EPA Pesticide Factsheets

This plan identifies mandated and selected assignment topics continuing from FY 2010 and scheduled to be started during FY 2011, providing for unforeseen work requested by Agency leadership and Congress, and through ongoing OIG Hotline activities.

Mixed-Initiative Planning in MAPGEN: Capabilities and Shortcomings

NASA Technical Reports Server (NTRS)

Bresina, John L.; Jonsson, Ari K.; Morris, Paul H.; Rajan, Kanna

2005-01-01

MAPGEN (Mixed-initiative Activity Plan GENerator) is a mixed-initiative system that employs automated constraint-based planning, scheduling, and temporal reasoning to assist the Mars Exploration Rover mission operations staff in generating the daily activity plans. This paper describes the mixed-initiative capabilities of MAPGEN, identifies shortcomings with the deployed system, and discusses ongoing work to address some of these shortcomings.

College of DuPage Planning Process: College of DuPage Planning, the Foundation for Decision Making.

ERIC Educational Resources Information Center

College of DuPage, Glen Ellyn, IL. Office of Research and Planning.

At College of DuPage (CD), in Glen Ellyn, Illinois, institutional planning is a multi-level, on-going process involving continuous college-wide input. The nine schematic levels in the CD planning process are interconnected and progress from global and broad-based issues, answering such questions as why the college exists, to concrete levels…

NASA personnel in a control room during the successful second flight of the X-43A aircraft

NASA Image and Video Library

2004-03-27

NASA personnel in a control room during the successful second flight of the X-43A aircraft. front row, left to right: Randy Voland, LaRC Propulsion; Craig Christy, Boeing Systems; Dave Reubush, NASA Hyper-X Deputy Program Manager; and Vince Rausch, NASA Hyper-X Program Manager. back row, left to right: Bill Talley, DCI/consultant; Pat Stoliker, DFRC Director (Acting) of Research Engineering; John Martin, LaRC G&C; and Dave Bose, AMA/Controls.

Medical Research: A Bibliography of Walter Reed Army Medical Center Staff Publications, 1986-1989. Volume 1

DTIC Science & Technology

1990-01-01

Wilson PD Jr: Fracture of the femoral component. Analysis of failure and long-term follow-up of rev-ision. Orthop Chin North Am 1988 Jul;19(3):637-47...DMED,DCI 88224857 Dysart SH, Savory CG, Callaghan JJ: Nonoperative treatment of a postoperative fracture around an uncemented porous-coated femoral...trochanter fractures of the hip without intertrochanteric extension: a case report. Milit Med 1988 Aug;153(8):421-3. DSURG 89015096 Lucente FE, Patow

Regulation of BRCA1 Function by DNA Damage-Induced Site-Specific Phosphorylation

DTIC Science & Technology

2005-06-01

Nature 382, 678-679. 8. Haile , D.T., and Parvin, J.D. (1999). Activation of transcription in vitro by the BRCAI Carboxyl-terminal domain. J. Biol. Chem...for Public Release; Distribution Unlimited The views, opinions and/or findings contained in this report are those of the author(s) and should not be...construed as an official Department of the Army position, policy or decision unless so designated by other documentation. 20051101 125 REPOR DCI P Form

AGOR 28: SIO Shipyard Representative Bi-Weekly Progress Report

DTIC Science & Technology

2015-05-08

work on initial outfitting lists for Sally Ride. ii. Working on NS5 Hierarchy 4. Operator Concerns: • Tuff-Mass MLV and Acoustic Tiles – The...yard is continuing to install the Quad-zero MLV in various locations throughout Sally Ride. DCI is holding off on installing any new insulation in...Traction Winch Rm fwd bulkhead tiles • Sally Ride Quad-Zero MLV – The yard continues to install the Quad-Zero in location with no sound dampening tiles

China and Proliferation of Weapons of Mass Destruction and Missiles: Policy Issues

DTIC Science & Technology

2007-05-09

medium-range ballistic missile (MRBM), which is based on the North Korean No Dong missile. U.S. intelligence was said to suspect that China Poly Ventures...stories, the DCI reported in August 2000 that, besides North Korean help, PRC entities provided “increased assistance” to Pakistan’s ballistic missile...development of the Shahab-3 and Shahab-4 MRBMs (with ranges, respectively, of about 800 mi. and 1,250 mi.). Over 100 PRC and North Korean experts worked there

Manual for Calculating the Seepage Strength of Earthfill Dams,

DTIC Science & Technology

1976-07-01

gravity of material of soil particles; d--diameter of soil particles; dio...d 17 ...dsr-diameters of soil particles, the smallest of which in its...compcsition may be present as 10... 17 ...60% by weight; dci--diameter of (piping) particles of soil which may be carried away by the seepage flow; -dso Y1 d...should, however, be reduced, assuming: k" onnfrmsi S(Jk)dnonuniform soil = [(Jk)d]uniform soil ( 17 ) where 7is the coefficient of reduction (less than

Operating Policies for Non- stationary Two-Echelon Inventory Systems for Reparable Items.

DTIC Science & Technology

1986-05-01

resupply policy. Even under an HCP, we might want to change the resupply policy at management igtervention times to reflect what we predict will happen...management is concerned with the worst performance predicted during the horizon. Regardless of the average performance over the horizon, management may not...locations in DCi(tm-ll tm ) and INi(tm-l tm) . Case 3 a: ASi(tm I ) > ASi(tm); INi(tm- lstm ) empty. Disposals must be made to lover the asset positions

Planning Effective Educational Programs for Adult Learners

ERIC Educational Resources Information Center

Shi, Hong

2017-01-01

Educational program planning is a complex ongoing process and planners should reflect on and consider for all of the involved factors, context, and people. The purpose of this study is to analyze how to plan effective educational programs for adult learners. Adult education is a developmental process and interacts with broad social events. Adult…

A Capital-Financing Plan for School Systems and Local Government

ERIC Educational Resources Information Center

Hodge, Penny

2012-01-01

School business officials are best equipped to lead in funding operating and capital needs because they understand the need for a methodical means of funding ongoing costs over time and the benefits of planning for future financial needs rather than letting emergencies dictate spending priorities. A capital-financing plan makes it possible to…

Integrating species distributional, conservation planning, and individual based population models: A case study in critical habitat evaluation for the Northern Spotted Owl

EPA Science Inventory

Background / Question / Methods As part of the ongoing northern spotted owl recovery planning effort, we evaluated a series of alternative potential critical habitat scenarios using a species-distribution model (MaxEnt), a conservation-planning model (Zonation), and an individua...

What's your game plan? Advice from the capital markets.

PubMed

Grube, Mark E; Wareham, Therese L

2005-11-01

Healthcare organizations are most attractive to the capital markets if they demonstrate or make use of: High-level strategic thinking and integrated strategic and financial planning. Comprehensive data on market and strategic position. A measurable, measured, and achieved strategy. Market strength and competitive differentiation. An ongoing planning process. Frequent communication and well-considered documentation.

Five Recession-Driven Strategies for Planning and Managing Campus Facilities

ERIC Educational Resources Information Center

Rudden, Michael S.

2010-01-01

Colleges and universities continue to face significant fiscal challenges in the current recession. A review of ongoing campus facilities planning projects, coupled with a review of more than 30 recent campus master planning requests for proposals and the relevant literature, indicates that colleges and universities are finding innovative ways to…

Implementation Never Ends! The Postimplementation Organizational and Operational Implications of ERP

ERIC Educational Resources Information Center

Goldstein, Philip J.

2006-01-01

Planning for the ongoing support and maintenance that accompany implementation of new enterprise resource planning systems may be more essential to realizing benefit from a technology investment than choosing the product with the most features. (Contains 1 table.)

Do large hiatal hernias affect esophageal peristalsis?

PubMed Central

Roman, Sabine; Kahrilas, Peter J; Kia, Leila; Luger, Daniel; Soper, Nathaniel; Pandolfino, John E

2013-01-01

Background & Aim Large hiatal hernias can be associated with a shortened or tortuous esophagus. We hypothesized that these anatomic changes may alter esophageal pressure topography (EPT) measurements made during high-resolution manometry (HRM). Our aim was to compare EPT measures of esophageal motility in patients with large hiatal hernias to those of patients without hernia. Methods Among 2000 consecutive clinical EPT, we identified 90 patients with large (>5 cm) hiatal hernias on endoscopy and at least 7 evaluable swallows on EPT. Within the same database a control group without hernia was selected. EPT was analyzed for lower esophageal sphincter (LES) pressure, Distal Contractile Integral (DCI), contraction amplitude, Contractile Front Velocity (CFV) and Distal Latency time (DL). Esophageal length was measured on EPT from the distal border of upper esophageal sphincter to the proximal border of the LES. EPT diagnosis was based on the Chicago Classification. Results The manometry catheter was coiled in the hernia and did not traverse the crural diaphragm in 44 patients (49%) with large hernia. Patients with large hernias had lower average LES pressures, lower DCI, slower CFV and shorter DL than patients without hernia. They also exhibited a shorter mean esophageal length. However, the distribution of peristaltic abnormalities was not different in patients with and without large hernia. Conclusions Patients with large hernias had an alteration of EPT measurements as a consequence of the associated shortened esophagus. However, the distribution of peristaltic disorders was unaffected by the presence of hernia. PMID:22508779

A combined time-of-flight and depth-of-interaction detector for total-body positron emission tomography

PubMed Central

Berg, Eric; Roncali, Emilie; Kapusta, Maciej; Du, Junwei; Cherry, Simon R.

2016-01-01

Purpose: In support of a project to build a total-body PET scanner with an axial field-of-view of 2 m, the authors are developing simple, cost-effective block detectors with combined time-of-flight (TOF) and depth-of-interaction (DOI) capabilities. Methods: This work focuses on investigating the potential of phosphor-coated crystals with conventional PMT-based block detector readout to provide DOI information while preserving timing resolution. The authors explored a variety of phosphor-coating configurations with single crystals and crystal arrays. Several pulse shape discrimination techniques were investigated, including decay time, delayed charge integration (DCI), and average signal shapes. Results: Pulse shape discrimination based on DCI provided the lowest DOI positioning error: 2 mm DOI positioning error was obtained with single phosphor-coated crystals while 3–3.5 mm DOI error was measured with the block detector module. Minimal timing resolution degradation was observed with single phosphor-coated crystals compared to uncoated crystals, and a timing resolution of 442 ps was obtained with phosphor-coated crystals in the block detector compared to 404 ps without phosphor coating. Flood maps showed a slight degradation in crystal resolvability with phosphor-coated crystals; however, all crystals could be resolved. Energy resolution was degraded by 3%–7% with phosphor-coated crystals compared to uncoated crystals. Conclusions: These results demonstrate the feasibility of obtaining TOF–DOI capabilities with simple block detector readout using phosphor-coated crystals. PMID:26843254

A combined time-of-flight and depth-of-interaction detector for total-body positron emission tomography

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

Berg, Eric, E-mail: eberg@ucdavis.edu; Roncali, Emilie; Du, Junwei

Purpose: In support of a project to build a total-body PET scanner with an axial field-of-view of 2 m, the authors are developing simple, cost-effective block detectors with combined time-of-flight (TOF) and depth-of-interaction (DOI) capabilities. Methods: This work focuses on investigating the potential of phosphor-coated crystals with conventional PMT-based block detector readout to provide DOI information while preserving timing resolution. The authors explored a variety of phosphor-coating configurations with single crystals and crystal arrays. Several pulse shape discrimination techniques were investigated, including decay time, delayed charge integration (DCI), and average signal shapes. Results: Pulse shape discrimination based on DCI providedmore » the lowest DOI positioning error: 2 mm DOI positioning error was obtained with single phosphor-coated crystals while 3–3.5 mm DOI error was measured with the block detector module. Minimal timing resolution degradation was observed with single phosphor-coated crystals compared to uncoated crystals, and a timing resolution of 442 ps was obtained with phosphor-coated crystals in the block detector compared to 404 ps without phosphor coating. Flood maps showed a slight degradation in crystal resolvability with phosphor-coated crystals; however, all crystals could be resolved. Energy resolution was degraded by 3%–7% with phosphor-coated crystals compared to uncoated crystals. Conclusions: These results demonstrate the feasibility of obtaining TOF–DOI capabilities with simple block detector readout using phosphor-coated crystals.« less

State Systems Change Spotlight: Nevada. Transforming State Systems to Improve Outcomes for Children with Disabilities

ERIC Educational Resources Information Center

Ruedel, Kristin; Nelson, Gena; Bailey, Tessie; Pierce, Jennifer

2018-01-01

Data show that effective and ongoing communication and evaluation can have a positive impact on local and statewide systems change. Local and statewide systems change requires ongoing communication and evaluation. The Nevada Department of Education (NDE) used a communication protocol to support implementation of the Assess-Plan-Teach (APT) model.…

78 FR 20354 - Notice of Public Meeting, Las Cruces District Resource Advisory Council Meeting, New Mexico

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-04

... Street, Las Cruces, NM, 88005, 575-525-4338. Persons who use a telecommunications device for the deaf... the BLM, on a variety of planning and management issues associated with public land management in New... ongoing issues and planning efforts, presentation on the TriCounty Resource Management Plan/ Environmental...

45 CFR 1386.30 - State plan requirements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... in effect, a State Plan which meets the requirements of sections 122 and 124 of the Act (42 U.S.C... reviewed at least once every three years. (e) (1) The State Plan may provide for funding projects to... demonstrations must be short-term and include a strategy to locate on-going funding from other sources. For each...

Regulating and Negotiating Linguistic Diversity: Top-Down and Bottom-Up Language Planning in the Moroccan City

ERIC Educational Resources Information Center

Hassa, Samira

2012-01-01

This study examines language planning as displayed in street names, advertising posters, billboards, and supermarket product displays in three Moroccan cities: Casablanca, Fes, and Rabat. The study reveals somewhat confusing language planning stemming from on-going political, economic, and social transformation in Morocco. More than 50 years after…

Space Station Freedom operations planning

NASA Technical Reports Server (NTRS)

Smith, Kevin J.

1988-01-01

This paper addresses the development of new planning methodologies which will evolve to serve the Space Station Freedom program; these planning processes will focus on the complex task of effectively managing the resources provided by the Space Station Freedom and will be made available to the diverse international community of space station users in support of their ongoing investigative activities.

Pandemic Planning: Are Universities Really Prepared?

ERIC Educational Resources Information Center

Pokrywka, Francis J.

2016-01-01

Planning for a pandemic influenza outbreak at a college or university cannot be done in a vacuum. Like any emergency plan, it needs to be a coordinated effort by a dedicated and unselfish group of individuals at the university pulling together a multitude of people and resources focused on a common goal. There is an ongoing struggle among…

Report of a Planning Conference for Solar Technology Information Transfer. Austin, Texas, 12-13 June 1979).

ERIC Educational Resources Information Center

Southwestern Library Association, Stillwater, OK.

Charged with the responsibility of determining the best way to plan for solar technology information transfer within the state of Texas, participants in the Planning Conference for Solar Technology Information Transfer met to discuss the many ongoing activities related to energy information dissemination, to analyze the resources available in…

Myo-inositol vs. D-chiro inositol in PCOS treatment.

PubMed

Formuso, C; Stracquadanio, M; Ciotta, L

2015-08-01

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women in fertile age. It is an endocrine and metabolic disorder characterized by oligo-anovulation, hyperandrogenism and insulin-resistance. Various therapeutic approaches have been attempted in PCOS, including diet and the use of pharmacological agents such as oral contraceptives (OCs) or anti-androgens. Recently, the introduction of inositol in the treatment plan has proved to be as reasonable as useful in countering the endocrine-metabolic disorders of this syndrome. The aim of our study was to compare the clinical, endocrine and metabolic response after 6 months of therapy in 137 PCOS women characterized by oligomenorrhea and/or acne and/or mild hirsutism and insulin-resistance. The patients were treated with myo-inositol or with D-chiro-inositol or with placebo. Our study showed that both myo-inositol (MI-PG) and D-chiro inositol (DCI-PG) treatments are able to significantly improve the regularity of the menstrual cycle, the Acne Score, the endocrine and metabolic parameters and the insulin-resistence in young, overweight, PCOS patients. Definitely, we assumed that both treatments with myo-inositol and with D-chiro inositol could be proposed as a potential valid therapeutic approach for the treatment of patients with PCOS. Additionally, further examination and for a longer period of treatment are needed.

Ethnomedicinal uses of plants in the treatment of paediatric geohelminth infections in Kalat district of Northern Balochistan, Pakistan.

PubMed

Bibi, Tahira; Ahmad, Mushtaq; Edwards, Sarah E; Tareen, Niaz Mohammad; Jabeen, Rukhsana; Abdullah, Irum

2016-05-13

Infection by intestinal parasitic worms (soil-transmitted helminths or geohelminths) is prevalent in many parts of the world, and poses a particular health risk to children. This paper presents findings from a preliminary study with the primary aim to document indigenous knowledge about the use of herbal medicines in the treatment of intestinal worm infections in children among the local communities of Kalat district of northern Balochistan, Pakistan. Ethnomedicinal data were collected through a triangulation approach, that included participant-observation and rapid appraisal methods. Prior-informed consent (PIC) was obtained from participants before conducting structured and semi-structured interviews and delivering an open ended questionnaire. A total of 94 participants, including 28 men (of whom 7 were traditional healers), and 66 women of four different age groups were interviewed. Results were analyzed using quantitative indices of Use Value citations (UVC) and Disease-Consensus Index (DCI). Fewer men than women agreed to be interviewed, thus overall women in the area appeared to have more ethnomedicinal knowledge. The majority of study participants belonged to the older age group (>55 years). A total of 49 plant species, belonging to 47 genera, distributed in 30 families were reported. The families Asteraceae and Lamiaceae were most frequently represented, with four species each. Trees were the most common life form, with seeds the most frequently cited plant part used (29%). Nearly a third (31%) of plant-based remedies reported in the treatment of intestinal worms were administered as a decoction. The highest UVC and DCI was reported for the species Ferula assa-foetida sL. (UVC 0.51, DCI 0.46). This study provides previously unreported data on the use of medicinal plants in the treatment of geohelminth infections in children of Kalat. Eight species, Acacia modesta Wall., Asparagus capitatus Baker, Microcephala lamellata (Bunge) Pobed., Nepeta praetervisa Rech.f., Plantago ciliata Desf., Pistacia atlantica Desf., Seriphidium quettense (Podlech) Y.R.Ling and Thymus linearis Benth. are reported here as anthelmintics for the first time. Detailed studies on the anthelmintic activity of chemical constituents of these species are lacking from existing literature. Further phytochemical, pharmacological and toxicity studies are required in order to evaluate the efficacy and safety of these newly reported anthelmintic species. These plants may provide a source of novel anthelmintic drug leads, which are urgently required due to the problem of global anthelmintic resistance. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Accident rates at a busy diving centre.

PubMed

Davis, Michael; Malcolm, Kate

2008-06-01

Dear Editor, The Poor Knights Islands in Northland, New Zealand, is a world-famous, temperate-water, diving tourism destination, popularised many years ago by Jacques Cousteau. By far the largest dive operator there is Dive! Tutukaka, with five vessels carrying up to 30 divers, operating on a regular basis throughout the year. Dive! Tutukaka is required to keep a detailed, daily vessel manifest. Thus, the number of divers is known accurately and all incidents are recorded by the Skipper or the Chief Divemaster on board. Although all dives are logged (time in, time out and maximum depth for every diver) and kept permanently, these data were not utilised for this brief report. Each customer does two dives on a trip and there are between one and four divemasters on board who may do one, two or more dives a day (van der Hulst G, unpublished observations). Thus the accident rate per diver is known, and it is assumed that the rate per dive is very close to half this figure. In addition, under health and safety regulations all non-diving injuries both on shore and on board are documented, but these will include some non-divers. For the three financial years between July 2005 and 14 June 2008, 32,302 customers dived with Dive! Tutukaka, approximately 63,000 dives (a small minority did only one dive). Over the same period, there were an estimated 7,600 dives conducted by the divemasters. The injuries documented during this time are shown in Table 1. There were seven cases of decompression illness (DCI), a rate of about 1 per 10,000 divers (0.5 per 10,000 dives). Two of the seven DCI cases involved serious neurological injury. There was one further possible case of DCI who did not seek medical advice. If this diver is included then the rate is 1.14 per 10,000 divers. More minor diving injuries and incidents occurred at a rate of approximately 2 per 10,000 divers. Non-diving injuries occurred rarely, the most common being various musculo-skeletal injuries to staff, requiring time off work. Many of these were secondary to lifting and carrying heavy diving equipment, particularly dive tanks. This indicates an area where improved practices by staff could be achieved. We believe these injury data are robust and provide an accurate picture of a single, mainstream, international tourism diving centre in temperate waters, and indicate a low rate of injury, comparable to the international literature.

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

None, None

The SSL R&D Plan provides analysis and direction for ongoing R&D activities to advance SSL technology and increase energy savings. The R&D Plan also reviews SSL technology status and trends for both LEDs and OLEDs and offers an overview of the current DOE SSL R&D project portfolio.

Child restraint workshop series. Volume 2, Ongoing and planned programs

DOT National Transportation Integrated Search

1979-09-01

This final report describes the planning and implementing details of the Child Restraint Workshop series. A child restraint workshop was conducted in each of the : ten NHTSA regions. The purpose of the workshops was to improve the effectiveness of gr...

Approaches to Legacy System Evolution.

DTIC Science & Technology

1997-12-01

such as migrating legacy systems, to more distributed open environments. This framework draws out the important global issues early in the planning...ongoing system evolution initiatives, for drawing out important global issues early in the planning cycle using the checklists as a guide, and for

The hemodialysis patient: object of diagnosis or part of the treatment team?

PubMed

Burnell, M S

1997-04-01

Through multidisciplinary diagnosis, the end-stage renal disease (ESRD) treatment team defines the patients's problems and sets goals to reach positive outcomes. Each of the team members has a voice in recommending strategies to reach these goals, because each has been trained in appropriate treatment objectives. Patient noncompliance (nonadherence) with team recommendations can be a major, ongoing problem for the team. The untrained, unhealthy, and often unconsulted amateur member of the team is the patient who is asked to carry out the team plan. Where is the patient's place on the team? There is no doubt that the patient can enhance the planning and development of the treatment objectives. But is the patient's presence seen as a hindrance to planning? More consideration needs to be given to this ongoing issue in an effort to achieve successful patient-oriented outcomes.

Strategic Plan for Electronic Commerce, Defense Personnel Support Center

DTIC Science & Technology

1993-07-01

faster, less expensive and far more accurate electronic commerce business methods that use Electronic Data Interchange standards. As a context for that...management responsibilities, establishes a plan of action and milestones, and describes ongoing electronic commerce projects at the corporate and business unit level.

Dealing with Prospective Memory Demands While Performing an Ongoing Task: Shared Processing, Increased On-Task Focus, or Both?

ERIC Educational Resources Information Center

Rummel, Jan; Smeekens, Bridget A.; Kane, Michael J.

2017-01-01

Prospective memory (PM) is the cognitive ability to remember to fulfill intended action plans at the appropriate future moment. Current theories assume that PM fulfillment draws on attentional processes. Accordingly, pending PM intentions interfere with other ongoing tasks to the extent to which both tasks rely on the same processes. How do people…

Planning for pre-exposure prophylaxis to prevent HIV transmission: challenges and opportunities

PubMed Central

2010-01-01

There are currently several ongoing or planned trials evaluating the efficacy of pre-exposure prophylaxis (PrEP) as a preventative approach to reducing the transmission of HIV. PrEP may prove ineffective, demonstrate partial efficacy, or show high efficacy and have the potential to reduce HIV infection in a significant way. However, in addition to the trial results, it is important that issues related to delivery, implementation and further research are also discussed. As a part of the ongoing discussion, in June 2009, the Bill & Melinda Gates Foundation sponsored a Planning for PrEP conference with stakeholders to review expected trial results, outline responsible educational approaches, and develop potential delivery and implementation strategies. The conference reinforced the need for continued and sustained dialogue to identify where PrEP implementation may fit best within an integrated HIV prevention package. This paper identifies the key action points that emerged from the Planning for PrEP meeting. PMID:20624303

78 FR 22281 - Notice of Intent To Collect Fees at the Henneberry House on Public Land in Beaverhead County...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-15

... local media. Fees would be collected as outlined in the field office's Fee Business Plan. The Henneberry... offset those ongoing costs. The BLM's mission for the Dillon Field Office Fee Business Plan (Project) is... addressed in the Dillon Field Office Recreation Fee Business Plan, prepared pursuant to the REA and BLM...

Heliotropamide, a novel oxopyrrolidine-3-carboxamide from Heliotropium ovalifolium.

PubMed

Guntern, A; Ioset, J-R; Queiroz, E F; Sándor, P; Foggin, C M; Hostettmann, K

2003-12-01

Heliotropamide (1), a new alkaloid with a novel oxopyrrolidine-3-carboxamide central moiety, has been isolated as the major product of the dicholoromethane extract of Heliotropium ovalifolium aerial parts. Its structure was elucidated by spectrometric methods including ESI-HR, EI, D/CI mass spectrometry, (1)H, (13)C, and 2D NMR experiments, and chemical derivatization. Neither heliotropamide nor its acetylated derivative (1a) showed any antifungal activity against Cladosporium cucumerinum and Candida albicans, antibacterial activity against Bacillus subtilis, radical-scavenging properties in the DPPH test, or inhibitory potential toward acetylcholinesterase.

Measurement Systems Advisory Group

DTIC Science & Technology

1974-04-01

US NavyLib MSAG- 1 REPORT 001 qL5 ID I APRIL 1974 MA2C91SMAR 2 0 19 81 F Prepared For "LONG RANGE ACOUSTIC PROPAGATION PROJECT 7 opt/ icl S[ D _STRIBU...34 j •( - _> ...ailability Codes IV !VM Avail and/or -~’Dist IspecialL K OFFICE OF NAVAL RESEARCH Department of the Navy Washington, D.C.I L 1 April 23...respect and very much appreciated. The report will be distributed to selected members of the user community for their information and comment. Because 1

Evaluation of Causes of Large 96-H and 120-H Track Errors in the Western North Pacific

DTIC Science & Technology

2006-06-01

Interpolated GFS (A) forecast track for 11W ( Mawar ) for the 0600 UTC 22 August 2005 E-DCI-m case study. The solid sections of the forecast tracks...fields for 11W ( Mawar ) predicted by GFS for taus (a) 54 and (c) 66 for 0600 UTC 22 August 2005 and the corresponding verifying 00-h NOGAPS analyses...pressure (mb) fields for 11W ( Mawar ) predicted by GFS for taus (a) 90 and (c) 114 for 0600 UTC 22 August 2005 and the corresponding verifying 00-h

Environmental Degradation of Fuels, Fluids and Related Materials for Aircraft

DTIC Science & Technology

1976-03-01

23. As a final step of this treatment, the tube is rinsed with hot (200*F) 5% oxalic acid solution to remove metal oxides and com- plex salts. This...of DuPont Method for Deter- 70 mination of DCI-4A Corrosion Inhibitor D. Determination of Total Acid Number for 71 Coirosion Inhibitor No. 4269-28 E...Analyses of Hydrocarbon Fuels 58 18 Heat of Combustion of Benzoic Acid 60 19 Heat of Combustion Values for Ten JP-4 Specimens 61 ix -I /𔃻 " ’ List of Tables

Numerical Studies of Localized Vibrating Structures in Nonlinear Lattices

DTIC Science & Technology

1991-03-01

transmit soliton pulses, greatly increasing the permissible time-bandwidth product of a given system ( Hasegawa and Tappert [1973]). Solitons, which are...CIO CD 0 Fi->ue111.4 F ia aknlk tt fe rg ndcy 8 !78 CoI I o (0))ep Udw FiUeI1.4 FiaIak lk tt afe riho dcy I 78 IV. THE NONLINEAR LATTICE II...equation", PysiCa. D41, 341-355. Hasegawa , A. and Tappert, F. : ’Transmission of stationary nonlinear optical pulses in dispersive dielectric fibers

Late Rather Than Early Onset Bubbles in the Pulmonary Artery During Altitude Exposures Correlate Better with the Onset of "Pain-Only" Decompression Illness

NASA Technical Reports Server (NTRS)

Conkin, J.; Gernhardt, M. L.; Powell, M. R.

2005-01-01

Mechanistic insight about "pain-only" decompression illness (DCI) is limited given indirect information about venous gas emboli (VGE) detected in the pulmonary artery with Doppler ultrasound. However, we show that VGE first detected late in an altitude exposure are closely associated with subsequent symptom onset. Knowing that VGE occur late is an indication that a symptom will occur soon, but this is not a sufficient condition to guarantee that a symptom will occur.

Meta-expert system for cargo container screening

NASA Astrophysics Data System (ADS)

Alberts, David S.

1994-02-01

This paper reports upon improvements and extensions of rule-based expert systems and related technologies in the context of their application to the cargo container screening problem. These innovations have been incorporated into a system built for and deployed by U.S. Customs with funding provided by the DCI's Counter Narcotics Committee. Given the serious nature of the drug smuggling threat and the low probability of intercept, the ability to target the extremely limited inspectional resources available to U.S. Customs is a prerequisite for success in fighting the `Drug War.'

Planning a graduate programme in public health nutrition for experienced nutrition professionals.

PubMed

Fox, Ann; Beyers, Joanne

2011-08-01

Public health renewal in Canada has highlighted the need for development and expansion of the public health nutrition workforce, particularly in northern and rural communities. The purpose of the present paper is to describe the planning of a more accessible graduate programme for experienced nutrition professionals. The planning effort was challenged by a short timeframe between programme approval and implementation and required intense collaboration with stakeholders and students. The programme planning model developed by The Health Communication Unit (THCU) at the Centre for Health Promotion was used to guide the process. This six-step model was familiar to key stakeholders and involved pre-planning, conducting a situational assessment, establishing goals and objectives, developing strategies and outcome indicators, and monitoring feedback. Resource constraints, short timelines and debates around distance education options presented challenges that were overcome by conducting a thorough needs assessment, creating an advisory committee, engaging key stakeholders in the planning process, and building on existing resources. Extensive involvement of the first cohort of students in ongoing planning and evaluation was particularly helpful in informing the evolution of the programme. The THCU planning model provided a useful framework for stakeholder collaboration and for planning and implementing the new graduate programme in public health nutrition. Preliminary data suggest that graduates are benefiting from their educational experiences through career enhancement opportunities. The evaluation strategies built into the programme design will be useful in informing ongoing programme development.

Buffalo Public Schools Action Plan.

ERIC Educational Resources Information Center

Reville, Eugene T.

This report discusses improvements in Buffalo, New York, public schools since 1976, the first year of a court-ordered desegregation plan. Problems, solved and ongoing, are identified and programs addressing them are described. Recommendations are offered for further advancement, and projections about the future of Buffalo schools are also…

Adapting Entry-Level Engineering Courses to Emphasize Critical Thinking

ERIC Educational Resources Information Center

Hagerty, D. Joseph; Rockaway, Thomas D.

2012-01-01

The University of Louisville recently developed a Quality Enhancement Plan (QEP) to improve undergraduate instruction across all disciplines as part of its ongoing accreditation requirements. Central elements of the plan are emphasis on critical thinking; integration of critical thinking throughout the curriculum; service learning for…

Reasoning with inaccurate spatial knowledge. [for Planetary Rover

NASA Technical Reports Server (NTRS)

Doshi, Rajkumar S.; White, James E.; Lam, Raymond; Atkinson, David J.

1988-01-01

This paper describes work in progress on spatial planning for a semiautonomous mobile robot vehicle. The overall objective is to design a semiautonomous rover to plan routes in unknown, natural terrains. The approach to spatial planning involves deduction of common-sense spatial knowledge using geographical information, natural terrain representations, and assimilation of new and possibly conflicting terrain information. This report describes the ongoing research and implementation.

From National to Theater: Developing Strategy

DTIC Science & Technology

2013-01-01

operational planning as it guides the development of the Theater Campaign Plan ( TCP ). Theater strategy, and the TCP that operationalizes it, should offer...doctrine or other guidance on developing it. Perhaps this is a contributing factor in Charles Bouchat’s observation that “No two combatant commands...approach to TCPs and country-level planning that considers ongoing security cooperation efforts, current operations, the Phase 0 component of con

ABA Southern Region Burn disaster plan: the process of creating and experience with the ABA southern region burn disaster plan.

PubMed

Kearns, Randy D; Cairns, Bruce A; Hickerson, William L; Holmes, James H

2014-01-01

The Southern Region of the American Burn Association began to craft a regional plan to address a surge of burn-injured patients after a mass casualty event in 2004. Published in 2006, this plan has been tested through modeling, exercise, and actual events. This article focuses on the process of how the plan was created, how it was tested, and how it interfaces with other ongoing efforts on preparedness. One key to success regarding how people respond to a disaster can be traced to preexisting relationships and collaborations. These activities would include training or working together and building trust long before the crisis. Knowing who you can call and rely on when you need help, within the context of your plan, can be pivotal in successfully managing a disaster. This article describes how a coalition of burn center leaders came together. Their ongoing personal association has facilitated the development of planning activities and has kept the process dynamic. This article also includes several of the building blocks for developing a plan from creation to composition, implementation, and testing. The plan discussed here is an example of linking leadership, relationships, process, and documentation together. On the basis of these experiences, the authors believe these elements are present in other regions. The intent of this work is to share an experience and to offer it as a guide to aid others in their regional burn disaster planning efforts.

The Integrated Curriculum of "Planned Approach to Healthier Schools"

ERIC Educational Resources Information Center

Lounsbery, Monica; Gast, Julie; Smith, Nicole

2005-01-01

Planned Approach to Healthier Schools (PATHS) is a multicomponent school program that aims to establish and sustain a social norm consistent with physical activity and healthy nutrition in the school community. The PATHS components include: (1) a professional development and wellness program for faculty and staff; (2) ongoing social-marketing…

300 area TEDF NPDES Permit Compliance Monitoring Plan

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

Loll, C.M.

1995-09-05

This document presents the 300 Area Treated Effluent Disposal Facility (TEDF) National Pollutant Discharge Elimination System (NPDES) Permit Compliance Monitoring Plan (MP). The MP describes how ongoing monitoring of the TEDF effluent stream for compliance with the NPDES permit will occur. The MP also includes Quality Assurance protocols to be followed.

How School Principals Can Foster Effective Literacy Instruction: A Ten-Step Plan

ERIC Educational Resources Information Center

Hinchman, Kathleen A.

2009-01-01

School principals can foster effective literacy instruction by orchestrating community collaboration in an ongoing cycle of literacy program development, implementation, evaluation, and revision outlined in this ten-step plan. The steps address forming a community advisory board, appointing a building literacy leader, forming a literacy team,…

Residual lower esophageal sphincter pressure as a prognostic factor in the pneumatic balloon treatment of achalasia.

PubMed

Park, Jung Ho; Lee, Yong Chan; Lee, Hyuk; Park, Hyojin; Youn, Young Hoon; Park, Hyung Seok; Lee, Tae Hee; Hong, Kyoung Sup

2015-01-01

Pneumatic balloon dilatation (PD) is a mainstay in achalasia treatment. The aim of this study was to identify predictive factors for successful treatment. We retrospectively reviewed 76 patients with a diagnosis of achalasia who underwent PD from June 2010 to May 2013. Clinical symptoms were assessed using Eckardt score and manometry data were analyzed using resting and relaxation pressure (4sIRP) of lower esophageal sphincter (LES) and the distal contractile integral (DCI), which was calculated for 10 s from the start of deglutition between the upper margin of the LES and lower margin of upper esophageal contraction. Patients with achalasia were classified into three groups based on the Chicago classification. Among 76 patients, 52 patients received PD, and the treatment was unsuccessful in 9 patients (6 in class I and 3 in class III). When comparing prognostic factors between successful and unsuccessful treatment groups, the mean value for 4sIRP in the unsuccessful treatment group was significantly lower than that in the successful treatment group (P < 0.05). However, no difference was noticed in resting LES pressure, DCI, age, and sex. Furthermore, a lower mean value of 4sIRP was significantly related to unsuccessful treatment of achalasia (odds ratio, 1.092; 95% confidence interval, 1.001-1.191) even after adjustment for a series of confounding factors. Lower 4sIRP may be a prognostic indicator for poor treatment outcome after PD. © 2014 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.

Esophageal motility after peroral endoscopic myotomy for achalasia.

PubMed

Hu, Yue; Li, Meng; Lu, Bin; Meng, Lina; Fan, Yihong; Bao, Haibiao

2016-05-01

Peroral endoscopic myotomy (POEM) has been introduced as a novel endoscopic treatment for achalasia. The aim of this work is to assess the changes in esophageal motility caused by POEM in patients with achalasia. Forty-one patients with achalasia underwent POEM from September 2012 to November 2014. Esophageal motility of all patients was evaluated preoperatively and 1 month after POEM utilizing high-resolution manometry, which was performed with ten water swallows, ten steamed bread swallows, and multiple rapid swallows (MRS). In single swallows, including liquid swallows and bread swallows, all the parameters of lower esophagus sphincter resting pressure (LESP), 4-s integrated relaxation pressure (4sIRP), and intra-bolus pressure (IBP) were decreased between pre- and post-POEM patients (all p < 0.05). Postoperatively, the trend of distal contractile integral (DCI) and distal esophageal peristaltic amplitude declined in subtype II and subtype III (subtype II: p < 0.05; subtype III: p > 0.05), but increased in subtype I (subtype I: p > 0.05). In liquid swallows, the Eckardt score of subtype II patients decreased with DCI, and distal esophageal peristaltic amplitude after POEM was significantly lower compared with those showing increased values of those two parameters (p < 0.05). In MRS, the rate of LES relaxation increased from 66.67 to 95.24%, but without normal response in all achalasia patients. POEM reduces LES pressure in achalasia, and partly restores esophageal motility. POEM displayed varying effect on esophageal motility in patients with different patterns of swallowing. In addition, the changes in parameters associated with esophageal peristalsis correlated with decreases in Eckardt score.

Effect of Hydroxyethyl Starch Solution on Incidence of Acute Kidney Injury in Patients Suffering from Cerebral Vasospasm Following Aneurysmal Subarachnoid Hemorrhage.

PubMed

Kieninger, Martin; Unbekannt, Daniel; Schneiker, André; Sinner, Barbara; Bele, Sylvia; Prasser, Christopher

2017-02-01

The application of third-generation hydroxyethyl starch (HES) solutions in critically ill patients suffering from aneurysmal subarachnoid hemorrhage (aSAH) was often part of the treatment of delayed cerebral ischemia (DCI). However, there is increasing evidence showing a correlation between the application of HES and the incidence of acute kidney injury (AKI). In a single-center retrospective analysis including 81 patients without a preexisting renal disorder suffering from aSAH who had received higher volumes of 6 % HES 130/0.4 due to standard treatment of DCI, the incidence of AKI during intensive care unit (ICU) stay was recorded using AKIN criteria. Furthermore, the course of serum creatinine after discharge from ICU was observed. 6 % HES 130/0.4 was given over a period of 12.9 ± 7.1 days resulting in a cumulative dose of 12543.2 ± 7743.6 mL. Four patients (4.9 %) fulfilled AKIN criteria stage 1 during ICU stay. In two of these patients, serum creatinine was within normal range again on day of discharge. Five patients showed elevated levels of serum creatinine within 1 to 22 months after hospitalization. A correlation between the amount of HES given and the incidence of AKI could not be found. The application of 6 % HES 130/0.4 did not lead to an elevated incidence of AKI in patients without an elevated baseline serum creatinine. However, there is still a lack of high-level evidence as prospective randomized trials are missing yet.

Developmental dysplasia of the hip in the newborn: A systematic review

PubMed Central

Gulati, Vivek; Eseonu, Kelechi; Sayani, Junaid; Ismail, Nizar; Uzoigwe, Chika; Choudhury, Muhammed Zaki; Gulati, Pooja; Aqil, Adeel; Tibrewal, Saket

2013-01-01

Developmental dysplasia of the hip (DDH) denotes a wide spectrum of conditions ranging from subtle acetabular dysplasia to irreducible hip dislocations. Clinical diagnostic tests complement ultrasound imaging in allowing diagnosis, classification and monitoring of this condition. Classification systems relate to the alpha and beta angles in addition to the dynamic coverage index (DCI). Screening programmes for DDH show considerable geographic variation; certain risk factors have been identified which necessitate ultrasound assessment of the newborn. The treatment of DDH has undergone significant evolution, but the current gold standard is still the Pavlik harness. Duration of Pavlik harness treatment has been reported to range from 3 to 9.3 mo. The beta angle, DCI and the superior/lateral femoral head displacement can be assessed via ultrasound to estimate the likelihood of success. Success rates of between 7% and 99% have been reported when using the harness to treat DDH. Avascular necrosis remains the most devastating complication of harness usage with a reported rate of between 0% and 28%. Alternative non-surgical treatment methods used for DDH include devices proposed by LeDamany, Frejka, Lorenz and Ortolani. The Rosen splint and Wagner stocking have also been used for DDH treatment. Surgical treatment for DDH comprises open reduction alongside a combination of femoral or pelvic osteotomies. Femoral osteotomies are carried out in cases of excessive anteversion or valgus deformity of the femoral neck. The two principal pelvic osteotomies most commonly performed are the Salter osteotomy and Pemberton acetabuloplasty. Serious surgical complications include epiphyseal damage, sciatic nerve damage and femoral neck fracture. PMID:23610749

[Analysis of the characteristic of pharyngeal paraesthesia patients by high resolution manometry].

PubMed

Gu, Yun; Qian, Wei

2015-09-01

To discuss the pressure changing characteristics of upper esophageal sphincter (UES), lower esophageal sphincter (LES) and the esophagus kinetic characteristics of pharyngeal paraesthesia patients. To take high resolution manometry in 44 cases of pharyngeal paraesthesia patients and 23 normal subjects separately. According to the RSI score,the 44 patients were divided into group A (the group without reflux, RSI < 13, n = 25) and group B (the group with reflux, RSI ≥ 13, n = 19). The UES average resting pressure and average residual pressure of patients group were higher than the control group (P < 0.05); The UES average resting pressure and average residual pressure of group B were higher than group A (P < 0.05); The LES average resting pressure and average residual pressure of group B were lower than group A and the control group (P < 0.05); The comparison of LES average resting pressure and average residual pressure between group A and the control group was not statistically significant (P > 0.05). The esophagus DCI of group B was lower than that of group A and control group (P < 0.05). The esophagus DCI comparison between group A and control group was not statistically significant (P > 0.05). The pharyngeal paresthesia symptoms of'patients was associated with the increasing of UES pressure. The pharyngeal paresthesia symptoms of group with reflux was related to low pressure of LES and high pressure of UES. The last part of esophagus of group with reflux had obstacles in powers, which weaken the peristalsis and declined the ability to clear the bolus and gastric reflux material.

Embedded Protostellar Disks Around (Sub-)Solar Stars. II. Disk Masses, Sizes, Densities, Temperatures, and the Planet Formation Perspective

NASA Astrophysics Data System (ADS)

Vorobyov, Eduard I.

2011-03-01

We present basic properties of protostellar disks in the embedded phase of star formation (EPSF), which is difficult to probe observationally using available observational facilities. We use numerical hydrodynamics simulations of cloud core collapse and focus on disks formed around stars in the 0.03-1.0 M sun mass range. Our obtained disk masses scale near-linearly with the stellar mass. The mean and median disk masses in the Class 0 and I phases (M mean d,C0 = 0.12 M sun, M mdn d,C0 = 0.09 M sun and M mean d,CI = 0.18 M sun, M mdn d,CI = 0.15 M sun, respectively) are greater than those inferred from observations by (at least) a factor of 2-3. We demonstrate that this disagreement may (in part) be caused by the optically thick inner regions of protostellar disks, which do not contribute to millimeter dust flux. We find that disk masses and surface densities start to systematically exceed that of the minimum mass solar nebular for objects with stellar mass as low as M * = 0.05-0.1 M sun. Concurrently, disk radii start to grow beyond 100 AU, making gravitational fragmentation in the disk outer regions possible. Large disk masses, surface densities, and sizes suggest that giant planets may start forming as early as in the EPSF, either by means of core accretion (inner disk regions) or direct gravitational instability (outer disk regions), thus breaking a longstanding stereotype that the planet formation process begins in the Class II phase.

Manager's assistant systems for space system planning

NASA Technical Reports Server (NTRS)

Bewley, William L.; Burnard, Robert; Edwards, Gary E.; Shoop, James

1992-01-01

This paper describes a class of knowledge-based 'assistant' systems for space system planning. Derived from technology produced for the DARPA/USAF Pilot's Associate program, these assistant systems help the human planner by doing the bookkeeping to maintain plan data and executing the procedures and heuristics currently used by the human planner to define, assess, diagnose, and revise plans. Intelligent systems for Space Station Freedom assembly sequence planning and Advanced Launch System modeling will be presented as examples. Ongoing NASA-funded work on a framework supporting the development of such tools will also be described.

Planning applications in image analysis

NASA Technical Reports Server (NTRS)

Boddy, Mark; White, Jim; Goldman, Robert; Short, Nick, Jr.

1994-01-01

We describe two interim results from an ongoing effort to automate the acquisition, analysis, archiving, and distribution of satellite earth science data. Both results are applications of Artificial Intelligence planning research to the automatic generation of processing steps for image analysis tasks. First, we have constructed a linear conditional planner (CPed), used to generate conditional processing plans. Second, we have extended an existing hierarchical planning system to make use of durations, resources, and deadlines, thus supporting the automatic generation of processing steps in time and resource-constrained environments.

Fee-for-Service Medicare in a Competitive Market Environment

PubMed Central

Dowd, Bryan E.; Coulam, Robert F.; Feldman, Roger; Pizer, Steven D.

2005-01-01

Since its inception, the Medicare Program has allowed for the participation of private health plans, but the relationship of private plans to the government-sponsored fee-for-service (FFS) plan has been the subject of debate. Increased payments to private plans, the introduction of regional preferred provider organizations (PPOs), and a mandated demonstration of price competition that includes FFS Medicare reflect an ongoing attempt to define the role of private plans. The purpose of this article is to explore the roles of private plans and FFS Medicare and to attempt to identify the advantages and disadvantages of each. PMID:17290642

Education Business Plan 2008-11: Ministry Business Plan

ERIC Educational Resources Information Center

Alberta Education, 2008

2008-01-01

The Ministry of Education has identified one core business that is an ongoing key responsibility. It is called "Core Business One: Lead and Support the Education System So That All Students Are Successful at Learning." The core business includes three goals with specific outcomes that describe the end results the Ministry wants to…

Updating and Maintaining School Emergency Management Plans. Helpful Hints for School Emergency Management. Volume 2, Issue 3, 2007

ERIC Educational Resources Information Center

US Department of Education, 2007

2007-01-01

"Helpful Hints" offers a quick overview of school emergency preparedness topics that are frequently the subject of inquiries. Developing and implementing comprehensive, multi-hazard emergency management plans is an ongoing process that must be consistently reinforced and strengthened. Opportunities for reviewing, strengthening and updating…

The Power of Investigating: Guiding Authentic Assessments

ERIC Educational Resources Information Center

McGough, Julie V.; Nyberg, Lisa M.

2017-01-01

Children want to explore, dig, build, play, and wonder. To do this they need to touch, feel, see, observe, listen, manipulate, plan, and create. How does a teacher build and maintain a learning environment that will help students investigate meaningful questions? How does a teacher plan and manage ongoing investigations? How does a teacher use…

Franklin School: Vandalism Prevention Through School Pride. Technical Assistance Bulletin 34.

ERIC Educational Resources Information Center

National School Resource Network, Washington, DC.

Following a costly and destructive fire, Franklin Elementary School in Newark (New Jersey) developed an action plan for reducing violence and vandalism. The plan called for ongoing cooperation between all segments of the school population and of the local, largely Hispanic, community. Security measures were strengthened, but the thrust of the…

75 FR 17151 - Agency Information Collection Activities: Submission for OMB Review; Comment Request, OMB No...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-05

.... 1660--NEW; FEMA Form 089-23, Buffer Zone Plan; FEMA Form 089-23A, Vulnerability Reduction Purchasing...-23A, Vulnerability Reduction Purchasing Plan. Abstract: The information collection activity is the... enables FEMA to evaluate applications and make award decisions, monitor ongoing performance and manage the...

Investigation of Bose Condensation in Ideal Bose Gas Trapped under Generic Power Law Potential in d Dimension

NASA Astrophysics Data System (ADS)

Mehedi Faruk, Mir; Sazzad Hossain, Md.; Muktadir Rahman, Md.

2016-02-01

The changes in characteristics of Bose condensation of ideal Bose gas due to an external generic power law potential U=\\sumi=1dci\\vert xi/ai\\vertni are studied carefully. Detailed calculation of Kim et al. (J. Phys. Condens. Matter 11 (1999) 10269) yielded the hierarchy of condensation transitions with changing fractional dimensionality. In this manuscript, some theorems regarding specific heat at constant volume CV are presented. Careful examination of these theorems reveal the existence of hidden hierarchy of the condensation transition in trapped systems as well.

Master Environmental Plan for Fort Devens, Massachusetts

DTIC Science & Technology

1992-04-01

sites located in proximity to each other were grouped together. The rationale for the order of priority assigned to the study areas in this section is...following priority categories: 1. High priority for action. All group 1 study areas have known contamination. Group IA includes sites that have ongoing...remedial investigations. Group 1B includes sites that have ongoing site inspections. 2. Moderate to high priority for action. Study areas in groups 3

EPA Region 3 Quality Management Plans

EPA Pesticide Factsheets

Has links to resources that describe the Region's Quality Assurance Program, which is a collection of the Region's ongoing quality assurance (QA) policies, procedures, responsibilities and management systems.

The Ohio Department of Education L10H23 "Critical Analysis of Evolution"; Innovative Lesson Plan or Stealthy Advocacy Tool?

ERIC Educational Resources Information Center

Day, Robert

2006-01-01

This paper will discuss the ongoing controversy surrounding a particular Ohio Department of Education tenth grade lesson plan titled "Critical Analysis of Evolution" (Ohio Department of Education identification L10H23). The lesson professes to encourage students to "critically examine" evidences for and against evolution and…

77 FR 77090 - Notice of Public Meeting, Las Cruces District Resource Advisory Council Meeting, New Mexico

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-31

... use a telecommunications device for the deaf (TDD) may call the Federal Information Relay Service... RAC advises the Secretary of the Interior, through the BLM, on a variety of planning and management... from the BLM Las Cruces District Manager, updates on ongoing issues and planning efforts, and Restore...

78 FR 44590 - Notice of Public Meeting, Las Cruces District Resource Advisory Council Meeting, New Mexico

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-24

... Street, Las Cruces, NM, 88005, 575-525-4338. Persons who use a telecommunications device for the deaf... the BLM, on a variety of planning and management issues associated with public land management in New... Manager, updates on ongoing issues and planning efforts, presentation on the TriCounty Resource Management...

50 CFR 18.114 - How do I obtain a Letter of Authorization?

Code of Federal Regulations, 2012 CFR

2012-10-01

... region described in § 18.112 that may cause the taking of Pacific walruses (walruses) or polar bears and... mitigate the effects of the proposed activity on walruses and polar bears encountered during the ongoing... bear awareness and interaction plan, i.e., a polar bear interaction plan. (4) A record of community...

50 CFR 18.114 - How do I obtain a Letter of Authorization?

Code of Federal Regulations, 2011 CFR

2011-10-01

... region described in § 18.112 that may cause the taking of Pacific walruses (walruses) or polar bears and... mitigate the effects of the proposed activity on walruses and polar bears encountered during the ongoing... bear awareness and interaction plan, i.e., a polar bear interaction plan. (4) A record of community...

50 CFR 18.114 - How do I obtain a Letter of Authorization?

Code of Federal Regulations, 2010 CFR

2010-10-01

... region described in § 18.112 that may cause the taking of Pacific walruses (walruses) or polar bears and... mitigate the effects of the proposed activity on walruses and polar bears encountered during the ongoing... bear awareness and interaction plan, i.e., a polar bear interaction plan. (4) A record of community...

Play for All Guidelines: Planning, Design and Management of Outdoor Play Settings for All Children. Second Edition.

ERIC Educational Resources Information Center

Moore, Robin C., Ed.; Goltsman, Susan M., Ed.; Iacofano, Daniel S., Ed.

These guidelines assist professional designers, park and recreation managers, and community groups when making decisions about the planning, design, and ongoing management of children's public play environments. The guidelines are updated to meet or exceed the requirements of the Americans with Disabilities Act Guidelines (July 26, 1991) and the…

The Effects of Self-Monitoring and Performance Feedback on the Treatment Integrity of Behavior Intervention Plan Implementation and Generalization

ERIC Educational Resources Information Center

Mouzakitis, Angela; Codding, Robin S.; Tryon, Georgiana

2015-01-01

Accurate implementation of individualized behavior intervention plans (BIPs) is a critical aspect of evidence-based practice. Research demonstrates that neither training nor consultation is sufficient to improve and maintain high rates of treatment integrity (TI). Therefore, evaluation of ongoing support strategies is needed. The purpose of this…

Comparison of two high-resolution manometry software systems in evaluating esophageal motor function.

PubMed

Rengarajan, A; Drapekin, J; Patel, A; Gyawali, C P

2016-12-01

High-resolution manometry (HRM) utilizes software tools to diagnose esophageal motor disorders. Performance of these software metrics could be affected by averaging and by software characteristics of different manufacturers. High-resolution manometry studies on 86 patients referred for antireflux surgery (61.6 ± 1.4 year, 70% F) and 20 healthy controls (27.9 ± 0.7 year, 45% F) were first subject to standard analysis (Medtronic, Duluth, GA, USA). Coordinates for each of 10 test swallows were exported and averaged to generate a composite swallow. The swallows and averaged composites were imported as ASCII file format into Manoview (Medtronic) and Medical Measurement Systems database reporter (MMS, Dover, NH, USA), and analyses repeated. Comparisons were made between standard and composite swallow interpretations. Correlation between the two systems was high for mean distal contractile integral (DCI, r 2 ≥ 0.9) but lower for integrated relaxation pressure (IRP, r 2 = 0.7). Excluding achalasia, six patients with outflow obstruction (mean IRP 23.2 ± 2.1 with 10-swallow average) were identified by both systems. An additional nine patients (10.5%) were identified as outflow obstruction (15 mmHg threshold) with MMS 10-swallow and four with MMS composite swallow evaluation; only one was confirmed. Ineffective esophageal motility was diagnosed by 10-swallow evaluation in 19 (22.1%) with Manoview, and 20 (23.3%) with MMS. On Manoview composite, 17 had DCI <450 mmHg/cm/s, and on MMS composite, 21, (p ≥ 0.85 for each comparison) but these did not impact diagnostic conclusions. Comparison of 10 swallow and composite swallows demonstrate variability in software metrics between manometry systems. Our data support use of manufacturer specific software metrics on 10-swallow sequences. © 2016 John Wiley & Sons Ltd.

The Dominance Concept Inventory: A Tool for Assessing Undergraduate Student Alternative Conceptions about Dominance in Mendelian and Population Genetics.

PubMed

Abraham, Joel K; Perez, Kathryn E; Price, Rebecca M

2014-01-01

Despite the impact of genetics on daily life, biology undergraduates understand some key genetics concepts poorly. One concept requiring attention is dominance, which many students understand as a fixed property of an allele or trait and regularly conflate with frequency in a population or selective advantage. We present the Dominance Concept Inventory (DCI), an instrument to gather data on selected alternative conceptions about dominance. During development of the 16-item test, we used expert surveys (n = 12), student interviews (n = 42), and field tests (n = 1763) from introductory and advanced biology undergraduates at public and private, majority- and minority-serving, 2- and 4-yr institutions in the United States. In the final field test across all subject populations (n = 709), item difficulty ranged from 0.08 to 0.84 (0.51 ± 0.049 SEM), while item discrimination ranged from 0.11 to 0.82 (0.50 ± 0.048 SEM). Internal reliability (Cronbach's alpha) was 0.77, while test-retest reliability values were 0.74 (product moment correlation) and 0.77 (intraclass correlation). The prevalence of alternative conceptions in the field tests shows that introductory and advanced students retain confusion about dominance after instruction. All measures support the DCI as a useful instrument for measuring undergraduate biology student understanding and alternative conceptions about dominance. © 2014 J. K. Abraham et al. CBE—Life Sciences Education © 2014 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

Effects of viscosity and volume on the patterns of esophageal motility in healthy adults using high-resolution manometry.

PubMed

Park, J H; Lee, H; Rhee, P-L; Park, J H

2015-01-01

The purpose of this study was to determine the effects of age, sex, body mass index (BMI), viscosity, and volume on esophageal motility using high-resolution manometry (HRM). Manometric studies were performed on 60 asymptomatic volunteers (27 men and 33 women, age: 19-56 years) while in a supine position. Manometric protocol included 10 water swallows (5 cc), 10 jelly swallows (5 cc), and 1 water swallow (20 cc). Evaluation of HRM parameters including length of proximal pressure trough (PPT length), distal latency (DL), contractile front velocity (CFV), distal contractile integral (DCI), and 4-second integrated relaxation pressure (IRP) was performed using MATLAB. Significant differences were noted in median IRP between water 5 cc (median 7.2 mmHg [range 5.5-9.6]), jelly 5 cc (median 6.0 mmHg [range 3.8-8.0]), and water 20 cc {(Median 4.8 mmHg [range 3.3-7.4]), P < 0.01}. DL were significantly different between water 5 cc, jelly 5 cc, and water 20 cc (P < 0.01), and in terms of PPT, proportions of small (2 cm ≤ < 5 cm) and large (5 cm≤) break for jelly 5 cc were significantly higher than those for the water 5 cc swallow (P < 0.05). Furthermore, DCI increased with age for water 5 cc, and a significant negative correlation was noticed between proportions of small break and BMI for water 5 cc. Manometric measurements vary depending on age, BMI, viscosity, and volume. These findings need to be taken into account in the interpretation of manometry results. © 2014 International Society for Diseases of the Esophagus.

Quantification of myo-inositol, 1,5-anhydro-D-sorbitol, and D-chiro-inositol using high-performance liquid chromatography with electrochemical detection in very small volume clinical samples

PubMed Central

Schimpf, Karen J.; Meek, Claudia C.; Leff, Richard D.; Phelps, Dale L.; Schmitz, Daniel J.; Cordle, Christopher T.

2015-01-01

Inositol is a six-carbon sugar alcohol and is one of nine biologically significant isomers of hexahydroxycyclohexane. Myo-inositol is the primary biologically active form and is present in higher concentrations in the fetus and newborn than in adults. It is currently being examined for the prevention of retinopathy of prematurity in newborn preterm infants. A robust method for quantifying myo-inositol (MI), D-chiro-inositol (DCI) and 1,5-anhydro-D-sorbitol (ADS) in very small-volume (25 μL) urine, blood serum and/or plasma samples was developed. Using a multiple-column, multiple mobile phase liquid chromatographic system with electrochemical detection, the method was validated with respect to (a) selectivity, (b) accuracy/recovery, (c) precision/reproducibility, (d) sensitivity, (e) stability and (f) ruggedness. The standard curve was linear and ranged from 0.5 to 30 mg/L for each of the three analytes. Above-mentioned performance measures were within acceptable limits described in the Food and Drug Administration’s Guidance for Industry: Bioanalytical Method Validation. The method was validated using blood serum and plasma collected using four common anticoagulants, and also by quantifying the accuracy and sensitivity of MI measured in simulated urine samples recovered from preterm infant diaper systems. The method performs satisfactorily measuring the three most common inositol isomers on 25 μL clinical samples of serum, plasma milk, and/or urine. Similar performance is seen testing larger volume samples of infant formulas and infant formula ingredients. MI, ADS and DCI may be accurately tested in urine samples collected from five different preterm infant diapers if the urine volume is greater than 2–5 mL. PMID:26010453

Rv0004 is a new essential member of the mycobacterial DNA replication machinery

PubMed Central

Hooppaw, Anna J.; Richardson, Kirill; Lee, Hark Joon; Kimmey, Jacqueline M.; Aldridge, Bree B.

2017-01-01

DNA replication is fundamental for life, yet a detailed understanding of bacterial DNA replication is limited outside the organisms Escherichia coli and Bacillus subtilis. Many bacteria, including mycobacteria, encode no identified homologs of helicase loaders or regulators of the initiator protein DnaA, despite these factors being essential for DNA replication in E. coli and B. subtilis. In this study we discover that a previously uncharacterized protein, Rv0004, from the human pathogen Mycobacterium tuberculosis is essential for bacterial viability and that depletion of Rv0004 leads to a block in cell cycle progression. Using a combination of genetic and biochemical approaches, we found that Rv0004 has a role in DNA replication, interacts with DNA and the replicative helicase DnaB, and affects DnaB-DnaA complex formation. We also identify a conserved domain in Rv0004 that is predicted to structurally resemble the N-terminal protein-protein interaction domain of DnaA. Mutation of a single conserved tryptophan within Rv0004’s DnaA N-terminal-like domain leads to phenotypes similar to those observed upon Rv0004 depletion and can affect the association of Rv0004 with DnaB. In addition, using live cell imaging during depletion of Rv0004, we have uncovered a previously unappreciated role for DNA replication in coordinating mycobacterial cell division and cell size. Together, our data support that Rv0004 encodes a homolog of the recently identified DciA family of proteins found in most bacteria that lack the DnaC-DnaI helicase loaders in E. coli and B. subtilis. Therefore, the mechanisms of Rv0004 elucidated here likely apply to other DciA homologs and reveal insight into the diversity of bacterial strategies in even the most conserved biological processes. PMID:29176877

Host-guest complex of N-(2-chloroethyl), N-nitroso, N‧, N‧ -dicyclohexylsulfamid with β-cyclodextrin: Fluorescence, QTAIM analysis and structure-chemical reactivity

NASA Astrophysics Data System (ADS)

Bensouilah, Nadjia; Fisli, Hassina; Bensouilah, Hamza; Zaater, Sihem; Abdaoui, Mohamed; Boutemeur-Kheddis, Baya

2017-10-01

In this work, the inclusion complex of DCY/CENS: N-(2-chloroethyl), N-nitroso, N‧, N‧-dicyclohexylsulfamid and β-cyclodextrin (β-CD) is investigated using the fluorescence spectroscopy, PM3, ONIOM2 and DFT methods. The experimental part reveals that DCY/CENS forms a 1:1 stoichiometric ratio inclusion complex with β-CD. The constant of stability is evaluated using the Benesi-Hildebrand equation. The results of the theoretical optimization showed that the lipophilic fraction of molecule (cyclohexyl group) is inside of β-CD. Accordingly, the Nitroso-Chloroethyl moiety is situated outside the cavity of the macromolecule host. The favorable structure of the optimized complex indicates the existence of weak intermolecular hydrogen bonds and the most important van der Waals (vdW) interactions which are studied on the basis of Natural Bonding Orbital (NBO) analysis. The NBO is employed to compute the electronic donor-acceptor exchanges between drug and β-CD. Furthermore, a detailed topological charge density analysis based on the quantum theory of atoms in molecules (QTAIM), has been accomplished on the most favorable complex using B3LYP/6-31G(d) method. The presence of stabilizing intermolecular hydrogen bonds and van der Waals interactions in the most favorable complex is predicted. Also, the energies of these interactions are estimated with Espinosa's formula. The findings of this investigation reveal that the correlation between the structural parameters and the electronic density is good. Finally, and based on DFT calculations, the reactivity of the interesting molecule in free state was studied and compared with that in the complexed state using chemical potential, global hardness, global softness, electronegativity, electrophilicity and local reactivity descriptors.

Rv0004 is a new essential member of the mycobacterial DNA replication machinery.

PubMed

Mann, Katherine M; Huang, Deborah L; Hooppaw, Anna J; Logsdon, Michelle M; Richardson, Kirill; Lee, Hark Joon; Kimmey, Jacqueline M; Aldridge, Bree B; Stallings, Christina L

2017-11-01

DNA replication is fundamental for life, yet a detailed understanding of bacterial DNA replication is limited outside the organisms Escherichia coli and Bacillus subtilis. Many bacteria, including mycobacteria, encode no identified homologs of helicase loaders or regulators of the initiator protein DnaA, despite these factors being essential for DNA replication in E. coli and B. subtilis. In this study we discover that a previously uncharacterized protein, Rv0004, from the human pathogen Mycobacterium tuberculosis is essential for bacterial viability and that depletion of Rv0004 leads to a block in cell cycle progression. Using a combination of genetic and biochemical approaches, we found that Rv0004 has a role in DNA replication, interacts with DNA and the replicative helicase DnaB, and affects DnaB-DnaA complex formation. We also identify a conserved domain in Rv0004 that is predicted to structurally resemble the N-terminal protein-protein interaction domain of DnaA. Mutation of a single conserved tryptophan within Rv0004's DnaA N-terminal-like domain leads to phenotypes similar to those observed upon Rv0004 depletion and can affect the association of Rv0004 with DnaB. In addition, using live cell imaging during depletion of Rv0004, we have uncovered a previously unappreciated role for DNA replication in coordinating mycobacterial cell division and cell size. Together, our data support that Rv0004 encodes a homolog of the recently identified DciA family of proteins found in most bacteria that lack the DnaC-DnaI helicase loaders in E. coli and B. subtilis. Therefore, the mechanisms of Rv0004 elucidated here likely apply to other DciA homologs and reveal insight into the diversity of bacterial strategies in even the most conserved biological processes.

Lactobacillus cerevisiae sp. nov., isolated from a spoiled brewery sample.

PubMed

Koob, Jennifer; Jacob, Fritz; Wenning, Mareike; Hutzler, Mathias

2017-09-01

A Gram-stain-positive, non-motile, rod-shaped bacterium, designated TUM BP 140423000-2250T (=DSM 100836T=LMG 29073T), was isolated from spoiled beer. This bacterium did not form spores, and was catalase-negative and facultatively anaerobic. Its taxonomic position was determined in a polyphasic study. The 16S rRNA gene sequence similarity data showed that the strain belonged to the Lactobacillus genus with the nearest neighbours being Lactobacillus koreensis DCY50T (sequence similarity 99.5 %), Lactobacillus yonginensis THK-V8T (99.2 %) and Lactobacillus parabrevis LMG 11984T (98.7 %). Sequence comparisons of additional phylogenetic markers, pheS and rpoA, confirmed the 16S rRNA gene sequence tree topology. The maximum rpoA sequence similarity was 92.3 % with L. yonginensis THK-V8T. The DNA G+C content of the isolate was 50.0 mol%. The DNA-DNA relatedness showed that strain TUM BP 140423000-2250T could be clearly distinguished from L. koreensis DCY 50T (30.8±0.4 %) and L. yonginensis THK-V8T (23.6±5.9 %). The major fatty acids were C18 : 1ω9c, summed feature 7 (comprised of C19 : 0 cyclo ω10c/C19 : 1ω6c) and C16 : 0. Based on phenotypic and genotypic studies, the authors propose classifying the new isolate as a representative of a novel species of the genus Lactobacillus, Lactobacillus cerevisiae sp. nov. The type strain is deposited at the Research Centre Weihenstephan for Brewing and Food Quality as TUM BP 140423000-2250T (=DSM 100836T=LMG 29073T).

The physicochemical characteristics and anaerobic degradability of desiccated coconut industry waste water.

PubMed

Chanakya, H N; Khuntia, Himanshu Kumar; Mukherjee, Niranjan; Aniruddha, R; Mudakavi, J R; Thimmaraju, Preeti

2015-12-01

Desiccated coconut industries (DCI) create various intermediates from fresh coconut kernel for cosmetic, pharmaceutical and food industries. The mechanized and non-mechanized DCI process between 10,000 and 100,000 nuts/day to discharge 6-150 m(3) of malodorous waste water leading to a discharge of 264-6642 kg chemical oxygen demand (COD) daily. In these units, three main types of waste water streams are coconut kernel water, kernel wash water and virgin oil waste water. The effluent streams contain lipids (1-55 g/l), suspended solids (6-80 g/l) and volatile fatty acids (VFA) at concentrations that are inhibitory to anaerobic bacteria. Coconut water contributes to 20-50% of the total volume and 50-60% of the total organic loads and causes higher inhibition of anaerobic bacteria with an initial lag phase of 30 days. The lagooning method of treatment widely adopted failed to appreciably treat the waste water and often led to the accumulation of volatile fatty acids (propionic acid) along with long-chain unsaturated free fatty acids. Biogas generation during biological methane potential (BMP) assay required a 15-day adaptation time, and gas production occurred at low concentrations of coconut water while the other two streams did not appear to be inhibitory. The anaerobic bacteria can mineralize coconut lipids at concentrations of 175 mg/l; however; they are severely inhibited at a lipid level of ≥350 mg/g bacterial inoculum. The modified Gompertz model showed a good fit with the BMP data with a simple sigmoid pattern. However, it failed to fit experimental BMP data either possessing a longer lag phase and/or diauxic biogas production suggesting inhibition of anaerobic bacteria.

A Total Quality-Control Plan with Right-Sized Statistical Quality-Control.

PubMed

Westgard, James O

2017-03-01

A new Clinical Laboratory Improvement Amendments option for risk-based quality-control (QC) plans became effective in January, 2016. Called an Individualized QC Plan, this option requires the laboratory to perform a risk assessment, develop a QC plan, and implement a QC program to monitor ongoing performance of the QC plan. Difficulties in performing a risk assessment may limit validity of an Individualized QC Plan. A better alternative is to develop a Total QC Plan including a right-sized statistical QC procedure to detect medically important errors. Westgard Sigma Rules provides a simple way to select the right control rules and the right number of control measurements. Copyright © 2016 Elsevier Inc. All rights reserved.

Intelligent Vehicle Initiative : business plan

DOT National Transportation Integrated Search

1997-11-01

Ongoing and recently completed research and development indicate that collision avoidance systems offer the potential for significantly reducing motor vehicle crashes. Preliminary estimates by the National Highway Traffic Safety Administration (NHTSA...

Treatment planning capability assessment of a beam shaping assembly for accelerator-based BNCT.

PubMed

Herrera, M S; González, S J; Burlon, A A; Minsky, D M; Kreiner, A J

2011-12-01

Within the frame of an ongoing project to develop a folded Tandem-Electrostatic-Quadrupole accelerator facility for Accelerator-Based Boron Neutron Capture Therapy (AB-BNCT) a theoretical study was performed to assess the treatment planning capability of different configurations of an optimized beam shaping assembly for such a facility. In particular this study aims at evaluating treatment plans for a clinical case of Glioblastoma. Copyright © 2011 Elsevier Ltd. All rights reserved.

Comprehensive Oversight Plan for Southwest Asia and Surrounding Areas. FY 2010 Update

DTIC Science & Technology

2010-02-01

responsible drawdown operations in Iraq? AAA ONGOING IRAQ Follow-Up Audit on Sensitive Items Accountability and Control at Abu Ghraib (A-2010...ONGOING KUWAIT Security 5 Security Army Deferred Maintenance on the Abrams Tank Fleet as a Result of the Global War on Terror (D2008-D000FJ...0210.000). Objective: Determine the extent and causes of deferred maintenance on the Army Abrams tanks that were used in the Global War on Terror

CRI planning and scheduling for space

NASA Technical Reports Server (NTRS)

Aarup, Mads

1994-01-01

Computer Resources International (CRI) has many years of experience in developing space planning and scheduling systems for the European Space Agency. Activities range from AIT/AIV planning over mission planning to research in on-board autonomy using advanced planning and scheduling technologies in conjunction with model based diagnostics. This article presents four projects carried out for ESA by CRI with various subcontractors: (1) DI, Distributed Intelligence for Ground/Space Systems is an on-going research project; (2) GMPT, Generic Mission Planning Toolset, a feasibility study concluded in 1993; (3) OPTIMUM-AIV, Open Planning Tool for AIV, development of a knowledge based AIV planning and scheduling tool ended in 1992; and (4) PlanERS-1, development of an AI and knowledge-based mission planning prototype for the ERS-1 earth observation spacecraft ended in 1991.

78 FR 65356 - Notice of Public Meeting, Las Cruces District Resource Advisory Council Meeting, New Mexico

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-31

... deaf (TDD) may call the Federal Information Relay Service (FIRS) at 1-800-877-8229 to contact the above... the BLM, on a variety of planning and management issues associated with public land management in New... District Manager, updates on ongoing issues and planning efforts, and a presentation on land tenure in the...

Parental Insights on the Effects of the Secondary Transition Planning Process on the Postsecondary Outcomes of Graduates with Disabilities

ERIC Educational Resources Information Center

Miller-Warren, Vickie

2016-01-01

Research shows that transition planning for students with disabilities is an ongoing process that requires the collaboration of students, families, and teachers to ensure a successful adult life for students after graduation (Clark, 1996; Clark & Unruh, 2010; Gil, 2007; Kellems & Morningstar, 2010). This study examined the insights of the…

Field Operational Seminar in Functional Literacy Linked with Population Education and Family Planning (Indonesia, February 26-March 18, 1973). Synthesis of the Final Report.

ERIC Educational Resources Information Center

United Nations Educational, Scientific, and Cultural Organization, Bangkok (Thailand). Regional Office for Education in Asia and Oceania.

The primary objectives of this seminar was to provide concrete and diversified field experiences in functional literacy approaches, principles, methods and techniques carried out within the framework of an ongoing population education and family planning program. Included in the report are an introduction, general operational procedures…

Topic Areas to Consider when Planning Transition from High School to Postsecondary Education for Students with Autism Spectrum Disorders

ERIC Educational Resources Information Center

Roberts, Kelly D.

2010-01-01

For many individuals with an autism spectrum disorder (ASD), attending and completing postsecondary education is a viable option. However, success in postsecondary education for these individuals may require more planning and ongoing support than students without an ASD. This article provides educators and transition support personnel with a range…

Recovery After Stroke: Coping with Emotions

MedlinePlus

... gain  Being unable to concentrate, remember or make decisions like you used to  Feeling worthless or helpless  Feelings of guilt  Ongoing thoughts of death or suicide, suicide planning ...

Remote sensing as a source of data for outdoor recreation planning

NASA Technical Reports Server (NTRS)

Reed, W. E.; Goodell, H. G.; Emmitt, G. D.

1972-01-01

Specific data needs for outdoor recreation planning and the ability of tested remote sensors to provide sources for these data are examined. Data needs, remote sensor capabilities, availability of imagery, and advantages and problems of incorporating remote sensing data sources into ongoing planning data collection programs are discussed in detail. Examples of the use of imagery to derive data for a range of common planning analyses are provided. A selected bibliography indicates specific uses of data in planning, basic background materials on remote sensing technology, and sources of information on environmental information systems expected to use remote sensing to provide new environmental data of use in outdoor recreation planning.

News and Updates from Proctor Creek

EPA Pesticide Factsheets

This page contains news and updates from the Proctor Creek Urban Waters Partnership location. They span ongoing projects, programs, and initiatives that this Atlanta-based partnership is taking on in its work plan.

Service-based health human resources planning for older adults.

PubMed

Tomblin Murphy, Gail; MacKenzie, Adrian; Rigby, Janet; Rockwood, Kenneth; Gough, Amy; Greeley, Gogi; Montpetit, Frederick; Dill, Donna; Alder, Robert; Lackie, Kelly

2013-08-01

To test a service-based health human resources (HHR) planning approach for older adults in the context of home and long term care (LTC); to create a practical template/tools for use in various jurisdictions and/or health care settings. The most serious health needs of seniors in 2 Canadian jurisdictions were identified and linked to the specific services and associated competencies required of health care providers (HCPs) to address those needs. The amounts of each service required were quantified and compared against the capacity of HCPs to perform the services, measured using a self-assessment survey, by using a previously developed analytical framework. Home and LTC sectors in Nova Scotia and Nunavut, Canada. Regulated and nonregulated HCPs were invited to complete either an online or paper-based competency self-assessment survey. Survey response rates in Nova Scotia and Nunavut were 11% (160 responses) and 20% (22 responses), respectively. Comparisons of the estimated number of seniors likely to need each service with the number who can be served by the workforces in each jurisdiction indicated that the workforces in both jurisdictions are sufficiently numerous, active, productive, and competent to provide most of the services likely to be required. However, significant gaps were identified in pharmacy services, ongoing client assessment, client/family education and involvement, and client/family functional and social supports. Service-based HHR planning is feasible for identifying gaps in services required by older adults, and can guide policy makers in planning hiring/recruitment, professional development, and provider education curricula. Implementation will require commitment of policy makers and other stakeholders, as well as ongoing evaluation of its effectiveness. More broadly, the ongoing effectiveness of the approach will depend on workforce planning being conducted in an iterative way, driven by regular reevaluation of population health needs and HHR effectiveness. Copyright © 2013 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

Analytic innovations for air quality modeling

EPA Science Inventory

The presentation provides an overview of ongoing research activities at the U.S. EPA, focusing on improving long-term emission projections and the development of decision support systems for coordinated environmental, climate and energy planning.

Marketing your skills outside the hospital walls.

PubMed

Waxman, K T

1998-08-01

As patient care shifts from acute care to outpatient and community home health care, nurses need to repackage their skills. A personal skill assessment on an ongoing basis helps nurses plan for the future.

Solving the O&M Equation.

ERIC Educational Resources Information Center

Flach, Robert; Dorgan, Chad B.

2003-01-01

Concerning the issue of molds and indoor air quality in school buildings, addresses the importance of planning and design for building operations and maintenance, the effects of indoor air quality, and ongoing documentation and training. (EV)

Bioterrorism Preparedness for Infectious Disease

DTIC Science & Technology

2005-01-01

outbreak. The PDC was asked to use its Geographical Information System (GIS) and Global Positioning System (GPS) technology and capabilities to perform data...improvements in the health system . For example, on May 10, 2002, the Hawaii State Department of Health unveiled plans for its long-term dengue fever...management strategy. The plan included a long-term dengue surveillance system statewide, a statewide mosquito population survey, and ongoing vector control

Robotic Access to Planetary Surfaces Capability Roadmap

NASA Technical Reports Server (NTRS)

2005-01-01

A set of robotic access to planetary surfaces capability developments and supporting infrastructure have been identified. Reference mission pulls derived from ongoing strategic planning. Capability pushes to enable broader mission considerations. Facility and flight test capability needs. Those developments have been described to the level of detail needed for high-level planning. Content and approach. Readiness and metrics. Rough schedule and cost. Connectivity to mission concepts.

[President's Information Technology Advisory Committee (PITAC) Review of the Information Technology for the Twenty-First Century Initiative and Its Implementation Plan.

ERIC Educational Resources Information Center

National Coordination Office for Information Technology Research and Development, Arlington, VA.

As a part of its ongoing mission, the President's Information Technology Advisory Committee (PITAC) has completed an initial review of the Information Technology for the 21st Century (IT[squared]) initiative and its implementation plan put forward by the participating federal agencies. This letter conveys the initial conclusions of that review.…

A patient centered care plan in the EHR: improving collaboration and engagement.

PubMed

Chunchu, Kavitha; Mauksch, Larry; Charles, Carol; Ross, Valerie; Pauwels, Judith

2012-09-01

Patients attempting to manage their chronic conditions require ongoing support in changing and adopting self-management behaviors. However, patient values, health goals, and action plans are not well represented in the electronic health record (EHR) impeding the ability of the team (MA and providers) to provide respectful, ongoing self-management support. We evaluated whether a team approach to using an EHR based patient centered care plan (PCCP) improved collaborative self-management planning. An experimental, prospective cohort study was conducted in a family medicine residency clinic. The experimental group included 7 physicians and a medical assistant who received 2 hr of PCCP training. The control group consisted of 7 physicians and a medical assistant. EHR charts were analyzed for evidence of 8 behavior change elements. Follow-up interviews with experimental group patients and physicians and the medical assistant assessed their experiences. We found that PCCP charts had more documented behavior change elements than control charts in all 8 domains (p < .001). Experimental group physicians valued the PCCP model and suggested ways to improve its use. Patient feedback demonstrated support for the model. A PCCP can help team members to engage patients with chronic illnesses in goal setting and action planning to support self-management. An EHR design that stores patient values, health goals, and action plans may strengthen continuity and quality of care between patients and primary care team members. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

FRX-L Research Status and Plans

NASA Astrophysics Data System (ADS)

Wurden, G. A.; Intrator, T. P.; Taccetti, J. M.; Furno, I. G.; Hsu, S. C.; Zhang, S. Y.; Degnan, J. H.; Grabowski, C.; Ruden, E. L.

2003-10-01

Our research plans for FRX-L, the field reversed configuration plasma injector at LANL for magnetized target fusion (MTF), have been planned for the next 4-year period. FRX-L has been successfully operating now for the last two years, although construction for both the machine and diagnostic sets is ongoing. Efforts in FY04 begin with continued improvements in the basic high density FRC parameters, through operation at increased magnetic fields and with the addition of a more effective main bank crowbar to reduce parasitic ringing in the high current main coil circuit. Translation experiments into a "fake" metal liner, perforated with diagnostic access ports, will start after designing and constructing the translation section. Another bank of capacitors will be added to power the additional guide and mirror coils. After demonstrating trapping of the plasma in the aluminum liner, and diagnosing sufficient plasma parameters (density, temperature, lifetime, purity), we will begin preparations for the integrated plasma/liner compression experiment at the Air Force Research Laboratory Shiva-Star machine in FY05. Construction of the new hardware will continue during FY06, and the first fusion-relevant demonstration of compression of plasma by an imploding metal liner is planned for FY07. Our MTF plans also include new initiatives with U of Washington, U of Wisconsin, and the University of New Mexico, in addition to ongoing theory ties to LLNL and GA.

77 FR 53225 - National Earthquake Prediction Evaluation Council (NEPEC)

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-31

... meeting, the Council will receive briefings on: ongoing and planned work with social and behavioral... below), and will be posted to the web site (above) when finalized. In order to ensure sufficient seating...

77 FR 36577 - Agency Information Collection Activities; Submission for OMB Review; Comment Request; Tax...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-19

... PERFORMS, the performance management system for the UI program. UI PERFORMS incorporates a strategic planning process of identifying priorities; ongoing collection and monitoring of valid data to measure...

78 FR 6331 - Agency Information Collection Activities: Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-30

...--New); Frequency: Occasionally; Affected Public: Private Sector. Number of Respondents: 4,900. Number... competitiveness. Each agency was directed to establish an ongoing plan to reduce or eliminate burdensome, obsolete...

NASA/MSFC FY-81 Atmospheric Processes Research Review

NASA Technical Reports Server (NTRS)

Turner, R. E. (Compiler)

1981-01-01

Progress in ongoing research programs and future plans for satellite investigations into global weather, upper atmospheric phenomena, and severe storms and local weather are summarized. Principle investigators and publications since June 1980 are listed.

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

Trujillo, Angelina Michelle

Strategy, Planning, Acquiring- very large scale computing platforms come and go and planning for immensely scalable machines often precedes actual procurement by 3 years. Procurement can be another year or more. Integration- After Acquisition, machines must be integrated into the computing environments at LANL. Connection to scalable storage via large scale storage networking, assuring correct and secure operations. Management and Utilization – Ongoing operations, maintenance, and trouble shooting of the hardware and systems software at massive scale is required.

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

Rutqvist, Jonny; Blanco Martin, Laura; Mukhopadhyay, Sumit

The modeling efforts in support of the field test planning conducted at LBNL leverage on recent developments of tools for modeling coupled thermal-hydrological-mechanical-chemical (THMC) processes in salt and their effect on brine migration at high temperatures. This work includes development related to, and implementation of, essential capabilities, as well as testing the model against relevant information and published experimental data related to the fate and transport of water. These are modeling capabilities that will be suitable for assisting in the design of field experiment, especially related to multiphase flow processes coupled with mechanical deformations, at high temperature. In this report,more » we first examine previous generic repository modeling results, focusing on the first 20 years to investigate the expected evolution of the different processes that could be monitored in a full-scale heater experiment, and then present new results from ongoing modeling of the Thermal Simulation for Drift Emplacement (TSDE) experiment, a heater experiment on the in-drift emplacement concept at the Asse Mine, Germany, and provide an update on the ongoing model developments for modeling brine migration. LBNL also supported field test planning activities via contributions to and technical review of framework documents and test plans, as well as participation in workshops associated with field test planning.« less

Notification: Municipal Sewer Systems - Consent Decree Progress and Challenges

EPA Pesticide Factsheets

Project #OPE-FY14-0045, August 6, 2014. The EPA OIG plans to begin preliminary research on the EPA's ongoing enforcement initiative focused on keeping raw sewage and contaminated stormwater out of our nation's waters.

Drugs and highway safety 1980

DOT National Transportation Integrated Search

1980-05-01

This report presents findings of a study to describe (1) present knowledge about the relationship between drug use by drivers and highway safety, and (2) efforts to detect and prevent drug-impaired driving. Past, ongoing, and planned activities at fe...

Alternative methods for developing external travel survey data.

DOT National Transportation Integrated Search

2010-10-01

The Texas Department of Transportation (TxDOT) has a comprehensive on-going travel survey : program that supports the travel demand models being developed for transportation planning efforts in urban : areas throughout Texas. One component of the sur...

Cell module and fuel conditioner

NASA Technical Reports Server (NTRS)

Hoover, D. Q., Jr.

1981-01-01

The results of the completed tests on Stack 561 and the on-going tests of 562 (23 cell stacks of the MK-1 and M-2 designs respectively) are reported and their performance is compared. Results of the on-going endurance test of Stack 560 (5 cell, MK-2) are reported. Plans for fabrication of Stacks 563 and 564 (23 cell stacks of the MK-1 and MK-2 design) are summarized. Results of the burner tests are given. Excellent performance was achieved on simulated anode exhaust gas over very wide load and air/fuel ranges.

A self-care plan for hospice workers.

PubMed

Jones, Sally Hill

2005-01-01

Caring for dying patients and their families is a fulfilling, enriching, and meaningful experience. It can also be extremely stressful. Maintaining the balance between the output and input of energy in a caregiver's professional and personal life is an ongoing process. Clinical staff members often formulate plans of care for patients. To prevent worker burnout, hospice caregivers must develop a plan of self-care to balance their own needs with the needs of their patients. The goal of this article is to provide an overview of ways for hospice caregivers to relieve stress and develop an individualized self-care plan within the context of their work.

Succession Planning and Management: The Backbone of the Radiology Group's Future.

PubMed

Donner, E Michael; Gridley, Daniel; Ulreich, Sidney; Bluth, Edward I

2017-01-01

The transition of leadership within radiology practices is often not a planned replacement process with formal development of potential future leaders. To ensure their ongoing success, however, practices need to develop comprehensive succession plans that include a robust developmental program for potential leaders consisting of mentoring, coaching, structured socialization, 360-degree feedback, developmental stretch assignments, job rotation, and formal education. Succession planning and leadership development will be necessary in the future for a practice to be successful in its business relationships and to be financially viable. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

An Evaluation and Redesign of the Conflict Prediction and Trial Planning Planview Graphical User Interface

NASA Technical Reports Server (NTRS)

Laudeman, Irene V.; Brasil, Connie L.; Stassart, Philippe

1998-01-01

The Planview Graphical User Interface (PGUI) is the primary display of air traffic for the Conflict Prediction and Trial Planning, function of the Center TRACON Automation System. The PGUI displays air traffic information that assists the user in making decisions related to conflict detection, conflict resolution, and traffic flow management. The intent of this document is to outline the human factors issues related to the design of the conflict prediction and trial planning portions of the PGUI, document all human factors related design changes made to the PGUI from December 1996 to September 1997, and outline future plans for the ongoing PGUI design.

Planned and ongoing projects (pop) database: development and results.

PubMed

Wild, Claudia; Erdös, Judit; Warmuth, Marisa; Hinterreiter, Gerda; Krämer, Peter; Chalon, Patrice

2014-11-01

The aim of this study was to present the development, structure and results of a database on planned and ongoing health technology assessment (HTA) projects (POP Database) in Europe. The POP Database (POP DB) was set up in an iterative process from a basic Excel sheet to a multifunctional electronic online database. The functionalities, such as the search terminology, the procedures to fill and update the database, the access rules to enter the database, as well as the maintenance roles, were defined in a multistep participatory feedback loop with EUnetHTA Partners. The POP Database has become an online database that hosts not only the titles and MeSH categorizations, but also some basic information on status and contact details about the listed projects of EUnetHTA Partners. Currently, it stores more than 1,200 planned, ongoing or recently published projects of forty-three EUnetHTA Partners from twenty-four countries. Because the POP Database aims to facilitate collaboration, it also provides a matching system to assist in identifying similar projects. Overall, more than 10 percent of the projects in the database are identical both in terms of pathology (indication or disease) and technology (drug, medical device, intervention). In addition, approximately 30 percent of the projects are similar, meaning that they have at least some overlap in content. Although the POP DB is successful concerning regular updates of most national HTA agencies within EUnetHTA, little is known about its actual effects on collaborations in Europe. Moreover, many non-nationally nominated HTA producing agencies neither have access to the POP DB nor can share their projects.

Anthropometric Source Book. Volume 2: A Handbook of Anthropometric Data

DTIC Science & Technology

1978-07-01

a.mw* % A W " " -I4 0-4DB~M’a~P Z.=22014 MO ZW=O𔃾WW4L" 0 "OBCOO&WWOWWBAB z z 34 " 14 0-44 BBP o z:.~Bwz 1 Wz0 V1O󈧵 j =P.’)ON- 01-0 e e o 0 t...4 c: P) POP~f pol IV)~) ~ P)V) t) PFrW)WW))m x dCY4 0- -a I.- - 0 ~ ItTt t: 1 1 % t’Q.4 O’*t%if! N D Dc ! 4 1Dff~ ffa ul In .4 NV4 W v4 q4v4 v4 NUM

Bioactive Components of the Traditionally used Mushroom Podaxis pistillaris

PubMed Central

Al-Fatimi, M. A. A.; Jülich, W.-D.; Jansen, R.; Lindequist, U.

2006-01-01

In the course of an ethnobotanical study on fungi used in Yemeni ethnomedicine the fungus Podaxis pistillaris (Podaxales, Podaxaceae, Basidiomycetes) was found to exhibit antibacterial activity against Staphylococcus aureus, Micrococcus flavus, Bacillus subtilis, Proteus mirabilis, Serratia marcescens and Escherichia coli. In the culture medium of P. pistillaris three epidithiodiketopiperazines were identified by activity-guided isolation. Based on spectral data (NMR, ESI-MS and DCI-MS) their identity was established as epicorazine A (1), epicorazine B (2) and epicorazine C (3, antibiotic F 3822), which have not been reported as constituents of P. pistillaris previously. It is assumed that the identified compounds contribute to the antibacterial activity of the extract. PMID:16550228

The Time Bomb Continues to Tick.

ERIC Educational Resources Information Center

Schaw, Walter A.

1989-01-01

Higher Education faces two issues in capital renewal and replacement: (1) quantifying and funding the accumulated backlog of capital needs due to deferred maintenance, and (2) developing an ongoing funding plan to ensure backlogs do not accumulate in the future. (MSE)

The Conservation Reserve Program: Planting for the future

USGS Publications Warehouse

Hyberg, Skip; Allen, Arthur

2006-01-01

Proceedings are now available from a scientific and technical forum held to review ongoing and planned research, identify lessons learned, and determine future research needs for the purpose of developing a rigorous scientific basis for future CRP policy discussions.

Integrating Capital Studies within Physical Plant Operations.

ERIC Educational Resources Information Center

Christensen, Douglas K.

1986-01-01

Brigham Young University's program integrating ongoing campus capital replacement and renewal into overall physical plant administration is described, including the initial capital needs study, planning for replacement cycles and one-time expenditures, and management of the information gathered. (MSE)

Robotic System for Condition Assessment of Concrete Bridge Decks : Data Driven Decisions [Tech Brief

DOT National Transportation Integrated Search

2012-12-11

In the United States, the stewardship and management of approximately 599,000 bridges present ongoing planning, operational, maintenance, and economic challenges for Federal, State, and local transportation agencies. To help overcome these challenges...

32 CFR 159.6 - Procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

....49, “Orchestrating, Synchronizing, and Integrating Program Management of Contingency Acquisition... increased risk or planned or ongoing military operations, including how PSC personnel will be rapidly... 13 shall provide the framework for the development of guidance and procedures without regard to the...

Should cities hosting mass gatherings invest in public health surveillance and planning? Reflections from a decade of mass gatherings in Sydney, Australia

PubMed Central

Thackway, Sarah; Churches, Timothy; Fizzell, Jan; Muscatello, David; Armstrong, Paul

2009-01-01

Background Mass gatherings have been defined by the World Health Organisation as "events attended by a sufficient number of people to strain the planning and response resources of a community, state or nation". This paper explores the public health response to mass gatherings in Sydney, the factors that influenced the extent of deployment of resources and the utility of planning for mass gatherings as a preparedness exercise for other health emergencies. Discussion Not all mass gatherings of people require enhanced surveillance and additional response. The main drivers of extensive public health planning for mass gatherings reflect geographical spread, number of international visitors, event duration and political and religious considerations. In these instances, the implementation of a formal risk assessment prior to the event with ongoing daily review is important in identifying public health hazards. Developing and utilising event-specific surveillance to provide early-warning systems that address the specific risks identified through the risk assessment process are essential. The extent to which additional resources are required will vary and depend on the current level of surveillance infrastructure. Planning the public health response is the third step in preparing for mass gatherings. If the existing public health workforce has been regularly trained in emergency response procedures then far less effort and resources will be needed to prepare for each mass gathering event. The use of formal emergency management structures and co-location of surveillance and planning operational teams during events facilitates timely communication and action. Summary One-off mass gathering events can provide a catalyst for innovation and engagement and result in opportunities for ongoing public health planning, training and surveillance enhancements that outlasted each event. PMID:19735577

Should cities hosting mass gatherings invest in public health surveillance and planning? Reflections from a decade of mass gatherings in Sydney, Australia.

PubMed

Thackway, Sarah; Churches, Timothy; Fizzell, Jan; Muscatello, David; Armstrong, Paul

2009-09-08

Mass gatherings have been defined by the World Health Organisation as "events attended by a sufficient number of people to strain the planning and response resources of a community, state or nation". This paper explores the public health response to mass gatherings in Sydney, the factors that influenced the extent of deployment of resources and the utility of planning for mass gatherings as a preparedness exercise for other health emergencies. Not all mass gatherings of people require enhanced surveillance and additional response. The main drivers of extensive public health planning for mass gatherings reflect geographical spread, number of international visitors, event duration and political and religious considerations. In these instances, the implementation of a formal risk assessment prior to the event with ongoing daily review is important in identifying public health hazards.Developing and utilising event-specific surveillance to provide early-warning systems that address the specific risks identified through the risk assessment process are essential. The extent to which additional resources are required will vary and depend on the current level of surveillance infrastructure.Planning the public health response is the third step in preparing for mass gatherings. If the existing public health workforce has been regularly trained in emergency response procedures then far less effort and resources will be needed to prepare for each mass gathering event. The use of formal emergency management structures and co-location of surveillance and planning operational teams during events facilitates timely communication and action. One-off mass gathering events can provide a catalyst for innovation and engagement and result in opportunities for ongoing public health planning, training and surveillance enhancements that outlasted each event.

Annotating MYC Status in Treatment-Resistant Metastatic Castration-Resistant Prostate Cancer With Gallium-68 Citrate PET

DTIC Science & Technology

2017-09-01

ongoing and interim analysis is planned within the next 6 months. Planned analyses include: 1) correlation of gallium citrate uptake on PET with MYC...utility of Gallium citrate PET as a pharmacodynamic and predictive biomarker of MYC pathway inhibition in mCRPC. Correlative pre- and post-treatment...completed Milestone Achieved: Last patient completes study follow up scan 36 Not yet completed Assess correlation between SUVmax on gallium

Simulation Technologies for C2IS Development & Training

DTIC Science & Technology

2008-02-01

break down complex goals or meta -reasoning events that the agent uses to decide which plans to implement. They are integral to the ongoing...controlled through various programming means, which may include the posting of a PlanChoice event. JACK agents are fully capable of meta -level...China [6] Jaillet, Christophe; Krajecki, Michael; and Fugere, Dr. Benoit Jean (2002). ParaZJeZisation en memoire partagee d’un moteur de simulation du

Telescope Array Results on UHE Cosmic Rays and the Plan

NASA Astrophysics Data System (ADS)

Sagawa, Hiroyuki

The Telescope Array (TA) is the largest experiment in the Northern Hemisphere studying the origin and nature of ultra-high-energy cosmic rays. The TA detector consists of a surface array of 507 scintillation counters covering approximately 700 km2, and 38 fluorescence telescopes located at three sites looking over the surface array. Here, recent TA results using the first five years of data and our ongoing and near-future plans are presented.

Integration of technology-based outcome measures in clinical trials of Parkinson and other neurodegenerative diseases.

PubMed

Artusi, Carlo Alberto; Mishra, Murli; Latimer, Patricia; Vizcarra, Joaquin A; Lopiano, Leonardo; Maetzler, Walter; Merola, Aristide; Espay, Alberto J

2018-01-01

We sought to review the landscape of past, present, and future use of technology-based outcome measures (TOMs) in clinical trials of neurodegenerative disorders. We systematically reviewed PubMed and ClinicalTrials.gov for published and ongoing clinical trials in neurodegenerative disorders employing TOMs. In addition, medical directors of selected pharmaceutical companies were surveyed on their companies' ongoing efforts and future plans to integrate TOMs in clinical trials as primary, secondary, or exploratory endpoints. We identified 164 published clinical trials indexed in PubMed that used TOMs as outcome measures in Parkinson disease (n = 132) or other neurodegenerative disorders (n = 32). The ClinicalTrials.gov search yielded 42 clinical trials using TOMs, representing 2.7% of ongoing trials. Sensor-based technology accounted for over 75% of TOMs applied. Gait and physical activity were the most common targeted domains. Within the next 5 years, 83% of surveyed pharmaceutical companies engaged in neurodegenerative disorders plan to deploy TOMs in clinical trials. Although promising, TOMs are underutilized in clinical trials of neurodegenerative disorders. Validating relevant endpoints, standardizing measures and procedures, establishing a single platform for integration of data and algorithms from different devices, and facilitating regulatory approvals should advance TOMs integration into clinical trials. Copyright © 2017 Elsevier Ltd. All rights reserved.

Pandemic influenza planning, United States, 1978-2008.

PubMed

Iskander, John; Strikas, Raymond A; Gensheimer, Kathleen F; Cox, Nancy J; Redd, Stephen C

2013-06-01

During the past century, 4 influenza pandemics occurred. After the emergence of a novel influenza virus of swine origin in 1976, national, state, and local US public health authorities began planning efforts to respond to future pandemics. Several events have since stimulated progress in public health emergency planning: the 1997 avian influenza A(H5N1) outbreak in Hong Kong, China; the 2001 anthrax attacks in the United States; the 2003 outbreak of severe acute respiratory syndrome; and the 2003 reemergence of influenza A(H5N1) virus infection in humans. We outline the evolution of US pandemic planning since the late 1970s, summarize planning accomplishments, and explain their ongoing importance. The public health community's response to the 2009 influenza A(H1N1)pdm09 pandemic demonstrated the value of planning and provided insights into improving future plans and response efforts. Preparedness planning will enhance the collective, multilevel response to future public health crises.

Guidelines for development of the Iowa statewide transportation improvement program (STIP). Revised.

DOT National Transportation Integrated Search

2004-01-01

The Transportation Equity Act for the 21st Century (TEA-21) continues the Intermodal Surface Transportation Efficiency Act of 1991's requirement for an extensive, ongoing cooperative planning effort for programming federal funding. Iowa's STIP is dev...

Missouri Professional Development Guidelines for Student Success.

ERIC Educational Resources Information Center

Missouri State Dept. of Elementary and Secondary Education, Jefferson City.

These guidelines help professional development chairs, administrators, and teachers collaboratively plan for the ongoing skill development and content acquisition of staff members. Section 1, "Missions, Mandates, and Regulations for Professional Development," describes the mission of professional development as supporting teachers in…

Segmentation: Slicing the Urban Pie.

ERIC Educational Resources Information Center

Keim, William A.

1981-01-01

Explains market segmentation and defines undifferentiated, concentrated, and differentiated marketing strategies. Describes in detail the marketing planning process at the Metropolitan Community Colleges. Focuses on the development and implementation of an ongoing recruitment program designed for the market segment composed of business employees.…

Solid-State Lighting R&D Plan - 2015

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

Bardsley, Norman; Bland, Stephen; Hansen, Monica

2015-05-28

Provides analysis and direction for ongoing R&D activities to advance SSL technology and increase energy savings, reviewing SSL technology status and trends for both LEDs and OLEDs and offering an overview of the current DOE SSL R&D project portfolio.

77 FR 1060 - Proposed Information Collection; Comment Request; Survey of the Need for the Improvement of...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-09

... ). SUPPLEMENTARY INFORMATION: I. Abstract This is a request for a new information collection. The Sensor Science... ongoing effort, and in response to many inquiries and requests in recent years, NIST plans to survey...

Integration of climate change considerations in statewide and regional transportation planning processes

DOT National Transportation Integrated Search

2009-07-01

This report is part on on-going work for the US Department of Transportations Center for Climate Change and Environmental Forecasting and the Federal Highway Administration to highlight innovative actions and initiatives undertaken by states and m...

Collaborative Evaluation within a Framework of Stakeholder-Oriented Evaluation Approaches

ERIC Educational Resources Information Center

O'Sullivan, Rita G.

2012-01-01

Collaborative Evaluation systematically invites and engages stakeholders in program evaluation planning and implementation. Unlike "distanced" evaluation approaches, which reject stakeholder participation as evaluation team members, Collaborative Evaluation assumes that active, on-going engagement between evaluators and program staff,…

From plans to actions in patient and public involvement: qualitative study of documented plans and the accounts of researchers and patients sampled from a cohort of clinical trials

PubMed Central

Buck, Deborah; Gamble, Carrol; Dudley, Louise; Preston, Jennifer; Hanley, Bec; Williamson, Paula R; Young, Bridget

2014-01-01

Patient and public involvement (PPI) in research is increasingly required, although evidence to inform its implementation is limited. Objective Inform the evidence base by describing how plans for PPI were implemented within clinical trials and identifying the challenges and lessons learnt by research teams. Methods We compared PPI plans extracted from clinical trial grant applications (funded by the National Institute for Health Research Health Technology Assessment Programme between 2006 and 2010) with researchers’ and PPI contributors’ interview accounts of PPI implementation. Analysis of PPI plans and transcribed qualitative interviews drew on the Framework technique. Results Of 28 trials, 25 documented plans for PPI in funding applications and half described implementing PPI before applying for funding. Plans varied from minimal to extensive, although almost all anticipated multiple modes of PPI. Interview accounts indicated that PPI plans had been fully implemented in 20/25 trials and even expanded in some. Nevertheless, some researchers described PPI within their trials as tokenistic. Researchers and contributors noted that late or minimal PPI engagement diminished its value. Both groups perceived uncertainty about roles in relation to PPI, and noted contributors’ lack of confidence and difficulties attending meetings. PPI contributors experienced problems in interacting with researchers and understanding technical language. Researchers reported difficulties finding ‘the right’ PPI contributors, and advised caution when involving investigators’ current patients. Conclusions Engaging PPI contributors early and ensuring ongoing clarity about their activities, roles and goals, is crucial to PPI's success. Funders, reviewers and regulators should recognise the value of preapplication PPI and allocate further resources to it. They should also consider whether PPI plans in grant applications match a trial's distinct needs. Monitoring and reporting PPI before, during and after trials will help the research community to optimise PPI, although the need for ongoing flexibility in implementing PPI should also be recognised. PMID:25475243

Dealing with prospective memory demands while performing an ongoing task: Shared processing, increased on-task focus, or both?

PubMed

Rummel, Jan; Smeekens, Bridget A; Kane, Michael J

2017-07-01

Prospective memory (PM) is the cognitive ability to remember to fulfill intended action plans at the appropriate future moment. Current theories assume that PM fulfillment draws on attentional processes. Accordingly, pending PM intentions interfere with other ongoing tasks to the extent to which both tasks rely on the same processes. How do people manage the competition between PM and ongoing-task demands? Based on research relating mind wandering and attentional control (Kane & McVay, 2012), we argue that people may not only change the way they process ongoing-task stimuli when given a PM intention, but they may also engage in less off-task thinking than they otherwise would. That is, people focus more strongly on the tasks at hand and dedicate considerable conscious thought to the PM goal. We tested this hypothesis by asking subjects to periodically report on their thoughts during prototypical PM (and control) tasks. Task-unrelated thought rates dropped when participants performed an ongoing task while holding a PM intention versus performing the ongoing task alone (Experiment 1), even when PM demands were minimized (Experiment 2) and more so when PM execution was especially rewarded (Experiment 3). Our findings suggest that PM demands not only elicit a cost to ongoing-task processing, but they also induce a stronger on-task focus and promote conscious thoughts about the PM intention. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Advancing the state of the art in healthcare strategic planning.

PubMed

Zuckerman, Alan M

2006-01-01

A recent survey of the state of strategic planning among healthcare organizations indicates that planners and executives believe that healthcare strategic planning practices are effective and provide the appropriate focus and direction for their organizations. When compared to strategic planning practices employed outside of the healthcare field, however, most healthcare strategic planning processes have not evolved to the more advanced, state-of-the-art levels of planning being used successfully outside of healthcare. While organizations that operate in stable markets may be able to survive using basic strategic planning practices, the volatile healthcare market demands that providers be nimble competitors with advanced, ongoing planning processes that drive growth and organizational effectiveness. What should healthcare organizations do to increase the rigor and sophistication of their strategic planning practices? This article identifies ten current healthcare strategic planning best practices and recommends five additional innovative approaches from pathbreaking companies outside of healthcare that have used advanced strategic planning practices to attain high levels of organizational success.

Picking the Best from the All-Resources Menu: Advanced Tools for Resource Planning

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

Palmintier, Bryan S

Introduces the wide range of electric power systems modeling types and associated questions they can help answer. The presentation focusses on modeling needs for high levels of Distributed Energy Resources (DERs), renewables, and inverter-based technologies as alternatives to traditional centralized power systems. Covers Dynamics, Production Cost/QSTS, Metric Assessment, Resource Planning, and Integrated Simulations with examples drawn from NREL's past and on-going projects. Presented at the McKnight Foundation workshop on 'An All-Resources Approach to Planning for a More Dynamic, Low-Carbon Grid' exploring grid modernization options to replace retiring coal plants in Minnesota.

Middle School Teacher Misconceptions and Anxieties Concerning Space Science Disciplinary Core Ideas in NGSS

NASA Astrophysics Data System (ADS)

Larsen, Kristine

2017-01-01

The Disciplinary Core Ideas (DCI) of the Next Generation Science Standards (NGSS) are grouped into the broad disciplinary areas of Physical Sciences, Life Sciences, Earth and Space Sciences, and Engineering, Technology and Application of Science, and feature learning progressions based on endpoint targets for each grade band. Since the Middle School DCIs build on the expected learning achievements to be reached by the end of Fifth Grade, and High School DCI similarly build on the expected learning achievements expected for the end of Eighth Grade, the Middle School grade band is of particular importance as the bridge between the Elementary and High School curriculum. In states where there is not a special Middle School Certification many of these science classes are taught by teachers prepared to teach at the Elementary level (and who may have limited content background). As a result, some pre-service and in-service teachers have expressed reduced self-confidence in both their own science content knowledge and their ability to apply it in the NGSS-based classroom, while decades of research has demonstrated the pervasiveness of science misconceptions among teachers. Thus the adoption of NGSS has the potential to drive talented teachers out of the profession who feel that they are ill-prepared for this sweeping transition. The key is providing rigorous education in both content and pedagogy for pre-service teachers and quality targeted professional development for in-service teachers. This report focuses on the Middle School Space Sciences grade band DCIs and presents research on specific difficulties, misconceptions and uncertainties with the material demonstrated by pre-service education students over the past four years in a required university science content course, as well as two year-long granted workshop series for current Middle School teachers. This information is relevant to the development of both new content courses aligned with NGSS for pre-service teachers and professional development for in-service teachers.

Brain iron metabolism and brain injury following subarachnoid hemorrhage: iCeFISH-pilot (CSF iron in SAH).

PubMed

Gomes, Joao A; Selim, Magdy; Cotleur, Anne; Hussain, M Shazam; Toth, Gabor; Koffman, Lauren; Asi, Khaled; Provencio, J Javier

2014-10-01

Iron-mediated oxidative damage has been implicated in the genesis of cerebral vasospasm in animal models of SAH. We sought to explore the relationship between levels of non-protein bound iron in cerebrospinal fluid and the development of brain injury in patients with aneurysmal SAH. Patients admitted with aneurysmal subarachnoid hemorrhage to a Neurointensive care unit of an academic, tertiary medical center, with Hunt and Hess grades 2-4 requiring ventriculostomy insertion as part of their clinical management were included in this pilot study. Samples of cerebrospinal fluid (CSF) were obtained on days 1, 3, and 5. A fluorometric assay that relies on an oxidation sensitive probe was used to measure unbound iron, and levels of iron-handling proteins were measured by means of enzyme-linked immunosorbent assays. We prospectively collected and recorded demographic, clinical, and radiological data. A total of 12 patients were included in this analysis. Median Hunt and Hess score on admission was 3.5 (IQR: 1) and median modified Fisher scale score was 4 (IQR: 1). Seven of 12 patients (58 %) developed delayed cerebral ischemia (DCI). Day 5 non-transferrin bound iron (NTBI) (7.88 ± 1 vs. 3.58 ± 0.8, p = 0.02) and mean NTBI (7.39 ± 0.4 vs. 3.34 + 0.4 p = 0.03) were significantly higher in patients who developed DCI. Mean redox-active iron, as well as day 3 levels of redox-active iron correlated with development of angiographic vasospasm in logistic regression analysis (p = 0.02); while mean redox-active iron and lower levels of ceruloplasmin on days 3, 5, and peak concentration were correlated with development of deep cerebral infarcts. Our preliminary data indicate a causal relationship between unbound iron and brain injury following SAH and suggest a possible protective role for ceruloplasmin in this setting, particularly in the prevention of cerebral ischemia. Further studies are needed to validate these findings and to probe their clinical significance.

Inter- and intrarater reliability of the Chicago Classification in pediatric high-resolution esophageal manometry recordings.

PubMed

Singendonk, M M J; Smits, M J; Heijting, I E; van Wijk, M P; Nurko, S; Rosen, R; Weijenborg, P W; Abu-Assi, R; Hoekman, D R; Kuizenga-Wessel, S; Seiboth, G; Benninga, M A; Omari, T I; Kritas, S

2015-02-01

The Chicago Classification (CC) facilitates interpretation of high-resolution manometry (HRM) recordings. Application of this adult based algorithm to the pediatric population is unknown. We therefore assessed intra and interrater reliability of software-based CC diagnosis in a pediatric cohort. Thirty pediatric solid state HRM recordings (13M; mean age 12.1 ± 5.1 years) assessing 10 liquid swallows per patient were analyzed twice by 11 raters (six experts, five non-experts). Software-placed anatomical landmarks required manual adjustment or removal. Integrated relaxation pressure (IRP4s), distal contractile integral (DCI), contractile front velocity (CFV), distal latency (DL) and break size (BS), and an overall CC diagnosis were software-generated. In addition, raters provided their subjective CC diagnosis. Reliability was calculated with Cohen's and Fleiss' kappa (κ) and intraclass correlation coefficient (ICC). Intra- and interrater reliability of software-generated CC diagnosis after manual adjustment of landmarks was substantial (mean κ = 0.69 and 0.77 respectively) and moderate-substantial for subjective CC diagnosis (mean κ = 0.70 and 0.58 respectively). Reliability of both software-generated and subjective diagnosis of normal motility was high (κ = 0.81 and κ = 0.79). Intra- and interrater reliability were excellent for IRP4s, DCI, and BS. Experts had higher interrater reliability than non-experts for DL (ICC = 0.65 vs ICC = 0.36 respectively) and the software-generated diagnosis diffuse esophageal spasm (DES, κ = 0.64 vs κ = 0.30). Among experts, the reliability for the subjective diagnosis of achalasia and esophageal gastric junction outflow obstruction was moderate-substantial (κ = 0.45-0.82). Inter- and intrarater reliability of software-based CC diagnosis of pediatric HRM recordings was high overall. However, experience was a factor influencing the diagnosis of some motility disorders, particularly DES and achalasia. © 2014 John Wiley & Sons Ltd.

Impact of thoracic surgery on esophageal motor function—Evaluation by high resolution manometry

PubMed Central

Kandulski, Arne; Malfertheiner, Peter; Riedel, Sandra; Zardo, Patrick; Hachenberg, Thomas; Schreiber, Jens

2017-01-01

Background Alteration of esophageal function is a potential risk factor for postoperative complications in thoracic surgery. This prospective study investigates esophageal motility and function during and after thoracic procedures via high resolution manometry (HRM) and impedance technology with spatiotemporal representation of pressure data. Methods Twelve consecutive patients eligible for elective thoracic surgery underwent preoperative and postoperative (48 hours and 7 days) esophageal HRM. Swallowing acts were carried out with 5 mL of water, 10 mL of water and 1 cm3 bread in physiological posture to evaluate distal contraction integral (DCI). Length and location of contractile integrity breaks were measured by investigators blinded to the form of surgical intervention. The impact of surgical procedures on esophageal motility was quantified according to current Chicago Classification (CC) criteria. Pre-, intra- and postoperative 24-hour multi-channel impedance pH–metry (MII-pH) was performed to further analyze gastroesophageal reflux patterns. Results All patients were investigated 48 hours prior to and 7 days after thoracic procedures, with a total of n=675 swallowing acts being included in our study. Increased motility patterns of the tubular esophagus occurred temporally 48 hours postoperatively. DCI 48 hours after surgery increased significantly (5 mL, P=0.049; solid, P=0.014) and returned to baseline values after seven days (5 mL, P=0.039; solid, P=0.039). Break length was significantly reduced 48 hours postoperatively, especially in the proximal esophageal segment (transition zone). Follow-up measurements after another week were comparable to preoperative baseline findings. The perioperative MII-pH measurement showed numerous artifacts caused by intubation and ventilation during surgery also with increasing short and frequent acidic reflux episodes. Conclusions Thoracic procedures cause a transient modulation of esophageal peristalsis with postoperative increased contractility of the tubular esophagus, presumably without affecting intraesophageal reflex arcs. Although limited by the number of patients, we can conclude on our data that postoperative esophageal hypomotility is unlikely to promote secondary pulmonary complications. PMID:28740669

Impact of thoracic surgery on esophageal motor function-Evaluation by high resolution manometry.

PubMed

Wäsche, Anja; Kandulski, Arne; Malfertheiner, Peter; Riedel, Sandra; Zardo, Patrick; Hachenberg, Thomas; Schreiber, Jens

2017-06-01

Alteration of esophageal function is a potential risk factor for postoperative complications in thoracic surgery. This prospective study investigates esophageal motility and function during and after thoracic procedures via high resolution manometry (HRM) and impedance technology with spatiotemporal representation of pressure data. Twelve consecutive patients eligible for elective thoracic surgery underwent preoperative and postoperative (48 hours and 7 days) esophageal HRM. Swallowing acts were carried out with 5 mL of water, 10 mL of water and 1 cm 3 bread in physiological posture to evaluate distal contraction integral (DCI). Length and location of contractile integrity breaks were measured by investigators blinded to the form of surgical intervention. The impact of surgical procedures on esophageal motility was quantified according to current Chicago Classification (CC) criteria. Pre-, intra- and postoperative 24-hour multi-channel impedance pH-metry (MII-pH) was performed to further analyze gastroesophageal reflux patterns. All patients were investigated 48 hours prior to and 7 days after thoracic procedures, with a total of n=675 swallowing acts being included in our study. Increased motility patterns of the tubular esophagus occurred temporally 48 hours postoperatively. DCI 48 hours after surgery increased significantly (5 mL, P=0.049; solid, P=0.014) and returned to baseline values after seven days (5 mL, P=0.039; solid, P=0.039). Break length was significantly reduced 48 hours postoperatively, especially in the proximal esophageal segment (transition zone). Follow-up measurements after another week were comparable to preoperative baseline findings. The perioperative MII-pH measurement showed numerous artifacts caused by intubation and ventilation during surgery also with increasing short and frequent acidic reflux episodes. Thoracic procedures cause a transient modulation of esophageal peristalsis with postoperative increased contractility of the tubular esophagus, presumably without affecting intraesophageal reflex arcs. Although limited by the number of patients, we can conclude on our data that postoperative esophageal hypomotility is unlikely to promote secondary pulmonary complications.

Polyuria and cerebral vasospasm after aneurysmal subarachnoid hemorrhage.

PubMed

Brown, Robert J; Epling, Brian P; Staff, Ilene; Fortunato, Gilbert; Grady, James J; McCullough, Louise D

2015-10-13

Natriuresis with polyuria is common after aneurysmal subarachnoid hemorrhage (aSAH). Previous studies have shown an increased risk of symptomatic cerebral vasospasm or delayed cerebral ischemia (DCI) in patients with hyponatremia and/or the cerebral salt wasting syndrome (CSW). However, natriuresis may occur in the absence of hyponatremia or hypovolemia and it is not known whether the increase in DCI in patients with CSW is secondary to a concomitant hypovolemia or because the physiology that predisposes to natriuretic peptide release also predisposes to cerebral vasospasm. Therefore, we investigated whether polyuria per se was associated with vasospasm and whether a temporal relationship existed. A retrospective review of patients with aSAH was performed. Exclusion criteria were admission more than 48 h after aneurysmal rupture, death within 5 days, and the development of diabetes insipidus or acute renal failure. Polyuria was defined as > 6 liters of urine in a 24 h period. Vasospasm was defined as a mean velocity > 120 m/s on Transcranial Doppler Ultrasonography (TCDs) or by evidence of vasospasm on computerized tomography (CT) or catheter angiography. Multivariable logistic regression was performed to assess the relationship between polyuria and vasospasm. 95 patients were included in the study. 51 had cerebral vasospasm and 63 met the definition of polyuria. Patients with polyuria were significantly more likely to have vasospasm (OR 4.301, 95% CI 1.378-13.419) in multivariate analysis. Polyuria was more common in younger patients (52 vs 68, p <.001) but did not impact mortality after controlling for age and disease severity. The timing of the development of polyuria was clustered around the diagnosis of vasospasm and patients with polyuria developed vasospasm faster than those without polyuria. Polyuria is common after aSAH and is significantly associated with cerebral vasospasm. The development of polyuria may be temporally related to the development of vasospasm. An increase in urine volume may be a useful clinical predictor of patients at risk for vasospasm.

Epilithonimonas psychrotolerans sp. nov., isolated from alpine permafrost.

PubMed

Ge, Liang; Zhao, Qi; Sheng, Hongmei; Wu, Jianmin; An, Lizhe

2015-11-01

A bacterial strain, designated TSBY 57T, was isolated during a study on the phylogenetic diversity of culturable bacteria from alpine permafrost in Tianshan Mountains, China, and was classified by means of a polyphasic taxonomic approach. The novel strain was found to belong to the genus Epilithonimonas and was distinguished from recognized species of this genus. Strain TSBY 57T grew aerobically, at 0-30 °C, with 0-1.5% (w/v) NaCl and at pH 6-8.Cells were Gram-stain-negative, non-motile, non-spore-forming rods. Compared with the reference strains, the novel strain was psychrotolerant. The predominant fatty acids were summed feature 3 (consisting of C16:1ω7c and/or C16:1ω6c), anteiso-C15:0 and iso-C15:0.The sole respiratory quinone was MK-6.Phosphatidylethanolamine was predominant in the polar lipid profile of strain TSBY 57T. These chemotaxonomic traits were in good agreement with the characteristics of the genus Epilithonimonas. On the basis of 16S rRNA gene sequence similarity, strain TSBY 57T was a member of the genus Epilithonimonas and was closely related to Epilithonimonas tenax DSM 16811T (99.0%), Epilithonimonas ginsengisoli DCY78T (98.6%) and Epilithonimonas lactis H1T (98.5%). However, DNA-DNA reassociation values between strain TSBY 57T and E. tenax DSM 16811T, E. ginsengisoli DCY78T and E. lactis H1T were 39.5 ± 2.6, 37.7 ± 1.0 and 37.3 ± 1.1%, respectively. The G+C content of the DNA was 34.4 ± 0.2  mol%. Based on data from this polyphasic taxonomic study, strain TSBY 57T represents a novel species of the genus Epilithonimonas, for which the name Epilithonimonas psychrotolerans sp. nov. is proposed. The type strain is TSBY 57T ( = NRRL B-51307T=CCTCC AB 207182T).

Risk assessment and management of radiofrequency radiation exposure

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

Dabala, Dana; Surducan, Emanoil; Surducan, Vasile

2013-11-13

Radiofrequency radiation (RFR) industry managers, occupational physicians, security department, and other practitioners must be advised on the basic of biophysics and the health effects of RF electromagnetic fields so as to guide the management of exposure. Information on biophysics of RFR and biological/heath effects is derived from standard texts, literature and clinical experiences. Emergency treatment and ongoing care is outlined, with clinical approach integrating the circumstances of exposure and the patient's symptoms. Experimental risk assessment model in RFR chronic exposure is proposed. Planning for assessment and monitoring exposure, ongoing care, safety measures and work protection are outlining the proper management.

The early Earth Observing System reference handbook: Earth Science and Applications Division missions, 1990-1997

NASA Technical Reports Server (NTRS)

1990-01-01

Prior to the launch of the Earth Observing System (EOS) series, NASA will launch and operate a wide variety of new earth science satellites and instruments, as well as undertake several efforts collecting and using the data from existing and planned satellites from other agencies and nations. These initiatives will augment the knowledge base gained from ongoing Earth Science and Applications Division (ESAD) programs. This volume describes three sets of ESAD activities -- ongoing exploitation of operational satellite data, research missions with upcoming launches between now and the first launch of EOS, and candidate earth probes.

Risk assessment and management of radiofrequency radiation exposure

NASA Astrophysics Data System (ADS)

Dabala, Dana; Surducan, Emanoil; Surducan, Vasile; Neamtu, Camelia

2013-11-01

Radiofrequency radiation (RFR) industry managers, occupational physicians, security department, and other practitioners must be advised on the basic of biophysics and the health effects of RF electromagnetic fields so as to guide the management of exposure. Information on biophysics of RFR and biological/heath effects is derived from standard texts, literature and clinical experiences. Emergency treatment and ongoing care is outlined, with clinical approach integrating the circumstances of exposure and the patient's symptoms. Experimental risk assessment model in RFR chronic exposure is proposed. Planning for assessment and monitoring exposure, ongoing care, safety measures and work protection are outlining the proper management.

Mars Rover/Sample Return (MRSR) Mission: Mars Rover Technology Workshop

NASA Technical Reports Server (NTRS)

1987-01-01

A return to the surface of Mars has long been an objective of NASA mission planners. The ongoing Mars Rover and Sample Return (MRSR) mission study represents the latest stage in that interest. As part of NASA's preparation for a possible MRSR mission, a technology planning workshop was held to attempt to define technology requirements, options, and preliminary plans for the principal areas of Mars rover technology. The proceedings of that workshop are presented.

Considerations for preparing collaborative international research: a Ugandan experience.

PubMed

Musil, Carol M; Mutabaazi, Jemimah; Walusimbi, Mariam; Okonsky, Jennifer G; Biribonwa, Yedidah; Eagan, Sabrina; Dimarco, Marguerite A; Mbaballi, Speciosa; Fitzpatrick, Joyce J

2004-08-01

This article describes issues to consider when planning and conducting international research projects. Key considerations include building collaboration, developing a comprehensive and feasible research plan, funding and budgets, addressing human subjects concerns, and analyzing and disseminating project findings. These considerations and related methodological issues are discussed in the context of a replication pilot project conducted outside Kampala, Uganda. Ongoing dialog, flexibility, and collaboration, in addition to good science, are critical to developing successful international research projects.

Environmental Assessment for Replace Military Family Housing - Phase VI MacDill AFB, Florida

DTIC Science & Technology

2005-01-01

sulfur oxides (SOx), and particulate matter (PM10) were determined to be less than USEP A de minimis values and less than 10% of the Hillsborough County...by implementation of a sediment and erosion control plan as well as best management practices. Indirect and Cumulative Impacts: There are no site...housing units. The constmction and demolition activities of the Proposed Action were considered in conjunction with other on-going or planned constmction

Imaging Depression in Adults with ASD

DTIC Science & Technology

2017-10-01

collected temporally close enough to imaging data in Phase 2 to be confidently incorporated in the planned statistical analyses, and (b) not unduly risk...Phase 2 to be confidently incorporated in the planned statistical analyses, and (b) not unduly risk attrition between Phase 1 and 2, we chose to hold...supervision is ongoing (since 9/2014). • Co-l Dr. Lerner’s 2nd year Clinical Psychology PhD students have participated in ADOS- 2 Introductory Clinical

EPA's Ongoing Green Infrastructure Research

EPA Science Inventory

Green Infrastructure is a concept originating in the United States in the mid-1990's that highlights the importance of the natural environment in decisions about land use planning. In particular there is an emphasis on the “life support” functions provided by the natural environm...

The Choice Controversy.

ERIC Educational Resources Information Center

Cookson, Peter W., Jr., Ed.

Issues in school choice--constitutionality, feasibility, equity, and educational productivity--are examined in this book. The controversy requires an ongoing analysis of the origins of the school-choice movement, the kinds of plans proposed and implemented, their educational and social consequences, and the philosophical assumptions underlying the…

Advanced Education Business Plan 2005-2008

ERIC Educational Resources Information Center

Alberta Advanced Education, 2005

2005-01-01

In collaboration with learning providers, the advanced education system, industry, communities, government agencies and non-governmental organizations, Advanced Education strives to create accessible, affordable and quality learning opportunities that are responsive to the ongoing learning needs of Albertans. The Ministry's 2005-08 Business Plan…

The Long-Term Pavement Performance Program Roadmap: A Strategic Plan

DOT National Transportation Integrated Search

1995-09-01

The goal of the ongoing, 20-year long-term pavement performance (LTPP) studies is to give State and Provincial transportation departments- the owners and customers of the LTPP program-the information and tools they need to build and maintain longer-l...

A Consortium Approach to Faculty Renewal

ERIC Educational Resources Information Center

Taylor, William R.

1975-01-01

Four Long Island two- and four-year institutions have developed a model program of faculty development for history instructors. The plan offers workshops and conferences organized into an ongoing, adequately supported program that enables teachers to periodically renew and deepen their skills. (Author/NHM)

Best Practices in e-Assessment

ERIC Educational Resources Information Center

Buzetto-More, Nicole A.; Alade, Ayodele Julius

2006-01-01

According to Martell and Calderon (2005), assessment is an ongoing process that involves planning, discussion, consensus building, reflection, measuring, analyzing, and improving based on the data and artifacts gathered about a learning objective. Impacting education from early childhood through graduate studies, the assessment movement is based…

12 CFR 917.5 - Strategic business plan.

Code of Federal Regulations, 2010 CFR

2010-01-01

... ongoing market research and consultations with members, associates and public and private organizations... quantitative performance goals for Bank products related to multi-family housing, small business, small farm... existing activities; and (5) Be supported by appropriate and timely research and analysis of relevant...

12 CFR 917.5 - Strategic business plan.

Code of Federal Regulations, 2014 CFR

2014-01-01

... ongoing market research and consultations with members, associates and public and private organizations... quantitative performance goals for Bank products related to multi-family housing, small business, small farm... existing activities; and (5) Be supported by appropriate and timely research and analysis of relevant...

12 CFR 917.5 - Strategic business plan.

Code of Federal Regulations, 2013 CFR

2013-01-01

... ongoing market research and consultations with members, associates and public and private organizations... quantitative performance goals for Bank products related to multi-family housing, small business, small farm... existing activities; and (5) Be supported by appropriate and timely research and analysis of relevant...

12 CFR 917.5 - Strategic business plan.

Code of Federal Regulations, 2012 CFR

2012-01-01

... ongoing market research and consultations with members, associates and public and private organizations... quantitative performance goals for Bank products related to multi-family housing, small business, small farm... existing activities; and (5) Be supported by appropriate and timely research and analysis of relevant...

12 CFR 917.5 - Strategic business plan.

Code of Federal Regulations, 2011 CFR

2011-01-01

... ongoing market research and consultations with members, associates and public and private organizations... quantitative performance goals for Bank products related to multi-family housing, small business, small farm... existing activities; and (5) Be supported by appropriate and timely research and analysis of relevant...

An assessment of options for integrating taxicabs into an urban environment

DOT National Transportation Integrated Search

2001-03-01

Discussions surrounding the inclusion of taxicabs into the planning processes in urban areas have been ongoing since the oil crises of the 1970s. While there are some commonalties in the regulatory guidelines concerning taxicabs, most of the regulati...

75 FR 52701 - Approval and Promulgation of Implementation Plans; State of Missouri

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-27

... information claimed to be Confidential Business Information (CBI) or other information whose disclosure is.... Ventilation Limits 5. Ongoing Ventilation Testing and Reporting Requirements 6. Winter Construction Work..., including building enclosure and ventilation projects, implementation of work practice standards, process...

Arizona Road Weather Information System (RWIS) communications plan

DOT National Transportation Integrated Search

2003-04-01

There have been two implementations of Roadway Weather Information Systems in Arizona, known as RWIS Phase 0 and Phase 1. Each Phase has met with limited success and has on-going issues that need to be addressed before new RWIS sites are implemented....

Integrating strategic environmental assessment with industry planning: a case study of the Pasquai-Porcupine forest management plan, Saskatchewan, Canada.

PubMed

Noble, Bram F

2004-03-01

Strategic environmental assessment (SEA) is gaining widespread recognition as a tool for integrating environmental considerations in policy, plan, and program development and decision-making. Notwithstanding the potential of SEA to improve higher-order decision processes, there has been very little attention given to integrating SEA with industry planning practices. As a result, the benefits of SEA have yet to be fully realized among industrial proponents. That said, SEA practice is ongoing, albeit informally and often under a different label, and is proving to be a valuable tool for industry planning and decision-making. Based on a case study of the Pasquai-Porcupine forest management plan in Saskatchewan, Canada, this paper illustrates how an integrated approach to SEA can contribute to industry environmental decision-making and can enhance the quality and deliverability of industry plans.

Trust, but verify - Accuracy of clinical commercial radiation Treatment Planning Systems

NASA Astrophysics Data System (ADS)

Lehmann, J.; Kenny, J.; Lye, J.; Dunn, L.; Williams, I.

2014-03-01

Computer based Treatment Planning Systems (TPS) are used worldwide to design and calculate treatment plans for treating radiation therapy patients. TPS are generally well designed and thoroughly tested by their developers and local physicists prior to clinical use. However, the wide-reaching impact of their accuracy warrants ongoing vigilance. This work reviews the findings of the Australian national audit system and provides recommendations for checks of TPS. The Australian Clinical Dosimetry Service (ACDS) has designed and implemented a national system of audits, currently in a three year test phase. The Level III audits verify the accuracy of a beam model of a facility's TPS through a comparison of measurements with calculation at selected points in an anthropomorphic phantom. The plans are prescribed by the ACDS and all measurement equipment is brought in for independent onsite measurements. In this first version of audits, plans are comparatively simple, involving asymmetric fields, wedges and inhomogeneities. The ACDS has performed 14 Level III audits to-date. Six audits returned at least one measurement at Action Level, indicating that the measured dose differed more than 3.3% (but less than 5%) from the planned dose. Two audits failed (difference >5%). One fail was caused by a data transmission error coupled with quality assurance (QA) not being performed. The second fail was investigated and reduced to Action Level with the onsite audit team finding phantom setup at treatment a contributing factor. The Action Level results are attributed to small dose calculation deviations within the TPS, which are investigated and corrected by the facilities. Small deviations exist in clinical TPS which can add up and can combine with output variations to result in unacceptable variations. Ongoing checks and independent audits are recommended.

Minimizing treatment planning errors in proton therapy using failure mode and effects analysis

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

Zheng, Yuanshui, E-mail: yuanshui.zheng@okc.procure.com; Johnson, Randall; Larson, Gary

Purpose: Failure mode and effects analysis (FMEA) is a widely used tool to evaluate safety or reliability in conventional photon radiation therapy. However, reports about FMEA application in proton therapy are scarce. The purpose of this study is to apply FMEA in safety improvement of proton treatment planning at their center. Methods: The authors performed an FMEA analysis of their proton therapy treatment planning process using uniform scanning proton beams. The authors identified possible failure modes in various planning processes, including image fusion, contouring, beam arrangement, dose calculation, plan export, documents, billing, and so on. For each error, the authorsmore » estimated the frequency of occurrence, the likelihood of being undetected, and the severity of the error if it went undetected and calculated the risk priority number (RPN). The FMEA results were used to design their quality management program. In addition, the authors created a database to track the identified dosimetric errors. Periodically, the authors reevaluated the risk of errors by reviewing the internal error database and improved their quality assurance program as needed. Results: In total, the authors identified over 36 possible treatment planning related failure modes and estimated the associated occurrence, detectability, and severity to calculate the overall risk priority number. Based on the FMEA, the authors implemented various safety improvement procedures into their practice, such as education, peer review, and automatic check tools. The ongoing error tracking database provided realistic data on the frequency of occurrence with which to reevaluate the RPNs for various failure modes. Conclusions: The FMEA technique provides a systematic method for identifying and evaluating potential errors in proton treatment planning before they result in an error in patient dose delivery. The application of FMEA framework and the implementation of an ongoing error tracking system at their clinic have proven to be useful in error reduction in proton treatment planning, thus improving the effectiveness and safety of proton therapy.« less

Minimizing treatment planning errors in proton therapy using failure mode and effects analysis.

PubMed

Zheng, Yuanshui; Johnson, Randall; Larson, Gary

2016-06-01

Failure mode and effects analysis (FMEA) is a widely used tool to evaluate safety or reliability in conventional photon radiation therapy. However, reports about FMEA application in proton therapy are scarce. The purpose of this study is to apply FMEA in safety improvement of proton treatment planning at their center. The authors performed an FMEA analysis of their proton therapy treatment planning process using uniform scanning proton beams. The authors identified possible failure modes in various planning processes, including image fusion, contouring, beam arrangement, dose calculation, plan export, documents, billing, and so on. For each error, the authors estimated the frequency of occurrence, the likelihood of being undetected, and the severity of the error if it went undetected and calculated the risk priority number (RPN). The FMEA results were used to design their quality management program. In addition, the authors created a database to track the identified dosimetric errors. Periodically, the authors reevaluated the risk of errors by reviewing the internal error database and improved their quality assurance program as needed. In total, the authors identified over 36 possible treatment planning related failure modes and estimated the associated occurrence, detectability, and severity to calculate the overall risk priority number. Based on the FMEA, the authors implemented various safety improvement procedures into their practice, such as education, peer review, and automatic check tools. The ongoing error tracking database provided realistic data on the frequency of occurrence with which to reevaluate the RPNs for various failure modes. The FMEA technique provides a systematic method for identifying and evaluating potential errors in proton treatment planning before they result in an error in patient dose delivery. The application of FMEA framework and the implementation of an ongoing error tracking system at their clinic have proven to be useful in error reduction in proton treatment planning, thus improving the effectiveness and safety of proton therapy.

Robustness via Run-Time Adaptation of Contingent Plans

NASA Technical Reports Server (NTRS)

Bresina, John L.; Washington, Richard; Norvig, Peter (Technical Monitor)

2000-01-01

In this paper, we discuss our approach to making the behavior of planetary rovers more robust for the purpose of increased productivity. Due to the inherent uncertainty in rover exploration, the traditional approach to rover control is conservative, limiting the autonomous operation of the rover and sacrificing performance for safety. Our objective is to increase the science productivity possible within a single uplink by allowing the rover's behavior to be specified with flexible, contingent plans and by employing dynamic plan adaptation during execution. We have deployed a system exhibiting flexible, contingent execution; this paper concentrates on our ongoing efforts on plan adaptation, Plans can be revised in two ways: plan steps may be deleted, with execution continuing with the plan suffix; and the current plan may be merged with an "alternate plan" from an on-board library. The plan revision action is chosen to maximize the expected utility of the plan. Plan merging and action deletion constitute a more conservative general-purpose planning system; in return, our approach is more efficient and more easily verified, two important criteria for deployed rovers.

A Proof of the Convexity of the Free Boundary for Porous Flow through a Rectangular Dam Using the Maximum Principle.

DTIC Science & Technology

1979-04-01

di v a l u tat iv i n el la fisica— matematica , Accad. Naz. dci Lincel. 161—188(1975). fu LLER. K.: Barriers on cor.es for uniforalu elliptic...t ) — t ldt , (1.101 y and derived many properties of w . Further properties of w and u — y - ~~ have been obt .i i nod by C a f fa r el 11 t a...i ves art expa nsio n for t lit’ solution near t st-paid— t i O l l ~ o l n t C , and A it ch i s o n ( 1977) gives numer ica l solutions . R e c

Considerations for high occupancy vehicle (HOV) to high occupancy toll (HOT) lanes conversions guidebook.

DOT National Transportation Integrated Search

2007-06-01

The intent of this study is to explore the planning, design, and ongoing operation and maintenance of HOT facilities and to provide lessons learned and applicable technical guidance that will assist the state and local transportation planners and des...

Math CAMMP: A Constructivist Summer Camp for Teachers and Students

ERIC Educational Resources Information Center

Green, Michael; Piel, John A.

2012-01-01

A summer session, math methods course for elementary teachers incorporates 30 hours of instruction that emphasizes (1) developmentally appropriate instructional strategies, (2) hierarchical levels of increasingly abstract manipulatives, (3) ongoing assessment of student learning, (4) integrated thematic instructional modules, (5) team planning and…

Nurse-Managed Clinics: A Blueprint for Success Using the Covey Framework.

ERIC Educational Resources Information Center

Starck, Patricia L.; And Others

1995-01-01

Describes the process from inception to successful operation of a university-based, nurse-managed clinic, based on Covey's seven habits of highly effective people. Includes information on the planning process, financing, political strategies for gaining approval, and ongoing development of services. (JOW)

Computing and Systems Applied in Support of Coordinated Energy, Environmental, and Climate Planning

EPA Science Inventory

This talk focuses on how Dr. Loughlin is applying Computing and Systems models, tools and methods to more fully understand the linkages among energy systems, environmental quality, and climate change. Dr. Loughlin will highlight recent and ongoing research activities, including: ...

Expansion of the border crossing information system : final report, March 15, 2009.

DOT National Transportation Integrated Search

2009-03-15

There is no reliable system in place to measure and report border crossing times to either commercial : trade or travelers planning to cross the U.S.-Mexico border. This research project, in combination with : three other already funded and ongoing p...

Dietary Intervention to Mitigate the Health Effects of PM Exposure in Humans

EPA Science Inventory

Exposure to ambient air pollution is a major cause of global morbidity and mortality. This presentation will highlight previously published, ongoing and planned studies conducted at the Human Studies Facility that have examined the efficacy of nutritional supplementation in modul...

76 FR 56128 - Retrospective Review of Existing Regulations

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-12

..., welfare, safety, and our environment while promoting economic growth, innovation, competitiveness, and job creation.'' In furtherance of its ongoing efforts to update regulations to reflect market developments and... Commission in considering the development of a plan for the retrospective review of its regulations. DATES...

INVESTIGATING THE EFFICACY OF CLINICAL TRIAL MONITORING STRATEGIES: Design and Implementation of the Cluster Randomized START Monitoring Substudy

PubMed Central

Hullsiek, Katherine Huppler; Kagan, Jonathan M; Engen, Nicole; Grarup, Jesper; Hudson, Fleur; Denning, Eileen T; Carey, Catherine; Courtney-Rodgers, David; Finley, Elizabeth B; Jansson, Per O; Pearson, Mary T; Peavy, Dwight E; Belloso, Waldo H

2014-01-01

Background Trial monitoring protects participant safety and study integrity. While monitors commonly go on-site to verify source data, there is little evidence that this practice is efficient or effective. An ongoing international HIV treatment trial (START) provides an opportunity to explore the usefulness of different monitoring approaches. Methods All START sites are centrally monitored and required to follow a local monitoring plan requiring specific quality assurance activities. Additionally, sites were randomized (1:1) to receive, or not receive, annual on-site monitoring. The study will determine if on-site monitoring increases the identification of major protocol deviations (eligibility or consent violations, improper study drug use, primary or serious event underreporting, data alteration or fraud). Results The START study completed enrollment in December 2013, with planned follow-up through December 2016. The monitoring study is ongoing at 196 sites in 34 countries. Results are expected when the START study concludes in December 2016. PMID:25973346

Age-related changes in event-cued visual and auditory prospective memory proper.

PubMed

Uttl, Bob

2006-06-01

We rely upon prospective memory proper (ProMP) to bring back to awareness previously formed plans and intentions at the right place and time, and to enable us to act upon those plans and intentions. To examine age-related changes in ProMP, younger and older participants made decisions about simple stimuli (ongoing task) and at the same time were required to respond to a ProM cue, either a picture (visually cued ProM test) or a sound (auditorily cued ProM test), embedded in a simultaneously presented series of similar stimuli (either pictures or sounds). The cue display size or loudness increased across trials until a response was made. The cue size and cue loudness at the time of response indexed ProMP. The main results showed that both visual and auditory ProMP declined with age, and that such declines were mediated by age declines in sensory functions (visual acuity and hearing level), processing resources, working memory, intelligence, and ongoing task resource allocation.

Indexing NASA programs for technology transfer methods development and feasibility

NASA Technical Reports Server (NTRS)

Clingman, W. H.

1972-01-01

This project was undertaken to evaluate the application of a previously developed indexing methodology to ongoing NASA programs. These programs are comprehended by the NASA Program Approval Documents (PADS). Each PAD contains a technical plan for the area it covers. It was proposed that these could be used to generate an index to the complete NASA program. To test this hypothesis two PADS were selected by the NASA Technology Utilization Office for trial indexing. Twenty-five individuals indexed the two PADS using NASA Thesaurus terms. The results demonstrated the feasibility of indexing ongoing NASA programs using PADS as the source of information. The same indexing methodology could be applied to other documents containing a brief description of the technical plan. Results of this project showed that over 85% of the concepts in the technology should be covered by the indexing. Also over 85% of the descriptors chosen would be accurate. This completeness and accuracy for the indexing is considered satisfactory for application in technology transfer.

Ongoing contraception after use of emergency contraception from a specialist contraceptive service.

PubMed

Cameron, Sharon T; Glasier, Anna; Johnstone, Anne; Rae, Leanne

2011-10-01

A consultation for emergency contraception (EC) gives way to an opportunity to provide women with an ongoing effective method of contraception. A review of the case notes of women seeking EC from a large family planning clinic in Edinburgh, Scotland, was conducted to determine what percentage of women were provided with an effective method of ongoing contraception. Case notes of 460 women presenting for EC over a 2-year period were reviewed. Women were of mean age 26 years (range 15-49 years) and presented because they had used no contraception (47%), experienced condom failure (42%) or missed oral contraceptive pills (9%). Only 2% (n=11) were given an intrauterine device for EC. All women who had missed contraceptive pills prior to taking EC opted to continue this method. Only 23% (n=89) of women using no method or condoms at EC received supplies of an effective contraceptive method (pills, patch, injectable). Two thirds (n=263) of the women chose condoms for ongoing contraception. Research is required to develop strategies to improve the uptake of effective contraception after EC. Copyright © 2011 Elsevier Inc. All rights reserved.

A software tool for advanced MRgFUS prostate therapy planning and follow up

NASA Astrophysics Data System (ADS)

van Straaten, Dörte; Hoogenboom, Martijn; van Amerongen, Martinus J.; Weiler, Florian; Issawi, Jumana Al; Günther, Matthias; Fütterer, Jurgen; Jenne, Jürgen W.

2017-03-01

US guided HIFU/FUS ablation for the therapy of prostate cancer is a clinical established method, while MR guided HIFU/FUS applications for prostate recently started clinical evaluation. Even if MRI examination is an excellent diagnostic tool for prostate cancer, it is a time consuming procedure and not practicable within an MRgFUS therapy session. The aim of our ongoing work is to develop software to support therapy planning and post-therapy follow-up for MRgFUS on localized prostate cancer, based on multi-parametric MR protocols. The clinical workflow of diagnosis, therapy and follow-up of MR guided FUS on prostate cancer was deeply analyzed. Based on this, the image processing workflow was designed and all necessary components, e.g. GUI, viewer, registration tools etc. were defined and implemented. The software bases on MeVisLab with several implemented C++ modules for the image processing tasks. The developed software, called LTC (Local Therapy Control) will register and visualize automatically all images (T1w, T2w, DWI etc.) and ADC or perfusion maps gained from the diagnostic MRI session. This maximum of diagnostic information helps to segment all necessary ROIs, e.g. the tumor, for therapy planning. Final therapy planning will be performed based on these segmentation data in the following MRgFUS therapy session. In addition, the developed software should help to evaluate the therapy success, by synchronization and display of pre-therapeutic, therapy and follow-up image data including the therapy plan and thermal dose information. In this ongoing project, the first stand-alone prototype was completed and will be clinically evaluated.

Space station freedom life sciences activities

NASA Technical Reports Server (NTRS)

Taylor, G. R.

1994-01-01

Life sciences activities being planned for Space Station Freedom (SSF) as of Fall 1992 are discussed. Planning for these activities is ongoing. Therefore, this description should be viewed as indicative of the prevailing ideas at one particular time in the SSF development cycle. The proposed contributions of the Canadian Space Agency (CSN) the European Space Agency (ESA), Japan, and the United States are all discussed in detail. In each case, the life sciences goals, and the way in which each partner proposes to achieve their goals, are reviewed.

Measures of Effectiveness-CONUS Reorganization 1973 (As Pertains to FORSCOM, TRADOC, HSC, OTEA and CAA). Volume 2. Detailed Evaluation Plan and Appendixes A to E

DTIC Science & Technology

1974-11-01

management, organization, and operation of activities designed to achieve the mission/function covered by the measure. An important use of the...presents an evaluation plan designed to assist the Army in the overall assessment of its effectiveness in terms of the goals of the CONUS...ongoing operations plus encourage the design and imple- mentation of any needed changes in the future without excessive delav and turbulence

Human Space Flight Plans Committee

NASA Image and Video Library

2009-06-16

Norman Augustine, chair of the Human Space Flight Review Committee, listens to a comment from the audience during the first of several public meetings at different U.S. locations, Wednesday, June 17, 2009, at the Carnegie Institution in Washington. The panel will examine ongoing and planned NASA development activities and potential alternatives in order to present options for advancing a safe, innovative, affordable and sustainable human space flight program following the space shuttle's retirement. The committee wil present its results by August 2009. Photo Credit: (NASA/Paul E. Alers)

Human Space Flight Plans Committee

NASA Image and Video Library

2009-06-16

Norman Augustine, chair of the Human Space Flight Review Committee, makes a point during the first of several public meetings at different U.S. locations, Wednesday, June 17, 2009, at the Carnegie Institution in Washington. The panel will examine ongoing and planned NASA development activities and potential alternatives in order to present options for advancing a safe, innovative, affordable and sustainable human space flight program following the space shuttle's retirement. The committee wil present its results by August 2009. Photo Credit: (NASA/Paul E. Alers)

Development of practice principles for the management of ongoing suicidal ideation in young people diagnosed with major depressive disorder.

PubMed

Rice, Simon M; Simmons, Magenta B; Bailey, Alan P; Parker, Alexandra G; Hetrick, Sarah E; Davey, Christopher G; Phelan, Mark; Blaikie, Simon; Edwards, Jane

2014-01-01

There is a lack of clear guidance regarding the management of ongoing suicidality in young people experiencing major depressive disorder. This study utilised an expert consensus approach in identifying practice principles to complement relevant clinical guidelines for the treatment of major depressive disorder in young people. The study also sought to outline a broad treatment framework for clinical intervention with young people experiencing ongoing suicidal ideation. In-depth focus groups were undertaken with a specialist multidisciplinary clinical team (the Youth Mood Clinic at Orygen Youth Health Clinical Program, Melbourne) working with young people aged 15-25 years experiencing ongoing suicidal ideation. Each focus group was audio recorded and transcribed verbatim using orthographic conventions. Principles of grounded theory and thematic analysis were used to analyse and code the resultant data. The identified codes were subsequently synthesised into eight practice principles reflecting engagement and consistency of care, ongoing risk assessment and documentation, individualised crisis planning, engaging systems of support, engendering hopefulness, development of adaptive coping, management of acute risk, and consultation and supervision. The identified practice principles provide a broad management framework, and may assist to improve treatment consistency and clinical management of young people experiencing ongoing suicidal ideation. The practice principles may be of use to health professionals working within a team-based setting involved in the provision of care, even if peripherally, to young people with ongoing suicidal ideation. Findings address the lack of treatment consistency and shared terminology and may provide containment and guidance to multidisciplinary clinicians working with this at-risk group.

Effectiveness of an Ongoing, Community-Based Breast Cancer Prevention Program for Korean American Women.

PubMed

Koh, Eun; Choi, Ga-Young; Cho, Ji Young

2016-02-01

The study evaluates the effectiveness of an ongoing, community-based breast cancer prevention program offered by a local social services agency in the Washington, DC, metropolitan area. Korean American women who participated in this breast cancer prevention program were compared with those who did not participate in their knowledge, attitude, and screening behaviors. The study found that the intervention group was more knowledgeable on breast cancer and related services and reported more positive attitudes toward breast cancer screening services than the comparison group. The participants in the intervention group were also more likely to plan to receive a mammogram than those in the comparison group. However, significant differences were not observed in the two groups in their intention to receive a clinical breast examination. The study findings suggest that an ongoing, community-based breast cancer prevention program can be an effective method of addressing breast cancer prevention disparities observed among Korean American women.

Workshop proceedings: Information Systems for Space Astrophysics in the 21st Century, volume 1

NASA Technical Reports Server (NTRS)

Cutts, James (Editor); Ng, Edward (Editor)

1991-01-01

The Astrophysical Information Systems Workshop was one of the three Integrated Technology Planning workshops. Its objectives were to develop an understanding of future mission requirements for information systems, the potential role of technology in meeting these requirements, and the areas in which NASA investment might have the greatest impact. Workshop participants were briefed on the astrophysical mission set with an emphasis on those missions that drive information systems technology, the existing NASA space-science operations infrastructure, and the ongoing and planned NASA information systems technology programs. Program plans and recommendations were prepared in five technical areas: Mission Planning and Operations; Space-Borne Data Processing; Space-to-Earth Communications; Science Data Systems; and Data Analysis, Integration, and Visualization.

Tomorrow Is Today at Silver Ridge.

ERIC Educational Resources Information Center

Wise, B. J.

1994-01-01

Describes a Washington State school's efforts to forego factory-model education for a boldly restructured curriculum dependent on new technologies, such as computer networks, two-year classrooms, ongoing staff development and planning sessions, and an innovative onsite day-care program for staff and students. The school has succeeded in…

Considerations for high occupancy vehicle (HOV) lane to high occupancy toll (HOT) lane conversions guidebook

DOT National Transportation Integrated Search

2007-06-01

The intent of this study is to explore the planning, design, and ongoing operation and maintenance of HOT facilities and to provide lessons learned and applicable technical guidance that will assist the state and local transportation planners and des...

Kaua'i National Wildlife Refuge Complex : Kilauea Point National Wildlife Refuge comprehensive transportation planning study.

DOT National Transportation Integrated Search

2017-03-01

An increase in the intensity of visitation and an associated increase in congestion entering the Klauea Point National Wildlife Refuge prompted the U.S. Fish and Wildlife Service (USFWS) to find solutions to ease ongoing traffic-related problems. W...

Managing Ongoing EVSE Costs

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

Hodge, Cabell

The costs associated with EVSE begin with picking the best location and unit for the job, but they continue with electricity and network charges through the life of your vehicle. This presentation tells how to balance electricity demand charges and network management costs through smart planning at your program's inception.

Assessing the Effectiveness of the International Counterproliferation Program

DTIC Science & Technology

2011-01-01

a box labeled “Ongoing needs assessment.” Within this box are the two key planning actions that contribute to this type of assessment: identification ...nation, all participating countries tend to receive a fairly standardized set of courses. This course lineup is determined largely by the ICP

The Role of Modern Control Theory in the Design of Controls for Aircraft Turbine Engines

NASA Technical Reports Server (NTRS)

Zeller, J.; Lehtinen, B.; Merrill, W.

1982-01-01

Accomplishments in applying Modern Control Theory to the design of controls for advanced aircraft turbine engines were reviewed. The results of successful research programs are discussed. Ongoing programs as well as planned or recommended future thrusts are also discussed.

Living-History Villages as Popular Entertainers.

ERIC Educational Resources Information Center

Geist, Christopher D.

1994-01-01

Discusses the furor created when Walt Disney Studios announced plans to develop a "historic amusement park" near the Manassas (Virginia) National Battlefield Park. Maintains that the public debate over the popular understanding of history reflects an ongoing tension between academic historians and the purveyors of popular history. (CFR)

75 FR 3753 - Tishomingo National Wildlife Refuge, Comprehensive Conservation Plan, Johnston County, OK

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-22

... equivalent to existing restoration practices. Recreational opportunities would continue to be limited to... improved or expanded to accommodate more visitors. Current habitat management practices would continue... management practices would contribute to ongoing monitoring and modification of Refuge resources for years to...

Multi-species benefits of the proposed North American sage-grouse management plan

Treesearch

Clait E. Braun

2005-01-01

The population size and distribution of the two species of sage-grouse (Greater – Centrocercus urophasianus and Gunnison – C. minimus) populations have become greatly reduced throughout western North America because of habitat changes. Threats are ongoing to the remaining sagebrush (Artemisia ...

[An application of the strategy results cycle to HIV/AIDS strategic planning in Latin America].

PubMed

Rodríguez-García, Rosalía; Rosenberg, Hernán

2013-07-01

To describe the Strategy Results Cycle (SRC), a model that approaches planning as an ongoing cycle of seven phases that continually responds and adapts to existing evidence. Reliable sources were used for the preparation of databases and expenditure-costing data for resources needs analysis. The planning process 6-9 months to complete a national strategic plan that was informed by evidence, focused on results and costed. Knowledge transfer facilitated national leadership and stakeholders' participation. Between 2007 and 2011, 13 of 16 countries adopted the Strategy Results Cycle model. The evidence supported the identification of results and the expenditure-costing analysis improved budget allocation efficiency. The SRC facilitated purposeful participation and added value to previous planning approaches by connecting "thinking" and "doing" which resulted in national strategic plans that are designed by stakeholders, relevant to local conditions, and can guide implementation and resource mobilization.

Pandemic Influenza Planning, United States, 1978–2008

PubMed Central

Strikas, Raymond A.; Gensheimer, Kathleen F.; Cox, Nancy J.; Redd, Stephen C.

2013-01-01

During the past century, 4 influenza pandemics occurred. After the emergence of a novel influenza virus of swine origin in 1976, national, state, and local US public health authorities began planning efforts to respond to future pandemics. Several events have since stimulated progress in public health emergency planning: the 1997 avian influenza A(H5N1) outbreak in Hong Kong, China; the 2001 anthrax attacks in the United States; the 2003 outbreak of severe acute respiratory syndrome; and the 2003 reemergence of influenza A(H5N1) virus infection in humans. We outline the evolution of US pandemic planning since the late 1970s, summarize planning accomplishments, and explain their ongoing importance. The public health community’s response to the 2009 influenza A(H1N1)pdm09 pandemic demonstrated the value of planning and provided insights into improving future plans and response efforts. Preparedness planning will enhance the collective, multilevel response to future public health crises. PMID:23731839

Communications Contingency Plan: Planning for Crises and Controversy. Phase 1

NASA Technical Reports Server (NTRS)

Treise, Deborah; Bernstein, Arla G.; Yates, Brad

1998-01-01

Interviews were conducted with a variety of Marshall Space Flight Center personnel and local media representatives in Huntsville, Alabama, in order to identify the current perceptions of these individuals regarding communication effectiveness between MSFC and the media. The purposes of the Phase One report are to (1) assess the need for a contingency plan for communicating in situations of crisis and controversy; (2) identify goals and objectives for the planning process; and (3) provide recommendations for future planning activities to achieve the goals and objectives outlined in Phase One. It is strongly recommended that MSFC personnel who are involved in communications with the media participate in a facilitated, strategic communications planning process in order to develop Phase Two of the Communications Contingency Plan (CCP). Phase Two will address (1) the categorizing, ranking and prioritizing of crises and controversies; (2) the development of action steps and implementation strategies for the CCP; and (3) the development of a monitoring and evaluation process for ongoing plan effectiveness.

The PLAID graphics analysis impact on the space program

NASA Technical Reports Server (NTRS)

Nguyen, Jennifer P.; Wheaton, Aneice L.; Maida, James C.

1994-01-01

An ongoing project design often requires visual verification at various stages. These requirements are critically important because the subsequent phases of that project might depend on the complete verification of a particular stage. Currently, there are several software packages at JSC that provide such simulation capabilities. We present the simulation capabilities of the PLAID modeling system used in the Flight Crew Support Division for human factors analyses. We summarize some ongoing studies in kinematics, lighting, EVA activities, and discuss various applications in the mission planning of the current Space Shuttle flights and the assembly sequence of the Space Station Freedom with emphasis on the redesign effort.

Bringing Back a Healthy Buzz? Invertebrate Parasites and Reintroductions: A Case Study in Bumblebees.

PubMed

Brown, Mark J F; Sainsbury, Anthony W; Vaughan-Higgins, Rebecca J; Measures, Gavin H; Jones, Catherine M; Gammans, Nikki

2017-03-01

Reintroductions can play a key role in the conservation of endangered species. Parasites may impact reintroductions, both positively and negatively, but few case studies of how to manage parasites during reintroductions exist. Bumblebees are in decline at regional and global scales, and reintroductions can be used to re-establish extinct local populations. Here we report on how the risks associated with parasites are being managed in an ongoing reintroduction of the short-haired bumblebee, Bombus subterraneus, to the UK. Disease risk analysis was conducted and disease risk management plans constructed to design a capture-quarantine-release system that minimised the impacts on both the bumblebees and on their natural parasites. Given that bumblebee parasites are (i) generalists, (ii) geographically ubiquitous, and (iii) show evidence of local adaptation, the disease risk management plan was designed to limit the co-introduction of parasites from the source population in Sweden to the destination site in the UK. Results suggest that this process at best eliminated, or at least severely curtailed the co-introduction of parasites, and ongoing updates of the plan enabled minimization of impacts on natural host-parasite dynamics in the Swedish source population. This study suggests that methods designed for reintroductions of vertebrate species can be successfully applied to invertebrates. Future reintroductions of invertebrates where the parasite fauna is less well known should take advantage of next-generation barcoding and multiple survey years prior to the start of reintroductions, to develop comprehensive disease risk management plans.

Social Impact Management Plans: Innovation in corporate and public policy

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

Franks, Daniel M., E-mail: d.franks@uq.edu.au; Vanclay, Frank, E-mail: frank.vanclay@rug.nl

Social Impact Assessment (SIA) has traditionally been practiced as a predictive study for the regulatory approval of major projects, however, in recent years the drivers and domain of focus for SIA have shifted. This paper details the emergence of Social Impact Management Plans (SIMPs) and undertakes an analysis of innovations in corporate and public policy that have put in place ongoing processes – assessment, management and monitoring – to better identify the nature and scope of the social impacts that might occur during implementation and to proactively respond to change across the lifecycle of developments. Four leading practice examples aremore » analyzed. The International Finance Corporation (IFC) Performance Standards require the preparation of Environmental and Social Management Plans for all projects financed by the IFC identified as having significant environmental and social risks. Anglo American, a major resources company, has introduced a Socio-Economic Assessment Toolbox, which requires mine sites to undertake regular assessments and link these assessments with their internal management systems, monitoring activities and a Social Management Plan. In South Africa, Social and Labour Plans are submitted with an application for a mining or production right. In Queensland, Australia, Social Impact Management Plans were developed as part of an Environmental Impact Statement, which included assessment of social impacts. Collectively these initiatives, and others, are a practical realization of theoretical conceptions of SIA that include management and monitoring as core components of SIA. The paper concludes with an analysis of the implications for the practice of impact assessment including a summary of key criteria for the design and implementation of effective SIMPs. -- Highlights: • Social impact management plans are effective strategies to manage social issues. • They are developed in partnership with regulatory agencies, investors and community. • SIMPs link assessment to ongoing management and address social and community issues. • SIMPs clarify responsibilities in the management of impacts, opportunities and risks. • SIMPs demonstrate a shift to include management as a core component of SIA practice.« less

A School-Based Quality Improvement Program.

ERIC Educational Resources Information Center

Rappaport, Lewis A.

1993-01-01

As one Brooklyn high school discovered, quality improvement begins with administrator commitment and participants' immersion in the literature. Other key elements include ongoing training of personnel involved in the quality-improvement process, tools such as the Deming Cycle (plan-do-check-act), voluntary and goal-oriented teamwork, and a worthy…

The Management Development Needs of Front-Line Managers: Voices from the Field.

ERIC Educational Resources Information Center

Longenecker, Clinton O.; Neubert, Mitchell

2003-01-01

A survey of 524 managers identified key practices to improve performance in a changing environment: clarifying roles, goals, and expectations; ongoing performance evaluation, feedback, and coaching; mentoring; challenging assignments; formal career planning; customer contact; cross-training; and 360-degree feedback. (Contains 31 references.) (SK)

The Dynamics of University/City Government Relationships: It's Personal

ERIC Educational Resources Information Center

Curry, Joanne E.

2016-01-01

The rich potential of university/city government relationships is often overwhelmed by day-to-day conflicts over everything from planning and land use to transportation and noise. Such disputes--even a single, unresolved incident--can create an enduring narrative of antagonism that undermines the relationship ongoing. Leveraging recent doctoral…

Embrace the Chaos

ERIC Educational Resources Information Center

Huwe, Terence K.

2009-01-01

"Embracing the chaos" is an ongoing challenge for librarians. Embracing the chaos means librarians must have a plan for responding to the flood of new products, widgets, web tools, and gizmos that students use daily. In this article, the author argues that library instruction and access services have been grappling with that chaos with…

Assessment of Institutional Effectiveness at the University of Tennessee, Knoxville.

ERIC Educational Resources Information Center

Banta, Trudy W.; And Others

1986-01-01

The University of Tennessee at Knoxville has successfully integrated a program for assessing student outcomes in the ongoing institutional processes of peer review, strategic planning, and internal resource allocation. Students are tested in general education and their major fields and participate in curriculum and instructional evaluations.…

Merging Expertise: Preparing Collaborative Educators

ERIC Educational Resources Information Center

Altieri, Elizabeth M.; Colley, Kenna M.; Daniel, Leslie S.; Dickenson, Kathie W.

2015-01-01

In this article, teacher education faculty of a medium-size university, historically grounded in teacher preparation within a rural context, describe their ongoing work to transform their practice in order to prepare special and general educators who co-plan, co-teach, and co-assess with their counterparts in the field. Follow-up research with…

Managing for Results--Linking Performance Measures and Budgets.

ERIC Educational Resources Information Center

McGee, William L.; Fountain, James R., Jr.

1995-01-01

The Government Accounting Standards Board notion of service efforts and accomplishments reporting is one step in a process of managing for results that includes strategic planning, development and use of performance measures of managing ongoing programs, and outputs to budgetary appropriation. Reports a trial application to one school district.…

Funding for Library Automation.

ERIC Educational Resources Information Center

Thompson, Ronelle K. H.

This paper provides a brief overview of planning and implementing a project to fund library automation. It is suggested that: (1) proposal budgets should include all costs of a project, such as furniture needed for computer terminals, costs for modifying library procedures, initial supplies, or ongoing maintenance; (2) automation does not save…

Glacier National Park : Going-to-the-Sun Road Corridor management plan - existing conditions of the transportation system

DOT National Transportation Integrated Search

2014-06-27

The Going-to-the-Sun Road (GTSR) Corridor has been undergoing major shifts in use due to ongoing construction, implementation of a shuttle system, and changes in visitor use patterns. Glacier National Park (GLAC) is developing the GTSR Transportation...

Implementing RTI[superscript 2]: Reports from the Field. Policy Brief

ERIC Educational Resources Information Center

Dawkins, Shardae

2014-01-01

Starting in 2014-15, districts across the state of Tennessee must implement a Response to Instruction and Intervention (RTI[superscript 2]) plan. RTI[superscript 2] is an instructional framework which provides ongoing monitoring of student performance and progress through the use of universal student screeners and interventions targeted at…

A Relationship Marketing Approach to Academic Initiative Planning: A Case in Point

ERIC Educational Resources Information Center

Mobley, Mary F.; Basciano, Peter

2012-01-01

Many higher education initiatives are dependent upon the development of multiple relationships across academic and support functions. The probability of achieving superior initiative outcomes rests, in part, on the construction of an infrastructure that supports the goals, strategies, tactics, and ongoing mission of a defined project. Through…

Secondary School Transition: Planning for Success.

ERIC Educational Resources Information Center

Hemphill, Rae

Parents of adolescents with attention deficit disorders are offered suggestions for easing the transition of their teen from elementary to secondary school. Careful scheduling of classes with the guidance counselor to "fit" the individual teen's needs is urged. The importance of ongoing communication with the school concerning class progress,…

The Role of Curriculum in Organizational Significant Change Planning

ERIC Educational Resources Information Center

Chrusciel, Don

2006-01-01

Purpose: With significant change as an ongoing challenge, the development and use of a flexible change curriculum is identified as a success factor that will allow an organization to optimize the outcome from change transformations. Design/methodology/approach: After discussing significant change, this paper will contrast two organizations in…

Prevention-Related Research Targeting African American Alternative Education Program Students

ERIC Educational Resources Information Center

Carswell, Steven B.; Hanlon, Thomas E.; Watts, Amy M.; O'Grady, Kevin E.

2014-01-01

This article reports on a program of research that examined the background, planning, implementation, and evaluation of an after-school preventive intervention program within an ongoing urban alternative education program targeting African American students referred to the school because of their problematic behavior in regular schools. The…

40 CFR 51.368 - Public information and consumer protection.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 2 2013-07-01 2013-07-01 false Public information and consumer.../Maintenance Program Requirements § 51.368 Public information and consumer protection. (a) Public awareness. The SIP shall include a plan for informing the public on an ongoing basis throughout the life of the I...

Closing the Chasm: Preparing and Building Post-Conflict Civil Capacity

DTIC Science & Technology

2010-03-18

vii Background and Analysis ...CLOSING THE CHASM: PREPARING AND BUILDING POST-CONFLICT CIVIL CAPACITY Background and Analysis Introduction Plans fail for lack of counsel... rhythmic comfort zone. The lack of Human Resource depth in the military and other Federal agencies‘ directly impact their priorities of ongoing

36 CFR 72.17 - Preliminary Action Program-commitments to be included.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 36 Parks, Forests, and Public Property 1 2011-07-01 2011-07-01 false Preliminary Action Program-commitments to be included. 72.17 Section 72.17 Parks, Forests, and Public Property NATIONAL PARK SERVICE... commitment to park and recreation systems by establishing ongoing planning, rehabilitation, service...

36 CFR 72.17 - Preliminary Action Program-commitments to be included.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 36 Parks, Forests, and Public Property 1 2010-07-01 2010-07-01 false Preliminary Action Program-commitments to be included. 72.17 Section 72.17 Parks, Forests, and Public Property NATIONAL PARK SERVICE... commitment to park and recreation systems by establishing ongoing planning, rehabilitation, service...

78 FR 5409 - Ongoing Equivalence Verifications of Foreign Food Regulatory Systems

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-25

... of data shared. Finally, with respect to POE re-inspections, NACMPI recommended the targeting of high-risk product and high-risk imports for sampling and other verification activities during reinspection... authority; the availability of contingency plans in the country for containing and mitigating the effects of...

Strategies for monitoring terrestrial animals and habitats

Treesearch

Richard Holthausen; Raymond L. Czaplewski; Don DeLorenzo; Greg Hayward; Winifred B. Kessler; Pat Manley; Kevin S. McKelvey; Douglas S. Powell; Leonard F. Ruggiero; Michael K. Schwartz; Bea Van Horne; Christina D. Vojta

2005-01-01

This General Technical Report (GTR) addresses monitoring strategies for terrestrial animals and habitats. It focuses on monitoring associated with National Forest Management Act planning and is intended to apply primarily to monitoring efforts that are broader than individual National Forests. Primary topics covered in the GTR are monitoring requirements; ongoing...

76 FR 10064 - Notice of Public Meeting of the Central California Resource Advisory Council

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-23

... associated with public land management in Central California. At this meeting, agenda topics will include an update on Resource Management Plans and other resource management issues. Additional ongoing business... DEPARTMENT OF THE INTERIOR Bureau of Land Management [LLCAC01000 L10100000.XZ0000 LXSIOVHD0000...

The Research Funding Guidebook: Getting It, Managing It, and Renewing It.

ERIC Educational Resources Information Center

Ries, Joanne B.; Leukefeld, Carl G.

This guide, intended primarily for new or inexperienced researchers, provides suggestions for obtaining and maintaining external funding from grants and contracts. It emphasizes that this effort requires considerable thought, ongoing planning, sound management, and clear decisions. The book uses the National Institutes of Health application and…

Developing a Successful Asynchronous Online Extension Program for Forest Landowners

ERIC Educational Resources Information Center

Zobrist, Kevin W.

2014-01-01

Asynchronous online Extension classes can reach a wide audience, is convenient for the learner, and minimizes ongoing demands on instructor time. However, producing such classes takes significant effort up front. Advance planning and good communication with contributors are essential to success. Considerations include delivery platforms, content…

The Possibility of Public Education in an Instrumentalist Age

ERIC Educational Resources Information Center

Higgins, Chris

2011-01-01

In our increasingly instrumentalist culture, debates over the privatization of schooling may be beside the point. Whether we hatch some new plan for chartering or funding schools, or retain the traditional model of government-run schools, the ongoing instrumentalization of education threatens the very possibility of public education. Indeed, in…

Aerothermodynamics and Turbulence

DTIC Science & Technology

2013-03-08

Surface Heat Transfer and Detailed Flow Structure Fuel Injection in a Scramjet Combustor Reduced Uncertainty in Complex Flows Addressing... hypersonic flight data to capture shock interaction unsteadiness National Hypersonic Foundational Research Plan Joint Technology Office... Hypersonics Basic Science Roadmap Assessment of SOA and Future Research Directions Ongoing Basic Research for Understanding and Controlling Noise

Homogeneous v. Heterogeneous: Is Tracking a Barrier to Equity?

ERIC Educational Resources Information Center

Polansky, Harvey B.

1995-01-01

Tracking has contributed considerably to the basic inequality of funding among American schools. To move to a heterogenous environment, districts must understand the concept of resource and program equity, commit to a planning process that allocates time and resources, provide ongoing inservice, downplay standardized test results, and phase-in…

NASA Wallops Flight Facility Air-Sea Interaction Research Facility

NASA Technical Reports Server (NTRS)

Long, Steven R.

1992-01-01

This publication serves as an introduction to the Air-Sea Interaction Research Facility at NASA/GSFC/Wallops Flight Facility. The purpose of this publication is to provide background information on the research facility itself, including capabilities, available instrumentation, the types of experiments already done, ongoing experiments, and future plans.

SPring-8 BL44XU, beamline designed for structure analysis of large biological macromolecular assemblies

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

Higashiura, Akifumi, E-mail: hgsur-a@protein.osaka-u.ac.jp; Yamashita, Eiki; Yoshimura, Masato

2016-07-27

Beamline BL44XU at SPring-8 is operated by the Institute for Protein Research of Osaka University. The beamline is designed for X-ray crystallography of large biological macromolecular assemblies. Here we show its detailed performances, results, and the ongoing upgrade plans.

A Method to Assess Climate-Relevant Decisions: Application in the Chesapeake Bay (2010 External Review Draft)

EPA Science Inventory

The goal of this study is to formalize an approach to inventory and analyze management decisions in order to produce useful information targeted toward effective adaptation to climate change. The approach uses as its starting point ongoing planning processes and decisions geared ...

42 CFR 51.10 - Remedial actions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 1 2011-10-01 2011-10-01 false Remedial actions. 51.10 Section 51.10 Public Health... actions. Failure to submit an annual report in the designated format on time or to submit requested information and documentation, corrective action plans and ongoing implementation status reports in response...

It Takes a Community

ERIC Educational Resources Information Center

Weasmer, Jerie; Woods, Amelia Mays

2010-01-01

Modifying course plans to accommodate diverse learners seems simple in theory. However, when faced with specific applications, many teachers feel lost. In a school community, they need not feel alone. General classroom teachers have several sources of ongoing support available to help them extend their teaching repertoire to meet their students'…

The Role of Learner-Centred Assessment in Postsecondary Organisational Change

ERIC Educational Resources Information Center

Webber, Karen L.; Tschepikow, Kyle

2013-01-01

For postsecondary institutions, organisational change is an inevitable and ongoing process. Institutions face a growing need to assess student learning assessment as part of an institution's comprehensive assessment plan. While a growing body of literature suggests that learner-centred assessment is a best practice in higher education pedagogy, it…

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

Benioff, R.; Ness, E.; Hirst, J.

Under its Support for National Action Plans (SNAP) initiative, the U.S. Country Studies Program is providing financial and technical assistance to 18 countries for the development of climate change action plans. Although most of the countries have not yet completed their plans, the important lessons learned thus far are valuable and should be shared with other countries and international institutions that have an interest in the process of action plan development. This interim report describes the experience of 11 countries that are the furthest along in their planning activity and who have offered to share their results to date withmore » the larger community of interested nations. These action plans delineate specific mitigation and adaptation measures that the countries will implement and integrate into their ongoing development programs. This report focuses on the measures the countries have selected and the methods they used to prepare their action plans. This executive summary presents key lessons and common themes using a structure similar to that used in the individual country chapters.« less

Proceedings of Colloquium/Workshop on Composite Materials and Structures, Standardization, Qualification, Certification Held at Washington, DC on 8-10 May 1984.

DTIC Science & Technology

1984-07-01

CHANNON JUL 84 IDA-D-7e EhhhChEIE’hSED hhhE-84C-hhIE/G11/hI A~ 4 - &1220 MICROCOPY RESOLUTION TEST CHART NATIONAL BUREAU Of STANDARDS-1963-A cm" 154dM...IDALg N.NO W0.2 W8 . . . .. . . . .’% >. .’. 2. *~~~~~~7 F. V.* * 4 .-& - * ** The wrk rupsed hIts d.... de wuo uumiucd maig Peurt b MM 06384 C 0631...I REP REPORT DOCUMENTATION PAGE E DCY SOJ I. REPOR mussee A4rEV~ION NO. PMRS4 EN TI CATALO0 GE , 4 T~IT iW# sbftt Clcui bkhP Or REPORT a PERIOD

Developing clinical leadership capability.

PubMed

Pintar, Kristi A; Capuano, Terry A; Rosser, Gwendolyn D

2007-01-01

Nursing facilities must be committed to ongoing leadership development and to developing and retaining their staff in the increasingly competitive healthcare market. In this article, the authors share the processes involved in creating a focused small group approach to developing clinical leaders. Programmatic approaches to development, clarity of needs of those targeted for development, individual development plans, external expertise partnerships, and small group session dynamics are discussed. Applications of the process and lessons learned from the program will benefit others in their efforts to enhance organization succession planning, leadership development, group learning, and program administration.

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

Not Available

This publication is one in an ongoing series of case studies for "Laboratories for the 21st Century," a joint program of the U.S. Environmental Protection Agency and the U.S. Department of Energy Federal Energy Management Program. It is intended for all those who plan, design, and construct public and private-sector laboratory buildings. This study describes how the Nidus Center, a nonprofit incubator for life sciences and plan biotechnology established by Monsanto Company, employs daylighting, an energy-efficient mechanical system featuring energy recovery, and water conservation practices, among others, to save energy and money and help conserve natural resources.

The American Jobs Creation Act and its impact on deferred compensation: reassessment from a business perspective.

PubMed

Johnson, David G

2005-01-01

The American Jobs Creation Act (AJCA), which was signed into law in October 2004, will have an impact on almost every deferred compensation program in the United States. This article argues that as companies continue to evaluate the transition alternatives under AJCA and contemplate the necessary changes to the plan program, companies also should consider simultaneously addressing broader issues surrounding nonqualified deferred compensation arrangements. These include ongoing business purpose, financial planning considerations, education of participants, corporate governance considerations and the potential implications to international assignees.

Regenerative Life Support Evaluation

NASA Technical Reports Server (NTRS)

Kleiner, G. N.; Thompson, C. D.

1977-01-01

This paper describes the development plan and design concept of the Regenerative Life Support Evaluation (RLSE) planned for flight testing in the European Space Agency Spacelab. The development plan encompasses the ongoing advanced life support subsystem and a systems integration effort to evolve concurrently subsystem concepts that perform their function and can be integrated with other subsystems in a flight demonstration of a regenerative life support system. The design concept for RLSE comprises water-electrolysis O2 generation, electrochemically depolarized CO2 removal, and Sabatier CO2 reduction for atmosphere regeneration, urine vapor-compression distillation, and wash-water hyperfiltration for waste-water recovery. The flight demonstration by RLSE is an important step in qualifying the regenerative concepts for life support in space stations.

Ernest Orlando Lawrence Berkeley National Laboratory Institutional Plan FY 2000-2004

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

Chartock, Mike; Hansen, Todd

1999-08-01

The FY 2000-2004 Institutional Plan provides an overview of the Ernest Orlando Lawrence Berkeley National Laboratory (Berkeley Lab, the Laboratory) mission, strategic plan, initiatives, and the resources required to fulfill its role in support of national needs in fundamental science and technology, energy resources, and environmental quality. To advance the Department of Energy's ongoing efforts to define the Integrated Laboratory System, the Berkeley Lab Institutional Plan reflects the strategic elements of our planning efforts. The Institutional Plan is a management report that supports the Department of Energy's mission and programs and is an element of the Department of Energy's strategicmore » management planning activities, developed through an annual planning process. The Plan supports the Government Performance and Results Act of 1993 and complements the performance-based contract between the Department of Energy and the Regents of the University of California. It identifies technical and administrative directions in the context of the national energy policy and research needs and the Department of Energy's program planning initiatives. Preparation of the plan is coordinated by the Office of Planning and Communications from information contributed by Berkeley Lab's scientific and support divisions.« less

Marketing a continuing education course for healthcare managers.

PubMed

Welnetz, K

1990-01-01

The purpose of this article was to elicit from the relevant literature the important considerations to make when planning to market continuing education (CE) within hospitals. References on marketing from both institutions of higher education and hospitals were reviewed. Based on this review, a strategic marketing plan was developed and initially implemented in the hospital. A 1-day course for healthcare managers, entitled "Successful Writing of Proposals and Reports," was offered twice and tested, using the steps outlined in the strategic marketing plan. The plan proved to be most beneficial in systematically guiding our first attempts at marketing CE to hospitals and other healthcare facilities. From this plan, efforts are currently being made to further develop curricula and determine other programs that might be marketable to these same target groups. In addition, closer links with nearby educational institutions or affiliated hospitals are being pursued to support and maintain our ongoing marketing endeavors.

Career planning and development for nurses: the time has come.

PubMed

Donner, G J; Wheeler, M M

2001-06-01

Developments in how the nursing profession is perceived by nurses and by society, along with unparalleled changes in health care systems, have created an environment in which individual nurses must take control of their careers and futures. Educators, employers and professional organizations also have a key role to play in fostering the career planning and development of nurses, usually the largest employee group in most health care organizations. This article provides an overview of what career planning and development is and why it is important for nurses. A career planning and development model is described that provides nurses with a focused strategy to take greater responsibility for engaging in the ongoing planning process that is crucial throughout the major stages of their career. Finally, educators, employers and professional organizations are challenged to collaborate with individual nurses on career-development activities that will enable nurses to continue to provide high-quality care in ever-changing health care systems.

The Need For Ongoing Surveys About Physician Practice Costs.

PubMed

Berk, Marc L

2016-09-01

Physicians continue to be the subject of many survey efforts asking them about a wide range of issues including training, retirement plans, satisfaction with practice, practice organization, and practice costs. The resources dedicated to the collection of different types of data have changed over time. Collection efforts have both expanded and contracted. Here I discuss this phenomenon for several types of physician surveys, with particular focus on the reduction in ongoing survey efforts about physician practice costs. The diminution of efforts to collect information about these costs represents an important challenge since the lack of timely, high-quality data could impair the correct calculation of reimbursement rates. Project HOPE—The People-to-People Health Foundation, Inc.

The Politics of Information: Building a Relational Database To Support Decision-Making at a Public University.

ERIC Educational Resources Information Center

Friedman, Debra; Hoffman, Phillip

2001-01-01

Describes creation of a relational database at the University of Washington supporting ongoing academic planning at several levels and affecting the culture of decision making. Addresses getting started; sharing the database; questions, worries, and issues; improving access to high-demand courses; the advising function; management of instructional…

26 CFR 1.412(c)(3)-1 - Reasonable funding methods.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 5 2010-04-01 2010-04-01 false Reasonable funding methods. 1.412(c)(3)-1... Reasonable funding methods. (a) Introduction—(1) In general. This section prescribes rules for determining whether or not, in the case of an ongoing plan, a funding method is reasonable for purposes of section 412...

ePortfolios in Australian Higher Education Arts: Differences and Differentiations

ERIC Educational Resources Information Center

Rowley, Jennifer; Bennett, Dawn

2016-01-01

This paper reports the findings of a project that investigated uses of electronic portfolios (ePortfolios) in the creative and performing arts at four Australian universities and raises four significant areas for discussion: engaging technologies as an ongoing requirement of planning, delivery and evaluation of teaching and learning in higher…

ITEA Financial Report--Fiscal 2003

ERIC Educational Resources Information Center

Technology Teacher, 2004

2004-01-01

The figures in this report reflect the financial year, which ended on June 30, 2003. The balance shown is the result of specifically planned activities on behalf of the Board of Directors and the headquarters staff to balance the budget. The Board monitors the financial condition of the association and foundation on an ongoing basis through its…

KSC-04PD-2634

NASA Technical Reports Server (NTRS)

2004-01-01

KENNEDY SPACE CENTER, FLA. Adm. Craig Steidle, associate administrator for Exploration Systems, speaks to attendees of the One NASA Leader-Led Workshop about the Agency plan for achieving the Vision for Space Exploration. The workshop included senior leadership in the Agency who talked about ongoing Transformation activities and Kennedys role in the Vision for Space Exploration.

The BlackBerry Project: Capturing the Content of Adolescents' Text Messaging

ERIC Educational Resources Information Center

Underwood, Marion K.; Rosen, Lisa H.; More, David; Ehrenreich, Samuel E.; Gentsch, Joanna K.

2012-01-01

This article presents an innovative method for capturing the content of adolescents' electronic communication on handheld devices: text messaging, e-mail, and instant messaging. In an ongoing longitudinal study, adolescents were provided with BlackBerry devices with service plans paid for by the investigators, and use of text messaging was…

Spent Nuclear Fuel Project Configuration Management Plan

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

Reilly, M.A.

This document is a rewrite of the draft ``C`` that was agreed to ``in principle`` by SNF Project level 2 managers on EDT 609835, dated March 1995 (not released). The implementation process philosphy was changed in keeping with the ongoing reengineering of the WHC Controlled Manuals to achieve configuration management within the SNF Project.

Raising Standards through INQUIRE in Pre-Service Teacher Education

ERIC Educational Resources Information Center

Elster, D.; Barendziak, T.; Haskamp, F.; Kastenholz, L.

2014-01-01

Raising standards through inquiry-based science education (IBSE)--what are the challenges for pre-service teacher education? What do ongoing teachers and active teachers learn from each other when planning, conducting and evaluating minds-on and hands-on IBSE activities in the classroom? What do they learn "beyond" IBSE? The Bremen…

78 FR 53187 - Early Scoping Notification for the Alternatives Analysis of the GA 400 Transit Initiative in...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-28

... (MARTA) issue this early scoping notice to advise other agencies and the public that they intend to... the public and agency officials to help support the ongoing alternatives analysis and system planning... considered, the transportation problems that are being addressed by the alternatives analysis study, public...

Promoting Student Mental Health, Learning & Welfare: 1995-96 School Psychology Services Accountability Studies.

ERIC Educational Resources Information Center

McDaid, Janet L.; Reifman, Arthur

As part of an ongoing project to determine how effectively school psychological services promote student mental health, learning, and welfare in San Diego City Schools (California), accountability studies were conducted. A previously developed planning model guided the process. During the 1995-96 school year, school psychologists gathered data…

SUNY Contracts for Cogeneration.

ERIC Educational Resources Information Center

Freeman, Laurie

1996-01-01

The State University of New York-Stony Brook forged a public-private partnership to fund a new plan for cogeneration, a two-step process that uses one fuel source--natural gas--to make two forms of energy. The agreement is designed to free the university from the need to make ongoing capital investment in its utility infrastructure. (MLF)

26 CFR 1.412(c)(3)-1 - Reasonable funding methods.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 26 Internal Revenue 5 2012-04-01 2011-04-01 true Reasonable funding methods. 1.412(c)(3)-1 Section...(c)(3)-1 Reasonable funding methods. (a) Introduction—(1) In general. This section prescribes rules for determining whether or not, in the case of an ongoing plan, a funding method is reasonable for...

26 CFR 1.412(c)(3)-1 - Reasonable funding methods.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 5 2011-04-01 2011-04-01 false Reasonable funding methods. 1.412(c)(3)-1...(c)(3)-1 Reasonable funding methods. (a) Introduction—(1) In general. This section prescribes rules for determining whether or not, in the case of an ongoing plan, a funding method is reasonable for...

26 CFR 1.412(c)(3)-1 - Reasonable funding methods.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 26 Internal Revenue 5 2013-04-01 2013-04-01 false Reasonable funding methods. 1.412(c)(3)-1...(c)(3)-1 Reasonable funding methods. (a) Introduction—(1) In general. This section prescribes rules for determining whether or not, in the case of an ongoing plan, a funding method is reasonable for...

Closing the prediction gap between agricultural nutrient losses and riparian zone ecology

USDA-ARS?s Scientific Manuscript database

The ecological health of the Chesapeake Bay is an ongoing concern and, as the more obvious and direct contributors are mitigated, focus is moving upstream to the agricultural headwaters of the basin. TMDLs and Watershed Implementation Plans (WIPs) have been developed by all states in the basin to co...

Privatization of Education: An Ongoing Debate.

ERIC Educational Resources Information Center

IIEP Newsletter, 2001

2001-01-01

This newsletter focuses on matters related to the privatization of education in different contexts around the world. Over the past few years, the International Institute for Educational Planning has carried out a number of studies in a wide range of contexts to identify what the real-life experiments in school organization are, why they have…

Think Summer: Early Planning, Teacher Support Boost Summer Learning Programs

ERIC Educational Resources Information Center

Browne, Daniel

2013-01-01

A fundamental problem that continues to plague educators is the achievement gap between low-income and higher-income students. In the ongoing search for solutions, one of the more promising approaches is expanding opportunities for learning, particularly in the summer. This article describes a project funded by The Wallace Foundation that offers…

77 FR 26576 - Notice of Public Meeting of the Central California Resource Advisory Council

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-04

... this meeting, agenda topics will include an update on Resource Management Plans and other resource management issues. Additional ongoing business will be discussed by the council. All meetings are open to the... DEPARTMENT OF THE INTERIOR Bureau of Land Management [LLCAC01000 L10100000.XZ0000 LXSIOVHD0000...

Guidelines for Planning and Implementing a Comprehensive Community Environmental Inventory. Revised, 1972.

ERIC Educational Resources Information Center

Bennett, Dean B.; MacGown, Richard H.

A comprehensive community environmental inventory is an ongoing process of investigation and study to compile and evaluate information about the natural and man-made environmental features and characteristics of an area, as well as related social, political, and economic information. Such information is important to the community in developmental…

The Alabama Counseling Association: A Legacy of Community and Professional Service

ERIC Educational Resources Information Center

Clark, Eddie, Jr.

2007-01-01

The Alabama Counseling Association (ALCA) has an ongoing plan for professional growth and development reflective of the multiple counseling professions and the diversity of its members. Based on the development and history of the organization, this research project was designed to assess ALCA's progress toward achieving its stated outcome goals. A…

10 CFR 110.42 - Export licensing criteria.

Code of Federal Regulations, 2010 CFR

2010-01-01

...) through (9) of appendix A to this part, when exported separately from the items described in paragraphs (1... in the United States. (9)(i) Except as provided in paragraph (a)(9)(ii) of this section, with respect... ongoing and planned experiments and isotope production to be conducted in the reactor without a large...

10 CFR 110.42 - Export licensing criteria.

Code of Federal Regulations, 2011 CFR

2011-01-01

...) through (9) of appendix A to this part, when exported separately from the items described in paragraphs (1... in the United States. (9)(i) Except as provided in paragraph (a)(9)(ii) of this section, with respect... ongoing and planned experiments and isotope production to be conducted in the reactor without a large...

The 3Ps of oak regeneration: planning, patience and persistence

Treesearch

Dale R. Weigel; Daniel C. Dey; John. Kabrick

2012-01-01

Oak regeneration research in the United States has been ongoing in earnest since the late 1950s. Most research has focused on specific silvicultural practices, regeneration processes, site characteristics, and local limiting factors such as deer browsing or interfering species. Research has evaluated the effects of thinning on regeneration development, methods for oak...

Building Self-Efficacy for Exercise among Rural High School Students: It Takes Ongoing Practice

ERIC Educational Resources Information Center

Hortz, Brian; Petosa, R. Lingyak; Grim, Melissa L.; Stevens, Emily

2015-01-01

Background: Self-efficacy has been associated with adolescent exercise. Previous studies have revealed that self-efficacy is relatively resistant to change. Effective strategies to build self-efficacy among adolescents are needed. Purpose: To describe the changes in self-efficacy and leisure time exercise produced by the "Planning to be…

Educator Effectiveness in Colorado: The Connection between Evaluation and Professional Learning

ERIC Educational Resources Information Center

O'Brien, Colleen

2014-01-01

Purpose: The purpose of this study was to understand how schools and districts plan professional learning that provides the ongoing feedback and support needed to improve teacher performance under the new Colorado Educator Effectiveness Law. The study focused on the professional learning that follows a teacher's rating on the new educator…

Flight and mission operations support for Voyager spacecraft launching and Viking-Mars mission

NASA Technical Reports Server (NTRS)

1978-01-01

The activities of the Jet Propulsion Laboratory during fiscal year 1976-1977 are summarized. Areas covered include ongoing and planned flight projects, DSN operations and development, research and advanced development in science and engineering, and civil systems projects. In addition, administrative and operational facilities and developments are described.

Legal Requirements. Planning for Lutheran Elementary Schools. E06.

ERIC Educational Resources Information Center

Lutheran Church, Missouri Synod, St. Louis, MO.

Part of a 13-volume series designed to help Lutheran communities assess the feasibility of starting a Lutheran elementary school and to assist ongoing schools in current operation, this volume focuses on legal requirements affecting Lutheran schools. The first part deals with Lutheran schools under law and begins by touching on parental rights and…

Management needs assessment for the Copper River Delta, Alaska.

Treesearch

L.E. Kruger; C.B. Tyler

1995-01-01

This report assesses needs, problems, and perceptions relevant to management for the Copper River Delta (Alaska)—the largest coastal wetland on the Pacific coast of North America. The assessment provides a basis for planning and decisionmaking and a framework for ongoing research, development, and application. It also underscores concerns about human impacts...

Mitigating Errors of Representation: A Practical Case Study of the University Experience Survey

ERIC Educational Resources Information Center

Whiteley, Sonia

2014-01-01

The Total Survey Error (TSE) paradigm provides a framework that supports the effective planning of research, guides decision making about data collection and contextualises the interpretation and dissemination of findings. TSE also allows researchers to systematically evaluate and improve the design and execution of ongoing survey programs and…

Bloodborne Pathogens: HIV and HBV Contagion Risks at Camp.

ERIC Educational Resources Information Center

Skaros, Susan

1996-01-01

AIDS and hepatitis B are diseases caused by the viruses HIV and HBV, respectively, which are spread in blood and body fluids. HBV is 100 times more contagious than HIV. Diligent implementation of universal precautions, an exposure control plan, use of personal protective equipment, a vaccination program, and ongoing staff and camper education can…

The 3 Ps of oak regeneration: planning, persistence, and patience

Treesearch

Dale R. Weigel; Daniel C. Dey; John Kabrick

2012-01-01

Oak regeneration research in the United States has been ongoing in earnest since the late 1950s. Most research has focused on specific silvicultural practices, regeneration processes, site characteristics, and local limiting factors such as deer browsing or interfering species. Research has evaluated the effects of thinning on regeneration development, methods for oak...

Alternative Education for Disruptive Youth: Recommended Parameters and Best Practices for Effective Programs

ERIC Educational Resources Information Center

Pennsylvania Department of Education, 2005

2005-01-01

This document was prepared to serve as an aid in the planning, design, implementation, and ongoing evaluation of Alternative Education for Disruptive Youth Programs in Pennsylvania. School Codes and Public Laws are cited for guidance on mandatory issues. The suggestions and implementation strategies provided in this document are not requirements…

Ralph Bunche: University and Diplomatic Legacies Fostering Innovative Paradigms

ERIC Educational Resources Information Center

Lindsay, Beverly

2004-01-01

This article is based upon the 2003 24th Annual Charles H. Thompson Lecture at Howard University. It devotes attention to the nexuses between Ralph Bunche's scholarly publications and diplomatic speeches and their relationships to contemporary university plans and programs to address ongoing crises. In-depth interviews with a university chancellor…

The Virtual Counseling Center: Its Niche, Resources, and Ongoing Research and Development Activity

ERIC Educational Resources Information Center

Horan, John J.

2010-01-01

Thomas Friedman's best sellers have raised awareness of our nation's need to remain competitive in science, technology, engineering, and math (STEM) disciplines. However, advances in these fields cannot occur without the proper cultivation of human potential. The usual costs of career assessment and planning systems preclude their scalability to…

Developing a Deep Brain Stimulation Neuromodulation Network for Parkinson Disease, Essential Tremor, and Dystonia: Report of a Quality Improvement Project

PubMed Central

O’Suilleabhain, Padraig E.; Sanghera, Manjit; Patel, Neepa; Khemani, Pravin; Lacritz, Laura H.; Chitnis, Shilpa; Whitworth, Louis A.; Dewey, Richard B.

2016-01-01

Objective To develop a process to improve patient outcomes from deep brain stimulation (DBS) surgery for Parkinson disease (PD), essential tremor (ET), and dystonia. Methods We employed standard quality improvement methodology using the Plan-Do-Study-Act process to improve patient selection, surgical DBS lead implantation, postoperative programming, and ongoing assessment of patient outcomes. Results The result of this quality improvement process was the development of a neuromodulation network. The key aspect of this program is rigorous patient assessment of both motor and non-motor outcomes tracked longitudinally using a REDCap database. We describe how this information is used to identify problems and to initiate Plan-Do-Study-Act cycles to address them. Preliminary outcomes data is presented for the cohort of PD and ET patients who have received surgery since the creation of the neuromodulation network. Conclusions Careful outcomes tracking is essential to ensure quality in a complex therapeutic endeavor like DBS surgery for movement disorders. The REDCap database system is well suited to store outcomes data for the purpose of ongoing quality assurance monitoring. PMID:27711133