Grassroots branding.

PubMed

Ferris, Michael T

2005-04-01

In home care and hospice, effective branding begins at the grassroots level. Historically, high-level, widespread branding initiatives have proven relatively unsuccessful in these industries, and have not delivered a positive return on investment. This is generally because in home care and hospice, branding is most successfully implemented at individual and local levels. Since an agency's "brand" is established at this personal level, relationships are the crucial keys to sales and marketing success.

Diabetes quality of care in academic endocrinology practice: a descriptive study.

PubMed

Shah, Baiju R; James, Jacqueline E; Lawton, Carolyn; Montada-Atin, Tess; Sigmond, Marianne; Cauch-Dudek, Karen; Booth, Gillian L

2009-01-01

To describe the quality of diabetes care delivered by academic endocrinologists practicing at 4 teaching hospitals affiliated with a single medical school. Up to 30 patients who first saw an endocrinologist for an ambulatory consultation for diabetes between January 2004 and December 2005 were randomly selected for chart review. Process and intermediate measures of quality of care were abstracted. There were 417 patient charts available for analysis. Quality of care was generally high, with 61% of patients achieving a glycated hemoglobin of ≤7.0%, 77% achieving blood pressure ≤130/80 mm Hg and 73% achieving a low-density lipoprotein cholesterol level of ≤2.5 mmol/L. More than 80% of patients had had eye examinations, microalbuminuria screening and foot examinations. There were no significant differences in quality between hospitals. The quality of diabetes care delivered by academic endocrinologists in this setting was high and approached the "ideal" levels of care recommended by practice guidelines. Compared to past studies in both the primary and specialist care settings, the results show that high-quality care can be delivered in routine academic clinical practice without having previously instituted a specific quality improvement program. Copyright © 2009 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

Real-time movement detection and analysis for video surveillance applications

NASA Astrophysics Data System (ADS)

Hueber, Nicolas; Hennequin, Christophe; Raymond, Pierre; Moeglin, Jean-Pierre

2014-06-01

Pedestrian movement along critical infrastructures like pipes, railways or highways, is of major interest in surveillance applications as well as its behavior in urban environment. The goal is to anticipate illicit or dangerous human activities. For this purpose, we propose an all-in-one small autonomous system which delivers high level statistics and reports alerts in specific cases. This situational awareness project leads us to manage efficiently the scene by performing movement analysis. A dynamic background extraction algorithm is developed to reach the degree of robustness against natural and urban environment perturbations and also to match the embedded implementation constraints. When changes are detected in the scene, specific patterns are applied to detect and highlight relevant movements. Depending on the applications, specific descriptors can be extracted and fused in order to reach a high level of interpretation. In this paper, our approach is applied to two operational use cases: pedestrian urban statistics and railway surveillance. In the first case, a grid of prototypes is deployed over a city centre to collect pedestrian movement statistics up to a macroscopic level of analysis. The results demonstrate the relevance of the delivered information; in particular, the flow density map highlights pedestrian preferential paths along the streets. In the second case, one prototype is set next to high speed train tracks to secure the area. The results exhibit a low false alarm rate and assess our approach of a large sensor network for delivering a precise operational picture without overwhelming a supervisor.

A Wii Bit of Fun: A Novel Platform to Deliver Effective Balance Training to Older Adults

PubMed Central

Merriman, Niamh A.; Young, William R.; Newell, Fiona N.; Craig, Cathy

2015-01-01

Abstract Background: Falls and fall-related injuries are symptomatic of an aging population. This study aimed to design, develop, and deliver a novel method of balance training, using an interactive game-based system to promote engagement, with the inclusion of older adults at both high and low risk of experiencing a fall. Study Design: Eighty-two older adults (65 years of age and older) were recruited from sheltered accommodation and local activity groups. Forty volunteers were randomly selected and received 5 weeks of balance game training (5 males, 35 females; mean, 77.18 ± 6.59 years), whereas the remaining control participants recorded levels of physical activity (20 males, 22 females; mean, 76.62 ± 7.28 years). The effect of balance game training was measured on levels of functional balance and balance confidence in individuals with and without quantifiable balance impairments. Results: Balance game training had a significant effect on levels of functional balance and balance confidence (P < 0.05). This was further demonstrated in participants who were deemed at high risk of falls. The overall pattern of results suggests the training program is effective and suitable for individuals at all levels of ability and may therefore play a role in reducing the risk of falls. Conclusions: Commercial hardware can be modified to deliver engaging methods of effective balance assessment and training for the older population. PMID:26469308

Multi-Center Pilot Study to Evaluate the Safety Pro le of High Energy Fractionated Radiofrequency With Insulated Microneedles to Multiple Levels of the Dermis.

PubMed

Cohen, Joel L; Weiner, Steven F; Pozner, Jason N; Ibrahimi, Omar A; Vasily, David B; Ross, E Victor; Gabriel, Zena

2016-11-01

In this multi-center pilot study, the safety pro le of high intensity focused radiofrequency (RF) delivered to the dermis was evaluated for safety in the treatment of the aging neck and face. A newly designed insulated microneedle system delivers a signi cant coagulative thermal injury into the dermis while sparing the epidermis from RF injury. Thirty- ve healthy subjects from seven aesthetic practices were evaluated, and data from each were incorporated in this case report. The subjects received a single treatment using settings that delivered the highest RF energies suggested from the new recommended protocols. The depth of thermal delivery was adjusted before each pass and all subjects received a minimum of two to three passes to the treated areas. Before and after photographs along with adverse effects were recorded. This case report demonstrates the ability to deliver significant RF thermal injury to several layers of the dermis with insulated microneedles safely with little injury to the epidermis and minimum downtime. J Drugs Dermatol. 2016;15(11):1308-1312..

Identifying Professional Development Needs of High School Teachers Tasked with Online Course Design

ERIC Educational Resources Information Center

Lugar, Debbie J.

2017-01-01

To satisfy demand for online learning opportunities at the high school level, 3 school districts in the northeast United States established a consortium to share resources to develop and deliver online courses. High school teachers who volunteered to develop courses for the consortium attempted the task without previous training in online course…

First-trimester working conditions and birthweight: a prospective cohort study.

PubMed

Vrijkotte, Tanja G M; van der Wal, Marcel F; van Eijsden, Manon; Bonsel, Gouke J

2009-08-01

We investigated the relationship between women's first-trimester working conditions and infant birthweight. Pregnant women (N = 8266) participating in the Amsterdam Born Children and Their Development study completed a questionnaire gathering information on employment and working conditions. After exclusions, 7135 women remained in our analyses. Low birthweight and delivery of a small-for-gestational-age (SGA) infant were the main outcome measures. After adjustment, a workweek of 32 hours or more (mean birthweight decrease of 43 g) and high job strain (mean birthweight decrease of 72 g) were significantly associated with birthweight. Only high job strain increased the risk of delivering an SGA infant (odds ratio [OR] = 1.5; 95% confidence interval [CI] = 1.1, 2.2). After adjustment, the combination of high job strain and a long workweek resulted in the largest birthweight reduction (150 g) and the highest risk of delivering an SGA infant (OR = 2.0; 95% CI = 1.2, 3.2). High levels of job strain during early pregnancy are associated with reduced birthweight and an increased risk of delivering an SGA infant, particularly if mothers work 32 or more hours per week.

Risk profiles for poor treatment response to internet-delivered CBT in people with social anxiety disorder.

PubMed

Tillfors, Maria; Furmark, Tomas; Carlbring, Per; Andersson, Gerhard

2015-06-01

In social anxiety disorder (SAD) co-morbid depressive symptoms as well as avoidance behaviors have been shown to predict insufficient treatment response. It is likely that subgroups of individuals with different profiles of risk factors for poor treatment response exist. This study aimed to identify subgroups of social avoidance and depressive symptoms in a clinical sample (N = 167) with SAD before and after guided internet-delivered CBT, and to compare these groups on diagnostic status and social anxiety. We further examined individual movement between subgroups over time. Using cluster analysis we identified four subgroups, including a high-problem cluster at both time-points. Individuals in this cluster showed less remission after treatment, exhibited higher levels of social anxiety at both assessments, and typically remained in the high-problem cluster after treatment. Thus, in individuals with SAD, high levels of social avoidance and depressive symptoms constitute a risk profile for poor treatment response. Copyright © 2015 Elsevier Ltd. All rights reserved.

Implementation fidelity of a self-management course for epilepsy: method and assessment.

PubMed

Wojewodka, G; Hurley, S; Taylor, S J C; Noble, A J; Ridsdale, L; Goldstein, L H

2017-07-11

Complex interventions such as self-management courses are difficult to evaluate due to the many interacting components. The way complex interventions are delivered can influence the effect they have for patients, and can impact the interpretation of outcomes of clinical trials. Implementation fidelity evaluates whether complex interventions are delivered according to protocol. Such assessments have been used for one-to-one psychological interventions; however, the science is still developing for group interventions. We developed and tested an instrument to measure implementation fidelity of a two-day self-management course for people with epilepsy, SMILE(UK). Using audio recordings, we looked at adherence and competence of course facilitators. Adherence was assessed by checklists. Competence was measured by scoring group interaction, an overall impression score and facilitator "didacticism". To measure "didacticism", we developed a novel way to calculate facilitator speech using computer software. Using this new instrument, implementation fidelity of SMILE(UK) was assessed on three modules of the course, for 28% of all courses delivered. Using the instrument for adherence, scores from two independent raters showed substantial agreement with weighted Kappa of 0.67 and high percent agreement of 81.2%. For didacticism, the results from both raters were highly correlated with an intraclass coefficient of 0.97 (p < 0.0001). We found that the courses were delivered with a good level of adherence (> 50% of scored items received the maximum of 2 points) and high competence. Groups were interactive (mean score: 1.9-2.0 out of 2) and the overall impression was on average assessed as "good". Didacticism varied from 42% to 93% of total module time and was not associated with the other competence scores. The instrument devised to measure implementation fidelity was reproducible and easy to use. The courses for the SMILE(UK) study were delivered with a good level of adherence to protocol while not compromising facilitator competence. ISRCTN57937389 .

An Analysis of Indonesian and Japanese Students' Understandings of Macroscopic and Submicroscopic Levels of Representing Matter and Its Changes

ERIC Educational Resources Information Center

Rahayu, Sri; Kita, Masakazu

2010-01-01

This study investigated Indonesian and Japanese students' understandings of macroscopic and submicroscopic levels of representing matter and its changes and the difficulties they have with these concepts. A multiple-choice questionnaire was constructed and delivered to 447 Indonesian and 446 Japanese public senior high school students. The data…

Endogenous Groups and Dynamic Selection in Mechanism Design*

PubMed Central

Madeira, Gabriel A.; Townsend, Robert M.

2010-01-01

We create a dynamic theory of endogenous risk sharing groups, with good internal information, and their coexistence with relative performance, individualistic regimes, which are informationally more opaque. Inequality and organizational form are determined simultaneously. Numerical techniques and succinct re-formulations of mechanism design problems with suitable choice of promised utilities allow the computation of a stochastic steady state and its transitions. Regions of low inequality and moderate to high wealth (utility promises) produce the relative performance regime, while regions of high inequality and low wealth produce the risk sharing group regime. If there is a cost to prevent coalitions, risk sharing groups emerge at high wealth levels also. Transitions from the relative performance regime to the group regime tend to occur when rewards to observed outputs exacerbate inequality, while transitions from the group regime to the relative performance regime tend to come with a decrease in utility promises. Some regions of inequality and wealth deliver long term persistence of organization form and inequality, while other regions deliver high levels of volatility. JEL Classification Numbers: D23,D71,D85,O17. PMID:20107614

The Supply Chain’s Role in Improving Animal Welfare

PubMed Central

Harvey, David; Hubbard, Carmen

2013-01-01

Simple Summary The ability of supply chains to deliver high(er) levels and standards of animal welfare is subject to two critical conditions: (a) the innovative and adaptive capacity of actors in the chain to respond to society’s demands; (b) consumers actually buying animal-friendly products. Unless citizens are willing to support suppliers who comply with high(er) standards, their votes for better animal welfare risk exporting poor animal welfare to other countries with less rigorous standards. The logic of market failure in the case of animal welfare points to the superiority of consumer subsidies over producer subsidies to deliver improved animal welfare. Abstract Supply chains are already incorporating citizen/consumer demands for improved animal welfare, especially through product differentiation and the associated segmentation of markets. Nonetheless, the ability of the chain to deliver high(er) levels and standards of animal welfare is subject to two critical conditions: (a) the innovative and adaptive capacity of the chain to respond to society’s demands; (b) the extent to which consumers actually purchase animal-friendly products. Despite a substantial literature reporting estimates of willingness to pay (WTP) for animal welfare, there is a belief that in practice people vote for substantially more and better animal welfare as citizens than they are willing to pay for as consumers. This citizen-consumer gap has significant consequences on the supply chain, although there is limited literature on the capacity and willingness of supply chains to deliver what the consumer wants and is willing to pay for. This paper outlines an economic analysis of supply chain delivery of improved standards for farm animal welfare in the EU and illustrates the possible consequences of improving animal welfare standards for the supply chain using a prototype belief network analysis. PMID:26479533

Persistent high TRAb values during pregnancy predict increased risk of neonatal hyperthyroidism following radioiodine therapy for refractory hyperthyroidism.

PubMed

Hamada, Noboru; Momotani, Naoko; Ishikawa, Naofumi; Yoshimura Noh, Jaeduk; Okamoto, Yasuyuki; Konishi, Toshiaki; Ito, Koichi; Ito, Kunihiko

2011-01-01

Serum levels of TSH receptor antibody (TRAb) often increase after radioiodine treatment for Graves' disease, and high-serum levels of maternal TRAb in late pregnancy indicate a risk of neonatal hyperthyroidism. The aim of this retrospective study is to investigate the characteristics of Graves' women who had a history of radioiodine treatment for intractable Graves' disease, and whose neonates suffered from hyperthyroidism. The subjects of this study were 45 patients with Graves' disease who became pregnant during the period from 1988 to 1998 after receiving radioiodine treatment at Ito Hospital. 25 of the 45 subjects had had a relapse of hyperthyroidism after surgical treatment for Graves' disease. 19 pregnancies were excluded because of artificial or spontaneous abortion. In the remaining 44 pregnancies of 35 patients, neonatal hyperthyroidism developed in 5 (11.3%) pregnancies of 4 patients. Serum levels of TRAb at delivery were higher in patients whose neonates suffered from hyperthyroidism (NH mother) than those of patients who delivered normal infants (N mother). Furthermore, serum levels of TRAb in NH mother did not change during pregnancy, although those of 4 patients of N mother, in which serum levels of TRAb before radioiodine treatment were as high as in NH mother, decreased significantly during pregnancy. In conclusion, women who delivered neonates with hyperthyroidism following radioiodine treatment seem to have very severe and intractable Graves' disease. Persistent high TRAb values during pregnancy observed in those patients may be a cause of neonatal hyperthyroidism.

Endocrine Profiles, Haematology and Pregnancy Outcomes of Late Pregnant Holstein Dairy Heifers Sired by Bulls Giving a High or Low Incidence of Stillbirth

PubMed Central

Kornmatitsuk, B; Dahl, E; Ropstad, E; Beckers, JF; Gustafsson, H; Kindahl, H

2004-01-01

The high incidence of stillbirth in Swedish Holstein heifers has increased continuously during the last 15 years to an average of 11% today. The pathological reasons behind the increased incidence of stillbirth are unknown. The present experiment was undertaken to investigate possible causes of stillbirth and to study possible physiological markers for predicting stillbirth. Twenty Swedish Holstein dairy heifers sired by bulls with breeding values for a high risk of stillbirth (n = 12) (experimental group) and a low risk of stillbirth (n = 8) (control group, group B) were selected based on information in the Swedish AI-data base. The experimental group consisted of 2 subgroups of heifers (groups A1 and A2) inseminated with 2 different bulls with 3.5% and 9% higher stillbirth rates than the average, and the control group consisted of heifers pregnant with 5 different bulls with 0%–6% lower stillbirth rates than the average. The bull used for group A1 had also calving difficulties due to large calves as compared to the bull in group A2 showing no calving difficulties. The heifers were supervised from 6–7 months of pregnancy up to birth, and the pregnancies and parturitions were compared between groups regarding hormonal levels, haematology, placental characteristics and calf viability. In group A1, 1 stillborn, 1 weak and 4 normal calves were recorded. In group A2, 2 stillborn and 4 normal calves were registered. All animals in the control group gave birth to a normal living calf without any assistance. The weak calf showed deviating profiles of body temperature, saturated oxygen and heart rates, compared with the normal living calves. No differences of the placentome thickness, measured in vivo by ultrasonography were seen between the groups. The number of leukocytes and differential cell counts in groups A1 and A2 followed the profiles found in the control group. In group A1, a slight decrease of oestrone sulphate (E1SO4) levels was found in the animal delivering a stillborn calf from the first 24-h blood sampling at 6 weeks to the second at 3 weeks prior to delivery, while the levels of E1SO4 at both periods in the animal delivering a weak calf followed the profile in animals delivering a normal living calf. During late pregnancy and at the time of parturition, the levels of E1SO4 and PAGs in animals delivering a stillborn or weak calf (from group A1) followed the normal profiles found in animals delivering a normal living calf. In group A2, low levels of E1SO4 and pregnancy associated glycoproteins (PAGs) over 24 h at both 3 and 6 weeks prior to parturition (<1.5 nmol/L) were recorded in animals delivering a stillborn calf. During late pregnancy and parturition, the levels of E1SO4 and PAGs were slightly lower during 30–50 days prior to delivery and increased with a lower magnitude at the time of parturition. In conclusion, our results indicate that the aetiology behind stillbirth varies depending on the AI-bulls used and is associated with dystocia or low viability of the calves. Deviating profiles of oestrone sulphate (E1SO4) and pregnancy associated glycoproteins (PAGs) in animals delivering a stillborn calf not caused by dystocia were observed, suggesting placental dysfunction as a possible factor. The finding suggests that the analyses of E1SO4 and PAGs could be used for monitoring foetal well-being in animals with a high risk of stillbirth at term. PMID:15535086

Acceptability of a theory of planned behaviour email-based nutrition intervention.

PubMed

Kothe, E J; Mullan, B A

2014-03-01

This study investigated feasibility and acceptability of a new email-delivered intervention promoting fruit and vegetable consumption in a university-based population of Australian young adults. The study explored whether there are differences in the reported feasibility and acceptability between demographic groups within the population of interest and at three levels of intervention intensity. The email-delivered intervention program consists of an implementation intention 'planning task' and between 3 and 15 short email messages over a 15-day study period. The intervention program was developed using the Theory of Planned Behaviour and was designed to modify perceived behavioural control. One hundred and ten participants (mean age = 19.21 years, 25.6% male) completed the feasibility and acceptability questionnaire at Day 15. This questionnaire contained items about all intervention components. High acceptability and feasibility scores were found for all intervention parts and at all levels of intervention intensity. There were few significant differences in the reported acceptability of items between key demographic sub-groups, and no differences in reported acceptability at different levels of intervention intensity. These results suggest that this email-delivered intervention is an acceptable and feasible tool for promoting fruit and vegetable consumption for participants in the target population.

An internet survey of the characteristics and physical activity of community-dwelling Australian adults with acquired brain injury: Exploring interest in an internet-delivered self-management program focused on physical activity.

PubMed

Jones, Taryn M; Dean, Catherine M; Dear, Blake F; Hush, Julia M; Titov, Nickolai

2016-01-01

Individuals with acquired brain injury (ABI) are more likely to be physically inactive and experience barriers to accessing services to address inactivity. This study was designed to guide the development of an internet-delivered self-management program to increase physical activity after ABI. The aims of this study were to examine the current physical activity status of community-dwelling Australian adults with ABI, the barriers to physical activity they experience and to explore interest an internet-delivered self-management program aimed at increasing physical activity. An online survey of Australian adults with ABI was used to collect information about demographic characteristics; general health; emotional well-being; mobility and physical activity status, and satisfaction; barriers to physical activity; confidence in overcoming barriers, and; interest in an internet self-management program. Data were analyzed descriptively and correlational analyses examined relationships between variables. Data were analyzed from 59 respondents. Over half were not satisfied with their current physical activity status. The most frequently reported barriers were pain/discomfort, fatigue and fear, and confidence to overcome these barriers was very low. Interest in an internet-delivered self-management program was high (74%) and not related to the amount of physical activity, satisfaction with physical activity and mobility status or total number of barriers. Australian adults with ABI are not satisfied with their activity levels and experience barriers in maintaining their physical activity levels. Participants were interested in accessing an internet-delivered self-management program aimed at improving physical activity levels. Therefore such a program warrants development and evaluation. Copyright © 2016 Elsevier Inc. All rights reserved.

Measuring trainer fidelity in the transfer of suicide prevention training

PubMed Central

Cross, Wendi F.; Pisani, Anthony R.; Schmeelk-Cone, Karen; Xia, Yinglin; Tu, Xin; McMahon, Marcie; Munfakh, Jimmie Lou; Gould, Madelyn S.

2014-01-01

Background Finding effective and efficient models to train large numbers of suicide prevention interventionists, including ‘hotline’ crisis counselors, is a high priority. Train-the-trainer (TTT) models are widely used but understudied. Aims To assess the extent to which trainers following TTT delivered the Applied Suicide Intervention Skills Training (ASIST) program with fidelity, and to examine fidelity across two trainings and seven training segments. Methods We recorded and reliably rated trainer fidelity, defined as adherence to program content and competence of program delivery, for 34 newly trained ASIST trainers delivering the program to crisis center staff on two separate occasions. A total of 324 observations were coded. Trainer demographics were also collected. Results On average, trainers delivered two-thirds of the program. Previous training was associated with lower levels of trainer adherence to the program. 18% of trainers' observations were rated as solidly competent. Trainers did not improve fidelity from their first to second training. Significantly higher fidelity was found for lectures and lower fidelity was found for interactive training activities including asking about suicide and creating a safe plan. Conclusions We found wide variability in trainer fidelity to the ASIST program following TTT and few trainers had high levels of both adherence and competence. More research is needed to examine the cost-effectiveness of TTT models. PMID:24901061

Inactivated poliovirus type 2 vaccine delivered to rat skin via high density microprojection array elicits potent neutralising antibody responses.

PubMed

Muller, David A; Pearson, Frances E; Fernando, Germain J P; Agyei-Yeboah, Christiana; Owens, Nick S; Corrie, Simon R; Crichton, Michael L; Wei, Jonathan C J; Weldon, William C; Oberste, M Steven; Young, Paul R; Kendall, Mark A F

2016-02-25

Polio eradication is progressing rapidly, and the live attenuated Sabin strains in the oral poliovirus vaccine (OPV) are being removed sequentially, starting with type 2 in April 2016. For risk mitigation, countries are introducing inactivated poliovirus vaccine (IPV) into routine vaccination programs. After April 2016, monovalent type 2 OPV will be available for type 2 outbreak control. Because the current IPV is not suitable for house-to-house vaccination campaigns (the intramuscular injections require health professionals), we developed a high-density microprojection array, the Nanopatch, delivered monovalent type 2 IPV (IPV2) vaccine to the skin. To assess the immunogenicity of the Nanopatch, we performed a dose-matched study in rats, comparing the immunogenicity of IPV2 delivered by intramuscular injection or Nanopatch immunisation. A single dose of 0.2 D-antigen units of IPV2 elicited protective levels of poliovirus antibodies in 100% of animals. However, animals receiving IPV2 by IM required at least 3 immunisations to reach the same neutralising antibody titres. This level of dose reduction (1/40th of a full dose) is unprecedented for poliovirus vaccine delivery. The ease of administration coupled with the dose reduction observed in this study points to the Nanopatch as a potential tool for facilitating inexpensive IPV for mass vaccination campaigns.

Development and Implementation: B’More Healthy Communities for Kid’s Store and Wholesaler Intervention

PubMed Central

Schwendler, Teresa; Shipley, Cara; Budd, Nadine; Trude, Angela; Surkan, Pamela J.; Steeves, Elizabeth Anderson; de Morais Sato, Priscila; Eckmann, Thomas; Loh, Hong; Gittelsohn, Joel

2017-01-01

Higher rates of obesity and obesity-related chronic disease are prevalent in communities where there is limited access to affordable, healthy food. The B’More Healthy Communities for Kids (BHCK) trial worked at multiple levels of the food environment including food wholesalers and corner stores to improve the surrounding community’s access to healthy food. The objective of this article is to describe the development and implementation of BHCK’s corner store and wholesaler interventions through formal process evaluation. Researchers evaluated each level of the intervention to assess reach, dose delivered, and fidelity. Corner store and wholesaler reach, dose delivered, and fidelity were measured by number of interactions, promotional materials distributed, and maintenance of study materials, respectively. Overall, the corner store implementation showed moderate reach, dose delivered, and high fidelity. The wholesaler intervention was implemented with high reach, dose, and fidelity. The program held 355 corner store interactive sessions and had 9,347 community member interactions, 21% of which were with children between the ages of 10 and 14 years. There was a 15% increase in corner store promoted food stocking during Wave 1 and a 17% increase during Wave 2. These findings demonstrate a successfully implemented food retailer intervention in a low-income urban setting. PMID:28343413

Drivers of facility deliveries in Africa and Asia: regional analyses using the demographic and health surveys.

PubMed

Diamond-Smith, Nadia; Sudhinaraset, May

2015-01-16

In the past few decades many countries have worked to increase the number of women delivering in facilities, with the goal of improving maternal and neonatal health outcomes. The purpose of this study is to explore the current situation of facility deliveries in Africa and Asia to understand where and with whom women deliver. Furthermore, we aim to test potential drivers of facility delivery at the individual, household, and community-level. Demographic and Health Survey data collected since 2003 from 43 countries in Africa and Asia is explored to understand the patterns of where women are delivering. We look at patterns by region and wealth quintile and urban/rural status. We then run a series of multi-level models looking at relationships between individual, household and community-level factors and the odds of a woman delivering in a facility. We explore this for Asia and Africa separately. We also look at correlates of delivery with a trained provider, in a public facility, in a private facility, with a doctor and in a hospital. The majority of women deliver in a facility and with a provider; however, about 20% of deliveries are still with no one or a friend/relative or alone. Rates of facility delivery are lower in Asia overall, and a greater proportion of deliveries take place in private facilities in Asia compared to Africa. Most of the individual level factors that have been found in past studies to be associated with delivering in a facility hold true for the multi-country-level analyses, and small differences exist between Asia and Africa. Women who deliver in private facilities differ from women who deliver in public facilities or at home. Most women in Africa and Asia are delivering in a facility, and drivers of facility delivery identified in smaller level or country specific studies hold true in multi-country national level data. More data and research is needed on other drivers, especially at the country-level and relating to the quality of care and maternal health complications.

Transdiagnostic Internet-delivered cognitive behaviour therapy in Canada: An open trial comparing results of a specialized online clinic and nonspecialized community clinics.

PubMed

Hadjistavropoulos, H D; Nugent, M M; Alberts, N M; Staples, L; Dear, B F; Titov, N

2016-08-01

Effects of Internet-delivered cognitive behaviour therapy (ICBT) for anxiety and depression are not well understood when delivered in non-specialized as compared to specialized clinic settings. This open trial (n=458 patients) examined the benefits of transdiagnostic-ICBT when delivered in Canada by therapists (registered providers or graduate students) working in either a specialized online clinic or one of eight nonspecialized community clinics. Symptoms of depression and anxiety were assessed at pre-treatment, post-treatment and at 3-month follow-up. Completion rates and satisfaction were high. Significant and large reductions (effect sizes 1.17-1.31) were found on symptom measures. Completion rates, satisfaction levels and outcomes did not differ whether ICBT was delivered by therapists working in a specialized online clinic or nonspecialized community clinics. Differences were also not found between registered providers and graduate students, or therapists trained in psychology or another discipline. The findings support the public health potential of ICBT. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Can trainees design and deliver a national audit of epistaxis management? A pilot of a secure web-based audit tool and research trainee collaboratives.

PubMed

Mehta, N; Williams, R J; Smith, M E; Hall, A; Hardman, J C; Cheung, L; Ellis, M P; Fussey, J M; Lakhani, R; McLaren, O; Nankivell, P C; Sharma, N; Yeung, W; Carrie, S; Hopkins, C

2017-06-01

To investigate the feasibility of a national audit of epistaxis management led and delivered by a multi-region trainee collaborative using a web-based interface to capture patient data. Six trainee collaboratives across England nominated one site each and worked together to carry out this pilot. An encrypted data capture tool was adapted and installed within the infrastructure of a university secure server. Site-lead feedback was assessed through questionnaires. Sixty-three patients with epistaxis were admitted over a two-week period. Site leads reported an average of 5 minutes to complete questionnaires and described the tool as easy to use. Data quality was high, with little missing data. Site-lead feedback showed high satisfaction ratings for the project (mean, 4.83 out of 5). This pilot showed that trainee collaboratives can work together to deliver an audit using an encrypted data capture tool cost-effectively, whilst maintaining the highest levels of data quality.

75 FR 43495 - Sunshine Act Notice

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-26

... DEFENSE NUCLEAR FACILITIES SAFETY BOARD Sunshine Act Notice AGENCY: Defense Nuclear Facilities..., structures, and components, and (5) safety-related design aspects of new facilities or modifications of existing facilities needed to deliver high-level waste feed. The Board will be prepared to accept any other...

Level of C - reactive protein as an indicator for prognosis of premature uterine contractions.

PubMed

Najat Nakishbandy, Bayar M; Barawi, Sabat A M

2014-01-01

high concentrations of maternal C-reactive protein have been associated with adverse pregnancy outcome, and premature uterine contraction may be predicted by elevated levels of C-reactive protein. This may ultimately be simple and cost-effective enough to introduce as a low-risk screening program. an observational case control study was performed from May 1st, 2010 to December 1st, 2010 at Maternity Teaching Hospital-Erbil/ Kurdistan Region/ Iraq. The sample size was (200) cases. Hundred of them were presented with premature uterine contractions at 24(+0)-36(+6) weeks. The other hundred were control group at same gestational ages. The level of C-reactive protein was determined in both groups and both groups were followed till delivery. (93) out of (100) women with premature uterine contractions had elevated level of C-Reactive protein and 91% delivered prematurely while in the control group only (9) out of (100) women had elevated level of C-reactive protein and only 8% of them delivered preterm. Differences were statistically highly significant. C-reactive protein can be used as a biomarker in prediction of premature delivery when it is associated with premature uterine contractions. As well it can be used as a screening test to detect cases that are at risk of premature delivery.

A Triple-Fluorophore-Labeled Nucleic Acid pH Nanosensor to Investigate Non-viral Gene Delivery.

PubMed

Wilson, David R; Routkevitch, Denis; Rui, Yuan; Mosenia, Arman; Wahlin, Karl J; Quinones-Hinojosa, Alfredo; Zack, Donald J; Green, Jordan J

2017-07-05

There is a need for new tools to better quantify intracellular delivery barriers in high-throughput and high-content ways. Here, we synthesized a triple-fluorophore-labeled nucleic acid pH nanosensor for measuring intracellular pH of exogenous DNA at specific time points in a high-throughput manner by flow cytometry following non-viral transfection. By including two pH-sensitive fluorophores and one pH-insensitive fluorophore in the nanosensor, detection of pH was possible over the full physiological range. We further assessed possible correlation between intracellular pH of delivered DNA, cellular uptake of DNA, and DNA reporter gene expression at 24 hr post-transfection for poly-L-lysine and branched polyethylenimine polyplex nanoparticles. While successful transfection was shown to clearly depend on median cellular pH of delivered DNA at the cell population level, surprisingly, on an individual cell basis, there was no significant correlation between intracellular pH and transfection efficacy. To our knowledge, this is the first reported instance of high-throughput single-cell analysis between cellular uptake of DNA, intracellular pH of delivered DNA, and gene expression of the delivered DNA. Using the nanosensor, we demonstrate that the ability of polymeric nanoparticles to avoid an acidic environment is necessary, but not sufficient, for successful transfection. Copyright © 2017 The American Society of Gene and Cell Therapy. Published by Elsevier Inc. All rights reserved.

Use of web based systems to support postgraduate medical education.

PubMed

Tochel, C; Beggs, K; Haig, A; Roberts, J; Scott, H; Walker, K; Watson, M

2011-12-01

BACKGROUND To meet the demands of delivering the Foundation programme across a geographically diverse country, two web based systems (ePortfolio and eLearning) were developed to promote accessibility to training material and assessment tools on standardised platforms. This study evaluated the use of both tools throughout an entire academic year. METHODS All Scottish Foundation trainees' online learning and assessment data in 2007/08 were analysed, providing a national breakdown of post specialty, completion rates of mandatory assessments (including summary analysis of anonymised scores), and trainees' use of non-mandatory learning tools. Independent verification of competence data was sought from Deaneries. RESULTS There were high levels of engagement with both the ePortfolio (75-97% assessment completion) and eLearning systems (89-98% induction course completion), and the majority of trainees completed all required elements. There was extensive use of ePortfolio beyond mandatory levels for recording of learning events, including almost 20 000 personal learning records submitted by second year trainees. There was evidence that ePortfolio was used to record achievement of clinical competence rather than to track improvements towards competence (median workplace based assessment scores were 'high' or 'very high'). Online learning modules received positive feedback and its flexible format suited the trainees' working environment. External verification of formal assessment data revealed good correlation with locally stored outcomes, both indicating approximately 99% programme completion rates. CONCLUSIONS Core components of the Foundation programme have been delivered successfully to thousands of trainees across Scotland using web based systems to deliver and support education and assessment. There is great potential for further exploration of this carefully managed, rich dataset at individual, regional, and national levels to inform the future of medical education.

From the Cover: A polymer library approach to suicide gene therapy for cancer

NASA Astrophysics Data System (ADS)

Anderson, Daniel G.; Peng, Weidan; Akinc, Akin; Hossain, Naushad; Kohn, Anat; Padera, Robert; Langer, Robert; Sawicki, Janet A.

2004-11-01

Optimal gene therapy for cancer must (i) deliver DNA to tumor cells with high efficiency, (ii) induce minimal toxicity, and (iii) avoid gene expression in healthy tissues. To this end, we generated a library of >500 degradable, poly(-amino esters) for potential use as nonviral DNA vectors. Using high-throughput methods, we screened this library in vitro for transfection efficiency and cytotoxicity. We tested the best performing polymer, C32, in mice for toxicity and DNA delivery after intratumor and i.m. injection. C32 delivered DNA intratumorally 4-fold better than one of the best commercially available reagents, jetPEI (polyethyleneimine), and 26-fold better than naked DNA. Conversely, the highest transfection levels after i.m. administration were achieved with naked DNA, followed by polyethyleneimine; transfection was rarely observed with C32. Additionally, polyethyleneimine induced significant local toxicity after i.m. injection, whereas C32 demonstrated no toxicity. Finally, we used C32 to deliver a DNA construct encoding the A chain of diphtheria toxin (DT-A) to xenografts derived from LNCaP human prostate cancer cells. This construct regulates toxin expression both at the transcriptional level by the use of a chimeric-modified enhancer/promoter sequence of the human prostate-specific antigen gene and by DNA recombination mediated by Flp recombinase. C32 delivery of the A chain of diphtheria toxin DNA to LNCaP xenografts suppressed tumor growth and even caused 40% of tumors to regress in size. Because C32 transfects tumors locally at high levels, transfects healthy muscle poorly, and displays no toxicity, it may provide a vehicle for the local treatment of cancer. prostate | cationic polymers

Routine human-competitive machine intelligence by means of genetic programming

NASA Astrophysics Data System (ADS)

Koza, John R.; Streeter, Matthew J.; Keane, Martin

2004-01-01

Genetic programming is a systematic method for getting computers to automatically solve a problem. Genetic programming starts from a high-level statement of what needs to be done and automatically creates a computer program to solve the problem. The paper demonstrates that genetic programming (1) now routinely delivers high-return human-competitive machine intelligence; (2) is an automated invention machine; (3) can automatically create a general solution to a problem in the form of a parameterized topology; and (4) has delivered a progression of qualitatively more substantial results in synchrony with five approximately order-of-magnitude increases in the expenditure of computer time. Recent results involving the automatic synthesis of the topology and sizing of analog electrical circuits and controllers demonstrate these points.

Level of Immersion in Virtual Environments Impacts the Ability to Assess and Teach Social Skills in Autism Spectrum Disorder

PubMed Central

Bugnariu, Nicoleta L.

2016-01-01

Abstract Virtual environments (VEs) may be useful for delivering social skills interventions to individuals with autism spectrum disorder (ASD). Immersive VEs provide opportunities for individuals with ASD to learn and practice skills in a controlled replicable setting. However, not all VEs are delivered using the same technology, and the level of immersion differs across settings. We group studies into low-, moderate-, and high-immersion categories by examining five aspects of immersion. In doing so, we draw conclusions regarding the influence of this technical manipulation on the efficacy of VEs as a tool for assessing and teaching social skills. We also highlight ways in which future studies can advance our understanding of how manipulating aspects of immersion may impact intervention success. PMID:26919157

Folic acid-decorated polyamidoamine dendrimer mediates selective uptake and high expression of genes in head and neck cancer cells.

PubMed

Xu, Leyuan; Kittrell, Shannon; Yeudall, W Andrew; Yang, Hu

2016-11-01

Folic acid (FA)-decorated polyamidoamine dendrimer G4 (G4-FA) was synthesized and studied for targeted delivery of genes to head and neck cancer cells expressing high levels of folate receptors (FRs). Cellular uptake, targeting specificity, cytocompatibility and transfection efficiency were evaluated. G4-FA competes with free FA for the same binding site. G4-FA facilitates the cellular uptake of DNA plasmids in a FR-dependent manner and selectively delivers plasmids to FR-high cells, leading to enhanced gene expression. G4-FA is a suitable vector to deliver genes selectively to head and neck cancer cells. The fundamental understandings of G4-FA as a vector and its encouraging transfection results for head and neck cancer cells provided support for its further testing in vivo.

"XSEL" Virtual Selective High School Provision: Delivering Academically Selective Secondary Curriculum in Regional, Rural and Remote NSW

ERIC Educational Resources Information Center

Furney, Ann-Marie; McDiarmid, Carole

2014-01-01

This paper describes the development and implementation of the "xsel" program in Western NSW. The program supports identified high school students from regional, rural and remote communities to access the study of English, maths and science at an academically selective level. A program review was undertaken during 2012 using a structured…

Virological diagnosis of Ebolavirus infection.

PubMed

Smith, D W; Rawlinson, W D; Kok, J; Dwyer, D E; Catton, M

2015-08-01

Ebolaviruses, and the other viral causes of haemorrhagic fevers (VHF) have always posed special problems for diagnostic laboratories. These arise from the rarity of human infections, minimal documented experience with test delivery and interpretation, the paucity of established commercial or in-house assays, the lack of clinical material for test development and validation, the high level containment required for handling live virus, the ongoing evolution of the viruses, and the high personal and public health requirements for accurate diagnosis. This article addresses the current situation and the ongoing challenges associated with delivering timely, high quality and safe testing within Australia for people exposed as part of the current major outbreak of Ebolavirus disease (EVD) in Western Africa. The members of the Public Health Laboratory Network have developed deliverable and reliable nucleic acid detection tests, and also have the laboratory capacity to handle the live viruses if necessary. However delivering and maintaining these services necessitates high levels of experience in developing and applying tests for exotic and emerging infections, strong national and international links and collaborations, ongoing monitoring and reassessment of test design and performance, innovative approaches to generation of positive control material, and a regular quality assurance program.

Virological diagnosis of Ebolavirus infection

PubMed Central

Smith, D. W.; Rawlinson, W. D.; Kok, J.; Dwyer, D. E.; Catton, M.

2015-01-01

Summary Ebolaviruses, and the other viral causes of haemorrhagic fevers (VHF) have always posed special problems for diagnostic laboratories. These arise from the rarity of human infections, minimal documented experience with test delivery and interpretation, the paucity of established commercial or in-house assays, the lack of clinical material for test development and validation, the high level containment required for handling live virus, the ongoing evolution of the viruses, and the high personal and public health requirements for accurate diagnosis. This article addresses the current situation and the ongoing challenges associated with delivering timely, high quality and safe testing within Australia for people exposed as part of the current major outbreak of Ebolavirus disease (EVD) in Western Africa. The members of the Public Health Laboratory Network have developed deliverable and reliable nucleic acid detection tests, and also have the laboratory capacity to handle the live viruses if necessary. However delivering and maintaining these services necessitates high levels of experience in developing and applying tests for exotic and emerging infections, strong national and international links and collaborations, ongoing monitoring and reassessment of test design and performance, innovative approaches to generation of positive control material, and a regular quality assurance program. PMID:26126050

Extending dental nurses' duties: a national survey investigating skill-mix in Scotland's child oral health improvement programme (Childsmile).

PubMed

Gnich, Wendy; Deas, Leigh; Mackenzie, Sarah; Burns, Jacqueline; Conway, David I

2014-11-25

Childsmile is Scotland's national child oral health improvement programme. To support the delivery of prevention in general dental practice in keeping with clinical guidelines, Childsmile sought accreditation for extended duty training for dental nurses to deliver clinical preventive care. This approach has allowed extended duty dental nurses (EDDNs) to take on roles traditionally undertaken by general dental practitioners (GDPs). While skill-mix approaches have been found to work well in general medicine, they have not been formally evaluated in dentistry. Understanding the factors which influence nurses' ability to fully deliver their extended roles is necessary to ensure nurses' potential is reached and that children receive preventive care in line with clinical guidance in a cost-effective way. This paper investigates the supplementation of GDPs' roles by EDDNs, in general dental practice across Scotland. A cross-sectional postal survey aiming to reach all EDDNs practising in general dental practice in Scotland was undertaken. The survey measured nurses': role satisfaction, perceived utility of training, frequency, and potential behavioural mediators of, preventive delivery. Frequencies, correlations and multi-variable linear regression were used to analyse the data. Seventy-three percent of practices responded with 174 eligible nurses returning questionnaires. Respondents reported a very high level of role satisfaction and the majority found their training helpful in preparing them for their extended role. While a high level of preventive delivery was reported, fluoride vanish (FV) was delivered less frequently than dietary advice (DA), or oral hygiene advice (OHA). Delivering FV more frequently was associated with higher role satisfaction (p < 0.001). Those nurses who had been practising longer reported delivering FV less frequently than those more recently qualified (p < 0.001). Perceived difficulty of delivering preventive care (skills) and motivation to do so were most strongly associated with frequency of delivery (p < 0.001 for delivery of FV, DA and OHA). This study has provided insight into EDDNs' experiences and demonstrates that with appropriate training and support, EDDNs can supplement GDPs' roles in general dental practice in Scotland. However, some barriers to delivery were identified with delivery of FV showing scope for improvement.

Mindfulness in Motion (MIM): An Onsite Mindfulness Based Intervention (MBI) for Chronically High Stress Work Environments to Increase Resiliency and Work Engagement.

PubMed

Klatt, Maryanna; Steinberg, Beth; Duchemin, Anne-Marie

2015-07-01

A pragmatic mindfulness intervention to benefit personnel working in chronically high-stress environments, delivered onsite during the workday, is timely and valuable to employee and employer alike. Mindfulness in Motion (MIM) is a Mindfulness Based Intervention (MBI) offered as a modified, less time intensive method (compared to Mindfulness-Based Stress Reduction), delivered onsite, during work, and intends to enable busy working adults to experience the benefits of mindfulness. It teaches mindful awareness principles, rehearses mindfulness as a group, emphasizes the use of gentle yoga stretches, and utilizes relaxing music in the background of both the group sessions and individual mindfulness practice. MIM is delivered in a group format, for 1 hr/week/8 weeks. CDs and a DVD are provided to facilitate individual practice. The yoga movement is emphasized in the protocol to facilitate a quieting of the mind. The music is included for participants to associate the relaxed state experienced in the group session with their individual practice. To determine the intervention feasibility/efficacy we conducted a randomized wait-list control group in Intensive Care Units (ICUs). ICUs represent a high-stress work environment where personnel experience chronic exposure to catastrophic situations as they care for seriously injured/ill patients. Despite high levels of work-related stress, few interventions have been developed and delivered onsite for such environments. The intervention is delivered on site in the ICU, during work hours, with participants receiving time release to attend sessions. The intervention is well received with 97% retention rate. Work engagement and resiliency increase significantly in the intervention group, compared to the wait-list control group, while participant respiration rates decrease significantly pre-post in 6/8 of the weekly sessions. Participants value institutional support, relaxing music, and the instructor as pivotal to program success. This provides evidence that MIM is feasible, well accepted, and can be effectively implemented in a chronically high-stress work environment.

Mindfulness in Motion (MIM): An Onsite Mindfulness Based Intervention (MBI) for Chronically High Stress Work Environments to Increase Resiliency and Work Engagement

PubMed Central

Klatt, Maryanna; Steinberg, Beth; Duchemin, Anne-Marie

2015-01-01

A pragmatic mindfulness intervention to benefit personnel working in chronically high-stress environments, delivered onsite during the workday, is timely and valuable to employee and employer alike. Mindfulness in Motion (MIM) is a Mindfulness Based Intervention (MBI) offered as a modified, less time intensive method (compared to Mindfulness-Based Stress Reduction), delivered onsite, during work, and intends to enable busy working adults to experience the benefits of mindfulness. It teaches mindful awareness principles, rehearses mindfulness as a group, emphasizes the use of gentle yoga stretches, and utilizes relaxing music in the background of both the group sessions and individual mindfulness practice. MIM is delivered in a group format, for 1 hr/week/8 weeks. CDs and a DVD are provided to facilitate individual practice. The yoga movement is emphasized in the protocol to facilitate a quieting of the mind. The music is included for participants to associate the relaxed state experienced in the group session with their individual practice. To determine the intervention feasibility/efficacy we conducted a randomized wait-list control group in Intensive Care Units (ICUs). ICUs represent a high-stress work environment where personnel experience chronic exposure to catastrophic situations as they care for seriously injured/ill patients. Despite high levels of work-related stress, few interventions have been developed and delivered onsite for such environments. The intervention is delivered on site in the ICU, during work hours, with participants receiving time release to attend sessions. The intervention is well received with 97% retention rate. Work engagement and resiliency increase significantly in the intervention group, compared to the wait-list control group, while participant respiration rates decrease significantly pre-post in 6/8 of the weekly sessions. Participants value institutional support, relaxing music, and the instructor as pivotal to program success. This provides evidence that MIM is feasible, well accepted, and can be effectively implemented in a chronically high-stress work environment. PMID:26168365

Feasibility and Acceptability of Internet-delivered Cognitive Behavioral Therapy for Chronic Pain in Adolescents With Sickle Cell Disease and Their Parents.

PubMed

Palermo, Tonya M; Dudeney, Joanne; Santanelli, James P; Carletti, Alexie; Zempsky, William T

2018-03-01

Pain is a clinical hallmark of sickle cell disease (SCD), and is rarely optimally managed. Cognitive-behavioral therapy (CBT) for pain has been effectively delivered through the Internet in other pediatric populations. We tested feasibility and acceptability of an Internet-delivered CBT intervention in 25 adolescents with SCD (64% female, mean age=14.8 y) and their parents randomized to Internet CBT (n=15) or Internet Pain Education (n=10). Participants completed pretreatment/posttreatment measures. Eight dyads completed semistructured interviews to evaluate treatment acceptability. Feasibility indicators included recruitment and participation rates, engagement and adherence to intervention, and completion of outcome measures. In total, 87 referrals were received from 9 study sites; our recruitment rate was 60% from those families approached for screening. Among participants, high levels of initial intervention engagement (>90%), and adherence (>70%) were demonstrated. Most participants completed posttreatment outcome and diary measures (>75%). Retention at posttreatment was 80%. High treatment acceptability was reported in interviews. Our findings suggest that Internet-delivered CBT for SCD pain is feasible and acceptable to adolescents with SCD and their parents. Engagement and adherence were good. Next steps are to modify recruitment plans to enhance enrollment and determine efficacy of Internet CBT for SCD pain in a large multisite randomized controlled trial.

1,25-Dihydroxyvitamin D Deficiency Is Associated With Preterm Birth in African American and Caucasian Women

PubMed Central

Menon, Ramkumar; Fortunato, Stephen J.; Brou, Lina; Lee, Jae-Eun; Al-Hendy, Ayman

2014-01-01

Vitamin (vit) D deficiency and preterm birth (PTB) are more prevalent among African American (AA) women compared to caucasian (Cau) women. Because vit D is important in regulating cell-mediated immune responses, vit D insufficiency or deficiency during pregnancy may enhance inflammation in pregnant women and increase the risk of PTB. In this study, circulatory levels of 25-hydroxy (OH) and 1,25-dihydroxy (OH)2 vit D were measured using chemiluminescence and radioimmunoassay techniques, respectively, in AA (n = 108) and Cau (n = 84) women who delivered at term and preterm. The results from this study suggest that the serum levels of the 25-(OH) vit D concentrations tend to decrease (P = .06) in the Cau women who delivered at preterm compared to those delivering at term. However, the 25-(OH) vit D levels in Cau and AA between term and preterm deliveries were not significantly different. The serum levels of 1,25-(OH)2 vit D were found to be significantly lower in AA women compared to Cau women (P < .02) at term, and in the Cau (P < .01) and AA (P < .04) women delivering at preterm compared to those delivering at term. One-way analysis of variance demonstrated that 1,25-(OH)2 vit D levels were significantly lower in participants delivering at preterm (<34 weeks and between 34 and 37 weeks) compared to those delivering at term (>37 weeks).These results suggest that low levels of serum 1,25-(OH)2 vit D are associated with PTB, and vit D can potentially be used as a novel diagnostic marker in the detection of PTB. PMID:23793474

Inactivated poliovirus type 2 vaccine delivered to rat skin via high density microprojection array elicits potent neutralising antibody responses

PubMed Central

Muller, David A.; Pearson, Frances E.; Fernando, Germain J.P.; Agyei-Yeboah, Christiana; Owens, Nick S.; Corrie, Simon R.; Crichton, Michael L.; Wei, Jonathan C.J.; Weldon, William C.; Oberste, M. Steven; Young, Paul R.; Kendall, Mark A. F.

2016-01-01

Polio eradication is progressing rapidly, and the live attenuated Sabin strains in the oral poliovirus vaccine (OPV) are being removed sequentially, starting with type 2 in April 2016. For risk mitigation, countries are introducing inactivated poliovirus vaccine (IPV) into routine vaccination programs. After April 2016, monovalent type 2 OPV will be available for type 2 outbreak control. Because the current IPV is not suitable for house-to-house vaccination campaigns (the intramuscular injections require health professionals), we developed a high-density microprojection array, the Nanopatch, delivered monovalent type 2 IPV (IPV2) vaccine to the skin. To assess the immunogenicity of the Nanopatch, we performed a dose-matched study in rats, comparing the immunogenicity of IPV2 delivered by intramuscular injection or Nanopatch immunisation. A single dose of 0.2 D-antigen units of IPV2 elicited protective levels of poliovirus antibodies in 100% of animals. However, animals receiving IPV2 by IM required at least 3 immunisations to reach the same neutralising antibody titres. This level of dose reduction (1/40th of a full dose) is unprecedented for poliovirus vaccine delivery. The ease of administration coupled with the dose reduction observed in this study points to the Nanopatch as a potential tool for facilitating inexpensive IPV for mass vaccination campaigns. PMID:26911254

HOME-BASED SELF-DELIVERED MIRROR THERAPY FOR PHANTOM PAIN: A PILOT STUDY*

PubMed Central

Darnall, Beth D.; Li, Hong

2014-01-01

Objective To test the feasibility and preliminary efficacy of self-delivered home-based mirror therapy for phantom pain. Design Uncontrolled prospective treatment outcome pilot study. Participants Forty community-dwelling adults with unilateral amputation and phantom pain >3 on a 0–10 numeric rating scale enrolled either during a one-time study visit (n = 30) or remotely (n = 10). Methods Participants received an explanation of mirror therapy and were asked to self-treat for 25 min daily. Participants completed and posted back sets of outcomes questionnaires at months 1 and 2 post-treatment. Main outcome was mean phantom pain intensity at post-treatment. Results A significant reduction in mean phantom pain intensity was found at month 1 (n = 31, p = 0.0002) and at month 2 (n = 26, p = 0.002). The overall median percentage reduction at month 2 was 15.4%. Subjects with high education (>16 years) compared with low education (<16 years) (37.5% vs 4.1%) had greater reduction in pain intensity (p = 0.01). Conclusion These findings support the feasibility and efficacy of home-based self-delivered mirror therapy; this low-cost treatment may defray medical costs, therapy visits, and the patient travel burden for people with motivation and a high level of education. More research is needed to determine methods of cost-effective support for people with lower levels of education. PMID:22378591

Is Beauty in the Eyes of the Beholder? Aesthetic Quality versus Technical Skill in Movement Evaluation of Tai Chi.

PubMed

Zamparo, Paola; Zorzi, Elena; Marcantoni, Sara; Cesari, Paola

2015-01-01

The aim of this study was to compare experts to naïve practitioners in rating the beauty and the technical quality of a Tai Chi sequence observed in video-clips (of high and middle level performances). Our hypothesis are: i) movement evaluation will correlate with the level of skill expressed in the kinematics of the observed action but ii) only experts will be able to unravel the technical component from the aesthetic component of the observed action. The judgments delivered indicate that both expert and non-expert observers are able to discern a good from a mediocre performance; however, as expected, only experts discriminate the technical from the aesthetic component of the action evaluated and do this independently of the level of skill shown by the model (high or middle level performances). Furthermore, the judgments delivered were strongly related to the kinematic variables measured in the observed model, indicating that observers rely on specific movement kinematics (e.g. movement amplitude, jerk and duration) for action evaluation. These results provide evidence of the complementary functional role of visual and motor action representation in movement evaluation and underline the role of expertise in judging the aesthetic quality of movements.

Is Beauty in the Eyes of the Beholder? Aesthetic Quality versus Technical Skill in Movement Evaluation of Tai Chi

PubMed Central

2015-01-01

The aim of this study was to compare experts to naïve practitioners in rating the beauty and the technical quality of a Tai Chi sequence observed in video-clips (of high and middle level performances). Our hypothesis are: i) movement evaluation will correlate with the level of skill expressed in the kinematics of the observed action but ii) only experts will be able to unravel the technical component from the aesthetic component of the observed action. The judgments delivered indicate that both expert and non-expert observers are able to discern a good from a mediocre performance; however, as expected, only experts discriminate the technical from the aesthetic component of the action evaluated and do this independently of the level of skill shown by the model (high or middle level performances). Furthermore, the judgments delivered were strongly related to the kinematic variables measured in the observed model, indicating that observers rely on specific movement kinematics (e.g. movement amplitude, jerk and duration) for action evaluation. These results provide evidence of the complementary functional role of visual and motor action representation in movement evaluation and underline the role of expertise in judging the aesthetic quality of movements. PMID:26047473

Bringing together integration technologies in GaAs, InP and Si to deliver low-cost high performance DWDM optoelectronic components and solutions

NASA Astrophysics Data System (ADS)

Carter, Andrew C.; Wale, Michael J.; Simmons, T.; Whitbread, Neil; Asghari, M.

2003-06-01

A key attribute emerging in the optoelectronic component supply industry is the ability to deliver 'solution level' products rather than discrete optical components to equipment manufacturers. This approach is primarily aimed at reducing cost for the equipment manufacturer both in engineering and assembly. Such 'solutions' must be designed to be cost effective - offering costs substantially below discrete components - and must be compatible with subcontract board manufacture without the traditional and expensive skills of fibre handling, splicing and management. Examples of 'solutions' in this context may be the core of a multifunctional OADM or a DWDM laser transmitter subsystem, with modulation, wavelength and power management all included in a simple to use module. Essential to the cost effective production of such solutions is a high degree of optical/optoelectronic integration. Co-packaging of discrete components and electronics into modules will not deliver the cost reduction demanded. At Bookham Technology we have brought together what we believe to be the three key integration technologies - InP for monolithic tunable sources, GaAs for high performance integrated modulation and ASOC for smart passives and hybrid platforms - which can deliver this cost reduction, together with performance enhancement, over a wide range of applications. In the paper we will demonstrate and compare our above integration approaches with the competing alternatives and seek to show how the power of integration is finally being harnessed in optoelectronics, delivering radical cost reduction as well as enabling system concepts virtually impossible to achieve with discrete components. In the paper we will demonstrate and compare our above integration approaches with the competing alternatives and seek to show how the power of integration is finally being harnessed in optoelectronics, delivering radical cost reduction as well as enabling system concepts virtually impossible to achieve with discrete components.

Anthranilic Diamide Insecticides Delivered via Multiple Approaches to Control Vegetable Pests: A Case Study in Snap Bean.

PubMed

Schmidt-Jeffris, Rebecca A; Nault, Brian A

2016-12-01

Many vegetable insect pests are managed using neonicotinoid and pyrethroid insecticides. Unfortunately, these insecticides are toxic to many bees and natural enemies and no longer control some pests that have developed resistance. Anthranilic diamide insecticides provide systemic control of many herbivorous arthropod pests, but exhibit low toxicity to beneficial arthropods and mammals, and may be a promising alternative to neonicotinoids and pyrethroids. Anthranilic diamides may be delivered to vegetable crops via seed, in-furrow, or foliar treatments; therefore, it would be desirable to identify which application method provides high levels of pest control while minimizing the amount of active ingredient. As a case study, chlorantraniliprole and cyantraniliprole applied via the methods listed above were evaluated for managing seedcorn maggot, Delia platura (Meigen) (Diptera: Anthomyiidae), and European corn borer, Ostrinia nubilalis (Hübner) (Lepidoptera: Crambidae), in snap bean. Chlorantraniliprole and cyantraniliprole delivered as seed and in-furrow treatments reduced D. platura damage to the same level as the standard neonicotinoid seed treatment. Both diamides applied via all three methods significantly reduced O. nubilalis damage, but only the foliar application provided similar control as the standard pyrethroid spray. Results from laboratory bioassays revealed that both diamides applied as seed and in-furrow treatments caused high O. nubilalis neonate mortality up to 44 d after application. While the diamides provided equivalent control of these pests as the neonicotinoid and pyrethroid standards when applied in the same manner, chlorantraniliprole delivered as a seed treatment showed the most promise for managing both pests. © The Authors 2016. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Population-Wide Parenting Intervention Training: Initial Feasibility

ERIC Educational Resources Information Center

Shapiro, Cheri J.; Prinz, Ronald J.; Sanders, Matthew R.

2008-01-01

A population-level approach to deliver parenting and family support is a necessary but neglected approach needed to reduce the high prevalence of emotional/behavioral problems in children, decrease inadequate and potentially abusive parenting practices, and to provide improved parenting support to all parents within a specified population. We…

Can Education for Sustainable Development Change Entrepreneurship Education to Deliver a Sustainable Future?

ERIC Educational Resources Information Center

Strachan, Glenn

2018-01-01

An objective of the European Union's Entrepreneurship 2020 Action Plan is to address high levels of youth unemployment in Europe by promoting entrepreneurship. Implementing entrepreneurship education in schools, colleges and universities is one of three strategic interventions proposed by the Action Plan. Sustainable entrepreneurship is a…

School-Based Cognitive-Behavioral Therapy for Adolescent Depression: A Benchmarking Study

ERIC Educational Resources Information Center

Shirk, Stephen R.; Kaplinski, Heather; Gudmundsen, Gretchen

2009-01-01

The current study evaluated cognitive-behavioral therapy (CBT) for adolescent depression delivered in health clinics and counseling centers in four high schools. Outcomes were benchmarked to results from prior efficacy trials. Fifty adolescents diagnosed with depressive disorders were treated by eight doctoral-level psychologists who followed a…

An Educative, Values-Engaged Approach to Evaluating STEM Educational Programs

ERIC Educational Resources Information Center

Greene, Jennifer C.; DeStefano, Lizanne; Burgon, Holli; Hall, Jori

2006-01-01

There is concern that the nation's schools are not preparing students to excel in science, technology, engineering, and mathematics (STEM) fields. At both precollege and postsecondary levels, much effort is needed to create and implement powerful STEM curricula, prepare and support highly qualified teachers, deliver effective instruction, and give…

Who delivers where? The effect of obstetric risk on facility delivery in East Africa.

PubMed

Virgo, Sandra; Gon, Giorgia; Cavallaro, Francesca L; Graham, Wendy; Woodd, Susannah

2017-09-01

Skilled attendance at birth is key for the survival of pregnant women. This study investigates whether women at increased risk of maternal and newborn complications in four East African countries are more likely to deliver in a health facility than those at lower risk. Demographic and Health Survey data for Kenya 2014, Rwanda 2014-15, Tanzania 2015-16 and Uganda 2011 were used to study women with a live birth in the three years preceding the survey. A three-level obstetric risk index was created using known risk factors. Generalised linear Poisson regression was used to investigate the association between obstetric risk and facility delivery. We analysed data from 13 119 women across the four countries of whom 42-45% were considered at medium risk and 12-17% at high risk, and the remainder were at low risk. In Rwanda, 93% of all women delivered in facilities but this was lower (59-66%) in the other three countries. There was no association between a woman's obstetric risk level and her place of delivery in any country; greater wealth and more education were, however, independently strongly associated with facility delivery. In four East African countries, women at higher obstetric risk were not more likely to deliver in a facility than those with lower risk. This calls for a renewed focus on antenatal risk screening and improved communication on birth planning to ensure women with an increased chance of maternal and newborn complications are supported to deliver in facilities with skilled care. © 2017 John Wiley & Sons Ltd.

Improvement in delivery of type 2 diabetes services differs by mode of care: a retrospective longitudinal analysis in the Aboriginal and Torres Strait Islander Primary Health Care setting.

PubMed

Schierhout, Gill; Matthews, Veronica; Connors, Christine; Thompson, Sandra; Kwedza, Ru; Kennedy, Catherine; Bailie, Ross

2016-10-07

Addressing evidence-practice gaps in primary care remains a significant public health challenge and is likely to require action at different levels of the health system. Whilst Continuous Quality Improvement (CQI) is associated with improvements in overall delivery, little is known about delivery of different types of care processes, and their relative improvement during CQI. We used data from over 15,000 clinical audit records of clients with Type 2 diabetes collected as part of a wide-scale CQI program implemented between 2005 and 2014 in 162 Aboriginal and Torres Strait Islander health centres. We abstracted data from clinical records on 15 service items recommended in clinical guidelines and categorised these items into five modes of care on the basis of the mechanism through which care is delivered: laboratory tests; generalist-delivered physical checks; specialist-delivered checks; education/counselling for nutrition and physical activity and education/counselling for high risk substance use. We calculated delivery for each patient for each of mode of care by determining the proportion of recommended services delivered for that mode. We used multilevel regression models to quantify variation attributable to health centre or client level factors and to identify factors associated with greater adherence to clinical guidelines for each mode of care. Clients on average received 43 to 60 % of recommended care in 2005/6. Different modes of care showed different patterns of improvement. Generalist-delivered physical checks (delivered by a non-specialist) showed a steady year on year increase, delivery of laboratory tests showed improvement only in the later years of the study, and delivery of counselling/education interventions showed early improvement which then plateaued. Health centres participating in CQI had increased odds of top quartile service delivery for all modes compared to baseline, but effects differed by mode. Health centre factors explained 20-52 % of the variation across jurisdictions and health centres for different modes of care. Levels of adherence to clinical guidelines and patterns of improvement during participation in a CQI program differed for different modes of care. Policy and funding decisions may have had important effects on the level and nature of improvements achieved.

Advancements in high-power diode laser stacks for defense applications

NASA Astrophysics Data System (ADS)

Pandey, Rajiv; Merchen, David; Stapleton, Dean; Patterson, Steve; Kissel, Heiko; Fassbender, Wilhlem; Biesenbach, Jens

2012-06-01

This paper reports on the latest advancements in vertical high-power diode laser stacks using micro-channel coolers, which deliver the most compact footprint, power scalability and highest power/bar of any diode laser package. We present electro-optical (E-O) data on water-cooled stacks with wavelengths ranging from 7xx nm to 9xx nm and power levels of up to 5.8kW, delivered @ 200W/bar, CW mode, and a power-conversion efficiency of >60%, with both-axis collimation on a bar-to-bar pitch of 1.78mm. Also, presented is E-O data on a compact, conductively cooled, hardsoldered, stack package based on conventional CuW and AlN materials, with bar-to-bar pitch of 1.8mm, delivering average power/bar >15W operating up to 25% duty cycle, 10ms pulses @ 45C. The water-cooled stacks can be used as pump-sources for diode-pumped alkali lasers (DPALs) or for more traditional diode-pumped solid-state lasers (DPSSL). which are power/brightness scaled for directed energy weapons applications and the conductively-cooled stacks as illuminators.

Gaze-Aware Streaming Solutions for the Next Generation of Mobile VR Experiences.

PubMed

Lungaro, Pietro; Sjoberg, Rickard; Valero, Alfredo Jose Fanghella; Mittal, Ashutosh; Tollmar, Konrad

2018-04-01

This paper presents a novel approach to content delivery for video streaming services. It exploits information from connected eye-trackers embedded in the next generation of VR Head Mounted Displays (HMDs). The proposed solution aims to deliver high visual quality, in real time, around the users' fixations points while lowering the quality everywhere else. The goal of the proposed approach is to substantially reduce the overall bandwidth requirements for supporting VR video experiences while delivering high levels of user perceived quality. The prerequisites to achieve these results are: (1) mechanisms that can cope with different degrees of latency in the system and (2) solutions that support fast adaptation of video quality in different parts of a frame, without requiring a large increase in bitrate. A novel codec configuration, capable of supporting near-instantaneous video quality adaptation in specific portions of a video frame, is presented. The proposed method exploits in-built properties of HEVC encoders and while it introduces a moderate amount of error, these errors are indetectable by users. Fast adaptation is the key to enable gaze-aware streaming and its reduction in bandwidth. A testbed implementing gaze-aware streaming, together with a prototype HMD with in-built eye tracker, is presented and was used for testing with real users. The studies quantified the bandwidth savings achievable by the proposed approach and characterize the relationships between Quality of Experience (QoE) and network latency. The results showed that up to 83% less bandwidth is required to deliver high QoE levels to the users, as compared to conventional solutions.

Examining exposure reciprocity in a resin based composite using high irradiance levels and real-time degree of conversion values.

PubMed

Selig, Daniela; Haenel, Thomas; Hausnerová, Berenika; Moeginger, Bernhard; Labrie, Daniel; Sullivan, Braden; Price, Richard B T

2015-05-01

Exposure reciprocity suggests that, as long as the same radiant exposure is delivered, different combinations of irradiance and exposure time will achieve the same degree of resin polymerization. This study examined the validity of exposure reciprocity using real time degree of conversion results from one commercial flowable dental resin. Additionally a new fitting function to describe the polymerization kinetics is proposed. A Plasma Arc Light Curing Unit (LCU) was used to deliver 0.75, 1.2, 1.5, 3.7 or 7.5 W/cm(2) to 2mm thick samples of Tetric EvoFlow (Ivoclar Vivadent). The irradiances and radiant exposures received by the resin were determined using an integrating sphere connected to a fiber-optic spectrometer. The degree of conversion (DC) was recorded at a rate of 8.5 measurements a second at the bottom of the resin using attenuated total reflectance Fourier Transform mid-infrared spectroscopy (FT-MIR). Five specimens were exposed at each irradiance level. The DC reached after 170s and after 5, 10 and 15 J/cm(2) had been delivered was compared using analysis of variance and Fisher's PLSD post hoc multiple comparison tests (alpha=0.05). The same DC values were not reached after the same radiant exposures of 5, 10 and 15 J/cm(2) had been delivered at an irradiance of 3.7 and 7.5 W/cm(2). Thus exposure reciprocity was not supported for Tetric EvoFlow (p<0.05). For Tetric EvoFlow, there was no significant difference in the DC when 5, 10 and 15J/cm(2) were delivered at irradiance levels of 0.75, 1.2 and 1.5 W/cm(2). The optimum combination of irradiance and exposure time for this commercial dental resin may be close to 1.5 W/cm(2) for 12s. Copyright © 2015 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Quality indicators for family support services and their relationship to organizational social context.

PubMed

Olin, S Serene; Williams, Nate; Pollock, Michele; Armusewicz, Kelsey; Kutash, Krista; Glisson, Charles; Hoagwood, Kimberly E

2014-01-01

Quality measurement is an important component of healthcare reform. The relationship of quality indicators (QIs) for parent-delivered family support services to organizational social contexts known to improve quality is unexamined. This study employs data collected from 21 child mental health programs that deliver team-based family support services. Performance on two levels of QIs-those targeting the program and staff-were significantly associated with organizational social context profiles and dimensions. High quality program policies are associated with positive organizational cultures and engaging climates. Inappropriate staff practices are associated with resistant cultures. Implications for organizational strategies to improve service quality are discussed.

Quality Indicators for Family Support Services and Their Relationship to Organizational Social Context

PubMed Central

Olin, S. Serene; Williams, Nate; Pollock, Michele; Armusewicz, Kelsey; Kutash, Krista; Glisson, Charles; Hoagwood, Kimberly E.

2013-01-01

Quality measurement is an important component of healthcare reform. The relationship of quality indicators (QIs) for parent-delivered family support services to organizational social contexts known to improve quality is unexamined. This study employs data collected from 21 child mental health programs that deliver team-based family support services. Performance on two levels of QIs —those targeting the program and staff -- were significantly associated with organizational social context profiles and dimensions. High quality program policies are associated with positive organizational cultures and engaging climates. Inappropriate staff practices are associated with resistant cultures. Implications for organizational strategies to improve service quality are discussed. PMID:23709286

[Breech presentation terminated by cesarean section].

PubMed

Milasinović, L; Bregun-Dragić, N; Nikolić, L; Radeka, G

1992-01-01

The prospective study was carried out in 86 mothers and their newborns born in breech presentation; 41 were delivered by cesarean section, 45 vaginally. The incidence of prepathologic and pathologic CTGs was rather high in both groups (34.14% and 24.34%) as well as the presence of meconium in the amniotic fluid (34.15% and 22.22%). The infants delivered by cesarean section have significantly (p < 0.05) higher pH levels (7.28 +/- 0.068) than those delivered vaginally (7.25 +/- 0.093). The acidosis incidence (pH +/- 7.20) is significantly (p < 0.01) lower in the first (9.76%) than in the second (26.66%) group. In the early neonatal period 24.35% of the children in the first group and 35.55% of the children in the second group developed a disease (p < 0.05). The difference in the morbidity rate can also be found in the fact that in the studied group no intracranial hemorrhage was diagnosed while in the control group it was found in 17.77% of the children. Manifest cerebral disfunction syndrome was detected in 2.44% of the children delivered by cesarean section and in 8.88% of the children delivered vaginally. One child (2.22%) delivered with manual help has died. The morbidity of the mothers was significantly (p < 0.05) higher in women who gave birth abdominally (17.68%) than in those who gave birth vaginally (8.88%).

Using EPIC to Find Conflicts, Inconsistencies, and Gaps in Department of Defense Policies

DTIC Science & Technology

2013-01-01

documentation; or deliver preliminary findings. All RAND reports un- dergo rigorous peer review to ensure that they meet high standards for research quality...responsibilities and the products that result from their execution. Once the high -level frame- work was defined, successive lower layers were developed to further...Lead or Chief Engineer Component Acquisition Executive ( CAE ) Managers Configuration Steering Board Materiel developer Contractor Milestone Decision

Massively parallel single-molecule and single-cell emulsion reverse transcription polymerase chain reaction using agarose droplet microfluidics.

PubMed

Zhang, Huifa; Jenkins, Gareth; Zou, Yuan; Zhu, Zhi; Yang, Chaoyong James

2012-04-17

A microfluidic device for performing single copy, emulsion Reverse Transcription Polymerase Chain Reaction (RT-PCR) within agarose droplets is presented. A two-aqueous-inlet emulsion droplet generator was designed and fabricated to produce highly uniform monodisperse picoliter agarose emulsion droplets with RT-PCR reagents in carrier oil. Template RNA or cells were delivered from one inlet with RT-PCR reagents/cell lysis buffer delivered separately from the other. Efficient RNA/cell encapsulation and RT-PCR at the single copy level was achieved in agarose-in-oil droplets, which, after amplification, can be solidified into agarose beads for further analysis. A simple and efficient method to graft primer to the polymer matrix using 5'-acrydite primer was developed to ensure highly efficient trapping of RT-PCR products in agarose. High-throughput single RNA molecule/cell RT-PCR was demonstrated in stochastically diluted solutions. Our results indicate that single-molecule RT-PCR can be efficiently carried out in agarose matrix. Single-cell RT-PCR was successfully performed which showed a clear difference in gene expression level of EpCAM, a cancer biomarker gene, at the single-cell level between different types of cancer cells. This work clearly demonstrates for the first time, single-copy RT-PCR in agarose droplets. We believe this will open up new possibilities for viral RNA detection and single-cell transcription analysis.

Youth Risk Assessment in Complex Agency Practice

ERIC Educational Resources Information Center

Groner, Mark R.; Solomon, Jean

2007-01-01

Advancements in the delivery of community-based services and tight utilization management of high-cost treatment options result in youths with serious behavior problems receiving intervention in lower levels of care than was true ten or fifteen years ago. This shift in where services tend to be delivered necessitates enhancement of risk assessment…

Distributing stand inventory data and maps over a wide area network

Treesearch

Thomas E. Burk

2000-01-01

High-speed networks connecting multiple levels of management are becoming commonplace among forest resources organizations. Such networks can be used to deliver timely spatial and aspatial data relevant to the management of stands to field personnel. A network infrastructure allows maintenance of cost-effective, centralized databases with the potential for updating by...

The Technical Baccalaureate: Providing Excellence in Vocational Education?

ERIC Educational Resources Information Center

Acquah, Daniel K.; Malpass, Debra

2017-01-01

Proposals for a technical baccalaureate have received cross-party support in England. The technical baccalaureate is intended to deliver the necessary training to enable young people to fill the UK's skills gap in intermediate-level occupations in STEM and other sectors. This paper explores how to design and implement a high-quality technical…

The Noticeability and Effectiveness of Corrective Feedback in Relation to Target Type

ERIC Educational Resources Information Center

Kartchava, Eva; Ammar, Ahlem

2014-01-01

This quasi-experimental study investigated the noticeability and effectiveness of three corrective feedback (CF) techniques (recasts, prompts and a combination of the two) delivered in the language classroom. The participants were four groups of high-beginner college level francophone learners of English as a second language (ESL) (n = 99) and…

Performance Analysis of TCP Enhancements in Satellite Data Networks

NASA Technical Reports Server (NTRS)

Broyles, Ren H.

1999-01-01

This research examines two proposed enhancements to the well-known Transport Control Protocol (TCP) in the presence of noisy communication links. The Multiple Pipes protocol is an application-level adaptation of the standard TCP protocol, where several TCP links cooperate to transfer data. The Space Communication Protocol Standard - Transport Protocol (SCPS-TP) modifies TCP to optimize performance in a satellite environment. While SCPS-TP has inherent advantages that allow it to deliver data more rapidly than Multiple Pipes, the protocol, when optimized for operation in a high-error environment, is not compatible with legacy TCP systems, and requires changes to the TCP specification. This investigation determines the level of improvement offered by SCPS-TP's Corruption Mode, which will help determine if migration to the protocol is appropriate in different environments. As the percentage of corrupted packets approaches 5 %, Multiple Pipes can take over five times longer than SCPS-TP to deliver data. At high error rates, SCPS-TP's advantage is primarily caused by Multiple Pipes' use of congestion control algorithms. The lack of congestion control, however, limits the systems in which SCPS-TP can be effectively used.

Sensitivity to microstimulation of somatosensory cortex distributed over multiple electrodes.

PubMed

Kim, Sungshin; Callier, Thierri; Tabot, Gregg A; Tenore, Francesco V; Bensmaia, Sliman J

2015-01-01

Meaningful and repeatable tactile sensations can be evoked by electrically stimulating primary somatosensory cortex. Intracortical microstimulation (ICMS) may thus be a viable approach to restore the sense of touch in individuals who have lost it, for example tetraplegic patients. One of the potential limitations of this approach, however, is that high levels of current can damage the neuronal tissue if the resulting current densities are too high. The limited range of safe ICMS amplitudes thus limits the dynamic range of ICMS-evoked sensations. One way to get around this limitation would be to distribute the ICMS over multiple electrodes in the hopes of intensifying the resulting percept without increasing the current density experienced by the neuronal tissue. Here, we test whether stimulating through multiple electrodes is a viable solution to increase the dynamic range of ICMS-elicited sensations without increasing the peak current density. To this end, we compare the ability of non-human primates to detect ICMS delivered through one vs. multiple electrodes. We also compare their ability to discriminate pulse trains differing in amplitude when these are delivered through one or more electrodes. We find that increasing the number of electrodes through which ICMS is delivered only has a marginal effect on detectability or discriminability despite the fact that 2-4 times more current is delivered overall. Furthermore, the impact of multielectrode stimulation (or lack thereof) is found whether pulses are delivered synchronously or asynchronously, whether the leading phase of the pulses is cathodic or anodic, and regardless of the spatial configuration of the electrode groups.

Gated Mesoporous Silica Nanocarriers for a "Two-Step" Targeted System to Colonic Tissue.

PubMed

González-Alvarez, Marta; Coll, Carmen; Gonzalez-Alvarez, Isabel; Giménez, Cristina; Aznar, Elena; Martínez-Bisbal, M Carmen; Lozoya-Agulló, Isabel; Bermejo, Marival; Martínez-Máñez, Ramón; Sancenón, Félix

2017-12-04

Colon targeted drug delivery is highly relevant not only to treat colonic local diseases but also for systemic therapies. Mesoporous silica nanoparticles (MSNs) have been demonstrated as useful systems for controlled drug release given their biocompatibility and the possibility of designing gated systems able to release cargo only upon the presence of certain stimuli. We report herein the preparation of three gated MSNs able to deliver their cargo triggered by different stimuli (redox ambient (S1), enzymatic hydrolysis (S2), and a surfactant or being in contact with cell membrane (S3)) and their performance in solution and in vitro with Caco-2 cells. Safranin O dye was used as a model drug to track cargo fate. Studies of cargo permeability in Caco-2 monolayers demonstrated that intracellular safranin O levels were significantly higher in Caco-2 monolayers when using MSNs compared to those of free dye. Internalization assays indicated that S2 nanoparticles were taken up by cells via endocytosis. S2 nanoparticles were selected for in vivo tests in rats. For in vivo assays, capsules were filled with S2 nanoparticles and coated with Eudragit FS 30 D to target colon. The enteric coated capsule containing the MSNs was able to deliver S2 nanoparticles in colon tissue (first step), and then nanoparticles were able to deliver safranin O inside the colonic cells after the enzymatic stimuli (second step). This resulted in high levels of safranin O in colonic tissue combined with low dye levels in plasma and body tissues. The results suggested that this combination of enzyme-responsive gated MSNs and enteric coated capsules may improve the absorption of drugs in colon to treat local diseases with a reduction of systemic effects.

Drug delivery strategies for poorly water-soluble drugs.

PubMed

Fahr, Alfred; Liu, Xiangli

2007-07-01

The drug candidates coming from combinatorial chemistry research and/or the drugs selected from biologically based high-throughput screening are quite often very lipophilic, as these drug candidates exert their pharmacological action at or in biological membranes or membrane-associated proteins. This challenges drug delivery institutions in industry or academia to develop carrier systems for the optimal oral and parenteral administration of these drugs. To mention only a few of the challenges for this class of drugs: their oral bioavailability is poor and highly variable, and carrier development for parenteral administration is faced with problems, including the massive use of surface-active excipients for solubilisation. Formulation specialists are confronted with an even higher level of difficulties when these drugs have to be delivered site specifically. This article addresses the emerging formulation designs for delivering of poorly water-soluble drugs.

Design and feasibility testing of a novel group intervention for young women who binge drink in groups.

PubMed

Irvine, Linda; Crombie, Iain K; Swanson, Vivien; Dimova, Elena D; Melson, Ambrose J; Fraser, Tracey M; Barbour, Rosaline; Rice, Peter M; Allan, Sheila

2018-01-01

Young women frequently drink alcohol in groups and binge drinking within these natural drinking groups is common. This study describes the design of a theoretically and empirically based group intervention to reduce binge drinking among young women. It also evaluates their engagement with the intervention and the acceptability of the study methods. Friendship groups of women aged 18-35 years, who had two or more episodes of binge drinking (>6 UK units on one occasion; 48g of alcohol) in the previous 30 days, were recruited from the community. A face-to-face group intervention, based on the Health Action Process Approach, was delivered over three sessions. Components of the intervention were woven around fun activities, such as making alcohol free cocktails. Women were followed up four months after the intervention was delivered. The target of 24 groups (comprising 97 women) was recruited. The common pattern of drinking was infrequent, heavy drinking (mean consumption on the heaviest drinking day was UK 18.1 units). Process evaluation revealed that the intervention was delivered with high fidelity and acceptability of the study methods was high. The women engaged positively with intervention components and made group decisions about cutting down. Twenty two groups set goals to reduce their drinking, and these were translated into action plans. Retention of individuals at follow up was 87%. This study successfully recruited groups of young women whose patterns of drinking place them at high risk of acute harm. This novel approach to delivering an alcohol intervention has potential to reduce binge drinking among young women. The high levels of engagement with key steps in the behavior change process suggests that the group intervention should be tested in a full randomised controlled trial.

Design and feasibility testing of a novel group intervention for young women who binge drink in groups

PubMed Central

Crombie, Iain K.; Swanson, Vivien; Dimova, Elena D.; Melson, Ambrose J.; Fraser, Tracey M.; Barbour, Rosaline; Rice, Peter M.; Allan, Sheila

2018-01-01

Background Young women frequently drink alcohol in groups and binge drinking within these natural drinking groups is common. This study describes the design of a theoretically and empirically based group intervention to reduce binge drinking among young women. It also evaluates their engagement with the intervention and the acceptability of the study methods. Methods Friendship groups of women aged 18–35 years, who had two or more episodes of binge drinking (>6 UK units on one occasion; 48g of alcohol) in the previous 30 days, were recruited from the community. A face-to-face group intervention, based on the Health Action Process Approach, was delivered over three sessions. Components of the intervention were woven around fun activities, such as making alcohol free cocktails. Women were followed up four months after the intervention was delivered. Results The target of 24 groups (comprising 97 women) was recruited. The common pattern of drinking was infrequent, heavy drinking (mean consumption on the heaviest drinking day was UK 18.1 units). Process evaluation revealed that the intervention was delivered with high fidelity and acceptability of the study methods was high. The women engaged positively with intervention components and made group decisions about cutting down. Twenty two groups set goals to reduce their drinking, and these were translated into action plans. Retention of individuals at follow up was 87%. Conclusions This study successfully recruited groups of young women whose patterns of drinking place them at high risk of acute harm. This novel approach to delivering an alcohol intervention has potential to reduce binge drinking among young women. The high levels of engagement with key steps in the behavior change process suggests that the group intervention should be tested in a full randomised controlled trial. PMID:29494683

Protection from the toxicity of diisopropylfluorophosphate by adeno-associated virus expressing acetylcholinesterase

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

Li Bin; Duysen, Ellen G.; Poluektova, Larisa Y.

2006-07-15

Organophosphorus esters (OP) are highly toxic chemicals used as pesticides and nerve agents. Their acute toxicity is attributed to inhibition of acetylcholinesterase (AChE, EC 3.1.1.7) in nerve synapses. Our goal was to find a new therapeutic for protection against OP toxicity. We used a gene therapy vector, adeno-associated virus serotype 2 (AAV-2), to deliver murine AChE to AChE-/- mice that have no endogenous AChE activity. The vector encoded the most abundant form of AChE: exons 2, 3, 4, and 6. Two-day old animals, with an immature immune system, were injected. AChE delivered intravenously was expressed up to 5 months inmore » plasma, liver, heart, and lung, at 5-15% of the level in untreated wild-type mice. A few mice formed antibodies, but antibodies did not block AChE activity. The plasma AChE was a mixture of dimers and tetramers. AChE delivered intramuscularly had 40-fold higher activity levels than in wild-type muscle. None of the AChE was collagen-tailed. No retrograde transport through the motor neurons to the central nervous system was detected. AChE delivered intrastriatally assembled into tetramers. In brain, the AAV-2 vector transduced neurons, but not astrocytes and microglia. Vector-treated AChE-/- mice lived longer than saline-treated controls. AChE-/- mice were protected from diisopropylfluorophosphate-induced respiratory failure when the vector was delivered intravenously, but not intrastriatally. Since vector-treated animals had no AChE activity in diaphragm muscle, protection from respiratory failure came from AChE in other tissues. We conclude that AChE scavenged OP and in this way protected the activity of butyrylcholinesterase (BChE, EC 3.1.1.8) in motor endplates.« less

Challenges in managing elderly people with diabetes in primary care settings in Norway

PubMed Central

2013-01-01

Abstract Objective To explore the experiences and clinical challenges that nurses and nursing assistants face when providing high-quality diabetes-specific management and care for elderly people with diabetes in primary care settings. Design Focus-group interviews. Subjects and setting Sixteen health care professionals: 12 registered nurses and four nursing assistants from nursing homes (10), district nursing service (5), and a service unit (1) were recruited by municipal managers who had local knowledge and knew the workforce. All the participants were women aged 32–59 years with clinical experience ranging from 1.5 to 38 years. Results Content analysis revealed a discrepancy between the level of expertise which the participants described as important to delivering high-quality care and their capacity to deliver such care. The discrepancy was due to lack of availability and access to current information, limited ongoing support, lack of cohesion among health care professionals, and limited confidence and autonomy. Challenges to delivering high-quality care included complex, difficult patient situations and lack of confidence to make decisions founded on evidence-based guidelines. Conclusion Participants lacked confidence and autonomy to manage elderly people with diabetes in municipal care settings. Lack of information, support, and professional cohesion made the role challenging. PMID:24205973

Expression kinetics of nucleoside-modified mRNA delivered in lipid nanoparticles to mice by various routes.

PubMed

Pardi, Norbert; Tuyishime, Steven; Muramatsu, Hiromi; Kariko, Katalin; Mui, Barbara L; Tam, Ying K; Madden, Thomas D; Hope, Michael J; Weissman, Drew

2015-11-10

In recent years, in vitro transcribed messenger RNA (mRNA) has emerged as a potential therapeutic platform. To fulfill its promise, effective delivery of mRNA to specific cell types and tissues needs to be achieved. Lipid nanoparticles (LNPs) are efficient carriers for short-interfering RNAs and have entered clinical trials. However, little is known about the potential of LNPs to deliver mRNA. Here, we generated mRNA-LNPs by incorporating HPLC purified, 1-methylpseudouridine-containing mRNA comprising codon-optimized firefly luciferase into stable LNPs. Mice were injected with 0.005-0.250mg/kg doses of mRNA-LNPs by 6 different routes and high levels of protein translation could be measured using in vivo imaging. Subcutaneous, intramuscular and intradermal injection of the LNP-encapsulated mRNA translated locally at the site of injection for up to 10days. For several days, high levels of protein production could be achieved in the lung from the intratracheal administration of mRNA. Intravenous and intraperitoneal and to a lesser extent intramuscular and intratracheal deliveries led to trafficking of mRNA-LNPs systemically resulting in active translation of the mRNA in the liver for 1-4 days. Our results demonstrate that LNPs are appropriate carriers for mRNA in vivo and have the potential to become valuable tools for delivering mRNA encoding therapeutic proteins. Copyright © 2015 Elsevier B.V. All rights reserved.

Nonlinear pulse compression stage delivering 43-W few-cycle pulses with GW peak-power at 2-μm wavelength

NASA Astrophysics Data System (ADS)

Gebhardt, Martin; Gaida, Christian; Heuermann, T.; Stutzki, F.; Jauregui, C.; Antonio-Lopez, J.; Schüuzgen, A.; Amezcua-Correa, R.; Tünnermann, A.; Limpert, J.

2018-02-01

In this contribution we demonstrate the nonlinear pulse compression of an ultrafast thulium-doped fiber laser down to 14 fs FWHM duration (sub-3 optical cycles) at a record average power of 43 W and 34.5 μJ pulse energy. To the best of our knowledge, we present the highest average power few-cycle laser source at 2 μm wavelength. This performance level in combination with GW-class peak power makes our laser source extremely interesting for driving high-harmonic generation or for generating mid-infrared frequency combs via intra-pulse frequency down-conversion at an unprecedented average power. The experiments were enabled by an ultrafast thulium-doped fiber laser delivering 110 fs pulses at high repetition rates, and an argon gas-filled antiresonant hollow-core fiber (ARHCF) with excellent transmission and weak anomalous dispersion, leading to the self-compression of the pulses. We have shown that ARHCFs are well-suited for nonlinear pulse compression around 2 μm wavelength and that this concept features excellent power handling capabilities. Based on this result, we discuss the next steps for energy and average power scaling including upscaling the fiber dimensions in order to fully exploit the capabilities of our laser system, which can deliver several GW of peak power. This way, a 100 W-class laser source with mJ-level few-cycle pulses at 2 μm wavelength is feasible in the near future.

A high-speed DAQ framework for future high-level trigger and event building clusters

NASA Astrophysics Data System (ADS)

Caselle, M.; Ardila Perez, L. E.; Balzer, M.; Dritschler, T.; Kopmann, A.; Mohr, H.; Rota, L.; Vogelgesang, M.; Weber, M.

2017-03-01

Modern data acquisition and trigger systems require a throughput of several GB/s and latencies of the order of microseconds. To satisfy such requirements, a heterogeneous readout system based on FPGA readout cards and GPU-based computing nodes coupled by InfiniBand has been developed. The incoming data from the back-end electronics is delivered directly into the internal memory of GPUs through a dedicated peer-to-peer PCIe communication. High performance DMA engines have been developed for direct communication between FPGAs and GPUs using "DirectGMA (AMD)" and "GPUDirect (NVIDIA)" technologies. The proposed infrastructure is a candidate for future generations of event building clusters, high-level trigger filter farms and low-level trigger system. In this paper the heterogeneous FPGA-GPU architecture will be presented and its performance be discussed.

Persistent organic pollutants in maternal blood plasma and breast milk from Russian arctic populations.

PubMed

Klopov, V; Odland, J O; Burkow, I C

1998-10-01

Under the auspices of Arctic Monitoring and Assessment Programme (AMAP), a Russian-Norwegian co-operation project was established to assess the exposure of delivering women to persistent organic pollutants (POPs) in Arctic areas of Russia. In the period 1993-95 blood and breast milk samples were collected from 94 delivering women in Yamal and Tajmyr Autonomous Regions of Siberia. Concentrations of chlorinated pesticides and polychlorinated biphenyls (PCBs) were determined by high resolution gas chromatography with electron capture detection. The POP levels in maternal plasma among the non-indigenous women were higher than the native population, especially in total PCB, HCHs (hexachlorocyclohexanes) and the DDT-group. The dietary questionnaires showed that the non-indigenous populations consumed considerably less local food items like reindeer meat and fresh water fish. There was no correlation between local food consumption and elevated levels of pollutants. Even if the indigenous groups had lower concentrations of the most important pollutants than the non-indigenous population, they were still higher than the levels measured in the Scandinavian countries of the AMAP-study and up to levels of medical concern. The most important sources of organic pollutants for the Russian Arctic populations of Yamal and Tajmyr seems to be imported food from other areas of Russia and local use of pesticides. It must be a high priority concern to further elucidate these trends and initiate prophylactic measures for the exposed population groups.

Method for technology-delivered healthcare measures.

PubMed

Kramer-Jackman, Kelli Lee; Popkess-Vawter, Sue

2011-12-01

Current healthcare literature lacks development and evaluation methods for research and practice measures administered by technology. Researchers with varying levels of informatics experience are developing technology-delivered measures because of the numerous advantages they offer. Hasty development of technology-delivered measures can present issues that negatively influence administration and psychometric properties. The Method for Technology-delivered Healthcare Measures is designed to systematically guide the development and evaluation of technology-delivered measures. The five-step Method for Technology-delivered Healthcare Measures includes establishment of content, e-Health literacy, technology delivery, expert usability, and participant usability. Background information and Method for Technology-delivered Healthcare Measures steps are detailed.

Using mixed methods to assess fidelity of delivery and its influencing factors in a complex self-management intervention for people with osteoarthritis and low back pain.

PubMed

Toomey, Elaine; Matthews, James; Hurley, Deirdre A

2017-08-04

Despite an increasing awareness of the importance of fidelity of delivery within complex behaviour change interventions, it is often poorly assessed. This mixed methods study aimed to establish the fidelity of delivery of a complex self-management intervention and explore the reasons for these findings using a convergent/triangulation design. Feasibility trial of the Self-management of Osteoarthritis and Low back pain through Activity and Skills (SOLAS) intervention (ISRCTN49875385), delivered in primary care physiotherapy. 60 SOLAS sessions were delivered across seven sites by nine physiotherapists. Fidelity of delivery of prespecified intervention components was evaluated using (1) audio-recordings (n=60), direct observations (n=24) and self-report checklists (n=60) and (2) individual interviews with physiotherapists (n=9). Quantitatively, fidelity scores were calculated using percentage means and SD of components delivered. Associations between fidelity scores and physiotherapist variables were analysed using Spearman's correlations. Interviews were analysed using thematic analysis to explore potential reasons for fidelity scores. Integration of quantitative and qualitative data occurred at an interpretation level using triangulation. Quantitatively, fidelity scores were high for all assessment methods; with self-report (92.7%) consistently higher than direct observations (82.7%) or audio-recordings (81.7%). There was significant variation between physiotherapists' individual scores (69.8% - 100%). Both qualitative and quantitative data (from physiotherapist variables) found that physiotherapists' knowledge (Spearman's association at p=0.003) and previous experience (p=0.008) were factors that influenced their fidelity. The qualitative data also postulated participant-level (eg, individual needs) and programme-level factors (eg, resources) as additional elements that influenced fidelity. The intervention was delivered with high fidelity. This study contributes to the limited evidence regarding fidelity assessment methods within complex behaviour change interventions. The findings suggest a combination of quantitative methods is suitable for the assessment of fidelity of delivery. A mixed methods approach provided a more insightful understanding of fidelity and its influencing factors. ISRCTN49875385; Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Operational forecasting with the subgrid technique on the Elbe Estuary

NASA Astrophysics Data System (ADS)

Sehili, Aissa

2017-04-01

Modern remote sensing technologies can deliver very detailed land surface height data that should be considered for more accurate simulations. In that case, and even if some compromise is made with regard to grid resolution of an unstructured grid, simulations still will require large grids which can be computationally very demanding. The subgrid technique, first published by Casulli (2009), is based on the idea of making use of the available detailed subgrid bathymetric information while performing computations on relatively coarse grids permitting large time steps. Consequently, accuracy and efficiency are drastically enhanced if compared to the classical linear method, where the underlying bathymetry is solely discretized by the computational grid. The algorithm guarantees rigorous mass conservation and nonnegative water depths for any time step size. Computational grid-cells are permitted to be wet, partially wet or dry and no drying threshold is needed. The subgrid technique is used in an operational forecast model for water level, current velocity, salinity and temperature of the Elbe estuary in Germany. Comparison is performed with the comparatively highly resolved classical unstructured grid model UnTRIM. The daily meteorological forcing data are delivered by the German Weather Service (DWD) using the ICON-EU model. Open boundary data are delivered by the coastal model BSHcmod of the German Federal Maritime and Hydrographic Agency (BSH). Comparison of predicted water levels between classical and subgrid model shows a very good agreement. The speedup in computational performance due to the use of the subgrid technique is about a factor of 20. A typical daily forecast can be carried out within less than 10 minutes on standard PC-like hardware. The model is capable of permanently delivering highly resolved temporal and spatial information on water level, current velocity, salinity and temperature for the whole estuary. The model offers also the possibility to recalculate any previous situation. This can be helpful to figure out for instance the context in which a certain event occurred like an accident. In addition to measurement, the model can be used to improve navigability by adjusting the tidal transit-schedule for container vessels that are depending on the tide to approach or leave the port of Hamburg.

Using mixed methods to assess fidelity of delivery and its influencing factors in a complex self-management intervention for people with osteoarthritis and low back pain

PubMed Central

Toomey, Elaine; Matthews, James; Hurley, Deirdre A

2017-01-01

Objectives and design Despite an increasing awareness of the importance of fidelity of delivery within complex behaviour change interventions, it is often poorly assessed. This mixed methods study aimed to establish the fidelity of delivery of a complex self-management intervention and explore the reasons for these findings using a convergent/triangulation design. Setting Feasibility trial of the Self-management of Osteoarthritis and Low back pain through Activity and Skills (SOLAS) intervention (ISRCTN49875385), delivered in primary care physiotherapy. Methods and outcomes 60 SOLAS sessions were delivered across seven sites by nine physiotherapists. Fidelity of delivery of prespecified intervention components was evaluated using (1) audio-recordings (n=60), direct observations (n=24) and self-report checklists (n=60) and (2) individual interviews with physiotherapists (n=9). Quantitatively, fidelity scores were calculated using percentage means and SD of components delivered. Associations between fidelity scores and physiotherapist variables were analysed using Spearman’s correlations. Interviews were analysed using thematic analysis to explore potential reasons for fidelity scores. Integration of quantitative and qualitative data occurred at an interpretation level using triangulation. Results Quantitatively, fidelity scores were high for all assessment methods; with self-report (92.7%) consistently higher than direct observations (82.7%) or audio-recordings (81.7%). There was significant variation between physiotherapists’ individual scores (69.8% - 100%). Both qualitative and quantitative data (from physiotherapist variables) found that physiotherapists’ knowledge (Spearman’s association at p=0.003) and previous experience (p=0.008) were factors that influenced their fidelity. The qualitative data also postulated participant-level (eg, individual needs) and programme-level factors (eg, resources) as additional elements that influenced fidelity. Conclusion The intervention was delivered with high fidelity. This study contributes to the limited evidence regarding fidelity assessment methods within complex behaviour change interventions. The findings suggest a combination of quantitative methods is suitable for the assessment of fidelity of delivery. A mixed methods approach provided a more insightful understanding of fidelity and its influencing factors. Trial registration number ISRCTN49875385; Pre-results. PMID:28780544

Status of HiLASE project: High average power pulsed DPSSL systems for research and industry

NASA Astrophysics Data System (ADS)

Mocek, T.; Divoky, M.; Smrz, M.; Sawicka, M.; Chyla, M.; Sikocinski, P.; Vohnikova, H.; Severova, P.; Lucianetti, A.; Novak, J.; Rus, B.

2013-11-01

We introduce the Czech national R&D project HiLASE which focuses on strategic development of advanced high-repetition rate, diode pumped solid state laser (DPSSL) systems that may find use in research, high-tech industry and in the future European large-scale facilities such as HiPER and ELI. Within HiLASE we explore two major concepts: thin-disk and cryogenically cooled multislab amplifiers capable of delivering average output powers above 1 kW level in picosecond-to-nanosecond pulsed regime. In particular, we have started a programme of technology development to demonstrate the scalability of multislab concept up to the kJ level at repetition rate of 1-10 Hz.

Improving the reliability of inverter-based welding machines

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

Schiedermayer, M.

1997-02-01

Although inverter-based welding power sources have been available since the late 1980s, many people hesitated to purchase them because of reliability issues. Unfortunately, their hesitancy had a basis, until now. Recent improvements give some inverters a reliability level that approaches that of traditional, transformer-based industrial welding machines, which have a failure rate of about 1%. Acceptance of inverter-based welding machines is important because, for many welding applications, they provide capabilities that solid-state, transformer-based machines cannot deliver. These advantages include enhanced pulsed gas metal arc welding (GMAW-P), lightweight portability, an ultrastable arc, and energy efficiency--all while producing highly aesthetic weld beadsmore » and delivering multiprocess capabilities.« less

Accelerated HIV testing for PMTCT in maternity and labour wards is vital to capture mothers at a critical point in the programme at district level in Malawi.

PubMed

Beltman, J J; Fitzgerald, M; Buhendwa, L; Moens, M; Massaquoi, M; Kazima, J; Alide, N; van Roosmalen, J

2010-11-01

Round the clock (24 hours×7 days) HIV testing is vital to maintain a high prevention of mother to child transmission (PMTCT) coverage for women delivering in district health facilities. PMTCT coverage increases when most of the pregnant women will have their HIV status tested. Therefore routine offering of HIV testing should be integrated and seen as a part of comprehensive antenatal care. For women who miss antenatal care and deliver in a health facility without having had their HIV status tested, the labour and maternity ward could still serve as other entry points.

From E- to M-Learning: Feasibility for an African-Delivered Tertiary Program

ERIC Educational Resources Information Center

Benner, Allison; Pence, Alan

2013-01-01

Since 2000, the Early Childhood Development Virtual University (ECDVU) has offered graduate-level programs in sub-Saharan Africa. These programs have been highly successful in creating a cadre of early childhood development (ECD) leaders in countries throughout Africa. When ECDVU was launched, the program was considered to be at the cutting edge…

A Telepresence Learning Environment for Opera Singing: Distance Lessons Implementations over Internet2

ERIC Educational Resources Information Center

Alpiste Penalba, Francisco; Rojas-Rajs, Teresa; Lorente, Pedro; Iglesias, Francisco; Fernández, Joaquín; Monguet, Josep

2013-01-01

The Opera eLearning project developed a solution for opera singing distance lessons at the graduate level, using high bandwidth to deliver a quality audio and video experience that has been evaluated by singing teachers, chorus and orchestra directors, singers and other professional musicians. Prior to finding a technological model that suits the…

Podcasts and Wiki's: Delivering Content Information to Students Using Technology. Article #4 in a 6-Part Series

ERIC Educational Resources Information Center

Mears, Derrick

2009-01-01

One of the most difficult tasks for today's physical educator is to ensure students maintain high levels of physical activity during physical education courses and demonstrate knowledge of cognitive content. The National Standards for Physical Education (NASPE) indicate that students should not only demonstrate motor competency, but also an…

49 CFR 192.197 - Control of the pressure of gas delivered from high-pressure distribution systems.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 3 2010-10-01 2010-10-01 false Control of the pressure of gas delivered from high-pressure distribution systems. 192.197 Section 192.197 Transportation Other Regulations Relating to... STANDARDS Design of Pipeline Components § 192.197 Control of the pressure of gas delivered from high...

Mesotocin influences pinyon jay prosociality.

PubMed

Duque, J F; Leichner, W; Ahmann, H; Stevens, J R

2018-04-01

Many species exhibit prosocial behaviour, in which one individual's actions benefit another individual, often without an immediate benefit to itself. The neuropeptide oxytocin is an important hormonal mechanism influencing prosociality in mammals, but it is unclear whether the avian homologue mesotocin plays a similar functional role in birds. Here, we experimentally tested prosociality in pinyon jays ( Gymnorhinus cyanocephalus ), a highly social corvid species that spontaneously shares food with others. First, we measured prosocial preferences in a prosocial choice task with two different pay-off distributions: Prosocial trials delivered food to both the subject and either an empty cage or a partner bird, whereas Altruism trials delivered food only to an empty cage or a partner bird (none to subject). In a second experiment, we examined whether administering mesotocin influenced prosocial preferences. Compared to choices in a control condition, we show that subjects voluntarily delivered food rewards to partners, but only when also receiving food for themselves (Prosocial trials), and administration of high levels of mesotocin increased these behaviours. Thus, in birds, mesotocin seems to play a similar functional role in facilitating prosocial behaviours as oxytocin does in mammals, suggesting an evolutionarily conserved hormonal mechanism for prosociality. © 2018 The Author(s).

ATLAS FTK a - very complex - custom super computer

NASA Astrophysics Data System (ADS)

Kimura, N.; ATLAS Collaboration

2016-10-01

In the LHC environment for high interaction pile-up, advanced techniques of analysing the data in real time are required in order to maximize the rate of physics processes of interest with respect to background processes. The Fast TracKer (FTK) is a track finding implementation at the hardware level that is designed to deliver full-scan tracks with pT above 1 GeV to the ATLAS trigger system for events passing the Level-1 accept (at a maximum rate of 100 kHz). In order to achieve this performance, a highly parallel system was designed and currently it is being commissioned within in ATLAS. Starting in 2016 it will provide tracks for the trigger system in a region covering the central part of the ATLAS detector, and will be extended to the full detector coverage. The system relies on matching hits coming from the silicon tracking detectors against one billion patterns stored in custom ASIC chips (Associative memory chip - AM06). In a first stage, coarse resolution hits are matched against the patterns and the accepted hits undergo track fitting implemented in FPGAs. Tracks with pT > 1GeV are delivered to the High Level Trigger within about 100 ps. Resolution of the tracks coming from FTK is close to the offline tracking and it will allow for reliable detection of primary and secondary vertexes at trigger level and improved trigger performance for b-jets and tau leptons. This contribution will give an overview of the FTK system and present the status of commissioning of the system. Additionally, the expected FTK performance will be briefly described.

Morphodynamics and stratigraphic architecture of shelf-edge deltas subject to constant vs. dynamic environmental forcings

NASA Astrophysics Data System (ADS)

Straub, K. M.

2017-12-01

When deltas dock at the edge of continental margins they generally construct thick stratigraphic intervals and activate channelized continental slope systems. Deposits of shelf-edge deltas have the capacity to store detailed paleo-environmental records, given their location in the source to sink system. However, present day highstand sea-level conditions have pushed most deltaic systems well inbound of their shelf-edges, making it difficult to study their space-time dynamics and resulting stratigraphic products. Several competing theories describe how deltas and their downslope environments respond to sea-level cycles of varying magnitude and periodicity. We explore these hypotheses in a physical experiment where the topographic evolution of a coupled delta and downdip slope system was monitored at high temporal and spatial resolution. The experiment had three stages. In the first stage a delta aggraded at the shelf-edge under constant water and sediment supply, in addition to a constant generation of accommodation through a sea-level rise. In the second stage the sediment transport system responded to low magnitude and high frequency sea-level cycles. Finally, in the third stage the transport system responded to a high magnitude and long period sea-level cycle. In each stage, fine sediment from the input grain size distribution and dissolved salt in the input water supply promoted plunging hyperpycnal flows. Specifically, we compare the mean and temporal variability of the sediment delivered to the slope system between stages. In addition, we compare stratigraphic architecture and sediment sizes delivered to the slope system in each stage. These results are used to improve inversion of slope deposits for paleo-environmental forcings.

High-energy master oscillator power amplifier with near-diffraction-limited output based on ytterbium-doped PCF fiber

NASA Astrophysics Data System (ADS)

Li, Rao; Qiao, Zhi; Wang, Xiaochao; Fan, Wei; Lin, Zunqi

2017-10-01

With the development of fiber technologies, fiber lasers are able to deliver very high power beams and high energy pulses which can be used not only in scientific researches but industrial fields (laser marking, welding,…). The key of high power fiber laser is fiber amplifier. In this paper, we present a two-level master-oscillator power amplifier system at 1053 nm based on Yb-doped photonic crystal fibers. The system is used in the front-end of high power laser facility for the amplification of nano-second pulses to meet the high-level requirements. Thanks to the high gain of the system which is over 50 dB, the pulse of more than 0.89 mJ energy with the nearly diffraction-limited beam quality has been obtained.

Polyamine levels in breast milk are associated with mothers' dietary intake and are higher in preterm than full-term human milk and formulas.

PubMed

Atiya Ali, M; Strandvik, B; Sabel, K-G; Palme Kilander, C; Strömberg, R; Yngve, A

2014-10-01

Polyamine intake from milk is considered essential for post-natal maturation of the immune system and small intestine. The present study aimed to determine polyamine content in human milk after preterm delivery and the association with mothers' dietary intake. In comparison, the polyamine levels were compared with those in term breast milk and some corresponding formulas. Transitional breast milk was collected from 40 mothers delivering after 24-36 weeks of gestation, and from 12 mothers delivering after full term. Food intake was assessed in mothers delivering preterm babies using a 3-day diary. Polyamines were analysed by high-performance liquid chromatography. The dietary intake of polyamines was significantly associated with breast milk content but weaker for spermine than for spermidine and putrescine. Total polyamine level was higher in preterm than term milk and lower in the corresponding formulas. Putrescine, spermidine and spermine contents [mean (SEM)] in preterm milk were 165.6 (25), 615.5 (80) and 167.7 (16) nmol dL⁻¹, respectively, with the levels of putrescine and spermidine being 50% and 25% higher than in term milk. The content of spermine did not differ. Dietary intake of polyamines has an impact on the content in breast milk. The difference between human milk after preterm and term delivery might be considered when using donor human milk for preterm infants. The corresponding formulas had lower contents. Further studies are important for determining the relationship between tissue growth and maturation and optimal intake. © 2013 The British Dietetic Association Ltd.

A feeding protocol for delivery of agents to assess development in Varroa mites

PubMed Central

2017-01-01

A novel feeding protocol for delivery of bio-active agents to Varroa mites was developed by providing mites with honey bee larva hemolymph supplemented with cultured insect cells and selected materials delivered on a fibrous cotton substrate. Mites were starved, fed on treated hemolymph to deliver selected agents and then returned to bee larvae. Transcript levels of two reference genes, actin and glyceraldehyde 3-phosphate dehydrogenase (GAPDH), as well as for nine selected genes involved in reproductive processes showed that the starvation and feeding protocol periods did not pose a high level of stress to the mites as transcript levels remained comparable between phoretic mites and those completing the protocol. The feeding protocol was used to deliver molecules such as hormone analogs or plasmids. Mites fed with Tebufenozide, an ecdysone analog, had higher transcript levels of shade than untreated or solvent treated mites. In order to extend this feeding protocol, cultured insect cells were incorporated to a final ratio of 1 part cells and 2 parts hemolymph. Although supplementation with Bombyx mori Bm5 cells increased the amount of hemolymph consumed per mite, there was a significant decrease in the percentage of mites that fed and survived. On the other hand, Drosophila melanogaster S2 cells reduced significantly the percentage of mites that fed and survived as well as the amount of hemolymph consumed. The feeding protocol provides a dynamic platform with which to challenge the Varroa mite to establish efficacy of control agents for this devastating honey bee pest. PMID:28448606

Relay Forward-Link File Management Services (MaROS Phase 2)

NASA Technical Reports Server (NTRS)

Allard, Daniel A.; Wallick, Michael N.; Hy, Franklin H.; Gladden, Roy E.

2013-01-01

This software provides the service-level functionality to manage the delivery of files from a lander mission repository to an orbiter mission repository for eventual spacelink relay by the orbiter asset on a specific communications pass. It provides further functions to deliver and track a set of mission-defined messages detailing lander authorization instructions and orbiter data delivery state. All of the information concerning these transactions is persisted in a database providing a high level of accountability of the forward-link relay process.

Estimated Maternal Pesticide Exposure from Drinking Water and Heart Defects in Offspring

PubMed Central

Kim, Jihye; Swartz, Michael D.; Langlois, Peter H.; Romitti, Paul A.; Weyer, Peter; Mitchell, Laura E.; Ramakrishnan, Anushuya; Malik, Sadia; Lupo, Philip J.; Feldkamp, Marcia L.; Meyer, Robert E.; Winston, Jennifer J.; Reefhuis, Jennita; Blossom, Sarah J.; Bell, Erin; Agopian, A. J.

2017-01-01

Our objective was to examine the relationship between estimated maternal exposure to pesticides in public drinking water and the risk of congenital heart defects (CHD). We used mixed-effects logistic regression to analyze data from 18,291 nonsyndromic cases with heart defects from the Texas Birth Defects Registry and 4414 randomly-selected controls delivered in Texas from 1999 through 2005. Water district-level pesticide exposure was estimated by linking each maternal residential address to the corresponding public water supply district’s measured atrazine levels. We repeated analyses among independent subjects from the National Birth Defects Prevention Study (NBDPS) (1620 nonsyndromic cases with heart defects and 1335 controls delivered from 1999 through 2005). No positive associations were observed between high versus low atrazine level and eight CHD subtypes or all included heart defects combined. These findings should be interpreted with caution, in light of potential misclassification and relatively large proportions of subjects with missing atrazine data. Thus, more consistent and complete monitoring and reporting of drinking water contaminants will aid in better understanding the relationships between pesticide water contaminants and birth defects. PMID:28786932

Estimated Maternal Pesticide Exposure from Drinking Water and Heart Defects in Offspring.

PubMed

Kim, Jihye; Swartz, Michael D; Langlois, Peter H; Romitti, Paul A; Weyer, Peter; Mitchell, Laura E; Luben, Thomas J; Ramakrishnan, Anushuya; Malik, Sadia; Lupo, Philip J; Feldkamp, Marcia L; Meyer, Robert E; Winston, Jennifer J; Reefhuis, Jennita; Blossom, Sarah J; Bell, Erin; Agopian, A J

2017-08-08

Our objective was to examine the relationship between estimated maternal exposure to pesticides in public drinking water and the risk of congenital heart defects (CHD). We used mixed-effects logistic regression to analyze data from 18,291 nonsyndromic cases with heart defects from the Texas Birth Defects Registry and 4414 randomly-selected controls delivered in Texas from 1999 through 2005. Water district-level pesticide exposure was estimated by linking each maternal residential address to the corresponding public water supply district's measured atrazine levels. We repeated analyses among independent subjects from the National Birth Defects Prevention Study (NBDPS) (1620 nonsyndromic cases with heart defects and 1335 controls delivered from 1999 through 2005). No positive associations were observed between high versus low atrazine level and eight CHD subtypes or all included heart defects combined. These findings should be interpreted with caution, in light of potential misclassification and relatively large proportions of subjects with missing atrazine data. Thus, more consistent and complete monitoring and reporting of drinking water contaminants will aid in better understanding the relationships between pesticide water contaminants and birth defects.

Can physical therapists deliver a pain coping skills program? An examination of training processes and outcomes.

PubMed

Bryant, Christina; Lewis, Prudence; Bennell, Kim L; Ahamed, Yasmin; Crough, Denae; Jull, Gwendolen A; Kenardy, Justin; Nicholas, Michael K; Keefe, Francis J

2014-10-01

Physical therapists are well established as providers of treatments for common, painful, and disabling conditions, such as knee osteoarthritis (OA). Thus, they are well placed to deliver treatments that integrate physical and psychosocial elements. Attention is usually given to outcomes of such programs, but few studies have examined the processes and outcomes of training physical therapists to deliver such treatments. The aim of this study was to describe the processes in training physical therapists: (1) to deliver a standardized pain coping skills treatment and (2) to evaluate the effectiveness of that training. This study was an analysis of data relating to therapist performance in a randomized clinical trial. Eleven physical therapists were trained to deliver a 10-session pain coping skills training program for people with knee OA as part of a randomized controlled trial (N=222). The initial training was provided in a workshop format and included extensive, ongoing supervision by a psychologist and rigorous use of well-defined performance criteria to assess competence. Adherence to the program, ratings of performance, and use of advanced skills were all measured against these criteria in a sample (n=74, 10%) of the audio recordings of the intervention sessions. Overall, the physical therapists achieved a very high standard of treatment delivery, with 96.6% adherence to the program and mean performance ratings all in the satisfactory range. These results were maintained throughout the intervention and across all sessions. Only 10% of the delivered sessions were analyzed, and the physical therapists who took part in the study were a self-selected group. This study demonstrated that a systematic approach to training and accrediting physical therapists to deliver a standardized pain coping skills program can result in high and sustained levels of adherence to the program. Training fidelity was achieved in this group of motivated clinicians, but the supervision provided was time intensive. The data provide a promising indicator of greater potential for psychologically informed practice to be a feature of effective health care. © 2014 American Physical Therapy Association.

Lay health workers perceptions of an anemia control intervention in Karnataka, India: a qualitative study.

PubMed

Shet, Arun S; Rao, Abha; Jebaraj, Paul; Mascarenhas, Maya; Zwarenstein, Merrick; Galanti, Maria Rosaria; Atkins, Salla

2017-09-18

Lay health workers (LHWs) are increasingly used to complement health services internationally. Their perceptions of the interventions they implement and their experiences in delivering community based interventions in India have been infrequently studied. We developed a novel LHW led intervention to improve anemia cure rates in rural community dwelling children attending village day care centers in South India. Since the intervention is delivered by the village day care center LHW, we sought to understand participating LHWs' acceptance of and perspectives regarding the intervention, particularly in relation to factors affecting daily implementation. We conducted a qualitative study alongside a cluster randomized controlled trial evaluating a complex community intervention for childhood anemia control in Karnataka, South India. Focus group discussions (FGDs) were conducted with trained LHWs assigned to deliver the educational intervention. These were complemented by non-participant observations of LHWs delivering the intervention. Transcripts of the FGDs were translated and analyzed using the framework analysis method. Several factors made the intervention acceptable to the LHWs and facilitated its implementation including pre-implementation training modules, intervention simplicity, and ability to incorporate the intervention into the routine work schedule. LHWs felt that the intervention impacted negatively on their preexisting workload. Fluctuating relationships with mothers weakened the LHWs position as providers of the intervention and hampered efficient implementation, despite the LHWs' highly valued position in the community. Modifiable barriers to the successful implementation of this intervention were seen at two levels. At a broader contextual level, hindering factors included the LHW being overburdened, inadequately reimbursed, and receiving insufficient employer support. At the health system level, lack of streamlining of LHW duties, inability of LHWs to diagnose anemia and temporary shortfalls in the availability of iron supplements constituted potentially modifiable barriers. This qualitative study identified some of the practical challenges as experienced by LHWs while delivering a community health intervention in India. Methodologically, it highlights the value of qualitative research in understanding implementation of complex community interventions. On the contextual level, the results indicate that efficient delivery of community interventions will require streamlining of LHW workloads and improved health system infrastructure support. This trial was registered with ISRCTN.com (identifier: ISRCTN68413407 ) on 23 September 2013.

A randomized pilot trial of a videoconference couples communication intervention for advanced GI cancer.

PubMed

Porter, Laura S; Keefe, Francis J; Baucom, Donald H; Olsen, Maren; Zafar, S Yousuf; Uronis, Hope

2017-07-01

This study aims to test the feasibility and preliminary efficacy of a couple-based communication intervention for advanced GI cancer delivered via videoconference. Thirty-two couples were randomly assigned to either couples communication skills training (CCST) or an education comparison intervention, both delivered via videoconference. Participation was limited to couples who reported communication difficulties at screening. Patients and partners completed measures of relationship functioning and individual functioning at baseline and post-intervention. Eighty-eight percent of randomized dyads completed all six sessions and reported high levels of satisfaction with the intervention. Between-group effect sizes suggested that the CCST intervention led to improvements in relationship satisfaction for patients and partners and to improvements in intimacy and communication for patients. A couples-based communication intervention delivered via videoconference is feasible and acceptable in the context of advanced cancer. Preliminary findings suggest that the intervention shows promise in contributing to enhanced relationship functioning. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

The Pain Course: Exploring the Feasibility of an Internet-delivered Pain Management Program When Offered by a Tertiary Pain Management Service.

PubMed

Dear, Blake F; Courtney, Catherine; Khor, Kok Eng; McDonald, Sarah; Ricciardi, Tahlia; Gandy, Milena; Fogliati, Vincent J; Titov, Nick

2018-06-01

This study examined the acceptability and preliminary outcomes of an internet-delivered pain management program, the Pain Course, when offered by a specialist pain management clinic in a large public hospital. A single-group feasibility open-trial design was used and 39 patients participated in the program, which ran for 8 weeks. Participants were supported through the program with weekly contact from a Clinical Psychologist at the clinic. All participants provided data at posttreatment and >90% of participants completed all 5 lessons of the course. High levels of satisfaction were observed and relatively little clinician time (M=71.99 min/participant; SD=32.82 min) was required to support patients through the program. Preliminary evidence of clinical improvements in depression symptoms (avg. improvement=38%; Cohen d=0.74), but not disability levels or anxiety symptoms, was observed in the overall sample. However, evidence of improvements was observed across all the primary outcomes among patients who had clinical levels of difficulties with disability (n=20; avg. improvement=11%; Cohen d=0.64), depression (n=17; avg. improvement=35%; Cohen d=1.24) and anxiety (n=8; avg. improvement=29%; Cohen d=0.57). These findings highlight the potential value of internet-delivered programs when provided by specialist pain management clinics as a part of their services and the value of larger scale studies in this area.

Fibrocytes in the fibrotic lung: altered phenotype detected by flow cytometry.

PubMed

Reese, Charles; Lee, Rebecca; Bonner, Michael; Perry, Beth; Heywood, Jonathan; Silver, Richard M; Tourkina, Elena; Visconti, Richard P; Hoffman, Stanley

2014-01-01

Fibrocytes are bone marrow hematopoietic-derived cells that also express a mesenchymal cell marker (commonly collagen I) and participate in fibrotic diseases of multiple organs. Given their origin, they or their precursors must be circulating cells before recruitment into target tissues. While most previous studies focused on circulating fibrocytes, here we focus on the fibrocyte phenotype in fibrotic tissue. The study's relevance to human disease is heightened by use of a model in which bleomycin is delivered systemically, recapitulating several features of human scleroderma including multi-organ fibrosis not observed when bleomycin is delivered directly into the lungs. Using flow cytometry, we find in the fibrotic lung a large population of CD45(high) fibrocytes (called Region I) rarely found in vehicle-treated control mice. A second population of CD45+ fibrocytes (called Region II) is observed in both control and fibrotic lung. The level of CD45 in circulating fibrocytes is far lower than in either Region I or II lung fibrocytes. The chemokine receptors CXCR4 and CCR5 are expressed at higher levels in Region I than in Region II and are present at very low levels in all other lung cells including CD45+/collagen I- leucocytes. The collagen chaperone HSP47 is present at similar high levels in both Regions I and II, but at a higher level in fibrotic lung than in control lung. There is also a major population of HSP47(high)/CD45- cells in fibrotic lung not present in control lung. CD44 is present at higher levels in Region I than in Region II and at much lower levels in all other cells including CD45+/collagen I- leucocytes. When lung fibrosis is inhibited by restoring caveolin-1 activity using a caveolin-1 scaffolding domain peptide (CSD), a strong correlation is observed between fibrocyte number and fibrosis score. In summary, the distinctive phenotype of fibrotic lung fibrocytes suggests that fibrocyte differentiation occurs primarily within the target organ.

Fibrocytes in the fibrotic lung: altered phenotype detected by flow cytometry

PubMed Central

Reese, Charles; Lee, Rebecca; Bonner, Michael; Perry, Beth; Heywood, Jonathan; Silver, Richard M.; Tourkina, Elena; Visconti, Richard P.; Hoffman, Stanley

2014-01-01

Fibrocytes are bone marrow hematopoietic-derived cells that also express a mesenchymal cell marker (commonly collagen I) and participate in fibrotic diseases of multiple organs. Given their origin, they or their precursors must be circulating cells before recruitment into target tissues. While most previous studies focused on circulating fibrocytes, here we focus on the fibrocyte phenotype in fibrotic tissue. The study's relevance to human disease is heightened by use of a model in which bleomycin is delivered systemically, recapitulating several features of human scleroderma including multi-organ fibrosis not observed when bleomycin is delivered directly into the lungs. Using flow cytometry, we find in the fibrotic lung a large population of CD45high fibrocytes (called Region I) rarely found in vehicle-treated control mice. A second population of CD45+ fibrocytes (called Region II) is observed in both control and fibrotic lung. The level of CD45 in circulating fibrocytes is far lower than in either Region I or II lung fibrocytes. The chemokine receptors CXCR4 and CCR5 are expressed at higher levels in Region I than in Region II and are present at very low levels in all other lung cells including CD45+/collagen I- leucocytes. The collagen chaperone HSP47 is present at similar high levels in both Regions I and II, but at a higher level in fibrotic lung than in control lung. There is also a major population of HSP47high/CD45- cells in fibrotic lung not present in control lung. CD44 is present at higher levels in Region I than in Region II and at much lower levels in all other cells including CD45+/collagen I- leucocytes. When lung fibrosis is inhibited by restoring caveolin-1 activity using a caveolin-1 scaffolding domain peptide (CSD), a strong correlation is observed between fibrocyte number and fibrosis score. In summary, the distinctive phenotype of fibrotic lung fibrocytes suggests that fibrocyte differentiation occurs primarily within the target organ. PMID:24999331

The Effectiveness of Aligned Developmental Feedback on the Overhand Throw in Third-Grade Students

ERIC Educational Resources Information Center

Cohen, Rona; Goodway, Jacqueline D.; Lidor, Ronnie

2012-01-01

Background: To improve student performance, teachers need to evaluate the developmental level of the child and to deliver feedback statements that correspond with the student's ability to process the information delivered. Therefore, feedback aligned with the developmental level of the child (aligned developmental feedback--ADF) is sometimes…

Ultrafast disk technology enables next generation micromachining laser sources

NASA Astrophysics Data System (ADS)

Heckl, Oliver H.; Weiler, Sascha; Luzius, Severin; Zawischa, Ivo; Sutter, Dirk

2013-02-01

Ultrashort pulsed lasers based on thin disk technology have entered the 100 W regime and deliver several tens of MW peak power without chirped pulse amplification. Highest uptime and insensitivity to back reflections make them ideal tools for efficient and cost effective industrial micromachining. Frequency converted versions allow the processing of a large variety of materials. On one hand, thin disk oscillators deliver more than 30 MW peak power directly out of the resonator in laboratory setups. These peak power levels are made possible by recent progress in the scaling of the pulse energy in excess of 40 μJ. At the corresponding high peak intensity, thin disk technology profits from the limited amount of material and hence the manageable nonlinearity within the resonator. Using new broadband host materials like for example the sesquioxides will eventually reduce the pulse duration during high power operation and further increase the peak power. On the other hand industry grade amplifier systems deliver even higher peak power levels. At closed-loop controlled 100W, the TruMicro Series 5000 currently offers the highest average ultrafast power in an industry proven product, and enables efficient micromachining of almost any material, in particular of glasses, ceramics or sapphire. Conventional laser cutting of these materials often requires UV laser sources with pulse durations of several nanoseconds and an average power in the 10 W range. Material processing based on high peak power laser sources makes use of multi-photon absorption processes. This highly nonlinear absorption enables micromachining driven by the fundamental (1030 nm) or frequency doubled (515 nm) wavelength of Yb:YAG. Operation in the IR or green spectral range reduces the complexity and running costs of industrial systems initially based on UV light sources. Where UV wavelength is required, the TruMicro 5360 with a specified UV crystal life-time of more than 10 thousand hours of continues operation at 15W is an excellent choice. Currently this is the world's most powerful industrial sub-10 ps UV laser.

Cost effectiveness of a computer-delivered intervention to improve HIV medication adherence

PubMed Central

2013-01-01

Background High levels of adherence to medications for HIV infection are essential for optimal clinical outcomes and to reduce viral transmission, but many patients do not achieve required levels. Clinician-delivered interventions can improve patients’ adherence, but usually require substantial effort by trained individuals and may not be widely available. Computer-delivered interventions can address this problem by reducing required staff time for delivery and by making the interventions widely available via the Internet. We previously developed a computer-delivered intervention designed to improve patients’ level of health literacy as a strategy to improve their HIV medication adherence. The intervention was shown to increase patients’ adherence, but it was not clear that the benefits resulting from the increase in adherence could justify the costs of developing and deploying the intervention. The purpose of this study was to evaluate the relation of development and deployment costs to the effectiveness of the intervention. Methods Costs of intervention development were drawn from accounting reports for the grant under which its development was supported, adjusted for costs primarily resulting from the project’s research purpose. Effectiveness of the intervention was drawn from results of the parent study. The relation of the intervention’s effects to changes in health status, expressed as utilities, was also evaluated in order to assess the net cost of the intervention in terms of quality adjusted life years (QALYs). Sensitivity analyses evaluated ranges of possible intervention effectiveness and durations of its effects, and costs were evaluated over several deployment scenarios. Results The intervention’s cost effectiveness depends largely on the number of persons using it and the duration of its effectiveness. Even with modest effects for a small number of patients the intervention was associated with net cost savings in some scenarios and for durations greater than three months and longer it was usually associated with a favorable cost per QALY. For intermediate and larger assumed effects and longer durations of intervention effectiveness, the intervention was associated with net cost savings. Conclusions Computer-delivered adherence interventions may be a cost-effective strategy to improve adherence in persons treated for HIV. Trial registration Clinicaltrials.gov identifier NCT01304186. PMID:23446180

Cost effectiveness of a computer-delivered intervention to improve HIV medication adherence.

PubMed

Ownby, Raymond L; Waldrop-Valverde, Drenna; Jacobs, Robin J; Acevedo, Amarilis; Caballero, Joshua

2013-02-28

High levels of adherence to medications for HIV infection are essential for optimal clinical outcomes and to reduce viral transmission, but many patients do not achieve required levels. Clinician-delivered interventions can improve patients' adherence, but usually require substantial effort by trained individuals and may not be widely available. Computer-delivered interventions can address this problem by reducing required staff time for delivery and by making the interventions widely available via the Internet. We previously developed a computer-delivered intervention designed to improve patients' level of health literacy as a strategy to improve their HIV medication adherence. The intervention was shown to increase patients' adherence, but it was not clear that the benefits resulting from the increase in adherence could justify the costs of developing and deploying the intervention. The purpose of this study was to evaluate the relation of development and deployment costs to the effectiveness of the intervention. Costs of intervention development were drawn from accounting reports for the grant under which its development was supported, adjusted for costs primarily resulting from the project's research purpose. Effectiveness of the intervention was drawn from results of the parent study. The relation of the intervention's effects to changes in health status, expressed as utilities, was also evaluated in order to assess the net cost of the intervention in terms of quality adjusted life years (QALYs). Sensitivity analyses evaluated ranges of possible intervention effectiveness and durations of its effects, and costs were evaluated over several deployment scenarios. The intervention's cost effectiveness depends largely on the number of persons using it and the duration of its effectiveness. Even with modest effects for a small number of patients the intervention was associated with net cost savings in some scenarios and for durations greater than three months and longer it was usually associated with a favorable cost per QALY. For intermediate and larger assumed effects and longer durations of intervention effectiveness, the intervention was associated with net cost savings. Computer-delivered adherence interventions may be a cost-effective strategy to improve adherence in persons treated for HIV. Clinicaltrials.gov identifier NCT01304186.

Problems in Comprehensive Ambulatory Health Care for High-Risk Adolescents.

ERIC Educational Resources Information Center

Fielding, Jon E., Ed.

This volume contains 21 articles on aspects held to be important for delivering comprehensive health care to young adults who are at higher than average risk levels for a number of health and health-related problems; choice of topics for the articles is based on experience gained in directing the health program for the Job Corps. Most of the…

Effect of Computer-Delivered Testing on Achievement in a Mastery Learning Course of Study with Partial Scoring and Variable Pacing.

ERIC Educational Resources Information Center

Evans, Richard M.; Surkan, Alvin J.

The recent arrival of portable computer systems with high-level language interpreters now makes it practical to rapidly develop complex testing and scoring programs. These programs permit undergraduates access, at arbitrary times, to testing as an integral part of a mastery learning strategy. Effects of introducing the computer were studied by…

A Comparative Study of Paper-and-Pen versus Computer-Delivered Assessment Modes on Students' Writing Quality: A Singapore Study

ERIC Educational Resources Information Center

Cheung, Yin Ling

2016-01-01

Much research has been conducted to investigate the quality of writing and high-level revisions in word processing-assisted and pen-and-paper writing modes. Studies that address cognitive aspects, such as experience and comfort with computers, by which students compose essays during writing assessments have remained relatively unexplored. To fill…

Recruiting, Retaining and Engaging Men in Social Interventions: Lessons for Implementation Focusing on a Prison-Based Parenting Intervention for Young Incarcerated Fathers

ERIC Educational Resources Information Center

Buston, Katie

2018-01-01

Recruiting, retaining and engaging men in social interventions can be challenging. The focus of this paper is the successful implementation of a parenting programme for incarcerated fathers, delivered in a Young Offender Institution (YOI) in Scotland. Reasons for high levels of recruitment, retention and engagement are explored, with barriers…

Results from a clinical yoga program for veterans: yoga via telehealth provides comparable satisfaction and health improvements to in-person yoga.

PubMed

Schulz-Heik, R Jay; Meyer, Hilary; Mahoney, Louise; Stanton, Michael V; Cho, Rachael H; Moore-Downing, Danae P; Avery, Timothy J; Lazzeroni, Laura C; Varni, Joanne M; Collery, Linda Martin; Bayley, Peter J

2017-04-04

Yoga is increasingly popular, though little data regarding its implementation in healthcare settings is available. Similarly, telehealth is being utilized more frequently to increase access to healthcare; however we know of no research on the acceptability or effectiveness of yoga delivered through telehealth. Therefore, we evaluated the feasibility, acceptability, and patient-reported effectiveness of a clinical yoga program at a Veterans Affairs Medical Center and assessed whether these outcomes differed between those participating in-person and those participating via telehealth. Veterans who attended a yoga class at the VA Palo Alto Health Care System were invited to complete an anonymous program evaluation survey. 64 Veterans completed the survey. Participants reported high satisfaction with the classes and the instructors. More than 80% of participants who endorsed a problem with pain, energy level, depression, or anxiety reported improvement in these symptoms. Those who participated via telehealth did not differ from those who participated in-person in any measure of satisfaction, overall improvement (p = .40), or improvement in any of 16 specific health problems. Delivering yoga to a wide range of patients within a healthcare setting appears to be feasible and acceptable, both when delivered in-person and via telehealth. Patients in this clinical yoga program reported high levels of satisfaction and improvement in multiple problem areas. This preliminary evidence for the effectiveness of a clinical yoga program complements prior evidence for the efficacy of yoga and supports the use of yoga in healthcare settings.

High Levels Of Capitation Payments Needed To Shift Primary Care Toward Proactive Team And Nonvisit Care.

PubMed

Basu, Sanjay; Phillips, Russell S; Song, Zirui; Bitton, Asaf; Landon, Bruce E

2017-09-01

Capitated payments in the form of fixed monthly payments to cover all of the costs associated with delivering primary care could encourage primary care practices to transform the way they deliver care. Using a microsimulation model incorporating data from 969 US practices, we sought to understand whether shifting to team- and non-visit-based care is financially sustainable for practices under traditional fee-for-service, capitated payment, or a mix of the two. Practice revenues and costs were computed for fee-for-service payments and a range of capitated payments, before and after the substitution of team- and non-visit-based services for low-complexity in-person physician visits. The substitution produced financial losses for simulated practices under fee-for-service payment of $42,398 per full-time-equivalent physician per year; however, substitution produced financial gains under capitated payment in 95 percent of cases, if more than 63 percent of annual payments were capitated. Shifting to capitated payment might create an incentive for practices to increase their delivery of team- and non-visit-based primary care, if capitated payment levels were sufficiently high. Project HOPE—The People-to-People Health Foundation, Inc.

Manager traits and quality-of-care performance in hospitals.

PubMed

Aij, Kjeld Harald; Aernoudts, René L M C; Joosten, Gepke

2015-07-06

This paper aims to assess the impact of the leadership traits of chief executive officers (CEOs) on hospital performance in the USA. The effectiveness and efficiency of the CEO is of critical importance to the performance of any organization, including hospitals. Management systems and manager behaviours (traits) are of crucial importance to any organization because of their connection with organizational performance. To identify key factors associated with the quality of care delivered by hospitals, the authors gathered perceptions of manager traits from chief executive officers (CEOs) and followers in three groups of US hospitals delivering different levels of quality of care performance. Three high- and three low-performing hospitals were selected from the top and bottom 20th percentiles, respectively, using a national hospital ranking system based on standard quality of care performance measures. Three lean hospitals delivering intermediate performance were also selected. A survey was used to gather perceptions of manager traits (providing a modern or lean management system inclination) from CEOs and their followers in the three groups, which were compared. Four traits were found to be significantly different (alpha < 0.05) between lean (intermediate-) and low-performing hospitals. The different perceptions between these two hospital groups were all held by followers in the low-performing hospitals and not the CEOs, and all had a modern management inclination. No differences were found between lean (intermediate-) and high-performing hospitals, or between high- and low-performing hospitals. These findings support a need for hospital managers to acquire appropriate traits to achieve lean transformation, support a benefit of measuring manager traits to assess progress towards lean transformation and lend weight to improved quality of care that can be delivered by hospitals adopting a lean system of management.

Effects of Nebulizer Position, Gas Flow, and CPAP on Aerosol Bronchodilator Delivery: An In Vitro Study.

PubMed

Ball, Lorenzo; Sutherasan, Yuda; Caratto, Valentina; Sanguineti, Elisa; Marsili, Maria; Raimondo, Pasquale; Ferretti, Maurizio; Kacmarek, Robert M; Pelosi, Paolo

2016-03-01

The aim of this study was to investigate the effects of different delivery circuit configurations, nebulizer positions, CPAP levels, and gas flow on the amount of aerosol bronchodilator delivered during simulated spontaneous breathing in an in vitro model. A pneumatic lung simulator was connected to 5 different circuits for aerosol delivery, 2 delivering CPAP through a high-flow generator tested at 30, 60, and 90 L/min supplementary flow and 5, 10, and 15 cm H2O CPAP and 3 with no CPAP: a T-piece configuration with one extremity closed with a cap, a T-piece configuration without cap and nebulizer positioned proximally, and a T-piece configuration without cap and nebulizer positioned distally. Albuterol was collected with a filter, and the percentage amount delivered was measured by infrared spectrophotometry. Configurations with continuous high-flow CPAP delivered higher percentage amounts of albuterol compared with the configurations without CPAP (9.1 ± 6.0% vs 6.2 ± 2.8%, P = .03). Among configurations without CPAP, the best performance was obtained with a T-piece with one extremity closed with a cap. In CPAP configurations, the highest delivery (13.8 ± 4.4%) was obtained with the nebulizer placed proximal to the lung simulator, independent of flow. CPAP at 15 cm H2O resulted in the highest albuterol delivery (P = .02). Based on our in vitro study, without CPAP, a T-piece with a cap at one extremity maximizes albuterol delivery. During high-flow CPAP, the nebulizer should always be placed proximal to the patient, after the T-piece, using the highest CPAP clinically indicated. Copyright © 2016 by Daedalus Enterprises.

Intensive weekend group treatment for panic disorder and its impact on co-occurring PTSD: A pilot study.

PubMed

Teng, Ellen J; Barrera, Terri L; Hiatt, Emily L; Chaison, Angelic D; Dunn, Nancy Jo; Petersen, Nancy J; Stanley, Melinda A

2015-06-01

This pilot study examines the feasibility, acceptability, and potential effectiveness of delivering an intensive weekend group treatment for panic disorder (PD) to Veterans returning from deployments to Iraq and Afghanistan with co-occurring posttraumatic stress disorder (PTSD). The treatment program lasted 6h each day and was delivered by two experienced therapists. Patients received core components of panic treatment, including psychoeducation, cognitive restructuring, and interoceptive exposure. The interoceptive exposure exercises directly targeted anxiety sensitivity, a psychological construct also implicated in the maintenance of PTSD. Eighty-nine percent of patients who expressed interest in the treatment attended a baseline evaluation, and 63% of those who were study eligible initiated treatment. Treatment retention was high, with all 10 patients who initiated treatment completing the program. Veterans reported finding the treatment and delivery format highly acceptable and reported high levels of satisfaction. Panic symptoms improved significantly following the treatment and were maintained at a 7-month follow-up, with 71.4% of the sample reporting being panic free. Co-occurring PTSD symptoms also improved along with symptoms of anxiety and depression. Preliminary findings suggest that brief and intensive group treatments for PD/PTSD are a promising method of delivering cognitive behavioral therapy that may rapidly improve symptoms. This innovative treatment delivery format also may be a cost-effective way of increasing treatment engagement through increased access to quality care. Published by Elsevier Ltd.

Performance and heat transfer characteristics of the laser-heated rocket - A future space transportation system

NASA Technical Reports Server (NTRS)

Shoji, J. M.; Larson, V. R.

1976-01-01

The application of advanced liquid-bipropellant rocket engine analysis techniques has been utilized for prediction of the potential delivered performance and the design of thruster wall cooling schemes for laser-heated rocket thrusters. Delivered specific impulse values greater than 1000 lbf-sec/lbm are potentially achievable based on calculations for thrusters designed for 10-kW and 5000-kW laser beam power levels. A thruster wall-cooling technique utilizing a combination of regenerative cooling and a carbon-seeded hydrogen boundary layer is presented. The flowing carbon-seeded hydrogen boundary layer provides radiation absorption of the heat radiated from the high-temperature plasma. Also described is a forced convection thruster wall cooling design for an experimental test thruster.

Airport Noise Tech Challenge Overview

NASA Technical Reports Server (NTRS)

Bridges, James

2011-01-01

The Supersonics Project, operating under NASA Aeronautics Mission Directorate#s Fundamental Aero Program, has been organized around the Technical Challenges that have historically precluded commercial supersonic flight. One of these Challenges is making aircraft that are capable of such high aerodynamic performance quiet enough around airports that they will not be objectionable. It is recognized that a successful civilian supersonic aircraft will be a system where many new technologies will come together, and for this to happen not only will new low noise propulsion concepts be required, but new engineering tools that predict the noise of the aircraft as these technologies are combined and compromised with the rest of the aircraft design. These are the two main objectives of the Airport Noise Tech Challenge. " ! As a Project in the Fundamental Aero Program, we work at a relatively low level of technology readiness. However, we have high level milestones which force us to integrate our efforts to impact systems-level activities. To keep the low-level work tied to delivering engineering tools and low-noise concepts, we have structured our milestones around development of the concepts and organized our activities around developing and applying our engineering tools to these concepts. The final deliverables in these milestones are noise prediction modules validated against the best embodiment of each concept. These will then be used in cross-disciplinary exercises to demonstrate the viability of aircraft designs to meet all the Technical Challenges. Some of the concepts being developed are shown: Fan Flow Diverters, Multi-jet Shielding, High-Aspect Ratio Embedded Nozzles, Plasma Actuated Instability Manipulation, Highly Variable Cycle Mixer- Ejectors, and Inverted Velocity Profiles. These concepts are being developed for reduced jet noise along with the design tools which describe how they perform when used in various aircraft configurations. Several key upcoming events are highlighted, including tests of the Highly Variable Cycle Mixer-Ejectors, and Inverted Velocity Profiles. Other key events are milestones to be delivered within the next calendar year.

Effects of high-level pulse train stimulation on retinal function.

PubMed

Cohen, Ethan D

2009-06-01

We examined how stimulation of the local retina by high-level current pulse trains affected the light-evoked responses of the retinal ganglion cells. The spikes of retinal ganglion cell axons were recorded extracellularly using an in vitro eyecup preparation of the rabbit retina. Epiretinal electrical stimulation was delivered via a 500 microm inner diameter saline-filled, transparent tube positioned over the retinal surface forming the receptive field center. Spot stimuli were presented periodically to the receptive field center during the experiment. Trains of biphasic 1 ms current pulses were delivered to the retina at 50 Hz for 1 min. Pulse train charge densities of 1.3-442 microC/cm(2)/phase were examined. After pulse train stimulation with currents >or=300 microA (133 microC/cm(2)/phase), the ganglion cell's ability to respond to light was depressed and a significant time was required for recovery of the light-evoked response. During train stimulation, the ganglion cell's ability to spike following each current pulse fatigued. The current levels evoking train-evoked depression were suprathreshold to those evoking action potentials. Train-evoked depression was stronger touching the retinal surface, and in some cases impaired ganglion cell function for up to 30 min. This overstimulation could cause a transient refractory period for electrically stimulated perception in the retinal region below the electrode.

An absolute calibration system for millimeter-accuracy APOLLO measurements

NASA Astrophysics Data System (ADS)

Adelberger, E. G.; Battat, J. B. R.; Birkmeier, K. J.; Colmenares, N. R.; Davis, R.; Hoyle, C. D.; Huang, L. R.; McMillan, R. J.; Murphy, T. W., Jr.; Schlerman, E.; Skrobol, C.; Stubbs, C. W.; Zach, A.

2017-12-01

Lunar laser ranging provides a number of leading experimental tests of gravitation—important in our quest to unify general relativity and the standard model of physics. The apache point observatory lunar laser-ranging operation (APOLLO) has for years achieved median range precision at the  ∼2 mm level. Yet residuals in model-measurement comparisons are an order-of-magnitude larger, raising the question of whether the ranging data are not nearly as accurate as they are precise, or if the models are incomplete or ill-conditioned. This paper describes a new absolute calibration system (ACS) intended both as a tool for exposing and eliminating sources of systematic error, and also as a means to directly calibrate ranging data in situ. The system consists of a high-repetition-rate (80 MHz) laser emitting short (< 10 ps) pulses that are locked to a cesium clock. In essence, the ACS delivers photons to the APOLLO detector at exquisitely well-defined time intervals as a ‘truth’ input against which APOLLO’s timing performance may be judged and corrected. Preliminary analysis indicates no inaccuracies in APOLLO data beyond the  ∼3 mm level, suggesting that historical APOLLO data are of high quality and motivating continued work on model capabilities. The ACS provides the means to deliver APOLLO data both accurate and precise below the 2 mm level.

Diabetes management in Thailand: a literature review of the burden, costs, and outcomes

PubMed Central

2013-01-01

Management of diabetes represents an enormous challenge for health systems at every level of development. The latter are tested for their ability to continuously deliver high quality care to patients from the day they are diagnosed throughout their life. In this study, we review the status of diabetes management in Thailand and try to identify the key challenges the country needs to address to reduce the current (and future) medical and economic burden caused by the disease. We conducted a literature review on the burden, costs, and outcomes of diabetes in Thailand. This information was complemented by personal communication with senior officials in the Thai Ministry of Health. We identified the following priorities for the future management of diabetes in Thailand. First, increasing screening of diabetes in high risk population and promoting annual screening of diabetes complications in all diabetic patients. Second, identifying and addressing factors affecting poor treatment outcomes. Third, policy should specify clear targets and provide and use a monitoring framework to track progress. Fourth, efforts are needed to further improve data availability. Up-to-date data on the medical and economic burden of diabetes representative at the national level and at least the regional level are essential to identify needs and monitor progress towards established targets. Fifth, promotion of a healthy lifestyle for prevention of diabetes through education and quality information delivered to the public. PMID:23497447

Factors influencing the purity of electronic grade phosphine delivered to MOCVD tools

NASA Astrophysics Data System (ADS)

Feng, Jun; Owens, Mitch; Raynor, Mark W.

2010-04-01

Increasing mobility of InP films with usage time of one PH 3 cylinder prompted an investigation into factors influencing the purity of delivered PH 3. The presence of hygroscopic H xPO y residues in a delivery system greatly increases the dry-down time compared to that of a clean system. Static delivery system tests show increasing H 2O concentration with time and twice the increase in PH 3 versus N 2 over 48 h indicating reaction of metal oxides in components with PH 3 to generate H 2O. Gas purity may also vary during cylinder usage. Depletion of a high-purity PH 3 cylinder shows consistently low gas phase H 2O levels before phase-break but increasing levels after phase-break, as the cylinder depressurizes. The results highlight the importance of using pure PH 3, employing rigorous cycle-purging procedures to prevent H xPO y contamination, switching out cylinders in good time and using purification technology to control H 2O.

Post-exposure treatment of Ebola virus disease in guinea pigs using EBOTAb, an ovine antibody-based therapeutic.

PubMed

Dowall, Stuart D; Bosworth, Andrew; Rayner, Emma; Taylor, Irene; Landon, John; Cameron, Ian; Coxon, Ruth; Al Abdulla, Ibrahim; Graham, Victoria A; Hall, Graham; Kobinger, Gary; Hewson, Roger; Carroll, Miles W

2016-07-28

Ebola virus (EBOV) is highly pathogenic, with a predisposition to cause outbreaks in human populations accompanied by significant mortality. An ovine polyclonal antibody therapy has been developed against EBOV, named EBOTAb. When tested in the stringent guinea pig model of EBOV disease, EBOTAb has been shown to confer protection at levels of 83.3%, 50% and 33.3% when treatment was first started on days 3, 4 and 5 post-challenge, respectively. These timepoints of when EBOTAb treatment was initiated correspond to when levels of EBOV are detectable in the circulation and thus mimic when treatment would likely be initiated in human infection. The effects of EBOTAb were compared with those of a monoclonal antibody cocktail, ZMapp, when delivered on day 3 post-challenge. Results showed ZMapp to confer complete protection against lethal EBOV challenge in the guinea pig model at this timepoint. The data reported demonstrate that EBOTAb is an effective treatment against EBOV disease, even when delivered late after infection.

Local delivery of hormonal therapy with silastic tubing for prevention and treatment of breast cancer.

PubMed

Park, Jeenah; Thomas, Scott; Zhong, Allison Y; Wolfe, Alan R; Krings, Gregor; Terranova-Barberio, Manuela; Pawlowska, Nela; Benet, Leslie Z; Munster, Pamela N

2018-01-08

Broad use of germline testing has identified an increasing number of women at risk for breast cancer with a need for effective chemoprevention. We report a novel method to selectively deliver various anti-estrogens at high drug levels to the breast tissue by implanting a device comprised of silastic tubing. Optimized tubing properties allow elution of otherwise poorly bioavailable anti-estrogens, such as fulvestrant, into mammary tissue in vitro and in vivo with levels sufficient to inhibit estrogen receptor activation and tumor cell proliferation. Implantable silastic tubing delivers fulvestrant selectively to mouse mammary fat tissue for one year with anti-tumor effects similar to those achieved with systemic fulvestrant exposure. Furthermore, local delivery of fulvestrant significantly decreases cell proliferation, as assessed by Ki67 expression, most effectively in tumor sections adjacent to tubing. This approach may thereby introduce a potential paradigm shift and offer a promising alternative to systemic therapy for prevention and early interception of breast cancer.

Recruiting, Retaining and Engaging Men in Social Interventions: Lessons for Implementation Focusing on a Prison-based Parenting Intervention for Young Incarcerated Fathers

PubMed Central

Buston, Katie

2018-01-01

ABSTRACT Recruiting, retaining and engaging men in social interventions can be challenging. The focus of this paper is the successful implementation of a parenting programme for incarcerated fathers, delivered in a Young Offender Institution (YOI) in Scotland. Reasons for high levels of recruitment, retention and engagement are explored, with barriers identified. A qualitative design was employed using ethnographic approaches including participant observation of the programme, informal interactions, and formal interviews with programme participants, the facilitators and others involved in managing the programme. Framework analysis was conducted on the integrated data set. The prison as the setting for programme delivery was both an opportunity and a challenge. It enabled easy access to participants and required low levels of effort on their part to attend. The creation of a nurturing and safe environment within the prison classroom facilitated engagement: relationships between the facilitators and participants, and between the participants themselves were key to understanding high levels of retention and engagement. The most fundamental challenge to high engagement levels arose from clashes in embedded institutional ways of working, between the host institution and the organisation experienced in delivering such intervention work. This threatened to compromise trust between the participants and the facilitators. Whilst adding specifically to the very sparse literature on reaching incarcerated young fathers and engaging them in parenting work, the findings have transferability to other under-researched areas: the implementation of social interventions generally in the prison setting, and engaging marginalised fathers in parenting/family work in community settings. The paper highlights ways of overcoming some of the challenges faced. PMID:29503596

Delivery at Term: Impact of University Education by Week of Gestation.

PubMed

Auger, Nathalie; Leduc, Line; Naimi, Ashley I; Fraser, William D

2016-02-01

Data on risk factors for early term delivery are scant despite greater complications in infants born at 37 and 38 weeks' gestation. We determined the probability of delivery by gestational week at term according to level of maternal education, an established risk factor for preterm birth. We analyzed 2 319 697 live singleton births at term (≥37 weeks) in Quebec from 1981 to 2010. We estimated hazard ratios with 95% confidence intervals (CI) of delivery according to level of maternal education, adjusting for individual characteristics. The main outcome measure was the probability of delivery at term by week of gestation for women with university education versus high school education. Early term birth at 37 and 38 weeks of gestation was less common for university-educated women (23.1%) than for high school-educated women (25.8%; P < 0.001). Compared with women with a high school education, university-educated women had a 15% lower probability of delivery at 37 to 38 weeks (95% CI: 0.84 to 0.86), a 4% lower probability of delivery at 39 weeks (95% CI: 0.96 to 0.97) and a 2% lower probability of delivery at 40 weeks (95% CI: 0.97 to 0.98). University-educated women were, however, more likely to deliver at 41 weeks. A higher level of education was associated with longer duration of pregnancy at term. Women who were university-educated had a lower chance of delivery at 37, 38, 39, and even 40 weeks of gestation. Clinicians should be aware that women with lower levels of education are more likely to deliver earlier at term. Copyright © 2016 Society of Obstetricians and Gynaecologists of Canada. Published by Elsevier Inc. All rights reserved.

An Experiment Comparing HBSE Graduate Social Work Classes: Face-to-Face and at a Distance

ERIC Educational Resources Information Center

Woehle, Ralph; Quinn, Andrew

2009-01-01

This article describes a quasi-experimental comparison of two master's level social work classes delivering content on human behavior in the social environment. One class, delivered face-to-face, was largely synchronous. The other class, delivered using distance technologies, was more asynchronous than the first. The authors hypothesized that…

A Cabin Air Separator for EVA Oxygen

NASA Technical Reports Server (NTRS)

Graf, John C.

2011-01-01

Presently, the Extra-Vehicular Activities (EVAs) conducted from the Quest Joint Airlock on the International Space Station use high pressure, high purity oxygen that is delivered to the Space Station by the Space Shuttle. When the Space Shuttle retires, a new method of delivering high pressure, high purity oxygen to the High Pressure Gas Tanks (HPGTs) is needed. One method is to use a cabin air separator to sweep oxygen from the cabin air, generate a low pressure/high purity oxygen stream, and compress the oxygen with a multistage mechanical compressor. A main advantage to this type of system is that the existing low pressure oxygen supply infrastructure can be used as the source of cabin oxygen. ISS has two water electrolysis systems that deliver low pressure oxygen to the cabin, as well as chlorate candles and compressed gas tanks on cargo vehicles. Each of these systems can feed low pressure oxygen into the cabin, and any low pressure oxygen source can be used as an on-board source of oxygen. Three different oxygen separator systems were evaluated, and a two stage Pressure Swing Adsorption system was selected for reasons of technical maturity. Two different compressor designs were subjected to long term testing, and the compressor with better life performance and more favorable oxygen safety characteristics was selected. These technologies have been used as the basis of a design for a flight system located in Equipment Lock, and taken to Preliminary Design Review level of maturity. This paper describes the Cabin Air Separator for EVA Oxygen (CASEO) concept, describes the separator and compressor technology trades, highlights key technology risks, and describes the flight hardware concept as presented at Preliminary Design Review (PDR)

Perinatal factors influencing infant feeding practices at birth: the Bedouin Infant Feeding Study.

PubMed

Forman, M R; Berendest, H W; Lewando-Hundt, G; Sarov, B; Naggan, L

1991-04-01

Bedouin Arab women delivering newborns at Soroka Medical Center, Israel, during 1 year were interviewed in hospital to determine the factors influencing infant feeding practices at birth. Eighty-six per cent breastfed, 11% breast and bottlefed, and 3% bottlefed at birth. Based on a multiple logistic regression analysis, the factors that significantly reduced the odds ratio (OR) of exclusive breastfeeding vs. breast and bottle feeding or bottle feeding at birth include: delivering during the high birth season (OR = 0.49); maternal recall of feeling unwell during pregnancy (OR = 0.59); delivering a low birthweight newborn (OR = 0.10); a newborn diagnosed with major malformations (OR = 0.30) or with major illnesses (OR = 0.32); and delivering by Caesarean section (OR = 0.09). In contrast, multiparae experienced an increased odds (OR = 1.67) of breastfeeding. Among primiparae, the factors that significantly reduced the odds of exclusive breastfeeding include: delivering during the high birth season (OR = 0.47); delivering a low birthweight newborn (OR = 0.12); and delivering by Caesarean section (OR = 0.18). Mothers of high-risk neonates and those who deliver by Caesarean section need to be educated about the benefits of exclusive breastfeeding. Young primiparae are a challenge and require qualitative and quantitative research into the reasons precluding exclusive breastfeeding.

Rethinking "General Audience": A Comparison of Students' Understanding of Popular Film in High School Honors and General-Level Classes

ERIC Educational Resources Information Center

Journell, Wayne; Buchanan, Lisa Brown

2012-01-01

Research suggests that secondary teachers across the United States are regularly turning to popular film as a way to engage students and deliver content. However, research on the use of film in secondary education has yet to focus on how students of varying abilities are able to understand and synthesize academic content when it is presented…

The Experience of Receiving and Delivering Consultation in a Residential Childcare Setting for Looked-After and Accommodated Children: A Sequential Exploratory Design

ERIC Educational Resources Information Center

Durka, Katie; Hacker, Thomas

2015-01-01

Looked-after and accommodated children are at higher risk of poor mental health and behavioural difficulties and experience high levels of emotional and psychological distress. Consultation plays a pivotal role in providing indirect support to vulnerable children and young people. The aim of this study was to explore the experience of consultation…

Adult Educators and Cultural Competence within Health Care Systems: Change at the Individual and Structural Levels

ERIC Educational Resources Information Center

Ziegahn, Linda; Ton, Hendry

2011-01-01

Goals of cultural competence are commonly described as creation of a health care system and workforce capable of delivering high-quality care to all patients regardless of race, ethnicity, culture, or language. While this "system" is made up of individuals, it also has a life of its own, as with all institutions. In this chapter, the…

Benefits and Limitations of iPads in the High School Science Classroom and a Trophic Cascade Lesson Plan

ERIC Educational Resources Information Center

Ward, Nicholas D.; Finley, Rachel J.; Keil, Richard G.; Clay, Tansy G.

2013-01-01

This study explores the utility of a set of tablet-based personal computers in the K-12 science, technology, engineering, and mathematics classroom. Specifically, a lesson on food-chain dynamics and predator-prey population controls was designed on the Apple® iPad platform and delivered to three sophomore-level ecology classes (roughly 30 students…

Harnessing the complexity of education with information technology

NASA Astrophysics Data System (ADS)

Gershenson, Carlos

2015-05-01

Education at all levels is facing several challenges in most countries, such as low quality, high costs, lack of educators, and unsatisfied student demand. Traditional approaches are becoming unable to deliver the required education. Several causes for this inefficiency can be identified. I argue that beyond specific causes, the lack of effective education is related to complexity. However, information technology is helping us overcome this complexity.

Teaching and the Transformative Promise of Public Education: What Went Wrong? Have We Lost Our Way? A Perspective from Two Government School Teachers

ERIC Educational Resources Information Center

Gupta, Snehlata; Ahmad, Firoz

2016-01-01

The discourse around public education in recent times presents an abysmal picture of failing public schools delivering low levels of learning. The key constituent held responsible for this failure is the permanent teacher of government schools who is supposedly taking undue advantage of "high salaries" paid according to the…

Micro-Credit and Community Wildlife Management: Complementary Strategies to Improve Conservation Outcomes in Serengeti National Park, Tanzania

NASA Astrophysics Data System (ADS)

Kaaya, Emmanuel; Chapman, Margaret

2017-09-01

Community wildlife management programs in African protected areas aim to deliver livelihood and social benefits to local communities in order to bolster support for their conservation objectives. Most of these benefits are delivered at the community level. However, many local people are also seeking more individual or household-level livelihood benefits from community wildlife management programs because it is at this level that many of the costs of protected area conservation are borne. Because community wildlife management delivers few benefits at this level, support for their conservation objectives amongst local people often declines. The study investigated the implications of this for reducing poaching in Serengeti National Park, Tanzania. Three community wildlife management initiatives undertaken by Park management were compared with regard to their capacity to deliver the individual and household-level benefits sought by local people: community conservation services, wildlife management areas and community conservation banks. Interviews were carried out with poachers and local people from four villages in the Western Serengeti including members of village conservation banks, as well as a number of key informants. The results suggest that community conservation banks could, as a complementary strategy to existing community wildlife management programs, potentially provide a more effective means of reducing poaching in African protected areas than community wildlife management programs alone.

Factors predicting distress among parents/caregivers of children with neurological disease and home enteral nutrition.

PubMed

Pedrón-Giner, C; Calderón, C; Martínez-Costa, C; Borraz Gracia, S; Gómez-López, L

2014-05-01

Caregivers of children with chronic diseases included in a home enteral nutrition (HEN) programme are at risk of experiencing a feeling of burden, high level of anxiety and psychological distress. The aims of this study were: first, to examine the prevalence of symptoms of anxiety-depression in caregivers of children with neurological diseases requiring HEN by gastrostomy tube (GT); second, to compare the characteristics of caregivers with high or low risk of exhibiting symptoms of anxiety-depression; and third, to investigate possible associations to child disease severity and nutrition support mode. A cross-sectional observational study was performed in 58 caregivers of children (31 boys, aged 0.3-18 years) with neurological diseases and GT feeding. The characteristics of caregivers with high or low risk of presenting symptoms of anxiety-depression were compared regarding the following variables: socio-demographic characteristics, the primary caregiver's intrapsychic factors, anthropometric parameters of the child, length of HEN, type of nutrients delivered by GT and infusion regime. All primary caregivers were mothers. Fifty-three per cent of them showed high risk of exhibiting symptoms of anxiety-depression. Mothers with high or low risk of presenting symptoms of anxiety-depression were comparable in age and family socio-economic status. They were also similar in terms of age, anthropometric conditions and length of HEN in their children.No differences were found between the two groups of mothers according to the level of the child's motor function impairment, type of nutrients delivered by GT and infusion regime. Higher levels of psychological distress and perception of burden overload were found in mothers with high risk of exhibiting symptoms of anxiety-depression. This study found a high prevalence of symptoms of anxiety-depression, perception of burden overload and psychological distress in caregivers of children with HEN. Thus, greater practical and emotional support is required for these families. © 2013 John Wiley & Sons Ltd.

Factors influencing delivered mean airway pressure during nasal CPAP with the RAM cannula.

PubMed

Gerdes, Jeffrey S; Sivieri, Emidio M; Abbasi, Soraya

2016-01-01

To measure mean airway pressure (MAP) delivered through the RAM Cannula® when used with a ventilator in CPAP mode as a function of percent nares occlusion in a simulated nasal interface/test lung model and to compare the results to MAPs using a nasal continuous positive airway pressure (NCPAP) interface with nares fully occluded. An artificial airway model was connected to a spontaneous breathing lung model in which MAP was measured at set NCPAP levels between 4 and 8 cmH2 O provided by a Dräger Evita XL® ventilator and delivered through three sizes of RAM cannulae. Measurements were performed with varying leakage at the nasal interface by decreasing occlusion from 100% to 29%, half-way prong insertion, and simulated mouth leakage. Comparison measurements were made using the Dräger BabyFlow® NCPAP interface with a full nasal seal. With simulated mouth closed, the Dräger interface delivered MAPs within 0.5 cmH2 O of set CPAP levels. For the RAM cannula, with 60-80% nares occlusion, overall delivered MAPs were 60 ± 17% less than set CPAP levels (P < 0.001). Further, MAP decreased progressively with decreasing percent nares occlusion. The simulated open mouth condition resulted in significantly lower MAPs to <1.7 cmH2 O. The one-half prong insertion depth condition, with closed mouth, yielded MAPs approximately 35 ± 9% less than full insertion pressures (P < 0.001). In our bench tests, the RAM interface connected to a ventilator in NCPAP mode failed to deliver set CPAP levels when applied using the manufacturer recommended 60-80% nares occlusion, even with closed mouth and full nasal prong insertion conditions. © 2015 Wiley Periodicals, Inc.

Low-level light therapy for zymosan-induced arthritis in rats

NASA Astrophysics Data System (ADS)

Castano, Ana P.; Dai, Tianhong; Demidova-Rice, Tatiana N.; Salomatina, Elena V.; Yaroslavsky, Anna N.; Yaroslavsky, Ilya; Cohen, Richard; Apruzzese, William A.; Smotrich, Michael H.; Hamblin, Michael R.

2007-02-01

It has been known for many years that low level laser (or light) therapy (LLLT) can ameliorate the pain, swelling and inflammation associated with various forms of arthritis. Light is absorbed by mitochondrial chromophores leading to an increase in ATP, reactive oxygen species and/or cyclic AMP production and consequent gene transcription via activation of transcription factors. However, despite many reports about the positive effects of LLLT in medicine, its use remains controversial. Our laboratory has developed animal models designed to objectively quantify response to LLLT and compare different light delivery regimens. In the arthritis model we inject zymosan into rat knee joints to induce inflammatory arthritis. We have compared illumination regimens consisting of a high and low fluence (3 J/cm2 and 30 J/cm2), delivered at a high and low irradiance (5 mW/cm2 and 50 mW/cm2) using 810-nm laser light daily for 5 days, with the effect of conventional corticosteroid (dexamethasone) therapy. Results indicated that illumination with 810-nm laser is highly effective (almost as good as dexamethasone) at reducing swelling and that longer illumination time was more important in determining effectiveness than either total fluence delivered or irradiance. Experiments carried out using 810-nm LLLT on excisional wound healing in mice also confirmed the importance of longer illumination times. These data will be of value in designing clinical trials of LLLT.

Assessing Program Sustainability in an Eating Disorder Prevention Effectiveness Trial Delivered by College Clinicians

PubMed Central

Rohde, Paul; Shaw, Heather; Butryn, Meghan L.; Stice, Eric

2015-01-01

Sustainability of the Body Project, a dissonance-based selective eating disorder prevention program supported by efficacy and effectiveness trials, has not previously been examined. This mixed-methods study collected qualitative and quantitative data on training, supervision, and the intervention from 27 mental health clinicians from eight US universities who participated in an effectiveness trial and quantitative data on 2-year sustainability of program delivery. Clinicians, who were primarily masters-level mental health providers, had limited experience delivering manualized interventions. They rated the training and manual favorably, noting that they particularly liked the role-plays of session activities and intervention rationale, but requested more discussion of processes and group management issues. Clinicians were satisfied receiving emailed supervision based on videotape review. They reported enjoying delivering the Body Project but reported some challenges with the manualized format and time constraints. Most clinicians anticipated running more groups after the study ended but only four universities (50%) reported providing additional Body Project groups at the 1-year follow-up assessment and sustained delivery of the groups decreased substantially two years after study completion, with only one university (12%) continuing to deliver groups. The most commonly reported barriers for conducting additional groups were limited time and high staff turnover. PMID:26143559

Glucose Levels in Newborns with Special Reference to Hypoglycemia: A Study from Rural India

PubMed Central

Dias, Edwin; Gada, Sandeep

2014-01-01

Hypoglycemia is one of the common metabolic problems in neonatal medicine. There is association between blood glucose levels and neurological development. The study involved 100 mothers and neonates blood glucose levels were measured using a standard glucometer in mother delivering babies within half an hour of delivery and in newborns at 0, 3, 6, 12, 24 h of life. Blood glucose levels were low at 0th and 6th h and maximum at 24th h. Neonates born to mothers with high maternal blood glucose levels were hypoglycemic showing a negative correlation. The mean blood glucose levels were low in pre-term and post-term compared with term babies and range of blood glucose levels were wide in preterm and post term babies. PMID:24741538

Targeted alpha therapy using short-lived alpha-particles and the promise of nanobodies as targeting vehicle

PubMed Central

Dekempeneer, Yana; Keyaerts, Marleen; Krasniqi, Ahmet; Puttemans, Janik; Muyldermans, Serge; Lahoutte, Tony; D’huyvetter, Matthias; Devoogdt, Nick

2016-01-01

ABSTRACT Introduction: The combination of a targeted biomolecule that specifically defines the target and a radionuclide that delivers a cytotoxic payload offers a specific way to destroy cancer cells. Targeted radionuclide therapy (TRNT) aims to deliver cytotoxic radiation to cancer cells and causes minimal toxicity to surrounding healthy tissues. Recent advances using α-particle radiation emphasizes their potential to generate radiation in a highly localized and toxic manner because of their high level of ionization and short range in tissue. Areas covered: We review the importance of targeted alpha therapy (TAT) and focus on nanobodies as potential beneficial vehicles. In recent years, nanobodies have been evaluated intensively as unique antigen-specific vehicles for molecular imaging and TRNT. Expert opinion: We expect that the efficient targeting capacity and fast clearance of nanobodies offer a high potential for TAT. More particularly, we argue that the nanobodies’ pharmacokinetic properties match perfectly with the interesting decay properties of the short-lived α-particle emitting radionuclides Astatine-211 and Bismuth-213 and offer an interesting treatment option particularly for micrometastatic cancer and residual disease. PMID:27145158

Integration of High-Performance Computing into Cloud Computing Services

NASA Astrophysics Data System (ADS)

Vouk, Mladen A.; Sills, Eric; Dreher, Patrick

High-Performance Computing (HPC) projects span a spectrum of computer hardware implementations ranging from peta-flop supercomputers, high-end tera-flop facilities running a variety of operating systems and applications, to mid-range and smaller computational clusters used for HPC application development, pilot runs and prototype staging clusters. What they all have in common is that they operate as a stand-alone system rather than a scalable and shared user re-configurable resource. The advent of cloud computing has changed the traditional HPC implementation. In this article, we will discuss a very successful production-level architecture and policy framework for supporting HPC services within a more general cloud computing infrastructure. This integrated environment, called Virtual Computing Lab (VCL), has been operating at NC State since fall 2004. Nearly 8,500,000 HPC CPU-Hrs were delivered by this environment to NC State faculty and students during 2009. In addition, we present and discuss operational data that show that integration of HPC and non-HPC (or general VCL) services in a cloud can substantially reduce the cost of delivering cloud services (down to cents per CPU hour).

Levels and determinants of low birth weight in infants delivered under the national health insurance scheme in Northern Ghana.

PubMed

Ibrahim, Abdallah; O'Keefe, Anne Marie; Hawkins, Anita; Hossain, Mian Bazle

2015-06-01

This research determined the levels and odds ratios for low birth weight (LBW) infants delivered under the National Health Insurance Scheme (NHIS) compared to LBW infants delivered under the previous "Cash and Carry" system in Northern Ghana. Birth records of infants delivered before and after implementation of the NHIS in Northern Ghana were examined. Records of each day's births during the identified periods were abstracted. Days with fewer or no births were accommodated by oversampling from days before or after. Chi squared tests of independence were used to examine the bivariate association between categorical independent variables and LBW. Multiple logistic regression models were used to examine the relationships among selected variables for mothers and infants and the odds ratios for LBW. Infants delivered under NHIS had lower rates of LBW (16.8 %) compared to infants born under Cash and Carry (23.3 %). Mothers who delivered under NHIS were significantly less likely to have infants at LBW (unadjusted OR 0.65; 95 % CI 0.49, 0.86). The rate of LBW among infants delivered under NHIS is significantly lower than among infants delivered under Cash and Carry. The rate of LBW under Cash and Carry in 2000 fell by 27 % in relation to the NHIS in 2010. These findings confirm that the NHIS, which gives pregnant women in Northern Ghana four antenatal visits and access to skilled health professionals for delivery at no cost to the mother, significantly improved birth weight outcomes.

Pilot study of enhanced tobacco-cessation services coverage for low-income smokers.

PubMed

Doescher, Mark P; Whinston, Melicent A; Goo, Alvin; Cummings, Diane; Huntington, Jane; Saver, Barry G

2002-01-01

This study explored the feasibility of covering nicotine replacement therapy (NRT) and paying for pharmacist-delivered smoking cessation counseling at the time of NRT pick-up for low-income, managed Medicaid and Basic Health Plan (a state insurance program) enrollees. A prospective pilot intervention was used at two community health centers (CHCs) and two community pharmacies. Participants were adult managed-Medicaid or Basic Health Plan enrollees who attended the pilot CHCs and smoked. An innovative insurance benefit that included coverage for NRT and $15 payment to the pharmacist to deliver cessation counseling with each prescription fill. Proportion of eligible patients who used the cessation benefit and patient and pharmacist satisfaction with the intervention. During the 9-month intervention, 32 patients at the pilot clinics were referred for NRT and pharmacist-delivered counseling. This number represented roughly 5% of eligible smokers. Of these, 26 received NRT with concomitant pharmacist-delivered cessation counseling at least once. Recipients reported a high level of satisfaction with this intervention. Pharmacists indicated they would continue providing counseling if reimbursement remained adequate and if counseling lasted no longer than 5-10 min. However, 12 (38%) who were referred were no longer insured by the sponsoring plan by the end of the 9-month pilot period. Pharmacist-delivered cessation counseling may be feasible and merits further study. More importantly, this pilot reveals two key obstacles in our low-income, culturally diverse setting: low participation and rapid turnover of insureds. Future interventions will need to address these barriers.

Analysis of factors affecting satisfaction level on problem based learning approach using structural equation modeling

NASA Astrophysics Data System (ADS)

Hussain, Nur Farahin Mee; Zahid, Zalina

2014-12-01

Nowadays, in the job market demand, graduates are expected not only to have higher performance in academic but they must also be excellent in soft skill. Problem-Based Learning (PBL) has a number of distinct advantages as a learning method as it can deliver graduates that will be highly prized by industry. This study attempts to determine the satisfaction level of engineering students on the PBL Approach and to evaluate their determinant factors. The Structural Equation Modeling (SEM) was used to investigate how the factors of Good Teaching Scale, Clear Goals, Student Assessment and Levels of Workload affected the student satisfaction towards PBL approach.

Sociocultural determinants of home delivery in Ethiopia: a qualitative study.

PubMed

Kaba, Mirgissa; Bulto, Tesfaye; Tafesse, Zergu; Lingerh, Wassie; Ali, Ismael

2016-01-01

Maternal health remains a major public health problem in Ethiopia. Despite the government's measures to ensure institutional delivery assisted by skilled attendants, home delivery remains high, estimated at over 80% of all pregnant women. The study aims to identify determinants that sustain home delivery in Ethiopia. A total of 48 women who delivered their most recent child at home, 56 women who delivered their most recent child in a health facility, 55 husbands of women who delivered within 1 year preceding the study, and 23 opinion leaders in selected districts of Amhara, Oromia, Southern Nations, Nationalities, and Peoples' Region, and Tigray regions were involved in the study. Key informant interview, in-depth interviews, and focus group discussions were conducted to collect data using checklists developed for this purpose. Data reduction and analysis were facilitated by Maxqda qualitative data analysis software version 11. Findings show that pregnancy and delivery is a normal and natural life event. Research participants unanimously argue that such a life event should not be linked with health problems. Home is considered a natural space for delivery and most women aspire to deliver at home where rituals during labor and after delivery are considered enjoyable. Even those who delivered in health facilities appreciate events in connection to home delivery. Efforts are underway to create home-like environments in health facilities, but health facilities are not yet recognized as a natural place of delivery. The positive tendency to deliver at home is further facilitated by poor service delivery at the facility level. Perceived poor competence of providers and limited availability of supplies and equipment were found to maintain the preference to deliver at home. The government's endeavor to improve maternal health has generated positive results with more women now attending antenatal care. Yet over 80% of women deliver at home and this was found to be the preferred option. Thus, the current form of intervention needs to focus on factors that determine decisions to deliver at home and also focus on investing in improving service delivery at health facilities.

Sociocultural determinants of home delivery in Ethiopia: a qualitative study

PubMed Central

Kaba, Mirgissa; Bulto, Tesfaye; Tafesse, Zergu; Lingerh, Wassie; Ali, Ismael

2016-01-01

Background Maternal health remains a major public health problem in Ethiopia. Despite the government’s measures to ensure institutional delivery assisted by skilled attendants, home delivery remains high, estimated at over 80% of all pregnant women. Objective The study aims to identify determinants that sustain home delivery in Ethiopia. Methods A total of 48 women who delivered their most recent child at home, 56 women who delivered their most recent child in a health facility, 55 husbands of women who delivered within 1 year preceding the study, and 23 opinion leaders in selected districts of Amhara, Oromia, Southern Nations, Nationalities, and Peoples’ Region, and Tigray regions were involved in the study. Key informant interview, in-depth interviews, and focus group discussions were conducted to collect data using checklists developed for this purpose. Data reduction and analysis were facilitated by Maxqda qualitative data analysis software version 11. Results Findings show that pregnancy and delivery is a normal and natural life event. Research participants unanimously argue that such a life event should not be linked with health problems. Home is considered a natural space for delivery and most women aspire to deliver at home where rituals during labor and after delivery are considered enjoyable. Even those who delivered in health facilities appreciate events in connection to home delivery. Efforts are underway to create home-like environments in health facilities, but health facilities are not yet recognized as a natural place of delivery. The positive tendency to deliver at home is further facilitated by poor service delivery at the facility level. Perceived poor competence of providers and limited availability of supplies and equipment were found to maintain the preference to deliver at home. Conclusion The government’s endeavor to improve maternal health has generated positive results with more women now attending antenatal care. Yet over 80% of women deliver at home and this was found to be the preferred option. Thus, the current form of intervention needs to focus on factors that determine decisions to deliver at home and also focus on investing in improving service delivery at health facilities. PMID:27114718

Delivering modern, high-quality, affordable pathology and laboratory medicine to low-income and middle-income countries: a call to action.

PubMed

Horton, Susan; Sullivan, Richard; Flanigan, John; Fleming, Kenneth A; Kuti, Modupe A; Looi, Lai Meng; Pai, Sanjay A; Lawler, Mark

2018-05-12

Modern, affordable pathology and laboratory medicine (PALM) systems are essential to achieve the 2030 Sustainable Development Goals for health in low-income and middle-income countries (LMICs). In this last in a Series of three papers about PALM in LMICs, we discuss the policy environment and emphasise three crucial high-level actions that are needed to deliver universal health coverage. First, nations need national strategic laboratory plans; second, these plans require adequate financing for implementation; and last, pathologists themselves need to take on leadership roles to advocate for the centrality of PALM to achieve the Sustainable Development Goals for health. The national strategic laboratory plan should deliver a tiered, networked laboratory system as a central element. Appropriate financing should be provided, at a level of at least 4% of health expenditure. Financing of new technologies such as molecular diagnostics is challenging for LMICs, even though many of these tests are cost-effective. Point-of-care testing can substantially reduce test-reporting time, but this benefit must be balanced with higher costs. Our research analysis highlights a considerable deficiency in advocacy for PALM; pathologists have been invisible in national and international health discourse and leadership. Embedding PALM in LMICs can only be achieved if pathologists advocate for these services, and undertake leadership roles, both nationally and internationally. We articulate eight key recommendations to address the current barriers identified in this Series and issue a call to action for all stakeholders to come together in a global alliance to ensure the effective provision of PALM services in resource-limited settings. Copyright © 2018 Elsevier Ltd. All rights reserved.

The effectiveness of conjugate Haemophilus influenzae type B vaccine in The Gambia 14 years after introduction.

PubMed

Howie, Stephen R C; Oluwalana, Claire; Secka, Ousman; Scott, Susana; Ideh, Readon C; Ebruke, Bernard E; Balloch, Anne; Sambou, Sana; Erskine, James; Lowe, Yamundow; Corrah, Tumani; Adegbola, Richard A

2013-12-01

The Gambia was the first country in Africa to introduce conjugate Haemophilus influenzae type b (Hib) vaccine, which, as in other developing countries but unlike industrialized countries, is delivered as a 3-dose primary series with no booster. This study assessed its effectiveness 14 years after introduction. Using methods standardized during >20 years in the study site, clinical and microbiological surveillance for invasive Hib disease (primarily meningitis) in the Western Region of The Gambia from 2007 to 2010 was complemented with studies of Hib carriage in children aged 1 to <2 years, Hib antibody levels in children aged <5 years, and Hib vaccine coverage and timing in children aged 1 to <2 years. The incidence of Hib meningitis remained low (averaging 1.3 per 100 000 children aged <5 years annually), as did the Hib oropharyngeal carriage rate (0.9%). Hib antibody levels were protective in >99% of those surveyed, albeit with lower titers in older children; and coverage of conjugate Hib vaccination was high (91% having 3 doses at 1-2 years of age) using a schedule that was delivered at median ages of 2.6 months, 4.3 months, and 6 months for the first, second, and third doses, respectively. Conjugate Hib vaccine was delivered on time in a 3-dose primary series without booster to a high proportion of eligible children and this was associated with effective disease control up to 14 years after introduction. It is important that surveillance continues in this first African country to introduce the vaccine to determine if effective control persists or if a booster dose becomes necessary as has been the case in industrialized countries.

Large-pore mesoporous silica nanospheres as vehicles for delivering TRAF3-shRNA plasmids to Kupffer cells

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

Zhang, Junyong, E-mail: zhangmachine@hotmail.com; Guo, Shipeng, E-mail: guoshipeng2008@126.com; Zhang, Wenfeng, E-mail: Sadengren8881@163.com

The currently available techniques for transferring exogenous genes into macrophages, especially the targeted import of exogenous genes into Kupffer cells (KCs) in vivo, are inefficient and achieve only low targeting. Novel Large-Pore Mesoporous Silica Nanospheres (LPMSNs) may be a promising gene transfection agent for KCs because of their superior biodegradation and hypotoxic characteristics, as well as their ability to retain the biological function of KCs and the high loading-rate of exogenous plasmid. LPMSNs were able to completely adsorb shRNA-TRAF3 (tumor necrosis factor receptor-associated factor-3) plasmid at a mass ratio as low as 30:1, and exhibited a low cytotoxicity for KCs. LPMSNsmore » were detected in KC cytoplasm in vitro, and transmission electron microscopy (TEM) revealed that they were present only in KCs in liver tissue in vivo. The max KC transfection efficiency with LPMSNs was 34.8± 0.07%, as evaluated using flow cytometry, and the protein and mRNA levels of TRAF3 were significantly inhibited (P < 0.05) by shRNA-TRAF3 plasmid transfection after 24 h in vitro and 48 h in vivo. In conclusion, KC targeted transfection was achieved successfully by LPMSNs carrying shRNA-TRAF3 plasmids in vitro and vivo. The protein and mRNA levels of TRAF3 were suppressed significantly. These results suggest that LPMSNs are a promising vehicle for delivering exogenous genes into KCs in vitro and vivo. - Highlights: • We constructed Large-Pore Mesoporous Silica Nanospheres (LPMSNs). • LPMSNs adsorbed high quantity of plasmid. • Low cytotoxicity of LPMSNs to Kupffer cells. • LPMSNs delivered plasmid into Kupffer cells.« less

The Effectiveness of Conjugate Haemophilus influenzae Type B Vaccine in The Gambia 14 Years After Introduction

PubMed Central

Howie, Stephen R. C.; Oluwalana, Claire; Secka, Ousman; Scott, Susana; Ideh, Readon C.; Ebruke, Bernard E.; Balloch, Anne; Sambou, Sana; Erskine, James; Lowe, Yamundow; Corrah, Tumani; Adegbola, Richard A.

2013-01-01

Background. The Gambia was the first country in Africa to introduce conjugate Haemophilus influenzae type b (Hib) vaccine, which, as in other developing countries but unlike industrialized countries, is delivered as a 3-dose primary series with no booster. This study assessed its effectiveness 14 years after introduction. Methods. Using methods standardized during >20 years in the study site, clinical and microbiological surveillance for invasive Hib disease (primarily meningitis) in the Western Region of The Gambia from 2007 to 2010 was complemented with studies of Hib carriage in children aged 1 to <2 years, Hib antibody levels in children aged <5 years, and Hib vaccine coverage and timing in children aged 1 to <2 years. Results. The incidence of Hib meningitis remained low (averaging 1.3 per 100 000 children aged <5 years annually), as did the Hib oropharyngeal carriage rate (0.9%). Hib antibody levels were protective in >99% of those surveyed, albeit with lower titers in older children; and coverage of conjugate Hib vaccination was high (91% having 3 doses at 1–2 years of age) using a schedule that was delivered at median ages of 2.6 months, 4.3 months, and 6 months for the first, second, and third doses, respectively. Conclusions. Conjugate Hib vaccine was delivered on time in a 3-dose primary series without booster to a high proportion of eligible children and this was associated with effective disease control up to 14 years after introduction. It is important that surveillance continues in this first African country to introduce the vaccine to determine if effective control persists or if a booster dose becomes necessary as has been the case in industrialized countries. PMID:24046305

The effects of non-invasive respiratory support on oropharyngeal temperature and humidity: a neonatal manikin study.

PubMed

Roberts, Calum T; Kortekaas, Rebecca; Dawson, Jennifer A; Manley, Brett J; Owen, Louise S; Davis, Peter G

2016-05-01

Heating and humidification of inspired gases is routine during neonatal non-invasive respiratory support. However, little is known about the temperature and humidity delivered to the upper airway. The International Standards Organization (ISO) specifies that for all patients with an artificial airway humidifiers should deliver ≥33 g/m(3) absolute humidity (AH). We assessed the oropharyngeal temperature and humidity during different non-invasive support modes in a neonatal manikin study. Six different modes of non-invasive respiratory support were applied at clinically relevant settings to a neonatal manikin, placed in a warmed and humidified neonatal incubator. Oropharyngeal temperature and relative humidity (RH) were assessed using a thermohygrometer. AH was subsequently calculated. Measured temperature and RH varied between devices. Bubble and ventilator continuous positive airway pressure (CPAP) produced temperatures >34°C and AH >38 g/m(3). Variable flow CPAP resulted in lower levels of AH than bubble or ventilator CPAP, and AH decreased with higher gas flow. High-flow (HF) therapy delivered by Optiflow Junior produced higher AH with higher gas flow, whereas with Vapotherm HF the converse was true. Different non-invasive devices deliver inspiratory gases of variable temperature and humidity. Most AH levels were above the ISO recommendation; however, with some HF and variable flow CPAP devices at higher gas flow this was not achieved. Clinicians should be aware of differences in the efficacy of heating and humidification when choosing modes of non-invasive respiratory support. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Partnering Urban Academic Medical Centers And Rural Primary Care Clinicians To Provide Complex Chronic Disease Care

PubMed Central

Arora, Sanjeev; Kalishman, Summers; Dion, Denise; Som, Dara; Thornton, Karla; Bankhurst, Arthur; Boyle, Jeanne; Harkins, Michelle; Moseley, Kathleen; Murata, Glen; Komaramy, Miriam; Katzman, Joanna; Colleran, Kathleen; Deming, Paulina; Yutzy, Sean

2013-01-01

Many of the estimated thirty-two million Americans expected to gain coverage under the Affordable Care Act are likely to have high levels of unmet need for various chronic illnesses and to live in areas that are already underserved. In New Mexico an innovative new model of health care education and delivery known as Project ECHO (Extension for Community Healthcare Outcomes) provides high-quality primary and specialty care to a comparable population. Using state-of-the-art telehealth technology and case-based learning, Project ECHO enables specialists at the University of New Mexico Health Sciences Center to partner with primary care clinicians in underserved areas to deliver complex specialty care to patients with hepatitis C, asthma, diabetes, HIV/AIDS, pediatric obesity and mental illness. As of March 2011, 298 Project ECHO teams across New Mexico have delivered more than 10,000 specialty care consultations for hepatitis C and other chronic diseases. PMID:21596757

A linear refractive photovoltaic concentrator solar array flight experiment

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

Jones, P.A.; Murphy, D.M.; Piszczor, M.F.

1995-12-31

Concentrator arrays deliver a number of generic benefits for space including high array efficiency, protection from space radiation effects, and minimized plasma interactions. The line focus concentrator concept delivers two added advantages: (1) low-cost mass production of the lens material and, (2) relaxation of precise array tracking requirements to only a single axis. New array designs emphasize lightweight, high stiffness, stow-ability and ease of manufacture and assembly. The linear refractive concentrator can be designed to provide an essentially flat response over a wide range of longitudinal pointing errors for satellites having only single-axis tracking capability. In this paper the authorsmore » address the current status of the SCARLET linear concentrator program with special emphasis on hardware development of an array-level linear refractive concentrator flight experiment. An aggressive, 6-month development and flight validation program, sponsored by the Ballistic Missile Defense Organization (BMDO) and NASA Lewis Research Center, will quantify and verify SCARLET benefits with in-orbit performance measurements.« less

Preliminary study of injury from heating systemically delivered, nontargeted dextran–superparamagnetic iron oxide nanoparticles in mice

PubMed Central

Kut, Carmen; Zhang, Yonggang; Hedayati, Mohammad; Zhou, Haoming; Cornejo, Christine; Bordelon, David; Mihalic, Jana; Wabler, Michele; Burghardt, Elizabeth; Gruettner, Cordula; Geyh, Alison; Brayton, Cory; Deweese, Theodore L; Ivkov, Robert

2013-01-01

Aim To assess the potential for injury to normal tissues in mice due to heating systemically delivered magnetic nanoparticles in an alternating magnetic field (AMF). Materials & methods Twenty three male nude mice received intravenous injections of dextran–superparamagnetic iron oxide nanoparticles on days 1–3. On day 6, they were exposed to AMF. On day 7, blood, liver and spleen were harvested and analyzed. Results Iron deposits were detected in the liver and spleen. Mice that had received a high-particle dose and a high AMF experienced increased mortality, elevated liver enzymes and significant liver and spleen necrosis. Mice treated with low-dose superparamagnetic iron oxide nanoparticles and a low AMF survived, but had elevated enzyme levels and local necrosis in the spleen. Conclusion Magnetic nanoparticles producing only modest heat output can cause damage, and even death, when sequestered in sufficient concentrations. Dextran–superparamagnetic iron oxide nanoparticles are deposited in the liver and spleen, making these the sites of potential toxicity. PMID:22830502

Performance Characterization of High Energy Commercial Lithium-ion Cells

NASA Technical Reports Server (NTRS)

Schneidegger, Brianne T.

2010-01-01

The NASA Glenn Research Center Electrochemistry Branch performed characterization of commercial lithium-ion cells to determine the cells' performance against Exploration Technology Development Program (ETDP) Key Performance Parameters (KPP). The goals of the ETDP Energy Storage Project require significant improvements in the specific energy of lithium-ion technology over the state-of-the-art. This work supports the high energy cell development for the Constellation customer Lunar Surface Systems (LSS). In support of these goals, testing was initiated in September 2009 with high energy cylindrical cells obtained from Panasonic and E-One Moli. Both manufacturers indicated the capability of their cells to deliver specific energy of at least 180 Wh/kg or higher. Testing is being performed at the NASA Glenn Research Center to evaluate the performance of these cells under temperature, rate, and cycling conditions relevant to the ETDP goals for high energy cells. The cell-level specific energy goal for high energy technology is 180 Wh/kg at a C/10 rate and 0 C. The threshold value is 165 Wh/kg. The goal is to operate for at least 2000 cycles at 100 percent DOD with greater than 80 percent capacity retention. The Panasonic NCR18650 cells were able to deliver nearly 200 Wh/kg at the aforementioned conditions. The E-One Moli ICR18650J cells also met the specific energy goal by delivering 183 Wh/kg. Though both cells met the goal for specific energy, this testing was only one portion of the testing required to determine the suitability of commercial cells for the ETDP. The cells must also meet goals for cycle life and safety. The results of this characterization are summarized in this report.

Fixed-energy biphasic waveform defibrillation in a pediatric model of cardiac arrest and resuscitation.

PubMed

Tang, Wanchun; Weil, Max Harry; Jorgenson, Dawn; Klouche, Kada; Morgan, Carl; Yu, Ting; Sun, Shijie; Snyder, David

2002-12-01

For adults, 150-J fixed-energy, impedance-compensating biphasic truncated exponential (ICBTE) shocks are now effectively used in automated defibrillators. However, the high energy levels delivered by adult automated defibrillators preclude their use for pediatric patients. Accordingly, we investigated a method by which adult automated defibrillators may be adapted to deliver a 50-J ICBTE shock for pediatric defibrillation. Prospective, randomized study. A university-affiliated research institution. Domestic piglets. We initially investigated four groups of anesthetized mechanically ventilated piglets weighing 3.8, 7.5, 15, and 25 kg. Ventricular fibrillation was induced with an AC current delivered to the right ventricular endocardium. After 7 mins of untreated ventricular fibrillation, a conventional manual defibrillator was used to deliver up to three 50-J ICBTE shocks. If ventricular fibrillation was not reversed, a 1-min interval of precordial compression preceded a second sequence of up to three shocks. The protocol was repeated until spontaneous circulation was restored, or for a total of 15 mins. In a second set of experiments, we evaluated a 150-J biphasic adult automated defibrillator that was operated in conjunction with energy-reducing electrodes such as to deliver 50-J shocks. The same resuscitation protocol was then exercised on piglets weighing 3.7, 13.5, and 24.2 kg. All animals were successfully resuscitated. Postresuscitation hemodynamic and myocardial function quickly returned to baseline values in both experimental groups, and all animals survived. An adaptation of a 150-J biphasic adult automated defibrillator in which energy-reducing electrodes delivered 50-J shocks successfully resuscitated animals ranging from 3.7 to 25 kg without compromise of postresuscitation myocardial function or survival.

Healthcare librarians and the delivery of critical appraisal training: attitudes, level of involvement and support.

PubMed

Maden-Jenkins, Michelle

2010-12-01

Although healthcare librarians are undertaking training in critical appraisal skills, what is not so clear is the impact of the training on the understanding and dissemination of these skills. This study aims to examine the attitudes of healthcare librarians towards delivering critical appraisal training and their level of involvement. A questionnaire survey of 57 library services across 48 NHS Trust Library Services in north-west England followed up with 21 semi-structured interviews. Seventy-three per cent of respondents felt that they ought to be involved in delivering critical appraisal training, however less than a third (29%) are actually involved. Librarians are involved in critical appraisal facilitation at various levels. Debate continues over the extent of librarian involvement in delivering critical appraisal training. As long as healthcare librarians recognise their own capabilities and identify the boundaries within which they feel comfortable then there is no reason why they should not be involved in delivering critical appraisal training. © 2010 The authors. Health Information and Libraries Journal © 2010 Health Libraries Group.

Effects of combined pressure and temperature on enzymes related to quality of fruits and vegetables: from kinetic information to process engineering aspects.

PubMed

Ludikhuyze, L; Van Loey, A; Indrawati; Smout, C; Hendrickx, M

2003-01-01

Throughout the last decade, high pressure technology has been shown to offer great potential to the food processing and preservation industry in delivering safe and high quality products. Implementation of this new technology will be largely facilitated when a scientific basis to assess quantitatively the impact of high pressure processes on food safety and quality becomes available. Besides, quantitative data on the effects of pressure and temperature on safety and quality aspects of foods are indispensable for design and evaluation of optimal high pressure processes, i.e., processes resulting in maximal quality retention within the constraints of the required reduction of microbial load and enzyme activity. Indeed it has to be stressed that new technologies should deliver, apart from the promised quality improvement, an equivalent or preferably enhanced level of safety. The present paper will give an overview from a quantitative point of view of the combined effects of pressure and temperature on enzymes related to quality of fruits and vegetables. Complete kinetic characterization of the inactivation of the individual enzymes will be discussed, as well as the use of integrated kinetic information in process engineering.

Combinatorial programming of human neuronal progenitors using magnetically-guided stoichiometric mRNA delivery.

PubMed

Azimi, Sayyed M; Sheridan, Steven D; Ghannad-Rezaie, Mostafa; Eimon, Peter M; Yanik, Mehmet Fatih

2018-05-01

Identification of optimal transcription-factor expression patterns to direct cellular differentiation along a desired pathway presents significant challenges. We demonstrate massively combinatorial screening of temporally-varying mRNA transcription factors to direct differentiation of neural progenitor cells using a dynamically-reconfigurable magnetically-guided spotting technology for localizing mRNA, enabling experiments on millimetre size spots. In addition, we present a time-interleaved delivery method that dramatically reduces fluctuations in the delivered transcription-factor copy-numbers per cell. We screened combinatorial and temporal delivery of a pool of midbrain-specific transcription factors to augment the generation of dopaminergic neurons. We show that the combinatorial delivery of LMX1A, FOXA2 and PITX3 is highly effective in generating dopaminergic neurons from midbrain progenitors. We show that LMX1A significantly increases TH -expression levels when delivered to neural progenitor cells either during proliferation or after induction of neural differentiation, while FOXA2 and PITX3 increase expression only when delivered prior to induction, demonstrating temporal dependence of factor addition. © 2018, Azimi et al.

Using Free Internet Videogames in Upper Extremity Motor Training for Children with Cerebral Palsy.

PubMed

Sevick, Marisa; Eklund, Elizabeth; Mensch, Allison; Foreman, Matthew; Standeven, John; Engsberg, Jack

2016-06-07

Movement therapy is one type of upper extremity intervention for children with cerebral palsy (CP) to improve function. It requires high-intensity, repetitive and task-specific training. Tedium and lack of motivation are substantial barriers to completing the training. An approach to overcome these barriers is to couple the movement therapy with videogames. This investigation: (1) tested the feasibility of delivering a free Internet videogame upper extremity motor intervention to four children with CP (aged 8-17 years) with mild to moderate limitations to upper limb function; and (2) determined the level of intrinsic motivation during the intervention. The intervention used free Internet videogames in conjunction with the Microsoft Kinect motion sensor and the Flexible Action and Articulated Skeleton Toolkit software (FAAST) software. Results indicated that the intervention could be successfully delivered in the laboratory and the home, and pre- and post- impairment, function and performance assessments were possible. Results also indicated a high level of motivation among the participants. It was concluded that the use of inexpensive hardware and software in conjunction with free Internet videogames has the potential to be very motivating in helping to improve the upper extremity abilities of children with CP. Future work should include results from additional participants and from a control group in a randomized controlled trial to establish efficacy.

Maternal Fatty Acids and Their Association with Birth Outcome: A Prospective Study

PubMed Central

Meher, Akshaya; Randhir, Karuna; Mehendale, Savita; Wagh, Girija; Joshi, Sadhana

2016-01-01

Maternal nutrition, especially LCPUFA, is an important factor in determining fetal growth and development. Our earlier cross sectional study reports lower docosahexanoic acid (DHA) levels at the time of delivery in mothers delivering low birth weight (LBW) babies. This study was undertaken to examine the role of the maternal omega-3 and omega-6 fatty acid profile across the gestation in fetal growth. This is a hospital based study where women were recruited in early gestation. Maternal blood was collected at 3 time points, i.e., T1 = 16th–20th week, T2 = 26th–30th week and T3 = at delivery. Cord blood was collected at delivery. At delivery, these women were divided into 2 groups: those delivering at term a baby weighing >2.5kg [Normal birth weight (NBW) group] and those delivering at term a baby weighing <2.5kg [LBW group]. The study reports data on 111 women recruited at T1, out of which 60 women delivered an NBW baby at term and 51 women delivered an LBW baby at term. Fatty acids were analysed using gas chromatography. At T1 of gestation, maternal erythrocyte DHA levels were positively (p<0.05) associated with baby weight. Maternal plasma and erythrocyte arachidonic acid and total erythrocyte omega-6 fatty acid levels at T2 were higher (p<0.05 for both) in the LBW group. Total erythrocyte omega-3 fatty acid levels were lower (p<0.05) while total erythrocyte omega-6 fatty acid levels were higher (p<0.05) in the LBW group at delivery. Our data demonstrates the possible role of LCPUFA in the etiology of LBW babies right from early pregnancy. PMID:26815428

Haemoglobin discordances in twins: due to differences in timing of cord clamping?

PubMed

Verbeek, Lianne; Zhao, Depeng P; Middeldorp, Johanna M; Oepkes, Dick; Hooper, Stuart B; Te Pas, Arjan B; Lopriore, Enrico

2017-07-01

Our objective was to study the differences in haemoglobin (Hb) at birth in dichorionic (DC) versus monochorionic (MC) twins in relation to birth order and mode of delivery. All consecutive DC twin pregnancies and uncomplicated MC twin pregnancies with two live-born twins delivered at our centre were included in this retrospective cohort study. Hb levels at birth and on day 2 were evaluated in association with birth order and mode of delivery. The occurrence of polycythaemia (venous haematocrit >65%) was also recorded. A total of 300 DC and 290 MC twin pairs were included. In DC and MC twins delivered vaginally, second-born twins had a higher Hb level at birth compared with their co-twin (mean Hb level 16.7 vs 15.9 g/dL (p<0.01) in DC twins and 17.8 vs 16.1 g/dL (p<0.01) in MC twins). In twins delivered through caesarean section, no intertwin differences in Hb levels were detected. Polycythaemia occurred significantly more often in second-born twins compared with first-born twins delivered vaginally: 10 (5%) vs 2 (1%) (p=0.02) in DC twins and 20 (12%) vs 2 (1%) (p<0.01) in MC twins. Second-born DC and MC twins delivered vaginally have higher Hb levels at birth compared with first-born twins. Intertwin Hb differences in MC twins may partly be related to blood transfusion through the vascular anastomoses. Since DC twins do not have anastomoses, other factors may lead to Hb differences, including differences in timing of umbilical cord clamping. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

In situ heating to detoxify organic-contaminated soils

DOEpatents

Buelt, James L.; Oma, Kenton H.

1990-01-01

A method and apparatus for decontaminating ground areas where toxic chemicals are buried comprises disposition of a plurality of spaced electrodes in the ground to be treated and application of a voltage across the electrodes for bringing about current flow through the ground. Power delivered to the ground volatilizes the chemicals which are collected and directed to a gas treatment system. The preferred form of the invention employs high voltage arc discharge between the electrodes for heating a ground region to relatively high temperatures at relatively low power levels.

Assessing the dosimetric and geometric accuracy of stereotactic radiosurgery

NASA Astrophysics Data System (ADS)

Dimitriadis, Alexis

Stereotactic radiosurgery (SRS) is a non-invasive treatment predominantly used for the management of malignant and benign brain tumours. The treatment can be delivered by various platforms in a single fraction where a high dose of radiation is delivered to the target whilst the surrounding healthy tissue is spared. This requires a high degree of accuracy in terms of the dose level delivered but also in terms of geometric precision. The purpose of this work was to identify the variations of SRS practice in the UK and develop a novel method compatible with all practices, capable of assessing the accuracy of delivery. The motivation behind this effort was to contribute to safety in SRS delivery, provide confidence through a quality assurance audit and form a basis to support standardisation in SRS. A national survey was performed to investigate SRS practices in the UK and to help guide the methodology of this thesis. This resulted to the development of a method for an end-to-end audit of SRS. This was based on an anthropomorphic head phantom with a medium sized target located centrally in the brain, in close proximity to the brainstem. This realistic patient scenario was presented to all 26 radiosurgery centres in the UK who were asked to treat it with SRS. The dose delivered was assessed using two novel commercially available radiation detectors, a plastic scintillator and radiochromic film. These detectors were characterised for measuring the dose delivered in SRS. Another established dosimetry system, alanine, was also used alongside these detectors to assess the accuracy of each delivery. The results allowed the assessment of SRS practices in the UK and the comparison of all centres that participated in the audit. The results were also used to evaluate the performance of the dosimeters used for the purposes of quality assurance measurements and audit.

The Apollo Accreditation Program: A web-based Joint Commission International standards compliance management tool.

PubMed

Dewan, Shaveta; Sibal, Anupam; Uberoi, R S; Kaur, Ishneet; Nayak, Yogamaya; Kar, Sujoy; Loria, Gaurav; Yatheesh, G; Balaji, V

2014-01-01

Creating and implementing processes to deliver quality care in compliance with accreditation standards is a challenging task but even more daunting is sustaining these processes and systems. There is need for frequent monitoring of the gap between the expected level of care and the level of care actually delivered so as to achieve consistent level of care. The Apollo Accreditation Program (AAP) was implemented as a web-based single measurable dashboard to display, measure and compare compliance levels for established standards of care in JCI accredited hospitals every quarter and resulted in an overall 15.5% improvement in compliance levels over one year.

Hemoglobin Differences in Uncomplicated Monochorionic Twins in Relation to Birth Order and Mode of Delivery.

PubMed

Verbeek, Lianne; Zhao, Depeng P; Te Pas, Arjan B; Middeldorp, Johanna M; Hooper, Stuart B; Oepkes, Dick; Lopriore, Enrico

2016-06-01

To determine the differences in hemoglobin (Hb) levels in the first 2 days after birth in uncomplicated monochorionic twins in relation to birth order and mode of delivery. All consecutive uncomplicated monochorionic pregnancies with two live-born twins delivered at our center were included in this retrospective study. We recorded Hb levels at birth and on day 2, and analyzed Hb levels in association with birth order, mode of delivery, and time interval between delivery of twin 1 and 2. A total of 290 monochorionic twin pairs were analyzed, including 171 (59%) twins delivered vaginally and 119 (41%) twins born by cesarean section (CS). In twins delivered vaginally, mean Hb levels at birth and on day 2 were significantly higher in second-born twins compared to first-born twins: 17.8 versus 16.1 g/dL and 18.0 versus 14.8 g/dL, respectively (p < .01). Polycythemia was detected more often in second-born twins (12%, 20/166) compared to first-born twins (1%, 2/166; p < .01). Hb differences within twin pairs delivered by CS were not statistically or clinically significant. We found no association between inter-twin delivery time intervals and Hb differences. Second-born twins after vaginal delivery have higher Hb levels and more often polycythemia than their co-twin, but not when born by CS.

"Stepped care": a health technology solution for delivering cognitive behavioral therapy as a first line insomnia treatment.

PubMed

Espie, Colin A

2009-12-01

There is a large body of evidence that Cognitive Behavioral Therapy for insomnia (CBT) is an effective treatment for persistent insomnia. However, despite two decades of research it is still not readily available, and there are no immediate signs that this situation is about to change. This paper proposes that a service delivery model, based on "stepped care" principles, would enable this relatively scarce healthcare expertise to be applied in a cost-effective way to achieve optimal development of CBT services and best clinical care. The research evidence on methods of delivering CBT, and the associated clinical leadership roles, is reviewed. On this basis, self-administered CBT is posited as the "entry level" treatment for stepped care, with manualized, small group, CBT delivered by nurses, at the next level. Overall, a hierarchy comprising five levels of CBT stepped care is suggested. Allocation to a particular level should reflect assessed need, which in turn represents increased resource requirement in terms of time, cost and expertise. Stepped care models must also be capable of "referring" people upstream where there is an incomplete therapeutic response to a lower level intervention. Ultimately, the challenge is for CBT to be delivered competently and effectively in diversified formats on a whole population basis. That is, it needs to become "scalable". This will require a robust approach to clinical governance.

A systematic review of the use of an expertise-based randomised controlled trial design.

PubMed

Cook, Jonathan A; Elders, Andrew; Boachie, Charles; Bassinga, Ted; Fraser, Cynthia; Altman, Doug G; Boutron, Isabelle; Ramsay, Craig R; MacLennan, Graeme S

2015-05-30

Under a conventional two-arm randomised trial design, participants are allocated to an intervention and participating health professionals are expected to deliver both interventions. However, health professionals often have differing levels of expertise in a skill-based interventions such as surgery or psychotherapy. An expertise-based approach to trial design, where health professionals only deliver an intervention in which they have expertise, has been proposed as an alternative. The aim of this project was to systematically review the use of an expertise-based trial design in the medical literature. We carried out a comprehensive search of nine databases--AMED, BIOSIS, CENTRAL, CINAHL, Cochrane Methodology Register, EMBASE, MEDLINE, Science Citation Index, and PsycINFO--from 1966 to 2012 and performed citation searches using the ISI Citation Indexes and Scopus. Studies that used an expertise-based trial design were included. Two review authors independently screened the titles and abstracts and assessed full-text reports. Data were extracted and summarised on the study characteristics, general and expertise-specific study methodology, and conduct. In total, 7476 titles and abstracts were identified, leading to 43 included studies (54 articles). The vast majority (88%) used a pure expertise-based design; three (7%) adopted a hybrid design, and two (5%) used a design that was unclear. Most studies compared substantially different interventions (79%). In many cases, key information relating to the expertise-based design was absent; only 12 (28%) reported criteria for delivering both interventions. Most studies recruited the target sample size or very close to it (median of 101, interquartile range of 94 to 118), although the target was reported for only 40% of studies. The proportion of participants who received the allocated intervention was high (92%, interquartile range of 82 to 99%). While use of an expertise-based trial design is growing, it remains uncommon. Reporting of study methodology and, particularly, expertise-related methodology was poor. Empirical evidence provided some support for purported benefits such as high levels of recruitment and compliance with allocation. An expertise-based trial design should be considered but its value seems context-specific, particularly when interventions differ substantially or interventions are typically delivered by different health professionals.

Mobius Assembly: A versatile Golden-Gate framework towards universal DNA assembly.

PubMed

Andreou, Andreas I; Nakayama, Naomi

2018-01-01

Synthetic biology builds upon the foundation of engineering principles, prompting innovation and improvement in biotechnology via a design-build-test-learn cycle. A community-wide standard in DNA assembly would enable bio-molecular engineering at the levels of predictivity and universality in design and construction that are comparable to other engineering fields. Golden Gate Assembly technology, with its robust capability to unidirectionally assemble numerous DNA fragments in a one-tube reaction, has the potential to deliver a universal standard framework for DNA assembly. While current Golden Gate Assembly frameworks (e.g. MoClo and Golden Braid) render either high cloning capacity or vector toolkit simplicity, the technology can be made more versatile-simple, streamlined, and cost/labor-efficient, without compromising capacity. Here we report the development of a new Golden Gate Assembly framework named Mobius Assembly, which combines vector toolkit simplicity with high cloning capacity. It is based on a two-level, hierarchical approach and utilizes a low-frequency cutter to reduce domestication requirements. Mobius Assembly embraces the standard overhang designs designated by MoClo, Golden Braid, and Phytobricks and is largely compatible with already available Golden Gate part libraries. In addition, dropout cassettes encoding chromogenic proteins were implemented for cost-free visible cloning screening that color-code different cloning levels. As proofs of concept, we have successfully assembled up to 16 transcriptional units of various pigmentation genes in both operon and multigene arrangements. Taken together, Mobius Assembly delivers enhanced versatility and efficiency in DNA assembly, facilitating improved standardization and automation.

Automatic Near-Real-Time Image Processing Chain for Very High Resolution Optical Satellite Data

NASA Astrophysics Data System (ADS)

Ostir, K.; Cotar, K.; Marsetic, A.; Pehani, P.; Perse, M.; Zaksek, K.; Zaletelj, J.; Rodic, T.

2015-04-01

In response to the increasing need for automatic and fast satellite image processing SPACE-SI has developed and implemented a fully automatic image processing chain STORM that performs all processing steps from sensor-corrected optical images (level 1) to web-delivered map-ready images and products without operator's intervention. Initial development was tailored to high resolution RapidEye images, and all crucial and most challenging parts of the planned full processing chain were developed: module for automatic image orthorectification based on a physical sensor model and supported by the algorithm for automatic detection of ground control points (GCPs); atmospheric correction module, topographic corrections module that combines physical approach with Minnaert method and utilizing anisotropic illumination model; and modules for high level products generation. Various parts of the chain were implemented also for WorldView-2, THEOS, Pleiades, SPOT 6, Landsat 5-8, and PROBA-V. Support of full-frame sensor currently in development by SPACE-SI is in plan. The proposed paper focuses on the adaptation of the STORM processing chain to very high resolution multispectral images. The development concentrated on the sub-module for automatic detection of GCPs. The initially implemented two-step algorithm that worked only with rasterized vector roads and delivered GCPs with sub-pixel accuracy for the RapidEye images, was improved with the introduction of a third step: super-fine positioning of each GCP based on a reference raster chip. The added step exploits the high spatial resolution of the reference raster to improve the final matching results and to achieve pixel accuracy also on very high resolution optical satellite data.

A high-power versatile wireless power transfer for biomedical implants.

PubMed

Jiang, Hao; Zhang, Jun Min; Liou, Shy Shenq; Fechter, Richard; Hirose, Shinjiro; Harrison, Michael; Roy, Shuvo

2010-01-01

Implantable biomedical actuators are highly desired in modern medicine. However, how to power up these biomedical implants remains a challenge since most of them need more than several hundreds mW of power. The air-core based radio-frequency transformer (two face-to-face inductive coils) has been the only non-toxic and non-invasive power source for implants for the last three decades [1]. For various technical constraints, the maximum delivered power is limited by this approach. The highest delivered power reported is 275 mW over 1 cm distance [2]. Also, the delivered power is highly vulnerable to the coils' geometrical arrangement and the electrical property of the medium around them. In this paper, a novel rotating-magnets based wireless power transfer that can deliver ∼10 W over 1 cm is demonstrated. The delivered power is significantly higher than the existing start-of-art. Further, the new method is versatile since there is no need to have the impedance matching networks that are highly susceptible to the operating frequency, the coil arrangement and the environment.

Apparatus for in situ heating and vitrification

DOEpatents

Buelt, James L.; Oma, Kenton H.; Eschbach, Eugene A.

1994-01-01

An apparatus for decontaminating ground areas where toxic chemicals are buried includes a plurality of spaced electrodes located in the ground and to which a voltage is applied for bringing about current flow. Power delivered to the ground volatilizes the chemicals that are then collected and directed to a gas treatment system. A preferred form of the invention employs high voltage arc discharge between the electrodes for heating a ground region to relatively high temperatures at relatively low power levels. Electrodes according to the present invention are provided with preferentially active lower portions between which current flows for the purpose of soil heating or for soil melting and vitrification. Promoting current flow below ground level avoids predominantly superficial treatment and increases electrode life.

Apparatus for in situ heating and vitrification

DOEpatents

Buelt, J.L.; Oma, K.H.; Eschbach, E.A.

1994-05-31

An apparatus for decontaminating ground areas where toxic chemicals are buried includes a plurality of spaced electrodes located in the ground and to which a voltage is applied for bringing about current flow. Power delivered to the ground volatilizes the chemicals that are then collected and directed to a gas treatment system. A preferred form of the invention employs high voltage arc discharge between the electrodes for heating a ground region to relatively high temperatures at relatively low power levels. Electrodes according to the present invention are provided with preferentially active lower portions between which current flows for the purpose of soil heating or for soil melting and vitrification. Promoting current flow below ground level avoids predominantly superficial treatment and increases electrode life. 15 figs.

Phase 1 Trial of Sorafenib and Stereotactic Body Radiation Therapy for Hepatocellular Carcinoma

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

Brade, Anthony M., E-mail: anthony.brade@rmp.uhn.on.ca; Department of Radiation Oncology, Faculty of Medicine, University of Toronto, Toronto, Ontario; Ng, Sylvia

Purpose: To determine the maximally tolerated dose of sorafenib delivered before, during, and after stereotactic body radiation therapy (SBRT) in hepatocellular carinoma (HCC). Methods and Materials: Eligible patients had locally advanced Child-Pugh class A HCC, showed Eastern Cooperative Oncology Group performance status 0-1, and were ineligible for standard local-regional therapies. Sorafenib was dose escalated in 2 strata: (1) low effective irradiated liver volume (veff) < 30% and (2) high veff 30%to 60%. Sorafenib (400 mg daily = dose level 1) was administered for 12 weeks, with 6 fractions SBRT delivered weeks 2 and 3, and escalation to full dose (400 mg twice daily) after 12 weeks as tolerated.more » Standard 3 + 3 cohorts with dose escalation of sorafenib were planned. Results: Sixteen patients (4 low veff, median dose 51 Gy; 12 high veff, median dose 33 Gy) were treated at 2 sorafenib dose levels. Of those patients 75% were had Barcelona Clinic Liver Cancer stage C, and 63% had main branch portal vein invasion. In the low veff stratum, no dose-limiting toxicities (DLTs) were observed in 4 patients treated with SBRT and sorafenib 400 mg. Inb the high veff stratum: 2 of 3 evaluable patients treated with sorafenib 400 mg experienced DLT (grade 3 large bowel bleed and grade 4 bowel obstruction 51 and 27 days, respectively, after SBRT). One of 6 evaluable patients at dose level −1 (200 mg once daily) experienced a grade 3 tumor rupture at week 5. Median overall survival and in-field local progression have not been reached. Worsening of Child-Pugh liver function class was seen in 6 of 12 patients in the high veff stratum. Conclusions: Significant toxicity was observed in the high veff stratum, and concurrent SBRT with sorafenib is not recommended outside a clinical trial.« less

Alcohol and disadvantaged men: A feasibility trial of an intervention delivered by mobile phone.

PubMed

Crombie, Iain K; Irvine, Linda; Falconer, Donald W; Williams, Brian; Ricketts, Ian W; Jones, Claire; Humphris, Gerry; Norrie, John; Slane, Peter; Rice, Peter

2017-07-01

Disadvantaged men suffer substantial harm from heavy drinking. This feasibility study developed and evaluated the methods for a trial of a brief intervention delivered by text messages to disadvantaged men. It aimed to test the methods for recruitment and retention, to monitor engagement with the intervention and assess the overall acceptability of study methods. Disadvantaged men aged 25-44 years who had ≥2 episodes of binge drinking (≥8 units in one session) in the preceding month were recruited. Two recruitment strategies were assessed: recruitment from general practice registers and by a community outreach strategy. Theoretically and empirically based text messages were tailored to the target group. The study recruited 67 disadvantaged men at high risk of alcohol-related harm, exceeding the target of 60. Evaluation showed that 95% of text messages were delivered, and the men engaged enthusiastically with the intervention. Retention at follow up was 96%. Outcomes were successfully measured on all men followed up. This provided data for the sample size calculation for the full trial. Post-study evaluation showed high levels of satisfaction with the study. This study has shown that disadvantaged men can be recruited and follow-up data obtained in an alcohol intervention study. The study methods were acceptable to the participants. The men recruited were at high risk of alcohol-related harms. It also clarified ways in which the recruitment strategy, the baseline questionnaire and the intervention could be improved. The full trial is currently underway. [Crombie IK, Irvine L, Falconer DW, Williams B, Ricketts IW, Jones C, Humphris G, Norrie J, Slane P, Rice P. Alcohol and disadvantaged men: A feasibility trial of an intervention delivered by mobile phone. Drug Alcohol Rev 2017;36:468-476]. © 2017 The Authors. Drug and Alcohol Review published by John Wiley & Sons Australia, Ltd on behalf of Australasian Professional Society on Alcohol and other Drugs.

Alcohol and disadvantaged men: A feasibility trial of an intervention delivered by mobile phone

PubMed Central

Irvine, Linda; Falconer, Donald W.; Williams, Brian; Ricketts, Ian W.; Jones, Claire; Humphris, Gerry; Norrie, John; Slane, Peter; Rice, Peter

2017-01-01

Abstract Introduction and Aims Disadvantaged men suffer substantial harm from heavy drinking. This feasibility study developed and evaluated the methods for a trial of a brief intervention delivered by text messages to disadvantaged men. It aimed to test the methods for recruitment and retention, to monitor engagement with the intervention and assess the overall acceptability of study methods. Design and Methods Disadvantaged men aged 25–44 years who had ≥2 episodes of binge drinking (≥8 units in one session) in the preceding month were recruited. Two recruitment strategies were assessed: recruitment from general practice registers and by a community outreach strategy. Theoretically and empirically based text messages were tailored to the target group. Results The study recruited 67 disadvantaged men at high risk of alcohol‐related harm, exceeding the target of 60. Evaluation showed that 95% of text messages were delivered, and the men engaged enthusiastically with the intervention. Retention at follow up was 96%. Outcomes were successfully measured on all men followed up. This provided data for the sample size calculation for the full trial. Post‐study evaluation showed high levels of satisfaction with the study. Discussion and Conclusions This study has shown that disadvantaged men can be recruited and follow‐up data obtained in an alcohol intervention study. The study methods were acceptable to the participants. The men recruited were at high risk of alcohol‐related harms. It also clarified ways in which the recruitment strategy, the baseline questionnaire and the intervention could be improved. The full trial is currently underway. [Crombie IK, Irvine L, Falconer DW, Williams B, Ricketts IW, Jones C, Humphris G, Norrie J, Slane P, Rice P. Alcohol and disadvantaged men: A feasibility trial of an intervention delivered by mobile phone. Drug Alcohol Rev 2017;36:468‐476] PMID:28295794

Redefining global health-care delivery.

PubMed

Kim, Jim Yong; Farmer, Paul; Porter, Michael E

2013-09-21

Initiatives to address the unmet needs of those facing both poverty and serious illness have expanded significantly over the past decade. But many of them are designed in an ad-hoc manner to address one health problem among many; they are too rarely assessed; best practices spread slowly. When assessments of delivery do occur, they are often narrow studies of the cost-effectiveness of a single intervention rather than the complex set of them required to deliver value to patients and their families. We propose a framework for global health-care delivery and evaluation by considering efforts to introduce HIV/AIDS care to resource-poor settings. The framework introduces the notion of care delivery value chains that apply a systems-level analysis to the complex processes and interventions that must occur, across a health-care system and over time, to deliver high-value care for patients with HIV/AIDS and cooccurring conditions, from tuberculosis to malnutrition. To deliver value, vertical or stand-alone projects must be integrated into shared delivery infrastructure so that personnel and facilities are used wisely and economies of scale reaped. Two other integrative processes are necessary for delivering and assessing value in global health: one is the alignment of delivery with local context by incorporating knowledge of both barriers to good outcomes (from poor nutrition to a lack of water and sanitation) and broader social and economic determinants of health and wellbeing (jobs, housing, physical infrastructure). The second is the use of effective investments in care delivery to promote equitable economic development, especially for those struggling against poverty and high burdens of disease. We close by reporting our own shared experience of seeking to move towards a science of delivery by harnessing research and training to understand and improve care delivery. Copyright © 2013 Elsevier Ltd. All rights reserved.

What are the Benefits of Interacting with Nature?

PubMed Central

Keniger, Lucy E.; Gaston, Kevin J.; Irvine, Katherine N.; Fuller, Richard A.

2013-01-01

There is mounting empirical evidence that interacting with nature delivers measurable benefits to people. Reviews of this topic have generally focused on a specific type of benefit, been limited to a single discipline, or covered the benefits delivered from a particular type of interaction. Here we construct novel typologies of the settings, interactions and potential benefits of people-nature experiences, and use these to organise an assessment of the benefits of interacting with nature. We discover that evidence for the benefits of interacting with nature is geographically biased towards high latitudes and Western societies, potentially contributing to a focus on certain types of settings and benefits. Social scientists have been the most active researchers in this field. Contributions from ecologists are few in number, perhaps hindering the identification of key ecological features of the natural environment that deliver human benefits. Although many types of benefits have been studied, benefits to physical health, cognitive performance and psychological well-being have received much more attention than the social or spiritual benefits of interacting with nature, despite the potential for important consequences arising from the latter. The evidence for most benefits is correlational, and although there are several experimental studies, little as yet is known about the mechanisms that are important for delivering these benefits. For example, we do not know which characteristics of natural settings (e.g., biodiversity, level of disturbance, proximity, accessibility) are most important for triggering a beneficial interaction, and how these characteristics vary in importance among cultures, geographic regions and socio-economic groups. These are key directions for future research if we are to design landscapes that promote high quality interactions between people and nature in a rapidly urbanising world. PMID:23466828

What are the benefits of interacting with nature?

PubMed

Keniger, Lucy E; Gaston, Kevin J; Irvine, Katherine N; Fuller, Richard A

2013-03-06

There is mounting empirical evidence that interacting with nature delivers measurable benefits to people. Reviews of this topic have generally focused on a specific type of benefit, been limited to a single discipline, or covered the benefits delivered from a particular type of interaction. Here we construct novel typologies of the settings, interactions and potential benefits of people-nature experiences, and use these to organise an assessment of the benefits of interacting with nature. We discover that evidence for the benefits of interacting with nature is geographically biased towards high latitudes and Western societies, potentially contributing to a focus on certain types of settings and benefits. Social scientists have been the most active researchers in this field. Contributions from ecologists are few in number, perhaps hindering the identification of key ecological features of the natural environment that deliver human benefits. Although many types of benefits have been studied, benefits to physical health, cognitive performance and psychological well-being have received much more attention than the social or spiritual benefits of interacting with nature, despite the potential for important consequences arising from the latter. The evidence for most benefits is correlational, and although there are several experimental studies, little as yet is known about the mechanisms that are important for delivering these benefits. For example, we do not know which characteristics of natural settings (e.g., biodiversity, level of disturbance, proximity, accessibility) are most important for triggering a beneficial interaction, and how these characteristics vary in importance among cultures, geographic regions and socio-economic groups. These are key directions for future research if we are to design landscapes that promote high quality interactions between people and nature in a rapidly urbanising world.

Evaluating display fidelity and interaction fidelity in a virtual reality game.

PubMed

McMahan, Ryan P; Bowman, Doug A; Zielinski, David J; Brady, Rachael B

2012-04-01

In recent years, consumers have witnessed a technological revolution that has delivered more-realistic experiences in their own homes through high-definition, stereoscopic televisions and natural, gesture-based video game consoles. Although these experiences are more realistic, offering higher levels of fidelity, it is not clear how the increased display and interaction aspects of fidelity impact the user experience. Since immersive virtual reality (VR) allows us to achieve very high levels of fidelity, we designed and conducted a study that used a six-sided CAVE to evaluate display fidelity and interaction fidelity independently, at extremely high and low levels, for a VR first-person shooter (FPS) game. Our goal was to gain a better understanding of the effects of fidelity on the user in a complex, performance-intensive context. The results of our study indicate that both display and interaction fidelity significantly affect strategy and performance, as well as subjective judgments of presence, engagement, and usability. In particular, performance results were strongly in favor of two conditions: low-display, low-interaction fidelity (representative of traditional FPS games) and high-display, high-interaction fidelity (similar to the real world).

VP2 (PTA motif) encoding DNA vaccine confers protection against lethal challenge with infectious pancreatic necrosis virus (IPNV) in trout.

PubMed

Ahmadivand, Sohrab; Soltani, Mehdi; Behdani, Mahdi; Evensen, Øystein; Alirahimi, Ehsan; Soltani, Elahe; Hassanzadeh, Reza; Ashrafi-Helan, Javad

2018-02-01

IPNV in Atlantic salmon is represented by various strains with different virulence and immunogenicity linked to various motifs of the VP2 capsid. IPNV variant with P 217 , T 221 , A 247 (PTA) motif is found to be avirulent in Atlantic salmon, but virulent in rainbow trout, and other salmonid species. This study describes a DNA vaccine delivered intramuscularly encoding the VP2 protein of infectious pancreatic necrosis virus (IPNV) with PTA motif that confers high protection in rainbow trout (Oncorhynchus mykiss). Intramuscular injection of 2, 5 and 10 μg of DNA (pcDNA3.1-VP2) in rainbow trout fry (4-5 g), confers relative protection of 75-83% in the different vaccine groups at 30 days post vaccination (450° days). The VP2 gene is expressed in spleen, kidney, muscle and liver at day 30 post-vaccination (RT-PCR), and IFN-1 and Mx-1 mRNA are upregulated at early time post vaccination, and so also for IgM, IgT, CD4 and CD8 in the head kidney of vaccinated fish compared to controls, 15 and 30 days post vaccination. Significant increase of serum anti-IPNV antibodies was found 30-90 days post-vaccination that was correlated with protection levels. Mortality corresponded with viral VP4 gene expression were significantly decreased in vaccinated and challenged fish. This shows for the first time that a VP2-encoding DNA vaccine delivered intramuscularly elicits a high level of protection alongside with high levels of circulating antibodies in rainbow trout and a lowered viral replication. Copyright © 2017 Elsevier Ltd. All rights reserved.

High-throughput Toroidal Grating Beamline for Photoelectron Spectroscopy at CAMD

PubMed Central

Kizilkaya, O; Jiles, R W; Patterson, M C; Thibodeaux, C A; Poliakoff, E D; Sprunger, P T; Kurtz, R L; Morikawa, E

2016-01-01

A 5 meter toroidal grating (5m-TGM) beamline has been commissioned to deliver 28 mrad of bending magnet radiation to an ultrahigh vacuum endstation chamber to facilitate angle resolved photoelectron spectroscopy. The 5m-TGM beamline is equipped with Au-coated gratings with 300, 600 and 1200 lines/mm providing monochromatized synchrotron radiation in the energy ranges 25-70 eV, 50–120 eV and 100–240 eV, respectively. The beamline delivers excellent flux (~1014-1017 photons/sec/100mA) and a combined energy resolution of 189 meV for the beamline (at 1.0 mm slit opening) and HA-50 hemispherical analyzer was obtained at the Fermi level of polycrystalline gold crystal. Our preliminary photoelectron spectroscopy results of phenol adsorption on TiO2 (110) surface reveals the metal ion (Ti) oxidation. PMID:27134636

Obstetric outcome in pregnant women subjected to domestic violence.

PubMed

Ameh, N; Shittu, S O; Abdul, M A

2009-06-01

To determine the prevalence of domestic violence and its relationship to adverse obstetric outcomes amongst pregnant women who deliver at a tertiary level hospital in Zaria, Nigeria. A cross-sectional study involving 310 women who delivered at the labour ward. Questionnaires were administered to parturient women. Details of their socio-demographic characteristics and obstetric outcome were compiled and the relationship to experiences of domestic violence studied. The prevalence of domestic violence was 28.4%. There was positive relationship between domestic violence during pregnancy, non-supervision of pregnancy and poor attendances to antenatal clinic (p<0.05). There was however, no statistically significant relationship between domestic violence, and complications of labour and neonatal outcome (p>0.05). The prevalence of domestic violence in pregnancy is high in this environment. Poor attendances to the antenatal clinic is a significant association.

High-Level Heteroatom Doped Two-Dimensional Carbon Architectures for Highly Efficient Lithium-Ion Storage.

PubMed

Wang, Zhijie; Wang, Yanyan; Wang, Wenhui; Yu, Xiaoliang; Lv, Wei; Xiang, Bin; He, Yan-Bing

2018-01-01

In this work, high-level heteroatom doped two-dimensional hierarchical carbon architectures (H-2D-HCA) are developed for highly efficient Li-ion storage applications. The achieved H-2D-HCA possesses a hierarchical 2D morphology consisting of tiny carbon nanosheets vertically grown on carbon nanoplates and containing a hierarchical porosity with multiscale pore size. More importantly, the H-2D-HCA shows abundant heteroatom functionality, with sulfur (S) doping of 0.9% and nitrogen (N) doping of as high as 15.5%, in which the electrochemically active N accounts for 84% of total N heteroatoms. In addition, the H-2D-HCA also has an expanded interlayer distance of 0.368 nm. When used as lithium-ion battery anodes, it shows excellent Li-ion storage performance. Even at a high current density of 5 A g -1 , it still delivers a high discharge capacity of 329 mA h g -1 after 1,000 cycles. First principle calculations verifies that such unique microstructure characteristics and high-level heteroatom doping nature can enhance Li adsorption stability, electronic conductivity and Li diffusion mobility of carbon nanomaterials. Therefore, the H-2D-HCA could be promising candidates for next-generation LIB anodes.

High-Level Heteroatom Doped Two-Dimensional Carbon Architectures for Highly Efficient Lithium-Ion Storage

NASA Astrophysics Data System (ADS)

Wang, Zhijie; Wang, Yanyan; Wang, Wenhui; Yu, Xiaoliang; Lv, Wei; Xiang, Bin; He, Yan-Bing

2018-04-01

In this work, high-level heteroatom doped two-dimensional hierarchical carbon architectures (H-2D-HCA) are developed for highly efficient Li-ion storage applications. The achieved H-2D-HCA possesses a hierarchical 2D morphology consisting of tiny carbon nanosheets vertically grown on carbon nanoplates and containing a hierarchical porosity with multiscale pore size. More importantly, the H-2D-HCA shows abundant heteroatom functionality, with sulfur (S) doping of 0.9 % and nitrogen (N) doping of as high as 15.5 %, in which the electrochemically active N accounts for 84 % of total N heteroatoms. In addition, the H-2D-HCA also has an expanded interlayer distance of 0.368 nm. When used as lithium-ion battery anodes, it shows excellent Li-ion storage performance. Even at a high current density of 5 A g-1, it still delivered a high discharge capacity of 329 mA h g-1 after 1000 cycles. First principle calculations verified that such unique microstructure characteristics and high-level heteroatom doping nature can enhance Li adsorption stability, electronic conductivity and Li diffusion mobility of carbon nanomaterials. Therefore, the H-2D-HCA could be promising candidates for next-generation LIB anodes.

Experience with the high-intensity sweetener saccharin impairs glucose homeostasis and GLP-1 release in rats

PubMed Central

Swithers, Susan E.; Laboy, Alycia F.; Clark, Kiely; Cooper, Stephanie; Davidson, T.L.

2012-01-01

Previous work from our lab has demonstrated that experience with high-intensity sweeteners in rats leads to increased food intake, body weight gain and adiposity, along with diminished caloric compensation and decreased thermic effect of food. These changes may occur as a result of interfering with learned relations between the sweet taste of food and the caloric or nutritive consequences of consuming those foods. The present experiments determined whether experience with the high-intensity sweetener saccharin versus the caloric sweetener glucose affected blood glucose homeostasis. The results demonstrated that during oral glucose tolerance tests, blood glucose levels were more elevated in animals that had previously consumed the saccharin-sweetened supplements. In contrast, during glucose tolerance tests when a glucose solution was delivered directly into the stomach, no differences in blood glucose levels between the groups were observed. Differences in oral glucose tolerance responses were not accompanied by differences in insulin release; insulin release was similar in animals previously exposed to saccharin and those previously exposed to glucose. However, release of GLP-1 in response to an oral glucose tolerance test, but not to glucose tolerance tests delivered by gavage, was significantly lower in saccharin-exposed animals compared to glucose-exposed animals. Differences in both blood glucose and GLP-1 release in saccharin animals were rapid and transient, and suggest that one mechanism by which exposure to high-intensity sweeteners that interfere with a predictive relation between sweet tastes and calories may impair energy balance is by suppressing GLP-1 release, which could alter glucose homeostasis and reduce satiety. PMID:22561130

Laser Remote Sensing from ISS: CATS Cloud and Aerosol Level 2 Data Products (Heritage Edition)

NASA Technical Reports Server (NTRS)

Rodier, Sharon; Palm, Steve; Vaughan, Mark; Yorks, John; McGill, Matt; Jensen, Mike; Murray, Tim; Trepte, Chip

2016-01-01

With the recent launch of the Cloud-Aerosol Transport System (CATS) we have the opportunity to acquire a continuous record of space based lidar measurements spanning from the Cloud-Aerosol Lidar and Infrared Pathfinder Satellite Observations (CALIPSO) era to the start of the EarthCARE mission. Utilizing existing well-validated science algorithms from the CALIPSO mission, we will ingest the CATS data stream and deliver high-quality lidar data sets to the user community at the earliest possible opportunity. In this paper we present an overview of procedures necessary to generate CALIPSO-like lidar level 2 data products from the CATS level 1 data products.

Following through: The consistency of survivorship care plan use in United States cancer programs

PubMed Central

Deal, Allison M.; Mayer, Deborah K.; Weiner, Bryan J.

2014-01-01

Background The Institute of Medicine suggests that consistent survivorship care plan (SCP) use involves developing and delivering SCPs to all cancer survivors and their primary care providers (PCPs). We describe the consistency of SCP use in US cancer programs and assess its relationship with cancer program-level determinants. Methods We surveyed employees knowledgeable about survivorship practices in cancer programs reporting current SCP use (n=36; 81% response rate). We operationalized consistent SCP use as whether SCPs were (1) developed for ≥75% survivors; (2) delivered to ≥75% survivors; (3) delivered to ≥75% PCPs; and (4) all of the above. We use descriptive statistics to report SCP use consistency and evaluate associations using Fisher’s Exact and Wilcoxon Rank Sum tests. Results SCPs were developed for ≥75% survivors in five programs (15%); eight (25%) delivered ≥75% SCPs to survivors; seven (23%) delivered ≥75% SCPs to PCPs; only one program (4%) met all three criteria. We found relationships between SCP use consistency and geographic region (p = .05); initiating SCP use in response to survivors’ requests (p = .03); and membership in the National Cancer Institute’s National Community Cancer Centers Program (p = .01). Conclusion SCP use is highly inconsistent. Survivors and cancer care quality improvement organizations may play a key role in improving the consistency of SCP use in US cancer programs. Survivors can initiate SCP use. Cancer care quality improvement organizations can specify how cancer programs’ compliance with SCP guidelines will be assessed. Future research should identify mechanisms underlying the relationships that we found. PMID:24577781

Measles Vaccine.

PubMed

Griffin, Diane E

2018-03-01

Measles remains an important cause of child morbidity and mortality worldwide despite the availability of a safe and efficacious vaccine. The current measles virus (MeV) vaccine was developed empirically by attenuation of wild-type (WT) MeV by in vitro passage in human and chicken cells and licensed in 1963. Additional passages led to further attenuation and the successful vaccine strains in widespread use today. Attenuation is associated with decreased replication in lymphoid tissue, but the molecular basis for this restriction has not been identified. The immune response is age dependent, inhibited by maternal antibody (Ab) and involves induction of both Ab and T cell responses that resemble the responses to WT MeV infection, but are lower in magnitude. Protective immunity is correlated with levels of neutralizing Ab, but the actual immunologic determinants of protection are not known. Because measles is highly transmissible, control requires high levels of population immunity. Delivery of the two doses of vaccine needed to achieve >90% immunity is accomplished by routine immunization of infants at 9-15 months of age followed by a second dose delivered before school entry or by periodic mass vaccination campaigns. Because delivery by injection creates hurdles to sustained high coverage, there are efforts to deliver MeV vaccine by inhalation. In addition, the safety record for the vaccine combined with advances in reverse genetics for negative strand viruses has expanded proposed uses for recombinant versions of measles vaccine as vectors for immunization against other infections and as oncolytic agents for a variety of tumors.

Performance Assessment of Baseline Cells for the High Efficiency Space Power Systems Project

NASA Technical Reports Server (NTRS)

Schneidegger, Brianne T.

2012-01-01

The Enabling Technology Development and Demonstration (ETDD) Program High Efficiency Space Power Systems (HESPS) Project, formerly the Exploration Technology Development Program (ETDP) Energy Storage Project is tasked with developing advanced lithium-ion cells for future NASA Exploration missions. Under this project, components under development via various in-house and contracted efforts are delivered to Saft America for scale-up and integration into cells. Progress toward meeting project goals will be measured by comparing the performance to these cells with cells of a similar format with Saft s state-of-the-art aerospace chemistry. This report discusses the results of testing performed on the first set of baseline cells delivered by Saft to the NASA Glenn Research Center. This build is a cylindrical "DD" geometry with a 10 Ah nameplate capacity. Testing is being performed to establish baseline cell performance at conditions relevant to ETDD HESPS Battery Key Performance Parameter (KPP) goals including various temperatures, rates, and cycle life conditions. Data obtained from these cells will serve as a performance baseline for future cell builds containing optimized ETDD HESPSdeveloped materials. A test plan for these cells was developed to measure cell performance against the high energy cell KPP goals. The goal for cell-level specific energy of the high energy technology is 180 Wh/kg at a C/10 discharge rate and 0 C. The cells should operate for at least 2000 cycles at 100 percent DOD with 80 percent capacity retention. Baseline DD cells delivered 152 Wh/kg at 20 C. This number decreased to 143.9 Wh/kg with a 0 C discharge. This report provides performance data and summarizes results of the testing performed on the DD cells.

Plasma source development for fusion-relevant material testing

DOE PAGES

Caughman, John B. O.; Goulding, Richard H.; Biewer, Theodore M.; ...

2017-05-01

Plasma facing materials in the divertor of a magnetic fusion reactor will have to tolerate steady-state plasma heat fluxes in the range of 10 MW/m2 for ~107 sec, in addition to fusion neutron fluences, which can damage the plasma facing materials to high displacements per atom (dpa) of ~50 dpa . Material solutions needed for the plasma facing components are yet to be developed and tested. The Materials Plasma Exposure eXperiment (MPEX) is a newly proposed steady state linear plasma device that is designed to deliver the necessary plasma heat flux to a target for this material testing, including themore » capability to expose a-priori neutron damaged material samples to those plasmas. The requirements of the plasma source needed to deliver this plasma heat flux are being developed on the Proto-MPEX device, which is a linear high-intensity radio frequency (RF) plasma source that combines a high-density helicon plasma generator with electron and ion heating sections. It is being used to study the physics of heating over-dense plasmas in a linear configuration. The helicon plasma is operated at 13.56 MHz with RF power levels up to 120 kW. Microwaves at 28 GHz (~30 kW) are coupled to the electrons in the over-dense helicon plasma via Electron Bernstein Waves (EBW), and ion cyclotron heating at 7-9 MHz (~30 kW) is via a magnetic beach approach. High plasma densities >6x1019/m3 have been produced in deuterium, with electron temperatures that can range from 2 to >10 eV. Operation with on-axis magnetic field strengths between 0.6 and 1.4 T is typical. The plasma heat flux delivered to a target can be > 10 MW/m2, depending on the operating conditions.« less

Plasma source development for fusion-relevant material testing

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

Caughman, John B. O.; Goulding, Richard H.; Biewer, Theodore M.

Plasma facing materials in the divertor of a magnetic fusion reactor will have to tolerate steady-state plasma heat fluxes in the range of 10 MW/m2 for ~107 sec, in addition to fusion neutron fluences, which can damage the plasma facing materials to high displacements per atom (dpa) of ~50 dpa . Material solutions needed for the plasma facing components are yet to be developed and tested. The Materials Plasma Exposure eXperiment (MPEX) is a newly proposed steady state linear plasma device that is designed to deliver the necessary plasma heat flux to a target for this material testing, including themore » capability to expose a-priori neutron damaged material samples to those plasmas. The requirements of the plasma source needed to deliver this plasma heat flux are being developed on the Proto-MPEX device, which is a linear high-intensity radio frequency (RF) plasma source that combines a high-density helicon plasma generator with electron and ion heating sections. It is being used to study the physics of heating over-dense plasmas in a linear configuration. The helicon plasma is operated at 13.56 MHz with RF power levels up to 120 kW. Microwaves at 28 GHz (~30 kW) are coupled to the electrons in the over-dense helicon plasma via Electron Bernstein Waves (EBW), and ion cyclotron heating at 7-9 MHz (~30 kW) is via a magnetic beach approach. High plasma densities >6x1019/m3 have been produced in deuterium, with electron temperatures that can range from 2 to >10 eV. Operation with on-axis magnetic field strengths between 0.6 and 1.4 T is typical. The plasma heat flux delivered to a target can be > 10 MW/m2, depending on the operating conditions.« less

A quick response four decade logarithmic high-voltage stepping supply

NASA Technical Reports Server (NTRS)

Doong, H.

1978-01-01

An improved high-voltage stepping supply, for space instrumentation is described where low power consumption and fast settling time between steps are required. The high-voltage stepping supply, utilizing an average power of 750 milliwatts, delivers a pair of mirror images with 64 level logarithmic outputs. It covers a four decade range of + or - 2500 to + or - 0.29 volts having an output stability of + or - 0.5 percent or + or - 20 millivolts for all line load and temperature variations. The supply provides a typical step setting time of 1 millisecond with 100 microseconds for the lower two decades. The versatile design features of the high-voltage stepping supply provides a quick response staircase generator as described or a fixed voltage with the option to change levels as required over large dynamic ranges without circuit modifications. The concept can be implemented up to + or - 5000 volts. With these design features, the high-voltage stepping supply should find numerous applications where charged particle detection, electro-optical systems, and high voltage scientific instruments are used.

Factors associated with patient preferences for communication of bad news.

PubMed

Fujimori, Maiko; Akechi, Tatsuo; Uchitomi, Yosuke

2017-06-01

Communication based on patient preferences can alleviate their psychological distress and is an important part of patient-centered care for physicians who have the task of conveying bad news to cancer patients. The present study aimed to explore the demographic, medical, and psychological factors associated with patient preferences with regard to communication of bad news. Outpatients with a variety of cancers were consecutively invited to participate in our study after their follow-up medical visit. A questionnaire assessed their preferences regarding the communication of bad news, covering four factors-(1) how bad news is delivered, (2) reassurance and emotional support, (3) additional information, and (4) setting-as well as on demographic, medical, and psychosocial factors. A total of 529 outpatients with a variety of cancers completed the questionnaire. Multiple regression analyses indicated that patients who were younger, female, had greater faith in their physician, and were more highly educated placed more importance on "how bad news is delivered" than patients who were older, male, had less faith in their physician, and a lower level of education. Female patients and patients without an occupation placed more importance on "reassurance and emotional support." Younger, female, and more highly educated patients placed more importance on "additional information." Younger, female, and more highly educated patients, along with patients who weren't undergoing active treatment placed more importance on "setting." Patient preferences with regard to communication of bad news are associated with factors related to patient background. Physicians should consider these characteristics when delivering bad news and use an appropriate communication style tailored to each patient.

Ku and K band GaN High Power Amplifier MMICs

DTIC Science & Technology

2017-03-20

end Ku-band HPA operates from 13 to 14.5 GHz and delivers 48 Watts of output power with 43% PAE. A high-end Ku-band HPA operates from 15.5 to 18 GHz and...delivers 25 Watts of output power with 45% PAE. A K-band HPA operates from 19.5 to 22 GHz and delivers 18 Watts of output power with 29% PAE...15.5 and 18 GHz. The circuit is a three-stage reactively-matched amplifier. A photograph of a fabricated high-end Ku-band GaN HPA is shown as an

Poly (lactide-co-glycolide)-polymethacrylate nanoparticles for intramuscular delivery of plasmid encoding interleukin-10 to prevent autoimmune diabetes in mice.

PubMed

Basarkar, Ashwin; Singh, Jagdish

2009-01-01

Determine the efficiency of cationic nanoparticles prepared by blending poly (lactide-co-glycolide; PLGA) and methacrylate copolymer (Eudragit(R) E100) to deliver a therapeutic gene encoding mouse interleukin-10, in vitro and in vivo. Nanoparticles prepared with PLGA and E100 were evaluated for delivery of plasmid DNA encoding mouse interleukin-10 in vitro and in vivo in mice upon intramuscular injection. Blood-glucose, serum interferon-gamma levels and histology of pancreas were studied to determine therapeutic efficacy. Histological evaluation of skeletal muscle from the injection site was performed to assess the biocompatibility of nanoparticles. PLGA/E100 nanoparticles showed endosomal escape evidenced by confocal microscopy and buffering ability. Transfecting HEK293 cells with plasmid-loaded PLGA/E100 nanoparticles resulted in significantly (p < 0.05) greater expression of interleukin-10 compared to PLGA nanoparticles. Mice treated with PLGA/E100 nanoparticles displayed higher serum levels of interleukin-10 and lower blood glucose levels compared to those treated with interleukin-10 plasmid alone or PLGA nanoparticles. High expression of interleukin-10 facilitated suppression of interferon-gamma levels and reduced islet infiltration. Histology of muscle showed that nanoparticles were biocompatible and did not cause chronic inflammatory response. Nanoparticles prepared by blending PLGA with methacrylate can efficiently and safely deliver plasmid DNA encoding mouse interleukin-10 leading to prevention of autoimmune diabetes.

Vertical silicon nanowires as a universal platform for delivering biomolecules into living cells

PubMed Central

Shalek, Alex K.; Robinson, Jacob T.; Karp, Ethan S.; Lee, Jin Seok; Ahn, Dae-Ro; Yoon, Myung-Han; Sutton, Amy; Jorgolli, Marsela; Gertner, Rona S.; Gujral, Taranjit S.; MacBeath, Gavin; Yang, Eun Gyeong; Park, Hongkun

2010-01-01

A generalized platform for introducing a diverse range of biomolecules into living cells in high-throughput could transform how complex cellular processes are probed and analyzed. Here, we demonstrate spatially localized, efficient, and universal delivery of biomolecules into immortalized and primary mammalian cells using surface-modified vertical silicon nanowires. The method relies on the ability of the silicon nanowires to penetrate a cell’s membrane and subsequently release surface-bound molecules directly into the cell’s cytosol, thus allowing highly efficient delivery of biomolecules without chemical modification or viral packaging. This modality enables one to assess the phenotypic consequences of introducing a broad range of biological effectors (DNAs, RNAs, peptides, proteins, and small molecules) into almost any cell type. We show that this platform can be used to guide neuronal progenitor growth with small molecules, knock down transcript levels by delivering siRNAs, inhibit apoptosis using peptides, and introduce targeted proteins to specific organelles. We further demonstrate codelivery of siRNAs and proteins on a single substrate in a microarray format, highlighting this technology’s potential as a robust, monolithic platform for high-throughput, miniaturized bioassays. PMID:20080678

The effects of environmental resource and security on aggressive behavior.

PubMed

Ng, Henry Kin Shing; Chow, Tak Sang

2017-05-01

Exposure to different environments has been reported to change aggressive behavior, but previous research did not consider the underlying elements that caused such an effect. Based on previous work on environmental perception, we examined the role of environmental resource and security in altering aggression level. In three experiments, participants were exposed to environments that varied in resource (High vs. Low) and security (High vs. Low) levels, after which aggression was measured. The environments were presented through visual priming (Experiments 1-2) and a first-person gameplay (Experiment 3). We observed a consistent resource-security interaction effect on aggression, operationalized as the level of noise blast (Experiment 1) and number of unpleasant pictures (Experiments 2-3) delivered to strangers by the participants. High resource levels associated with higher aggression in insecure conditions, but lower aggression in secure conditions. The findings suggest that the adaptive value of aggression varies under different environmental constraints. Implications are discussed in terms of the effects of adverse environments on aggression, and the nature's effects on social behavior. Aggr. Behav. 43:304-314, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Using Monte Carlo Simulation To Improve Cargo Mass Estimates For International Space Station Commercial Resupply Flights

DTIC Science & Technology

2016-12-01

laboratory. The transition of this function to the commercial sector under Firm Fixed-Price contracting has forced both NASA and commercial providers to...adjust to make this effort successful. Improving bag-level cargo launch manifests delivered from NASA to the provider more than a year in advance is...contracting has forced both NASA and commercial providers to adjust to make this effort successful. Improving bag-level cargo launch manifests delivered from

Integration & Validation of LCU with Different Sub-systems for Diacrode based amplifier

NASA Astrophysics Data System (ADS)

Rajnish, Kumar; Verma, Sriprakash; Soni, Dipal; Patel, Hriday; Suthar, Gajendra; Dalicha, Hrushikesh; Dhola, Hitesh; Patel, Amit; Upadhayay, Dishang; Jha, Akhil; Patel, Manoj; Trivedi, Rajesh; Machchhar, Harsha; Singh, Raghuraj; Mukherjee, Aparajita

2017-04-01

ITER-India is responsible to deliver nine (8+1 spare) ICH & CD Power Sources to ITER. Each power source is capable to deliver 2.5 MW at 35 to 65 MHz frequency range with a load condition up to VSWR 2:1. For remote operation of different subsystems, Local Control Unit (LCU) is developed. LCU is developed using PXI hardware and Schneider PLC with Lab VIEW-RT developmental environment. All the protection function of the amplifier is running on PXI 7841 R module that ensures hard wired protection logic. There are three level of protection function- first by power supply itself that detects overcurrent/overvoltage and trips itself and generate trip signal for further action. There are some direct hardwired signal interfaces between power supplies to protect the amplifier. Second level of protection is generated through integrated controller of amplifier i.e. Command Control Embedded (CCE) against arc and Anode over current. Third level of Protection is through LCU where different fault signals are received and processed to generate off command for different sub-systems. Before connecting different subsystem with High power RF amplifiers (Driver & Final stage), each subsystem is individually tested through LCU. All protection functions are tested before hooking up the subsystems with main amplifier and initiating RF operation.

Multitier specification for NSEP (National Security/Emergency Preparedness) enhancement of fiber-optic long-distance telecommunication networks. Volume 1. The multitier specification - an executive summary. Technical Information Bulletin

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

Peach, D.F.

1987-12-01

Fiber optic telecommunication systems are susceptible to both natural and man-made stress. National Security/Emergency Preparedness (NSEP) is a function of how durable these systems are in light of projected levels of stress. Emergency Preparedness in 1987 is not just a matter of--can they deliver food, water, energy and other essentials--but can they deliver the vital information necessary to maintain corporate function of our country. 'Communication stamina' is a function of 'probability of survival' when faced with stress. This report provides an overview of the enhancements to a fiber-optic communication system/installation that will increase durability. These enhancements are grouped, based onmore » their value in protecting the system, such that a Multitier Specification is created that presents multiple levels of hardness. Mitigation of effects due to high-altitude electromagnetic pulse (HEMP) and gamma radiation, and protection from vandalism and weather events are discussed in the report. The report is presented in two volumes. Volume I presents the Multitier Specification in a format that is usable for management review. The attributes of specified physical parameters, and the levels of protection stated in Volume I, are discussed in more detail in Volume II.« less

Compassion in practice-Evaluating the awareness, involvement and perceived impact of a national nursing and midwifery strategy amongst healthcare professionals in NHS Trusts in England.

PubMed

O'Driscoll, Mike; Allan, Helen; Liu, Liang; Corbett, Kevin; Serrant, Laura

2018-03-01

To report the findings from an evaluation of the impact of the Compassion in Practice Vision and Strategy (National Health Service England (NHSE), 2012) on nursing, midwifery and care staff. The Compassion in Practice Vision and Strategy was a programme of work to highlight the importance of compassionate care following the Francis Report in 2013 into the deficits in care in an NHS Hospital Trust. It was launched by NHS England in 2012 at a time when fiscal cuts were introduced by the Department of Health in England. Mixed methods. Inferential statistics were used to test whether there were significant differences between staff at different levels of seniority with regard to awareness and involvement in Compassion in Practice Vision and Strategy and their attitudes to it. Awareness and involvement of staff in Compassion in Practice Vision and Strategy were high amongst middle and senior management but limited at ward level. Staff involvement in Compassion in Practice Vision and Strategy was limited due to a lack of awareness. Ward level staff who were aware and involved, perceived a lack of support and communication from senior leadership to deliver the Compassion in Practice Vision and Strategy. Results reveal professional anger, distress and resistance to the Compassion in Practice Vision and Strategy and a view of the programme as a top-down initiative which did not sufficiently recognise structural constraints on nurses' ability to deliver compassionate care. We discuss the implications of our findings for global nursing. Participants emphasised that compassion for patients is only sustainable where there is compassion for staff and many participants felt that they were not being treated with compassion. National Health Service England should strongly affirm that nurses and midwives in general provide compassionate care. Trust leadership should provide support for ward level staff who deliver compassionate care in difficult circumstances. © 2017 John Wiley & Sons Ltd.

Dose Accuracy and Injection Force of Different Insulin Glargine Pens

PubMed Central

Friedrichs, Arnd; Bohnet, Janine; Korger, Volker; Adler, Steffen; Schubert-Zsilavecz, Manfred; Abdel-Tawab, Mona

2013-01-01

Background Dose accuracy and injection force, representing key parameters of insulin pens, were determined for three pens delivering insulin glargine-based copies, Pen Royale (WR) and DispoPen (WD) for Glaritus® (Wockhardt) and GanLee Pen (GL) for Basalin® (Gan & Lee), compared with pens of the originator, ClikSTAR® (CS) and S o l o S TA R® (SS) for Lantus® (Sanofi) . Methods Using the weighing procedure recommended by DIN EN ISO 11608–1:2000, dose accuracy was evaluated based on nonrandomized delivery of low (5 U), mid (30 U), and high (60 U) dosage levels. Injection force was measured by dispensing the maximum dose of insulin (60 U for the GL, WR, and WD; 80 U for the SS and CS) at dose speeds of 6 and 10 U/s. Results All tested pens delivered comparable average doses within the DIN EN ISO 11608–1:2000 limits at all dosage levels. The GL revealed a higher coefficient of variation (CV) at 5 U, and the WR and WD had higher CVs at all dosage levels compared with the CS and SS. Injection force was higher for the WR, WD, and GL compared with the CS and SS at both dose speeds. In contrast to the CS and SS with an end-of-content feature, doses exceeding the remaining insulin could be dialed with the WR, GL, and WD and, apparently, dispensed with the WD. Conclusions All pens fulfilled the dose accuracy requirements defined by DIN EN ISO 11608–1:2000 standards at all three dosage levels, with the WR, WD, and GL showing higher dosage variability and injection force compared with the SS and CS. Thus, the devices that deliver insulin glargine copies show different performance characteristics compared with the originator. J Diabetes Sci Technol 2013;7(5):1346–1353 PMID:24124963

The Effect of Supply Disruptions on Customer Service Levels: a Case for Delivering Fertilizer Products using Maritime Transportation

NASA Astrophysics Data System (ADS)

Siswanto, N.; Kurniawati, U.; Wiratno, S. E.; Rusdiansyah, A.

2018-04-01

Delivering a product to customers can have a series of activities. It starts with the production of the product and then transporting it to the customers. However, uncontrollable and undesirable chance of disruption can occur during the delivery either at the production facility/supply side or in the process of transporting the product. Many researches has been conducting in the process of delivering the product. However not many considers these disruptions, although the disruptions has negative impacts on company such as reduce the profit, produce unbalanced inventory, and affect its reputation. This research will focus on the effect of supply disruption on customer service levels in the maritime transportation problem in order to maintain inventory level both in the supply and destination warehouses during predetermined planning horizon. The system considered consists of one loading port and two discharge ports for distributing one product. By using discrete event simulation, the result showed that supply disruption affects unbalanced inventory in the destination warehouses so that it will also influence company’s service level. The results show that there is a significant decreasing both in delivery service level, about 14%, and production service level, about 15% when the disruption occurs. A scenario to increase production rate is simulated to improved the service level.

Free electron laser-driven ultrafast rearrangement of the electronic structure in Ti

PubMed Central

Principi, E.; Giangrisostomi, E.; Cucini, R.; Bencivenga, F.; Battistoni, A.; Gessini, A.; Mincigrucci, R.; Saito, M.; Di Fonzo, S.; D'Amico, F.; Di Cicco, A.; Gunnella, R.; Filipponi, A.; Giglia, A.; Nannarone, S.; Masciovecchio, C.

2015-01-01

High-energy density extreme ultraviolet radiation delivered by the FERMI seeded free-electron laser has been used to create an exotic nonequilibrium state of matter in a titanium sample characterized by a highly excited electron subsystem at temperatures in excess of 10 eV and a cold solid-density ion lattice. The obtained transient state has been investigated through ultrafast absorption spectroscopy across the Ti M2,3-edge revealing a drastic rearrangement of the sample electronic structure around the Fermi level occurring on a time scale of about 100 fs. PMID:26798835

High-energy D/sub 2/O submillimeter laser for plasma diagnostics

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

Semet, A.; Johnson, L.C.; Mansfield, D.K.

1983-01-01

A narrow line optically pumped D/sub 2/O laser operating at 385 ..mu..m has delivered more than 5 J in pulses longer than 3 ..mu..sec using a large aperture unstable resonator cavity design. Pulse levels which are > 1 J and 1 ..mu..sec are necessary for a single shot ion temperature measurement by Thomson scattering in large tokamaks. Experiments have, for the most part, been conducted at a 360 J, 5 ..mu..sec CO/sub 2/ laser pump level where high efficiency (approx. 2.5 J at 385 ..mu..m) has been obtained. These are the highest energies reported to date in the far infrared.more » In addition, the pulse length has been extended beyond the vibrational relaxation time.« less

Intra-operative hemodialysis during liver transplantation: an expanded role of the nephrology nurse.

PubMed

Henson, Angela; Carpenter, Sally

2010-01-01

Hemodialysis is widely acknowledged as a treatment option to stabilize acute medical conditions where biochemistry management is paramount. One of the most challenging situations is during liver transplantation, when patients with moderate renal dysfunction are likely to become acutely acidotic. For nephrology nurses, this extended role requires increased knowledge, advanced skills, and a high level of communication with unfamiliar team members. With appropriate procedures and a supportive environment, delivering such a service is feasible.

An Identification and Analysis of Students' Expectations and Views regarding Foreign-Sourced Tertiary Education Programs Delivered in China: Investigating the Next Stage of Internationalisation and Market Entry for Foreign Universities

ERIC Educational Resources Information Center

Willis, Mike

2005-01-01

There has been a wealth of research into various forms of educational export such as distance education and study abroad, but this paper focuses on the delivery of foreign-supplied courses and programs "within" a host country-in this case, China. Key findings include a high level of demand amongst Chinese students for business and…

Using Free Internet Videogames in Upper Extremity Motor Training for Children with Cerebral Palsy

PubMed Central

Sevick, Marisa; Eklund, Elizabeth; Mensch, Allison; Foreman, Matthew; Standeven, John; Engsberg, Jack

2016-01-01

Movement therapy is one type of upper extremity intervention for children with cerebral palsy (CP) to improve function. It requires high-intensity, repetitive and task-specific training. Tedium and lack of motivation are substantial barriers to completing the training. An approach to overcome these barriers is to couple the movement therapy with videogames. This investigation: (1) tested the feasibility of delivering a free Internet videogame upper extremity motor intervention to four children with CP (aged 8–17 years) with mild to moderate limitations to upper limb function; and (2) determined the level of intrinsic motivation during the intervention. The intervention used free Internet videogames in conjunction with the Microsoft Kinect motion sensor and the Flexible Action and Articulated Skeleton Toolkit software (FAAST) software. Results indicated that the intervention could be successfully delivered in the laboratory and the home, and pre- and post- impairment, function and performance assessments were possible. Results also indicated a high level of motivation among the participants. It was concluded that the use of inexpensive hardware and software in conjunction with free Internet videogames has the potential to be very motivating in helping to improve the upper extremity abilities of children with CP. Future work should include results from additional participants and from a control group in a randomized controlled trial to establish efficacy. PMID:27338485

Libraries Prepare for an Information Age.

ERIC Educational Resources Information Center

Breivik, Patricia Senn; Shaw, Ward

1989-01-01

Since funding levels will probably not change much, college libraries will need to shift emphasis from seeking more funding for current and new services to delivering more and better service for less, becoming leaner and more able to deliver adaptable services. Increased budget flexibility will be essential. (MSE)

Controlled power delivery for super-resolution imaging of biological samples using digital micromirror device

NASA Astrophysics Data System (ADS)

Valiya Peedikakkal, Liyana; Cadby, Ashley

2017-02-01

Localization based super resolution images of a biological sample is generally achieved by using high power laser illumination with long exposure time which unfortunately increases photo-toxicity of a sample, making super resolution microscopy, in general, incompatible with live cell imaging. Furthermore, the limitation of photobleaching reduces the ability to acquire time lapse images of live biological cells using fluorescence microscopy. Digital Light Processing (DLP) technology can deliver light at grey scale levels by flickering digital micromirrors at around 290 Hz enabling highly controlled power delivery to samples. In this work, Digital Micromirror Device (DMD) is implemented in an inverse Schiefspiegler telescope setup to control the power and pattern of illumination for super resolution microscopy. We can achieve spatial and temporal patterning of illumination by controlling the DMD pixel by pixel. The DMD allows us to control the power and spatial extent of the laser illumination. We have used this to show that we can reduce the power delivered to the sample to allow for longer time imaging in one area while achieving sub-diffraction STORM imaging in another using higher power densities.

Stress and preterm labor and birth in Black women.

PubMed

Gennaro, Susan; Shults, Justine; Garry, David J

2008-01-01

To examine (a) 3 commonly used measures of stress during pregnancy, (b) changes in stress over time to determine when stress is highest, and (c) whether any of the stress measures predict who will deliver preterm in pregnant Black women. Prospective descriptive study. Perinatal evaluation center and outpatient clinics of a teaching hospital in the northeast. Fifty-nine Black women: 39 were recruited in preterm labor from a Perinatal Evaluation Center, and 20 experiencing healthy pregnancies were recruited from the prenatal clinic. Stress was measured using 2 paper and pencil tests (the Prenatal Distress Questionnaire and the Perceived Stress Scale) and corticotropin-releasing hormone. There was not a high correlation between stress measures. Stress at 28 weeks as measured by Prenatal Distress Questionnaire and Perceived Stress Scale was at its highest, but corticotropin-releasing hormone increased to 32 weeks and then decreased. Perceived stress, prenatal distress, and corticotropin-releasing hormone do not all appear to be measuring the same phenomenon. Screening for stress in Black women at 28 weeks requires further research as perceived stress levels in Black women experiencing preterm labor around 28 weeks differentiated women who delivered preterm infants from Black women who delivered at term.

Project Pals: A Description of a High School-Based Tutorial Program Using Corrective Reading and Peer-Delivered Instruction

ERIC Educational Resources Information Center

Marchand-Martella, Nancy; Martella, Ronald C.; Bettis, Daniel F.; Blakely, Molly Riley

2004-01-01

The purpose of this investigation was to assess implementation aspects of a peer-delivered Corrective Reading Program (CRP), entitled "Project PALS" (Peer Assisted Learning System), in six area high schools. Specifically, high schools provided details on the following aspects of their programs: school and teachers, students receiving peer…

High repetition rate, high energy, actively Q-switched all-in-fiber laser

NASA Astrophysics Data System (ADS)

Lecourt, J. B.; Bertrand, A.; Guillemet, S.; Hernandez, Y.; Giannone, D.

2010-05-01

We report an actively Q-switched Ytterbium-doped all-in-fibre laser delivering 10ns pulses with high repetition rate (from 100kHz to 1MHz). The laser operation has been validated at three different wavelengths (1040, 1050 and 1064nm). The laser can deliver up to 20Watts average power with an high beam quality (M2 = 1).

High-precision γ -ray spectroscopy of the cardiac PET imaging isotope Rb 82 and its impact on dosimetry

DOE PAGES

Nino, M. N.; McCutchan, E. A.; Smith, S. V.; ...

2016-02-01

82Rb is a positron-emitting isotope used in cardiac positron emission tomography (PET) imaging which has been reported to deliver a significantly lower effective radiation dose than analogous imaging isotopes like 201Tl and 99mTc sestamibi. High-quality β-decay data are essential to accurately appraise the total dose received by the patients. A source of 82Sr was produced at the Brookhaven Linac Isotope Producer (BLIP), transported to Argonne National Laboratory, and studied with the Gammasphere facility. Significant revisions have been made to the level scheme of 82Kr including 12 new levels, 50 new γ-ray transitions, and the determination of many new spin assignmentsmore » through angular correlations. Lastly, these new high-quality data allow a precise reappraisal of the β-decay strength function and thus the consequent dose received by patients.« less

Mobius Assembly: A versatile Golden-Gate framework towards universal DNA assembly

PubMed Central

Andreou, Andreas I.

2018-01-01

Synthetic biology builds upon the foundation of engineering principles, prompting innovation and improvement in biotechnology via a design-build-test-learn cycle. A community-wide standard in DNA assembly would enable bio-molecular engineering at the levels of predictivity and universality in design and construction that are comparable to other engineering fields. Golden Gate Assembly technology, with its robust capability to unidirectionally assemble numerous DNA fragments in a one-tube reaction, has the potential to deliver a universal standard framework for DNA assembly. While current Golden Gate Assembly frameworks (e.g. MoClo and Golden Braid) render either high cloning capacity or vector toolkit simplicity, the technology can be made more versatile—simple, streamlined, and cost/labor-efficient, without compromising capacity. Here we report the development of a new Golden Gate Assembly framework named Mobius Assembly, which combines vector toolkit simplicity with high cloning capacity. It is based on a two-level, hierarchical approach and utilizes a low-frequency cutter to reduce domestication requirements. Mobius Assembly embraces the standard overhang designs designated by MoClo, Golden Braid, and Phytobricks and is largely compatible with already available Golden Gate part libraries. In addition, dropout cassettes encoding chromogenic proteins were implemented for cost-free visible cloning screening that color-code different cloning levels. As proofs of concept, we have successfully assembled up to 16 transcriptional units of various pigmentation genes in both operon and multigene arrangements. Taken together, Mobius Assembly delivers enhanced versatility and efficiency in DNA assembly, facilitating improved standardization and automation. PMID:29293531

Synthesis and characterization of sodium vanadium oxide gels: the effects of water (n) and sodium (x) content on the electrochemistry of Na(x)V2O5·nH2O.

PubMed

Lee, Chia-Ying; Marschilok, Amy C; Subramanian, Aditya; Takeuchi, Kenneth J; Takeuchi, Esther S

2011-10-28

Sodium vanadium oxide gels, Na(x)V(2)O(5)·nH(2)O, of varying sodium content (0.12 < x < 0.32) were prepared by careful control of an ion exchange process. The water content (0.23 > n > 0.01) and interlayer spacing were found to be inversely proportional to the sodium level (x), thus control of sodium (x) content provided a direct, chimie douce approach for control of hydration level (n) and interlayer spacing, without the need for high temperature treatment to affect dehydration. Notably, the use of high temperatures to modify hydration levels can result in crystallization and collapse of the interlayer structure, highlighting the distinct advantage of our novel chimie douce synthesis strategy. Subsequent to synthesis and characterization, results from an electrochemical study of a series of Na(x)V(2)O(5)·nH(2)O samples highlight the significant impact of interlayer water on delivered capacity of the layered materials. Specifically, the sodium vanadium oxide gels with higher sodium content and lower water content provided higher capacities in lithium based cells, where capacity delivered to 2.0 V under C/20 discharge ranged from 170 mAh/g for Na(0.12)V(2)O(5)·0.23H(2)O to 300 mAh/g for Na(0.32)V(2)O(5)·0.01H(2)O. The capacity differences were maintained as the cells were cycled. This journal is © the Owner Societies 2011

The population cost-effectiveness of delivering universal and indicated school-based interventions to prevent the onset of major depression among youth in Australia.

PubMed

Lee, Y Y; Barendregt, J J; Stockings, E A; Ferrari, A J; Whiteford, H A; Patton, G A; Mihalopoulos, C

2017-10-01

School-based psychological interventions encompass: universal interventions targeting youth in the general population; and indicated interventions targeting youth with subthreshold depression. This study aimed to: (1) examine the population cost-effectiveness of delivering universal and indicated prevention interventions to youth in the population aged 11-17 years via primary and secondary schools in Australia; and (2) compare the comparative cost-effectiveness of delivering these interventions using face-to-face and internet-based delivery mechanisms. We reviewed literature on the prevention of depression to identify all interventions targeting youth that would be suitable for implementation in Australia and had evidence of efficacy to support analysis. From this, we found evidence of effectiveness for the following intervention types: universal prevention involving group-based psychological interventions delivered to all participating school students; and indicated prevention involving group-based psychological interventions delivered to students with subthreshold depression. We constructed a Markov model to assess the cost-effectiveness of delivering universal and indicated interventions in the population relative to a 'no intervention' comparator over a 10-year time horizon. A disease model was used to simulate epidemiological transitions between three health states (i.e., healthy, diseased and dead). Intervention effect sizes were based on meta-analyses of randomised control trial data identified in the aforementioned review; while health benefits were measured as Disability-adjusted Life Years (DALYs) averted attributable to reductions in depression incidence. Net costs of delivering interventions were calculated using relevant Australian data. Uncertainty and sensitivity analyses were conducted to test model assumptions. Incremental cost-effectiveness ratios (ICERs) were measured in 2013 Australian dollars per DALY averted; with costs and benefits discounted at 3%. Universal and indicated psychological interventions delivered through face-to-face modalities had ICERs below a threshold of $50 000 per DALY averted. That is, $7350 per DALY averted (95% uncertainty interval (UI): dominates - 23 070) for universal prevention, and $19 550 per DALY averted (95% UI: 3081-56 713) for indicated prevention. Baseline ICERs were generally robust to changes in model assumptions. We conducted a sensitivity analysis which found that internet-delivered prevention interventions were highly cost-effective when assuming intervention effect sizes of 100 and 50% relative to effect sizes observed for face-to-face delivered interventions. These results should, however, be interpreted with caution due to the paucity of data. School-based psychological interventions appear to be cost-effective. However, realising efficiency gains in the population is ultimately dependent on ensuring successful system-level implementation.

Participant satisfaction with a school telehealth education program using interactive compressed video delivery methods in rural Arkansas.

PubMed

Bynum, Ann B; Cranford, Charles O; Irwin, Cathy A; Denny, George S

2002-08-01

Socioeconomic and demographic factors can affect the impact of telehealth education programs that use interactive compressed video technology. This study assessed program satisfaction among participants in the University of Arkansas for Medical Sciences' School Telehealth Education Program delivered by interactive compressed video. Variables in the one-group posttest study were age, gender, ethnicity, education, community size, and program topics for years 1997-1999. The convenience sample included 3,319 participants in junior high and high schools. The School Telehealth Education Program provided information about health risks, disease prevention, health promotion, personal growth, and health sciences. Adolescents reported medium to high levels of satisfaction regarding program interest and quality. Significantly higher satisfaction was expressed for programs on muscular dystrophy, anatomy of the heart, and tobacco addiction (p < 0.001 to p = 0.003). Females, African Americans, and junior high school students reported significantly greater satisfaction (p < 0.001 to p = 0.005). High school students reported significantly greater satisfaction than junior high school students regarding the interactive video equipment (p = 0.011). White females (p = 0.025) and African American males (p = 0.004) in smaller, rural communities reported higher satisfaction than White males. The School Telehealth Education Program, delivered by interactive compressed video, promoted program satisfaction among rural and minority populations and among junior high and high school students. Effective program methods included an emphasis on participants' learning needs, increasing access in rural areas among ethnic groups, speaker communication, and clarity of the program presentation.

Effectiveness of Musculoskeletal Education Interventions in People With Low Literacy Levels: A Systematic Review

PubMed Central

Lowe, Wendy; Ballinger, Claire; Protheroe, Jo; Lueddeke, Jill; Nutbeam, Don; Armstrong, Ray; Falzon, Louise; Edwards, Chris; Russell, Cynthia; McCaffery, Kirsten; Adams, Jo

2013-01-01

Objective To conduct a systematic review to assess the effectiveness of patient education interventions delivered or directed by health professionals for people with musculoskeletal conditions who also have lower levels of literacy. Methods Electronic databases were searched from 1946 to May 2012. Randomized controlled trials with primary interventions designed specifically for individuals with musculoskeletal conditions and lower levels of literacy were eligible for inclusion. The quality of the study was determined by assessing method of randomization, allocation concealment, creation and maintenance of comparable groups, blinding of patients and providers, control of confounding, and the validity and reliability of outcome measures. Results Of the 2,440 studies located using the search strategy, 6 studies met the inclusion criteria. Three public health community studies and 3 rheumatology clinic-based studies delivered educational programs to people with musculoskeletal conditions who also had lower levels of literacy. Three moderate quality studies suggest that musculoskeletal educational interventions had a small short-term effect on knowledge and 2 moderate quality studies suggest musculoskeletal interventions had a small effect on self-efficacy (although results on self-efficacy were conflicting in 1 of these studies). Only 1 moderate quality study showed a small effect on anxiety and 1 on self-perceived health and well-being in people with lower literacy. Conclusion High quality evidence is lacking on the effectiveness of musculoskeletal education interventions for people with lower literacy levels. Research programs that test the effectiveness of patient education interventions for arthritis must recruit and engage people with lower levels of literacy. PMID:23925869

A new generation of high performance engines for spacecraft propulsion

NASA Technical Reports Server (NTRS)

Rosenberg, Sanders D.; Schoenman, Leonard

1991-01-01

Experimental data validating advanced engine designs at three thrust levels (5, 15, and 100 lbF) is presented. All of the three engine designs considered employ a Moog bipropellant torque motor valve, platelet injector design, and iridium-lined rhenium combustion chamber. Attention is focused on the performance, robustness, duration, and flexibility characteristics of the engines. It is noted that the 5- and 15-lbF thrust engines can deliver a steady state specific impulse in excess of 310 lbF-sec/lbm at an area ratio of 150:1, while the 150-lbF thrust engines deliver a steady state specific impulse of 320 lbF-sec/lbm at an area ratio of 250:1. The hot-fire test results reveal specific impulse improvements of 15 to 25 sec over conventional fuel film cooled columbium chamber designs while operating at maximum chamber temperatures.

Sequence-specific antimicrobials using efficiently delivered RNA-guided nucleases.

PubMed

Citorik, Robert J; Mimee, Mark; Lu, Timothy K

2014-11-01

Current antibiotics tend to be broad spectrum, leading to indiscriminate killing of commensal bacteria and accelerated evolution of drug resistance. Here, we use CRISPR-Cas technology to create antimicrobials whose spectrum of activity is chosen by design. RNA-guided nucleases (RGNs) targeting specific DNA sequences are delivered efficiently to microbial populations using bacteriophage or bacteria carrying plasmids transmissible by conjugation. The DNA targets of RGNs can be undesirable genes or polymorphisms, including antibiotic resistance and virulence determinants in carbapenem-resistant Enterobacteriaceae and enterohemorrhagic Escherichia coli. Delivery of RGNs significantly improves survival in a Galleria mellonella infection model. We also show that RGNs enable modulation of complex bacterial populations by selective knockdown of targeted strains based on genetic signatures. RGNs constitute a class of highly discriminatory, customizable antimicrobials that enact selective pressure at the DNA level to reduce the prevalence of undesired genes, minimize off-target effects and enable programmable remodeling of microbiota.

A graphene-based electrochemical device with thermoresponsive microneedles for diabetes monitoring and therapy

NASA Astrophysics Data System (ADS)

Lee, Hyunjae; Choi, Tae Kyu; Lee, Young Bum; Cho, Hye Rim; Ghaffari, Roozbeh; Wang, Liu; Choi, Hyung Jin; Chung, Taek Dong; Lu, Nanshu; Hyeon, Taeghwan; Choi, Seung Hong; Kim, Dae-Hyeong

2016-06-01

Owing to its high carrier mobility, conductivity, flexibility and optical transparency, graphene is a versatile material in micro- and macroelectronics. However, the low density of electrochemically active defects in graphene synthesized by chemical vapour deposition limits its application in biosensing. Here, we show that graphene doped with gold and combined with a gold mesh has improved electrochemical activity over bare graphene, sufficient to form a wearable patch for sweat-based diabetes monitoring and feedback therapy. The stretchable device features a serpentine bilayer of gold mesh and gold-doped graphene that forms an efficient electrochemical interface for the stable transfer of electrical signals. The patch consists of a heater, temperature, humidity, glucose and pH sensors and polymeric microneedles that can be thermally activated to deliver drugs transcutaneously. We show that the patch can be thermally actuated to deliver Metformin and reduce blood glucose levels in diabetic mice.

Characterization, monitoring, and sensor technology crosscutting program: Technology summary

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

NONE

1995-06-01

The purpose of the Characterization, Monitoring, and Sensor Technology Crosscutting Program (CMST-CP) is to deliver appropriate characterization, monitoring, and sensor technology (CMST) to the Office of Waste Management (EM-30), the Office of Environmental Restoration (EM-40), and the Office of Facility Transition and Management (EM-60). The technology development must also be cost effective and appropriate to EM-30/40/60 needs. Furthermore, the required technologies must be delivered and implemented when needed. Accordingly, and to ensure that available DOE and other national resources are focused an the most pressing needs, management of the technology development is concentrated on the following Focus Areas: Contaminant Plumemore » Containment and Remediation (PFA); Landfill Stabilization (LSFA); High-Level Waste Tank Remediation (TFA); Mixed Waste Characterization, Treatment, and Disposal (MWFA); and Facility Deactivation, Decommissioning, and Material Disposition (FDDMDFA). Brief descriptions of CMST-CP projects funded in FY95 are presented.« less

Functional Land Management: Bridging the Think-Do-Gap using a multi-stakeholder science policy interface.

PubMed

O'Sullivan, Lilian; Wall, David; Creamer, Rachel; Bampa, Francesca; Schulte, Rogier P O

2018-03-01

Functional Land Management (FLM) is proposed as an integrator for sustainability policies and assesses the functional capacity of the soil and land to deliver primary productivity, water purification and regulation, carbon cycling and storage, habitat for biodiversity and recycling of nutrients. This paper presents the catchment challenge as a method to bridge the gap between science, stakeholders and policy for the effective management of soils to deliver these functions. Two challenges were completed by a wide range of stakeholders focused around a physical catchment model-(1) to design an optimised catchment based on soil function targets, (2) identify gaps to implementation of the proposed design. In challenge 1, a high level of consensus between different stakeholders emerged on soil and management measures to be implemented to achieve soil function targets. Key gaps including knowledge, a mix of market and voluntary incentives and mandatory measures were identified in challenge 2.

Development and validation of a child health workforce competence framework.

PubMed

Smith, Lynda; Hawkins, Jean; McCrum, Anita

2011-05-01

Providing high quality, effective services is fundamental to the delivery of key health outcomes for children and young people. This requires a competent workforce. This paper reports on the development of a validated competence framework tool for the children and young people's health workforce. The framework brings together policy, strategic agendas and existing workforce competences. The framework will contribute to the improvement of children's physical and mental wellbeing by identifying competences required to provide proactive services that respond to children and young people with acute, continuing and complex needs. It details five core competences for the workforce, the functions that underpin them and levels of competence required to deliver a particular service. The framework will be of value to commissioners to inform contracting, to providers to ensure services are delivered by a workforce with relevant competences to meet identified needs, and to the workforce to assess existing capabilities and identify gaps in competence.

Effects of a beta-adrenergic blocking agent timolol on intra ocular pressure responses induced by stimulation of cervical sympathetic nerve in the cat.

PubMed

Naito, A; Izumi, H; Karita, K; Tamai, M

2001-12-01

We clarified whether the intraocular pressure (IOP) response elicited by stimulation of the cervical sympathetic nerve (CSN) is influenced by changes in the baseline of IOP level and by beta-adrenergic blockade. The CSN was stimulated electrically for 30 seconds (10 V, 0.1-100 Hz, 2 milliseconds pulse duration) in urethane (100 mg/kg i.v.)-chloralose (50 mg/kg i.v.)-anesthetized, paralyzed cats. The IOP was monitored manometrically, and a controlled saline infusion was delivered into the anterior chamber to gradually increase IOP. CSN stimulation was delivered at the various baseline IOP levels so obtained. When required, a beta-adrenergic blocker timolol (2%) was delivered into the conjunctival cul-de-sac. The normal IOP in our cats was 25+/-3 mmHg. This value decreased transiently on CSN stimulation. The amplitude of this IOP response depended on stimulus frequency and the pre-stimulus baseline IOP level. Topical administration of timolol increased the IOP response to CSN stimulation at a given baseline level. These results suggest that beta-adrenergic blockade increases the alpha-adrenergic mediated-IOP reduction elicited by CSN stimulation at given baseline IOP level.

Assessing the effects of automatically delivered stimulation on the use of simple exercise tools by students with multiple disabilities.

PubMed

Lancioni, Giulio E; Singh, Nirbhay N; O'Reilly, Mark F; Oliva, Doretta; Campodonico, Francesca; Groeneweg, Jop

2003-01-01

We assessed the effects of automatically delivered stimulation on the activity level and mood (indices of happiness) of three students with multiple disabilities during their use of a stepper and a stationary bicycle. The stimulation involved a pool of favorite stimulus events that were delivered automatically, through an electronic control system, while the students were active in using the aforementioned exercise tools. Data showed that stimulation had an overall positive impact, but this was not evident on both measures (i.e., level of activity and indices of happiness) or with both exercise tools across students. These findings are discussed in relation to the outcome of an earlier study in the area by the same authors and in terms of practical implications for daily contexts.

Implementation Planning to Promote Parents' Treatment Integrity of Behavioral Interventions for Children with Autism

ERIC Educational Resources Information Center

Fallon, Lindsay M.; Collier-Meek, Melissa A.; Sanetti, Lisa M. H.; Feinberg, Adam B.; Kratochwill, Thomas R.

2016-01-01

Behavioral interventions delivered across home and school settings can promote positive outcomes for youth with autism spectrum disorders (ASD). Yet, stakeholders who deliver these interventions may struggle to implement interventions as intended. Low levels of treatment integrity can undermine potentially positive intervention outcomes. One way…

Method and apparatus for delivering high power laser energy over long distances

DOEpatents

Zediker, Mark S; Rinzler, Charles C; Faircloth, Brian O; Koblick, Yeshaya; Moxley, Joel F

2015-04-07

Systems, devices and methods for the transmission and delivery of high power laser energy deep into the earth and for the suppression of associated nonlinear phenomena. Systems, devices and methods for the laser drilling of a borehole in the earth. These systems can deliver high power laser energy down a deep borehole, while maintaining the high power to advance such boreholes deep into the earth and at highly efficient advancement rates.

Advanced Lithium-Ion Cell Development for NASA's Constellation Missions

NASA Technical Reports Server (NTRS)

Reid, Concha M.; Miller, Thomas B.; Manzo, Michelle A.; Mercer, Carolyn R.

2008-01-01

The Energy Storage Project of NASA s Exploration Technology Development Program is developing advanced lithium-ion batteries to meet the requirements for specific Constellation missions. NASA GRC, in conjunction with JPL and JSC, is leading efforts to develop High Energy and Ultra High Energy cells for three primary Constellation customers: Altair, Extravehicular Activities (EVA), and Lunar Surface Systems. The objective of the High Energy cell development is to enable a battery system that can operationally deliver approximately 150 Wh/kg for 2000 cycles. The Ultra High Energy cell development will enable a battery system that can operationally deliver 220 Wh/kg for 200 cycles. To accomplish these goals, cathode, electrolyte, separator, and safety components are being developed for High Energy Cells. The Ultra High Energy cell development adds lithium alloy anodes to the component development portfolio to enable much higher cell-level specific energy. The Ultra High Energy cell development is targeted for the ascent stage of Altair, which is the Lunar Lander, and for power for the Portable Life support System of the EVA Lunar spacesuit. For these missions, mass is highly critical, but only a limited number of cycles are required. The High Energy cell development is primarily targeted for Mobility Systems (rovers) for Lunar Surface Systems, however, due to the high risk nature of the Ultra High Energy cell development, the High Energy cell will also serve as a backup technology for Altair and EVA. This paper will discuss mission requirements and the goals of the material, component, and cell development efforts in further detail.

Design and physicochemical characterisation of novel dissolving polymeric microneedle arrays for transdermal delivery of high dose, low molecular weight drugs

PubMed Central

McCrudden, Maelíosa T.C.; Alkilani, Ahlam Zaid; McCrudden, Cian M.; McAlister, Emma; McCarthy, Helen O.; Woolfson, A. David; Donnelly, Ryan F.

2014-01-01

We describe formulation and evaluation of novel dissolving polymeric microneedle (MN) arrays for the facilitated delivery of low molecular weight, high dose drugs. Ibuprofen sodium was used as the model here and was successfully formulated at approximately 50% w/w in the dry state using the copolymer poly(methylvinylether/maleic acid). These MNs were robust and effectively penetrated skin in vitro, dissolving rapidly to deliver the incorporated drug. The delivery of 1.5 mg ibuprofen sodium, the theoretical mass of ibuprofen sodium contained within the dry MN alone, was vastly exceeded, indicating extensive delivery of the drug loaded into the baseplates. Indeed in in vitro transdermal delivery studies, approximately 33 mg (90%) of the drug initially loaded into the arrays was delivered over 24 h. Iontophoresis produced no meaningful increase in delivery. Biocompatibility studies and in vivo rat skin tolerance experiments raised no concerns. The blood plasma ibuprofen sodium concentrations achieved in rats (263 μg ml− 1 at the 24 h time point) were approximately 20 times greater than the human therapeutic plasma level. By simplistic extrapolation of average weights from rats to humans, a MN patch design of no greater than 10 cm2 could cautiously be estimated to deliver therapeutically-relevant concentrations of ibuprofen sodium in humans. This work, therefore, represents a significant progression in exploitation of MN for successful transdermal delivery of a much wider range of drugs. PMID:24556420

Usability and reliability of a remotely administered adult autism assessment, the autism diagnostic observation schedule (ADOS) module 4.

PubMed

Schutte, Jamie L; McCue, Michael P; Parmanto, Bambang; McGonigle, John; Handen, Benjamin; Lewis, Allen; Pulantara, I Wayan; Saptono, Andi

2015-03-01

The Autism Diagnostic Observation Schedule (ADOS) Module 4 is an autism assessment designed for verbally fluent adolescents and adults. Because of a shortage of available clinical expertise, it can be difficult for adults to receive a proper autism spectrum disorder (ASD) diagnostic assessment. A potential option to address this shortage is remote assessment. The objective of this study was to examine the feasibility, usability, and reliability of administering the ADOS Module 4 remotely using the Versatile and Integrated System for Telerehabilitation (VISYTER). VISYTER consists of computer stations at the client site and clinician site for video communication and a Web portal for managing and coordinating the assessment process. Twenty-three adults with an ASD diagnosis participated in a within-subject crossover design study in which both a remote ADOS and a face-to-face ADOS were administered. After completing the remote ADOS, participants completed a satisfaction survey. Participant satisfaction with the remote ADOS delivery system was high. The kappa value was greater than 0.61 on 21 of 31 ADOS items. There was substantial agreement on ADOS classification (i.e., diagnosis) between assessments delivered face-to-face versus assessments delivered remotely (interclass coefficient=0.92). Non-agreement may have been due to outside factors or practice effect despite a washout period. The results of this study demonstrate that an autism assessment designed to be delivered face to face can be administered remotely using an integrated Web-based system with high levels of usability and reliability.

Predictors of person-centered maternity care: the role of socioeconomic status, empowerment, and facility type.

PubMed

Afulani, Patience A; Sayi, Takudzwa S; Montagu, Dominic

2018-05-11

Low use of maternal health services, as well as poor quality care, contribute to the high maternal mortality in sub-Saharan Africa (SSA). In particular, poor person-centered maternity care (PCMC), which captures user experience, contributes both directly to pregnancy outcomes and indirectly through decreased demand for services. While many studies have examined disparities in use of maternal health services, few have examined disparities in quality of care, and none to our knowledge has empirically examined disparities in PCMC in SSA. The aim of this study is to examine factors associated with PCMC, particularly the role of household wealth, personal empowerment, and type of facility. Data are from a survey conducted in western Kenya in 2016, with women aged 15 to 49 years who delivered in the 9 weeks preceding the survey (N = 877). PCMC is operationalized as a summative score based on responses to 30 items in the PCMC scale capturing dignity and respect, communication and autonomy, and supportive care. We find that net of other factors; wealthier, employed, literate, and married women report higher PCMC than poorer, unemployed, illiterate, and unmarried women respectively. Also, women who have experienced domestic violence report lower PCMC than those who have never experienced domestic violence. In addition, women who delivered in health centers and private facilities reported higher PCMC than those who delivered in public hospitals. The effect of employment and facility type is conditional on wealth, and is strongest for the poorest women. Poor women who are unemployed and poor women who deliver in higher-level facilities receive the lowest quality PCMC. The findings imply the most disadvantaged women receive the lowest quality PCMC, especially when they seek care in higher-level facilities. Interventions to reduce disparities in PCMC are essential to improve maternal outcomes among disadvantaged groups.

Low-Level Laser Therapy for Zymosan-Induced Arthritis in Rats: Importance of Illumination Time

PubMed Central

Castano, Ana P.; Dai, Tianhong; Yaroslavsky, Ilya; Cohen, Richard; Apruzzese, William A.; Smotrich, Michael H.; Hamblin, Michael R.

2010-01-01

Background It has been proposed for many years that low-level laser (or light) therapy (LLLT) can ameliorate the pain, swelling, and inflammation associated with various forms of arthritis. Light is thought to be absorbed by mitochondrial chromophores leading to an increase in adenosine triphosphate (ATP), reactive oxygen species and/or cyclic AMP production and consequent gene transcription via activation of transcription factors. However, despite many reports about the positive effects of LLLT in arthritis and in medicine in general, its use remains controversial. For all indications (including arthritis) the optimum optical parameters have been difficult to establish and so far are unknown. Methods We tested LLLT on rats that had zymosan injected into their knee joints to induce inflammatory arthritis. We compared illumination regimens consisting of a high and low fluence (3 and 30 J/cm2), delivered at high and low irradiance (5 and 50 mW/cm2) using 810-nm laser light daily for 5 days, with the positive control of conventional corticosteroid (dexamethasone) therapy. Results Illumination with 810-nm laser was highly effective (almost as good as dexamethasone) at reducing swelling and a longer illumination time (10 or 100 minutes compared to 1 minute) was more important in determining effectiveness than either the total fluence delivered or the irradiance. LLLT induced reduction of joint swelling correlated with reduction in the inflammatory marker serum prostaglandin E2 (PGE2). Conclusion LLLT with 810-nm laser is highly effective in treating inflammatory arthritis in this model. Longer illumination times were more effective than short times regardless of total fluence or irradiance. These data will be of value in designing clinical trials of LLLT for various arthritides. PMID:17659584

Expression of intracellular reactive oxygen species (ROS) in haematopoietic stem cells (HSCs) correlates with time to neutrophil and platelet engraftment in patients undergoing autologous bone marrow transplantation.

PubMed

Bai, Lijun; Best, Giles; Xia, Wei; Peters, Lyndsay; Wong, Kelly; Ward, Christopher; Greenwood, Matthew

2018-06-19

Reactive oxygen species (ROS) play important roles in haematopoiesis and regulate the self-renewal, migration and myeloid differentiation of haemopoeitic stem cells (HSCs). This study was conducted to determine whether ROS levels in donor HSCs correlate with neutrophil and platelet engraftment in patients following bone marrow transplantation. Cryopreserved HSCs samples from 51 patients who underwent autologous transplantation were studied. Levels of intracellular ROS were assessed by flow cytometry using 2',7' dichlorodihydrofluorescein diacetate (H 2 DCFDA) in the CD45 + /CD34 + HSC population. Colony forming unit (CFU) assays were performed on HSCs isolated from the ROS high and ROS low populations to assess the differentiation potential of these two cell subsets. Distinct populations of ROS high and ROS low cells were evident in all patient samples. The median percentage of ROS high expressing HSCs in the study cohort was 75.8% (range 2% - 95.2%). A significant correlation was identified between the percentage of ROS high stem cells present in the HPC(A) product infused and the time to neutrophil engraftment (p < 0.001, R= - 0.54) as well as time to plt20, plt50 and plt100 (p < 0.001, R = - 0.55, - 0.59 and - 0.56 respectively). The dose of CD34 + / ROS high /kg infused also inversely correlated with a shorter time to neutrophil engraftment; time to engraftment for patients receiving > or ≤ 3 × 10 6 cells/kg was 11.5 (range 9 - 23) days vs. 14 (10 - 28) days respectively (p = 0.02). The dose of ROS high HSCs delivered did not correlate with platelet engraftment. Collectively, these data suggest that the dose of ROS high stem cells delivered to patients may predict time to neutrophil engraftment following autologous transplantation. Copyright © 2018. Published by Elsevier Inc.

High-average-power 2 μm few-cycle optical parametric chirped pulse amplifier at 100 kHz repetition rate.

PubMed

Shamir, Yariv; Rothhardt, Jan; Hädrich, Steffen; Demmler, Stefan; Tschernajew, Maxim; Limpert, Jens; Tünnermann, Andreas

2015-12-01

Sources of long wavelengths few-cycle high repetition rate pulses are becoming increasingly important for a plethora of applications, e.g., in high-field physics. Here, we report on the realization of a tunable optical parametric chirped pulse amplifier at 100 kHz repetition rate. At a central wavelength of 2 μm, the system delivered 33 fs pulses and a 6 W average power corresponding to 60 μJ pulse energy with gigawatt-level peak powers. Idler absorption and its crystal heating is experimentally investigated for a BBO. Strategies for further power scaling to several tens of watts of average power are discussed.

SWEET CubeSat - Water detection and water quality monitoring for the 21st century

NASA Astrophysics Data System (ADS)

Antonini, Kelly; Langer, Martin; Farid, Ahmed; Walter, Ulrich

2017-11-01

Water scarcity and contamination of clean water have been identified as major challenges of the 21st century, in particular for developing countries. According to the International Water Management Institute, about 30% of the world's population does not have reliable access to clean water. Consequently, contaminated water contributes to the death of about 3 million people every year, mostly children. Access to potable water has been proven to boost education, equality and health, reduce hunger, as well as help the economy of the developing world. Currently used in-situ water monitoring techniques are sparse, and often difficult to execute. Space-based instruments will help to overcome these challenges by providing means for water level and water quality monitoring of medium-to-large sweet (fresh) water reservoirs. Data from hyperspectral imaging instruments on past and present governmental missions, such as Envisat and Aqua, has been used for this purpose. However, the high cost of large multi-purpose space vessels, and the lack of dedicated missions limits the continuous monitoring of inland and coastal water quality. The proposed CubeSat mission SWEET (Sweet Water Earth Education Technologies) will try to fill this gap. The SWEET concept is a joint effort between the Technical University of Munich, the German Space Operations Center and the African Steering Committee of the IAF. By using a novel Fabry-Perot interferometer-based hyperspectral imager, the mission will deliver critical data directly to national water resource centers in Africa with an unmatched cost per pixel ratio and high temporal resolution. Additionally, SWEET will incorporate education of students in CubeSat design and water management. Although the aim of the mission is to deliver local water quality and water level data to African countries, further coverage could be achieved with subsequent satellites. Finally, a constellation of SWEET-like CubeSats would extend the coverage to the whole planet, delivering daily data to ensure reliable access to clean water for millions of people worldwide.

TH-A-9A-04: Incorporating Liver Functionality in Radiation Therapy Treatment Planning

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

Wu, V; Epelman, M; Feng, M

2014-06-15

Purpose: Liver SBRT patients have both variable pretreatment liver function (e.g., due to degree of cirrhosis and/or prior treatments) and sensitivity to radiation, leading to high variability in potential liver toxicity with similar doses. This work aims to explicitly incorporate liver perfusion into treatment planning to redistribute dose to preserve well-functioning areas without compromising target coverage. Methods: Voxel-based liver perfusion, a measure of functionality, was computed from dynamic contrast-enhanced MRI. Two optimization models with different cost functions subject to the same dose constraints (e.g., minimum target EUD and maximum critical structure EUDs) were compared. The cost functions minimized were EUDmore » (standard model) and functionality-weighted EUD (functional model) to the liver. The resulting treatment plans delivering the same target EUD were compared with respect to their DVHs, their dose wash difference, the average dose delivered to voxels of a particular perfusion level, and change in number of high-/low-functioning voxels receiving a particular dose. Two-dimensional synthetic and three-dimensional clinical examples were studied. Results: The DVHs of all structures of plans from each model were comparable. In contrast, in plans obtained with the functional model, the average dose delivered to high-/low-functioning voxels was lower/higher than in plans obtained with its standard counterpart. The number of high-/low-functioning voxels receiving high/low dose was lower in the plans that considered perfusion in the cost function than in the plans that did not. Redistribution of dose can be observed in the dose wash differences. Conclusion: Liver perfusion can be used during treatment planning potentially to minimize the risk of toxicity during liver SBRT, resulting in better global liver function. The functional model redistributes dose in the standard model from higher to lower functioning voxels, while achieving the same target EUD and satisfying dose limits to critical structures. This project is funded by MCubed and grant R01-CA132834.« less

High-Level Heteroatom Doped Two-Dimensional Carbon Architectures for Highly Efficient Lithium-Ion Storage

PubMed Central

Wang, Zhijie; Wang, Yanyan; Wang, Wenhui; Yu, Xiaoliang; Lv, Wei; Xiang, Bin; He, Yan-Bing

2018-01-01

In this work, high-level heteroatom doped two-dimensional hierarchical carbon architectures (H-2D-HCA) are developed for highly efficient Li-ion storage applications. The achieved H-2D-HCA possesses a hierarchical 2D morphology consisting of tiny carbon nanosheets vertically grown on carbon nanoplates and containing a hierarchical porosity with multiscale pore size. More importantly, the H-2D-HCA shows abundant heteroatom functionality, with sulfur (S) doping of 0.9% and nitrogen (N) doping of as high as 15.5%, in which the electrochemically active N accounts for 84% of total N heteroatoms. In addition, the H-2D-HCA also has an expanded interlayer distance of 0.368 nm. When used as lithium-ion battery anodes, it shows excellent Li-ion storage performance. Even at a high current density of 5 A g−1, it still delivers a high discharge capacity of 329 mA h g−1 after 1,000 cycles. First principle calculations verifies that such unique microstructure characteristics and high-level heteroatom doping nature can enhance Li adsorption stability, electronic conductivity and Li diffusion mobility of carbon nanomaterials. Therefore, the H-2D-HCA could be promising candidates for next-generation LIB anodes. PMID:29686985

An evaluative survey to assess the effectiveness of using an interactive workbook to deliver bereavement education to undergraduate student midwives.

PubMed

Hollins Martin, Caroline J; Forrest, Eleanor; Wylie, Linda; Martin, Colin R

2014-08-01

the NMSF (2009) reported that 74 Trusts (40%) in the UK lack expertise in delivering maternity based bereavement care. In response, three midwifery lecturers were issued with a small grant from NHS Scotland to devise and evaluate an interactive workbook intended to develop student midwives understanding of how to deliver high quality bereavement care. to develop a workbook called--'an interactive workbook to shape bereavement care for midwives in clinical practice'--and evaluate it for effectiveness at delivering learning objectives developed from the literature and from prior written lesson plans. an evaluative audit was carried out using a scored questionnaire--Understanding Bereavement Evaluation Tool (UBET)--to gather data before and post-workbook completion. The UBET was purposely designed to gather data about participants' perceived level of learning before and post-workbook completion. Participants were student midwives (n=179) in their second/third year of study on a three year midwifery degree programme at one of three universities. the mean pre-workbook UBET score equalled 16.04 (SD=3.81) and post-intervention 26.45 (SD=2.16). A significant main effect of observation point was observed (p<0.001), with post-intervention scores considerably higher than pre-intervention. findings demonstrate that the workbook is an effective method for teaching bereavement care to student midwives (it is available from the first author). Copyright © 2013 Elsevier Ltd. All rights reserved.

Translational Pharmacologic Efficacy Studies of Glial Growth Factor 2 (GGF2) in Spinal Cord Injury Models and in the Veterinary Clinical Setting

DTIC Science & Technology

2015-07-01

optimal dosage was examined using a model of rodent SCI and testing several dose levels delivered either subcutaneously (SC) or intravenously (IV...to saline treated controls. ANOVA with Dunett’s post hoc test , pɘ.05. Based on these results, the studies in year 2 compared effects of SC...ventrally and ventral- laterally . The lesion in the Acorda model was characterized by a dorsal-ventral flattening of the cord profile with a highly

Homebound Learning Opportunities: reaching out to older shut-ins and their caregivers.

PubMed

Penning, M; Wasyliw, D

1992-10-01

Homebound Learning Opportunities (HLO) represents an innovative health promotion and educational outreach service for homebound older adults and their caregivers. It provides over 125 topics for individualized learning programs delivered to participants in their own places of residence, an audiovisual lending library, educational television programming, and a peer counseling service. Shut-ins are recruited as instructors and as participants in service projects that benefit the greater community. Preliminary assessments reveal high levels of participation and satisfaction with the program.

Iron Deficiency Anemia, Active Component, U.S. Armed Forces, 2002-2011

DTIC Science & Technology

2012-07-01

loss from acute trauma or chronic conditions such as uter- ine leiomyomas, as well as inadequate body iron stores due to an iron poor diet or...avoidance of red meat, vegetarianism ) may fail to deliver sufficient amounts of iron to replace losses. High levels of consumption of coffee and...and inflammation. Am J Clin Nutr. 2010;92(1):93- 100. 16. Health AL, Skeaff CM, Williams S, et al. The role of blood loss and diet in the etiology

Photovoltaic energy converter as a chipscale high efficiency power source for implanted active microelectronic devices.

PubMed

Hwang, N-J; Patterson, W R; Song, Y-K; Atay, T; Nurmikko, A V

2004-01-01

We report the development of a microscale photovoltaic energy converter which has been designed and implemented to deliver power to CMOS-based microelectronic chips. The design targets the delivery of voltages on the order of 3V with power levels in excess of 10 mW. The geometry of the prototype device, which has been fabricated and tested, is specifically designed for coupling to an optical fiber, to facilitate remote power delivery in implantable component environment.

Evaluation of SuperLU on multicore architectures

NASA Astrophysics Data System (ADS)

Li, X. S.

2008-07-01

The Chip Multiprocessor (CMP) will be the basic building block for computer systems ranging from laptops to supercomputers. New software developments at all levels are needed to fully utilize these systems. In this work, we evaluate performance of different high-performance sparse LU factorization and triangular solution algorithms on several representative multicore machines. We included both Pthreads and MPI implementations in this study and found that the Pthreads implementation consistently delivers good performance and that a left-looking algorithm is usually superior.

Nitrous Oxide During Labor: Maternal Satisfaction Does Not Depend Exclusively on Analgesic Effectiveness.

PubMed

Richardson, Michael G; Lopez, Brandon M; Baysinger, Curtis L; Shotwell, Matthew S; Chestnut, David H

2017-02-01

Evidence on the analgesic effectiveness of nitrous oxide for labor pain is limited. Even fewer studies have looked at patient satisfaction. Although nitrous oxide appears less effective than neuraxial analgesia, it is unclear whether labor analgesic effectiveness is the most important factor in patient satisfaction. We sought to compare the relationship between analgesic effectiveness and patient satisfaction with analgesia in women who delivered vaginally using nitrous oxide, neuraxial analgesia (epidural or combined spinal-epidural [CSE]), or both (neuraxial after a trial of nitrous oxide). A standardized survey was recorded on the first postpartum day for all women who received anesthetic care for labor and delivery. Data were queried for women who delivered vaginally with nitrous oxide and/or neuraxial labor analgesia over a 34-month period in 2011 to 2014. Parturients with complete data for analgesia quality and patient satisfaction were included. Analgesia and satisfaction scores were grouped into 8 to 10 high, 5 to 7 intermediate, and 0 to 4 low. These scores were compared with the use of ordinal logistic regression across 3 groups: nitrous oxide alone, epidural or CSE alone, or nitrous oxide followed by neuraxial (epidural or CSE) analgesia. A total of 6507 women received anesthesia care and delivered vaginally. Complete data were available for 6242 (96%) women; 5261 (81%) chose neuraxial analgesia and 1246 (19%) chose nitrous oxide. Of the latter, 753 (60%) went on to deliver with nitrous oxide alone, and 493 (40%) switched to neuraxial analgesia. Most parturients who received neuraxial analgesia (>90%) reported high analgesic effectiveness. Those who used nitrous oxide alone experienced variable analgesic effectiveness, with only one-half reporting high effectiveness. Among all women who reported poor analgesia effectiveness (0-4; n = 257), those who received nitrous oxide alone were more likely to report high satisfaction (8-10) than women who received epidural analgesia alone (OR 2.5; 95% CI 1.4-4.5; P = .002). Women who reported moderate analgesia (5-7) and received nitrous oxide only were more likely to report high satisfaction compared with the other groups. Among women who reported a high level of analgesic effectiveness, satisfaction with anesthesia was high and not different among groups. Patients who received nitrous oxide alone were as likely to express satisfaction with anesthesia care as those who received neuraxial analgesia, even though they were less likely to report excellent analgesia. Although pain relief contributes to the satisfaction with labor analgesia care, our results suggest that analgesia is not the only contributor to maternal satisfaction.

A glutamine-rich carrier efficiently delivers anti-CD47 siRNA driven by "glutamine trap" to inhibit lung cancer cell growth.

PubMed

Wu, JiaMin; Li, Zhi; Yang, Zeping; Guo, Ling; Zhang, Ye; Deng, Huihui; Wang, Cuifeng; Feng, Min

2018-06-25

It is not efficient enough using the current approaches for tumor-selective drug delivery based on the EPR effect and ligand-receptor interactions, and they have largely failed to translate into the clinic. So it is urgent to explore an enhanced strategy for effective delivery of anticancer agents. Clinically, many cancers require large amounts of glutamine for their continued growth and survival, resulting in circulating glutamine extraction by the tumor being much greater than that for any organs, behaving as a "glutamine trap". In the present study, we sought to elucidate whether the glutamine trap effect could be exploited to deliver therapeutic agents to selectively kill cancer cells. Here, a macromolecular glutamine analog, glutamine-functionalized branched polyethylenimine (GPI), was constructed as the carrier to deliver anti-CD47 siRNA for the blockage of CD47 "don't eat me" signals on cancer cells. The GPI/siRNA glutamine-rich polyplexes exhibited remarkably high levels of cellular uptake by glutamine-dependent lung cancer cells, wild-type A549 cells (A549WT) and its cisplatin-resistant cells (A549DDP), specifically under glutamine-depleted conditions. It was noted that the glutamine transporter ASCT2 was highly expressed both on A549WT and A549DDP, but almost no expression in normal human lung fibroblasts cells. Inhibition of ASCT2 significantly prevented the internalization of GPI polyplexes. These findings raised the intriguing possibility that the glutamine-rich GPI polyplexes utilize the ASCT2 pathway to selectively facilitate their cellular uptake by cancer cells. GPI further delivered anti-CD47 siRNA efficiently both in vitro and in vivo to down-regulate the intratumoral mRNA and protein expression levels of CD47. CD47 functions as a "don't eat me" signal and binds to the immunoreceptor SIRPα inducing evasion of phagocytic clearance. GPI/anti-CD47 siRNA polyplexes achieved significant antitumor activities both on A549WT and A549DDP tumor-bearing nude mice. Notably, it had no adverse effect on CD47-expressing red blood cells and platelets, likely due to selective delivery. Therefore, the glutamine-rich carrier GPI driven by the glutamine trap effect provides a promising new strategy for designing anticancer drug delivery systems.

Effects of a common transcranial direct current stimulation (tDCS) protocol on motor evoked potentials found to be highly variable within individuals over 9 testing sessions.

PubMed

Horvath, Jared Cooney; Vogrin, Simon J; Carter, Olivia; Cook, Mark J; Forte, Jason D

2016-09-01

Transcranial direct current stimulation (tDCS) uses a weak electric current to modulate neuronal activity. A neurophysiologic outcome measure to demonstrate reliable tDCS modulation at the group level is transcranial magnetic stimulation engendered motor evoked potentials (MEPs). Here, we conduct a study testing the reliability of individual MEP response patterns following a common tDCS protocol. Fourteen participants (7m/7f) each underwent nine randomized sessions of 1 mA, 10 min tDCS (3 anode; 3 cathode; 3 sham) delivered using an M1/orbito-frontal electrode montage (sessions separated by an average of ~5.5 days). Fifteen MEPs were obtained prior to, immediately following and in 5 min intervals for 30 min following tDCS. TMS was delivered at 130 % resting motor threshold using neuronavigation to ensure consistent coil localization. A number of non-experimental variables were collected during each session. At the individual level, considerable variability was seen among different testing sessions. No participant demonstrated an excitatory response ≥20 % to all three anodal sessions, and no participant demonstrated an inhibitory response ≥20 % to all three cathodal sessions. Intra-class correlation revealed poor anodal and cathodal test-retest reliability [anode: ICC(2,1) = 0.062; cathode: ICC(2,1) = 0.055] and moderate sham test-retest reliability [ICC(2,1) = 0.433]. Results also revealed no significant effect of tDCS at the group level. Using this common protocol, we found the effects of tDCS on MEP amplitudes to be highly variable at the individual level. In addition, no significant effects of tDCS on MEP amplitude were found at the group level. Future studies should consider utilizing a more strict experimental protocol to potentially account for intra-individual response variations.

Feedback brake distribution control for minimum pitch

NASA Astrophysics Data System (ADS)

Tavernini, Davide; Velenis, Efstathios; Longo, Stefano

2017-06-01

The distribution of brake forces between front and rear axles of a vehicle is typically specified such that the same level of brake force coefficient is imposed at both front and rear wheels. This condition is known as 'ideal' distribution and it is required to deliver the maximum vehicle deceleration and minimum braking distance. For subcritical braking conditions, the deceleration demand may be delivered by different distributions between front and rear braking forces. In this research we show how to obtain the optimal distribution which minimises the pitch angle of a vehicle and hence enhances driver subjective feel during braking. A vehicle model including suspension geometry features is adopted. The problem of the minimum pitch brake distribution for a varying deceleration level demand is solved by means of a model predictive control (MPC) technique. To address the problem of the undesirable pitch rebound caused by a full-stop of the vehicle, a second controller is designed and implemented independently from the braking distribution in use. An extended Kalman filter is designed for state estimation and implemented in a high fidelity environment together with the MPC strategy. The proposed solution is compared with the reference 'ideal' distribution as well as another previous feed-forward solution.

Electroporation-delivered transdermal neostigmine in rats: equivalent action to intravenous administration

PubMed Central

Berkó, Szilvia; Szűcs, Kálmán F; Balázs, Boglárka; Csányi, Erzsébet; Varju, Gábor; Sztojkov-Ivanov, Anita; Budai-Szűcs, Mária; Bóta, Judit; Gáspár, Róbert

2016-01-01

Purpose Transdermal electroporation has become one of the most promising noninvasive methods for drug administration, with greatly increased transport of macromolecules through the skin. The cecal-contracting effects of repeated transdermal electroporation delivery and intravenous administration of neostigmine were compared in anesthetized rats. Methods The cecal contractions were detected with implantable strain gauge sensors, and the plasma levels of neostigmine were followed by high-performance liquid chromatography. Results Both intravenously and EP-administered neostigmine (0.2–66.7 μg/kg) increased the cecal contractions in a dose-dependent manner. For both the low doses and the highest dose, the neostigmine plasma concentrations were the same after the two modes of administration, while an insignificantly higher level was observed at a dose of 20 μg/kg after intravenous administration as compared with the electroporation route. The contractile responses did not differ significantly after the two administration routes. Conclusion The results suggest that electroporation-delivered neostigmine elicits action equivalent to that observed after intravenous administration as concerning both time and intensity. Electroporation permits the delivery of even lower doses of water-soluble compounds through the skin, which is very promising for clinical practice. PMID:27274203

SKIPing With Head Start Teachers: Influence of T-SKIP on Object-Control Skills.

PubMed

Brian, Ali; Goodway, Jacqueline D; Logan, Jessica A; Sutherland, Sue

2017-12-01

Children from disadvantaged settings are at risk for delays in their object-control (OC) skills. Fundamental motor skill interventions, such as the Successful Kinesthetic Instruction for Preschoolers (SKIP) Program, are highly successful when led by motor development experts. However, few preschools employ such experts. This study examined the extent to which Head Start teachers delivering an 8-week teacher-led SKIP (T-SKIP) intervention elicited learning of OC skills for Head Start children. Head Start teachers (n = 5) delivered T-SKIP for 8 weeks (450 min). Control teachers (n = 5) implemented the typical standard of practice, or well-equipped free play. All children (N = 122) were pretested and posttested on the OC Skill subscale of the Test of Gross Motor Development-2. Descriptive analyses at pretest identified 81% of the children were developmentally delayed in OC skills (below the 30th percentile). A 2-level hierarchical linear model demonstrated the effectiveness of T-SKIP with significant differences (β = 4.70), t(8) = 7.02, p < .001, η2 = .56, between T-SKIP children (n = 63) and control children (n = 59) at posttest. Head Start teachers who delivered T-SKIP could bring about positive changes in children's OC skills, thereby remediating the initial developmental delays presented. Control children remained delayed in their OC skills in spite of daily well-equipped free play, giving rise to concerns about their future motor competence and physical activity levels.

Protect-your-prostate message delivered on Parliament Hill

PubMed Central

Gray, C

1998-01-01

In March Charlotte Gray attended a luncheon on Parliament Hill where a message on prostate cancer was served along with the meatballs. Thirty MPs attended the event, and organizer Ted White hopes the prevention message delivered by Dr. Martin Gleave will eventually trickle down to politicians in other levels of government. PMID:9614828

Lacto N Tetraose, Fucosylation, and Secretor Status are Highly Variable in Human Milk Oligosaccharides From Women Delivering Preterm

PubMed Central

De Leoz, Maria Lorna A.; Gaerlan, Stephanie C.; Strum, John S.; Dimapasoc, Lauren M.; Mirmiran, Majid; Tancredi, Daniel J.; Smilowitz, Jennifer T.; Kalanetra, Karen M.; Mills, David A.; German, J. Bruce; Lebrilla, Carlito B.; Underwood, Mark A.

2012-01-01

Breast milk is the ideal nutrition for term infants but must be supplemented to provide adequate growth for most premature infants. Human milk oligosaccharides (HMOs) are remarkably abundant and diverse in breast milk and yet provide no nutritive value to the infant. HMOs appear to have at least two major functions: prebiotic activity (stimulation of the growth of commensal bacteria in the gut) and protection against pathogens. Investigations of HMOs in milk from women delivering preterm have been limited. We present the first detailed mass spectrometric analysis of the fucosylation and sialylation in HMOs in serial specimens of milk from fifteen women delivering preterm and seven women delivering at term using nano-high performance liquid chromatography chip/time-of-flight mass spectrometry. A mixed-effects model with Levene’s test was used for the statistical analyses. We find that lacto-N-tetraose, a core HMO, is both more abundant and more highly variable in the milk of women delivering preterm. Furthermore, fucosylation in preterm milk is not as well regulated as in term milk, resulting in higher within and between mother variation in women delivering preterm vs. term. Of particular clinical interest, the α1,2-linked fucosylated oligosaccharide 2′-fucosyllactose, an indicator of secretor status, is not consistently present across lactation of several mothers that delivered preterm. The immaturity of HMO production does not appear to resolve over the time of lactation and may have relevance to the susceptibility of premature infants to necrotizing enterocolitis, late onset sepsis, and related neurodevelopmental impairments. PMID:22900748

Gene delivery nanocarriers of bioactive glass with unique potential to load BMP2 plasmid DNA and to internalize into mesenchymal stem cells for osteogenesis and bone regeneration

NASA Astrophysics Data System (ADS)

Kim, Tae-Hyun; Singh, Rajendra K.; Kang, Min Sil; Kim, Joong-Hyun; Kim, Hae-Won

2016-04-01

The recent development of bioactive glasses with nanoscale morphologies has spurred their specific applications in bone regeneration, for example as drug and gene delivery carriers. Bone engineering with stem cells genetically modified with this unique class of nanocarriers thus holds great promise in this avenue. Here we report the potential of the bioactive glass nanoparticle (BGN) system for the gene delivery of mesenchymal stem cells (MSCs) targeting bone. The composition of 15% Ca-added silica, proven to be bone-bioactive, was formulated into surface aminated mesoporous nanospheres with enlarged pore sizes, to effectively load and deliver bone morphogenetic protein-2 (BMP2) plasmid DNA. The enlarged mesopores were highly effective in loading BMP2-pDNA with an efficiency as high as 3.5 wt% (pDNA w.r.t. BGN), a level more than twice than for small-sized mesopores. The BGN nanocarriers released the genetic molecules in a highly sustained manner (for as long as 2 weeks). The BMP2-pDNA/BGN complexes were effectively internalized to rat MSCs with a cell uptake level of ~73%, and the majority of cells were transfected to express the BMP2 protein. Subsequent osteogenesis of the transfected MSCs was demonstrated by the expression of bone-related genes, including bone sialoprotein, osteopontin, and osteocalcin. The MSCs transfected with BMP2-pDNA/BGN were locally delivered inside a collagen gel to the target calvarium defects. The results showed significantly improved bone regeneration, as evidenced by the micro-computed tomographic, histomorphometric and immunohistochemical analyses. This study supports the excellent capacity of the BGN system as a pDNA-delivery nanocarrier in MSCs, and the engineered system, BMP2-pDNA/BGN with MSCs, may be considered a new promising candidate to advance the therapeutic potential of stem cells through genetic modification, targeting bone defects and diseases.The recent development of bioactive glasses with nanoscale morphologies has spurred their specific applications in bone regeneration, for example as drug and gene delivery carriers. Bone engineering with stem cells genetically modified with this unique class of nanocarriers thus holds great promise in this avenue. Here we report the potential of the bioactive glass nanoparticle (BGN) system for the gene delivery of mesenchymal stem cells (MSCs) targeting bone. The composition of 15% Ca-added silica, proven to be bone-bioactive, was formulated into surface aminated mesoporous nanospheres with enlarged pore sizes, to effectively load and deliver bone morphogenetic protein-2 (BMP2) plasmid DNA. The enlarged mesopores were highly effective in loading BMP2-pDNA with an efficiency as high as 3.5 wt% (pDNA w.r.t. BGN), a level more than twice than for small-sized mesopores. The BGN nanocarriers released the genetic molecules in a highly sustained manner (for as long as 2 weeks). The BMP2-pDNA/BGN complexes were effectively internalized to rat MSCs with a cell uptake level of ~73%, and the majority of cells were transfected to express the BMP2 protein. Subsequent osteogenesis of the transfected MSCs was demonstrated by the expression of bone-related genes, including bone sialoprotein, osteopontin, and osteocalcin. The MSCs transfected with BMP2-pDNA/BGN were locally delivered inside a collagen gel to the target calvarium defects. The results showed significantly improved bone regeneration, as evidenced by the micro-computed tomographic, histomorphometric and immunohistochemical analyses. This study supports the excellent capacity of the BGN system as a pDNA-delivery nanocarrier in MSCs, and the engineered system, BMP2-pDNA/BGN with MSCs, may be considered a new promising candidate to advance the therapeutic potential of stem cells through genetic modification, targeting bone defects and diseases. Electronic supplementary information (ESI) available. See DOI: 10.1039/c5nr07933k

Knowledge of free delivery policy among women who delivered at health facilities in Oudomxay Province, Lao PDR.

PubMed

Chankham, Tengbriacheu; Yamamoto, Eiko; Reyer, Joshua A; Arafat, Rahman; Khonemany, Innoukham; Panome, Sayamoungkhoun; Hongkham, Dalavong; Bounfeng, Phommalaysith; Anonh, Xeuthvongsa; Hamajima, Nobuyuki

2017-02-01

To promote the utilization of maternal health services and reduce financial barriers, the Laos government introduced its "Free Maternal Health Services Policy" in 2012. This policy provides free maternal health services for pregnant women, which includes costs related to treatment, transportation, food fees, referral and an incentive for four antenatal care appointments. This study aims to ascertain the knowledge level regarding this policy among Lao women and determine their level of satisfaction with the maternal service provision. This is a cross-sectional study conducted in Xay district, La district, and Namore district of Oudomxay province, in August 2015. Three hundred and sixty women who delivered their children at the health facilities from July 2014 to June 2015 were randomly selected from the list of mothers who lived in each area. The majority of women had heard about the free delivery policy and knew that the main health services related to delivery and pregnancy were free of charge. Logistic regression analysis showed that education level (P=0.026), length of stay (P<0.0001) and receiving transportation support (P=0.005) had significant associations with the knowledge level. The women were highly satisfied with the quality of the services, health care providers, and health facilities. However, most mothers were not satisfied with accessibility to health facilities. To increase utilization of health facilities and reduce the maternal mortality ratio in rural areas, the government needs to improve people's education status and health care accessibility.

A Parallel Rendering Algorithm for MIMD Architectures

NASA Technical Reports Server (NTRS)

Crockett, Thomas W.; Orloff, Tobias

1991-01-01

Applications such as animation and scientific visualization demand high performance rendering of complex three dimensional scenes. To deliver the necessary rendering rates, highly parallel hardware architectures are required. The challenge is then to design algorithms and software which effectively use the hardware parallelism. A rendering algorithm targeted to distributed memory MIMD architectures is described. For maximum performance, the algorithm exploits both object-level and pixel-level parallelism. The behavior of the algorithm is examined both analytically and experimentally. Its performance for large numbers of processors is found to be limited primarily by communication overheads. An experimental implementation for the Intel iPSC/860 shows increasing performance from 1 to 128 processors across a wide range of scene complexities. It is shown that minimal modifications to the algorithm will adapt it for use on shared memory architectures as well.

Adolescent Literacy Tutoring: Face-to-Face and Via Webcam Technology

ERIC Educational Resources Information Center

Houge, Timothy T.; Peyton, David; Geier, Constance; Petrie, Bruce

2007-01-01

The purpose of this research project was to examine the effectiveness of supervised literacy tutoring delivered by 25 secondary teacher candidates to middle and high school students via webcam technology and in person. The results stem from two semester-long studies of technology-delivered tutoring from a university to middle and high school…

Distance Education: Why Are the Attrition Rates so High?

ERIC Educational Resources Information Center

Moody, Johnette

2004-01-01

Distance education is being hailed as the next best thing to sliced bread. But is it really? Many problems exist with distance-delivered courses. Everything from course development and management to the student not being adequately prepared are problematic and result in high attrition rates in distance-delivered courses. Students initially…

Optical Frequency Optimization of a High Intensity Laser Power Beaming System Utilizing VMJ Photovoltaic Cells

NASA Technical Reports Server (NTRS)

Raible, Daniel E.; Dinca, Dragos; Nayfeh, Taysir H.

2012-01-01

An effective form of wireless power transmission (WPT) has been developed to enable extended mission durations, increased coverage and added capabilities for both space and terrestrial applications that may benefit from optically delivered electrical energy. The high intensity laser power beaming (HILPB) system enables long range optical 'refueling" of electric platforms such as micro unmanned aerial vehicles (MUAV), airships, robotic exploration missions and spacecraft platforms. To further advance the HILPB technology, the focus of this investigation is to determine the optimal laser wavelength to be used with the HILPB receiver, which utilizes vertical multi-junction (VMJ) photovoltaic cells. Frequency optimization of the laser system is necessary in order to maximize the conversion efficiency at continuous high intensities, and thus increase the delivered power density of the HILPB system. Initial spectral characterizations of the device performed at the NASA Glenn Research Center (GRC) indicate the approximate range of peak optical-to-electrical conversion efficiencies, but these data sets represent transient conditions under lower levels of illumination. Extending these results to high levels of steady state illumination, with attention given to the compatibility of available commercial off-the-shelf semiconductor laser sources and atmospheric transmission constraints is the primary focus of this paper. Experimental hardware results utilizing high power continuous wave (CW) semiconductor lasers at four different operational frequencies near the indicated band gap of the photovoltaic VMJ cells are presented and discussed. In addition, the highest receiver power density achieved to date is demonstrated using a single photovoltaic VMJ cell, which provided an exceptionally high electrical output of 13.6 W/sq cm at an optical-to-electrical conversion efficiency of 24 percent. These results are very promising and scalable, as a potential 1.0 sq m HILPB receiver of similar construction would be able to generate 136 kW of electrical power under similar conditions.

“Elegant Tool” Delivers Genome-Level Science for Electrolytes

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

Keith Arterburn

Now, a ‘disruptive, virtual scientific simulation tool’ delivers a new, genome-level investigation for electrolytes to develop better, more efficient batteries. Dr. Kevin Gering, an Idaho National Laboratory researcher, has developed the Advanced Electrolyte Model (AEM), a copyrighted molecular-based simulation tool that has been scientifically proven and validated using at least a dozen ‘real-world’ physical metrics. Nominated for the 2014 international R&D 100 Award, AEM revolutionizes electrolyte materials selection, optimizing combinations and key design elements to make battery design and experimentation quick, accurate and responsive to specific needs.

Hyaluronic acid coated poly-epsilon-caprolactone nanospheres deliver high concentrations of cyclosporine A into the cornea.

PubMed

Yenice, Irem; Mocan, Mehmet C; Palaska, Erhan; Bochot, Amélie; Bilensoy, Erem; Vural, Imran; Irkeç, Murat; Hincal, A Atilla

2008-09-01

The objective of this study was to determine cyclosporine A (Cy A) levels in ocular tissues and fluids after topical administration of poly-epsilon-caprolactone (PCL)/benzalkonium chloride (BKC) nanospheres and hyaluronic acid (HA) coated PCL/BKC nanospheres onto healthy rabbit corneas. Nanospheres were prepared by nanoprecipitation and purified by gradient-rate centrifugation. Cy A (0.1%) in either castor oil solution (group 1), PCL/BKC nanosphere formulation (group 2) or HA coated PCL/BKC nanosphere formulation (group 3) was instilled onto rabbit corneas. Tear samples were adsorbed onto Schirmer tear strips. Cy A concentrations of fluid (blood, aqueous humor, tear) and specimen extracts (cornea, conjunctiva, iris/ciliary body) were determined by high performance liquid chromatography-mass spectrometry (LC-MS). The mean corneal Cy A concentration obtained at 0.5, 1, 2, 4, 8 and 24h following instillation of the formulations ranged between 0.12 and 1.2 ng/mg tissue for group 1, 5.9-15.5 ng/mg tissue for group 2 and 11.4-23.0 ng/mg for group 3 (one-way analysis of variance (ANOVA) and pairwise tests (SNK (Student-Newman-Keuls) and Tukey); p<0.05). Conjunctival Cy A levels of group 2 and 3 were not significantly different at any of the time points tested. However, there was a significant difference between Cy A concentration of castor oil formulation and that of PCL/BKC nanosphere formulation at 1 and 8h (p<0.05). The mean iris/ciliary body concentrations obtained with the three formulations were not significantly different at any time point with the exception of group 2 levels being higher than those of groups 1 and 3 at 1h (p<0.05). The lowest ocular tear Cy A concentrations (16-114 ng/ml) were found following the instillation of HA coated PCL/BKC nanoparticles (group 3) during the time period tested. Cy A loaded PCL/BKC and HA coated PCL/BKC nanospheres are able to achieve high levels of Cy A in the cornea that is 10-15-fold higher than that is achieved with Cy A solution in castor oil. Nanosphere formulation and HA may play an important role in delivering high levels of cyclosporine A into the cornea.

Design and validation of a diffuse reflectance and spectroscopic microendoscope with poly(dimethylsioxane)-based phantoms

PubMed Central

Greening, Gage J.; Powless, Amy J.; Hutcheson, Joshua A.; Prieto, Sandra P.; Majid, Aneeka A.; Muldoon, Timothy J.

2015-01-01

Many cases of epithelial cancer originate in basal layers of tissue and are initially undetected by conventional microendoscopy techniques. We present a bench-top, fiber-bundle microendoscope capable of providing high resolution images of surface cell morphology. Additionally, the microendoscope has the capability to interrogate deeper into material by using diffuse reflectance and broadband diffuse reflectance spectroscopy. The purpose of this multimodal technique was to overcome the limitation of microendoscopy techniques that are limited to only visualizing morphology at the tissue or cellular level. Using a custom fiber optic probe, high resolution surface images were acquired using topical proflavine to fluorescently stain non-keratinized epithelia. A 635 nm laser coupled to a 200 μm multimode fiber delivers light to the sample and the diffuse reflectance signal was captured by a 1 mm image guide fiber. Finally, a tungsten-halogen lamp coupled to a 200 μm multimode fiber delivers broadband light to the sample to acquire spectra at source-detector separations of 374, 729, and 1051 μm. To test the instrumentation, a high resolution proflavine-induced fluorescent image of resected healthy mouse colon was acquired. Additionally, five monolayer poly(dimethylsiloxane)-based optical phantoms with varying absorption and scattering properties were created to acquire diffuse reflectance profiles and broadband spectra. PMID:25983372

Doping management for high-power fiber lasers: 100 W, few-picosecond pulse generation from an all-fiber-integrated amplifier.

PubMed

Elahi, P; Yılmaz, S; Akçaalan, O; Kalaycıoğlu, H; Oktem, B; Senel, C; Ilday, F Ö; Eken, K

2012-08-01

Thermal effects, which limit the average power, can be minimized by using low-doped, longer gain fibers, whereas the presence of nonlinear effects requires use of high-doped, shorter fibers to maximize the peak power. We propose the use of varying doping levels along the gain fiber to circumvent these opposing requirements. By analogy to dispersion management and nonlinearity management, we refer to this scheme as doping management. As a practical first implementation, we report on the development of a fiber laser-amplifier system, the last stage of which has a hybrid gain fiber composed of high-doped and low-doped Yb fibers. The amplifier generates 100 W at 100 MHz with pulse energy of 1 μJ. The seed source is a passively mode-locked fiber oscillator operating in the all-normal-dispersion regime. The amplifier comprises three stages, which are all-fiber-integrated, delivering 13 ps pulses at full power. By optionally placing a grating compressor after the first stage amplifier, chirp of the seed pulses can be controlled, which allows an extra degree of freedom in the interplay between dispersion and self-phase modulation. This way, the laser delivers 4.5 ps pulses with ~200 kW peak power directly from fiber, without using external pulse compression.

Diabetes mellitus in older people: position statement on behalf of the International Association of Gerontology and Geriatrics (IAGG), the European Diabetes Working Party for Older People (EDWPOP), and the International Task Force of Experts in Diabetes.

PubMed

Sinclair, Alan; Morley, John E; Rodriguez-Mañas, Leo; Paolisso, Giuseppe; Bayer, Tony; Zeyfang, Andrej; Bourdel-Marchasson, Isabelle; Vischer, Ulrich; Woo, Jean; Chapman, Ian; Dunning, Trisha; Meneilly, Graydon; Rodriguez-Saldana, Joel; Gutierrez Robledo, Luis Miguel; Cukierman-Yaffe, Tali; Gadsby, Roger; Schernthaner, Guntram; Lorig, Kate

2012-07-01

Diabetes mellitus is a highly prevalent metabolic condition in ageing societies associated with high levels of morbidity, multiple therapies, and functional deterioration that challenges even the best of health care systems to deliver high-quality, individualized care. Most international clinical guidelines have ignored the often-unique issues of frailty, functional limitation, changes in mental health, and increasing dependency that characterize many aged patients with diabetes. A collaborative Expert Group of the IAGG and EDWPOP and an International Task Force have explored the key issues that affect diabetes in older people using a robust method comprising a Delphi process and an evidence-based review of the literature. Eight domains of interest were initially agreed and discussed: hypoglycemia, therapy, care home diabetes, influence of comorbidities, glucose targets, family/carer perspectives, diabetes education, and patient safety. A set of "consensus" statements was produced in each domain of interest. These form a foundation for future policy development in this area and should influence the clinical behavior and approach of all health professionals engaged in delivering diabetes care to older people. Copyright © 2012 American Medical Directors Association. Published by Elsevier Inc. All rights reserved.

Design and validation of a diffuse reflectance and spectroscopic microendoscope with poly(dimethylsiloxane)-based phantoms

NASA Astrophysics Data System (ADS)

Greening, Gage J.; Powless, Amy J.; Hutcheson, Joshua A.; Prieto, Sandra P.; Majid, Aneeka A.; Muldoon, Timothy J.

2015-03-01

Many cases of epithelial cancer originate in basal layers of tissue and are initially undetected by conventional microendoscopy techniques. We present a bench-top, fiber-bundle microendoscope capable of providing high resolution images of surface cell morphology. Additionally, the microendoscope has the capability to interrogate deeper into material by using diffuse reflectance and broadband diffuse reflectance spectroscopy. The purpose of this multimodal technique was to overcome the limitation of microendoscopy techniques that are limited to only visualizing morphology at the tissue or cellular level. Using a custom fiber optic probe, high resolution surface images were acquired using topical proflavine to fluorescently stain non-keratinized epithelia. A 635 nm laser coupled to a 200 μm multimode fiber delivers light to the sample and the diffuse reflectance signal was captured by a 1 mm image guide fiber. Finally, a tungsten-halogen lamp coupled to a 200 μm multimode fiber delivers broadband light to the sample to acquire spectra at source-detector separations of 374, 729, and 1051 μm. To test the instrumentation, a high resolution proflavine-induced fluorescent image of resected healthy mouse colon was acquired. Additionally, five monolayer poly(dimethylsiloxane)-based optical phantoms with varying absorption and scattering properties were created to acquire diffuse reflectance profiles and broadband spectra.

Exosomes derived from hypoxic epithelial ovarian cancer deliver microRNA-940 to induce macrophage M2 polarization.

PubMed

Chen, Xin; Ying, Xiang; Wang, Xinjing; Wu, Xiaoli; Zhu, Qinyi; Wang, Xipeng

2017-07-01

Hypoxia is a common feature of solid tumors. It is closely related to tumor progression. Exosomal microRNAs derived from cancers are considered to be mediators between cancer cells and the tumor microenvironment. In addition, the number of tumor-associated macrophages (TAMs) in the tumor microenvironment has also been demonstrated to correlate with tumor development. However, the relationship between tumor-secreted exosomes and TAM polarization under hypoxic conditions during tumor progression is not clear. Herein, we demonstrated that hypoxia induces the high expression of microRNA-940 (miR‑940) in exosomes derived from epithelial ovarian cancer (EOC). We also found that miR‑940 is highly expressed in exosomes isolated from ascites of EOC patients. Moreover, the overexpression of miR‑940 in macrophages delivered by exosomes stimulated M2 phenotype polarization, while the M2 subtype macrophages promoted EOC proliferation and migration. These results highlight the function of hypoxia in enhancing the high level of expression of miR‑940 in tumor exosomes taken up by macrophages. We also showed that the tumor-promoting function of miR‑940 is mediated by TAM polarization in EOC. These findings show that tumor-derived exosomal miR‑940 induced by hypoxia plays an important role in stimulating TAM polarization in the progression of EOC.

Mission Assessment of the Faraday Accelerator with Radio-frequency Assisted Discharge (FARAD)

NASA Technical Reports Server (NTRS)

Dankanich, John W.; Polzin, Kurt A.

2008-01-01

Pulsed inductive thrusters have typically been considered for future, high-power, missions requiring nuclear electric propulsion. These high-power systems, while promising equivalent or improved performance over state-of-the-art propulsion systems, presently have no planned missions for which they are well suited. The ability to efficiently operate an inductive thruster at lower energy and power levels may provide inductive thrusters near term applicability and mission pull. The Faraday Accelerator with Radio-frequency Assisted Discharge concept demonstrated potential for a high-efficiency, low-energy pulsed inductive thruster. The added benefits of energy recapture and/or pulse compression are shown to enhance the performance of the pulsed inductive propulsion system, yielding a system that con compete with and potentially outperform current state-of-the-art electric propulsion technologies. These enhancements lead to mission-level benefits associated with the use of a pulsed inductive thruster. Analyses of low-power near to mid-term missions and higher power far-term missions are undertaken to compare the performance of pulsed inductive thrusters with that delivered by state-of-the-art and development-level electric propulsion systems.

Neuroendocrine response to violence during pregnancy--impact on duration of pregnancy and fetal growth.

PubMed

Valladares, Eliette; Peña, Rodolfo; Ellsberg, Mary; Persson, Lars Ake; Högberg, Ulf

2009-01-01

To study the neuroendocrine release of cortisol in response to perceived stress among pregnant women exposed to partner violence and how this affects the duration of pregnancy and the intrauterine growth of the infant. Cross-sectional community-based study. Health and Demographic Surveillance System of Leon, Nicaragua. One-hundred and forty-seven pregnant women. Standardized scales to measure intimate partner violence, social resources, perceived stress, and socio-economic conditions were applied. Two salivary samples for cortisol were collected in the morning and afternoon on the same day. Linear regression and path analysis were used. Cortisol levels, gestational age, and weight at delivery. Partner violence during the pregnancy, low social resources, and perceived maternal stress were associated with high level of salivary cortisol. Pregnant women with high cortisol levels were significantly more likely to give birth to small-for-gestational age babies, but not to deliver preterm. A substantial decrease of birthweight, 121-186 g, was associated with an increase in cortisol in association with violence exposure. Partner violence during pregnancy is a stressor that provokes high levels of cortisol, which is associated with reduction of birthweight.

Online anatomy and physiology: piloting the use of an anatomy and physiology e-book-VLE hybrid in pre-registration and post-qualifying nursing programmes at the University of Salford.

PubMed

Raynor, Michael; Iggulden, Helen

2008-06-01

Anatomy and physiology (A&P) teaching and learning in nursing curricula poses problems for educators because of the often varying levels of students' background knowledge. This study reports on a pilot project that attempted to normalize these differentials by delivering A&P teaching using an online interactive e-book-virtual learning environment (VLE) hybrid. Evaluate the effectiveness of using an online interactive resource to deliver A&P teaching. Data were collected from pre-registration and post-qualifying students by questionnaire and observation, and from lecturers by structured interviews. Scale-up issues were identified and documented as part of support for the ongoing pilot. The pre-registration group encountered problems accessing the resource and yielded evidence to suggest that inexperienced learners require a high level of direction to use the resource effectively. The post-qualifying group benefited from the resource's interactive elements and 24/7 availability. There was clear evidence that the group were able to relate knowledge gained from the resource to practice. This hybrid has great potential to add value to A&P learning on nursing programmes at post-qualifying level. The resource could replace its printed equivalent; however, negotiations need to take place between institutions and publishers in order to resolve scale-up issues.

Future-proofing the pharmacy profession in a hypercompetitive market.

PubMed

Singleton, Judith A; Nissen, Lisa M

2014-01-01

This paper highlights the hypercompetitive nature of the current pharmacy landscape in Australia and to suggest either a superior level of differentiation strategy or a focused differentiation strategy targeting a niche market as two viable, alternative business models to cost leadership for small, independent community pharmacies. A description of the Australian health care system is provided as well as background information on the current community pharmacy environment in Australia. The authors propose a differentiation or focused differentiation strategy based on cognitive professional services (CPS) which must be executed well and of a superior quality to competitors' services. Market research to determine the services valued by target customers and that they are willing to pay for is vital. To achieve the superior level of quality that will engender high patient satisfaction levels and loyalty, pharmacy owners and managers need to develop, maintain and clearly communicate service quality specifications to the staff delivering these services. Otherwise, there will be a proliferation of pharmacies offering the same professional services with no evident service differential. However, to sustain competitive advantage over the long-term, these smaller, independent community pharmacies will need to exploit a broad core competency base in order to be able to continuously introduce new sources of competitive advantage. With the right expertise, the authors argue that smaller, independent community pharmacies can successfully deliver CPS and sustain profitability in a hypercompetitive market. Copyright © 2014 Elsevier Inc. All rights reserved.

Method and apparatus for delivering high power laser energy over long distances

DOEpatents

Zediker, Mark S; Rinzler, Charles C; Faircloth, Brian O; Koblick, Yeshaya; Moxley, Joel F

2013-08-20

Systems, devices and methods for the transmission of 1 kW or more of laser energy deep into the earth and for the suppression of associated nonlinear phenomena. Systems, devices and methods for the laser drilling of a borehole in the earth. These systems can deliver high power laser energy down a deep borehole, while maintaining the high power to advance such boreholes deep into the earth and at highly efficient advancement rates.

In Situ High-Level Nitrogen Doping into Carbon Nanospheres and Boosting of Capacitive Charge Storage in Both Anode and Cathode for a High-Energy 4.5 V Full-Carbon Lithium-Ion Capacitor.

PubMed

Sun, Fei; Liu, Xiaoyan; Wu, Hao Bin; Wang, Lijie; Gao, Jihui; Li, Hexing; Lu, Yunfeng

2018-05-02

To circumvent the imbalances of electrochemical kinetics and capacity between Li + storage anodes and capacitive cathodes for lithium-ion capacitors (LICs), we herein demonstrate an efficient solution by boosting the capacitive charge-storage contributions of carbon electrodes to construct a high-performance LIC. Such a strategy is achieved by the in situ and high-level doping of nitrogen atoms into carbon nanospheres (ANCS), which increases the carbon defects and active sites, inducing more rapidly capacitive charge-storage contributions for both Li + storage anodes and PF 6 - storage cathodes. High-level nitrogen-doping-induced capacitive enhancement is successfully evidenced by the construction of a symmetric supercapacitor using commercial organic electrolytes. Coupling a pre-lithiated ANCS anode with a fresh ANCS cathode enables a full-carbon LIC with a high operating voltage of 4.5 V and high energy and power densities thereof. The assembled LIC device delivers high energy densities of 206.7 and 115.4 Wh kg -1 at power densities of 0.225 and 22.5 kW kg -1 , respectively, as well as an unprecedented high-power cycling stability with only 0.0013% capacitance decay per cycle within 10 000 cycles at a high power output of 9 kW kg -1 .

A feasibility trial of an Internet-delivered and transdiagnostic cognitive behavioral therapy treatment program for anxiety, depression, and disability among adults with epilepsy.

PubMed

Gandy, Milena; Karin, Eyal; Fogliati, Vincent J; McDonald, Sarah; Titov, Nick; Dear, Blake F

2016-11-01

Anxiety and depression are highly prevalent in people with epilepsy (PWE) and contribute to increased disability. Unfortunately, there are numerous barriers (e.g., cost, distance, and stigma) and service gaps (e.g., lack of services and trained clinicians) that prevent many PWE from accessing traditional face-to-face psychological services. The aim of the present study was to examine the feasibility of a new transdiagnostic Internet-delivered cognitive behavioral therapy (iCBT) program, the Chronic Conditions Course, to simultaneously treat symptoms of anxiety, depression, and disability. A single-group feasibility open trial was employed involving 27 adults with epilepsy. The program comprises five online lessons delivered over 8 weeks and is provided with weekly contact from a mental health professional via e-mail and telephone. High treatment completion rates and levels of satisfaction were reported. Evidence of significant improvements in our primary outcomes (within-group Cohen's d [d]; average [avg.] reductions) of anxiety (d ≥ 1.28; avg. reduction ≥ 54%), depression (d ≥ 1.24; avg. reduction ≥ 54%), epilepsy-specific depression (d ≥ 0.95; avg. reduction ≥ 35%), and disability (d ≥ 0.62; avg. reduction ≥ 33%) were observed at posttreatment, which were sustained at or further improved to 3-month follow-up. On our secondary outcomes there were significant improvements for life satisfaction (d ≥ 0.70; avg. improvement ≥ 26%) but not for perceived cognitive difficulties (d ≥ 0.48; avg. reduction ≥ 15%). Highlighting the potential of the approach, relatively little clinician time was required per participant (mean 80.62 min, standard deviation [SD] 54.78), and the trial involved a broad range of geographically dispersed patients. The findings of the current study support the feasibility and potential of transdiagnostic Internet-delivered treatments for adults with epilepsy. Further large-scale controlled trials are warranted. Wiley Periodicals, Inc. © 2016 International League Against Epilepsy.

The nutritional status of women in the first trimester of pregnancy attending an inner-city antenatal department in the UK.

PubMed

Rees, Gail; Brooke, Zoe; Doyle, Wendy; Costeloe, Kate

2005-09-01

We have previously found high rates of poor iron and folate status in women who had delivered a low birthweight baby (LBW) in an ethnically diverse inner-city area of the UK. However, little was known of the nutritional status in the local general obstetric population. We therefore investigated biochemical measures of nutritional status in the first trimester of the first pregnancy. Routine blood samples collected at the antenatal booking clinic were analysed for haemoglobin (Hb), serum ferritin, red cell folate (RCF) (n = 100) and erythrocyte transketolase activation coefficient (ETKAC) for thiamin status (n = 90). We found 9% of women in our sample had a low Hb level, 10% had a low serum ferritin and only one had a low RCF. This is a substantially lower number of women with biochemical deficiencies than we found previously in women three months after delivering a LBW baby. However, 34% had low thiamin status. Thiamin status was negatively correlated with gestational age at birth (r = -0.407, p < 0.001). Differences in nutritional status were observed between ethnic and socio-economic groups. Hb levels differed between ethnic (p = 0.001) and socio-economic groups (p = 0.02), with Africans and women in manual occupations/unwaged having the lowest Hb levels. RCF levels also differed between groups (p < 0.001) with Caucasians and those in non-manual occupations having highest levels. ETKAC also differed between ethnic groups (p = 0.008) with Africans having the highest level indicating a poorer status. The study highlights the need to improve nutrition particularly in ethnic minorities and low income groups who are most at risk of adverse birth outcomes such as LBW.

The Impact of Trajectory Prediction Uncertainty on Air Traffic Controller Performance and Acceptability

NASA Technical Reports Server (NTRS)

Mercer, Joey S.; Bienert, Nancy; Gomez, Ashley; Hunt, Sarah; Kraut, Joshua; Martin, Lynne; Morey, Susan; Green, Steven M.; Prevot, Thomas; Wu, Minghong G.

2013-01-01

A Human-In-The-Loop air traffic control simulation investigated the impact of uncertainties in trajectory predictions on NextGen Trajectory-Based Operations concepts, seeking to understand when the automation would become unacceptable to controllers or when performance targets could no longer be met. Retired air traffic controllers staffed two en route transition sectors, delivering arrival traffic to the northwest corner-post of Atlanta approach control under time-based metering operations. Using trajectory-based decision-support tools, the participants worked the traffic under varying levels of wind forecast error and aircraft performance model error, impacting the ground automations ability to make accurate predictions. Results suggest that the controllers were able to maintain high levels of performance, despite even the highest levels of trajectory prediction errors.

Experimentally Assessing a Resource-Effective Design for ODL Environments

ERIC Educational Resources Information Center

Karoulis, Athanasis; Sfetsos, Panagiotis; Stamelos, Ioannis; Angelis, Lefteris; Pombortsis, Andreas

2004-01-01

This study is concerned with the formal assessment of a Distance Learning Environment (DLE) created to deliver a course on UML sequence diagrams to university-level students, divided into control and treatment groups. An ad-hoc DLE was constructed to deliver instruction to the treatment group, while the control group was taught in a traditional…

Organization of Functional Postural Responses Following Perturbations in Multiple Directions in Elderly Fallers Standing Quietly

ERIC Educational Resources Information Center

Matjacic, Zlatko; Sok, David; Jakovljevic, Miroljub; Cikajlo, Imre

2013-01-01

The objective of the study was to assess functional postural responses by analyzing the center-of-pressure trajectories resulting from perturbations delivered in multiple directions to elderly fallers. Ten elderly individuals were standing quietly on two force platforms while an apparatus delivered controlled perturbations at the level of pelvis…

Ultra-accelerated natural sunlight exposure testing facilities

DOEpatents

Lewandowski, Allan A.; Jorgensen, Gary J.

2003-08-12

A multi-faceted concentrator apparatus for providing ultra-accelerated natural sunlight exposure testing for sample materials under controlled weathering conditions comprising: facets that receive incident natural sunlight, transmits VIS/NIR and reflects UV/VIS to deliver a uniform flux of UV/VIS onto a sample exposure plane located near a center of a facet array in chamber means that provide concurrent levels of temperature and/or relative humidity at high levels of up to 100.times. of natural sunlight that allow sample materials to be subjected to accelerated irradiance exposure factors for a significant period of time of about 3 to 10 days to provide a corresponding time of about at least a years worth representative weathering of sample materials.

Platform C South Arrival

NASA Image and Video Library

2016-08-04

A heavy load transport truck from Tillett Heavy Hauling in Titusville, Florida, arrives at the Vehicle Assembly Building (VAB) at NASA’s Kennedy Space Center in Florida, carrying a section of the first half of the C-level work platforms, C south, for the agency’s Space Launch System (SLS) rocket. The platform will be delivered to the VAB staging area in the west parking lot. The Ground Systems Development and Operations Program is overseeing upgrades and modifications to VAB High Bay 3 to support processing of the SLS and Orion spacecraft. A total of 10 levels of new platforms, 20 platform halves altogether, will surround the SLS rocket and Orion spacecraft and provide access for testing and processing.

Agreeableness and alcohol-related aggression: the mediating effect of trait aggressivity.

PubMed

Miller, Cameron A; Parrott, Dominic J; Giancola, Peter R

2009-12-01

This study investigated the mediating effect of trait aggressivity on the relation between agreeableness and alcohol-related aggression in a laboratory setting. Participants were 116 healthy male social drinkers between 21 and 30 years of age. Agreeableness and trait aggressivity were measured using the Big Five Inventory and the Buss-Perry Aggression Questionnaire, respectively. Following the consumption of an alcohol or no-alcohol control beverage, participants completed a modified version of the Taylor Aggression Paradigm, in which electric shocks were received from and administered to a fictitious opponent during a competitive task. Aggression was operationalized as the proportion of the most extreme shocks delivered to the fictitious opponent under conditions of low and high provocation. Results indicated that lower levels of agreeableness were associated with higher levels of trait aggressivity. In turn, higher levels of trait aggressivity predicted extreme aggression in intoxicated, but not sober, participants under low, but not high, provocation. Findings highlight the importance of examining determinants of intoxicated aggression within a broader theoretical framework of personality.

Assessment of an Internet-Delivered Interactive Approach to Introductory Astronomy for Non-Science Majors

ERIC Educational Resources Information Center

Slater, Timothy F.; Jones, Lauren V.

2004-01-01

This project explores the effectiveness of learner-centered education (LCE) principles and practices on student learning and attitudes in an online interactive introductory astronomy course for non-science majors by comparing a high-quality Internet-delivered course with a high-quality on-campus course, both of which are based on the principles of…

Impact of a Parenting Program in a High-Risk, Multi-Ethnic Community: The PALS Trial

ERIC Educational Resources Information Center

Scott, Stephen; O'Connor, Thomas G.; Futh, Annabel; Matias, Carla; Price, Jenny; Doolan, Moira

2010-01-01

Background: Parenting programs have been shown to work when delivered to motivated ethnic majority parents in demonstration projects, but comparatively little is known about their impact when delivered to high-risk, multi-ethnic populations by routine local services. Methods: The Primary Age Learning Skills (PALS) trial was a randomized controlled…

Protein Transfer Into Human Cells by VSV-G-induced Nanovesicles

PubMed Central

Mangeot, Philippe-Emmanuel; Dollet, Sandra; Girard, Mathilde; Ciancia, Claire; Joly, Stéphane; Peschanski, Marc; Lotteau, Vincent

2011-01-01

Identification of new techniques to express proteins into mammal cells is of particular interest for both research and medical purposes. The present study describes the use of engineered vesicles to deliver exogenous proteins into human cells. We show that overexpression of the spike glycoprotein of the vesicular stomatitis virus (VSV-G) in human cells induces the release of fusogenic vesicles named gesicles. Biochemical and functional studies revealed that gesicles incorporated proteins from producer cells and could deliver them to recipient cells. This protein-transduction method allows the direct transport of cytoplasmic, nuclear or surface proteins in target cells. This was demonstrated by showing that the TetR transactivator and the receptor for the murine leukemia virus (MLV) envelope [murine cationic amino acid transporter-1 (mCAT-1)] were efficiently delivered by gesicles in various cell types. We further shows that gesicle-mediated transfer of mCAT-1 confers to human fibroblasts a robust permissiveness to ecotropic vectors, allowing the generation of human-induced pluripotent stem cells in level 2 biosafety facilities. This highlights the great potential of mCAT-1 gesicles to increase the safety of experiments using retro/lentivectors. Besides this, gesicles is a versatile tool highly valuable for the nongenetic delivery of functions such as transcription factors or genome engineering agents. PMID:21750535

Noninvasive, localized, and transient brain drug delivery using focused ultrasound and microbubbles

NASA Astrophysics Data System (ADS)

Choi, James J.

In the United States, Alzheimer's disease (AD), Parkinson's disease (PD), and brain cancer caused 72,432, 19,566 and 12,886 deaths in 2006, respectively. Whereas the number of deaths due to major disorders such as heart disease, stroke, and prostate cancer have decreased since 2006, deaths attributed to AD, PD, and brain cancer have not. Treatment options for patients with CNS disorders remain limited despite significant advances in knowledge of CNS disease pathways and development of neurologically potent agents. One of the major obstacles is that the cerebral microvasculature is lined by a specialized and highly regulated blood-brain barrier (BBB) that prevents large agents from entering the brain extracellular space. The purpose of this dissertation is to design a noninvasive, localized, and transient BBB opening system using focused ultrasound (FUS) and determine ultrasound and microbubble conditions that can effectively and safely deliver large pharmacologically-relevant-sized agents to the brain. To meet this end, an in vivo mouse brain drug delivery system using a stereotactic-based targeting method was developed. FUS was applied noninvasively through the intact skin and skull, which allowed for long-term and high-throughput studies. With this system, more than 150 mice were exposed to one of 31 distinct acoustic and microbubble conditions. The feasibility of delivering a large MRI contrast agent was first demonstrated in vivo in both wild-type and transgenic Alzheimer's disease model (APP/PS1) mice. A wide range of acoustic and microbubble conditions were then evaluated for their ability to deliver agents to a target region. Interestingly, the possible design space of parameters was found to be vast and different conditions resulted in distinct spatial distributions and doses delivered. In particular, BBB opening was shown to be dependent on the microbubble diameter, acoustic pressure, pulse repetition frequency (PRF), and pulse length (PL). Each set of conditions determined both the size of agents that can traverse the BBB, and also the level of safety of the technique. In one set of conditions (peak-rarefactional pressure: 0.61 MPa, PRF: 10 Hz, PL: 20 ms), large 70-kDa dextran was delivered to a target region, but were associated with detectable damaged sites as indicated by dark neurons, microvacuolations, and erythrocyte extravasations. Another set of conditions (peak-rarefactional pressure: 0.46 MPa, PRF: 5 Hz, PL: 0.2 ms) delivered 3-kDa dextran homogeneously and diffusely to a target region in the brain without any detectable dark neurons, microvacuolations, or erythrocyte extravasations. Each distinct set of conditions may thus be used for different clinical application, i.e., treatment of brain cancer and AD. In conclusion, an effective method to noninvasively, locally, and transiently deliver large therapeutic agents through the BBB was developed.

Empowerment in nurse leader groups in middle management: a quantitative comparative investigation.

PubMed

Spencer, Caroline; McLaren, Susan

2017-01-01

The aim was to investigate structural empowerment in nurse leaders in middle management positions. Objectives were to determine levels of empowerment of nurse leaders and to compare levels of empowerment between nurse leader groups. Access to formal and informal power, opportunity, resources, information and support are determinants of structural empowerment. Empowerment of nurse leaders in middle management positions is vital given their roles in enabling nursing teams to deliver high-quality care, benefitting both patient and workforce outcomes. Quantitative component of a mixed methods study using survey principles. The Conditions of Work Effectiveness Questionnaire II was distributed to the total population (n = 517) of nurse leaders in an NHS Foundation Trust in England. Nurse leader groups comprised unit leaders (sisters, matrons) and senior staff nurses. Quantitative data entered on spss v 17/18, were analysed using descriptive and inferential statistics. Overall, the unit response rate was 44·1% (n = 228). Levels of total and global empowerment were moderate and moderate to high respectively. Groups did not differ significantly on these parameters or on five elements of total empowerment, but significantly higher scores were found for unit leaders' access to information. Significantly higher scores were found for senior staff nurses on selected aspects of informal power and access to resources, but scores were significantly lower than unit leaders for components of support. A moderately empowered population of nurse leaders differed in relation to access to information, aspects of support, resources and informal power, reflecting differences in roles, spheres of responsibility, hierarchical position and the constraints on empowerment imposed on unit leaders by financial and resource pressures. Empowerment of nurse leaders in middle management is vital in enabling nursing teams to deliver high-quality care. Roles, spheres of responsibility, hierarchical position and constraints imposed by financial and resource pressures influence nurse leader empowerment. Administrative support is needed to sustain practice engagement. © 2016 John Wiley & Sons Ltd.

High brachytherapy doses can counteract hypoxia in cervical cancer—a modelling study

NASA Astrophysics Data System (ADS)

Lindblom, Emely; Dasu, Alexandru; Beskow, Catharina; Toma-Dasu, Iuliana

2017-01-01

Tumour hypoxia is a well-known adverse factor for the outcome of radiotherapy. For cervical tumours in particular, several studies indicate large variability in tumour oxygenation. However, clinical evidence shows that the management of cervical cancer including brachytherapy leads to high rate of success. It was the purpose of this study to investigate whether the success of brachytherapy for cervical cancer, seemingly regardless of oxygenation status, could be explained by the characteristics of the brachytherapy dose distributions. To this end, a previously used in silico model of tumour oxygenation and radiation response was further developed to simulate the treatment of cervical cancer employing a combination of external beam radiotherapy and intracavitary brachytherapy. Using a clinically-derived brachytherapy dose distribution and assuming a homogeneous dose delivered by external radiotherapy, cell survival was assessed on voxel level by taking into account the variation of sensitivity with oxygenation as well as the effects of repair, repopulation and reoxygenation during treatment. Various scenarios were considered for the conformity of the brachytherapy dose distribution to the hypoxic region in the target. By using the clinically-prescribed brachytherapy dose distribution and varying the total dose delivered with external beam radiotherapy in 25 fractions, the resulting values of the dose for 50% tumour control, D 50, were in agreement with clinically-observed values for high cure rates if fast reoxygenation was assumed. The D 50 was furthermore similar for the different degrees of conformity of the brachytherapy dose distribution to the tumour, regardless of whether the hypoxic fraction was 10%, 25%, or 40%. To achieve 50% control with external RT only, a total dose of more than 70 Gy in 25 fractions would be required for all cases considered. It can thus be concluded that the high doses delivered in brachytherapy can counteract the increased radioresistance caused by hypoxia if fast reoxygenation is assumed.

Perfluorochemical (PFC) liquid enhances recombinant adenovirus vector-mediated viral interleukin-10 (AdvIL-10) expression in rodent lung.

PubMed

Li, John T; Bonneau, Laura A; Zimmerman, Jerry J; Weiss, Daniel J

2007-05-01

Adenovirus and cationic liposome mediated transfer of Interleukin-10 (IL-10), a potent anti-inflammatory cytokine, has been shown to decrease pro-inflammatory cytokine levels and overall lung inflammation in models of lung transplantation and injury. Limitations to current approaches of IL-10 gene therapy include poor vector delivery methods and pro-inflammatory properties of human IL-10 under certain conditions. We hypothesize that using perfluorochemical (PFC) liquid to deliver the highly homologous viral IL-10 (vIL-10), which is predominantly anti-inflammatory with minimal pro-inflammatory activities, can potentially be a more effective strategy to combat inflammatory lung diseases. In this study, we compare the use of PFC liquid versus aerosolized method to deliver adenovirus encoding the vIL-10 gene (AdvIL-10) in C57Bl6 mice. Detectable vIL-10 levels were measured from bronchoalveolar lavage fluid and lung homogenates at one, four, ten and thirty days after AdvIL-10. Furthermore, we determined if use of PFC liquid could allow for the use of a lower dose of AdvIL-10 by comparing the levels of detectable vIL-10 at different doses of AdvIL-10 delivered +/- PFC liquid. Results showed that PFC liquid enhanced detectable vIL-10 by up to ten fold and that PFC liquid allowed the use of ten-fold less vector. PFC liquid increased detectable vIL-10 in lung homogenates at all time points; however, the increase in detectable vIL-10 in BAL fluid peaked at four days and was no longer evident by thirty days after intratracheal instillation. In summary, this is the first report utilizing PFC liquid to enhance the delivery of a potentially therapeutic molecule, vIL-10. We believe this strategy can be used to perform future studies on the use of the predominantly anti-inflammatory vIL-10 to treat inflammatory lung diseases.

Influence of formal maternal education on the use of maternity services in Enugu, Nigeria.

PubMed

Ikeako, L C; Onah, H E; Iloabachie, G C

2006-01-01

Although some previous studies have suggested formal maternal education as the most potent tool for reducing the mortality ratio in Nigeria, other studies found that the depressed Nigerian economy since 1986 has marginalised the benefits of education with the result that educated women stopped making use of existing health facilities because they could not afford the cost of health services. This study was carried out to determine the current influence of formal maternal education and other factors on the choice of place of delivery by pregnant women in Enugu, south-eastern Nigeria. It was a pre-tested interviewer-administered questionnaire study of women who delivered within 3 months before the date of data collection in the study area. In an increasing order of level of care, the outcome variable (place where the last delivery took place) was categorised into seven, with home deliveries representing the lowest category and private hospitals run by specialist obstetricians as the highest category. These were further sub-categorised into non-institutional deliveries and institutional deliveries. Maternal educational level was the main predictor variable. Other predictor variables were sociodemographic factors. Data analysis was by means of descriptive and inferential statistics including means, frequencies and chi2-tests at the 95% confidence (CI) level. Out of a total of 1,450 women to whom the questionnaires were administered, 1,095 women responded (a response rate of 75.5%). A total of 579 (52.9%) of the respondents delivered outside health institutions, while the remaining 516 (47.1%) delivered within health institutions. Regarding the educational levels of the respondents, 301 (27.5%) had no formal education; 410 (37.4%) had primary education; 148 (13.5%) secondary education and 236 (21.5%) post-secondary education. There was a significant positive correlation between the educational levels of the respondents and their husbands (r=0.86, p=0.000). With respect to occupational categories of the respondents, 88 (8.0%) of them belonged to occupational class I, 158 (14.4%) to occupational class II, 107 (9.8%) to occupational class III, 14 (1.3%) to occupational class IV and 728 to occupational class V. There was a significant positive correlation between the respondents' and their husbands' occupational levels (r=0.89, p=0.000). There were statistically significant associations between choice of institutional or non-institutional deliveries and respondents' educational level as well as place of residence (urban/rural), religion, tribe, marital status, occupational level, husband's occupational and educational levels, age and parity (p

Design of experiments with four-factors for a PEM fuel cell optimization

NASA Astrophysics Data System (ADS)

Olteanu, V.; Pǎtularu, L.; Popescu, C. L.; Popescu, M. O.; Crǎciunescu, A.

2017-07-01

Nowadays, many research efforts are allocated for the development of fuel cells, since they constitute a carbon-free electrical energy generator which can be used for stationary, mobile and portable applications. The maximum value of the delivered power of a fuel cell depends on many factors as: the height of plates' channels, the stoichiometry level of the air flow, the air pressure for the cathode, and of the actual operating electric current density. In this paper, two levels, full four-factors factorial experiment has been designed in order to obtain the appropriate response surface which approximates the maximum delivered power dependence of the above-mentioned factors. The optimum set of the fuel-cell factors which determine the maximum value of the delivered power was determined and a comparison between simulated and measured optimal Power versus Current Density characteristics is given.

DOE High Performance Computing Operational Review (HPCOR): Enabling Data-Driven Scientific Discovery at HPC Facilities

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

Gerber, Richard; Allcock, William; Beggio, Chris

2014-10-17

U.S. Department of Energy (DOE) High Performance Computing (HPC) facilities are on the verge of a paradigm shift in the way they deliver systems and services to science and engineering teams. Research projects are producing a wide variety of data at unprecedented scale and level of complexity, with community-specific services that are part of the data collection and analysis workflow. On June 18-19, 2014 representatives from six DOE HPC centers met in Oakland, CA at the DOE High Performance Operational Review (HPCOR) to discuss how they can best provide facilities and services to enable large-scale data-driven scientific discovery at themore » DOE national laboratories. The report contains findings from that review.« less

The use of a proactive dissemination strategy to optimize reach of an internet-delivered computer tailored lifestyle intervention.

PubMed

Schneider, Francine; Schulz, Daniela N; Pouwels, Loes H L; de Vries, Hein; van Osch, Liesbeth A D M

2013-08-05

The use of reactive strategies to disseminate effective Internet-delivered lifestyle interventions restricts their level of reach within the target population. This stresses the need to invest in proactive strategies to offer these interventions to the target population. The present study used a proactive strategy to increase reach of an Internet-delivered multi component computer tailored intervention, by embedding the intervention in an existing online health monitoring system of the Regional Public Health Services in the Netherlands. The research population consisted of Dutch adults who were invited to participate in the Adult Health Monitor (N = 96,388) offered by the Regional Public Health Services. This Monitor consisted of an online or a written questionnaire. A prospective design was used to determine levels of reach, by focusing on actual participation in the lifestyle intervention. Furthermore, adequacy of reach among the target group was assessed by composing detailed profiles of intervention users. Participants' characteristics, like demographics, behavioral and mental health status and quality of life, were included in the model as predictors. A total of 41,155 (43%) people participated in the Adult Health Monitor, of which 41% (n = 16,940) filled out the online version. More than half of the online participants indicated their interest (n = 9169; 54%) in the computer tailored intervention and 5168 participants (31%) actually participated in the Internet-delivered computer tailored intervention. Males, older respondents and individuals with a higher educational degree were significantly more likely to participate in the intervention. Furthermore, results indicated that especially participants with a relatively healthier lifestyle and a healthy BMI were likely to participate. With one out of three online Adult Health Monitor participants actually participating in the computer tailored lifestyle intervention, the employed proactive dissemination strategy succeeded in ensuring relatively high levels of reach. Reach among at-risk individuals (e.g. low socioeconomic status and unhealthy lifestyle) was modest. It is therefore essential to further optimize reach by putting additional effort into increasing interest in the lifestyle intervention among at-risk individuals and to encourage them to actually use the intervention. Dutch Trial Register (NTR1786) and Medical Ethics Committee of Maastricht University and the University Hospital Maastricht (NL2723506809/MEC0903016).

The use of a proactive dissemination strategy to optimize reach of an internet-delivered computer tailored lifestyle intervention

PubMed Central

2013-01-01

Background The use of reactive strategies to disseminate effective Internet-delivered lifestyle interventions restricts their level of reach within the target population. This stresses the need to invest in proactive strategies to offer these interventions to the target population. The present study used a proactive strategy to increase reach of an Internet-delivered multi component computer tailored intervention, by embedding the intervention in an existing online health monitoring system of the Regional Public Health Services in the Netherlands. Methods The research population consisted of Dutch adults who were invited to participate in the Adult Health Monitor (N = 96,388) offered by the Regional Public Health Services. This Monitor consisted of an online or a written questionnaire. A prospective design was used to determine levels of reach, by focusing on actual participation in the lifestyle intervention. Furthermore, adequacy of reach among the target group was assessed by composing detailed profiles of intervention users. Participants’ characteristics, like demographics, behavioral and mental health status and quality of life, were included in the model as predictors. Results A total of 41,155 (43%) people participated in the Adult Health Monitor, of which 41% (n = 16,940) filled out the online version. More than half of the online participants indicated their interest (n = 9169; 54%) in the computer tailored intervention and 5168 participants (31%) actually participated in the Internet-delivered computer tailored intervention. Males, older respondents and individuals with a higher educational degree were significantly more likely to participate in the intervention. Furthermore, results indicated that especially participants with a relatively healthier lifestyle and a healthy BMI were likely to participate. Conclusions With one out of three online Adult Health Monitor participants actually participating in the computer tailored lifestyle intervention, the employed proactive dissemination strategy succeeded in ensuring relatively high levels of reach. Reach among at-risk individuals (e.g. low socioeconomic status and unhealthy lifestyle) was modest. It is therefore essential to further optimize reach by putting additional effort into increasing interest in the lifestyle intervention among at-risk individuals and to encourage them to actually use the intervention. Trial registration Dutch Trial Register (NTR1786) and Medical Ethics Committee of Maastricht University and the University Hospital Maastricht (NL2723506809/MEC0903016). PMID:23914991

Psychosocial Adaptation and Depressive Manifestations in High-Risk Pregnant Women: Implications for Clinical Practice.

PubMed

Fiskin, Gamze; Kaydirak, Meltem Mecdi; Oskay, Umran Yesiltepe

2017-02-01

High-risk pregnancy research has focused primarily on psychological well-being. The aim is to determine psychosocial adaptation and depression levels of pregnant women who were admitted to hospital with diagnosis of high-risk pregnancy. This study was descriptive. Sampling was composed of 122 high-risk pregnant women who were hospitalized in the perinatology service of Istanbul University Medical School, Department of Obstetrics and Gynecology between January 1, 2014, and May 31, 2014, and met the study criteria. The Pregnant Introduction Form, Psychosocial Adjustment of Illness Scale-Self Report, and CES Depression Scale were used. Of high-risk pregnant women, 47% were found to have a poor level of psychosocial adaptation and 57% presented with depressive symptoms. There were statistically significant difference found between the levels of psychosocial adaptation and status of depressive manifestations. The difference between the average scores increased as the adaptation levels weaken and the pregnant women with a poor level of psychosocial adaptation showed more depressive manifestations. The results of this study indicate that, depending on the high-risk pregnancy status, pregnant women experience difficulty in adaptation to their current status and pregnant women with a poor level of psychosocial adaptation showed more depressive manifestations. Nurses should deliver care in high-risk pregnancies with the awareness of physiological needs as well the psychosocial needs of pregnant women, and information meetings should be held in order to increase the psychosocial support of their families and decrease their tendency toward depression. Nursing initiatives should be developed with further studies for the psychosocial adaptation of high-risk pregnancy and reduction of the depressive manifestations. © 2016 Sigma Theta Tau International.

Two-level image authentication by two-step phase-shifting interferometry and compressive sensing

NASA Astrophysics Data System (ADS)

Zhang, Xue; Meng, Xiangfeng; Yin, Yongkai; Yang, Xiulun; Wang, Yurong; Li, Xianye; Peng, Xiang; He, Wenqi; Dong, Guoyan; Chen, Hongyi

2018-01-01

A two-level image authentication method is proposed; the method is based on two-step phase-shifting interferometry, double random phase encoding, and compressive sensing (CS) theory, by which the certification image can be encoded into two interferograms. Through discrete wavelet transform (DWT), sparseness processing, Arnold transform, and data compression, two compressed signals can be generated and delivered to two different participants of the authentication system. Only the participant who possesses the first compressed signal attempts to pass the low-level authentication. The application of Orthogonal Match Pursuit CS algorithm reconstruction, inverse Arnold transform, inverse DWT, two-step phase-shifting wavefront reconstruction, and inverse Fresnel transform can result in the output of a remarkable peak in the central location of the nonlinear correlation coefficient distributions of the recovered image and the standard certification image. Then, the other participant, who possesses the second compressed signal, is authorized to carry out the high-level authentication. Therefore, both compressed signals are collected to reconstruct the original meaningful certification image with a high correlation coefficient. Theoretical analysis and numerical simulations verify the feasibility of the proposed method.

Evolution of a nursing education program delivered to baccalaureate-prepared Haitian nurses.

PubMed

Lev, Elise L; Lindgren, Teri G; Pearson, Gayle A; Alcindor, Hilda

2013-01-01

Haiti has high morbidity and mortality rates, a large proportion of people living in poverty, and a shortage of nurses and nursing faculty members. A partnership program between a US and Haitian university was formed to deliver a certificate program in nursing education. The authors describe their experiences developing, delivering, and evaluating the blended on-site and online program and their future goals.

The Distance-learning Part-time Masters and Doctoral Internet Programs in Astronomy at James Cook University, Australia

NASA Astrophysics Data System (ADS)

White, G. L.; Hons, A.; Orchiston, W.; Blank, D.

2006-08-01

The Centre for Astronomy at James Cook University (Townsville, Australia) specializes in the delivery of postgraduate distance-learning programs. In this paper, we report on the development of Internet-based Masters and Doctoral level degrees in Astrophysics, History of Astronomy and Astronomy Education that are offered by JCU. The Doctor of Astronomy (D.Astro.) degree is the world's only professional doctoral level program that is delivered over the Internet, and students can specialise in the areas of Astronomy Education, History of Astronomy or Astrophysics. An Internet-delivered Ph.D. is also available. There are two Masters level programs: the Master of Astronomy Education (M.Astro.Ed.), and the Master of Astronomy (M.Astro.), which incorporates a major in Astrophysics or History of Astronomy. There are also Internet-delivered Graduate Certificates and Graduate Diplomas in Astronomy. Instruments are being developed on-campus to support these programs (partially in collaboration with the Global Hands-On-Universe Consortium), however, most of the astrophysics research is undertaken using national and international facilities.

Process evaluation results from the HEALTHY physical education intervention

PubMed Central

Hall, William J.; Zeveloff, Abigail; Steckler, Allan; Schneider, Margaret; Thompson, Deborah; Pham, Trang; Volpe, Stella L.; Hindes, Katie; Sleigh, Adriana; McMurray, Robert G.

2012-01-01

Process evaluation is an assessment of the implementation of an intervention. A process evaluation component was embedded in the HEALTHY study, a primary prevention trial for Type 2 diabetes implemented over 3 years in 21 middle schools across the United States. The HEALTHY physical education (PE) intervention aimed at maximizing student engagement in moderate-to-vigorous physical activity through delivery of structured lesson plans by PE teachers. Process evaluation data collected via class observations and interventionist interviews assessed fidelity, dose delivered, implementor participation, dose received and barriers. Process evaluation results indicate a high level of fidelity in implementing HEALTHY PE activities and offering 225 min of PE every 10 school days. Concerning dose delivered, students were active for approximately 33 min of class, representing an average of 61% of the class time. Results also indicate that PE teachers were generally engaged in implementing the HEALTHY PE curriculum. Data on dose received showed that students were highly engaged with the PE intervention; however, student misbehavior was the most common barrier observed during classes. Other barriers included teacher disengagement, large classes, limited gym space and poor classroom management. Findings suggest that the PE intervention was generally implemented and received as intended despite several barriers. PMID:22156231

Process evaluation results from the HEALTHY physical education intervention.

PubMed

Hall, William J; Zeveloff, Abigail; Steckler, Allan; Schneider, Margaret; Thompson, Deborah; Pham, Trang; Volpe, Stella L; Hindes, Katie; Sleigh, Adriana; McMurray, Robert G

2012-04-01

Process evaluation is an assessment of the implementation of an intervention. A process evaluation component was embedded in the HEALTHY study, a primary prevention trial for Type 2 diabetes implemented over 3 years in 21 middle schools across the United States. The HEALTHY physical education (PE) intervention aimed at maximizing student engagement in moderate-to-vigorous physical activity through delivery of structured lesson plans by PE teachers. Process evaluation data collected via class observations and interventionist interviews assessed fidelity, dose delivered, implementor participation, dose received and barriers. Process evaluation results indicate a high level of fidelity in implementing HEALTHY PE activities and offering 225 min of PE every 10 school days. Concerning dose delivered, students were active for approximately 33 min of class, representing an average of 61% of the class time. Results also indicate that PE teachers were generally engaged in implementing the HEALTHY PE curriculum. Data on dose received showed that students were highly engaged with the PE intervention; however, student misbehavior was the most common barrier observed during classes. Other barriers included teacher disengagement, large classes, limited gym space and poor classroom management. Findings suggest that the PE intervention was generally implemented and received as intended despite several barriers.

Factors Influencing Science Content Accuracy in Elementary Inquiry Science Lessons

NASA Astrophysics Data System (ADS)

Nowicki, Barbara L.; Sullivan-Watts, Barbara; Shim, Minsuk K.; Young, Betty; Pockalny, Robert

2013-06-01

Elementary teachers face increasing demands to engage children in authentic science process and argument while simultaneously preparing them with knowledge of science facts, vocabulary, and concepts. This reform is particularly challenging due to concerns that elementary teachers lack adequate science background to teach science accurately. This study examined 81 in-classroom inquiry science lessons for preservice education majors and their cooperating teachers to determine the accuracy of the science content delivered in elementary classrooms. Our results showed that 74 % of experienced teachers and 50 % of student teachers presented science lessons with greater than 90 % accuracy. Eleven of the 81 lessons (9 preservice, 2 cooperating teachers) failed to deliver accurate science content to the class. Science content accuracy was highly correlated with the use of kit-based resources supported with professional development, a preference for teaching science, and grade level. There was no correlation between the accuracy of science content and some common measures of teacher content knowledge (i.e., number of college science courses, science grades, or scores on a general science content test). Our study concluded that when provided with high quality curricular materials and targeted professional development, elementary teachers learn needed science content and present it accurately to their students.

NASA's X2000 Program: An Institutional Approach to Enabling Smaller Spacecraft

NASA Technical Reports Server (NTRS)

Deutsch, Leslie J.; Salvo, Chris; Woerner, David

2000-01-01

The number of NASA science missions per year is increasing from less than one to more than six. At the same time, individual mission budgets are smaller and cannot afford their own dedicated technology developments. In response to this, NASA has formed the X2000 Program. This program, which is divided into a set of subsequent "deliveries" will provide the basic avionics, power, communications, and software capability for future science missions. X2000 First Delivery, which will be completed in early 2001, will provide a full-functioned one MRAD tolerant flight computer, power switching electronics, a highly efficient radioisotope power source, and a transponder that provides high-level services at both 8.4 GHz and 32 GHz bands. The X2000 Second Delivery, which will be completed in the 2003 time frame, will enable complete spacecraft in the 10-50 kg class. All capabilities delivered by the X2000 program will be commercialized within the US and therefore will be available for others to use. Although the immediate customers for these technologies are deep space missions, most of the capabilities being delivered are generic in nature and will be equally applicable to Earth Observation missions.

Hybrid architecture for building secure sensor networks

NASA Astrophysics Data System (ADS)

Owens, Ken R., Jr.; Watkins, Steve E.

2012-04-01

Sensor networks have various communication and security architectural concerns. Three approaches are defined to address these concerns for sensor networks. The first area is the utilization of new computing architectures that leverage embedded virtualization software on the sensor. Deploying a small, embedded virtualization operating system on the sensor nodes that is designed to communicate to low-cost cloud computing infrastructure in the network is the foundation to delivering low-cost, secure sensor networks. The second area focuses on securing the sensor. Sensor security components include developing an identification scheme, and leveraging authentication algorithms and protocols that address security assurance within the physical, communication network, and application layers. This function will primarily be accomplished through encrypting the communication channel and integrating sensor network firewall and intrusion detection/prevention components to the sensor network architecture. Hence, sensor networks will be able to maintain high levels of security. The third area addresses the real-time and high priority nature of the data that sensor networks collect. This function requires that a quality-of-service (QoS) definition and algorithm be developed for delivering the right data at the right time. A hybrid architecture is proposed that combines software and hardware features to handle network traffic with diverse QoS requirements.

Technology Roadmaps for Compound Semiconductors

PubMed Central

Bennett, Herbert S.

2000-01-01

The roles cited for compound semiconductors in public versions of existing technology roadmaps from the National Electronics Manufacturing Initiative, Inc., Optoelectronics Industry Development Association, Microelectronics Advanced Research Initiative on Optoelectronic Interconnects, and Optoelectronics Industry and Technology Development Association (OITDA) are discussed and compared within the context of trends in the Si CMOS industry. In particular, the extent to which these technology roadmaps treat compound semiconductors at the materials processing and device levels will be presented for specific applications. For example, OITDA’s Optical Communications Technology Roadmap directly connects the information demand of delivering 100 Mbit/s to the home to the requirement of producing 200 GHz heterojunction bipolar transistors with 30 nm bases and InP high electron mobility transistors with 100 nm gates. Some general actions for progress towards the proposed International Technology Roadmap for Compound Semiconductors (ITRCS) and methods for determining the value of an ITRCS will be suggested. But, in the final analysis, the value added by an ITRCS will depend on how industry leaders respond. The technical challenges and economic opportunities of delivering high quality digital video to consumers provide concrete examples of where the above actions and methods could be applied. PMID:27551615

Tobacco Dependence Treatment Training Programs: An International Survey

PubMed Central

Rigotti, Nancy A.; Raw, Martin; McNeill, Ann; Murray, Rachael; Piné-Abata, Hembadoon; Bitton, Asaf; McEwen, Andy

2016-01-01

Abstract Introduction: In line with Article 14 guidelines for the WHO Framework Convention on Tobacco Control, we aimed to assess the progress in training individuals to deliver tobacco cessation treatment. Methods: Cross-sectional web-based survey in May–September 2013 among 122 experts in tobacco control and training from 84 countries (73% response rate among 115 countries surveyed). We measured training program prevalence, participants, and challenges faced. Results: Overall, 21% ( n = 18/84) of countries, mostly low and middle-income countries (LMICs; P = .002), reported no training program. Among 66 countries reporting at least one training program, most (84%) trained healthcare professionals but 54% also trained other individuals including community health workers, teachers, and religious leaders. Most programs (54%) cited funding challenges, although stability of funding varied by income level. Government funding was more commonly reported in higher income countries (high 56%, upper middle 50%, lower middle 27%, low 25%; P = .03) while programs in LMICs relied more on nongovernmental organizations (high 11%, upper middle 37%, lower middle 27%, low 38%; P = .02). Conclusions: One in five countries reported having no tobacco treatment training program representing little progress in terms of training individuals to deliver tobacco treatment in LMICs. Without more trained tobacco treatment providers, one of the tenets of Article 14 is not yet being met and health inequalities are likely to widen. More effort and resources are needed to ensure that healthcare worker educational programs include training to assess tobacco use and deliver brief advice and that training is available for individuals outside the healthcare system in areas with limited healthcare access. PMID:26117835

HIGH-POWER TURBODRILL AND DRILL BIT FOR DRILLING WITH COILED TUBING

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

Robert Radtke; David Glowka; Man Mohan Rai

2008-03-31

Commercial introduction of Microhole Technology to the gas and oil drilling industry requires an effective downhole drive mechanism which operates efficiently at relatively high RPM and low bit weight for delivering efficient power to the special high RPM drill bit for ensuring both high penetration rate and long bit life. This project entails developing and testing a more efficient 2-7/8 in. diameter Turbodrill and a novel 4-1/8 in. diameter drill bit for drilling with coiled tubing. The high-power Turbodrill were developed to deliver efficient power, and the more durable drill bit employed high-temperature cutters that can more effectively drill hardmore » and abrasive rock. This project teams Schlumberger Smith Neyrfor and Smith Bits, and NASA AMES Research Center with Technology International, Inc (TII), to deliver a downhole, hydraulically-driven power unit, matched with a custom drill bit designed to drill 4-1/8 in. boreholes with a purpose-built coiled tubing rig. The U.S. Department of Energy National Energy Technology Laboratory has funded Technology International Inc. Houston, Texas to develop a higher power Turbodrill and drill bit for use in drilling with a coiled tubing unit. This project entails developing and testing an effective downhole drive mechanism and a novel drill bit for drilling 'microholes' with coiled tubing. The new higher power Turbodrill is shorter, delivers power more efficiently, operates at relatively high revolutions per minute, and requires low weight on bit. The more durable thermally stable diamond drill bit employs high-temperature TSP (thermally stable) diamond cutters that can more effectively drill hard and abrasive rock. Expectations are that widespread adoption of microhole technology could spawn a wave of 'infill development' drilling of wells spaced between existing wells, which could tap potentially billions of barrels of bypassed oil at shallow depths in mature producing areas. At the same time, microhole coiled tube drilling offers the opportunity to dramatically cut producers' exploration risk to a level comparable to that of drilling development wells. Together, such efforts hold great promise for economically recovering a sizeable portion of the estimated remaining shallow (less than 5,000 feet subsurface) oil resource in the United States. The DOE estimates this U.S. targeted shallow resource at 218 billion barrels. Furthermore, the smaller 'footprint' of the lightweight rigs utilized for microhole drilling and the accompanying reduced drilling waste disposal volumes offer the bonus of added environmental benefits. DOE analysis shows that microhole technology has the potential to cut exploratory drilling costs by at least a third and to slash development drilling costs in half.« less

Comparison of immune responses to different foot-and-mouth disease genetically engineered vaccines in guinea pigs.

PubMed

Yao, Qingxia; Qian, Ping; Huang, Qinfeng; Cao, Yi; Chen, Huanchun

2008-01-01

The P12A3C gene from FMDV (serotype O) encoding the capsid precursor protein, and the highly immunogenic gene FHG, which encodes multiple epitopes of FMDV capsid proteins, were inserted into eukaryotic expression vectors to compare different candidate genetically engineered vaccines for foot-and-mouth disease (FMD). A modified live pseudorabies virus (MLPRV) was also used to deliver P12A3C. Guinea pigs were inoculated intramuscularly with the candidate vaccines to compare the ability to elicit immunity of the DNA vector and a live viral vector. An indirect enzyme-linked immunosorbent assay (iELISA), virus-neutralization test and lymphoproliferation assay were used to detect antibody and cellular responses. The group immunized with P12A3C delivered by MLPRV produced significantly greater antibody and cellular responses indicating that MLPRV has a greater ability to mediate exogenous gene delivery than the plasmid DNA vector. Comparison of the immune responses induced by P12A3C and FHG, which were both mediated by DNA plasmids, showed that FHG and P12A3C elicited similar cellular responses, while P12A3C induced higher antibody levels, suggesting that P12A3C is a more powerful immunogen than FHG. In challenge experiments, guinea pigs vaccinated with P12A3C delivered by MLPRV were protected fully from FMDV challenge, whereas guinea pigs vaccinated with P12A3C or FHG delivered by DNA plasmid were only protected partially. This study provides a basis for future construction of a genetically engineered vaccine for FMDV.

State policy environment and the dental safety net: a case study of professional practice environments' effect on dental service availability in Federally Qualified Health Centers.

PubMed

Maxey, Hannah L; Norwood, Connor W; Liu, Ziyue

2016-09-01

To determine whether and to what extent the state policy environment for the dental hygiene workforce affects the availability of dental services at Federally Qualified Health Centers (FQHCs). We examined data drawn from the Uniform Data System on 1,135 unique FQHC grantees receiving community health center funding from the U.S. Health Center program between 2004 and 2012. The Dental Hygiene Professional Practice Index was used to quantify variations in state policy environment. We then examined the influence of state policy environment on the availability of dental care through generalized linear mixed-effects models. Approximately 80% of FQHCs reported delivering dental services. We consistently observed that FQHCs with favorable levels of state support had the highest proportion of FQHCs that delivered dental services, even more so than FQHCs with extremely high support. FQHCs located in the most restrictive states had 0.28 the odds of delivering dental services as did those located in the most supportive states. The state policy environment for the dental hygiene workforce is likely associated with the availability of dental services at FQHCs. The greatest proportion of FQHCs delivering dental services was found in states with policy provisions supporting professional independence in public health settings. Nevertheless, additional research is needed to understand the specific mechanism by which these policies affect FQHCs. © 2016 The Authors. Journal of Public Health Dentistry published by Wiley Periodicals, Inc. on behalf of American Association of Public Health Dentistry.

Quality of Voluntary Medical Male Circumcision Services during Scale-Up: A Comparative Process Evaluation in Kenya, South Africa, Tanzania and Zimbabwe

PubMed Central

Jennings, Larissa; Bertrand, Jane; Rech, Dino; Harvey, Steven A.; Hatzold, Karin; Samkange, Christopher A.; Omondi Aduda, Dickens S.; Fimbo, Bennett; Cherutich, Peter; Perry, Linnea; Castor, Delivette; Njeuhmeli, Emmanuel

2014-01-01

Background The rapid expansion of voluntary medical male circumcision (VMMC) has raised concerns whether health systems can deliver and sustain VMMC according to minimum quality criteria. Methods and Findings A comparative process evaluation was used to examine data from SYMMACS, the Systematic Monitoring of the Voluntary Medical Male Circumcision Scale-Up, among health facilities providing VMMC across two years of program scale-up. Site-level assessments examined the availability of guidelines, supplies and equipment, infection control, and continuity of care services. Direct observation of VMMC surgeries were used to assess care quality. Two sample tests of proportions and t-tests were used to examine differences in the percent of facilities meeting requisite preparedness standards and the mean number of directly-observed surgical tasks performed correctly. Results showed that safe, high quality VMMC can be implemented and sustained at-scale, although substantial variability was observed over time. In some settings, facility preparedness and VMMC service quality improved as the number of VMMC facilities increased. Yet, lapses in high performance and expansion of considerably deficient services were also observed. Surgical tasks had the highest quality scores, with lower performance levels in infection control, pre-operative examinations, and post-operative patient monitoring and counseling. The range of scale-up models used across countries additionally underscored the complexity of delivering high quality VMMC. Conclusions Greater efforts are needed to integrate VMMC scale-up and quality improvement processes in sub-Saharan African settings. Monitoring of service quality, not just adverse events reporting, will be essential in realizing the full health impact of VMMC for HIV prevention. PMID:24801073

Objective burden, resources, and other stressors among informal cancer caregivers: a hidden quality issue?†

PubMed Central

van Ryn, Michelle; Sanders, Sara; Kahn, Katherine; van Houtven, Courtney; Griffin, Joan M.; Martin, Michelle; Atienza, Audie A.; Phelan, Sean; Finstad, Deborah; Rowland, Julia

2015-01-01

A great deal of clinical cancer care is delivered in the home by informal caregivers (e.g. family, friends), who are often untrained. Caregivers' context varies widely, with many providing care despite low levels of resources and high levels of additional demands. Background Changes in health care have shifted much cancer care to the home, with limited data to inform this transition. We studied the characteristics, care tasks, and needs of informal caregivers of cancer patients. Methods Caregivers of seven geographically and institutionally defined cohorts of newly diagnosed colorectal and lung cancer patients completed self-administered questionnaires (n = 677). We combined this information with patient survey and chart abstraction data and focused on caregivers who reported providing, unpaid, at least 50% of the patient's informal cancer care. Results Over half of caregivers (55%) cared for a patient with metastatic disease, severe comorbidity, or undergoing current treatment. Besides assisting with activities of daily living, caregivers provided cancer-specific care such as watching for treatment side effects (68%), helping manage pain, nausea or fatigue (47%), administering medicine (34%), deciding whether to call a doctor (30%), deciding whether medicine was needed (29%), and changing bandages (19%). However, half of caregivers reported not getting training perceived as necessary. In addition, 49% of caregivers worked for pay, 21% reported poor or fair health, and 21% provided unpaid care for other individuals. One in four reported low confidence in the quality of the care they provided. Conclusions Much assistance for cancer patients is delivered in the home by informal caregivers, often without desired training, with a significant minority having limited resources and high additional demands. Future research should explore the potentially high yield of addressing caregiver needs in improving quality of cancer care and both survivors' and caregivers' outcomes. PMID:20201115

Neuropilin-1-targeted gold nanoparticles enhance therapeutic efficacy of platinum(IV) drug for prostate cancer treatment.

PubMed

Kumar, Anil; Huo, Shuaidong; Zhang, Xu; Liu, Juan; Tan, Aaron; Li, Shengliang; Jin, Shubin; Xue, Xiangdong; Zhao, YuanYuan; Ji, Tianjiao; Han, Lu; Liu, Hong; Zhang, XiaoNing; Zhang, Jinchao; Zou, Guozhang; Wang, Tianyou; Tang, Suoqin; Liang, Xing-Jie

2014-05-27

Platinum-based anticancer drugs such as cisplatin, oxaliplatin, and carboplatin are some of the most potent chemotherapeutic agents but have limited applications due to severe dose-limiting side effects and a tendency for cancer cells to rapidly develop resistance. The therapeutic index can be improved through use of nanocarrier systems to target cancer cells efficiently. We developed a unique strategy to deliver a platinum(IV) drug to prostate cancer cells by constructing glutathione-stabilized (Au@GSH) gold nanoparticles. Glutathione (GSH) has well-known antioxidant properties, which lead to cancer regression. Here, we exploit the advantages of both the antioxidant properties and high surface-area-to-volume ratio of Au@GSH NPs to demonstrate their potential for delivery of a platinum(IV) drug by targeting the neuropilin-1 receptor (Nrp-1). A lethal dose of a platinum(IV) drug functionalized with the Nrp-1-targeting peptide (CRGDK) was delivered specifically to prostate cancer cells in vitro. Targeted peptide ensures specific binding to the Nrp-1 receptor, leading to enhanced cellular uptake level and cell toxicity. The nanocarriers were themselves nontoxic, but exhibited high cytotoxicity and increased efficacy when functionalized with the targeting peptide and drug. The uptake of drug-loaded nanocarriers is dependent on the interaction with Nrp-1 in cell lines expressing high (PC-3) and low (DU-145) levels of Nrp-1, as confirmed through inductively coupled plasma mass spectrometry and confocal microscopy. The nanocarriers have effective anticancer activity, through upregulation of nuclear factor kappa-B (NF-κB) protein (p50 and p65) expression and activation of NF-κB-DNA-binding activity. Our preliminary investigations with platinum(IV)-functionalized gold nanoparticles along with a targeting peptide hold significant promise for future cancer treatment.

Parental involvement and association with adolescents' fruit and vegetable intake at follow-up: Process evaluation results from the multi-component school-based Boost intervention.

PubMed

Jørgensen, Sanne Ellegård; Jørgensen, Thea Suldrup; Aarestrup, Anne Kristine; Due, Pernille; Krølner, Rikke

2016-10-26

Based on the assumption of parental influence on adolescent behavior, multicomponent school-based dietary interventions often include a parental component. The effect of this intervention component is seldom reported and the evidence is inconsistent. We conducted a systematic process evaluation of the parental component and examined whether the leveal of parental involvement in a large multi-component intervention: the Boost study was associated with adolescents' fruit and vegetable (FV) intake at follow-up. The Boost study was targeting FV intake among 1,175 Danish 7 th graders (≈13- year-olds) in the school year 2010/11. The study included a school component: free FV in class and curricular activities; a local community component: fact sheets for sports- and youth clubs; and a parental component: presentation of Boost at a parent-school meeting, 6 newsletters to parents, 3 guided student-parent curricular activities, and a student-parent Boost event. Students whose parent replied to the follow-up survey (n = 347). Questionnaire data from students, parents and teachers at 20 intervention schools. Process evaluation measures: dose delivered, dose received, appreciation and level of parental involvement. Parental involvement was trichotomized into: low/no (0-2 points), medium (3 points) and high (4-6 points). The association between level of parental involvement and self-reported FV intake (24-h recall), was analyzed using multilevel regression analyses. The Boost study was presented at a parent-school meeting at all intervention schools. The dose delivered was low to moderate for the three other parental elements. Most parents appreciated the intervention and talked with their child about Boost (83.5 %). High, medium and low parental involvement was found among 30.5 %, 29.6 % and 39.4 % of the students respectively. Parental involvement was highest among women. More men agreed that the parental newsletters provided new information. Students with a medium and high level of parental involvement ate 47.5 and 95.2 g more FV per day compared to students with low level/no parental involvement (p = 0.02). Students with a high level of parental involvement ate significantly more FV at follow-up compared to students with a low level/no parental involvement. Parental involvement in interventions may improve adolescents' FV intake if challenges of implementation can be overcome. ISRCTN11666034 . Registered 06/01/2012. Retrospectively registered.

Development of guidelines and specifications for use of WMA technology in delivering HMA products inclusive of non-conventional mixtures such as SMA's, and mixtures with high RAP and RAS content.

DOT National Transportation Integrated Search

2014-08-01

This report documents the work completed in WHRP Project 0092-12-02, Development of Guidelines and Specifications : for Use of WMA Technology in Delivering HMA Products Inclusive of Non-Conventional Mixtures Such as SMAs, and : Mixtures with High ...

Recent Performance of and Plasma Outage Studies with the SNS H- Source

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

Stockli, Martin P; Han, Baoxi; Murray Jr, S N

2016-01-01

SNS ramps to higher power levels that can be sustained with high availability. The goal is 1.4 MW despite a compromised RFQ, which requires higher RF power than design levels to approach the nominal beam transmission. Unfortunately at higher power the RFQ often loses its thermal stability, a problem apparently enhanced by beam losses and high influxes of hydrogen. Delivering as much H- beam as possible with the least amount of hydrogen led to plasma outages. The root cause is the dense 1-ms long ~55-kW 2-MHz plasma pulses reflecting ~90% of the continuous ~300W, 13-MHz power, which was mitigated withmore » a 4-ms filter for the reflected power signal and an outage resistant, slightly-detuned 13-MHz match. Lowering the H2 also increased the H- beam current to ~55 mA, and increased the transmission by ~7%.« less

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

Rychel, Dwight

The Permian Basin Carbon Capture, Utilization and Storage (CCUS) Training Center was one of seven regional centers formed in 2009 under the American Recovery and Reinvestment Act of 2009 and managed by the Department of Energy. Based in the Permian Basin, it is focused on the utilization of CO 2 Enhanced Oil Recovery (EOR) projects for the long term storage of CO 2 while producing a domestic oil and revenue stream. It delivers training to students, oil and gas professionals, regulators, environmental and academia through a robust web site, newsletter, tech alerts, webinars, self-paced online courses, one day workshops, andmore » two day high level forums. While course material prominently features all aspects of the capture, transportation and EOR utilization of CO 2, the audience focus is represented by its high level forums where selected graduate students with an interest in CCUS interact with Industry experts and in-house workshops for the regulatory community.« less

Estimating Driving Performance Based on EEG Spectrum Analysis

NASA Astrophysics Data System (ADS)

Lin, Chin-Teng; Wu, Ruei-Cheng; Jung, Tzyy-Ping; Liang, Sheng-Fu; Huang, Teng-Yi

2005-12-01

The growing number of traffic accidents in recent years has become a serious concern to society. Accidents caused by driver's drowsiness behind the steering wheel have a high fatality rate because of the marked decline in the driver's abilities of perception, recognition, and vehicle control abilities while sleepy. Preventing such accidents caused by drowsiness is highly desirable but requires techniques for continuously detecting, estimating, and predicting the level of alertness of drivers and delivering effective feedbacks to maintain their maximum performance. This paper proposes an EEG-based drowsiness estimation system that combines electroencephalogram (EEG) log subband power spectrum, correlation analysis, principal component analysis, and linear regression models to indirectly estimate driver's drowsiness level in a virtual-reality-based driving simulator. Our results demonstrated that it is feasible to accurately estimate quantitatively driving performance, expressed as deviation between the center of the vehicle and the center of the cruising lane, in a realistic driving simulator.

The Effect of a Leisure Time Physical Activity Intervention Delivered via a Workplace: 15-Month Follow-Up Study

PubMed Central

Skogstad, Marit; Lunde, Lars-Kristian; Ulvestad, Bente; Aass, Hans Christian D.; Clemm, Thomas; Mamen, Asgeir

2018-01-01

In line with recommendations from both the World Health Organization and the European Union some employers encourage workplace health promotion through physical activity (PA) facilities and leisure time PA-initiatives. The current study describes a 15-month follow-up after an 8-week workplace delivered PA-initiative, investigates if improvements in cardiovascular risk status are sustainable, and elucidates differences according to educational level. One hundred and twenty one employees (43 women) were examined before and after the 8-week PA-initiative and 94 at the 15-month follow-up. PA-levels, blood pressure, resting heart rate, lipids, glycosylated hemoglobin (HbA1c), C-reactive protein (CRP), and selected markers of inflammation were registered at baseline, immediately after the 8-week PA-initiative, and 15 months after baseline. At the end of follow-up (15-month), PA-levels—increased during the 8-week intervention—had returned to baseline values. None of the five improvements in cardiovascular markers (total cholesterol, low density lipoprotein (LDL), P-selectin, CD40Ligand (CD40L) and Monocyte chemoattractant protein-1 (MCP-1)) seen at the 8-week follow-up were sustained. At the 15-month follow-up as compared to baseline HbA1c, CRP (log) and interleukin-6 (IL-6) were reduced by 0.06 mmol/L (95% CI −0.11,−0.01), 0.25 mg/L (95% CI −0.46,−0.04) and 0.39 pg/mL (95% CI −0.75, −0.04), respectively. At baseline, there were differences in cardiovascular risk factors comparing men with low versus high levels of education. No differences in changes in outcomes between these groups of men were found during follow-up. In this study highly educated men generally have lower levels of cardiovascular risk factors, but the effect of PA on such markers in this group do not differ from the effects seen in less educated men. PMID:29401699

Water content of delivered gases during non-invasive ventilation in healthy subjects.

PubMed

Lellouche, François; Maggiore, Salvatore Maurizio; Lyazidi, Aissam; Deye, Nicolas; Taillé, Solenne; Brochard, Laurent

2009-06-01

No clear recommendation exists concerning humidification during non-invasive ventilation (NIV) and high flow CPAP, and few hygrometric data are available. We measured hygrometry during NIV delivered to healthy subjects with different humidification strategies: heated humidifier (HH), heat and moisture exchanger, (HME) or no humidification (NoH). For each strategy, a turbine and an ICU ventilator were used with different FiO(2) settings, with and without leaks. During CPAP, two different HH and NoH were tested. Inspired gases hygrometry was measured, and comfort was assessed. On a bench, we also assessed the impact of ambient air temperature, ventilator temperature and minute ventilation on HH performances (with NIV settings). During NIV, with NoH, gas humidity was very low when an ICU ventilator was used (5 mgH(2)O/l), but equivalent to ambient air hygrometry with a turbine ventilator at minimal FiO(2) (13 mgH(2)O/l). HME and HH had comparable performances (25-30 mgH(2)O/l), but HME's effectiveness was reduced with leaks (15 mgH(2)O/l). HH performances were reduced by elevated ambient air and ventilator output temperatures. During CPAP, dry gases (5 mgH(2)O/l) were less tolerated than humidified gases. Gases humidified at 15 or 30 mgH(2)O/l were equally tolerated. This study provides data on the level of humidity delivered with different humidification strategies during NIV and CPAP. HH and HME provide gas with the highest water content. Comfort data suggest that levels above 15 mgH(2)O/l are well tolerated. In favorable conditions, HH and HMEs are capable of providing such values, even in the presence of leaks.

HealthMpowerment.org: Feasibility and Acceptability of Delivering an Internet Intervention to Young Black Men Who have Sex with Men

PubMed Central

Hightow-Weidman, Lisa B; Pike, Emily; Fowler, Beth; Matthews, Derrick M; Kibe, Jessica; McCoy, Regina; Adimora, Adaora A

2012-01-01

Young Black men who have sex with men (BMSM) are disproportionately affected by HIV/AIDS in the United States and continue to experience rapidly increasing HIV incidence. We designed a tailored, theory-based interactive HIV/STI prevention website for young BMSM, called HealthMpowerment.org (HMP) and conducted a small pilot trial comparing HMP to currently available HIV/STI websites. We present findings demonstrating feasibility and acceptability of delivering the intervention to the target population of young BMSM. Retention rates were 90% and 78% at one and three month follow-ups, respectively. Evaluation immediately after the intervention’s completion revealed that participants who used the HMP website reported high levels of user satisfaction and interest and low levels of website difficulty and frustration. At the end of the intervention, there was a trend in increased behavioral intentions to use condoms and engage in preparatory condom use behaviors in the intervention group compared to the control group (p=.10). We observed a reduction in mean scores on the CES-D scale among those in the intervention group that was not seen in the control group at the one-month follow-up, though this was not statistically significant. Feedback from exit interviews with study participants suggested that HMP is relevant to the prevention needs of young BMSM. Overall, the findings support the acceptability and feasibility of delivering this prevention program to a group that has few interventions despite bearing a significant burden of the epidemic. Future trials, combining internet and mobile phone technologies, are planned to test HMP among larger and more diverse populations of young BMSM. PMID:22272759

Hydrogel Ring for Topical Drug Delivery to the Ocular Posterior Segment.

PubMed

Shikamura, Yuko; Yamazaki, Yoshiko; Matsunaga, Toru; Sato, Takao; Ohtori, Akira; Tojo, Kakuji

2016-05-01

To investigate the efficacy of a topical hydrogel ring for drug delivery to the posterior segment of the rabbit eye. Novel hydrogel corneal lenses (CL), scleral/corneal lenses (S/CL), and rings were prepared using poly(hydroxyethyl methacrylate). The devices were immersed in 0.3% ofloxacin ophthalmic solution (OOS) to homogeneously distribute the drug throughout the hydrogel. The medicated CL, S/CL, Ring 1 (standard ring), or Ring 2 (shape-optimized ring) was applied to the surface of the cornea, cornea/bulbar conjunctiva, or bulbar conjunctiva of albino rabbits, respectively. Medicated rings did not touch the corneal surface. In another group, one OOS drop was administered to the eye. After 0.25-8 hours, the hydrogel devices were removed and ocular tissues were harvested. High-performance liquid chromatography (HPLC) was used to measure the ofloxacin concentration in the devices and tissues. The drug concentrations in the posterior segment tissues were compared among ofloxacin delivery methods. One hour after placement, eyes treated with Ring 1 or S/CL had markedly higher ofloxacin levels in the posterior segment tissues (conjunctiva, sclera, and retina/choroid) than eyes treated with topical OOS or a CL. Lower levels of ofloxacin were found in anterior segment tissues (cornea and aqueous humor) in eyes treated with Ring 1 compared to those treated with S/CL. Ring 2 most effectively delivered ofloxacin to the retina/choroid. The tissue ofloxacin concentration in the fellow eye was markedly lower than the eye treated with Ring 2. Our results suggest that hydrogel rings are effective in delivering topical ophthalmic drugs to the posterior segment. The drugs are most likely delivered via the transconjunctival/scleral route by lateral diffusion across the bulbar conjunctiva and through the sclera. Systemic drug delivery to the posterior segment is minimal.

KSC-08pd0280

NASA Image and Video Library

2008-02-12

KENNEDY SPACE CENTER, FLA. -- Viewed from an upper level in the Vehicle Assembly Building, space shuttle Endeavour is slowly lifted to the top of high bay 1. Crossing the I-beam, the shuttle will then be lowered onto the mobile launcher platform for mating with the external tank and solid rocket boosters in preparation for launch on the STS-123 mission, targeted for March 11. The mission will deliver the first section of the Japan Aerospace Exploration Agency's Kibo laboratory and the Canadian Space Agency's two-armed robotic system, Dextre. Photo credit: NASA/Dimitri Gerondidakis

Seamless service: maintaining momentum.

PubMed

Grinstead, N; Timoney, R

1994-01-01

Describes the process used by the Mater Infirmorum Hospital in Belfast in 1992-1994 to achieve high quality care (Seamless Service), motivate staff to deliver and measure performance. Aims of the project include focusing the organization on the customer, improving teamwork and motivation at all levels. After comprehensive data collection from GPs, patients and staff management forums developed a full TQM strategy to gain support and maintain momentum including innovative staff events (every staff member was given the opportunity to attend) where multilevel, multidisciplinary workshops enabled staff to design customer care standards, develop teams and lead customer-driven change.

Design and evaluation of Nemesis, a scalable, low-latency, message-passing communication subsystem.

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

Buntinas, D.; Mercier, G.; Gropp, W.

2005-12-02

This paper presents a new low-level communication subsystem called Nemesis. Nemesis has been designed and implemented to be scalable and efficient both in the intranode communication context using shared-memory and in the internode communication case using high-performance networks and is natively multimethod-enabled. Nemesis has been integrated in MPICH2 as a CH3 channel and delivers better performance than other dedicated communication channels in MPICH2. Furthermore, the resulting MPICH2 architecture outperforms other MPI implementations in point-to-point benchmarks.

The Role of Value-Based Care in Patients with Cirrhosis.

PubMed

Volk, Michael L

2017-02-01

Value-based care means delivering high-quality care while keeping costs at a reasonable level. Many physicians have long viewed quality care and the responsible utilization of resources to be an integral part of their professional responsibilities. As the health care system changes, however, physicians are increasingly being asked to objectively demonstrate value. In this review article, the author describes the reimbursement and regulatory shift toward value-based care, and provides specific strategies for meeting this care. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Optimising value and quality in general practice within the primary health care sector through relationship marketing: a conceptual framework.

PubMed

Bansal, Manjit K

2004-01-01

Discusses the rationale of applying relationship marketing and service quality concepts within the primary health care sector. The use of relational strategies in general practice, by modelling the relationships between practitioners and patients from a marketing perspective, could potentially lead to sustained high quality service being provided, and to more efficient use of resources. This essentially conceptually focused paper addresses an area that has not yet been researched in detail, and furthers understanding of the relationships that facilitate exchange within general practice and service delivery in non-profit, resource-constrained conditions. Deeper understanding of the needs and expectations of patients and the way these can be delivered by general practice can only lead to improvements for all parties involved. The relationship marketing paradigm presents itself as a potentially exciting way of addressing issues associated with ensuring that the highest level of quality is delivered in this area of the UK National Health Service.

Capacity building in the health sector to improve care for child nutrition and development.

PubMed

Yousafzai, Aisha K; Rasheed, Muneera A; Daelmans, Bernadette; Manji, Sheila; Arnold, Caroline; Lingam, Raghu; Muskin, Joshua; Lucas, Jane E

2014-01-01

The effectiveness of interventions promoting healthy child growth and development depends upon the capacity of the health system to deliver a high-quality intervention. However, few health workers are trained in providing integrated early child-development services. Building capacity entails not only training the frontline worker, but also mobilizing knowledge and support to promote early child development across the health system. In this paper, we present the paradigm shift required to build effective partnerships between health workers and families in order to support children's health, growth, and development, the practical skills frontline health workers require to promote optimal caregiving, and the need for knowledge mobilization across multiple institutional levels to support frontline health workers. We present case studies illustrating challenges and success stories around capacity development. There is a need to galvanize increased commitment and resources to building capacity in health systems to deliver early child-development services. © 2014 New York Academy of Sciences.

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

Woodford, William

This document is the final technical report from 24M Technologies on the project titled: Low Cost, Structurally Advanced Novel Electrode and Cell Manufacturing. All of the program milestones and deliverables were completed during the performance of the award. Specific accomplishments are 1) 24M demonstrated the processability and electrochemical performance of semi-solid electrodes with active volume contents increased by 10% relative to the program baseline; 2) electrode-level metrics, quality, and yield were demonstrated at an 80 cm 2 electrode footprint; 3) these electrodes were integrated into cells with consistent capacities and impedances, including cells delivered to Argonne National Laboratory for independentmore » testing; 4) those processes were scaled to a large-format (> 260 cm 2) electrode footprint and quality and yield were demonstrated; 5) a high-volume manufacturing approach for large-format electrode fabrication was demonstrated; and 6) large-format cells (> 100 Ah capacity) were prototyped with consistent capacity and impedance, including cells which were delivered to Argonne National Laboratory for independent testing.« less

Silencing GIRK4 expression in human atrial myocytes by adenovirus-delivered small hairpin RNA.

PubMed

Liu, Xiongtao; Yang, Jian; Shang, Fujun; Hong, Changming; Guo, Wangang; Wang, Bing; Zheng, Qiangsun

2009-07-01

GIRK4 has been shown to be a subunit of I(KACh), and the use of GIRK4 in human atrial myocytes to treat arrhythmia remains an important research pursuit. Adenovirus-delivered small hairpin RNA (shRNA) has been used to mediate gene knockdown in mouse cardiocytes, yet there is no information on the successful application of this technique in human cardiocytes. In the current study, we used a siRNA validation system to select the most efficient sequence for silencing GIRK4. To this end, adenovirus-delivered shRNA, which expresses this sequence, was used to silence GIRK4 expression in human atrial myocytes. Finally, the feasibility, challenges, and results of silencing GIRK4 expression were evaluated by RT-PCR, western blotting, and the voltage-clamp technique. The levels of mRNA and protein were depressed significantly in cells infected by adenovirus-delivered shRNA against GIRK4, approximately 86.3% and 51.1% lower than those cells infected by adenovirus-delivered nonsense shRNA, respectively. At the same time, I(KACh) densities were decreased 53% by adenovirus-delivered shRNA against GIRK4. In summary, adenovirus-delivered shRNA against GIRK4 mediated efficient GIRK4 knockdown in human atrial myocytes and decreased I(KACh) densities. As such, these data indicated that adenovirus-delivered shRNA against GIRK4 is a potential tool for treating arrhythmia.

Immunobiology of HPV and HPV vaccines.

PubMed

Stanley, Margaret

2008-05-01

Genital human papillomavirus (HPV) infection with both low- and high-risk types is common, but most infections resolve as a result of a cell-mediated immune response. Failure to induce an effective immune response is related to inefficient activation of innate immunity and ineffective priming of the adaptive immune response; this defective immune response facilitates viral persistence, a key feature of high-risk HPV infection. This milieu becomes operationally HPV antigen tolerant, and the host's defenses become irrevocably compromised. HPV antigen-specific effector cells are poorly recruited to the infected focus and their activity is downregulated; neoplastic HPV containing cervical keratinocytes expressing high levels of E6 and E7 oncoproteins are not killed in this immunosuppressive, tolerant milieu, and progression to high-grade disease and cancer can result. Highly efficacious prophylactic HPV L1 virus-like particle (VLP) vaccines circumvent viral epithelial evasion strategies since they are delivered by intramuscular injection. The stromal dendritic cells of the muscle that encounter the highly immunogenic repeat structure of the VLP then migrate with their cargo to the lymph node, initiating an immune cascade that results in a robust T-cell dependent B-cell response, which generates high levels of L1-specific serum neutralizing antibodies and immune memory.

Acceptability of Mental Health Services for Anxiety and Depression in an Arab Sample.

PubMed

Kayrouz, Rony; Dear, Blake F; Karin, Eyal; Fogliati, Vincent J; Gandy, Milena; Keyrouz, Liliane; Nehme, Edmond; Terides, Matthew D; Titov, Nickolai

2018-01-24

The aim of this paper was to examine the acceptability and use of mental health services in an Arab sample. An Internet survey was made available to Arab people worldwide and enquired about the acceptability of traditional face-to-face and internet-delivered mental health services. Five hundred and three participants were recruited via media and Facebook promotions. Of those surveyed, 36% (183/503), 46% (233/503), and 73% (365/503) reported that they would be willing to consult a mental health professional, take prescription medication and try an internet-delivered psychological treatment, respectively. Moderate to high acceptability rates for mental health services were found in this sample of Arab people. High acceptability of internet-delivered treatments among the current Arab sample, provides the opportunity for directing resources to the development of internet-delivered interventions to help reduce the stigma and burden of mental disease in the Arab world.

Self-esteem and stress coping among proficiency certificate level nursing students in nursing campus Maharajgunj and Lalitpur Nursing Campus.

PubMed

Shrestha, T

2013-09-01

Nursing requires high self-esteem and effective coping strategies for the quality of health services that they deliver. Self -esteem and stress coping mechanism developed during education period is foundation for professional practice. So, this study was conducted to identify self-esteem, coping activities, and their relationship. Descriptive cross sectional study was conducted among 287 PCL nursing students currently studying in different level in nursing campuses of the Institute of Medicine during June and July 2013. Self administered semi structured questionnaire and rating scales were used for the data collection. Findings showed that 21 (7.31%), 194 (67.5%), and 67 (23.34%), students had have very high, high and moderate, self-esteem and only five (1.74%) have low self-esteem.The difference in self-esteem level was insignificant with the level of the students. Students most frequently used problem focused (3.36±0.54) followed by emotion focused (3.04±0.45) and avoidance coping activities (2.91±0.63). The relationship of use of coping activities and level of students was statistically insignificant. Self-esteem level had positive relation with problem focused and emotion focused coping activities (Pearson r: 0.114 and 0.118), though the correlation was significant with emotion focused coping activities only. Bicytopenia and pancytopenia were seen in two cases each of myelodysplastic syndrome. Chronic myeloid leukemia and Non-Hodgkin lymphoma showed anemia and pancytopenia respectively. Majority of PCL nursing students have high level of self-esteem. They used problem focused coping activities most however, use of it decreased with increased level of students. Students with high self -esteem used problem focused followed by emotion focused coping activities. Students should be encouraged to use problem focused coping activities.

A simplified, low power system for effective vessel sealing

NASA Astrophysics Data System (ADS)

Lyle, Allison B.; Kennedy, Jenifer S.; Schmaltz, Dale F.; Kennedy, Aaron S.

2015-03-01

The first bipolar vessel sealing system was developed nearly 15 years ago and has since become standard of care in surgery. These systems make use of radio frequency current that is delivered between bipolar graspers to permanently seal arteries, veins and tissue bundles. Conventional vessel sealing generators are based off traditional electrosurgery generator architecture and deliver high power (150-300 Watts) and high current using complex control and sense algorithms to adjust the output for vessel sealing applications. In recent years, a need for small-scale surgical vessel sealers has developed as surgeons strive to further reduce their footprint on patients. There are many technical challenges associated with miniaturization of vessel sealing devices including maintaining electrical isolation while delivering high current in a saline environment. Research into creating a small, 3mm diameter vessel sealer revealed that a highly simplified generator system could be used to achieve excellent results and subsequently a low power vessel sealing system was developed. This system delivers 25 Watts constant power while limiting voltage (<= Vrms) and current (<= Amps) until an impedance endpoint is achieved, eliminating the use of complicated control and sensing software. The result is optimized tissue effect, where high seal strength is maintained (> 360mmHg), but seal times (1.7 +/- 0.7s versus 4.1 +/- 0.7s), thermal spread (<1mm vs <=2mm) and total energy delivery are reduced, when compared to an existing high power system.

Study to evaluate the effect of low-intensity pulsed electrical currents on levels of oedema in chronic non-healing wounds.

PubMed

Young, S; Hampton, S; Tadej, M

2011-08-01

To evaluate the efficacy of a medical device, Accel-Heal, which generates a low-intensity pulsed direct current, on the management of oedema in chronic leg ulcers, using high-frequency diagnostic ultrasound. High-frequency diagnostic ultrasound (20MHz) with an axial resolution of 60um was used to assess the effect of an electrical stimulation device delivering a low-intensity pulsed current on levels of oedema in chronic non-healing venous and mixed aetiology leg ulcers for a period of 10 days. Thirty patients' wounds were monitored over a 3-month period, during which time changes in levels of oedema in the wound bed and surrounding tissues were imaged and measured. A significant fall in the, previously high level, of periwound oedema was noted in the patient population after 10 days of device application. By 20 days after the first application of the device the level of periwound oedema had decreased by approximately 60% of the original level, which was maintained up to the 90-day follow-up. Occurring in parallel with this, scans of the wound bed showed a rapid decrease in the levels of oedema as the new wound matrix was laid down. The electrical stimulation device appeared to be effective in reducing oedema levels in a range of chronic wounds and their surrounding tissues. The study was funded by a grant from Synapse micro-current Ltd.

Crew resource management training in the intensive care unit. A multisite controlled before-after study.

PubMed

Kemper, Peter F; de Bruijne, Martine; van Dyck, Cathy; So, Ralph L; Tangkau, Peter; Wagner, Cordula

2016-08-01

There is a growing awareness today that adverse events in the intensive care unit (ICU) are more often caused by problems related to non-technical skills than by a lack of technical, or clinical, expertise. Team training, such as crew resource management (CRM), aims to improve these non-technical skills. The present study evaluated the effectiveness of CRM in the ICU. Six ICUs participated in a paired controlled trial, with one pretest and two post-test measurements (after 3 and 12 months). Three ICUs received CRM training and were compared with a matched control unit. The 2-day classroom-based training was delivered to multidisciplinary groups (ie, ICU physicians, nurses, managers). All levels of Kirkpatrick's evaluation framework were assessed using a mixed method design, including questionnaires, observations and routinely administered patient outcome data. Level I-reaction: participants were very positive directly after the training. Level II-learning: attitudes towards behaviour aimed at optimising situational awareness were relatively high at baseline and remained stable. Level III-behaviour: self-reported behaviour aimed at optimising situational awareness improved in the intervention group. No changes were found in observed explicit professional oral communication. Level IV-organisation: patient outcomes were unaffected. Error management culture and job satisfaction improved in the intervention group. Patient safety culture improved in both control and intervention units. We can conclude that CRM, as delivered in the present study, does not change behaviour or patient outcomes by itself, yet changes how participants think about errors and risks. This indicates that CRM requires a combination with other initiatives in order to improve clinical outcomes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Intestinal microbiota is different in women with preterm birth: results from terminal restriction fragment length polymorphism analysis.

PubMed

Shiozaki, Arihiro; Yoneda, Satoshi; Yoneda, Noriko; Yonezawa, Rika; Matsubayashi, Takamichi; Seo, Genichiro; Saito, Shigeru

2014-01-01

Preterm birth is a leading cause of perinatal morbidity and mortality. Studies using a cultivation method or molecular identification have shown that bacterial vaginosis is one of the risk factors for preterm birth. However, an association between preterm birth and intestinal microbiota has not been reported using molecular techniques, although the vaginal microbiota changes during pregnancy. Our aim here was to clarify the difference in intestinal and vaginal microbiota between women with preterm birth and women without preterm labor. 16S ribosomal ribonucleic acid genes were amplified from fecal and vaginal DNA by polymerase chain reaction. Using terminal restriction fragment length polymorphism (T-RFLP), we compared the levels of operational taxonomic units of both intestinal and vaginal flora among three groups: pregnant women who delivered term babies without preterm labor (non-PTL group) (n = 20), those who had preterm labor but delivered term babies (PTL group) (n = 11), and those who had preterm birth (PTB group) (n = 10). Significantly low levels of Clostridium subcluster XVIII, Clostridium cluster IV, Clostridium subcluster XIVa, and Bacteroides, and a significantly high level of Lactobacillales were observed in the intestinal microbiota in the PTB group compared with those in the non-PTL group. The levels of Clostridium subcluster XVIII and Clostridium subcluster XIVa in the PTB group were significantly lower than those in the PTL group, and these levels in the PTL group were significantly lower than those in non-PTL group. However, there were no significant differences in vaginal microbiota among the three groups. Intestinal microbiota in the PTB group was found to differ from that in the non-PTL group using the T-RFLP method.

Recent Advances in Design of Low Cost Film Concentrator and Low Pressure Free Piston Stirling Engines for Solar Power

NASA Technical Reports Server (NTRS)

Kleinwaechter, J.; Kleinwaechter, H.; Beale, W.

1984-01-01

The free piston Stirling-linear alternator was shown to be scalable to power levels of tens of kilowatts in a form which is simple, efficient, long lived and relatively inexpensive. It avoids entirely the vexing problem of high pressure shaft, and its control requirements are not severe nor do they represent a significant threat to durability. Linear alternators have demonstrated high efficiency and moderate weight, and are capable of delivering 3 phase power from single machines without great increases of cost or complexity. There remains no apparent impediments to the commercial exploitation of the free piston engine for solar electric power generation.

The interfacility transport of critically ill newborns

PubMed Central

Whyte, Hilary EA; Jefferies, Ann L

2015-01-01

The practice of paediatric/neonatal interfacility transport continues to expand. Transport teams have evolved into mobile intensive care units capable of delivering state-of-the-art critical care during paediatric and neonatal transport. While outcomes are best for high-risk infants born in a tertiary care setting, high-risk mothers often cannot be safely transferred. Their newborns may then have to be transported to a higher level of care following birth. The present statement reviews issues relating to transport of the critically ill newborn population, including personnel, team competencies, skills, equipment, systems and processes. Six recommendations for improving interfacility transport of critically ill newborns are highlighted, emphasizing the importance of regionalized care for newborns. PMID:26175564

Pi-CO₂ aqueous post-combustion CO₂ capture: Proof of concept through thermodynamic, hydrodynamic, and gas-lift pump modeling

DOE PAGES

Blount, G.; Gorensek, M.; Hamm, L.; ...

2014-12-31

Partnering in Innovation, Inc. (Pi-Innovation) introduces an aqueous post-combustion carbon dioxide (CO₂) capture system (Pi-CO₂) that offers high market value by directly addressing the primary constraints limiting beneficial re-use markets (lowering parasitic energy costs, reducing delivered cost of capture, eliminating the need for special solvents, etc.). A highly experienced team has completed initial design, modeling, manufacturing verification, and financial analysis for commercial market entry. Coupled thermodynamic and thermal-hydraulic mass transfer modeling results fully support proof of concept. Pi-CO₂ has the potential to lower total cost and risk to levels sufficient to stimulate global demand for CO₂ from local industrial sources.

To deliver or not to deliver cognitive behavioral therapy for eating disorders: Replication and extension of our understanding of why therapists fail to do what they should do.

PubMed

Mulkens, Sandra; de Vos, Chloé; de Graaff, Anastacia; Waller, Glenn

2018-07-01

This study investigated the extent to which therapists fail to apply empirically supported treatments in a sample of clinicians in The Netherlands, delivering cognitive behavioral therapy for eating disorders (CBT-ED). It aimed to replicate previous findings, and to extend them by examining other potential intra-individual factors associated with the level of (non-)use of core CBT-ED techniques. Participants were 139 clinicians (127 women; mean age 41.4 years, range = 24-64) who completed an online survey about the level of use of specific techniques, their beliefs (e.g., about the importance of the alliance and use of pretreatment motivational techniques), anxiety (Intolerance of Uncertainty Scale), and personality (Ten Item Personality Inventory). Despite some differences with Waller's (2012) findings, the present results continue to indicate that therapists are not reliably delivering the CBT-ED techniques that would be expected to provide the best treatment to their patients. This 'non-delivery' appears to be related to clinician anxiety, temporal factors, and clinicians' beliefs about the power of the therapeutic alliance in driving therapy outcomes. Improving treatment delivery will involve working with clinicians' levels of anxiety, clarifying the lack of benefit of pre-therapy motivational enhancement work, and reminding clinicians that the therapeutic alliance is enhanced by behavioral change in CBT-ED, rather than the other way around. Copyright © 2018 Elsevier Ltd. All rights reserved.

Preanalytical influence of pneumatic tube delivery system on results of routine biochemistry and haematology analysis.

PubMed

Petit, Morgane; Mine, Louis; Pascreau, Tiffany; Brouzes, Chantal; Majoux, Sandrine; Borgel, Delphine; Beaudeux, Jean-Louis; Lasne, Dominique; Hennequin, Carole

2017-12-01

Pneumatic tube delivery system (PTS) enables to reduce considerably turnaround times. The aim of the study was to assess the influence of the PTS on the quality of routine biochemical and hematological tests in our laboratory. Blood samples from 6 hospitalized patients and 8 healthy volunteers were analyzed. Blood samples were delivered to the laboratory by a PTS and by a human courier. We performed the following analysis: ionized calcium, sodium, potassium, lactate deshydrogenase (LDH), aspartate aminotransferase (ASAT), arterial blood gas, complete blood count and coagulation test as prothrombin time, activated partial thromboplastin time, factors V and VIII. Results were compared between the both method of transport according to the recommendation of the Société française de biologie clinique and the French committee for accreditation (SH-GTA01, norme NF ISO 5275-6). The hemolysis index of plasma was similar between the groups and no morphological differences were found on blood cells. For three samples, when delivered by PTS, LDH levels (two samples) and neutrophil polynuclear count (one sample) were above the recommended guidelines compared to those delivered by courier. Conversely, LDH levels and FVIII were below in two samples delivered by PTS. LDH levels, PNN count or factor VIII can be affected by PTS without the clinical interpretation being modified. We concluded that the PTS can be used to transport blood samples for routine biochemical and hematological analysis in our hospital.

Lifestyle Health Behaviors of Nurses and Midwives: The ‘Fit for the Future’ Study

PubMed Central

Xu, Xiaoyue; Gallagher, Robyn; Nicholls, Rachel; Sibbritt, David; Duffield, Christine

2018-01-01

Nurses and midwives (nurses) are the principle role models and health educators for the wider population. This study sought to identify the health-related behaviors of the nursing workforce of New South Wales (NSW), Australia, compared to contemporary recommendations for healthy living and to the Australian general population, matched by gender and age. An electronic cross-sectional survey delivered in 2014–2015 recruited 5041 nurses through the NSW Nurses and Midwives Association and professional networks. Validated health behavior measures were collected and compared to Australian National Health Survey data. Compared with younger nurses, older nurses reported greater adherence to fruit and vegetable guideline recommendations, but were more likely to be overweight or obese. Younger nurses (25–34 years) had the highest risk of harmful drinking. Compared with the Australian general population, slightly higher percentages of nurses met dietary recommendations and slightly fewer were obese, had central adiposity or smoked. Nurses had lower physical activity levels and higher levels of risky drinking across most gender and age groups. Many nurses have lifestyle health behaviors that place them at high risk for developing non-communicable diseases, sometimes at higher risk than the Australian population to whom they deliver health education. Health promotion strategies for nurses are urgently required. PMID:29747412

Pilot evaluation of parent-child interaction therapy delivered in an Australian community early childhood clinic setting.

PubMed

Phillips, Jane; Morgan, Susan; Cawthorne, Karen; Barnett, Bryanne

2008-08-01

Parent-child interaction therapy (PCIT) is a short-term, evidence-based parent training intervention used widely in the treatment of behaviourally disordered preschool-aged children. Outcome studies have shown PCIT to be associated with lasting improvements in child and sibling behaviours and in the interactional styles, stress levels, confidence, and psychological functioning of parents. To date, however, all outcome studies have been conducted in university research clinic settings, and therefore understanding about the effectiveness of PCIT applied in a real-world setting has been limited. The present study evaluated the effectiveness of PCIT delivered to families in an Australian community-based early childhood clinic. Participants included 43 families with children aged 19-52 months who were referred for treatment of disruptive child behaviours and who completed PCIT treatment at the Karitane Toddler Clinic, in Sydney, Australia. Parents provided pre- and post-treatment ratings of child behaviours, parental stress, parental psychopathology and parental attitudes to therapy. At the end of the programme, clinically and statistically significant improvements were seen in child behaviours and parental well-being, and parents reported high levels of satisfaction with treatment. Implications for the implementation of PCIT programmes in community-based settings are discussed and areas of further research are identified.

Lifestyle Health Behaviors of Nurses and Midwives: The 'Fit for the Future' Study.

PubMed

Perry, Lin; Xu, Xiaoyue; Gallagher, Robyn; Nicholls, Rachel; Sibbritt, David; Duffield, Christine

2018-05-09

Nurses and midwives (nurses) are the principle role models and health educators for the wider population. This study sought to identify the health-related behaviors of the nursing workforce of New South Wales (NSW), Australia, compared to contemporary recommendations for healthy living and to the Australian general population, matched by gender and age. An electronic cross-sectional survey delivered in 2014⁻2015 recruited 5041 nurses through the NSW Nurses and Midwives Association and professional networks. Validated health behavior measures were collected and compared to Australian National Health Survey data. Compared with younger nurses, older nurses reported greater adherence to fruit and vegetable guideline recommendations, but were more likely to be overweight or obese. Younger nurses (25⁻34 years) had the highest risk of harmful drinking. Compared with the Australian general population, slightly higher percentages of nurses met dietary recommendations and slightly fewer were obese, had central adiposity or smoked. Nurses had lower physical activity levels and higher levels of risky drinking across most gender and age groups. Many nurses have lifestyle health behaviors that place them at high risk for developing non-communicable diseases, sometimes at higher risk than the Australian population to whom they deliver health education. Health promotion strategies for nurses are urgently required.

myMoves Program: Feasibility and Acceptability Study of a Remotely Delivered Self-Management Program for Increasing Physical Activity Among Adults With Acquired Brain Injury Living in the Community.

PubMed

Jones, Taryn M; Dear, Blake F; Hush, Julia M; Titov, Nickolai; Dean, Catherine M

2016-12-01

People living with acquired brain injury (ABI) are more likely to be physically inactive and highly sedentary and, therefore, to have increased risks of morbidity and mortality. However, many adults with ABI experience barriers to participation in effective physical activity interventions. Remotely delivered self-management programs focused on teaching patients how to improve and maintain their physical activity levels have the potential to improve the overall health of adults with ABI. The study objective was to evaluate the acceptability and feasibility of a remotely delivered self-management program aimed at increasing physical activity among adults who dwell in the community and have ABI. A single-group design involving comparison of baseline measures with those taken immediately after intervention and at a 3-month follow-up was used in this study. The myMoves Program comprises 6 modules delivered over 8 weeks via email. Participants were provided with regular weekly contact with an experienced physical therapist via email and telephone. The primary outcomes were the feasibility (participation, attrition, clinician time, accessibility, and adverse events) and acceptability (satisfaction, worthiness of time, and recommendation) of the myMoves Program. The secondary outcomes were objective physical activity data collected from accelerometers, physical activity self-efficacy, psychological distress, and participation. Twenty-four participants commenced the program (20 with stroke, 4 with traumatic injury), and outcomes were collected for 23 and 22 participants immediately after the program and at a 3-month follow-up, respectively. The program required very little clinician contact time, with an average of 32.8 minutes (SD=22.8) per participant during the 8-week program. Acceptability was very high, with more than 95% of participants being either very satisfied or satisfied with the myMoves Program and stating that it was worth their time. All participants stated that they would recommend the program to others with ABI. The results were obtained from a small sample; hence, the results may not be generalizable to a larger ABI population. A remotely delivered self-management program aimed at increasing physical activity is feasible and acceptable for adults with ABI. Further large-scale efficacy trials are warranted. © 2016 American Physical Therapy Association.

The LHCb trigger and its upgrade

NASA Astrophysics Data System (ADS)

Dziurda, A.; LHCb Trigger Group

2016-07-01

The current LHCb trigger system consists of a hardware level, which reduces the LHC inelastic collision rate of 30 MHz, at which the entire detector is read out. In a second level, implemented in a farm of 20 k parallel-processing CPUs, the event rate is reduced to about 5 kHz. We review the performance of the LHCb trigger system during Run I of the LHC. Special attention is given to the use of multivariate analyses in the High Level Trigger. The major bottleneck for hadronic decays is the hardware trigger. LHCb plans a major upgrade of the detector and DAQ system in the LHC shutdown of 2018, enabling a purely software based trigger to process the full 30 MHz of inelastic collisions delivered by the LHC. We demonstrate that the planned architecture will be able to meet this challenge.

Using the infrastructure of a conditional cash transfer program to deliver a scalable integrated early child development program in Colombia: cluster randomized controlled trial.

PubMed

Attanasio, Orazio P; Fernández, Camila; Fitzsimons, Emla O A; Grantham-McGregor, Sally M; Meghir, Costas; Rubio-Codina, Marta

2014-09-29

To assess the effectiveness of an integrated early child development intervention, combining stimulation and micronutrient supplementation and delivered on a large scale in Colombia, for children's development, growth, and hemoglobin levels. Cluster randomized controlled trial, using a 2 × 2 factorial design, with municipalities assigned to one of four groups: psychosocial stimulation, micronutrient supplementation, combined intervention, or control. 96 municipalities in Colombia, located across eight of its 32 departments. 1420 children aged 12-24 months and their primary carers. Psychosocial stimulation (weekly home visits with play demonstrations), micronutrient sprinkles given daily, and both combined. All delivered by female community leaders for 18 months. Cognitive, receptive and expressive language, and fine and gross motor scores on the Bayley scales of infant development-III; height, weight, and hemoglobin levels measured at the baseline and end of intervention. Stimulation improved cognitive scores (adjusted for age, sex, testers, and baseline levels of outcomes) by 0.26 of a standard deviation (P=0.002). Stimulation also increased receptive language by 0.22 of a standard deviation (P=0.032). Micronutrient supplementation had no significant effect on any outcome and there was no interaction between the interventions. No intervention affected height, weight, or hemoglobin levels. Using the infrastructure of a national welfare program we implemented the integrated early child development intervention on a large scale and showed its potential for improving children's cognitive development. We found no effect of supplementation on developmental or health outcomes. Moreover, supplementation did not interact with stimulation. The implementation model for delivering stimulation suggests that it may serve as a promising blueprint for future policy on early childhood development.Trial registration Current Controlled trials ISRCTN18991160. © Attanasio et al 2014.

Brazil's PROFORMAÇÃO Project: A Case Study of an Integrated Virtual System for Delivering In-Service Teacher Education

ERIC Educational Resources Information Center

Moore, Michael G.

2016-01-01

A systems methodology was employed to design and deliver a highly successful demonstration of the effectiveness of distance education as a means of providing high quality training to tens of thousands of teachers in the most remote areas of Brazil. Key elements in the success of the program were significant funding, top political buy-in, and…

Fidelity in complex behaviour change interventions: a standardised approach to evaluate intervention integrity

PubMed Central

Mars, Tom; Ellard, David; Carnes, Dawn; Homer, Kate; Underwood, Martin; Taylor, Stephanie J C

2013-01-01

Objectives The aim of this study was to (1) demonstrate the development and testing of tools and procedures designed to monitor and assess the integrity of a complex intervention for chronic pain (COping with persistent Pain, Effectiveness Research into Self-management (COPERS) course); and (2) make recommendations based on our experiences. Design Fidelity assessment of a two-arm randomised controlled trial intervention, assessing the adherence and competence of the facilitators delivering the intervention. Setting The intervention was delivered in the community in two centres in the UK: one inner city and one a mix of rural and urban locations. Participants 403 people with chronic musculoskeletal pain were enrolled in the intervention arm and 300 attended the self-management course. Thirty lay and healthcare professionals were trained and 24 delivered the courses (2 per course). We ran 31 courses for up to 16 people per course and all were audio recorded. Interventions The course was run over three and a half days; facilitators delivered a semistructured manualised course. Outcomes We designed three measures to evaluate fidelity assessing adherence to the manual, competence and overall impression. Results We evaluated a random sample of four components from each course (n=122). The evaluation forms were reliable and had good face validity. There were high levels of adherence in the delivery: overall adherence was two (maximum 2, IQR 1.67–2.00), facilitator competence exhibited more variability, and overall competence was 1.5 (maximum 2, IQR 1.25–2.00). Overall impression was three (maximum 4, IQR 2.00–3.00). Conclusions Monitoring and assessing adherence and competence at the point of intervention delivery can be realised most efficiently by embedding the principles of fidelity measurement within the design stage of complex interventions and the training and assessment of those delivering the intervention. More work is necessary to ensure that more robust systems of fidelity evaluation accompany the growth of complex interventions. Trial Registration ISRCTN No ISRCTN24426731. PMID:24240140

Estimation of high risk pregnancy contributing to perinatal morbidity and mortality from a birth population-based regional survey in 2010 in China.

PubMed

Sun, Libo; Yue, Hongni; Sun, Bo; Han, Liangrong; Tian, Zhaofang; Qi, Meihua; Lu, Shuyan; Shan, Chunming; Luo, Jianxin; Fan, Yujing; Li, Shouzhong; Dong, Maotian; Zuo, Xiaofeng; Zhang, Yixing; Lin, Wenlong; Xu, Jinzhong; Heng, Yongbo

2014-09-30

Neonatal mortality reduction in China over past two decades was reported from nationwide sampling surveys, however, how high risk pregnancy affected neonatal outcome is unknown. The objective of this study was to explore relations of pregnancy complications and neonatal outcomes from a regional birth population. In a prospective, cross-sectional survey of complete birth population-based data file from 151 level I-III hospitals in Huai'an region in 2010, pregnancy complications were analyzed for perinatal morbidity and mortality in association with maternal and perinatal characteristics, hospital levels, mode of delivery, newborn birth weight and gestational age, using international definition for birth registry and morbidities. Pregnancy complications were found in 10% of all births, in which more than 70% were delivered at level II and III hospitals associated with higher proportions of fetal and neonatal death, preterm birth, death at delivery and congenital anomalies. High Cesarean section delivery was associated with higher pregnancy complications, and more neonatal critical illnesses. The pregnancy complications related perinatal morbidity and mortality in level III were 2-4 times as high as in level I and II hospitals. By uni- and multi-variate regression analysis, impact of pregnancy complications was along with congenital anomalies and preterm birth, and maternal child-bearing age and school education years contributing to the prevalence. This survey revealed variable links of pregnancy complications to perinatal outcome in association with very high Cesarean section deliveries, which warrants investigation for causal relations between high risk pregnancy and neonatal outcome in this emerging region.

Pulsed power accelerator for material physics experiments

DOE PAGES

Reisman, D.  B.; Stoltzfus, B.  S.; Stygar, W.  A.; ...

2015-09-01

We have developed the design of Thor: a pulsed power accelerator that delivers a precisely shaped current pulse with a peak value as high as 7 MA to a strip-line load. The peak magnetic pressure achieved within a 1-cm-wide load is as high as 100 GPa. Thor is powered by as many as 288 decoupled and transit-time isolated bricks. Each brick consists of a single switch and two capacitors connected electrically in series. The bricks can be individually triggered to achieve a high degree of current pulse tailoring. Because the accelerator is impedance matched throughout, capacitor energy is delivered tomore » the strip-line load with an efficiency as high as 50%. We used an iterative finite element method (FEM), circuit, and magnetohydrodynamic simulations to develop an optimized accelerator design. When powered by 96 bricks, Thor delivers as much as 4.1 MA to a load, and achieves peak magnetic pressures as high as 65 GPa. When powered by 288 bricks, Thor delivers as much as 6.9 MA to a load, and achieves magnetic pressures as high as 170 GPa. We have developed an algebraic calculational procedure that uses the single brick basis function to determine the brick-triggering sequence necessary to generate a highly tailored current pulse time history for shockless loading of samples. Thor will drive a wide variety of magnetically driven shockless ramp compression, shockless flyer plate, shock-ramp, equation of state, material strength, phase transition, and other advanced material physics experiments.« less

Electrically Heated Testing of the Kilowatt Reactor Using Stirling Technology (KRUSTY) Experiment Using a Depleted Uranium Core

NASA Technical Reports Server (NTRS)

Briggs, Maxwell H.; Gibson, Marc A.; Sanzi, James

2017-01-01

The Kilopower project aims to develop and demonstrate scalable fission-based power technology for systems capable of delivering 110 kW of electric power with a specific power ranging from 2.5 - 6.5 Wkg. This technology could enable high power science missions or could be used to provide surface power for manned missions to the Moon or Mars. NASA has partnered with the Department of Energys National Nuclear Security Administration, Los Alamos National Labs, and Y-12 National Security Complex to develop and test a prototypic reactor and power system using existing facilities and infrastructure. This technology demonstration, referred to as the Kilowatt Reactor Using Stirling TechnologY (KRUSTY), will undergo nuclear ground testing in the summer of 2017 at the Nevada Test Site. The 1 kWe variation of the Kilopower system was chosen for the KRUSTY demonstration. The concept for the 1 kWe flight system consist of a 4 kWt highly enriched Uranium-Molybdenum reactor operating at 800 degrees Celsius coupled to sodium heat pipes. The heat pipes deliver heat to the hot ends of eight 125 W Stirling convertors producing a net electrical output of 1 kW. Waste heat is rejected using titanium-water heat pipes coupled to carbon composite radiator panels. The KRUSTY test, based on this design, uses a prototypic highly enriched uranium-molybdenum core coupled to prototypic sodium heat pipes. The heat pipes transfer heat to two Advanced Stirling Convertors (ASC-E2s) and six thermal simulators, which simulate the thermal draw of full scale power conversion units. Thermal simulators and Stirling engines are gas cooled. The most recent project milestone was the completion of non-nuclear system level testing using an electrically heated depleted uranium (non-fissioning) reactor core simulator. System level testing at the Glenn Research Center (GRC) has validated performance predictions and has demonstrated system level operation and control in a test configuration that replicates the one to be used at the Device Assembly Facility (DAF) at the Nevada National Security Site. Fabrication, assembly, and testing of the depleted uranium core has allowed for higher fidelity system level testing at GRC, and has validated the fabrication methods to be used on the highly enriched uranium core that will supply heat for the DAF KRUSTY demonstration.

An Evaluation of Levels of Adaptation Used in the Teaching of Foreign University Degree Programs in China

ERIC Educational Resources Information Center

Willis, Mike

2004-01-01

Many universities now deliver courses and programs in overseas markets such as China. Often these programs are delivered by foreign academics who teach in these overseas locations. This style and format of educational delivery raises the issue of the degree to which subject material and teaching styles need to be adapted to meet the needs of…

Delivering Educational Multimedia Contents through an Augmented Reality Application: A Case Study on Its Impact on Knowledge Acquisition and Retention

ERIC Educational Resources Information Center

Perez-Lopez, David; Contero, Manuel

2013-01-01

This paper presents a study to analyze the use of augmented reality (AR) for delivering multimedia content to support the teaching and learning process of the digestive and circulatory systems at the primary school level, and its impact on knowledge retention. Our AR application combines oral explanations and 3D models and animations of anatomical…

Enhancement of Intermittent Androgen Ablation Therapy by Finasteride Administration in Animal Models

DTIC Science & Technology

2003-02-01

that intermittent androgen ablation therapy can be enhanced by finasteride , an inhibitor of T to DHT conversion, To test our hypothesis in animal...models, it is necessary to deliver exogenous T at physiologic levels and finasteride over a long period of time, We have worked out conditions to deliver T and finasteride in nude mice, which will allow us to test our hypothesis.

Pharmacokinetics and pharmacodynamics of smoked heroin.

PubMed

Jenkins, A J; Keenan, R M; Henningfield, J E; Cone, E J

1994-10-01

Despite the current popularity of smoking as a route of drug self-administration, there have been few human studies characterizing the pharmacokinetics and pharmacodynamics of smoked drugs of abuse. A variety of technological difficulties are encountered in the design of smoking studies, such as delivering reproducible doses and limiting the amount of pyrolysis of parent drug. As part of a concerted research effort to deliver precise, smoked doses of drug, a computer-assisted smoking device was utilized that delivered single puffs of heroin vapor to human subjects under controlled clinical conditions. Recovery studies indicated that the smoking device delivered approximately 89% of parent heroin to subjects. Although only two qualified heroin smokers could be identified as eligible volunteers, their participation provided the unique opportunity to study the pharmacokinetics and pharmacodynamics of smoked heroin. The two subjects were administered four smoked heroin doses in ascending order. In addition, four intravenous doses of heroin were administered for comparison of effects and estimation of bioavailability. Concurrent physiological, behavioral, and performance measures were collected along with blood samples. Blood was analyzed for heroin, 6-acetylmorphine, and morphine by solid-phase extraction gas chromatography-mass spectrometry. Heroin appeared rapidly in blood after administration and peaked 1-5 minutes after smoking, which is similar to that observed following intravenous administration. Heroin concentrations declined rapidly to the limit of detection (1.0 ng/mL) by 30 minutes. 6-Acetylmorphine blood concentrations also peaked and declined rapidly after smoked heroin with peak concentrations occurring at 1-2 minutes after smoking. Morphine levels rose and decayed more slowly. Mean elimination half-lives for heroin, 6-acetylmorphine, and morphine were 3.3 min, 5.4 min, and 18.8 min, respectively, by the smoked route. The bioavailability of smoked heroin was highly variable. Physiological measures such as pupil diameter demonstrated a counterclockwise hysteresis compared with heroin blood levels. The rapid onset of pharmacological effects together with the early appearance of heroin and metabolites in blood following smoked heroin demonstrated the effectiveness of this route of drug administration. It is evident that the smoking route enables individuals to obtain similar pharmacological effects as are produced by intravenous administration of heroin.

Quality of antenatal care service provision in health facilities across sub–Saharan Africa: Evidence from nationally representative health facility assessments

PubMed Central

Kanyangarara, Mufaro; Munos, Melinda K; Walker, Neff

2017-01-01

Background Utilization of antenatal care (ANC) services has increased over the past two decades. Continued gains in maternal and newborn health will require an understanding of both access and quality of ANC services. We linked health facility and household survey data to examine the quality of service provision for five ANC interventions across health facilities in sub–Saharan Africa. Methods Using data from 20 nationally representative health facility assessments – the Service Provision Assessment (SPA) and the Service Availability and Readiness Assessment (SARA), we estimated facility level readiness to deliver five ANC interventions: tetanus toxoid vaccine for pregnant women, intermittent preventive treatment for malaria in pregnancy (IPTp), syphilis detection and treatment in pregnancy, iron supplementation and hypertensive disease case management. Facility level indicators were stratified by health facility type, managing authority and location, then linked to estimates of ANC utilization in that stratum from the corresponding Demographic and Health Surveys (DHS) to generate population level estimates of the ‘likelihood of appropriate care’. Finally, the association between estimates of the ‘likelihood of appropriate care’ from the linking approach and estimates of coverage levels from the DHS were assessed. Findings A total of 10 534 health facilities were surveyed in the 20 health facility assessments, of which 8742 reported offering ANC services and were included in the analysis. Health facility readiness to deliver IPTp, iron supplementation, and tetanus toxoid vaccination was higher (median: 84.1%, 84.9% and 82.8% respectively) than readiness to deliver hypertensive disease case management and syphilis detection and treatment (median: 23.0% and 19.9% respectively). Coverage of at least 4 ANC visits ranged from 24.8% to 75.8%. Estimates of the likelihood of appropriate care derived from linking health facility and household survey data showed marked gaps for all interventions, particularly hypertensive disease case management and syphilis detection and treatment. There was fairly good concordance between our estimates of high likelihood of appropriate care and DHS estimates of coverage for iron supplementation, IPTp, and tetanus toxoid vaccination. Conclusion Linking household surveys to health facility assessments revealed marked gaps in population–level coverage of quality ANC interventions and underscored the need for a double–pronged approach to increase ANC utilization and improve the quality of ANC services. PMID:29163936

Quality of antenatal care service provision in health facilities across sub-Saharan Africa: Evidence from nationally representative health facility assessments.

PubMed

Kanyangarara, Mufaro; Munos, Melinda K; Walker, Neff

2017-12-01

Utilization of antenatal care (ANC) services has increased over the past two decades. Continued gains in maternal and newborn health will require an understanding of both access and quality of ANC services. We linked health facility and household survey data to examine the quality of service provision for five ANC interventions across health facilities in sub-Saharan Africa. Using data from 20 nationally representative health facility assessments - the Service Provision Assessment (SPA) and the Service Availability and Readiness Assessment (SARA), we estimated facility level readiness to deliver five ANC interventions: tetanus toxoid vaccine for pregnant women, intermittent preventive treatment for malaria in pregnancy (IPTp), syphilis detection and treatment in pregnancy, iron supplementation and hypertensive disease case management. Facility level indicators were stratified by health facility type, managing authority and location, then linked to estimates of ANC utilization in that stratum from the corresponding Demographic and Health Surveys (DHS) to generate population level estimates of the 'likelihood of appropriate care'. Finally, the association between estimates of the 'likelihood of appropriate care' from the linking approach and estimates of coverage levels from the DHS were assessed. A total of 10 534 health facilities were surveyed in the 20 health facility assessments, of which 8742 reported offering ANC services and were included in the analysis. Health facility readiness to deliver IPTp, iron supplementation, and tetanus toxoid vaccination was higher (median: 84.1%, 84.9% and 82.8% respectively) than readiness to deliver hypertensive disease case management and syphilis detection and treatment (median: 23.0% and 19.9% respectively). Coverage of at least 4 ANC visits ranged from 24.8% to 75.8%. Estimates of the likelihood of appropriate care derived from linking health facility and household survey data showed marked gaps for all interventions, particularly hypertensive disease case management and syphilis detection and treatment. There was fairly good concordance between our estimates of high likelihood of appropriate care and DHS estimates of coverage for iron supplementation, IPTp, and tetanus toxoid vaccination. Linking household surveys to health facility assessments revealed marked gaps in population-level coverage of quality ANC interventions and underscored the need for a double-pronged approach to increase ANC utilization and improve the quality of ANC services.

Evaluating the Effect of Flow and Interface Type on Pressures Delivered With Bubble CPAP in a Simulated Model.

PubMed

Bailes, Stephanie A; Firestone, Kimberly S; Dunn, Diane K; McNinch, Neil L; Brown, Miraides F; Volsko, Teresa A

2016-03-01

Bubble CPAP, used for spontaneously breathing infants to avoid intubation or postextubation support, can be delivered with different interface types. This study compared the effect that interfaces had on CPAP delivery. We hypothesized that there would be no difference between set and measured levels between interface types. A validated preterm infant nasal airway model was attached to the ASL 5000 breathing simulator. The simulator was programmed to deliver active breathing of a surfactant-deficient premature infant with breathing frequency at 70 breaths/min inspiratory time of 0.30 s, resistance of 150 cm H2O/L/s, compliance of 0.5 mL/cm H2O, tidal volume of 5 mL, and esophageal pressure of -10 cm H2O. Nasal CPAP prongs, size 4030, newborn and infant RAM cannulas were connected to a nasal airway model and a bubble CPAP system. CPAP levels were set at 4, 5, 6, 7, 8, and 9 cm H2O with flows of 6, 8, and 10 L/min each. Measurements were recorded after 1 min of stabilization. The analysis was performed using SAS 9.4. The Kolmogorov-Smirnov test assessed normality of the data. The Friedman test was used to compare non-normally distributed repeated measures. The Wilcoxon signed-rank test was used to conduct post hoc analysis. All tests were 2-sided, and P values of <.05 were considered as indicating significant differences unless otherwise indicated. At lower set CPAP levels, 4-6 cm H2O, measured CPAP dropped precipitously with the nasal prongs with the highest flow setting. At higher CPAP levels, 7-9 cm H2O measured CPAP concomitantly increased as the flow setting increased. Statistically significant differences in set and measured CPAP occurred for all devices across all CPAP levels, with the measured CPAP less than set for all conditions, P < .001. Set flow had a profound effect on measured CPAP. The concomitant drop in measured pressure with high and low flows could be attributed to increased resistance to spontaneous breathing or insufficient flow to meet inspiratory demand. Clinicians should be aware of the effect that the interface and flow have on CPAP delivery. Copyright © 2016 by Daedalus Enterprises.

Ultra-Accelerated Natural Sunlight Exposure Testing Facilities

DOEpatents

Lewandowski, Allan A.; Jorgensen, Gary J.

2004-11-23

A multi-faceted concentrator apparatus for providing ultra-accelerated natural sunlight exposure testing for sample materials under controlled weathering conditions comprising: facets that receive incident natural sunlight, transmits VIS/NIR and reflects UV/VIS onto a secondary reflector that delivers a uniform flux of UV/VIS onto a sample exposure plane located near a center of a facet array in a chamber that provide concurrent levels of temperature and/or relative humidity at high levels of up to 100.times. of natural sunlight that allow sample materials to be subjected to accelerated irradiance exposure factors for a significant period of time of about 3 to 10 days to provide a corresponding time of about at least a years worth representative weathering of sample materials.

Nanoporous metal/oxide hybrid electrodes for electrochemical supercapacitors

NASA Astrophysics Data System (ADS)

Lang, Xingyou; Hirata, Akihiko; Fujita, Takeshi; Chen, Mingwei

2011-04-01

Electrochemical supercapacitors can deliver high levels of electrical power and offer long operating lifetimes, but their energy storage density is too low for many important applications. Pseudocapacitive transition-metal oxides such as MnO2 could be used to make electrodes in such supercapacitors, because they are predicted to have a high capacitance for storing electrical charge while also being inexpensive and not harmful to the environment. However, the poor conductivity of MnO2 (10-5-10-6 S cm-1) limits the charge/discharge rate for high-power applications. Here, we show that hybrid structures made of nanoporous gold and nanocrystalline MnO2 have enhanced conductivity, resulting in a specific capacitance of the constituent MnO2 (~1,145 F g-1) that is close to the theoretical value. The nanoporous gold allows electron transport through the MnO2, and facilitates fast ion diffusion between the MnO2 and the electrolytes while also acting as a double-layer capacitor. The high specific capacitances and charge/discharge rates offered by such hybrid structures make them promising candidates as electrodes in supercapacitors, combining high-energy storage densities with high levels of power delivery.

Nanoporous metal/oxide hybrid electrodes for electrochemical supercapacitors.

PubMed

Lang, Xingyou; Hirata, Akihiko; Fujita, Takeshi; Chen, Mingwei

2011-04-01

Electrochemical supercapacitors can deliver high levels of electrical power and offer long operating lifetimes, but their energy storage density is too low for many important applications. Pseudocapacitive transition-metal oxides such as MnO(2) could be used to make electrodes in such supercapacitors, because they are predicted to have a high capacitance for storing electrical charge while also being inexpensive and not harmful to the environment. However, the poor conductivity of MnO(2) (10(-5)-10(-6) S cm(-1)) limits the charge/discharge rate for high-power applications. Here, we show that hybrid structures made of nanoporous gold and nanocrystalline MnO(2) have enhanced conductivity, resulting in a specific capacitance of the constituent MnO(2) (~1,145 F g(-1)) that is close to the theoretical value. The nanoporous gold allows electron transport through the MnO(2), and facilitates fast ion diffusion between the MnO(2) and the electrolytes while also acting as a double-layer capacitor. The high specific capacitances and charge/discharge rates offered by such hybrid structures make them promising candidates as electrodes in supercapacitors, combining high-energy storage densities with high levels of power delivery.

Does Health Literacy Level Influence the Effectiveness of a Kiosk-Based Intervention Delivered in the Pediatric Emergency Department?

PubMed

Shields, Wendy C; McDonald, Eileen M; McKenzie, Lara B; Gielen, Andrea C

2016-01-01

This study assesses parents' literacy skills and evaluates how literacy levels influenced the effectiveness of a health communication intervention designed to improve safety knowledge in low-income, urban families. A total of n = 450 parents of children aged 4 to 66 months completed the Rapid Estimate of Adult Literacy in Medicine (REALM) and participated in a randomized trial of an injury prevention intervention delivered via computer kiosk in a pediatric emergency department. A safety knowledge test was administered by telephone 2 to 4 weeks later. More than one-third of parents were assessed by the REALM to have marginal (30%) or inadequate (8%) reading levels; the remaining 62% of parents had adequate reading levels. REALM scores were independently associated with knowledge gains for poison storage and smoke alarms. Participants reading level had an independent and significant effect on safety knowledge outcomes. Literacy level should be considered in all patient education efforts. © The Author(s) 2015.

Evaluation of a group cognitive-behavioral depression prevention program for young adolescents: a randomized effectiveness trial.

PubMed

Gillham, Jane E; Reivich, Karen J; Brunwasser, Steven M; Freres, Derek R; Chajon, Norma D; Kash-Macdonald, V Megan; Chaplin, Tara M; Abenavoli, Rachel M; Matlin, Samantha L; Gallop, Robert J; Seligman, Martin E P

2012-01-01

Depression is a common psychological problem in adolescence. Recent research suggests that group cognitive-behavioral interventions can reduce and prevent symptoms of depression in youth. Few studies have tested the effectiveness of such interventions when delivered by school teachers and counselors (as opposed to research team staff). We evaluated the effectiveness of the Penn Resiliency Program for adolescents (PRP-A), a school-based group intervention that targets cognitive behavioral risk factors for depression. We randomly assigned 408 middle school students (ages 10-15) to one of three conditions: PRP-A, PRP-AP (in which adolescents participated in PRP-A and parents were invited to attend a parent intervention component), or a school-as-usual control. Adolescents completed measures of depression and anxiety symptoms, cognitive style, and coping at baseline, immediately after the intervention, and at 6-month follow-up. PRP-A reduced depression symptoms relative to the school as usual control. Baseline levels of hopelessness moderated intervention effects. Among participants with average and high levels of hopelessness, PRP (A and AP) significantly improved depression symptoms, anxiety symptoms, hopelessness, and active coping relative to control. Among participants with low baseline hopelessness, we found no intervention effects. PRP-AP was not more effective than PRP-A alone. We found no intervention effects on clinical levels of depression or anxiety. These findings suggest that cognitive-behavioral interventions can be beneficial when delivered by school teachers and counselors. These interventions may be most helpful to students with elevated hopelessness.

Development of stable, narrow spectral line-width, fiber delivered laser source for spin exchange optical pumping

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

Liu, Bo; Tong, Xin; Jiang, Chenyang

2015-06-05

In this study, we developed a stable, narrow spectral line-width, fiber delivered laser source for spin exchange optical pumping. An optimized external cavity equipped with an off-the-shelf volume holographic grating narrowed the spectral line-width of a 100 W high-power diode laser and stabilized the laser spectrum. The laser spectrum showed a high side mode suppression ratio of >30 dB and good long-term stability (center wavelength drifting within ±0.002 nm during 220 h of operation). Finally, our laser is delivered by a multimode fiber with power ~70 W, center wavelength of 794.77 nm, and spectral bandwidth of ~0.12 nm.

Radiation source with shaped emission

DOEpatents

Kubiak, Glenn D.; Sweatt, William C.

2003-05-13

Employing a source of radiation, such as an electric discharge source, that is equipped with a capillary region configured into some predetermined shape, such as an arc or slit, can significantly improve the amount of flux delivered to the lithographic wafers while maintaining high efficiency. The source is particularly suited for photolithography systems that employs a ringfield camera. The invention permits the condenser which delivers critical illumination to the reticle to be simplified from five or more reflective elements to a total of three or four reflective elements thereby increasing condenser efficiency. It maximizes the flux delivered and maintains a high coupling efficiency. This architecture couples EUV radiation from the discharge source into a ring field lithography camera.

Impact of Groundwater-Lake Interaction on Levels of E. coli in Near-Shore Swimming Waters at Beaches of the Great Lakes

NASA Astrophysics Data System (ADS)

Crowe, A. S.

2009-12-01

Beaches throughout the Great Lakes frequently are under health advisories for swimming due to elevated levels of E. coli. Many studies have shown that there are several potential sources of this E. coli (e.g., livestock, sewage treatment facilities, gulls and geese), and several mechanisms for delivering E. coli to the shoreline (e.g., rivers, creeks, storm water drains, currents, waves). But, groundwater is a mechanism for E. coli transport to the shoreline that is typically overlooked. Field studies undertaken at beaches throughout the Great lakes have measured levels of E. coli in the groundwater and sand at the groundwater-lake interface that are commonly over a 1000 times above Recreational Water Quality Guidelines, and that these high levels of E. coli are restricted to a zone below the beach adjacent to and within a few metres of the lake. Groundwater flow below beaches is always towards the shoreline with almost all groundwater discharge occurring at the groundwater-lake interface (i.e., not several or a few metres off-shore). Thus, groundwater discharge of the E. coli from zone represents a substantial and long-term reservoir for E. coli loading to the near shore recreational waters, and presents a potential health risk to swimmers. The high levels of E. coli in the sand and groundwater adjacent to the lake is also due to groundwater-lake interaction. During storms, wave runup and subsequent infiltration of lake water containing E. coli at the swash zone is the primary mechanism for delivering E. coli to the groundwater and sand adjacent to the lake. Field and modeling experiments show that storm events as short as a few hours can introduce substantial levels of E. coli to the groundwater because of the high inward groundwater velocities. However, its migration into the beach away from the shoreline is restricted to a few metres beyond the maximum extent of wave runup because groundwater flow below the beach continues to flow towards the shoreline creating a hydraulic barrier to inland migration of E. coli. Because groundwater discharge velocities following a storm event are much lower than the recharging groundwater velocities during infiltration, E. coli will enter the groundwater and sand much faster than in will discharge. Hence groundwater discharge of E. coli from this zone into the lake represents a long-term and continuous source of E. coli that will challenge regulators and beach managers who are trying to reduce levels of E. coli at swimming beaches throughout the Great Lakes.

Progressive Stochastic Reconstruction Technique (PSRT) for cryo electron tomography.

PubMed

Turoňová, Beata; Marsalek, Lukas; Davidovič, Tomáš; Slusallek, Philipp

2015-03-01

Cryo Electron Tomography (cryoET) plays an essential role in Structural Biology, as it is the only technique that allows to study the structure of large macromolecular complexes in their close to native environment in situ. The reconstruction methods currently in use, such as Weighted Back Projection (WBP) or Simultaneous Iterative Reconstruction Technique (SIRT), deliver noisy and low-contrast reconstructions, which complicates the application of high-resolution protocols, such as Subtomogram Averaging (SA). We propose a Progressive Stochastic Reconstruction Technique (PSRT) - a novel iterative approach to tomographic reconstruction in cryoET based on Monte Carlo random walks guided by Metropolis-Hastings sampling strategy. We design a progressive reconstruction scheme to suit the conditions present in cryoET and apply it successfully to reconstructions of macromolecular complexes from both synthetic and experimental datasets. We show how to integrate PSRT into SA, where it provides an elegant solution to the region-of-interest problem and delivers high-contrast reconstructions that significantly improve template-based localization without any loss of high-resolution structural information. Furthermore, the locality of SA is exploited to design an importance sampling scheme which significantly speeds up the otherwise slow Monte Carlo approach. Finally, we design a new memory efficient solution for the specimen-level interior problem of cryoET, removing all associated artifacts. Copyright © 2015 Elsevier Inc. All rights reserved.

BioCARS: a synchrotron resource for time-resolved X-ray science

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

Graber, T.; Anderson, S.; Brewer, H.

2011-08-16

BioCARS, a NIH-supported national user facility for macromolecular time-resolved X-ray crystallography at the Advanced Photon Source (APS), has recently completed commissioning of an upgraded undulator-based beamline optimized for single-shot laser-pump X-ray-probe measurements with time resolution as short as 100 ps. The source consists of two in-line undulators with periods of 23 and 27 mm that together provide high-flux pink-beam capability at 12 keV as well as first-harmonic coverage from 6.8 to 19 keV. A high-heat-load chopper reduces the average power load on downstream components, thereby preserving the surface figure of a Kirkpatrick-Baez mirror system capable of focusing the X-ray beammore » to a spot size of 90 {micro}m horizontal by 20 {micro}m vertical. A high-speed chopper isolates single X-ray pulses at 1 kHz in both hybrid and 24-bunch modes of the APS storage ring. In hybrid mode each isolated X-ray pulse delivers up to {approx}4 x 10{sup 10} photons to the sample, thereby achieving a time-averaged flux approaching that of fourth-generation X-FEL sources. A new high-power picosecond laser system delivers pulses tunable over the wavelength range 450-2000 nm. These pulses are synchronized to the storage-ring RF clock with long-term stability better than 10 ps RMS. Monochromatic experimental capability with Biosafety Level 3 certification has been retained.« less

Performance of a first generation X-band photoelectron rf gun

DOE PAGES

Limborg-Deprey, C.; Adolphsen, C.; McCormick, D.; ...

2016-05-04

Building more compact accelerators to deliver high brightness electron beams for the generation of high flux, highly coherent radiation is a priority for the photon science community. A relatively straightforward reduction in footprint can be achieved by using high-gradient X-band (11.4 GHz) rf technology. To this end, an X-band injector consisting of a 5.5 cell rf gun and a 1-m long linac has been commissioned at SLAC. It delivers an 85 MeV electron beam with peak brightness somewhat better than that achieved in S-band photoinjectors, such as the one developed for the Linac Coherent Light Source (LCLS). The X-band rfmore » gun operates with up to a 200 MV/m peak field on the cathode, and has been used to produce bunches of a few pC to 1.2 nC in charge. Notably, bunch lengths as short as 120 fs rms have been measured for charges of 5 pC (~3×10 7 electrons), and normalized transverse emittances as small as 0.22 mm-mrad have been measured for this same charge level. Bunch lengths as short as 400 (250) fs rms have been achieved for electron bunches of 100 (20) pC with transverse normalized emittances of 0.7 (0.35) mm-mrad. As a result, we report on the performance and the lessons learned from the operation and optimization of this first generation X-band gun.« less

BioCARS: a synchrotron resource for time-resolved X-ray science

PubMed Central

Graber, T.; Anderson, S.; Brewer, H.; Chen, Y.-S.; Cho, H. S.; Dashdorj, N.; Henning, R. W.; Kosheleva, I.; Macha, G.; Meron, M.; Pahl, R.; Ren, Z.; Ruan, S.; Schotte, F.; Šrajer, V.; Viccaro, P. J.; Westferro, F.; Anfinrud, P.; Moffat, K.

2011-01-01

BioCARS, a NIH-supported national user facility for macromolecular time-resolved X-ray crystallography at the Advanced Photon Source (APS), has recently completed commissioning of an upgraded undulator-based beamline optimized for single-shot laser-pump X-ray-probe measurements with time resolution as short as 100 ps. The source consists of two in-line undulators with periods of 23 and 27 mm that together provide high-flux pink-beam capability at 12 keV as well as first-harmonic coverage from 6.8 to 19 keV. A high-heat-load chopper reduces the average power load on downstream components, thereby preserving the surface figure of a Kirkpatrick–Baez mirror system capable of focusing the X-ray beam to a spot size of 90 µm horizontal by 20 µm vertical. A high-speed chopper isolates single X-ray pulses at 1 kHz in both hybrid and 24-bunch modes of the APS storage ring. In hybrid mode each isolated X-ray pulse delivers up to ∼4 × 1010 photons to the sample, thereby achieving a time-averaged flux approaching that of fourth-generation X-FEL sources. A new high-power picosecond laser system delivers pulses tunable over the wavelength range 450–2000 nm. These pulses are synchronized to the storage-ring RF clock with long-term stability better than 10 ps RMS. Monochromatic experimental capability with Biosafety Level 3 certification has been retained. PMID:21685684

Performance of a first generation X-band photoelectron rf gun

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

Limborg-Deprey, C.; Adolphsen, C.; McCormick, D.

Building more compact accelerators to deliver high brightness electron beams for the generation of high flux, highly coherent radiation is a priority for the photon science community. A relatively straightforward reduction in footprint can be achieved by using high-gradient X-band (11.4 GHz) rf technology. To this end, an X-band injector consisting of a 5.5 cell rf gun and a 1-m long linac has been commissioned at SLAC. It delivers an 85 MeV electron beam with peak brightness somewhat better than that achieved in S-band photoinjectors, such as the one developed for the Linac Coherent Light Source (LCLS). The X-band rfmore » gun operates with up to a 200 MV/m peak field on the cathode, and has been used to produce bunches of a few pC to 1.2 nC in charge. Notably, bunch lengths as short as 120 fs rms have been measured for charges of 5 pC (~3×10 7 electrons), and normalized transverse emittances as small as 0.22 mm-mrad have been measured for this same charge level. Bunch lengths as short as 400 (250) fs rms have been achieved for electron bunches of 100 (20) pC with transverse normalized emittances of 0.7 (0.35) mm-mrad. As a result, we report on the performance and the lessons learned from the operation and optimization of this first generation X-band gun.« less

Nanowire-based single-cell endoscopy

NASA Astrophysics Data System (ADS)

Yan, Ruoxue; Park, Ji-Ho; Choi, Yeonho; Heo, Chul-Joon; Yang, Seung-Man; Lee, Luke P.; Yang, Peidong

2012-03-01

One-dimensional smart probes based on nanowires and nanotubes that can safely penetrate the plasma membrane and enter biological cells are potentially useful in high-resolution and high-throughput gene and drug delivery, biosensing and single-cell electrophysiology. However, using such probes for optical communication across the cellular membrane at the subwavelength level remains limited. Here, we show that a nanowire waveguide attached to the tapered tip of an optical fibre can guide visible light into intracellular compartments of a living mammalian cell, and can also detect optical signals from subcellular regions with high spatial resolution. Furthermore, we show that through light-activated mechanisms the endoscope can deliver payloads into cells with spatial and temporal specificity. Moreover, insertion of the endoscope into cells and illumination of the guided laser did not induce any significant toxicity in the cells.

Formulation of a novel fixed dose combination of salmeterol xinafoate and mometasone furoate for inhaled drug delivery.

PubMed

Liu, Sha; Watts, Alan B; Du, Ju; Bui, Amanda; Hengsawas, Soraya; Peters, Jay I; Williams, Robert O

2015-10-01

Co-administration of an inhaled corticosteroid and long acting beta agonist for chronic obstructive pulmonary disease has reduced mortality compared to either drug alone. This combination reduces exacerbations, hospitalization, emergency department visits and health care costs. A novel fixed-dose combination of the long acting beta-2 agonist salmeterol xinafoate (SX) and the corticosteroid mometasone furoate (MF) were prepared in a composite particle formulation as brittle matrix powder (BMP) and investigated for suitability as an inhaled combination product. In this study, BMP fixed dose combinations of SX and MF with or without stabilizing excipients (lactose, mannitol, glycine and trehalose) were prepared and characterized with respect to their thermal properties, morphology, aerodynamic performance and physical stability. BMP combination formulations of SX and MF exhibited improved aerodynamic properties when delivered by dry powder inhalation as compared to the micronized blends of the same substances. Aerodynamic evaluation was carried out by next generation pharmaceutical impactor (NGI) with a marketed DPI device. Results demonstrated that co-deposition occurred when SX and MF were formulated together as composite particles in a BMP, while physical blends resulted in inconsistent deposition and dose uniformity. As a result of the bottom-up particle engineering approach, combination BMP formulations allow for dual API composite formulations to be dispersed as aerosolized particles. Aerosolized BMP combination formulations resulted in delivered dose uniformity and co-deposition of each API. Further, an excipient-free formulation, BMP SXMF, delivered approximately 50% of the loaded dose in the respirable range and demonstrated stability at ambient conditions for 6months. Single dose 24-h pharmacokinetic studies in rats demonstrated that lung tissue deposition and blood circulation (AUC0-24h) of two APIs were higher for the BMP combination group exhibiting a significantly higher lung concentration of drugs than for the crystalline physical blend. While high system drug levels are generally undesirable in lung targeted therapies, high blood levels in this rodent study could be indicative of increased pulmonary tissue exposure using BMP formulations. Copyright © 2015 Elsevier B.V. All rights reserved.

Vectored Intracerebral Immunization with the Anti-Tau Monoclonal Antibody PHF1 Markedly Reduces Tau Pathology in Mutant Tau Transgenic Mice.

PubMed

Liu, Wencheng; Zhao, Lingzhi; Blackman, Brittany; Parmar, Mayur; Wong, Man Ying; Woo, Thomas; Yu, Fangmin; Chiuchiolo, Maria J; Sondhi, Dolan; Kaminsky, Stephen M; Crystal, Ronald G; Paul, Steven M

2016-12-07

Passive immunization with anti-tau monoclonal antibodies has been shown by several laboratories to reduce age-dependent tau pathology and neurodegeneration in mutant tau transgenic mice. These studies have used repeated high weekly doses of various tau antibodies administered systemically for several months and have reported reduced tau pathology of ∼40-50% in various brain regions. Here we show that direct intrahippocampal administration of the adeno-associated virus (AAV)-vectored anti-phospho-tau antibody PHF1 to P301S tau transgenic mice results in high and durable antibody expression, primarily in neurons. Hippocampal antibody levels achieved after AAV delivery were ∼50-fold more than those reported following repeated systemic administration. In contrast to systemic passive immunization, we observed markedly reduced (≥80-90%) hippocampal insoluble pathological tau species and neurofibrillary tangles following a single dose of AAV-vectored PHF1 compared with mice treated with an AAV-IgG control vector. Moreover, the hippocampal atrophy observed in untreated P301S mice was fully rescued by treatment with the AAV-vectored PHF1 antibody. Vectored passive immunotherapy with an anti-tau monoclonal antibody may represent a viable therapeutic strategy for treating or preventing such tauopathies as frontotemporal dementia, progressive supranuclear palsy, or Alzheimer's disease. We have used an adeno-associated viral (AAV) vector to deliver the genes encoding an anti-phospho-tau monoclonal antibody, PHF1, directly to the brain of mice that develop neurodegeneration due to a tau mutation that causes frontotemporal dementia (FTD). When administered systemically, PHF1 has been shown to modestly reduce tau pathology and neurodegeneration. Since such antibodies do not readily cross the blood-brain barrier, we used an AAV vector to deliver antibody directly to the hippocampus and observed much higher antibody levels and a much greater reduction in tau pathology. Using AAV vectors to deliver antibodies like PHF1 directly to brain may constitute a novel approach to treating various neurodegenerative disorders, such as FTD and Alzheimer's disease. Copyright © 2016 the authors 0270-6474/16/3612425-11$15.00/0.

Intratracheal instillation of pravastatin for the treatment of murine allergic asthma: a lung-targeted approach to deliver statins

PubMed Central

Zeki, Amir A; Bratt, Jennifer M; Chang, Kevin Y; Franzi, Lisa M; Ott, Sean; Silveria, Mark; Fiehn, Oliver; Last, Jerold A; Kenyon, Nicholas J

2015-01-01

Systemic treatment with statins mitigates allergic airway inflammation, TH2 cytokine production, epithelial mucus production, and airway hyperreactivity (AHR) in murine models of asthma. We hypothesized that pravastatin delivered intratracheally would be quantifiable in lung tissues using mass spectrometry, achieve high drug concentrations in the lung with minimal systemic absorption, and mitigate airway inflammation and structural changes induced by ovalbumin. Male BALB/c mice were sensitized to ovalbumin (OVA) over 4 weeks, then exposed to 1% OVA aerosol or filtered air (FA) over 2 weeks. Mice received intratracheal instillations of pravastatin before and after each OVA exposure (30 mg/kg). Ultra performance liquid chromatography – mass spectrometry was used to quantify plasma, lung, and bronchoalveolar lavage fluid (BALF) pravastatin concentration. Pravastatin was quantifiable in mouse plasma, lung tissue, and BALF (BALF > lung > plasma for OVA and FA groups). At these concentrations pravastatin inhibited airway goblet cell hyperplasia/metaplasia, and reduced BALF levels of cytokines TNFα and KC, but did not reduce BALF total leukocyte or eosinophil cell counts. While pravastatin did not mitigate AHR, it did inhibit airway hypersensitivity (AHS). In this proof-of-principle study, using novel mass spectrometry methods we show that pravastatin is quantifiable in tissues, achieves high levels in mouse lungs with minimal systemic absorption, and mitigates some pathological features of allergic asthma. Inhaled pravastatin may be beneficial for the treatment of asthma by having direct airway effects independent of a potent anti-inflammatory effect. Statins with greater lipophilicity may achieve better anti-inflammatory effects warranting further research. PMID:25969462

Improving health and safety conditions in agriculture through professional training of Florida farm labor supervisors.

PubMed

Morera, Maria C; Monaghan, Paul F; Tovar-Aguilar, J Antonio; Galindo-Gonzalez, Sebastian; Roka, Fritz M; Asuaje, Cesar

2014-01-01

Because farm labor supervisors (FLSs) are responsible for ensuring safe work environments for thousands of workers, providing them with adequate knowledge is critical to preserving worker health. Yet a challenge to offering professional training to FLSs, many of whom are foreign-born and have received different levels of education in the US and abroad, is implementing a program that not only results in knowledge gains but meets the expectations of a diverse audience. By offering bilingual instruction on safety and compliance, the University of Florida Institute of Food and Agricultural Sciences (UF/IFAS) FLS Training program is helping to improve workplace conditions and professionalize the industry. A recent evaluation of the program combined participant observation and surveys to elicit knowledge and satisfaction levels from attendees of its fall 2012 trainings. Frequency distributions and dependent- and independent-means t-tests were used to measure and compare participant outcomes. The evaluation found that attendees rated the quality of their training experience as either high or very high and scored significantly better in posttraining knowledge tests than in pretraining knowledge tests across both languages. Nonetheless, attendees of the trainings delivered in English had significantly higher posttest scores than attendees of the trainings delivered in Spanish. As a result, the program has incorporated greater standardization of content delivery and staff development. Through assessment of its program components and educational outcomes, the program has documented its effectiveness and offers a replicable approach that can serve to improve the targeted outcomes of safety and health promotion in other states.

Using Action-Mapping to Design a Non-Majors Neuroeconomics Course to Teach First-Year Collegiate Skills

PubMed Central

Franssen, Catherine L.; Lowry, George S.; Franssen, R. Adam

2017-01-01

With its ability to address questions about how decisions are made and why, neuroeconomics is an excellent topic of study for college students at a variety of levels. In this paper we detail a neuroeconomics course specifically modified for undecided First-year students. One particularly daunting challenge was defining clear outcomes and delivering instruction at an appropriate level. We used Action-Mapping to achieve the course objectives of teaching collegiate skills applicable to any path of study or career while also delivering content suitable for credits in both a social science and natural science. PMID:29371842

Click "like" to change your behavior: a mixed methods study of college students' exposure to and engagement with Facebook content designed for weight loss.

PubMed

Merchant, Gina; Weibel, Nadir; Patrick, Kevin; Fowler, James H; Norman, Greg J; Gupta, Anjali; Servetas, Christina; Calfas, Karen; Raste, Ketaki; Pina, Laura; Donohue, Mike; Griswold, William G; Marshall, Simon

2014-06-24

Overweight or obesity is prevalent among college students and many gain weight during this time. Traditional face-to-face weight loss interventions have not worked well in this population. Facebook is an attractive tool for delivering weight loss interventions for college students because of its popularity, potential to deliver strategies found in successful weight loss interventions, and ability to support ongoing adaptation of intervention content. The objective of this study was to describe participant exposure to a Facebook page designed to deliver content to overweight/obese college students in a weight loss randomized controlled trial (N=404) and examine participant engagement with behavior change campaigns for weight loss delivered via Facebook. The basis of the intervention campaign model were 5 self-regulatory techniques: intention formation, action planning, feedback, goal review, and self-monitoring. Participants were encouraged to engage their existing social network to meet their weight loss goals. A health coach moderated the page and modified content based on usage patterns and user feedback. Quantitative analyses were conducted at the Facebook post- and participant-level of analysis. Participant engagement was quantified by Facebook post type (eg, status update) and interaction (eg, like) and stratified by weight loss campaign (sequenced vs nonsequenced). A subset of participants were interviewed to evaluate the presence of passive online engagement or "lurking." The health coach posted 1816 unique messages to the study's Facebook page over 21 months, averaging 3.45 posts per day (SD 1.96, range 1-13). In all, 72.96% (1325/1816) of the posts were interacted with at least once (eg, liked). Of these, approximately 24.75% (328/1325) had 1-2 interactions, 23.39% (310/1325) had 3-5 interactions, 25.13% (333/1325) had 6-8 interactions, and 41 posts had 20 or more interactions (3.09%, 41/1325). There was significant variability among quantifiable (ie, visible) engagement. Of 199 participants in the final intervention sample, 32 (16.1%) were highly active users and 62 (31.2%) never visibly engaged with the intervention on Facebook. Polls were the most popular type of post followed by photos, with 97.5% (79/81) and 80.3% (386/481) interacted with at least once. Participants visibly engaged less with posts over time (partial r=-.33; P<.001). Approximately 40% of the participants interviewed (12/29, 41%) reported passively engaging with the Facebook posts by reading but not visibly interacting with them. Facebook can be used to remotely deliver weight loss intervention content to college students with the help of a health coach who can iteratively tailor content and interact with participants. However, visible engagement with the study's Facebook page was highly variable and declined over time. Whether the level of observed engagement is meaningful in terms of influencing changes in weight behaviors and outcomes will be evaluated at the completion of the overall study.

MEDICARE PAYMENTS AND SYSTEM-LEVEL HEALTH-CARE USE

PubMed Central

ROBBINS, JACOB A.

2015-01-01

The rapid growth of Medicare managed care over the past decade has the potential to increase the efficiency of health-care delivery. Improvements in care management for some may improve efficiency system-wide, with implications for optimal payment policy in public insurance programs. These system-level effects may depend on local health-care market structure and vary based on patient characteristics. We use exogenous variation in the Medicare payment schedule to isolate the effects of market-level managed care enrollment on the quantity and quality of care delivered. We find that in areas with greater enrollment of Medicare beneficiaries in managed care, the non–managed care beneficiaries have fewer days in the hospital but more outpatient visits, consistent with a substitution of less expensive outpatient care for more expensive inpatient care, particularly at high levels of managed care. We find no evidence that care is of lower quality. Optimal payment policies for Medicare managed care enrollees that account for system-level spillovers may thus be higher than those that do not. PMID:27042687

Effects of High Sound Exposure During Air-Conducted Vestibular Evoked Myogenic Potential Testing in Children and Young Adults.

PubMed

Rodriguez, Amanda I; Thomas, Megan L A; Fitzpatrick, Denis; Janky, Kristen L

Vestibular evoked myogenic potential (VEMP) testing is increasingly utilized in pediatric vestibular evaluations due to its diagnostic capability to identify otolith dysfunction and feasibility of testing. However, there is evidence demonstrating that the high-intensity stimulation level required to elicit a reliable VEMP response causes acoustic trauma in adults. Despite utility of VEMP testing in children, similar findings are unknown. It is hypothesized that increased sound exposure may exist in children because differences in ear-canal volume (ECV) compared with adults, and the effect of stimulus parameters (e.g., signal duration and intensity) will alter exposure levels delivered to a child's ear. The objectives of this study are to (1) measure peak to peak equivalent sound pressure levels (peSPL) in children with normal hearing (CNH) and young adults with normal hearing (ANH) using high-intensity VEMP stimuli, (2) determine the effect of ECV on peSPL and calculate a safe exposure level for VEMP, and (3) assess whether cochlear changes exist after VEMP exposure. This was a 2-phase approach. Fifteen CNH and 12 ANH participated in phase I. Equivalent ECV was measured. In 1 ear, peSPL was recorded for 5 seconds at 105 to 125 dB SPL, in 5-dB increments for 500- and 750-Hz tone bursts. Recorded peSPL values (accounting for stimulus duration) were then used to calculate safe sound energy exposure values for VEMP testing using the 132-dB recommended energy allowance from the 2003 European Union Guidelines. Fifteen CNH and 10 ANH received cervical and ocular VEMP testing in 1 ear in phase II. Subjects completed tympanometry, pre- and postaudiometric threshold testing, distortion product otoacoustic emissions, and questionnaire addressing subjective otologic symptoms to study the effect of VEMP exposure on cochlear function. (1) In response to high-intensity stimulation levels (e.g., 125 dB SPL), CNH had significantly higher peSPL measurements and smaller ECVs compared with ANH. (2) A significant linear relationship between equivalent ECV (as measured by diagnostic tympanometry) and peSPL exists and has an effect on total sound energy exposure level; based on data from phase I, 120 dB SPL was determined to be an acoustically safe stimulation level for testing in children. (3) Using calculated safe stimulation level for VEMP testing, there were no significant effect of VEMP exposure on cochlear function (as measured by audiometric thresholds, distortion product otoacoustic emission amplitude levels, or subjective symptoms) in CNH and ANH. peSPL sound recordings in children's ears are significantly higher (~3 dB) than that in adults in response to high-intensity VEMP stimuli that are commonly practiced. Equivalent ECV contributes to peSPL delivered to the ear during VEMP testing and should be considered to determine safe acoustic VEMP stimulus parameters; children with smaller ECVs are at risk for unsafe sound exposure during routine VEMP testing, and stimuli should not exceed 120 dB SPL. Using 120 dB SPL stimulus level for children during VEMP testing yields no change to cochlear function and reliable VEMP responses.

A 2D ion chamber array audit of wedged and asymmetric fields in an inhomogeneous lung phantom.

PubMed

Lye, Jessica; Kenny, John; Lehmann, Joerg; Dunn, Leon; Kron, Tomas; Alves, Andrew; Cole, Andrew; Williams, Ivan

2014-10-01

The Australian Clinical Dosimetry Service (ACDS) has implemented a new method of a nonreference condition Level II type dosimetric audit of radiotherapy services to increase measurement accuracy and patient safety within Australia. The aim of this work is to describe the methodology, tolerances, and outcomes from the new audit. The ACDS Level II audit measures the dose delivered in 2D planes using an ionization chamber based array positioned at multiple depths. Measurements are made in rectilinear homogeneous and inhomogeneous phantoms composed of slabs of solid water and lung. Computer generated computed tomography data sets of the rectilinear phantoms are supplied to the facility prior to audit for planning of a range of cases including reference fields, asymmetric fields, and wedged fields. The audit assesses 3D planning with 6 MV photons with a static (zero degree) gantry. Scoring is performed using local dose differences between the planned and measured dose within 80% of the field width. The overall audit result is determined by the maximum dose difference over all scoring points, cases, and planes. Pass (Optimal Level) is defined as maximum dose difference ≤3.3%, Pass (Action Level) is ≤5.0%, and Fail (Out of Tolerance) is >5.0%. At close of 2013, the ACDS had performed 24 Level II audits. 63% of the audits passed, 33% failed, and the remaining audit was not assessable. Of the 15 audits that passed, 3 were at Pass (Action Level). The high fail rate is largely due to a systemic issue with modeling asymmetric 60° wedges which caused a delivered overdose of 5%-8%. The ACDS has implemented a nonreference condition Level II type audit, based on ion chamber 2D array measurements in an inhomogeneous slab phantom. The powerful diagnostic ability of this audit has allowed the ACDS to rigorously test the treatment planning systems implemented in Australian radiotherapy facilities. Recommendations from audits have led to facilities modifying clinical practice and changing planning protocols.

Student nurses perceptions of spirituality and competence in delivering spiritual care: a European pilot study.

PubMed

Ross, Linda; van Leeuwen, René; Baldacchino, Donia; Giske, Tove; McSherry, Wilfred; Narayanasamy, Aru; Downes, Carmel; Jarvis, Paul; Schep-Akkerman, Annemiek

2014-05-01

Spiritual care is expected of nurses, but it is not clear how undergraduates can achieve competency in spiritual care at point of registration as required by nursing/midwifery regulatory bodies. To describe undergraduate nurses'/midwives' perceptions of spirituality/spiritual care, their perceived competence in delivering spiritual care, and to test out the proposed method and suitability of measures for a larger multinational follow-on study. Cross-sectional, multinational, descriptive survey design. Author administered questionnaires were completed by 86% of the intended convenience sample of 618 undergraduate nurses/midwives from 6 universities in 4 European countries in 2010. Students held a broad view of spirituality/spiritual care and considered themselves to be marginally more competent than not in spiritual care. They were predominantly Christian and reported high levels of spiritual wellbeing and spiritual attitude and involvement. The proposed method and measures were appropriate and are being used in a follow-on study. The following are worthy of further investigation: whether the pilot study findings hold in student samples from more diverse cultural backgrounds; whether students' perceptions of spirituality can be broadened to include the full range of spiritual needs patients may encounter and whether their competence can be enhanced by education to better equip them to deliver spiritual care; identification of factors contributing to acquisition of spiritual caring skills and spiritual care competency. © 2013.

Predictors in Internet-delivered cognitive behavior therapy and behavioral stress management for severe health anxiety.

PubMed

Hedman, Erik; Andersson, Erik; Lekander, Mats; Ljótsson, Brjánn

2015-01-01

Severe health anxiety can be effectively treated with exposure-based Internet-delivered cognitive behavior therapy (ICBT), but information about which factors that predict outcome is scarce. Using data from a recently conducted RCT comparing ICBT (n = 79) with Internet-delivered behavioral stress management (IBSM) (n = 79) the presented study investigated predictors of treatment outcome. Analyses were conducted using a two-step linear regression approach and the dependent variable was operationalized both as end state health anxiety at post-treatment and as baseline-to post-treatment improvement. A hypothesis driven approach was used where predictors expected to influence outcome were based on a previous predictor study by our research group. As hypothesized, the results showed that baseline health anxiety and treatment adherence predicted both end state health anxiety and improvement. In addition, anxiety sensitivity, treatment credibility, and working alliance were significant predictors of health anxiety improvement. Demographic variables, i.e. age, gender, marital status, computer skills, educational level, and having children, had no significant predictive value. We conclude that it is possible to predict a substantial proportion of the outcome variance in ICBT and IBSM for severe health anxiety. The findings of the present study can be of high clinical value as they provide information about factors of importance for outcome in the treatment of severe health anxiety. Copyright © 2014 Elsevier Ltd. All rights reserved.

Interactive browsing of 3D environment over the Internet

NASA Astrophysics Data System (ADS)

Zhang, Cha; Li, Jin

2000-12-01

In this paper, we describe a system for wandering in a realistic environment over the Internet. The environment is captured by the concentric mosaic, compressed via the reference block coder (RBC), and accessed and delivered over the Internet through the virtual media (Vmedia) access protocol. Capturing the environment through the concentric mosaic is easy. We mount a camera at the end of a level beam, and shoot images as the beam rotates. The huge dataset of the concentric mosaic is then compressed through the RBC, which is specifically designed for both high compression efficiency and just-in-time (JIT) rendering. Through the JIT rendering function, only a portion of the RBC bitstream is accessed, decoded and rendered for each virtual view. A multimedia communication protocol -- the Vmedia protocol, is then proposed to deliver the compressed concentric mosaic data over the Internet. Only the bitstream segments corresponding to the current view are streamed over the Internet. Moreover, the delivered bitstream segments are managed by a local Vmedia cache so that frequently used bitstream segments need not be streamed over the Internet repeatedly, and the Vmedia is able to handle a RBC bitstream larger than its memory capacity. A Vmedia concentric mosaic interactive browser is developed where the user can freely wander in a realistic environment, e.g., rotate around, walk forward/backward and sidestep, even under a tight bandwidth of 33.6 kbps.

Evaluation of the fidelity of an interactive face-to-face educational intervention to improve general practitioner management of back pain

PubMed Central

French, Simon D; Green, Sally E; Francis, Jill J; Buchbinder, Rachelle; O'Connor, Denise A; Grimshaw, Jeremy M; Michie, Susan

2015-01-01

Objectives Implementation intervention effects can only be fully realised and understood if they are faithfully delivered. However the evaluation of implementation intervention fidelity is not commonly undertaken. The IMPLEMENT intervention was designed to improve the management of low back pain by general medical practitioners. It consisted of a two-session interactive workshop, including didactic presentations and small group discussions by trained facilitators. This study aimed to evaluate the fidelity of the IMPLEMENT intervention by assessing: (1) observed facilitator adherence to planned behaviour change techniques (BCTs); (2) comparison of observed and self-reported adherence to planned BCTs and (3) variation across different facilitators and different BCTs. Design The study compared planned and actual, and observed versus self-assessed delivery of BCTs during the IMPLEMENT workshops. Method Workshop sessions were audiorecorded and transcribed verbatim. Observed adherence of facilitators to the planned intervention was assessed by analysing the workshop transcripts in terms of BCTs delivered. Self-reported adherence was measured using a checklist completed at the end of each workshop session and was compared with the ‘gold standard’ of observed adherence using sensitivity and specificity analyses. Results The overall observed adherence to planned BCTs was 79%, representing moderate-to-high intervention fidelity. There was no significant difference in adherence to BCTs between the facilitators. Sensitivity of self-reported adherence was 95% (95% CI 88 to 98) and specificity was 30% (95% CI 11 to 60). Conclusions The findings suggest that the IMPLEMENT intervention was delivered with high levels of adherence to the planned intervention protocol. Trial registration number The IMPLEMENT trial was registered in the Australian New Zealand Clinical Trials Registry, ACTRN012606000098538 (http://www.anzctr.org.au/trial_view.aspx?ID=1162). PMID:26155819

Lean health care: what can hospitals learn from a world-class automaker?

PubMed

Kim, Christopher S; Spahlinger, David A; Kin, Jeanne M; Billi, John E

2006-05-01

With health care costs continuing to rise, a variety of process improvement methodologies have been proposed to address the reported inefficiencies in health care delivery. Lean production is one such method. The management philosophy and tools of lean production come from the manufacturing industry, where they were pioneered by Toyota Motor Corporation, which is viewed as the leader in utilizing these performance improvement methods. Lean has already enjoyed tremendous success in improving quality and efficiency in both the manufacturing and the service sector industries. Health care systems have just begun to utilize lean methods, with reports of improvements just beginning to appear in the literature. We describe some of the basic philosophy and principles of lean production methods and how these concepts can be applied in the health care environment. We describe some of the early success stories and ongoing endeavors of lean production in various health care organizations. We believe the hospital is an ideal setting for use of the lean production method, which could significantly affect how health care is delivered to patients. We conclude by discussing some of the potential challenges in introducing and implementing lean production methods in the health care environment. Lean production is a novel approach to delivering high-quality and efficient care to patients, and we believe that the health care sector can anticipate the same high level of success that the manufacturing and service industries have achieved using this approach. Hospitalists are primed to take action in delivering care of greater quality with more efficiency by applying these new principles in the hospital setting. (c) 2006 Society of Hospital Medicine.

Comparison of three humidifiers during high-frequency percussive ventilation using the VDR-4® Fail-safe Breathing Circuit Hub.

PubMed

Tiffin, Norman H; Short, Kathy A; Jones, Samuel W; Cairns, Bruce A

2011-01-01

The VDR-4® high-frequency percussive ventilator (HFPV) has been shown to be beneficial in the management of inhalation injury by improving secretion clearance while maintaining oxygenation and ventilation. Delivery of gas flow during HFPV could lack adequate humidification delivered to the patient because a major portion of the delivered gas flow would bypass the humidifier when using the original VDR-4® ventilator circuit. The authors tested a novel inline vaporizing humidifier and two gas-water interface humidifiers during HFPV using the new VDR-4® Fail-safe Breathing Circuit Hub® to determine whether delivered humidification could be improved. This new humidification system, the Hydrate Omni™, delivers water vapor into the gas flow of the ventilator circuit rather than water droplets as delivered by the gas-water interface humidifiers. Measurements of absolute humidity and gas temperature were made on the three different humidification systems using a test lung model under standard ambient conditions. The authors found that when using the novel inline vaporizer, it provided better humidification when compared with the standard gas-water interface humidifier during HFPV using the new VDR-4® breathing circuit.

Translating an Effective Group-Based HIV Prevention Program to a Program Delivered Primarily by a Computer: Methods and Outcomes

ERIC Educational Resources Information Center

Card, Josefina J.; Kuhn, Tamara; Solomon, Julie; Benner, Tabitha A.; Wingood, Gina M.; DiClemente, Ralph J.

2011-01-01

We describe development of SAHARA (SiSTAS Accessing HIV/AIDS Resources At-a-click), an innovative HIV prevention program that uses a computer to deliver an updated version of SiSTA, a widely used, effective group-level HIV prevention intervention for African American women ages 18-29. Fidelity to SiSTA's core components was achieved using: (1)…

Use of air-assisted electrostatic spraying system (ESS)or the sprayed lethality in container(SLIC) method to deliver anticmicrobials onto the surface of beef subprimals to ... shiga toxin-producing cells of Escherichia coli

USDA-ARS?s Scientific Manuscript database

We evaluated the efficacy of an air-assisted electrostatic spraying system (ESS) and/or the Sprayed Lethality in Container (SLIC) method to deliver antimicrobials onto the surface of beef subprimals to reduce levels of Shiga toxin-producing Escherichia coli (STEC). Beef subprimals were surface inocu...

The CORALIE study: improving patient education to help new users better understand their oral contraceptive.

PubMed

de Reilhac, Pia; Plu-Bureau, Geneviève; Serfaty, David; Letombe, Brigitte; Gondry, Jean; Christin-Maitre, Sophie

2016-10-01

Combined oral contraceptives (COCs) are the most widely used contraceptive method in Europe. Paradoxically, rates of unintended pregnancy and abortion are still remarkably high. A lack of knowledge about COCs is often reported to lead to poor adherence, suggesting an unmet need for adequate contraceptive counselling. Our objective was to investigate the impact on the knowledge level of users of a structured approach to deliver contraceptive information for a first COC prescription. The Oral Contraception Project to Optimise Patient Information (CORALIE) is a multicentre, prospective, randomised study conducted in France between March 2009 and January 2013. The intervention involved providing either an 'essential information' checklist or unstructured counselling to new COC users. The outcome measure was a questionnaire that assessed whether the information provided to the new user by the gynaecologist had been correctly understood. One hundred gynaecologists and an expert committee used the Delphi method to develop an 'essential information' checklist, after which 161 gynaecologists were randomised to two groups. Group I (n = 81) used the checklist with 324 new COC users and group II (n = 80) delivered unstructured information to 307 new COC users. The average score for understanding the information delivered during the visit was significantly higher in women in group I than in the women in group II, even after adjustment for age and previous history of pregnancy: 16.48/20 vs 14.27/20 (p < 0.0001). Delivering structured information for a first COC prescription is beneficial for understanding contraception. Our tool could ultimately contribute to increased adherence and should be investigated in a prospective study of long-term outcomes.

Prospective use of unmanned aerial vehicles for military medical evacuation in future conflicts.

PubMed

Handford, Charles; Reeves, F; Parker, P

2018-03-09

In order to continue to deliver outstanding medical care on the battlefield, the UK Defence Medical Services must continue to adapt, overcome and actively embrace change. One potential area is the rapid proliferation and sophistication of automated and remote systems such as unmanned aerial vehicles (UAVs). UAVs are already used to deliver blood to remote military locations in Afghanistan and defibrillators to those that need them in the USA and Sweden. An area of future opportunity would be to facilitate rapid evacuation of wounded personnel from high intensity, high threat, remote and austere areas directly to specialist care. Such a capability would reduce threat to human life while allowing rapid extraction of casualties from high risk or inaccessible environments straight back to Role 3 care, all of which in these situations is either not possible or carries too much risk using conventional aerial assets. The article aims to highlight a potential future capability, stimulate debate and reflection, all of which is essential for innovation and future organisational development. The potential uses and benefits of UAVs are highlighted including both the challenges and rewards of utilising UAVs for casualty evacuation. Key benefits are reduced risk to human life, cost, ability to insert into areas conventional aircraft cannot and the rapidity of transfer. Challenges are likely to be airspace management, decisions on appropriate level of care to deliver during transit and ultimately user acceptability. The article also highlights that in order to maximise our ability to exploit new technologies, all arms and trades within the military must be involved in collective research and development. Furthermore, sensible corroboration with private companies will further enhance our ability to acquire products that best serve our needs. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Recognition and home care of low birth weight neonates: a qualitative study of knowledge, beliefs and practices of mothers in Iganga-Mayuge Health and Demographic Surveillance Site, Uganda

PubMed Central

2014-01-01

Background Neonatal mortality has remained persistently high worldwide. In Uganda, neonatal deaths account for 50% of all infant deaths. Low birth weight is associated with a higher risk of death during the neonatal period. Failure to recognize low birth weight and inappropriate home care practices increase the risk of morbidity and mortality in this high risk group. This study explored mothers’ knowledge, beliefs and practices in recognising and providing home care for low birth weight babies. Methods The study was carried out in Eastern Uganda. In-depth interviews were conducted with sixteen mothers of small babies who delivered in health facilities (10) or at home (6) two months prior to the study. Interviews were conducted in mothers’ homes using the local language. Interviewer notes and audio recordings were transcribed and translated to English. Content analysis was done using Atlas-ti software. Results Recognition of low birth weight by mothers when a baby is not weighed was difficult. Mothers were aware of the causes of low birth weight though some mothers believed in the influence of supernatural powers. Mothers who delivered in hospital had better knowledge of appropriate home care practices for low birth weight babies compared to mothers who delivered at home or in a lower level health facility. Practices related to cord care and keeping the baby warm were good while poor practices were noted concerning initiation and exclusive breast feeding, and bathing the baby. Low birth weight was not appreciated as a danger sign in newborns and therefore mothers did not seek health care. Some mothers who initiated good care practices for low birth weight newborns in the facilities did not sustain them at home. Conclusions Recognition of low birth weight is still poor. This leads to inappropriate home care practices for these high risk newborns. Mothers’ knowledge and care practices can be improved through health education, and this should be extended to the community to reach mothers that deliver at home. Mechanisms to support mothers to sustain good practices should be put in place by taking advantage of existing village health teams and social support. PMID:24888464

Effectiveness of Psychosocial Interventions in Complex Palliative Care Patients: A Quasi-Experimental, Prospective Multicenter Study.

PubMed

Mateo-Ortega, Dolors; Gómez-Batiste, Xavier; Maté, Jorge; Beas, Elba; Ela, Sara; Lasmarias, Cristina; Limonero, Joaquín T

2018-03-13

To determine whether specific psychosocial interventions can ease discomfort in palliative care (PC) patients, particularly in those with high levels of pain or emotional distress. Changes in the psychological parameters of 8333 patients were assessed in a quasi-experimental, prospective, multicenter, single group pretest/post-test study. Psychosocial care was delivered by 29 psychosocial care teams (PSTs; 137 professionals). Pre- and post-intervention changes in these variables were assessed: mood, anxiety, and emotional distress. Patients were classified as complex, when presented with high levels of anxiety, mood, suffering (or perception of time as slow), and distress (or unease, or discomfort), or noncomplex. These groups were compared to assess changes in suffering-related parameters from baseline. Psychosocial interventions reduced patients' suffering. These interventions were more effective in complex patients. After successive psychosocial interventions, the level of suffering in complex patients decreased until close to parity with noncomplex patients, suggesting that patients with major complexity could benefit most from specific psychosocial treatment. These findings support the importance of assessing and treating patients' psychosocial needs.

Interteaching: An Evidence-Based Approach to Instruction

ERIC Educational Resources Information Center

Brown, Thomas Wade; Killingsworth, Kenneth; Alavosius, Mark P.

2014-01-01

This paper describes "interteaching" as an evidence-based method of instruction. Instructors often rely on more traditional approaches, such as lectures, as means to deliver instruction. Despite high usage, these methods are ineffective at achieving desirable academic outcomes. We discuss an innovative approach to delivering instruction…

A 100J-level nanosecond pulsed DPSSL for pumping high-efficiency, high-repetition rate PW-class lasers

NASA Astrophysics Data System (ADS)

De Vido, M.; Ertel, K.; Mason, P. D.; Banerjee, S.; Phillips, P. J.; Smith, J. M.; Butcher, T. J.; Chekhlov, O.; Divoky, M.; Pilar, J.; Hooker, C.; Shaikh, W.; Lucianetti, A.; Hernandez-Gomez, C.; Mocek, T.; Edwards, C.; Collier, J. L.

2017-02-01

In this paper, we review the development, at the STFC's Central Laser Facility (CLF), of high energy, high repetition rate diode-pumped solid-state laser (DPSSL) systems based on cryogenically-cooled multi-slab ceramic Yb:YAG. Up to date, two systems have been completed, namely the DiPOLE prototype and the DiPOLE100 system. The DiPOLE prototype has demonstrated amplification of nanosecond pulses in excess of 10 J at 10 Hz repetition rate with an opticalto- optical efficiency of 22%. The larger scale DiPOLE100 system, designed to deliver 100J temporally-shaped nanosecond pulses at 10 Hz repetition rate, has been developed at the CLF for the HiLASE project in the Czech Republic. Recent experiments conducted on the DiPOLE100 system demonstrated the energy scalability of the DiPOLE concept to the 100 J pulse energy level. Furthermore, second harmonic generation experiments carried out on the DiPOLE prototype confirmed the suitability of DiPOLE-based systems for pumping high repetition rate PW-class laser systems based on Ti:sapphire or optical parametric chirped pulse amplification (OPCPA) technology.

Simulation of the High Performance Time to Digital Converter for the ATLAS Muon Spectrometer trigger upgrade

NASA Astrophysics Data System (ADS)

Meng, X. T.; Levin, D. S.; Chapman, J. W.; Zhou, B.

2016-09-01

The ATLAS Muon Spectrometer endcap thin-Resistive Plate Chamber trigger project compliments the New Small Wheel endcap Phase-1 upgrade for higher luminosity LHC operation. These new trigger chambers, located in a high rate region of ATLAS, will improve overall trigger acceptance and reduce the fake muon trigger incidence. These chambers must generate a low level muon trigger to be delivered to a remote high level processor within a stringent latency requirement of 43 bunch crossings (1075 ns). To help meet this requirement the High Performance Time to Digital Converter (HPTDC), a multi-channel ASIC designed by CERN Microelectronics group, has been proposed for the digitization of the fast front end detector signals. This paper investigates the HPTDC performance in the context of the overall muon trigger latency, employing detailed behavioral Verilog simulations in which the latency in triggerless mode is measured for a range of configurations and under realistic hit rate conditions. The simulation results show that various HPTDC operational configurations, including leading edge and pair measurement modes can provide high efficiency (>98%) to capture and digitize hits within a time interval satisfying the Phase-1 latency tolerance.

A Comprehensive Approach of E-learning Design for Effective Learning Transfer

ERIC Educational Resources Information Center

Lim, Doo Hun

2012-01-01

Literature indicates that there is limited research on the national and organizational level decision processes to develop and deliver e-learning programs. In this paper, existing e-learning literature is analyzed in terms of national level factors (national culture, readiness for new technology, and infrastructure), organizational level factors…

Determinants of Prelacteal Feeding in Rural Northern India

PubMed Central

Roy, Manas Pratim; Mohan, Uday; Singh, Shivendra Kumar; Singh, Vijay Kumar; Srivastava, Anand Kumar

2014-01-01

Background: Prelacteal feeding is an underestimated problem in a developing country like India, where infant mortality rate is quite high. The present study tried to find out the factors determining prelacteal feeding in rural areas of north India. Methods: A crosssectional study was conducted among recently delivered women of rural Uttar Pradesh, India. Multistage random sampling was used for selecting villages. From them, 352 recently delivered women were selected as the subjects, following systematic random sampling. Chi-square test and logistic regression were used to find out the predictors for prelacteal feeding. Results: Overall, 40.1% of mothers gave prelacteal feeding to their newborn. Factors significantly associated with such practice, after simple logistic regression, were age, caste, socioeconomic status, and place of delivery. At multivariate level, age (odds ratio (OR) = 1.76, 95% confidence interval (CI) = 1.13-2.74), caste and place of delivery (OR = 2.23, 95% CI = 1.21-4.10) were found to determine prelacteal feeding significantly, indicating that young age, high caste, and home deliveries could affect the practice positively. Conclusions: The problem of prelacteal feeding is still prevalent in rural India. Age, caste, and place of delivery were associated with the problem. For ensuring neonatal health, the problem should be addressed with due gravity, with emphasis on exclusive breast feeding. PMID:24932400

Health Advocacy Project: Evaluating the Benefits of Service Learning to Nursing Students and Low Income Individuals Involved in a Community-Based Mental Health Promotion Project.

PubMed

Samuels-Dennis, Joan; Xia, Liudi; Secord, Sandra; Raiger, Amelia

2016-10-08

Poverty, along with other factors such as unemployment, work and life stressors, interpersonal violence, and lack of access to high quality health and/or social services all play a role in determining who develops a mental illness and for whom those symptoms persist or worsen. Senior nursing student preparing to enter the field and working in a service learning capacity may be able to influence early recovery and symptom abatement among those most vulnerable to mental illness. A consortium of community stakeholders and researchers collaboratively designed a 10-week mental health promotion project called the Health Advocacy Project (HAP). The project combines case management and system navigation support delivered by trained and highly supervised nursing students to individuals experiencing major depressive disorder (MDD) and/or post-traumatic stress disorder (PTSD). In this article, we present the findings of a qualitative fidelity evaluation that examines the effectiveness of nursing students in delivering the health advocacy intervention at the level and with the intensity originally intended. The findings demonstrate how the services of senior nursing students may be optimized to benefit our healthcare system and populations most at risk for developing MDD and PTSD.

Four birds with one stone? Reparative, neuroplastic, cardiorespiratory, and metabolic benefits of aerobic exercise poststroke.

PubMed

Ploughman, Michelle; Kelly, Liam P

2016-12-01

Converging evidence from animal models of stroke and clinical trials suggests that aerobic exercise has effects across multiple targets. The subacute phase is characterized by a period of heightened neuroplasticity when aerobic exercise has the potential to optimize recovery. In animals, low intensity aerobic exercise shrinks lesion size and reduces cell death and inflammation, beginning 24 h poststroke. Also in animals, aerobic exercise upregulates brain-derived neurotrophic factor near the lesion and improves learning. In terms of neuroplastic effects, clinical trial results are less convincing and have only examined effects in chronic stroke. Stroke patients demonstrate cardiorespiratory fitness levels below the threshold required to carry out daily activities. This may contribute to a 'neurorehabilitation ceiling' that limits capacity to practice at a high enough frequency and intensity to promote recovery. Aerobic exercise when delivered 2-5 days per week at moderate to high intensity beginning as early as 5 days poststroke improves cardiorespiratory fitness, dyslipidemia, and glucose tolerance. Based on the evidence discussed and applying principles of periodization commonly used to prepare athletes for competition, we have created a model of aerobic training in subacute stroke in which training is delivered in density blocks (duration × intensity) matched to recovery phases.

All for one and one for all: The value of grassroots collaboration in clinical research.

PubMed

Al Wattar, Bassel H; Tamblyn, Jennifer

2017-08-01

Collaboration in health research is common in current practice. Engaging grassroots clinicians in the evidence synthesis and research process can deliver impactful results and reduce research wastage. The UKARCOG is a group of specialty trainees in obstetrics and gynaecology in the UK aiming to promote women's health research by delivering high-quality impactful research and national audit projects. The collaborative enables trainees to develop essential academic skills and roll out multicentre research projects at high cost-effectiveness. Collective research work can face a number of challenges such as establishing a joint authorship style, gaining institutional support and acquiring funds to boost networking and deliver large scales studies. Copyright © 2017 Elsevier B.V. All rights reserved.

Report of the Air-to-Air Missile System Capability Review. July-November 1968. Volume 2. Appendices

DTIC Science & Technology

1969-01-01

Industry .. .. ..... ....................... ....................... 17N1 2.- Fleet Support organizations. .. .......................... 18 ~ .- ~- 3...I REPORT OF TASK TEAM ONE Chairman: Mr. B. W. Hays, Naval Weapons Center, China Lake ,,.’,. "Is Industry delivering to the Navy a high quality...IN’TRODUCTION A. The mission of Task Team One was to determine, "Is industry delivering to the Navy a high quality product, designed and built to

Accuracy of Oxygen Flow Delivered by Compressed-Gas Cylinders in Hospital and Prehospital Emergency Care.

PubMed

Duprez, Frédéric; Michotte, Jean Bernard; Cuvelier, Gregory; Legrand, Alexandre; Mashayekhi, Sharam; Reychler, Gregory

2018-03-01

Oxygen cylinders are widely used both in hospital and prehospital care. Excessive or inappropriate F IO 2 may be critical for patients with hypercapnia or hypoxia. Moreover, over-oxygenation could be deleterious in ischemic disorders. Supplemental oxygen from oxygen cylinder should therefore be delivered accurately. The aim of this study was to assess the accuracy of oxygen flows for oxygen cylinder in hospital and prehospital care. A prospective trial was conducted to evaluate accuracy of delivered oxygen flows (2, 4, 6, 9 and 12 L/min) for different oxygen cylinder ready for use in different hospital departments. Delivered flows were analyzed randomly using a calibrated thermal mass flow meter. Two types of oxygen cylinder were evaluated: 78 oxygen cylinder with a single-stage regulator and 70 oxygen cylinder with a dual-stage regulator. Delivered flows were compared to the required oxygen flow. The residual pressure value for each oxygen cylinder was considered. A coefficient of variation was calculated to compare the variability of the delivered flow between the two types of oxygen cylinder. The median values of delivered flows were all ≥ 100% of the required flow for single stage (range 100-109%) and < 100% of required flow for dual stage (range 95-97%). The median values of the delivered flow differed between single and dual stage. It was found that single stage is significantly higher than dual stage ( P = .01). At low flow, the dispersion of the measures for single stage was higher than with a high oxygen flow. Delivered flow differences were also found between low and high residual pressures, but only with single stage ( P = .02). The residual pressure for both oxygen cylinders (no. = 148) ranged from 73 to 2,900 pounds per square inch, and no significant difference was observed between the 2 types ( P = .86). The calculated coefficient of variation ranged from 7% (±1%) for dual stage to 8% (±2%) for single stage. This study shows good accuracy of oxygen flow delivered via oxygen cylinders. This accuracy was higher with dual stage. Single stage was also accurate, however, at low flow this accuracy is slightly less. Moreover, with single stage, when residual pressure decreases, the median value of delivered flow decreased. Copyright © 2018 by Daedalus Enterprises.

Competing stimuli in the treatment of multiply controlled problem behavior during hygiene routines.

PubMed

Long, Ethan S; Hagopian, Louis P; Deleon, Iser G; Marhefka, Jean Marie; Resau, Dawn

2005-01-01

The current study describes the use of noncontingent competing stimuli in the treatment of problem behavior exhibited by three individuals during staff-assisted hygiene routines. Functional analyses revealed that particular topographies of problem behaviors appeared to be maintained by their own sensory consequences, whereas other topographies appeared to be maintained by escape from demands. Competing stimulus assessments were then conducted to identify items associated with low levels of automatically-maintained problem behavior and high levels of stimulus engagement. Stimuli associated with low levels of automatically-maintained problem behavior (competing stimuli) were then delivered noncontingently during staff-assisted hygiene routines that were problematic for each participant. In all three cases, substantial reductions in all problem behaviors were observed. These results are discussed in terms of the relative ease of this intervention and possible mechanisms underlying the effects of competing stimuli on behaviors maintained by different types of reinforcement.

In Vivo Delivery of Cytoplasmic RNA Virus-derived miRNAs

PubMed Central

Langlois, Ryan A; Shapiro, Jillian S; Pham, Alissa M; tenOever, Benjamin R

2012-01-01

The discovery of microRNAs (miRNAs) revealed an unappreciated level of post-transcriptional control used by the cell to maintain optimal protein levels. This process has represented an attractive strategy for therapeutics that is currently limited by in vivo delivery constraints. Here, we describe the generation of a single-stranded, cytoplasmic virus of negative polarity capable of producing functional miRNAs. Cytoplasmic RNA virus-derived miRNAs accumulated to high levels in vitro, generated significant amounts of miRNA star strand, associated with the RNA-induced silencing complex (RISC), and conferred post transcriptional gene silencing in a sequence-specific manner. Furthermore, we demonstrate that these vectors could deliver miRNAs to a wide range of tissues, and sustain prolonged expression capable of achieving measurable knockdown of physiological targets in vivo. Taken together, these results validate noncanonical processing of cytoplasmic-derived miRNAs and provide a novel platform for small RNA delivery. PMID:22086233

Birth experience in women with low, intermediate or high levels of fear. Findings from the First Baby Study

PubMed Central

Elvander, Charlotte; Cnattingius, Sven; Kjerulff, Kristen H.

2013-01-01

Background Fear of childbirth and mode of delivery are two known factors that affect birth experience. The interactions between these two factors are unknown. The aim of this study was to estimate the effects of different levels of fear of birth and mode of delivery on birth experience 1 month after birth. Methods As part of an ongoing prospective study, we interviewed 3006 women in their third trimester and 1 month after first childbirth to assess fear of birth and birth experience. Logistic regression was performed to examine the interactions and associations between fear of birth, mode of delivery and birth experience. Results Compared to women with low levels of fear of birth, women with intermediate levels of fear and women with high levels of fear had a more negative birth experience and were more affected by an unplanned cesarean section or instrumental vaginal delivery. Compared to women with low levels of fears with a non-instrumental vaginal delivery, women with high levels of fear who were delivered by unplanned cesarean section had a 12-fold increased risk of reporting a negative birth experience (odds ratio 12.25; 95% confidence intervals 7.19-20.86). A non-instrumental vaginal delivery was associated with the most positive birth experience among the women in this study. Conclusions This study shows that both levels of prenatal fear of childbirth and mode of delivery are important for birth experience. Women with low fear of childbirth who had a non-instrumental vaginal delivery reported the most positive birth experience. PMID:24344710

Birth experience in women with low, intermediate or high levels of fear: findings from the first baby study.

PubMed

Elvander, Charlotte; Cnattingius, Sven; Kjerulff, Kristen H

2013-12-01

Fear of childbirth and mode of delivery are two known factors that affect birth experience. The interactions between these two factors are unknown. The aim of this study was to estimate the effects of different levels of fear of birth and mode of delivery on birth experience 1 month after birth. As part of an ongoing prospective study, we interviewed 3,006 women in their third trimester and 1 month after first childbirth to assess fear of birth and birth experience. Logistic regression was performed to examine the interactions and associations between fear of birth, mode of delivery and birth experience. Compared with women with low levels of fear of birth, women with intermediate levels of fear, and women with high levels of fear had a more negative birth experience and were more affected by an unplanned cesarean section or instrumental vaginal delivery. Compared with women with low levels of fears with a noninstrumental vaginal delivery, women with high levels of fear who were delivered by unplanned cesarean section had a 12-fold increased risk of reporting a negative birth experience (OR 12.25; 95% CI 7.19-20.86). A noninstrumental vaginal delivery was associated with the most positive birth experience among the women in this study. This study shows that both levels of prenatal fear of childbirth and mode of delivery are important for birth experience. Women with low fear of childbirth who had a noninstrumental vaginal delivery reported the most positive birth experience. © 2013, Copyright the Authors Journal compilation © 2013, Wiley Periodicals, Inc.

Radiation dosimetry with fiber Bragg gratings

NASA Astrophysics Data System (ADS)

Avino, S.; D'Avino, V.; Giorgini, A.; Pacelli, R.; Liuzzi, R.; Cella, L.; Gagliardi, G.; De Natale, P.

2014-05-01

The measurement and monitoring of radiation dose delivered in patient tissues is a critical aspect in radiation therapy. Various dosimeters have proven effective in measuring radiations at low doses. However, there is a growing demand for new dosimeters based on small, non-invasive and high resolution devices. Here we report on a miniature dosimeter based on an optical fiber cavity. We demonstrate an ultimate detection limit of 160 mGy with an effective interaction region of 6 x 10-4 mm3. Due to its reliability, compactness and biomedical dose level sensitivity, our system shows itself suitable for applications in radiation therapy dosimetry.

Seamless service: research and action.

PubMed

Grinstead, N; Timoney, R

1994-01-01

Describes the process used by the Mater Infirmorum Hospital in Belfast in 1992-1994 to achieve high quality care (Seamless Service), and motivate staff to deliver and measure performance. Aims of the project include focusing the organization on the customer, improving teamwork and motivation at all levels. After comprehensive data collection from GPs, patients and staff forums developed a full TQM strategy to gain support and maintain momentum including innovative staff events (every staff member was given the opportunity to attend) where multilevel, multidisciplinary workshops enabled staff to design customer care standards, develop teams and lead customer-driven change.

Spectrally tunable, temporally shaped parametric front end to seed high-energy Nd:glass laser systems

DOE PAGES

Dorrer, C.; Consentino, A.; Cuffney, R.; ...

2017-10-18

Here, we describe a parametric-amplification–based front end for seeding high-energy Nd:glass laser systems. The front end delivers up to 200 mJ by parametric amplification in 2.5-ns flat-in-time pulses tunable over more than 15 nm. Spectral tunability over a range larger than what is typically achieved by laser media at similar energy levels is implemented to investigate cross-beam energy transfer in multibeam target experiments. The front-end operation is simulated to explain the amplified signal’s sensitivity to the input pump and signal. A large variety of amplified waveforms are generated by closed-loop pulse shaping. Various properties and limitations of this front endmore » are discussed.« less

Spectrally tunable, temporally shaped parametric front end to seed high-energy Nd:glass laser systems

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

Dorrer, C.; Consentino, A.; Cuffney, R.

Here, we describe a parametric-amplification–based front end for seeding high-energy Nd:glass laser systems. The front end delivers up to 200 mJ by parametric amplification in 2.5-ns flat-in-time pulses tunable over more than 15 nm. Spectral tunability over a range larger than what is typically achieved by laser media at similar energy levels is implemented to investigate cross-beam energy transfer in multibeam target experiments. The front-end operation is simulated to explain the amplified signal’s sensitivity to the input pump and signal. A large variety of amplified waveforms are generated by closed-loop pulse shaping. Various properties and limitations of this front endmore » are discussed.« less

Monitoring the levels of important nutrients in the food supply.

PubMed

Neal, B; Sacks, G; Swinburn, B; Vandevijvere, S; Dunford, E; Snowdon, W; Webster, J; Barquera, S; Friel, S; Hawkes, C; Kelly, B; Kumanyika, S; L'Abbé, M; Lee, A; Lobstein, T; Ma, J; Macmullan, J; Mohan, S; Monteiro, C; Rayner, M; Sanders, D; Walker, C

2013-10-01

A food supply that delivers energy-dense products with high levels of salt, saturated fats and trans fats, in large portion sizes, is a major cause of non-communicable diseases (NCDs). The highly processed foods produced by large food corporations are primary drivers of increases in consumption of these adverse nutrients. The objective of this paper is to present an approach to monitoring food composition that can both document the extent of the problem and underpin novel actions to address it. The monitoring approach seeks to systematically collect information on high-level contextual factors influencing food composition and assess the energy density, salt, saturated fat, trans fats and portion sizes of highly processed foods for sale in retail outlets (with a focus on supermarkets and quick-service restaurants). Regular surveys of food composition are proposed across geographies and over time using a pragmatic, standardized methodology. Surveys have already been undertaken in several high- and middle-income countries, and the trends have been valuable in informing policy approaches. The purpose of collecting data is not to exhaustively document the composition of all foods in the food supply in each country, but rather to provide information to support governments, industry and communities to develop and enact strategies to curb food-related NCDs. © 2013 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of the International Association for the Study of Obesity.

Humidification performance of humidifying devices for tracheostomized patients with spontaneous breathing: a bench study.

PubMed

Chikata, Yusuke; Oto, Jun; Onodera, Mutsuo; Nishimura, Masaji

2013-09-01

Heat and moisture exchangers (HMEs) are commonly used for humidifying respiratory gases administered to mechanically ventilated patients. While they are also applied to tracheostomized patients with spontaneous breathing, their performance in this role has not yet been clarified. We carried out a bench study to investigate the effects of spontaneous breathing parameters and oxygen flow on the humidification performance of 11 HMEs. We evaluated the humidification provided by 11 HMEs for tracheostomized patients, and also by a system delivering high-flow CPAP, and an oxygen mask with nebulizer heater. Spontaneous breathing was simulated with a mechanical ventilator, lung model, and servo-controlled heated humidifier at tidal volumes of 300, 500, and 700 mL, and breathing frequencies of 10 and 20 breaths/min. Expired gas was warmed to 37°C. The high-flow CPAP system was set to deliver 15, 30, and 45 L/min. With the 8 HMEs that were equipped with ports to deliver oxygen, and with the high-flow CPAP system, measurements were taken when delivering 0 and 3 L/min of dry oxygen. After stabilization we measured the absolute humidity (AH) of inspired gas with a hygrometer. AH differed among HMEs applied to tracheostomized patients with spontaneous breathing. For all the HMEs, as tidal volume increased, AH decreased. At 20 breaths/min, AH was higher than at 10 breaths/min. For all the HMEs, when oxygen was delivered, AH decreased to below 30 mg/L. With an oxygen mask and high-flow CPAP, at all settings, AH exceeded 30 mg/L. None of the HMEs provided adequate humidification when supplemental oxygen was added. In the ICU, caution is required when applying HME to tracheostomized patients with spontaneous breathing, especially when supplemental oxygen is required.

Developing Quality Indicators for Family Support Services in Community Team-Based Mental Health Care

PubMed Central

Olin, S. Serene; Kutash, Krista; Pollock, Michele; Burns, Barbara J.; Kuppinger, Anne; Craig, Nancy; Purdy, Frances; Armusewicz, Kelsey; Wisdom, Jennifer; Hoagwood, Kimberly E.

2013-01-01

Quality indicators for programs integrating parent-delivered family support services for children’s mental health have not been systematically developed. Increasing emphasis on accountability under the Affordable Care Act highlights the importance of quality-benchmarking efforts. Using a modified Delphi approach, quality indicators were developed for both program level and family support specialist level practices. These indicators were pilot tested with 21 community-based mental health programs. Psychometric properties of these indicators are reported; variations in program and family support specialist performance suggest the utility of these indicators as tools to guide policies and practices in organizations that integrate parent-delivered family support service components. PMID:23709287

An e-health system for the elderly (Butler Project): a pilot study on acceptance and satisfaction.

PubMed

Botella, Cristina; Etchemendy, Ernestina; Castilla, Diana; Baños, Rosa María; García-Palacios, Azucena; Quero, Soledad; Alcañiz, Mariano; Lozano, José Antonio

2009-06-01

The Butler Project is a technological e-health platform that uses the Internet to connect various users; it was designed to deliver health care to the elderly. The Butler platform has three levels of implementation: diagnosis (mood monitoring, alert system, management reports), therapy (training in inducing positive moods, memory work), and entertainment (e-mail, chat, video, photo albums, music, friend forums, accessibility to the Internet). The objective of this work is to describe the psychological aspects of the platform and to present data obtained from four users. Results show that after using the system, the participants increased their positive emotions and decreased their negative ones; in addition, they obtained high levels of satisfaction and experienced little difficulty in using the system.

Mice prefer draught-free housing.

PubMed

Krohn, T C; Hansen, A K

2010-10-01

An increasing number of rodents are housed in individually ventilated cage (IVC) systems, as these seem to be very effective for the protection of animals against infections, as well as protecting the staff against allergens. For the IVC systems to be properly ventilated, a huge amount of air has to be blown into the cage, which may cause a draught at animal level inside the cage. The aim of the present study was to evaluate the preferences of mice for differing levels of air speeds and air changes inside the cage. It has been concluded that mice do react to draughts, whereas they do not seem to be affected by a high number of air changes delivered without draught, which underlines the importance of applying draught-free IVC systems for mice.

Using High Level Literacy Techniques to Teach Astronomy to Non-Science Majors

NASA Astrophysics Data System (ADS)

Garland, C. A.; Ratay, D. L.

2005-12-01

We present a discussion of an introductory-level college astronomy class which significantly relied on reading and writing assignments to deliver basic content knowledge and provide a basis for deeper analysis of the material. As opposed to the traditional problem-set method of homework, students were required to read popular articles from magazines and newspapers related to the content presented in class and then prepare responses. Responses ranged from methodological analysis to using the readings to create original science journalism. Other forms of assessment indicated that students benefitted from this type of course design. We propose that given the background of students in this type of course, the course design is better suited to engage students in the material and provides a better assessment of student achievement.

Documents from Chile Public Participation Training – Chile – January 2013

EPA Pesticide Factsheets

EPA delivered a two-day workshop in Chile, on public participation. The course intended to enable students to increase the level of public impact through the levels of public participation, found on EPA’s Public Participation Guide.

Documents from Chile Public Participation Training – Chile – March 2011

EPA Pesticide Factsheets

EPA delivered a two-day workshop in Santiago, Chile, on public participation. The course intended to enable students to increase the level of public impact through the levels of public participation, found on EPA’s Public Participation Guide.

Three electron beams from a laser-plasma wakefield accelerator and the energy apportioning question

PubMed Central

Yang, X.; Brunetti, E.; Gil, D. Reboredo; Welsh, G. H.; Li, F. Y.; Cipiccia, S.; Ersfeld, B.; Grant, D. W.; Grant, P. A.; Islam, M. R.; Tooley, M. P.; Vieux, G.; Wiggins, S. M.; Sheng, Z. M.; Jaroszynski, D. A.

2017-01-01

Laser-wakefield accelerators are compact devices capable of delivering ultra-short electron bunches with pC-level charge and MeV-GeV energy by exploiting the ultra-high electric fields arising from the interaction of intense laser pulses with plasma. We show experimentally and through numerical simulations that a high-energy electron beam is produced simultaneously with two stable lower-energy beams that are ejected in oblique and counter-propagating directions, typically carrying off 5–10% of the initial laser energy. A MeV, 10s nC oblique beam is ejected in a 30°–60° hollow cone, which is filled with more energetic electrons determined by the injection dynamics. A nC-level, 100s keV backward-directed beam is mainly produced at the leading edge of the plasma column. We discuss the apportioning of absorbed laser energy amongst the three beams. Knowledge of the distribution of laser energy and electron beam charge, which determine the overall efficiency, is important for various applications of laser-wakefield accelerators, including the development of staged high-energy accelerators. PMID:28281679

A novel method for preparing pomegranate-structured FePO{sub 4}/C composite materials as cathode for lithium-ion batteries

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

Hao, Guan-nan; State Key Laboratory of Chemical Resource Engineering, Beijing University of Chemical Technology, Beijing 100029; Zhang, Hao, E-mail: dr.h.zhang@hotmail.com

2012-12-15

Graphical abstract: Display Omitted Highlights: ► We designed and synthesized a pomegranate-structured FePO{sub 4}/C composite. ► We used a combination of electrospinning and solid-state reaction for preparation. ► We showed how the performance of pomegranate-structured FePO{sub 4} is highly enhanced. -- Abstract: A pomegranate-structured FePO{sub 4}/C composite was synthesized via a combination of electrospinning and high temperature reaction using micron-level FePO{sub 4} and polyacrylonitrile (PAN). Systematic studies on synthesis, modification, and characterization of FePO{sub 4}/C composites were conducted. The FePO{sub 4}/C composites delivered a specific discharge capacity of 109 mAh g{sup −1} at 0.2 C and 39 mAh g{sup −1}more » at 10 C, which were comparable with the reported nanometer-level FePO{sub 4}. We demonstrated that the three-dimensional net-like structure covered by porous carbon layers could highly enhance the electrochemical performance of FePO{sub 4}.« less

Undergraduate Neuropharmacology: A Model for Delivering College-Level Neuroscience to High School Students in situ.

PubMed

Martin-Morris, Linda E; Buckland, Helen T; Popa, Simina M; Cunningham, Susanna L

2015-01-01

Our university course for non-majors (Biology 100) on the neurobiology of drug addiction was recently retooled for delivery at high schools around the state of Washington in order to engage younger students in the study of psychoactive drugs. Many of these students are earning both high school and university credits (dual-enrollment). This paper outlines the course design principles we used to ensure that high school students are earning valid college credits. We present an analysis of learning gains experienced by both university and high school students as measured by before and after course knowledge surveys. We also describe how assessment strategies used for on-campus students have been transferred to our high school partner teachers and how generous interchange and observation ensure that the high school students are engaging deeply in their study of neuroscience. Indeed, many have had a transformative experience that inspires them to contemplate the field of neuroscience as they transition into university study.

Relationship between microRNA-146a expression and plasma renalase levels in hemodialyzed patients

PubMed Central

Koch, Wojciech; Kukula-Koch, Wirginia; Gaweł, Kinga; Bednarek-Skublewska, Anna; Małecka-Massalska, Teresa; Milanowski, Janusz; Petkowicz, Beata; Solski, Janusz

2017-01-01

Background microRNA (miRNA) belongs to the non-coding RNAs family responsible for the regulation of gene expression. Renalase is a protein composed of 342 amino acids, secreted by the kidneys and possibly plays an important role in the regulation of sympathetic tone and blood pressure. The aim of the present study was to investigate plasma renalase concentration, and explore the relationship between miRNA-146a-5p expression and plasma renalase levels in hemodialyzed patients. Methods The study population comprised 55 subjects who succumbed to various cardiac events, 27 women and 28 men, aged 65–70 years. The total RNA including miRNA fraction was isolated using QiagenmiRNEasy Serum/Plasma kit according to the manufacturer’s protocol. The isolated miRNAs were analyzed using a quantitative polymerase chain reaction (qRT-PCR) technique. The plasma renalase levels were measured using a commercial ELISA kit. Results In the group of patients with high levels of renalase, higher miRNA-146a expression was found, compared with those with low concentration of renalase. Patients with simultaneous low miRNA-146a expression and high level of renalase were confirmed to deliver a significantly longer survival time compared with other patients. Conclusions miRNA-146a and plasma renalase levels were estimated as independent prognostic factors of hemodialyzed patients’ survival time. Patients with low miRNA-146a expression demonstrated a significantly longer survival time in contrast to the patients with a high expression level of miRNA-146a. Moreover, a significantly longer survival time was found in patients with high renalase activity compared with patients with low activity of the enzyme. PMID:28614373

Toward more efficient fabrication of high-density 2-D VCSEL arrays for spatial redundancy and/or multi-level signal communication

NASA Astrophysics Data System (ADS)

Roscher, Hendrik; Gerlach, Philipp; Khan, Faisal Nadeem; Kroner, Andrea; Stach, Martin; Weigl, Alexander; Michalzik, Rainer

2006-04-01

We present flip-chip attached high-speed VCSELs in 2-D arrays with record-high intra-cell packing densities. The advances of VCSEL array technology toward improved thermal performance and more efficient fabrication are reviewed, and the introduction of self-aligned features to these devices is pointed out. The structure of close-spaced wedge-shaped VCSELs is discussed and their static and dynamic characteristics are presented including an examination of the modal structure by near-field measurements. The lasers flip-chip bonded to a silicon-based test platform exhibit 3-dB and 10-dB bandwidths of 7.7 GHz and 9.8 GHz, respectively. Open 12.5 Gbit/s two-level eye patterns are demonstrated. We discuss the uses of high packing densities for the increase of the total amount of data throughput an array can deliver in the course of its life. One such approach is to provide up to two backup VCSELs per fiber channel that can extend the lifetimes of parallel transmitters through redundancy of light sources. Another is to increase the information density by using multiple VCSELs per 50 μm core diameter multimode fiber to generate more complex signals. A novel scheme using three butt-coupled VCSELs per fiber for the generation of four-level signals in the optical domain is proposed. First experiments are demonstrated using two VCSELs butt-coupled to the same standard glass fiber, each modulated with two-level signals to produce four-level signals at the photoreceiver. A four-level direct modulation of one VCSEL within a triple of devices produced first 20.6 Gbit/s (10.3 Gsymbols/s) four-level eyes, leaving two VCSELs as backup sources.

Lifelong learning as an instrument for human capital development in Benin

NASA Astrophysics Data System (ADS)

Biao, Idowu

2015-10-01

A review of the Benin education system shows that it is still heavily school-based. Yet, a high level of wastage is currently being recorded at school level (about 50% success rate at primary level, about 40% success rate at high school level and about 1% enrolment rate of qualified candidates and success rate at tertiary level), leading to the unintentional creation of a large population of unskilled and unproductive youths and adults. Integrated education systems which hold great potential and opportunities for both initial and continuing education remain hardly explored and virtually untapped. Yet, the challenges of the 21st century are such that only the unveiling and continuous cultivation of multi-faceted human capital can help individual citizens lead both a productive and fulfilled life. Formal education alone or non-formal education alone, irrespective of how well each is delivered, is no longer sufficient in facing up to the multifarious challenges of the 21st century. If education is to serve Benin beneficially in this century, the current national system of education must be reoriented to free up citizens' human capital through the implementation of an integrated educational system. This article proposes a new national education system which is rooted in the concept of lifelong learning and combines formal and non-formal systems of education for Benin.

FiO2 delivered by a turbine portable ventilator with an oxygen concentrator in an Austere environment.

PubMed

Bordes, Julien; Erwan d'Aranda; Savoie, Pierre-Henry; Montcriol, Ambroise; Goutorbe, Philippe; Kaiser, Eric

2014-09-01

Management of critically ill patients in austere environments is a logistic challenge. Availability of oxygen cylinders for the mechanically ventilated patient may be difficult in such a context. A solution is to use a ventilator able to function with an oxygen concentrator. We tested the SeQual Integra™ (SeQual, San Diego, CA) 10-OM oxygen concentrator paired with the Pulmonetic System(®) LTV 1000 ventilator (Pulmonetic Systems, Minneapolis, MN) and evaluated the delivered fraction of inspired oxygen (FiO2) across a range of minute volumes and combinations of ventilator settings. Two LTV 1000 ventilators were tested. The ventilators were attached to a test lung and FiO2 was measured by a gas analyzer. Continuous-flow oxygen was generated by the OC from 0.5 L/min to 10 L/min and injected into the oxygen inlet port of the LTV 1000. Several combinations of ventilator settings were evaluated to determine the factors affecting the delivered FiO2. The LTV 1000 ventilator is a turbine ventilator that is able to deliver high FiO2 when functioning with an oxygen concentrator. However, modifications of the ventilator settings such as increase in minute ventilation affect delivered FiO2 even if oxygen flow is constant on the oxygen concentrator. The ability of an oxygen concentrator to deliver high FiO2 when used with a turbine ventilator makes this method of oxygen delivery a viable alternative to cylinders in austere environments when used with a turbine ventilator. However, FiO2 has to be monitored continuously because delivered FiO2 decreases when minute ventilation is increased. Copyright © 2014 Elsevier Inc. All rights reserved.

Determinants of postnatal care use at health facilities in rural Tanzania: multilevel analysis of a household survey.

PubMed

Mohan, Diwakar; Gupta, Shivam; LeFevre, Amnesty; Bazant, Eva; Killewo, Japhet; Baqui, Abdullah H

2015-10-30

Postnatal care (PNC) for the mother and infant is a neglected area, even for women who give birth in a health facility. Currently, there is very little evidence on the determinants of use of postnatal care from health facilities in Tanzania. This study examined the role of individual and community-level variables on the use of postnatal health services, defined as a check up from a heath facility within 42 days of delivery, using multilevel logistic regression analysis. We analyzed data of 1931 women, who had delivered in the preceding 2-14 months, from a two-stage household survey in 4 rural districts of Morogoro region, Tanzania. Individual level explanatory variables included i) Socio-demographic factors: age, birth order, education, and wealth, ii) Factors related to pregnancy: frequency of antenatal visits, history of complications, mode of delivery, place of delivery care, and counseling received. Community level variables included community levels of family planning, health service utilization, trust, poverty and education, and distance to health facility. Less than one in four women in Morogoro reported having visited a health facility for postnatal care. Individual-level attributes positively associated with postnatal care use were women's education of primary level or higher [Odds Ratio (OR) 1.37, 95 % Confidence Interval (CI) 1.04-1.81], having had a caesarean section or forceps delivery (2.95, 1.8-4.81), and being counseled by a community health worker to go for postnatal care at a health facility (2.3, 1.36-3.89). Other positive associations included those recommended HIV testing for baby (1.94, 1.19-3.15), and whose partners tested for HIV (1.41, 1.07-1.86). High community levels of postpartum family planning usage (2.48, 1.15-5.37) and high level of trust in health system (1.77, 1.12-2.79) were two significant community-level predictors. Lower postnatal care use was associated with having delivered at a hospital (0.5, 0.33-0.76), health center (0.57, 0.38-0.85), or dispensary (0.48, 0.33-0.69), and having had severe swelling of face and legs during pregnancy (0.65, 0.43-0.97). In the context of low postnatal care use in a rural setting, programs should direct efforts towards reaching women who do not avail themselves of postnatal care as identified in our study.

Solar thermal collectors using planar reflector

NASA Technical Reports Server (NTRS)

Espy, P. N.

1978-01-01

Specular reflectors have been used successfully with flat-plate collectors to achieve exceptionally high operating temperatures and high delivered energy per unit collector area. Optimal orientation of collectors and reflectors can result in even higher performance with an improved relationship between energy demand and supply. This paper reports on a study providing first order optimization of collector-reflector arrays in which single- and multiple-faceted reflectors in fixed or singly adjustable configurations provide delivered energy maxima in either summer or winter.

Hydrogen-oxygen catalytic ignition and thruster investigation. Volume 1: Catalytic ignition and low pressure thruster evaluations

NASA Technical Reports Server (NTRS)

Johnson, R. J.

1972-01-01

An experimental and analytical program was conducted to evaluate catalytic igniter operational limits, igniter scaling criteria, and delivered performance of cooled, flightweight gaseous hydrogen-oxygen reaction control thrusters. Specific goals were to: (1) establish operating life and environmental effects for both Shell 405-ABSG and Engelhard MFSA catalysts, (2) provide generalized igniter design guidelines for high response without flashback, and (3) to determine overall performance of thrusters at chamber pressures of 15 and 300 psia (103 and 2068 kN/sq m) and thrust levels of 30 and 1500 lbf, respectively. The experimental results have demonstrated the feasibility of reliable, high response catalytic ignition and the effectiveness of ducted chamber cooling for a high performance flightweight thruster. This volume presents the results of the catalytic igniter and low pressure thruster evaluations are presented.

Catalytic Enantioselective Olefin Metathesis in Natural Product Synthesis. Chiral Metal-Based Complexes that Deliver High Enantioselectivity and More

PubMed Central

Malcolmson, Steven J.; Meek, Simon J.; Zhugralin, Adil R.

2012-01-01

Chiral olefin metathesis catalysts enable chemists to access enantiomerically enriched small molecules with high efficiency; synthesis schemes involving such complexes can be substantially more concise than those that would involve enantiomerically pure substrates and achiral Mo alkylidenes or Ru-based carbenes. The scope of research towards design and development of chiral catalysts is not limited to discovery of complexes that are merely the chiral versions of the related achiral variants. A chiral olefin metathesis catalyst, in addition to furnishing products of high enantiomeric purity, can offer levels of efficiency, product selectivity and/or olefin stereoselectivity that are unavailable through the achiral variants. Such positive attributes of chiral catalysts (whether utilized in racemic or enantiomerically enriched form) should be considered as general, applicable to other classes of transformations. PMID:19967680

From strategy development to routine implementation: the cost of Intermittent Preventive Treatment in Infants for malaria control

PubMed Central

Manzi, Fatuma; Hutton, Guy; Schellenberg, Joanna; Tanner, Marcel; Alonso, Pedro; Mshinda, Hassan; Schellenberg, David

2008-01-01

Background Achieving the Millennium Development Goals for health requires a massive scaling-up of interventions in Sub Saharan Africa. Intermittent Preventive Treatment in infants (IPTi) is a promising new tool for malaria control. Although efficacy information is available for many interventions, there is a dearth of data on the resources required for scaling up of health interventions. Method We worked in partnership with the Ministry of Health and Social Welfare (MoHSW) to develop an IPTi strategy that could be implemented and managed by routine health services. We tracked health system and other costs of (1) developing the strategy and (2) maintaining routine implementation of the strategy in five districts in southern Tanzania. Financial costs were extracted and summarized from a costing template and semi-structured interviews were conducted with key informants to record time and resources spent on IPTi activities. Results The estimated financial cost to start-up and run IPTi in the whole of Tanzania in 2005 was US$1,486,284. Start-up costs of US$36,363 were incurred at the national level, mainly on the development of Behaviour Change Communication (BCC) materials, stakeholders' meetings and other consultations. The annual running cost at national level for intervention management and monitoring and drug purchase was estimated at US$459,096. Start-up costs at the district level were US$7,885 per district, mainly expenditure on training. Annual running costs were US$170 per district, mainly for printing of BCC materials. There was no incremental financial expenditure needed to deliver the intervention in health facilities as supplies were delivered alongside routine vaccinations and available health workers performed the activities without working overtime. The economic cost was estimated at 23 US cents per IPTi dose delivered. Conclusion The costs presented here show the order of magnitude of expenditures needed to initiate and to implement IPTi at national scale in settings with high Expanded Programme on Immunization (EPI) coverage. The IPTi intervention appears to be affordable even within the budget constraints of Ministries of Health of most sub-Saharan African countries. PMID:18671874

Elevated maternal serum-free β-human chorionic gonadotropin (β-hCG) and reduced risk of spontaneous preterm delivery.

PubMed

Soni, Shelly; Krantz, David A; Blitz, Matthew J; Vohra, Nidhi; Rochelson, Burton

2018-04-12

To evaluate the relationship between first and second trimester maternal serum-free β-hCG and the risk of spontaneous preterm delivery (PTD). This was a case-control study of women evaluated and delivered at our institution from 2011 to 2015. Spontaneous PTD was defined as delivery before 37 weeks due to spontaneous preterm labor or premature rupture of membranes. Patient with multifetal gestation and those with medically indicated term or PTD were excluded. Of 877 women meeting the inclusion criteria, 173 delivered preterm and 704 delivered at term, and 8.1% had high free β-hCG in one or both trimesters. High maternal first and/or second trimester free β-hCG (≥95th percentile) was associated with lower rates of PTD. Thirty-two women with high free β-hCG in both first and second trimesters delivered at term. Gestational age at delivery and birth weights were lower in women who did not have high free β-hCG in any trimester. Low free β-hCG (≤5th percentile) in either trimester was not associated with an increased or decreased likelihood of PTD. Logistic regression demonstrated an independent association of high free β-hCG (≥95th percentile) with a reduced likelihood of PTD. Stratified analysis revealed a stronger impact of this association in women with no prior history of PTD. High free β-hCG, in the absence of risk factors for medically indicated PTD, is associated with a reduced likelihood of spontaneous PTD and may represent a marker indicating lower risk.

Surface-mediated delivery of siRNA from fibrin hydrogels for knockdown of the BMP-2 binding antagonist noggin.

PubMed

Kowalczewski, Christine J; Saul, Justin M

2015-10-01

Antagonists and inhibitory molecules responsible for maintaining tissue homeostasis can present a significant barrier to healing when tissue engineering/regenerative medicine strategies are employed. One example of this situation is the up-regulation of antagonists such as noggin in response to increasing concentrations of bone morphogenetic protein-2 (BMP-2) present from endogenous bone repair processes or delivered exogenously from biomaterials (synthetic bone grafts). While recombinant human (rh)BMP-2 delivered from synthetic bone grafts has been shown to be an effective alternative to autografts and allografts, the supraphysiological doses of rhBMP-2 have led to clinically-adverse side effects. The high rhBMP-2 dosage may be required, in part, to overcome the presence of antagonists such as noggin. Small interfering RNA (siRNA) is an appealing approach to overcome this problem because it can knock-down antagonists or inhibitory molecules in a temporary manner. Here, we conducted fundamental studies on the delivery of siRNA from material surfaces as a means to knock-down antagonists like noggin. Non-viral cationic lipid (Lipofectamine)-siRNA complexes were delivered from a fibrin hydrogel surface to MC3T3-E1 preosteoblasts that were treated with a supraphysiological dose of rhBMP-2 to achieve noggin mRNA expression levels higher than cells naïve to rhBMP-2. Confocal microscopy and flow cytometry showed intracellular uptake of siRNA in over 98% of MC3T3-E1 cells after 48 h. Doses of 0.5 and 1 μg noggin siRNA were able to significantly reduce noggin mRNA to levels equivalent to those in MC3T3-E1 cells not exposed to rhBMP-2 with no effects on cell viability. Small interfering RNA (siRNA) has been considered for treatment of diseases ranging from Alzheimer's to cancer. However, the ability to use siRNA in conjunction with biomaterials to direct tissue regeneration processes has received relatively little attention. Using the bone morphogenetic protein 2 antagonist, noggin, as a model, this research describes an approach to knock-down molecules that are inhibitory to desired regenerative pathways at the mRNA level via siRNA delivery from a hydrogel surface. Interactions between the material (fibrin) surface and polycation-siRNA complexes, release of the siRNA from the material surface, high levels of cellular uptake/internalization of siRNA, and significant knockdown of the targeting (noggin) mRNA are demonstrated. Broader future applications include those to nerve regeneration, cardiovascular tissue engineering, directing (stem) cell behavior, and mitigating inflammatory responses to materials. Copyright © 2015 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

TH-CD-207A-12: Impacts of Inter- and Intra-Fractional Organ Motion for High-Risk Prostate Cancer Stereotactic Body Radiation Therapy

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

Hassan Rezaeian, N; Chi, Y; Zhou, Y

2016-06-15

Purpose: We are conducting a clinical trial on stereotactic body radiation therapy (SBRT) for high-risk prostate cancer. Doses to three targets, prostate, intra-prostatic lesion, and pelvic lymph node (PLN) region, are escalated to three different levels via simultaneous integrated boost technique. Inter-/intra-fractional organ motions deteriorate planned dose distribution. This study aims at developing a dose reconstruction system to comprehensively understand the impacts of organ motion in our clinical trial. Methods: A 4D dose reconstruction system has been developed for this study. Using a GPU-based Monte-Carlo dose engine and delivery log file, the system is able to reconstruct dose on staticmore » or dynamic anatomy. For prostate and intra-prostatic targets, intra-fractional motion is the main concern. Motion trajectory acquired from Calypso in previously treated SBRT patients were used to perform 4D dose reconstructions. For pelvic target, inter-fractional motion is one concern. Eight patients, each with four cone beam CTs, were used to derive fractional motion. The delivered dose was reconstructed on the deformed anatomy. Dosimetric parameters for delivered dose distributions of the three targets were extracted and compared with planned levels. Results: For prostate intra-fractional motion, the mean 3D motion amplitude during beam delivery ranged from 1.5mm to 5.0mm and the average among all patients was 2.61mm. Inter-fractional motion for the PLN target was more significant. The average amplitude among patients was 4mm with the largest amplitude up to 9.6mm. The D95% deviation from planned level for prostate PTVs and GTVs are on average less than<0.1% and this deviation for intra-prostatic lesion PTVs and GTVs were more prominent. The dose at PLN was significantly affected with D{sub 95}% reduced by up to 44%. Conclusion: Intra-/inter-fractional organ motion is a concern for high-risk prostate SBRT, particularly for the PLN target. Our dose reconstruction approach can also serve as the basis to guide treatment adaptation.« less

Knowledge and awareness of HPV vaccine and acceptability to vaccinate in sub-Saharan Africa: a systematic review.

PubMed

Perlman, Stacey; Wamai, Richard G; Bain, Paul A; Welty, Thomas; Welty, Edith; Ogembo, Javier Gordon

2014-01-01

We assessed the knowledge and awareness of cervical cancer, HPV and HPV vaccine, and willingness and acceptability to vaccinate in sub-Saharan African (SSA) countries. We further identified countries that fulfill the two GAVI Alliance eligibility criteria to support nationwide HPV vaccination. We conducted a systematic review of peer-reviewed studies on the knowledge and awareness of cervical cancer, HPV and HPV vaccine, and willingness and acceptability to vaccinate. Trends in Diphtheria-tetanus-pertussis (DTP3) vaccine coverage in SSA countries from 1990-2011 were extracted from the World Health Organization database. The review revealed high levels of willingness and acceptability of HPV vaccine but low levels of knowledge and awareness of cervical cancer, HPV or HPV vaccine. We identified only six countries to have met the two GAVI Alliance requirements for supporting introduction of HPV vaccine: 1) the ability to deliver multi-dose vaccines for no less than 50% of the target vaccination cohort in an average size district, and 2) achieving over 70% coverage of DTP3 vaccine nationally. From 2008 through 2011 all SSA countries, with the exception of Mauritania and Nigeria, have reached or maintained DTP3 coverage at 70% or above. There is an urgent need for more education to inform the public about HPV, HPV vaccine, and cervical cancer, particularly to key demographics, (adolescents, parents and healthcare professionals), to leverage high levels of willingness and acceptability of HPV vaccine towards successful implementation of HPV vaccination programs. There is unpreparedness in most SSA countries to roll out national HPV vaccination as per the GAVI Alliance eligibility criteria for supporting introduction of the vaccine. In countries that have met 70% DTP3 coverage, pilot programs need to be rolled out to identify the best practice and strategies for delivering HPV vaccines to adolescents and also to qualify for GAVI Alliance support.

Knowledge and Awareness of HPV Vaccine and Acceptability to Vaccinate in Sub-Saharan Africa: A Systematic Review

PubMed Central

Perlman, Stacey; Wamai, Richard G.; Bain, Paul A.; Welty, Thomas; Welty, Edith; Ogembo, Javier Gordon

2014-01-01

Objectives We assessed the knowledge and awareness of cervical cancer, HPV and HPV vaccine, and willingness and acceptability to vaccinate in sub-Saharan African (SSA) countries. We further identified countries that fulfill the two GAVI Alliance eligibility criteria to support nationwide HPV vaccination. Methods We conducted a systematic review of peer-reviewed studies on the knowledge and awareness of cervical cancer, HPV and HPV vaccine, and willingness and acceptability to vaccinate. Trends in Diphtheria-tetanus-pertussis (DTP3) vaccine coverage in SSA countries from 1990–2011 were extracted from the World Health Organization database. Findings The review revealed high levels of willingness and acceptability of HPV vaccine but low levels of knowledge and awareness of cervical cancer, HPV or HPV vaccine. We identified only six countries to have met the two GAVI Alliance requirements for supporting introduction of HPV vaccine: 1) the ability to deliver multi-dose vaccines for no less than 50% of the target vaccination cohort in an average size district, and 2) achieving over 70% coverage of DTP3 vaccine nationally. From 2008 through 2011 all SSA countries, with the exception of Mauritania and Nigeria, have reached or maintained DTP3 coverage at 70% or above. Conclusion There is an urgent need for more education to inform the public about HPV, HPV vaccine, and cervical cancer, particularly to key demographics, (adolescents, parents and healthcare professionals), to leverage high levels of willingness and acceptability of HPV vaccine towards successful implementation of HPV vaccination programs. There is unpreparedness in most SSA countries to roll out national HPV vaccination as per the GAVI Alliance eligibility criteria for supporting introduction of the vaccine. In countries that have met 70% DTP3 coverage, pilot programs need to be rolled out to identify the best practice and strategies for delivering HPV vaccines to adolescents and also to qualify for GAVI Alliance support. PMID:24618636

Production of MPS VII mouse (Gustm(hE540A·mE536A)Sly) doubly tolerant to human and mouse β-glucuronidase

PubMed Central

Tomatsu, Shunji; Orii, Koji O.; Vogler, Carole; Grubb, Jeffrey H.; Snella, Elizabeth M.; Gutierrez, Monica; Dieter, Tatiana; Holden, Christopher C.; Sukegawa, Kazuko; Orii, Tadao; Kondo, Naomi; Sly, William S.

2006-01-01

Mucopolysaccharidosis VII (MPS VII, Sly syndrome) is an autosomal recessive lysosomal storage disease caused by β-glucuronidase (GUS) deficiency. A naturally occurring mouse model of that disease has been very useful for studying experimental approaches to therapy. However, immune responses can complicate evaluation of the long-term benefits of enzyme replacement or gene therapy delivered to adult MPS VII mice. To make this model useful for studying the long-term effectiveness and side effects of experimental therapies delivered to adult mice, we developed a new MPS VII mouse model, which is tolerant to both human and murine GUS. To achieve this, we used homologous recombination to introduce simultaneously a human cDNA transgene expressing inactive human GUS into intron 9 of the murine Gus gene and a targeted active site mutation (E536A) into the adjacent exon 10. When the heterozygote products of germline transmission were bred to homozygosity, the homozygous mice expressed no GUS enzyme activity but expressed inactive human GUS protein highly and were tolerant to immune challenge with human enzyme. Expression of the mutant murine Gus gene was reduced to about 10% of normal levels, but the inactive murine GUS enzyme also conferred tolerance to murine GUS. This MPS VII mouse model should be useful to evaluate therapeutic responses in adult mice receiving repetitive doses of enzyme or mice receiving gene therapy as adults. Heterozygotes expressed only 9.5–26% of wild-type levels of murine GUS instead of the expected 50%, indicating a dominant-negative effect of the mutant enzyme monomers on the activity of GUS tetramers in different tissues. Corrective gene therapy in this model should provide high enough levels of expression of normal GUS monomers to overcome the dominant negative effect of mutant monomers on newly synthesized GUS tetramers in most tissues. PMID:12700165

Strategies for systemic radiotherapy of micrometastases using antibody-targeted 131I.

PubMed

Wheldon, T E; O'Donoghue, J A; Hilditch, T E; Barrett, A

1988-02-01

A simple analysis is developed to evaluate the likely effectiveness of treatment of micrometastases by antibody-targeted 131I. Account is taken of the low levels of tumour uptake of antibody-conjugated 131I presently achievable and of the "energy wastage" in targeting microscopic tumours with a radionuclide whose disintegration energy is widely dissipated. The analysis shows that only modest doses can be delivered to micrometastases when total body dose is restricted to levels which allow recovery of bone marrow. Much higher doses could be delivered to micrometastases when bone marrow rescue is used. A rationale is presented for targeted systemic radiotherapy used in combination with external beam total body irradiation (TBI) and bone marrow rescue. This has some practical advantages. The effect of the targeted component is to impose a biological non-uniformity on the total body dose distribution with regions of high tumour cell density receiving higher doses. Where targeting results in high doses to particular normal organs (e.g. liver, kidney) the total dose to these organs could be kept within tolerable limits by appropriate shielding of the external beam radiation component of the treatment. Greater levels of tumour cell kill should be achievable by the combination regime without any increase in normal tissue damage over that inflicted by conventional TBI. The predicted superiority of the combination regime is especially marked for tumours just below the threshold for detectability (e.g. approximately 1 mm-1 cm diameter). This approach has the advantage that targeted radiotherapy provides only a proportion of the total body dose, most of which is given by a familiar technique. The proportion of dose given by the targeted component could be increased as experience is gained. The predicted superiority of the combination strategy should be experimentally testable using laboratory animals. Clinical applications should be cautiously approached, with due regard to the limitations of the theoretical analysis.

Automated screening method for determining optimum preservative systems for personal and home care products.

PubMed

Lenczewski, M E; Kananen, L L

1998-01-01

A procedure was designed to determine the minimum preservative level (MPL) for personal and home care products. A highly preserved sample and an unpreserved sample were combined at different concentrations within a 96-well microtiter plate by using an autodilutor. A unique tip design made it possible to accurately deliver viscous test materials that cannot be dispensed using vacuum- or fluid-filled systems. After inoculation, the sample was evaluated at a specified time interval for the presence of surviving bacteria, yeast, and mold. The lowest concentration of preservative with no microbial growth is the recommended level of preservative for the product. Because sample turbidity may interfere with determination of the endpoint, a colorimetric endpoint was used to indicate growth of microorganisms and to differentiate product from growth. The predicted levels were tested with a modified Cosmetic, Toiletry, and Fragrance Association method. The method successfully predicted effective preservative levels in many personal and home care products with a broad range of viscosities.

GOES-R Space Weather Data: Ensuring Access and Usability

NASA Astrophysics Data System (ADS)

Tilton, M.; Rowland, W. F.; Wilkinson, D. C.; Denig, W. F.; Darnel, J.; Kress, B. T.; Loto'aniu, P. T. M.; Machol, J. L.; Redmon, R. J.; Rodriguez, J. V.

2015-12-01

The upcoming Geostationary Operational Environmental Satellite series, GOES-R, will provide critical space weather data. These data are used to prevent communication outages, mitigate the damage solar weather causes to satellites and power grids, and reduce astronaut radiation exposure. The space weather instruments aboard GOES-R will deliver an operational dataset of unprecedented breadth. However, NOAA's National Centers for Environmental Information (NCEI)—the organization that provides access to archived GOES-R data—has faced several challenges in delivering this information to customers in usable form. For instance, the GOES-R ground system was contracted to develop higher-level products for terrestrial data but not space weather data. Variations in GOES-R data file formats and archive locations have also threatened to create an inconsistent user experience. This presentation will examine the ways in which NCEI is making GOES-R space weather data more accessible and actionable for customers. These efforts include NCEI's development of high-level data products to meet the requirements of NOAA's Space Weather Prediction Center—a role NCEI has not previously played. In addition, NCEI is creating a demonstration system to show how these products can be produced in real-time. The organization is also examining customer usage of the GOES-NOP data access system and using these access patterns to drive decisions about the GOES-R user interface.

Patient credentialing as a population health management strategy: a diabetes case study.

PubMed

Watson, Lindsay L; Bluml, Benjamin M; Skoufalos, Alexandria

2015-06-01

When given the opportunity to become actively involved in the decision-making process, patients can positively impact their health outcomes. Understanding how to empower patients to become informed consumers of health care services is an important strategy for addressing disparities and variability in care. Patient credentialing identifies people who have a certain diagnosis and have achieved certain levels of competency in understanding and managing their disease. Patient credentialing was developed to meet 3 core purposes: (1) enhance patient engagement by increasing personal accountability for health outcomes, (2) create a mass customization strategy for providers to deliver high-quality, patient-centered collaborative care, and (3) provide payers with a foundation for properly aligning health benefit incentives. The Patient Self-Management Credential for Diabetes, a first-of-its-kind, psychometrically validated tool, has been deployed within 3 practice-based research initiatives as a component of innovative diabetes care. Results from these projects show improved clinical outcomes, reduced health care costs, and a relationship between credential achievement levels and clinical markers of diabetes. Implementing patient credentialing as part of collaborative care delivered within various settings across the health care system may be an effective way to reduce disparities, improve access to care and appropriate treatments, incentivize patient engagement in managing their health, and expend time and resources in a customized way to meet individual needs.

Mistletoe lectins enhance immune responses to intranasally co-administered herpes simplex virus glycoprotein D2

PubMed Central

Lavelle, E C; Grant, G; Pusztai, A; Pfüller, U; Leavy, O; McNeela, E; Mills, K H G; O'Hagan, D T

2002-01-01

The mucosal adjuvant properties of the three type 2 ribosome-inactivating proteins (RIPs) from the European mistletoe, Viscum album L., were investigated. Mistletoe lectins were compared with cholera toxin (CT) as adjuvants when delivered nasotracheally together with herpes simplex virus glycoprotein D2 (gD2). All three mistletoe lectins (MLI, MLII, MLIII) were potent mucosal adjuvants. Co-administration of MLI, MLII or MLIII with gD2 led to significantly higher levels of gD2-specific mucosal immunoglobulin A (IgA) and systemic immunoglobulin G (IgG) antibody than when the antigen was delivered alone. The levels of antibodies induced were similar to those generated in mice immunized with gD2 and the potent mucosal adjuvant CT. Administration of ML1 with gD2 enhanced the antigen-specific splenic T-cell proliferative response. Interleukin-5 (IL-5), but not interferon-γ (IFN-γ), was detected in supernatants from splenocytes stimulated in vitro with gD2. This indicates that MLI enhanced type 2 T-helper cell (Th2) responses to the bystander antigen, gD2. Analysis of the gD2- and lectin-specific IgG subclass titres in mice immunized with gD2 and MLI, MLII or MLIII revealed a high ratio of IgG1 : IgG2a, which is compatible with the selective induction of Th2-type immune responses. PMID:12383207

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

Harrison, F.L.; Rice, D.W. Jr.; Moore, D.H.

Traditional bioassays are unsuitable for assessing sublethal effects of low levels of radioactivity because mortality and phenotypic responses are not anticipated. We compared the usefulness of chromosomal aberration (CA) and sister chromatid exchange (SCE) induction as measures of low-level radiation effects in a sediment-dwelling marine worm, Neanthes arenaceodentata. Newly hatched larvae were exposed to two radiation exposure regimes. Groups of 100 larvae were exposed to either x rays delivered at high dose rates (0.7 Gy min/sup -1/) or to /sup 60/Co gamma rays delivered at low dose rates (4.8 X 10/sup -5/ to 1.2 X 10/sup -1/ Gy h/sup -1/).more » After irradiation, the larvae were exposed to 3 X 10/sup -5/M bromodeoxyuridine (BrdUrd) for 28 h (x-ray-irradiated larvae) or for 54 h (/sup 60/Co-irradiated larvae). Slides of larval cells were prepared for observation of CAs and SCEs. Frequencies of CAs were determined in first division cells; frequencies of SCEs were determined in second division cells. Results from x-ray irradiation indicated that dose-related increases occur in chromosome and chromatid deletions, but an x-ray dose greater than or equal to 2 Gy was required to observe a significant increase. Worm larvae receiving /sup 60/Co irradiation showed elevated SCE frequencies; a significant increase in SCE frequency was observed at 0.6 Gy. 49 references, 2 figures.« less

Recent performance of and plasma outage studies with the SNS H{sup −} source

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

Stockli, M. P., E-mail: stockli@ornl.gov; Han, B.; Murray, S. N.

2016-02-15

Spallation Neutron Source ramps to higher power levels that can be sustained with high availability. The goal is 1.4 MW despite a compromised radio frequency quadrupole (RFQ), which requires higher radio frequency power than design levels to approach the nominal beam transmission. Unfortunately at higher power the RFQ often loses its thermal stability, a problem apparently enhanced by beam losses and high influxes of hydrogen. Delivering as much H{sup −} beam as possible with the least amount of hydrogen led to plasma outages. The root cause is the dense 1-ms long ∼55-kW 2-MHz plasma pulses reflecting ∼90% of the continuousmore » ∼300 W, 13-MHz power, which was mitigated with a 4-ms filter for the reflected power signal and an outage resistant, slightly detuned 13-MHz match. Lowering the H{sub 2} gas also increased the H{sup −} beam current to ∼55 mA and increased the RFQ transmission by ∼7% (relative)« less

Models of care for the management of hepatitis C virus among people who inject drugs: one size does not fit all.

PubMed

Bruggmann, Philip; Litwin, Alain H

2013-08-01

One of the major obstacles to hepatitis C virus (HCV) care in people who inject drugs (PWID) is the lack of treatment settings that are suitably adapted for the needs of this vulnerable population. Nevertheless, HCV treatment has been delivered successfully to PWID through various multidisciplinary models such as community-based clinics, substance abuse treatment clinics, and specialized hospital-based clinics. Models may be integrated in primary care--all under one roof in either addiction care units or general practitioner-based models--or can occur in secondary or tertiary care settings. Additional innovative models include directly observed therapy and peer-based models. A high level of acceptance of the individual life circumstances of PWID rather than rigid exclusion criteria will determine the level of success of any model of HCV management. The impact of highly potent and well-tolerated interferon-free HCV treatment regimens will remain negligible as long as access to therapy cannot be expanded to the most affected risk groups.

An implementation research agenda

PubMed Central

Eccles, Martin P; Armstrong, David; Baker, Richard; Cleary, Kevin; Davies, Huw; Davies, Stephen; Glasziou, Paul; Ilott, Irene; Kinmonth, Ann-Louise; Leng, Gillian; Logan, Stuart; Marteau, Theresa; Michie, Susan; Rogers, Hugh; Rycroft-Malone, Jo; Sibbald, Bonnie

2009-01-01

In October 2006, the Chief Medical Officer (CMO) of England asked Professor Sir John Tooke to chair a High Level Group on Clinical Effectiveness in response to the chapter 'Waste not, want not' in the CMOs 2005 annual report 'On the State of the Public Health'. The high level group made recommendations to the CMO to address possible ways forward to improve clinical effectiveness in the UK National Health Service (NHS) and promote clinical engagement to deliver this. The report contained a short section on research needs that emerged from the process of writing the report, but in order to more fully identify the relevant research agenda Professor Sir John Tooke asked Professor Martin Eccles to convene an expert group – the Clinical Effectiveness Research Agenda Group (CERAG) – to define the research agenda. The CERAG's terms of reference were 'to further elaborate the research agenda in relation to pursuing clinically effective practice within the (UK) National Health Service'. This editorial presents the summary of the CERAG report and recommendations. PMID:19351400

Students as partners: Our experience of setting up and working in a student engagement friendly framework.

PubMed

Zdravković, Marko; Serdinšek, Tamara; Sobočan, Monika; Bevc, Sebastjan; Hojs, Radovan; Krajnc, Ivan

2018-03-11

Student engagement (SE) in the curriculum is a positive indicator in the development of students deeply involved in their learning. It also has several benefits for the schools' level of educational innovation and quality assurance. In order to identify the most important pearls from the last decade of educational developments within the field of SE at the Faculty of Medicine University of Maribor, we searched through our school's archives, publications and research in the field of medical education. Three areas were identified as the most important SE complements: (i) peer teaching, (ii) school governance, and (iii) extracurricular activities. The paper highlights how many student-driven initiatives move from informal frameworks toward a formal structure, elective courses, and, in the end, compulsory components of the curriculum. As demonstrated by the three educational achievements at our school, fostering a high level of SE can lead to innovative curricular changes, benefit the whole school and enable students to deliver highly impactful extracurricular projects.

Comparing Pharmacy Benefit Managers: Moving Well Beyond the Simple Spreadsheet Analysis

PubMed Central

Calabrese, David

2008-01-01

Unabated increases in prescription drug demands, advancing technology, and rising drug inflation rates combined with a sagging economy, continue to intensify budget pressures for payors responsible for delivering pharmacy benefits to plan members. At the same time, high levels of complexity and resource requirements in drug benefit administration have led to a state in which plan sponsors remain heavily dependent on pharmacy benefit managers to assist in these efforts. With pharmacy representing such a critical component of healthcare delivery from clinical and economic perspectives, it is essential that sponsors exercise high levels of due diligence in pharmacy benefit manager review and appraisal to ensure proper balance of quality clinical care, sufficient access, and optimal cost-efficiency in the delivery of such benefits. This review is designed to provide a comprehensive understanding of current pharmacy benefit management business practices and help equip plan sponsors with the knowledge, strategies, and safeguards to drive a well-informed pharmacy benefit selection process and, inevitably, a better-aligned pharmacy benefit management–payor relationship. PMID:25126235

The Supply Chain's Role in Improving Animal Welfare.

PubMed

Harvey, David; Hubbard, Carmen

2013-08-14

Supply chains are already incorporating citizen/consumer demands for improved animal welfare, especially through product differentiation and the associated segmentation of markets. Nonetheless, the ability of the chain to deliver high(er) levels and standards of animal welfare is subject to two critical conditions: (a) the innovative and adaptive capacity of the chain to respond to society's demands; (b) the extent to which consumers actually purchase animal-friendly products. Despite a substantial literature reporting estimates of willingness to pay (WTP) for animal welfare, there is a belief that in practice people vote for substantially more and better animal welfare as citizens than they are willing to pay for as consumers. This citizen-consumer gap has significant consequences on the supply chain, although there is limited literature on the capacity and willingness of supply chains to deliver what the consumer wants and is willing to pay for. This paper outlines an economic analysis of supply chain delivery of improved standards for farm animal welfare in the EU and illustrates the possible consequences of improving animal welfare standards for the supply chain using a prototype belief network analysis.

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

Bull, Diana L.; Costello, Ronan; Babarit, Aurelien

Capabilities and functions are hierarchical structures (i.e. taxonomies) that are used in a systems engineering framework to identify complimentary requirements for the system: what the system must do to achieve what it must be. In the case of capabilities, the taxonomy embodies the list of characteristics that are desired, from the perspective of the stakeholders, for the system to be successful. In terms of the functions, the hierarchy represents the solution agnostic (i.e. independent of specific design embodiments) elements that are needed to meet the stakeholder requirements. This paper will focus on the development of the functions. The functions definemore » the fundamental elements of the solution that must be provided in order to achieve the mission and deliver the capabilities. They identify the behaviors the farm must possess, i.e. the farm must be able to generate and deliver electricity from wave power. High-level functions are independent of the technology or design used to implement the function. However, detailed functions may begin to border on specific design choices. Hence a strong effort has been made to maintain functions that are design agnostic.« less

The Role of Liposomal Bupivacaine in Value-Based Care.

PubMed

Iorio, Richard

Multimodal pain control strategies are crucial in reducing opioid use and delivering effective pain management to facilitate improved surgical outcomes. The utility of liposomal bupivacaine in enabling effective pain control in multimodal strategies has been demonstrated in several studies, but others have found the value of liposomal bupivacaine in such approaches to be insignificant. At New York University Langone Medical Center, liposomal bupivacaine injection and femoral nerve block were compared in their delivery of efficacious and cost-effective multimodal analgesia among patients undergoing total joint arthroplasty (TJA). Retrospective analysis revealed that including liposomal bupivacaine in a multimodal pain control protocol for TJA resulted in improved quality and efficiency metrics, decreased narcotic use, and faster mobilization, all relative to femoral nerve block, and without a significant increase in admission costs. In addition, liposomal bupivacaine use was associated with elimination of the need for patient-controlled analgesia in TJA. Thus, at Langone Medical Center, the introduction of liposomal bupivacaine to TJA has been instrumental in achieving adequate pain control, delivering high-level quality of care, and controlling costs.

Applied Meteorology Unit (AMU) Quarterly Report Third Quarter FY · 13

NASA Technical Reports Server (NTRS)

Bauman, William; Crawford, Winifred; Watson, Leela; Shafer, Jaclyn; Huddleston, Lisa

2013-01-01

The AMU team worked on seven tasks for their customers: (1) Ms. Crawford completed the objective lightning forecast tool for east -central Florida airports and delivered the tool and the final report to the customers. (2) Ms. Shafer continued work for Vandenberg Air Force Base on an automated tool to relate pressure gradients to peak winds. (3) Dr. Huddleston updated and delivered the tool that shows statistics on the timing of the first lightning strike of the day in the Kennedy Space Center (KSC)/Cape Canaveral Air Force Station (CCAFS) area. (4) Dr. Bauman continued work on a severe weather forecast tool focused on the Eastern Range (ER). (5) Ms. Crawford acquired the software and radar data needed to create a dual-Doppler analysis over the east-central Florida and KSC/CCAFS areas. (6) Mr. Decker continued developing a wind pairs database for the Launch Services Program to use when evaluating upper-level winds for launch vehicles. (7) Dr. Watson continued work to assimilate observational data into the high-resolution model configurations she created for Wallops Flight Facility and the ER.

Beam-dynamic effects at the CMS BRIL van der Meer scans

NASA Astrophysics Data System (ADS)

Babaev, A.

2018-03-01

The CMS Beam Radiation Instrumentation and Luminosity Project (BRIL) is responsible for the simulation and measurement of luminosity, beam conditions and radiation fields in the CMS experiment. The project is engaged in operating and developing new detectors (luminometers), adequate for the experimental conditions associated with high values of instantaneous luminosity delivered by the CERN LHC . BRIL operates several detectors based on different physical principles and technologies. Precise and accurate measurements of the delivered luminosity is of paramount importance for the CMS physics program. The absolute calibration of luminosity is achieved by the van der Meer method, which is carried out under specially tailored conditions. This paper presents models used to simulate of beam-dynamic effects arising due to the electromagnetic interaction of colliding bunches. These effects include beam-beam deflection and dynamic-β effect. Both effects are important to luminosity measurements and influence calibration constants at the level of 1-2%. The simulations are carried out based on 2016 CMS van der Meer scan data for proton-proton collisions at a center-of-mass energy of 13 TeV.

Electronic cigarettes and nicotine dependence: evolving products, evolving problems.

PubMed

Cobb, Caroline O; Hendricks, Peter S; Eissenberg, Thomas

2015-05-21

Electronic cigarettes (ECIGs) use an electric heater to aerosolize a liquid that usually contains propylene glycol, vegetable glycerin, flavorants, and the dependence-producing drug nicotine. ECIG-induced nicotine dependence has become an important concern, as some ECIGs deliver very little nicotine while some may exceed the nicotine delivery profile of a tobacco cigarette. This variability is relevant to tobacco cigarette smokers who try to switch to ECIGs. Products with very low nicotine delivery may not substitute for tobacco cigarettes, so that ECIG use is accompanied by little reduced risk of cigarette-caused disease. Products with very high nicotine delivery may make quitting ECIGs particularly difficult should users decide to try. For non-smokers, the wide variability of ECIGs on the market is especially troublesome: low nicotine products may lead them to initiate nicotine self-administration and progress to higher dosing ECIGs or other products, and those that deliver more nicotine may produce nicotine dependence where it was not otherwise present. External regulatory action, guided by strong science, may be required to ensure that population-level nicotine dependence does not rise.

Delivery of high intensity beams with large clad step-index fibers for engine ignition

NASA Astrophysics Data System (ADS)

Joshi, Sachin; Wilvert, Nick; Yalin, Azer P.

2012-09-01

We show, for the first time, that step-index silica fibers with a large clad (400 μm core and 720 μm clad) can be used to transmit nanosecond duration pulses in a way that allows reliable (consistent) spark formation in atmospheric pressure air by the focused output light from the fiber. The high intensity (>100 GW/cm2) of the focused output light is due to the combination of high output power (typical of fibers of this core size) with high output beam quality (better than that typical of fibers of this core size). The high output beam quality, which enables tight focusing, is due to the large clad which suppresses microbending-induced diffusion of modal power to higher order modes owing to the increased rigidity of the core-clad interface. We also show that extending the pulse duration provides a means to increase the delivered pulse energy (>20 mJ delivered for 50 ns pulses) without causing fiber damage. Based on this ability to deliver high energy sparks, we report the first reliable laser ignition of a natural gas engine including startup under typical procedures using silica fiber optics for pulse delivery.

Proteasome inhibition blocks NF-κB and ERK1/2 pathways, restores antigen expression and sensitizes resistant human melanoma to TCR-engineered CTLs

PubMed Central

Jazirehi, Ali R.; Economou, James S.

2012-01-01

Adoptive cell transfer (ACT) of ex vivo engineered autologous lymphocytes encoding high-affinity MART-1/HLA-A*0201-specific T-cell receptor (TCR) α/β chains (F5 CTL), densely infiltrate into sites of metastatic disease, mediating dramatic but partial clinical responses in melanoma patients. We hypothesized that MART-1 down-modulation in addition to aberrant apoptotic/survival signaling could confer resistance to death signals delivered by transgenic CTLs. To explore this hypothesis, we established an in vitro model of resistant (R) lines from MART-1+/HLA-A*0201+ F5 CTL-sensitive parental (P) lines under serial F5 CTL-selective pressure. We have recently reported that several melanoma R lines, while retaining MART-1 expression, exhibited constitutive NF-κB activation and over-expression of NF-κB-dependent resistance factors. Another established melanoma cell line M244, otherwise sensitive to F5 CTL, yielded R lines after serial F5 CTL selective pressure which had both reduced MART-1 expression levels, thus, could not be recognized, and were resistant to CTL-delivered apoptotic death signals. The proteasome inhibitor bortezomib blocked NF-κB activity, decreased phopspho-ERK1/2, increased phospho-JNK levels, reduced expression of resistance-factors, restored MART-1 expression to sufficient levels, which in combination allowed M244R lines be sensitized to F5 CTL-killing. These findings suggest that proteasome inhibition in immune resistant tumors can restore proapoptotic signaling and improve tumor antigen expression. PMID:22532603

Evaluation of a group cognitive-behavioral depression prevention program for young adolescents: A randomized effectiveness trial

PubMed Central

Gillham, Jane E.; Reivich, Karen J.; Brunwasser, Steven M.; Freres, Derek R.; Chajon, Norma D.; Megan Kash-MacDonald, V.; Chaplin, Tara M.; Abenavoli, Rachel M.; Matlin, Samantha L.; Gallop, Robert J.; Seligman, Martin E.P.

2015-01-01

Objective Depression is a common psychological problem in adolescence. Recent research suggests that group cognitive-behavioral interventions can reduce and prevent symptoms of depression in youth. Few studies have tested the effectiveness of such interventions when delivered by school teachers and counselors (as opposed to research team staff). Method We evaluated the effectiveness of the Penn Resiliency Program for adolescents (PRP-A), a school-based group intervention that targets cognitive behavioral risk factors for depression. We randomly assigned 408 middle school students (ages 10-15) to one of three conditions: PRP-A, PRP-AP (in which adolescents participated in PRP-A and parents were invited to attend a parent intervention component), or a school-as-usual control. Adolescents completed measures of depression and anxiety symptoms, cognitive style, and coping at baseline, immediately after the intervention, and at 6-month follow-up. Results PRP-A reduced depression symptoms relative to the school as usual control. Baseline levels of hopelessness moderated intervention effects. Among participants with average and high levels of hopelessness, PRP (A and AP) significantly improved depression symptoms, anxiety symptoms, hopelessness, and active coping relative to control. Among participants with low baseline hopelessness, we found no intervention effects. PRP-AP was not more effective than PRP-A alone. We found no intervention effects on clinical levels of depression or anxiety. Conclusion These findings suggest that cognitive-behavioral interventions can be beneficial when delivered by school teachers and counselors. These interventions may be most helpful to students with elevated hopelessness. PMID:22889296

Preconception healthcare delivery at a population level: construction of public health models of preconception care.

PubMed

Shannon, Geordan D; Alberg, Corinna; Nacul, Luis; Pashayan, Nora

2014-08-01

A key challenge of preconception healthcare is identifying how it can best be delivered at a population level. To review current strategies of preconception healthcare, explore methods of preconception healthcare delivery, and develop public health models which reflect different preconception healthcare pathways. Preconception care strategies, programmes and evaluations were identified through a review of Medline and Embase databases. Search terms included: preconception, pre-pregnancy, intervention, primary care, healthcare, model, delivery, program, prevention, trial, effectiveness, congenital disorders OR abnormalities, evaluation, assessment, impact. Inclusion criteria for review articles were: (1) English, (2) human subjects, (3) women of childbearing age, (4) 1980–current data, (5) all countries, (6) both high risk and universal approaches, (7) guidelines or recommendations, (8) opinion articles, (9) experimental studies. Exclusion criteria were: (1) non-human subjects, (2) non-English, (3) outside of the specified timeframe, (4) articles on male healthcare. The results of the literature review were synthesised into public health models of care: (1) primary care; (2) hospital-based and inter-conception care; (3) specific preconception care clinics; and, (4) community outreach. Fifteen evaluations of preconception care were identified. Community programmes demonstrated a significant impact on substance use, folic acid supplementation, diabetes optimization, and hyperphenylalaninemia. An ideal preconception visits entail risk screening, education, and intervention if indicated. Subsequently, four public health models were developed synthesizing preconception care delivery at a population level. Heterogeneity of risk factors, health systems and strategies of care reflect the lack of consensus about the best way to deliver preconception care. The proposed models aim to reflect differing aspects of preconception healthcare delivery.

Determination of cytokine protein levels in oral secretions in patients undergoing radiotherapy for head and neck malignancies

PubMed Central

2012-01-01

Background Cytokines may be elevated in tumor and normal tissues following irradiation. Cytokine expression in these tissues may predict for toxicity or tumor control. The purpose of this pilot study was to determine the feasibility of measuring local salivary cytokine levels using buccal sponges in patients receiving chemo-radiation for head and neck malignancies. Patients and methods 11 patients with epithelial malignancies of the head and neck were recruiting to this study. All patients received radiotherapy to the head and neck region with doses ranging between 60 – 67.5 Gy. Chemotherapy was delivered concurrently with radiation in all patients. Salivary samples were obtained from high dose and low dose regions prior to treatment and at three intervals during treatment for assessment of cytokine levels (IL-4, IL-6, IL-8, IL-10, EGF, MCP-1, TNF-α, and VEGF). Results Cytokine levels were detectable in the salivary samples. Salivary cytokine levels of IL-4, IL-6, IL-8, EGF, MCP-1, TNF- α , and VEGF were higher in the high dose region compared to the low dose region at all time points (p < 0.05). A trend toward an increase in cytokine levels as radiation dose increased was observed for IL-6, IL-8, MCP-1, and TNF-α. Conclusion Assessment of salivary cytokine levels may provide a novel method to follow local cytokine levels during radiotherapy and may provide a mechanism to study cytokine levels in a regional manner. PMID:22537315

Welding Niobium Bearing HSLA Steels 'Myths and Magic'

NASA Astrophysics Data System (ADS)

Kirkwood, Phil

Niobium is not currently added to ferritic steels with the specific objective of improving weldability and is more likely to be present to harness its combined beneficial effects on strength and toughness. Nevertheless, as carbon levels in many classes of HSLA steel, are progressively reduced, there is an increasing awareness that, amongst the microalloying elements, niobium is uniquely placed to deliver the mechanical property combinations that modern specifications demand and simultaneously deliver a `bonus' by way of enhanced weldability.

Cybertherapy 2004: Using Interactive Media in Training and Therapeutic Interventions

DTIC Science & Technology

2005-03-01

headphones, which delivered a soundscape updated in real time according to their movement in the virtual town. The sounds were produced through tracked...which delivered a pants were debriefed after each session but soundscape updated in real time according to were not informed about the content of the fol...cybersickness scale was used added to the soundscape . Ambisonics is a 4 to assess the level of discomfort after exposure channel audio format that embodies

Population impact of a high cardiovascular risk management program delivered by village doctors in rural China: design and rationale of a large, cluster-randomized controlled trial.

PubMed

Yan, Lijing L; Fang, Weigang; Delong, Elizabeth; Neal, Bruce; Peterson, Eric D; Huang, Yining; Sun, Ningling; Yao, Chen; Li, Xian; MacMahon, Stephen; Wu, Yangfeng

2014-04-11

The high-risk strategy has been proven effective in preventing cardiovascular disease; however, the population benefits from these interventions remain unknown. This study aims to assess, at the population level, the effects of an evidence-based high cardiovascular risk management program delivered by village doctors in rural China. The study will employ a cluster-randomized controlled trial in which a total of 120 villages in five northern provinces of China, will be assigned to either intervention (60 villages) or control (60 villages). Village doctors in intervention villages will be trained to implement a simple evidence-based management program designed to identify, treat and follow-up as many as possible individuals at high-risk of cardiovascular disease in the village. The intervention will also include performance feedback as well as a performance-based incentive payment scheme and will last for 2 years. We will draw two different (independent) random samples, before and after the intervention, 20 men aged≥50 years and 20 women aged≥60 years from each village in each sample and a total of 9,600 participants from 2 samples to measure the study outcomes at the population level. The primary outcome will be the pre-post difference in mean systolic blood pressure, analyzed with a generalized estimating equations extension of linear regression model to account for cluster effect. Secondary outcomes will include monthly clinic visits, provision of lifestyle advice, use of antihypertensive medications and use of aspirin. Process and economic evaluations will also be conducted. This trial will be the first implementation trial in the world to evaluate the population impact of the high-risk strategy in prevention and control of cardiovascular disease. The results are expected to provide important information (effectiveness, cost-effectiveness, feasibility and acceptability) to guide policy making for rural China as well as other resource-limited countries. The trial is registered at ClinicalTrials.gov (NCT01259700). Date of initial registration is December 13, 2010.

Inhaled alpha 1-antitrypsin: gauging patient interest in a new treatment.

PubMed

Monk, Richard; Graves, Michael; Williams, Pamela; Strange, Charlie

2013-08-01

Given the high cost of plasma derived intravenous alpha 1-antitrypsin (AAT), a more efficient method of delivery to the lungs is desirable. Inhaled AAT has been shown feasible for the treatment of alpha 1-antitrypsin deficiency (AATD) and is currently in clinical trials. To better understand patient preferences about possible inhaled AAT therapy, a survey was conducted to explore patient attitudes. We conducted an email based survey of patients in the Alpha-1 Foundation Research Registry with AATD on intravenous AAT replacement. Respondents were asked to rate their interest in hypothetical nebulized or dry powder inhaled AAT. Respondents reported high levels of interest in both dried powder inhaler and nebulizer delivered inhaled AAT. The interest in dried powder inhaled was higher than interest in nebulized AAT (71% vs 64%, p = 0.0001). The interest in dried powder inhaled AAT was particularly high in respondents currently on bronchodilator therapy (p = 0.0053). Patients were just as likely to use or not use the product if it required 20% more out of pocket cost. There is a high level of patient interest in the development of a commercially available inhaled AAT replacement product.

Using Video Conferencing to Deliver a Brief Motivational Intervention for Alcohol and Sex Risk to Emergency Department Patients: A Proof-of-Concept Pilot Study

PubMed Central

Celio, Mark A.; Mastroleo, Nadine R.; DiGuiseppi, Graham; Barnett, Nancy P.; Colby, Suzanne M.; Kahler, Christopher W.; Operario, Don; Suffoletto, Brian; Monti, Peter M.

2016-01-01

Brief motivational intervention (MI) is an efficacious approach to reduce heavy drinking and associated sexual risk behavior among Emergency Department (ED) patients, but the intensity of demands placed on ED staff makes the implementation of in-person MIs logistically challenging. This proof-of-concept pilot study examined the acceptability and logistic feasibility of using video-conferencing technology to deliver an MI targeting heavy drinking and risky sexual behavior to patients in an ED setting. Rigorous screening procedures were employed to ensure that the pilot sample represents the target portion of ED patients who would benefit from this multi-target MI. Mixed qualitative and quantitative data from a sample of seven ED patients (57% Female; Mage = 35 years) who received MI by video conference consistently demonstrated high levels of satisfaction, engagement, and acceptability. The observed completion rate supports logistic feasibility, and patient feedback identified methods to improve the experience by using high-definition hardware, ensuring stronger network connectivity, and effectively communicating information regarding protection of privacy. Post-intervention patient ratings and independent ratings of the audio-recorded sessions (using the Motivational Interviewing Skills Coding system) were very high, suggesting that intervention fidelity and MI adherence was not compromised by delivery modality. Collectively, these data suggest video conferencing is a viable technology that can be employed to implement brief evidence-based MIs in ED settings. PMID:28649188

An Audit of Singleton Breech Deliveries in a Hospital with a High Rate of Vaginal Delivery

PubMed Central

Nordin, Noraihan Mohd.

2007-01-01

The term breech trial (TBT) has brought about radical changes but it is debatable whether it provides unequivocal evidence regarding the practice of breech deliveries. There is a need to publish the data of a study that was performed before the era of the TBT in a hospital where there was a high rate of breech vaginal delivery. The objectives were to ascertain the incidence, mode of delivery and fetal outcome in singleton breech deliveries. The study design was a retrospective cohort study where 165 consecutive breech and 165 controls (cephalic) were included. Statistical analysis, used were Chi squared and Fischer’s exact test. P<0.05 is taken as the level of significance. The incidence of breech deliveries was found to be 3% and has remained fairly constant but the rate of breech vaginal delivery has fallen and the CS rates have increased. Even though more breech compared to controls were significantly sectioned, majority of the breeches {n=137 (83%)} were planned for vaginal delivery and in these patients two-thirds attained vaginal delivery. There was 1 fetal death in the CS group compared to 12 deaths in the vaginally delivered breech. However, most death in the breech delivered vaginally are unavoidable. In conclusion, there is a high rate of breech vaginal delivery in this series of patients and most perinatal deaths were not related to the mode of delivery. PMID:22593649

Using Video Conferencing to Deliver a Brief Motivational Intervention for Alcohol and Sex Risk to Emergency Department Patients: A Proof-of-Concept Pilot Study.

PubMed

Celio, Mark A; Mastroleo, Nadine R; DiGuiseppi, Graham; Barnett, Nancy P; Colby, Suzanne M; Kahler, Christopher W; Operario, Don; Suffoletto, Brian; Monti, Peter M

2017-01-01

Brief motivational intervention (MI) is an efficacious approach to reduce heavy drinking and associated sexual risk behavior among Emergency Department (ED) patients, but the intensity of demands placed on ED staff makes the implementation of in-person MIs logistically challenging. This proof-of-concept pilot study examined the acceptability and logistic feasibility of using video-conferencing technology to deliver an MI targeting heavy drinking and risky sexual behavior to patients in an ED setting. Rigorous screening procedures were employed to ensure that the pilot sample represents the target portion of ED patients who would benefit from this multi-target MI. Mixed qualitative and quantitative data from a sample of seven ED patients (57% Female; M age = 35 years) who received MI by video conference consistently demonstrated high levels of satisfaction, engagement, and acceptability. The observed completion rate supports logistic feasibility, and patient feedback identified methods to improve the experience by using high-definition hardware, ensuring stronger network connectivity, and effectively communicating information regarding protection of privacy. Post-intervention patient ratings and independent ratings of the audio-recorded sessions (using the Motivational Interviewing Skills Coding system) were very high, suggesting that intervention fidelity and MI adherence was not compromised by delivery modality. Collectively, these data suggest video conferencing is a viable technology that can be employed to implement brief evidence-based MIs in ED settings.

ORNL Neutron Sciences Annual Report for 2007

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

Anderson, Ian S; Horak, Charlie M; Counce, Deborah Melinda

2008-07-01

This is the first annual report of the Oak Ridge National Laboratory Neutron Sciences Directorate for calendar year 2007. It describes the neutron science facilities, current developments, and future plans; highlights of the year's activities and scientific research; and information on the user program. It also contains information about education and outreach activities and about the organization and staff. The Neutron Sciences Directorate is responsible for operation of the High Flux Isotope Reactor and the Spallation Neutron Source. The main highlights of 2007 were highly successful operation and instrument commissioning at both facilities. At HFIR, the year began with themore » reactor in shutdown mode and work on the new cold source progressing as planned. The restart on May 16, with the cold source operating, was a significant achievement. Furthermore, measurements of the cold source showed that the performance exceeded expectations, making it one of the world's most brilliant sources of cold neutrons. HFIR finished the year having completed five run cycles and 5,880 MWd of operation. At SNS, the year began with 20 kW of beam power on target; and thanks to a highly motivated staff, we reached a record-breaking power level of 183 kW by the end of the year. Integrated beam power delivered to the target was 160 MWh. Although this is a substantial accomplishment, the next year will bring the challenge of increasing the integrated beam power delivered to 887 MWh as we chart our path toward 5,350 MWh by 2011.« less

Using the infrastructure of a conditional cash transfer program to deliver a scalable integrated early child development program in Colombia: cluster randomized controlled trial

PubMed Central

Attanasio, Orazio P; Fernández, Camila; Grantham-McGregor, Sally M; Meghir, Costas; Rubio-Codina, Marta

2014-01-01

Objective To assess the effectiveness of an integrated early child development intervention, combining stimulation and micronutrient supplementation and delivered on a large scale in Colombia, for children’s development, growth, and hemoglobin levels. Design Cluster randomized controlled trial, using a 2×2 factorial design, with municipalities assigned to one of four groups: psychosocial stimulation, micronutrient supplementation, combined intervention, or control. Setting 96 municipalities in Colombia, located across eight of its 32 departments. Participants 1420 children aged 12-24 months and their primary carers. Intervention Psychosocial stimulation (weekly home visits with play demonstrations), micronutrient sprinkles given daily, and both combined. All delivered by female community leaders for 18 months. Main outcome measures Cognitive, receptive and expressive language, and fine and gross motor scores on the Bayley scales of infant development-III; height, weight, and hemoglobin levels measured at the baseline and end of intervention. Results Stimulation improved cognitive scores (adjusted for age, sex, testers, and baseline levels of outcomes) by 0.26 of a standard deviation (P=0.002). Stimulation also increased receptive language by 0.22 of a standard deviation (P=0.032). Micronutrient supplementation had no significant effect on any outcome and there was no interaction between the interventions. No intervention affected height, weight, or hemoglobin levels. Conclusions Using the infrastructure of a national welfare program we implemented the integrated early child development intervention on a large scale and showed its potential for improving children’s cognitive development. We found no effect of supplementation on developmental or health outcomes. Moreover, supplementation did not interact with stimulation. The implementation model for delivering stimulation suggests that it may serve as a promising blueprint for future policy on early childhood development. Trial registration Current Controlled trials ISRCTN18991160. PMID:25266222

Periodic-Zone Model Predictive Control for Diurnal Closed-Loop Operation of an Artificial Pancreas

PubMed Central

Gondhalekar, Ravi; Dassau, Eyal; Zisser, Howard C.; Doyle, Francis J.

2013-01-01

Background The objective of this research is an artificial pancreas (AP) that performs automatic regulation of blood glucose levels in people with type 1 diabetes mellitus. This article describes a control strategy that performs algorithmic insulin dosing for maintaining safe blood glucose levels over prolonged, overnight periods of time and furthermore was designed with outpatient, multiday deployment in mind. Of particular concern is the prevention of nocturnal hypoglycemia, because during sleep, subjects cannot monitor themselves and may not respond to alarms. An AP intended for prolonged and unsupervised outpatient deployment must strategically reduce the risk of hypoglycemia during times of sleep, without requiring user interaction. Methods A diurnal insulin delivery strategy based on predictive control methods is proposed. The so-called “periodic-zone model predictive control” (PZMPC) strategy employs periodically time-dependent blood glucose output target zones and furthermore enforces periodically time-dependent insulin input constraints to modulate its behavior based on the time of day. Results The proposed strategy was evaluated through an extensive simulation-based study and a preliminary clinical trial. Results indicate that the proposed method delivers insulin more conservatively during nighttime than during daytime while maintaining safe blood glucose levels at all times. In clinical trials, the proposed strategy delivered 77% of the amount of insulin delivered by a time-invariant control strategy; specifically, it delivered on average 1.23 U below, compared with 0.31 U above, the nominal basal rate overnight while maintaining comparable, and safe, blood glucose values. Conclusions The proposed PZMPC algorithm strategically prevents nocturnal hypoglycemia and is considered a significant step toward deploying APs into outpatient environments for extended periods of time in full closed-loop operation. PMID:24351171

Scattering of exocomets by a planet chain: exozodi levels and the delivery of cometary material to inner planets

NASA Astrophysics Data System (ADS)

Marino, Sebastian; Bonsor, Amy; Wyatt, Mark C.; Kral, Quentin

2018-06-01

Exocomets scattered by planets have been invoked to explain observations in multiple contexts, including the frequently found near- and mid-infrared excess around nearby stars arising from exozodiacal dust. Here we investigate how the process of inward scattering of comets originating in an outer belt, is affected by the architecture of a planetary system, to determine whether this could lead to observable exozodi levels or deliver volatiles to inner planets. Using N-body simulations, we model systems with different planet mass and orbital spacing distributions in the 1-50 AU region. We find that tightly packed (Δap < 20RH, m) low mass planets are the most efficient at delivering material to exozodi regions (5-7% of scattered exocomets end up within 0.5 AU at some point), although the exozodi levels do not vary by more than a factor of ˜7 for the architectures studied here. We suggest that emission from scattered dusty material in between the planets could provide a potential test for this delivery mechanism. We show that the surface density of scattered material can vary by two orders of magnitude (being highest for systems of low mass planets with medium spacing), whilst the exozodi delivery rate stays roughly constant, and that future instruments such as JWST could detect it. In fact for η Corvi, the current Herschel upper limit rules our the scattering scenario by a chain of ≲30 M⊕ planets. Finally, we show that exocomets could be efficient at delivering cometary material to inner planets (0.1-1% of scattered comets are accreted per inner planet). Overall, the best systems at delivering comets to inner planets are the ones that have low mass outer planets and medium spacing (˜20RH, m).

Factors Associated with Teacher Delivery of a Classroom-Based Tier 2 Prevention Program.

PubMed

Sutherland, Kevin S; Conroy, Maureen A; McLeod, Bryce D; Algina, James; Kunemund, Rachel L

2018-02-01

Teachers sometimes struggle to deliver evidence-based programs designed to prevent and ameliorate chronic problem behaviors of young children with integrity. Identifying factors associated with variations in the quantity and quality of delivery is thus an important goal for the field. This study investigated factors associated with teacher treatment integrity of BEST in CLASS, a tier-2 prevention program designed for young children at risk for developing emotional/behavioral disorders. Ninety-two early childhood teachers and 231 young children at-risk for emotional/behavioral disorders participated in the study. Latent growth curve analyses indicated that both adherence and competence of delivery increased across six observed time points. Results suggest that teacher education and initial levels of classroom quality may be important factors to consider when teachers deliver tier-2 (i.e., targeted to children who are not responsive to universal or tier-1 programming) prevention programs in early childhood settings. Teachers with higher levels of education delivered the program with more adherence and competence initially. Teachers with higher initial scores on the Emotional Support subscale of the Classroom Assessment Scoring System (CLASS) delivered the program with more competence initially and exhibited higher growth in both adherence and competence of delivery across time. Teachers with higher initial scores on the Classroom Organization subscale of the CLASS exhibited lower growth in adherence across time. Contrary to hypotheses, teacher self-efficacy did not predict adherence, and teachers who reported higher initial levels of Student Engagement self-efficacy exhibited lower growth in competence of delivery. Results are discussed in relation to teacher delivery of evidence-based programs in early childhood classrooms.

Technologies for Investigating the Physiological Barriers to Efficient Lipid Nanoparticle–siRNA Delivery

PubMed Central

Abrams, Marc

2013-01-01

Small interfering RNA (siRNA) therapeutics have advanced from bench to clinical trials in recent years, along with new tools developed to enable detection of siRNA delivered at the organ, cell, and subcellular levels. Preclinical models of siRNA delivery have benefitted from methodologies such as stem-loop quantitative polymerase chain reaction, histological in situ immunofluorescent staining, endosomal escape assay, and RNA-induced silencing complex loading assay. These technologies have accelerated the detection and optimization of siRNA platforms to overcome the challenges associated with delivering therapeutic oligonucleotides to the cytosol of specific target cells. This review focuses on the methodologies and their application in the biodistribution of siRNA delivered by lipid nanoparticles. PMID:23504369

Optical fiber-mediated photosynthesis for enhanced subsurface oxygen delivery.

PubMed

Lanzarini-Lopes, Mariana; Delgado, Anca G; Guo, Yuanming; Dahlen, Paul; Westerhoff, Paul

2018-03-01

Remediation of polluted groundwater often requires oxygen delivery into subsurface to sustain aerobic bacteria. Air sparging or injection of oxygen containing solutions (e.g., hydrogen peroxide) into the subsurface are common. In this study visible light was delivered into the subsurface using radially emitting optical fibers. Phototrophic organisms grew near the optical fiber in a saturated sand column. When applying light in on-off cycles, dissolved oxygen (DO) varied from super saturation levels of >15 mg DO/L in presence of light to under-saturation (<5 mg DO/L) in absence of light. Non-photosynthetic bacteria dominated at longer radial distances from the fiber, presumably supported by soluble microbial products produced by the photosynthetic microorganisms. The dissolved oxygen variations alter redox condition changes in response to light demonstrate the potential to biologically deliver oxygen into the subsurface and support a diverse microbial community. The ability to deliver oxygen and modulate redox conditions on diurnal cycles using solar light may provide a sustainable, long term strategy for increasing dissolved oxygen levels in subsurface environments and maintaining diverse biological communities. Copyright © 2017 Elsevier Ltd. All rights reserved.

Efficiency of the Thermal Jacket on the Delivered Temperature of Prewarmed Crystalloid Intravenous Fluid

DTIC Science & Technology

1989-01-01

intervals over a 60 minute period at flow rates of 100, 250, 500, 750, and 1,000 ml/hr. Analysis of variance showed a highly significant group effect with a...significant difference between all groups except Group 3 and Group 4. Analysis of - .riance aiso showed a highly significant flow rate effect on...as effective as the conventional method of delivering warmed fluids. Also, within the range of flow rates studied, faster flow rates tended to yield a

The New Gold Rush: Establishing Effective Online Learning Policies

ERIC Educational Resources Information Center

Serim, Ferdi

2007-01-01

Online learning is the fastest growing segment of educational technology, for both the best and worst of reasons. The promise of delivering student-centered education, anytime, anywhere, at any pace provides the best reason. Online learning certainly has the potential to finally deliver on these promises. The temptation to replace highly skilled…

New Drug Self-Assembles and Delivers Itself to Its Target | Center for Cancer Research

Cancer.gov

Viruses self-assemble with high precision and disassemble upon fusion with the cell membrane and deliver this way their cargo to the interior of the cells. Using this talent, viruses are able to inject whole proteins and large nucleic acid molecules into certain types of cells.

A Case for Authoring Multi-Touch Interactive Open Educational Resources

ERIC Educational Resources Information Center

Mills, Michael S.

2016-01-01

As textbook prices continue to skyrocket, open educational resources (OER) offer a significant way to deliver high quality content to students in higher education. The pressing issue is whether these OER are engaging, relevant, and accurate. Authoring multi-touch interactive resources that are delivered to students as open-access may not only…

Defining High-Quality Palliative Care in Oncology Practice: An American Society of Clinical Oncology/American Academy of Hospice and Palliative Medicine Guidance Statement.

PubMed

Bickel, Kathleen E; McNiff, Kristen; Buss, Mary K; Kamal, Arif; Lupu, Dale; Abernethy, Amy P; Broder, Michael S; Shapiro, Charles L; Acheson, Anupama Kurup; Malin, Jennifer; Evans, Tracey; Krzyzanowska, Monika K

2016-09-01

Integrated into routine oncology care, palliative care can improve symptom burden, quality of life, and patient and caregiver satisfaction. However, not all oncology practices have access to specialist palliative medicine. This project endeavored to define what constitutes high-quality primary palliative care as delivered by medical oncology practices. An expert steering committee outlined 966 palliative care service items, in nine domains, each describing a candidate element of primary palliative care delivery for patients with advanced cancer or high symptom burden. Using modified Delphi methodology, 31 multidisciplinary panelists rated each service item on three constructs: importance, feasibility, and scope within medical oncology practice. Panelists endorsed the highest proportion of palliative care service items in the domains of End-of-Life Care (81%); Communication and Shared Decision Making (79%); and Advance Care Planning (78%). The lowest proportions were in Spiritual and Cultural Assessment and Management (35%) and Psychosocial Assessment and Management (39%). In the largest domain, Symptom Assessment and Management, there was consensus that all symptoms should be assessed and managed at a basic level, with more comprehensive management for common symptoms such as nausea, vomiting, diarrhea, dyspnea, and pain. Within the Appropriate Palliative Care and Hospice Referral domain, there was consensus that oncology practices should be able to describe the difference between palliative care and hospice to patients and refer patients appropriately. This statement describes the elements comprising high-quality primary palliative care for patients with advanced cancer or high symptom burden, as delivered by oncology practices. Oncology providers wishing to enhance palliative care delivery may find this information useful to inform operational changes and quality improvement efforts. Copyright © 2016 by American Society of Clinical Oncology.

Transdiagnostic internet-delivered cognitive-behaviour therapy (CBT) for adults with functional gastrointestinal disorders (FGID): A feasibility open trial.

PubMed

Dear, B F; Fogliati, V J; Fogliati, R; Gandy, M; McDonald, S; Talley, N; Holtmann, G; Titov, N; Jones, M

2018-05-01

Many people with functional gastrointestinal disorders (FGIDs) face significant barriers in accessing psychological treatments that are known to reduce symptoms and their psychological sequelae. This study examined the feasibility and initial outcomes of a transdiagnostic and internet-delivered cognitive behaviour therapy (iCBT) intervention, the Chronic Conditions Course, for adults with functional gastrointestinal disorders (FGIDs). A single-group feasibility open trial design was employed and administered to twenty seven participants. The course ran for 8 weeks and was provided with weekly contact from a Clinical Psychologist. Seventy percent of participants completed the course within the 8 weeks and 81.5% provided data at post-treatment. High levels of satisfaction were observed and relatively little clinician time (M = 42.70 min per participant; SD = 46.25 min) was required. Evidence of clinical improvements in FGID symptoms (ds ≥ 0.46; avg. improvement ≥21%), anxiety symptoms (ds ≥ 0.99; avg. improvement ≥42%), and depression symptoms (ds ≥ 0.75; avg. improvement ≥35%) were observed, which either maintained or continued to improve to 3-month follow-up. Evidence of improvement was also observed in pain catastrophising and mental-health related quality of life, but not physical-health related quality of life. These findings highlight the potential value of transdiagnostic internet-delivered programs for adults with FGIDs and support for the conduct of larger-scale controlled studies. Copyright © 2018 Elsevier Inc. All rights reserved.

Cell-penetrating DNA-binding protein as a safe and efficient naked DNA delivery carrier in vitro and in vivo

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

Kim, Eun-Sung; Yang, Seung-Woo; Hong, Dong-Ki

Non-viral gene delivery is a safe and suitable alternative to viral vector-mediated delivery to overcome the immunogenicity and tumorigenesis associated with viral vectors. Using the novel, human-origin Hph-1 protein transduction domain that can facilitate the transduction of protein into cells, we developed a new strategy to deliver naked DNA in vitro and in vivo. The new DNA delivery system contains Hph-1-GAL4 DNA-binding domain (DBD) fusion protein and enhanced green fluorescent protein (EGFP) reporter plasmid that includes the five repeats of GAL4 upstream activating sequence (UAS). Hph-1-GAL4-DBD protein formed complex with plasmid DNA through the specific interaction between GAL4-DBD and UAS,more » and delivered into the cells via the Hph-1-PTD. The pEGFP DNA was successfully delivered by the Hph-1-GAL4 system, and the EGFP was effectively expressed in mammalian cells such as HeLa and Jurkat, as well as in Bright Yellow-2 (BY-2) plant cells. When 10 {mu}g of pEGFP DNA was intranasally administered to mice using Hph-1-GAL4 protein, a high level of EGFP expression was detected throughout the lung tissue for 7 days. These results suggest that an Hph-1-PTD-mediated DNA delivery strategy may be an useful non-viral DNA delivery system for gene therapy and DNA vaccines.« less

Long-chain polyunsaturated fatty acids decline rapidly in milk from mothers delivering extremely preterm indicating the need for supplementation.

PubMed

Nilsson, Anders K; Löfqvist, Chatarina; Najm, Svetlana; Hellgren, Gunnel; Sävman, Karin; Andersson, Mats X; Smith, Lois E H; Hellström, Ann

2018-06-01

Our aim was to perform an in-depth analysis of the composition of fatty acids in milk from mothers delivering extremely preterm babies. We investigated longitudinal changes in milk fatty acid profiles and the relationship between several types of fatty acids, including omega-3 and omega-6. Milk samples were collected at three stages of lactation from 78 mothers who delivered at less than 28 weeks of pregnancy at the Sahlgrenska University Hospital, Gothenburg, Sweden, from April 2013 to September 2015. Fatty acid composition was analysed by gas chromatography-mass spectrometry. A reduction in long-chain polyunsaturated fatty acids (LCPUFAs) was observed during the lactation period. The concentrations of arachidonic acid and docosahexaenoic acid declined from medians of 0.34 to 0.22 mol% and 0.29 to 0.15 mol%, respectively, between postnatal day 7 and a postmenstrual age of 40 weeks. Strong correlations were found between the intermediates of several classes of fatty acids, including omega-3, omega-6 and omega-9. A rapid reduction in LCPUFA content in the mother's milk during the lactation period emphasises the importance of fatty acid supplementation to infants born extremely preterm, at least during the period corresponding to the third trimester, when rapid development of the brain and adipose tissue requires high levels of LCPUFAs. ©2018 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.

48 CFR 3452.224-70 - Release of information under the Freedom of Information Act.

Code of Federal Regulations, 2014 CFR

2014-10-01

...: (1) Unit prices, including labor rates; (2) Statements of Work/Performance Work Statements generated by the contractor; (3) Performance requirements, including incentives, performance standards, quality levels, and service level agreements; (4) Reports, deliverables, and work products delivered in...